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48 Cards in this Set

  • Front
  • Back

Skin is the largest organ in the body, accounts for ________ to ______% of body weight

15-20%

Skin Functions (5)

Protection


Insulation


Fluid Balance


Temperature Regulation


Vitamin D Synthesis (UV rays)

Causes of Skin diseases (6)

Injury (chemical toxin, burn, radiation, phys. trauma)


Infection


Allergens (meds or environment)


Systemic Origin


Neoplasm


Congenital (birthmark)

Sx/Sy - Pruritus

Itching



Suggests systemic disease if generalized


Scratching leads to increased inflammation - "excoriation"



Urticaria - hives (Allergic rxn)

Sx/Sy - Rash

Eruption on the skin

Sx/Sy - Xeroderma

Excessive dryness of the skin

Sx/Sy - Scaly Desquamation

PEELING

Other general sx/sy of skin disease (3)

Edema



Nail changes



changes in pigmentation

Primary Skin Lesions - Erythema

REDNESS

Primary Skin Lesions - Macule

UNRAISED SPOT

Primary Skin Lesions - Papule

RAISED MACULE

Primary Skin Lesions - Vesicle

BLISTER - FLUID FILLED MACULE

Primary Skin Lesions - Pustule

INFECTED vesicle

Primary Skin Lesions - Nodule

FIRM LUMP



"Erythema Nodosum" - tender nodules, usually on anterior legs

Primary Skin Lesions - Tumor

BIG NODULE

Primary Skin Lesions - Plaque

Superficial Scale

Primary Skin Lesions - Wheal

Urticaria (hive) - INFLAMED NODULE



Vascular rxn of the skin - smooth, slightly elevated patches, SEVERE ITCHING

Primary Skin Lesions - Blister

Big Vesicle



Pocket of fluid within upper layers of skin

Secondary skin lesions

Scale


Crust


Thickening


Erosion


Ulcer


Scar


Excoriation - scratch mark


Fissure - groove


Atrophy - thinned skin

How to describe a skin lesion?

Size/Shape/Color



Elevated, depressed, or flat



Location/distribution



Exudates



Associated Sy - itch, burn, etc

Herpes Simplex

Vesicles clustered on an erythematous base



Type A - FACIAL


Type B - GENITAL

Acne Vulgaris

Papules, Pustules

Drug Eruption

Confluent papules

Petechiae and Purpura

Hemorrhaging into the skin or mucosa - local leakage of blood vessels



DO NOT blanch to palpation



Petechiae < 3mm, Purpura 3-10 mm


ECCHYMOSIS >1 cm

Skin Turgor

Skin with decreased turgor remains elevated after being pulled up and released



Skin loses its normal turgor with dehydration



Not reliable test with elderly, who have decreased skin elasticity

Atopic Dermatitis (Eczema)

Dry, thickened, lichenified skin along creases or folds



Pruritus - itching



Skin may fissure and become secondarily infected

Contact Dermatitis

Pruritus, erythema, vesiculation, oozing, crusting, scale



Ex. Poison ivy, wearing sandals too long



Skin must be examined before and after every intervention for adverse rxns

Stasis Dermatitis

Dry, hyperpigmented shallow ulcers



Peeling and erythema in areas with DVT or chronic edema

Cellulitis

Rapidly spreading acute infection of skin and subcutaneous tissue



Frequently has some pre-existing condition

Impetigo

HIGHLY CONTAGIOUS



Usually caused by staph/strep, found in pre-school children more than adults



Honey colored crusted vesicular and pustular eruption

Furunculosis

Deep infection of the hair follicle



Forms Abcesses

Herpes Zoster (shingles)

Herpetic eruption - vesicles on erythemous base in a dermatomal distribution



Pre-existing varicella (chicken pox)



Vesicles often crust or become pustules before resolving



Often PAINFUL - herpetic neuralgia

Tinea Pedis

Fungal infection involving feet

Scabies

Allergic response caused by the mite Scarpotes Scabiei



Burrows under superficial layers of skin



CONTAGIOUS - by skin-to-skin



Predilection for body crease areas, webs of fingers/toes

Basal cell carcinoma

Pearly rolled edges, slightly raised, small blood vessels, painless slow growth, central ulceration



Very low likelihood of metastasis



May present as a red patch or crusty open sore that WILL NOT HEAL



Chronic sunlight exposure is MAIN Risk Factor

Squamous cell carcinoma

scaly red patch that sometimes crusts or bleeds, but DOES NOT HEAL



Chronic sun exposure MAIN Risk Factor



Slow growing, but higher chance of metastasis than basal cell carcinoma

Malignant Melanoma ABC's

A - Asymmetry


B - Border (uneven/crusty)


C - Color (not uniform)


D - Diameter (usually larger than pencil eraser)


E - Evolving (change in size/shape/color)


Melanoma Occurence

Can occur in any body part that contains melanocytes (skin, eye, bowel)



DNA damage that results from UV light exposure



May metastasize to other areas - poor px

Kaposi's Sarcoma

Tumor caused by human herpes virus (HHV8)



In immunosuppressed patients, is an AIDS defining illness



Not particularly contagious

Psoriasis

Immune mediated skin condition; not contagious



Reddish, scaly papules, patches and plaques



Usually found on extensor surfaces of extremities, scalp, palms/soles, genitals



May be associated c Arthritis, other immune

Systemic Lupus Erythematosis (SLE)

Multi-system immune disease



Rashes, arthralgias, serous membrane involvment, kidneys, CNS



Butterfly rash

Systemic Sclerosis (Scleroderma)

Autoimmune disorder



C-R-E-S-T syndrome - characteristic figures



Full blown scleroderma has visceral involvment

Frostbite

Most likely to happen in parts furthest from core, or in large exposed areas



Whirlpool is often used as rewarming protocol



Cryotherapy modalities can result in localized tissue damage

Burns - 1st degree

ex. sunburn



Epidermis only



Never blisters



Not calculated in burn extent

Burns - 2nd degree

Through the epidermis into the dermis



Pink, moist, painful

Burns - 3rd degree

Subcutaneous tissue involvement



Leathery, various colors depending on tissue exposed



Usually painless - nerve endings burnt away

Burn Implications

Infection control


Encourage deep breathing


Coincide meds with potentially painful therapy


Maintain burned areas in positions of function


Emotional support


Pressure Ulcers

Head, shoulder, sacrum, heel


Prevention:


- ID patients at risk


- Routine skin inspection


- Clean skin without friction force


- No massage on reddened areas


- Frequent turning/respositioning


- Early mobilization