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45 Cards in this Set

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When to refer animal or human bite for physician consultation?
When on the face, when the animal is rabid, when tendon, bone or joint could be involved or if patient develops systemic infection
Appropriate mgmt for minor burns
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
Patient teaching for minor burns
Wound check in 24 hours
Change dsg bid x 7-10 days
Elevate extremity involved
use analgesics
Health promotion to avoid minor burns
Protective equipment
ventilation
gloves
turn of electricity prior to fixing something
Characteristics of Basal Cell Carcinoma
Papular or nodular with raised pearly borders
Superficial telangiectases
Characteristics of Squamous Cell Carcinoma
Inderated papul, plaque or nodule
May be eroded, crusted or ulcerated
Characteristics of Malignant Melanoma
"ABCDE"
Aysmmetry
Border: irregular
Color variation within the lesion
Distribution
Elevation
6 mm
Distribution/Progression of Basal Cell Carcinoma
Sun damaged areas
Also in covered areas not sun damaged if genetically predisposed
Distribution/Progression of Squamous Cell Carcinoma
Sun damaged areas, but can occurred anywhere
Esp old burn scars
Distribution/Progression of Malignant Melanoma
Anywhere on body, including scalp
Dark skinned pts also have a risk of lesions on nails hands and feet
Association of Basal Cell Carcinoma
usually asymptomatic
Association of Squamous Cell Carcinoma
usually asymptomatic
Can be associated with HPV, immunosupression, industrail carcinogens, arsenic
Association of of Malignant Melanoma
Usu asymptomatic unless bleeding ulceration discharge is present
Diagnostic Studies of Basal Cell Carcinoma
Skin biopsy
Diagnostic Studies of Squamous Cell Carcinoma
Skin biopsy, excisional biopsy
Diagnostic Studies of Malignant Melanoma
Skin biopsy
excisional biopsy
Most common form of skin cancer
Basal cell carcinoma
Major cause of Basal cell carcinoma
chronic sunlight exposure to unprotected skin
Few cases of contact with arsenic, exposure to radiation, complications of burns,scars, vaccinations or tattoos
High risk population to Basal Cell carcinoma
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
Five Warning Signs of Basal Cell Carcinoma
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)
PreCancerous Conditions of Squamous Cell Carcinoma
Actinic Keratosis
Actinic Chielitis
Leukoplakia
Bowen's Disease
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
Clinical presentation of
Actinic Chielitis
A type of actinic keratosis that mainly affects the lower lip
Clinical presentation of Leukoplakia
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
Clinical presentation of Bowen's Disease
Persistent red-brown, scaly patch which may resemble psoriasis or eczema
generally considered tp be a superficial SCC
Warning signs of Squamous Cell Carcinoma
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
Four types of melanoma
Superficial Spreading
Nodular
Acrolentiginous
Lentigo Maligna
Herpes Simplex lesions have an incubation period of ???
with a mean of ???
Incubation period of 2-12 days
Mean incubation of 4 days
Appropriate treatment for dry skin
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
What is intertrigo
An erythramatous irritation of opposing skin surgaces cause by friction, most often occuring between upper thighs and under breasts
Clinical Presentation of intertrigo
Moist, red, and glistening plaques/patches or maoist red papules and pustules
Well defined borders
Patches erode epidermis, resulting in scaling
Management of intertrigo
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
Herpetic Whitlow
Infection of the area betwn the fascial plains of the distal finger
Paronychial Infection
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.
Causes of Paronychial Infection
Microorganism enters through a split in the epidermis from truama, a hangnail, irritation or chronic water exposure
Increase Risk of Ponronychial Infection
Frequent Manicures
Application of Artificial fingernails
Chronic water exposure
Postmenopausal women r/t decrease in estrogen
Occupation involving work with chemicals
Clinical presentation of Paronychial
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)
Causes of Purpura
Senile pupura
Stasis dermatitis
Drug hypersensitivity
Drug reaction
Bleeding from blood thinners
Rocky Mt Spotted Fever
Lyme Disease
Suphilis (later stages)
Gonococcemia
What is the significance of Palpable Purpura
The conditions associated with this can be life threatening and require prompt treatment
What is and
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
How is Seborreic Dermatitis treated?
Mgmt depends on location adn severity
Use antiseborreic shampoos 3-4xwk to decrease eruptions or clear up the condition
Treatment of Paronychial infections
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
Treatment Of Onchymycosis
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
Clinical presentation of Psoriasis
Papulosquamous eruption characterized by well circumscribed erythmatous macular and papular lesions with loosely adherent silvery white scale
Management of Psoriasis
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