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Dermatitis (Eczema)
- Inflammation → itching, redness, skin lesions
- Allergic, actinic, atopic causes
- Avoid use of alcohol
-
Bacterial Infections: 3 Types
- Impetigo = superficial skin infection, small pus-filled vesicles, itching
- Cellulitis = widespread inflammation of cellular/connective tissue
- Abscess = cavity containing pus, surrounded by inflamed tissue
-
Cellulitis: Treatment
- Antibiotics
- Elevation of part
- Cool/wet dressings
- Untreated → lymphangitis, gangrene, abscess, sepsis
-
Herpes Zoster: Symptoms
- Pain/tingling in spinal/CN dermatome → progresses to red papules along infected nerve
- Fever, chills, malaise, GI disturbances
- CN III (ocular complications) and V (loss of vision) involvement
-
Contraindications with Herpes Zoster
Heat/ultrasound
-
Lupus Erythematosus: Definition and Characteristics
- Chronic, progressive, autoimmune disorder
- 2 types: discoid lupus and systemic lupus
-
Discoid Lupus
- Affects only skin
- Flare ups with sun exposure
-
Systemic Lupus Symptoms
- Fever
- Malaise
- Butterfly rash
- Chronic fatigue
- Arthralgia
- Arthritis
- Skin rashes
- Photosensitivity
- Anemia
- Hair loss
- Raynauds
-
Scleroderma: Definition
- Fibrosis of skin, joints, blood vessels, and internal organs
- 2 types = limited and diffuse
-
Limited Systemic Sclerosis/Scleroderma
- Symmetrical
- Skin involvement of distal extremities and face
- Slow progression of changes
- Late visceral and pulmonary HTN
- CREST
-
Diffuse Systemic Sclerosis/Scleroderma
- Symmetrical
- Distal and prox extremities
- Face and trunk
- Rapid progression of skin changes
- Early appearance of visceral involvement
-
Scleroderma Precautions
- Skin sensitive to pressure
- Acute HTN may occur
- Pulm HTN → R sided HF in severe cases
-
Polymyositis: Definition and Characteristics
- Edema, inflammation, degeneration of muscle
- Prox muscles (shoulder and pelvic girdle, neck, pharynx), symmetrical
- Rapid, severe onset
- Cardiac involvement (may be fatal)
-
Polymyositis: Precautions
Additional muscle fiber damage with too much exercise
-
1st Degree Burns
- Epidermis damage
- No blistering
- Min edema
- Tenderness/delayed pain
- Spontaneous healing 3-7 days
- No scarring
-
2nd Degree Burns: Superficial Partial Thickness
- Epidermis and upper dermis
- Blanching with brisk cap refill
- Blisters, moist surface
- Mod edema
- Painful/sensitive
- Spontaneous healing 7-21 days
-
2nd Degree Burns: Deep Partial Thickness
- Epidermis and dermis with injury to nerve endings, hair follicles and sweat glands
- Blanching with slow cap refill
- Broken blisters/wet surface
- Mixed red, waxy white appearance
- Marked edema
- Sensitive to pressure, insensitive to light touch/pinprick
- Healing through scar formation and re-epithelialization
-
3rd Degree Burns
- Full thickness = epidermis, dermis and subcutaneous tissue
- White (ischemic), charred, tan or black
- No blanching, poor distal circulation
- Little pain
- Hypertrophic scarring and wound contracture without preventative measures
-
4th Degree Burns
- Subdermal = involvement of subcutaneous muscle and tissue
- Charred appearance
- Amputation may be necessary
-
Additional Complications with Electrical Burns
- V fib
- Acute kidney damage
- SC damage
-
Arterial Ulcers
- Irregular, smooth edges
- Min-no granulation
- Deep
- Lateral malleolus, ant tib
- Decreased/absent pulses
- Painful with LE elevated
- Severe, intermittent pain → progresses to pain at rest
- No drainage
- Gangrene may be present
- Intermittent claudication
- Trophic changes
- Cool temp
- Pallor with elevation, rumor on dependency
-
Venous Ulcers
- Dark pigmentation (hemosiderosis)
- Fibrotic (liposclerosis)
- Good granulation
- Shallow
- Med malleolus
- Present pulses
- Little pain, aches in dependent position
- Lg amounts of exudate
- No gangrene
- Marked edema
- Stasis dermatitis
- Cyanosis in dep. position
- Normal temperature
-
Compression with Venous Ulcer
Compression contraindicated with ABI < 0.7 or active DVT
-
Diabetic Ulcers
- Associated with arterial disease and peripheral neruopathy
- No pain, sensory loss present
- Present/diminished pulses
- Absent ankle jerks with neuropathy
- Monofilament testing
- Classified with Wagner system
-
Ulcer Grading: Stage 1
- Nonblanchable erythema of intact skin
- May include changes in skin temp, tissue consistency and/or sensation
-
Ulcer Grading: Stage II
- Partial-tickness skin loss
- Superficial ulcer
-
Ulcer Grading: Stage III
- Full thickness (subcutaneous tissue involvement
- Seep crater
-
Ulcer Grading: Stage IV
- Full thickness, involves muscle, bone, or supporting structures
- Undermining/sinus tracts may be present
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