Integumentary
herpes treatment
acyclovir, valacyclovir, famciclovir and soothing compresses
a common site for the lesions associated with atopic dermatitis is the...
antecubital space
allergic contact dermatitis
antigen-specific, type IV delayed hypersensitivity response
where is folliculitis most commonly found?
areas subjected to friction, moisture, rubbing or oil
ABCDE rule
asymmetry, border, color, diameter of more than 6mm, evolving in appearance
punch biopsy
removal of a small core of tissue using a hollow punch
irritant contact dermatitis
results from direct chemical injury to the skin
Steven Johnson Syndrome (SJS)
severe blistering of the skin, with mucous membrane involvement and fever and is an immune reaction to medication
squamous cell carcinoma can be caused by what?
smoking
usual causative agents of cellulitis
staph and strep
which two bacteria are most responsible for primary and secondary skin infections?
staph and strep
treatment for someone with toxic epidermal necrolysis
stop the drug and supportive care
verruca vulagaris treatment
surgery, liquid nitrogen, blistering agent (cantharidin), keratolytic agent, CO2 laser destruction
lichenification
thickening of epidermis with exaggerated markings resembling a washboard -caused by chronic scratching or rubbing of the skin
electrodesiccation
tissue is destroyed by burning with an electric spark
plantar wart treatment
topical immunotherapy, cryosurgery, salicylic acid, duct tape
before starting a corticosteroid what should be done?
try and diagnose the problem because of the local anti-inflammatory and antipruritic effects
the most important prognostic factor is what?
tumor thickness and site at the time of diagnosis
curettage
use of a sharp dermal curette to scrape away a skin lesion
herpes simplex, herpes zoster, and warts are all caused by what?
viral infections
clinical manifestation of a atypical or dysplastic nevi
- >5mm -irregular border, possibly notched -varying colors -central part often raised with flat edges
clinical manifestations of impetigo
- vesiculopustular lesions that develop thick, honey-colored crust surrounded by erythema - pruritic (itchy) - most common on face as primary infection
interprofessional care for dermatologic problems
-Phototherapy -Radiation therapy -Laser technology -Drug therapy (corticosteroids, antihistamines)
skin conditions treated by laser
-acne scars -hair removal -leg veins -pigment discoloration -port wine stain -psoriasis -rosacea -warts -wrinkles
how to control pruritus
-break the itch/scratch cycle -cool environment -hydration, wet compresses, moisturizers -topical drugs
clinical manifestation of actinic keratosis
-flat or elevated, dry, hyperkeratotic scaly papule -rough or wartlike -rough adherent scale on red base, which returns when removed
clinical manifestations of cellulitis
-hot -tender -erythematous -edematous area with diffuse borders -chills, malaise, fever
clinical manifestations of a melanoma
-occurs on the lower legs in women -occurs on the trunk and head in men -1/4 of melanomas occur in existing nevi or moles -often deep brown or black
treatment for ticks (borrelia burgdorferi)
-oral antibiotics (doxycycline) - IV antibiotics for arthritic, neuro, and cardiac symptoms
toxic epidermal necrolysis S/S
-painful, red area that spreads quickly -the skin may peel without blistering -raw areas of skin -discomfort -fever
basal cell carcinoma clinical manifestations
-small, slowly enlarging papule -borders semitranslucent or "pearly" with overlying telangiectasia -erosion, ulceration, and depression of center
isotretinoin contraindications
-women who want to get pregnant and who are pregnant -cannot donate blood during treatment and for 1 month after -may cause depression and suicidal ideation
risk factors for skin cancer
1. fair skin 2. history of sunbathing 3. living near the equator or high altitudes 4. family history 5. outdoor occupation 6. spending time outside for rec. 7. indoor tanning
what are the 5 clark levels?
1. intraepidermal 2. in papillary dermis 3. fills papillary dermis 4. reticular dermis 5. enters fat
what time is the greatest risk for sun damage?
10am-2pm
treatment for scabies (sarcoptes scabiei)
5% permethrin cream -1 overnight application and a second 1 week later
about half of all melanomas have mutations in the ___ gene
BRAF -vemurafenib, dabrafenib, trametinib, and cobimetinib are drugs that target BRAF mutations
targeted therapy for melanoma
BRAF and MEK inhibitors
plantar warts are caused by what?
HPV
erysipelas
a contagious disease of the skin and subcutaneous tissues caused by infection with strep; redness and swelling of affected areas
toxic epidermal necrolysis
a life-threatening skin disease in which the epidermis peels off in sheets
excision- Mohs procedure
a process in which thin layers of malignant growth are removed and each is examined under a microscope for diagnostic purposes
braden scale
a tool for predicting pressure ulcer risk
in teaching a patient who is using topical corticosteroids to treat acute dermatitis, the nurse should tell the patient that...
b. short term use of topical corticosteroids usually does not cause systemic side effects d. abruptly stopping the use may cause the dermatitis to reappear
what are the 2 nonmelanoma skin cancers?
basal cell and squamous cell -most common
what is the most common but least deadly skin cancer?
basal cell carcinoma
dermoscopy can help the HCP decide if the lesion should be ____
biopsied
what two races are more likely to develop a keloid at the site of an injury?
black and asian
furuncle
boil; inflammatory skin lesion due to infected hair follicle
what 2 methods are used to determine tumor thickness?
breslow measurement (mm) and clark level (higher the level deeper the melanoma)
squamous cell carcinoma
cancer arising from keratinizing epidermal cells
impetigo
caused by strep, staph or combination of both and is associated with poor hygiene
psoriasis
chronic, autoimmune skin condition producing red lesions covered with silvery scales
verruca vulgaris
common wart -also caused by HPV -prevalence greater in youth and immunosuppressed
immunotherapy for melanoma
cytokines, PD-1 inhibitors, and CTLA-4 inhibitors
what is one of the first steps in diagnosing a suspicious lesion?
dermoscopic examination
electrocoagulation
destroys tissues and controls bleeding by coagulation
there's an increased incidence of folliculitis in patients with what diease?
diabetes mellitus
a biopsy should be done using what?
excisional biopsy technique -shave biopsy, shave excision, or electrocauterization should not be done because they don't measure the depth of the lesion
where do nonmelanoma cancers usually develop?
face, head, neck, back of hands, and arms
squamous cell carcinoma does not have the chance to metastasize. true or false?
false
cellulitis can progress to what if not treated?
gangrene
carbuncle
infection of hair follicles / a cluster of connected furuncles (boils) -most common at nape of the neck
cellulitis
inflammation of subcutaneous tissues -may be a primary infection or secondary complication -often following break in skin
folliculitis
inflammation of the hair follicles usually staph infection
acne vulgaris
inflammation of the sebaceous glands
common drug used to treat acne
isotretinoin (accutane)
SJS involves what percentage of the total body surface area?
less than 10%
basal cell carcinoma
locally invasive cancer arising from epidermal basal cells
which wavelength does the most damage?
long (ultraviolet A [UVA])
which skin cancer causes the most deaths?
melanoma
how are fungal infections determined?
microscopic examination to show the appearance of hyphae OR a Wood's light exam of hair infected with certain fungi will fluoresce blue to green
which wavelength causes sunburn?
middle (ultraviolet B [UVB])
TEN involves what percentage of the total body surface area?
more than 30%
atypical or dysplastic nevi
morphologically between common acquired nevi and melanoma may be a precursor to melanoma
actinic keratosis (solar keratosis)
most common precancerous skin lesion and appears most often on skin that has been exposed to the sun or to artificial UV light
where are you most likely to get lyme disease?
northeast, upper Midwest, and northwestern states
if someone has an allergic skin problem, what can be done to determine the causative agent?
patch testing
the final result of cosmetic surgery is affected by what?
patient's age, general state of health, and skin type
who is most likely to get psoriasis?
white people, ages 15-35
initial treatment for melanoma
wide surgical excision
treatment for pediculosis (lice)
y-Benzene hexachloride or PYRETHRINS or spinosad topical suspension
is impetigo contagious?
yes, highly