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45 Cards in this Set
- Front
- Back
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When to refer animal or human bite for physician consultation?
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When on the face, when the animal is rabid, when tendon, bone or joint could be involved or if patient develops systemic infection
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Appropriate mgmt for minor burns
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Chemical burns: irrigate profusely
Give analgesics Clean burn w/mild soap and water Debrid blisters TD prophylaxis Cover burn w/thin layer of antimicrobial cream (Silver sufadine or bacitracin) and cover with dsg Do not use occlusve dsg on face, neck or perineum (have pt wash ointment off 3xdaily and reapply |
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Patient teaching for minor burns
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Wound check in 24 hours
Change dsg bid x 7-10 days Elevate extremity involved use analgesics |
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Health promotion to avoid minor burns
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Protective equipment
ventilation gloves turn of electricity prior to fixing something |
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Characteristics of Basal Cell Carcinoma
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Papular or nodular with raised pearly borders
Superficial telangiectases |
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Characteristics of Squamous Cell Carcinoma
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Inderated papul, plaque or nodule
May be eroded, crusted or ulcerated |
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Characteristics of Malignant Melanoma
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"ABCDE"
Aysmmetry Border: irregular Color variation within the lesion Distribution Elevation 6 mm |
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Distribution/Progression of Basal Cell Carcinoma
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Sun damaged areas
Also in covered areas not sun damaged if genetically predisposed |
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Distribution/Progression of Squamous Cell Carcinoma
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Sun damaged areas, but can occurred anywhere
Esp old burn scars |
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Distribution/Progression of Malignant Melanoma
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Anywhere on body, including scalp
Dark skinned pts also have a risk of lesions on nails hands and feet |
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Association of Basal Cell Carcinoma
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usually asymptomatic
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Association of Squamous Cell Carcinoma
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usually asymptomatic
Can be associated with HPV, immunosupression, industrail carcinogens, arsenic |
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Association of of Malignant Melanoma
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Usu asymptomatic unless bleeding ulceration discharge is present
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Diagnostic Studies of Basal Cell Carcinoma
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Skin biopsy
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Diagnostic Studies of Squamous Cell Carcinoma
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Skin biopsy, excisional biopsy
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Diagnostic Studies of Malignant Melanoma
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Skin biopsy
excisional biopsy |
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Most common form of skin cancer
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Basal cell carcinoma
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Major cause of Basal cell carcinoma
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chronic sunlight exposure to unprotected skin
Few cases of contact with arsenic, exposure to radiation, complications of burns,scars, vaccinations or tattoos |
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High risk population to Basal Cell carcinoma
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Fair skin
Blonde or red hair Blue, green or gray eyes Occupations requiring long hours outdoors People who spend extensive leisure time in the sun |
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Five Warning Signs of Basal Cell Carcinoma
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An open sore that bleeds oozes or crusts > than 3 wks
A Reddish Patch that may itch or hurt A shiny bump or nodule that is pearly or translucent border. Nodule will be pink red white tan black or brown A pink Growth with a slightly elecated rolled border and crusted indentation in the center Scar like area which is white, yellow or waxy with poorly defined borders (warning of aggressive tumor) |
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PreCancerous Conditions of Squamous Cell Carcinoma
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Actinic Keratosis
Actinic Chielitis Leukoplakia Bowen's Disease |
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Clinical presentation of
Actinic Keratosis |
Rough, scaly slightly raised growths that range in color from brown to red and may be up to one inch in diameter. Appear most often in adults
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Clinical presentation of
Actinic Chielitis |
A type of actinic keratosis that mainly affects the lower lip
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Clinical presentation of Leukoplakia
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White patches of plaques on the tonge or inside of the mouth
Caused by sources irritation (any tobacco use, rough edges of dentures or filling Could also appear on the lip |
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Clinical presentation of Bowen's Disease
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Persistent red-brown, scaly patch which may resemble psoriasis or eczema
generally considered tp be a superficial SCC |
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Warning signs of Squamous Cell Carcinoma
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A wart like growth that crusts and occasionally bleeds
A persistent, scaly red patch with ittegular borders that sometimes crust or bleeds An open sore that bleeds and crusts; persistent for wks An elevated growth w. central depression that occasionally bleeds |
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Four types of melanoma
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Superficial Spreading
Nodular Acrolentiginous Lentigo Maligna |
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Herpes Simplex lesions have an incubation period of ???
with a mean of ??? |
Incubation period of 2-12 days
Mean incubation of 4 days |
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Appropriate treatment for dry skin
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Take short baths in warm water
Use mild soap Pat dry Oil can be applied before or after drying to help retain moisure ***caution in infants (get slippery) and elderly (inc. risk of falls) Treat with lubricants and water in oil emulsions 2-3 x daily |
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What is intertrigo
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An erythramatous irritation of opposing skin surgaces cause by friction, most often occuring between upper thighs and under breasts
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Clinical Presentation of intertrigo
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Moist, red, and glistening plaques/patches or maoist red papules and pustules
Well defined borders Patches erode epidermis, resulting in scaling |
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Management of intertrigo
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Topical nystatin, imidazole or allylamine creams or powders 3-4 x dailty for 7-14 days. Continue for several days after skin clears
Low strength Hydrocor. can be applied if pruitis |
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Herpetic Whitlow
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Infection of the area betwn the fascial plains of the distal finger
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Paronychial Infection
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An infection of the finger that involves the tissue at the edges of the fingernail (periungual tissues). This infection is usually superficial and localized to the soft tissue and skin around the fingernail. This is the most common bacterial infection seen in the hand.
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Causes of Paronychial Infection
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Microorganism enters through a split in the epidermis from truama, a hangnail, irritation or chronic water exposure
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Increase Risk of Ponronychial Infection
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Frequent Manicures
Application of Artificial fingernails Chronic water exposure Postmenopausal women r/t decrease in estrogen Occupation involving work with chemicals |
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Clinical presentation of Paronychial
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Nail folds, nail and even digits are often described as throbbing
Nail may display distal onychomycosis, discoloration, distortion and ridging. Erythemia and edema around the nail fold may be present. Force applied to the affected area releases purulent, foul smelling discharge If infection related to Indinavir, pyogenic granuloma-like lesions and granulation tissue are seen in nail sulci (the hollow at the base of the nail from which it grows) |
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Causes of Purpura
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Senile pupura
Stasis dermatitis Drug hypersensitivity Drug reaction Bleeding from blood thinners Rocky Mt Spotted Fever Lyme Disease Suphilis (later stages) Gonococcemia |
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What is the significance of Palpable Purpura
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The conditions associated with this can be life threatening and require prompt treatment
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What is and
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A chronic Dermatoses
Greasy, slightly erythmators scaling that occurs in areas with the highest concentration of swear glands or sebaceous glands including the scalp, face , postauricular and intertriginious areas "Craddle Cap" in infants Dandruff in adults |
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How is Seborreic Dermatitis treated?
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Mgmt depends on location adn severity
Use antiseborreic shampoos 3-4xwk to decrease eruptions or clear up the condition |
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Treatment of Paronychial infections
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Hot compresses qid
If bacterial, PCN 25-50 kg/kg/day in divided doses 6-8 hours for 7-10 days depending on the severity of the infection |
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Treatment Of Onchymycosis
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Lamisil 250 mg daily for 6 weeks
OR Itraconazole 200 mg taken bid for 1 week on then 3 weeks off; repeated 2 or 3 times for fingernails, 3-4 times for toenails |
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Clinical presentation of Psoriasis
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Papulosquamous eruption characterized by well circumscribed erythmatous macular and papular lesions with loosely adherent silvery white scale
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Management of Psoriasis
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Topical applicaiton 2-3 times daily of mid-high potency glucocorticoids for 2-3 weeks
Monitor for skin atrophy and development of tolerance Instead of steriods, can place thin layers of Duoderm for 5-7 days Phototherapy with UVA and UVB |
