1. What is pruritus?
    symptoms associated with many disorders (itching)
  2. What can produce itching?
    • Histamine
    • Protease
    • Heat
    • Cold
    • Chemical
  3. What are Pressure Ulcers (Decubitus Ulcers)?
    Ischemic ulcers resulting from pressure, shearing forces, friction, moisture
  4. Common sites for Pressure Ulcers
    • Sacrum
    • Heels
    • Ischia
    • Greater Trochanter
  5. Unrelieved Pressures
    result in the endothelial cell lining capillaries becoming disrupted with platelet aggregation
  6. Four stages of pressure Ulcers
    1-Persistant redness in light pigmented skin, persistant redness w/ blue or purple hues in dark pigment

    2- Partial thickness skin loss involving the epidermis or dermis or both, Abrasion, blister, shallow crater

    3-Full thickness skin loss involving damage or necrosis of subcutanous tissue : Deep Crater w/ or w/o undermining of underlying tissue

    4- Full thickness skin loss with extensive destruction, tissue necrosis or damage to muscle bone or supporting structures
  7. Keloids
    • scars that are progressively enlargeing due to excessive collagen
    • shiny, hairless, elevated scars
    • more common in African Americans and Orientals, ages 10-30
  8. When do Keloids appear?
    within 1 year of trama
  9. Inflammatory disorders
    • Allergic Contact Dermatitis
    • Irritant Contact Dermatitis
    • Atopic Dermatitis
    • Stasis Dermatitis
    • Seborrheic Dermatitis
  10. Allergic Contact Dermatitis
    • Common form of cell mediated or delayed hypersensitivity
    • s/s-Erythema, prurites, vesticles
  11. What may cause Allergic Contact Dermitits?
    poison ivy, metals, latex
  12. Irritant Contact Dermatitis
    • Nonimmunologically mediated inflammatino of the skin
    • Severity R/T concentration and exposure time
    • Lesions similar to allergic type
  13. What may cause Irritant Contact dermatitis?
    Acids, soaps, detergents
  14. Atopic Dermatitis is AKA
  15. Atopic Dermatitis
    • more common in Infancy and childhood
    • has increase serum IgE
    • Family history of asthma, hay fever, atopic dermatitis
    • s/s- skin is dry sensitive, itchy, skin pruritus
  16. Stasis Dermatitis
    • occurs as a result of venous stasis and edema
    • Associated with varicosities, phlebitis and vasucular trauma
    • Erythema, pruritus, scaling, petechiae, hyperpigmentation, may progress to ulcerations
  17. Seborrheic Dermatitis
    • Chronic inflammation
    • on scalp, eyebrows, eyelids, ear canals, axilla, chest, back
    • Infants=cradle cap
    • Scaly, whitish, yellow, plaques
    • Pruritus
  18. Papulosquamous Disorders
    • Disorders charasterized by papules, scales, plaques, and erythema
    • Ex-Psoriasis
  19. Bacterial Infections commonly caused by Staph Aureus
    • Furuncles (Boils)
    • Carbuncle
    • Cellulitus
    • Impetigo
  20. Furuncles
    • (Boil)
    • Inflammation of hair follicle, single
    • Red, firm nodule that may progress to a cystic nodule
    • will see pus and necrotic tissue
  21. Carbuncle
    • Collection of infected hair follicles-multiple
    • See them on back of neck, upper back, lateral thighs
  22. Cellulitis
    • infection of dermis and subcutaneous tissue
    • Extension of a skin wound, ulcer, furuncles, carbuncles
    • Will see Erythema, warmth, edema, pain
  23. Impetigo
    • caused by Staph, group A B-hemolytic streph
    • Common in infants and childern-in summer season
    • Vesicles and pustules weep and crust
    • honey color serous liquid
    • Pruritus
    • Communitable
  24. Viral Infections (cause skin lesions)
    • HSV-1
    • HSV-2
    • Herpes Zoster
  25. HSV-1
    • Cold sore or fever blister
    • Nongenital sites--mouth and cornea
    • Vesicles rupture and form crust
    • Dormant in nerve ganglia
    • Recurrence stress, hormones
  26. HSV-2
    • Genital infections
    • Large number are sexually transmitted
    • Vesicles that progress to ulceration
  27. Herpes Zoster is AKA
  28. Herpes Zoster
    • Varicella occurs as a primary infection followed years later by herpes zoster
    • Burning pain, paresthesia localized to the affected dermatome
    • Vesicular eruptions
    • Find Face, cervical, thoracic dermatome
  29. Fungal Infection
    • Tinea Corporis
    • Tinea Capitis
    • Tinea Pedis
    • Candida
  30. Tinea Infection
    • fungal infections of the skin and are classified according to thier location on the body
    • can get from animal
  31. Tinea Corporis
    • Body
    • (Ring Worm)
  32. Tinea Capitis
  33. Tinea Pedis
    • Feet
    • (Athlets Foot)
  34. Candida
    • caused by yeastlike fungus Candida Albicans
    • Normally found on mucous membranes, skin , GI tract and Vagina
    • s/s Burning, itching, whitich yellow curdlike substance
    • ex-thrush
  35. Predisposing Factors to Candida
    • moist warm environment
    • antibiotics
    • pregnancy
    • cushing disease
    • diabetes mellitus
    • debilitated states
    • <6 months of age
    • Immunosuppression
  36. Benign Tumors
    • Tumors of the skin are normally associated with aging
    • Seborrheic Keratosis
    • Actinic Keratosis
  37. Seborrheic Keratosis
    • Benign proliferation of the basal cells that produce smooth or waxy elevated lesions
    • more common in older adults
    • on chest, back, face
    • Shades of tan, yellow, flesh colored, brown-black lesions
  38. Actinic Keratosis
    • precancerous tumors associated with exposure to UV radiation of the sun
    • risk=individuals w/ unprotected light skin
    • pigments patchese of rough skin
  39. Nevi
    • Mole
    • pigments and nonpigmented
    • Flat and elevated
    • watch for malignant transformation
  40. Risk Factor for skin cancer
    fair complexion, excessive exposure to the sun, tanning salons, or ultraviolet radiation predisposes a person
  41. Basal Cell Carcinoma
    • caused by sunlight exposure
    • on face, neck
    • slow growth
    • metastatic spread rate
    • more common in men then women
  42. Basal cell lesions..
    • start as nodule
    • Pearly/Ivory
    • Depressed Center and rolled borders
    • progressess to ulceration with waxy borders
  43. Squamous Cell Carcinoma
    • A tumor of the epidermis
    • Malignant potential
    • sun exposure and fair complexion
    • Red, scaly, elevated, irregular borders
    • shallow chronic ulcer
  44. Malignant Melanoma
    • A tumor originating from the melanocytes
    • Rapidly progressive, metastatic
    • intermittent intense sun exposure

    Raised, black, brown most from Nevi or moles shades of red, blue or white
  45. Melanocytes
    cells that synthesize the pigment melanin
  46. Cancer ACDE
    • A=Asymmetry
    • B=Border Irregularity
    • C=Color variation
    • D= diameter >6mm
    • E=Evolving Change
  47. Kaposi Sarcoma
    • Vascular Malignancy
    • Endothelial Cell
    • Purplish brown macules-develop into plaques and nodules
    • Immunosuppression, transplant recipient, AIDS, African middle aged blacks, Jewish descent
  48. Lupus Erythematosus
    • Inflammatory disease with cutaneous manifestations
    • Discoid (cutaneous) is limited to the skin and can lead to SLE
    • Lesions are often located on light-exposed areas of the skin, and photosensitivity is common
    • most common site=face "Butterfly Rash"
  49. Cause of Lupus Erthematosus
    altered immune responce to an unknown antigen
  50. Macule
    • flat, circumscribed area that is a change in the color of the skin
    • ex-freckle
  51. Papule
    • An elevared firm area circumscribed are less than 1 cm in diameter
    • ex-wart
  52. Patch
    • A flat nonplable, irregular shaped macule more than 1 cm in diameter
    • ex-port-wine stain
  53. Plaque
    • Elevated, firm and rough lesion with flat top surface more than 1 cm in diameter
    • ex-psoriasis
  54. wheal
    • elevated irregular shaped area of cutaneous edema
    • ex-insect bite
  55. Nodule
    Elevated firm circumscribed lesion; deeper in dermis that a papule
  56. Tumor
    Elevated solid lesion, may be clearly demarcated; deeper in dermis, more than 2 cm in diameter
  57. Vesicle
    • Elevated, circumscribed superficial not into dermis, filled with serous fluid- less than 1 cm in diameter
    • ex-chickpox
  58. Bulla
    • vesticle more than 1 cm in diameter
    • ex-blister
  59. Pustule
    • elevated superficial lesion similar to a vesicle but filled with purulent fluid
    • ex-acne
  60. Cyst
    • Elevated circumscribed encapsulated lesion, in dermis or subcutaneous layer, filled with liquid or semisold material
    • ex-sebaceous cyst
  61. Telangiectasia
    • Fine, irregular red lines produced by capillary dilation
    • ex- Telangiectasia in rosacea
  62. Scale
    heaped up, keratinized cell, flaky skin, irregular thick or thin
  63. Lichenification
    • rough, thickened epidermis secondary to persistent rubbing, itching, or skin irrritation
    • ex-chronic dermatitis
  64. Exciriation
    • loss of the epidermis, linear, hollowed out, crusted area
    • ex-abrasion, scabies
  65. Fissure
    linear crack or break from the epidermis to the dermis
  66. Erosion
    loss of part of the epidermis, depressed, moist, glistening, follows rupture of a vesicle or bulla
  67. Ulcer
    loss of epidermis and dermis, concave, varies in size
  68. Atrophy
    • thinning of the skin surface and loss of skin markings, skin appears translucent and paper like
    • ex=Aged skin, striae
Card Set
test 2 section 2