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