Term
| how many americans develop skin cancer |
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Definition
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Term
| what are the layers of the skin (4), function and cells of each |
|
Definition
stratum corneum: top
epidermis: outer skin, keeps fluid and germs out. (melanocytes make pigment, basal cells at base)
dermis: middle skin layer, vessels, nerves, CT, hair folicles, oil glands, pilosebaceous units
fat/SC layer: insulation, storage (collagen to keep shape) |
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Term
| what is a pilosebaceous unit |
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Definition
| hair follicle and oil/sebum gland |
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Term
| what are 4 functions of the skin |
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Definition
acts as barrier to protect from injury
regulates outer temp
recieves sensory info
synthesis of vit D |
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Term
| what do UVA do to your skin (4) |
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Definition
tanning rays: penetrate deep into skin
cause suntan, burn, damage |
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Term
| what do UVB do to your skin (5) |
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Definition
burn index
cause suntan, sunburn, damage
cause long term tanning |
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Term
| what are the UV index numbers and what do they mean |
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Definition
0-2 minimal
3-4 low
5-6 moderate
7-9 high
10+ very high |
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Term
| what are the effects of sun exposure (9) |
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Definition
premanent destruction of skin supporting structure
premature wrinkling
pre-cancerous skin lesions
drug reactions
eye damage
dilated vessels
sunburn
skin cancer |
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Term
| 5 changes to skin histology in sun exposure |
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Definition
stratum corneum: cracks and fissures
epidermis: gets thinner
keratinocytes: lose typical alignment and flatten
melanocytes: enlarge, increase, migrate higher
dermis: gets thinner |
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Term
| what are the 6 skin types and their reaction to sun |
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Definition
1: pale white: always burns, never tans
2: white: burns easy, tans minimally
3: white avg: burns moderarly, tans gradually to light brown
beige/lt tan: burns minimally, always tans to med brown
5: moderate brown/tan: rarley burns, tans profusley to dark
6: dark brown/black: never burns, deeply pigmented |
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Term
| who is at risk for skin cancer(7) |
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Definition
all skin types
medical insturment and x-ray exposure
scarring from disease or burn
occupation exposure (coal-tar, arsenic)
family hx
immunosupression
organ transplant |
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Term
| what is the prevlience of basl cell carcinoma (2) |
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Definition
80% of new cancers
90% of head, neck, and sun exposed area cancer |
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Term
| describe a basl cell carcinoma (3) |
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Definition
does not usually spread
infiltrates surrounding area destorying tissue
sclerosiing sometimes: worm looking, means it has shoots into skin |
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Term
| prognosis of basla cell carcinoma (2) |
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Definition
high cure rate, worse if sclerosing
20-40% chance of developing another case |
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Term
| where is squamous cell carcinoma (5) |
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Definition
outer layer of skin
sun exposed area
chronically irritated area
scared area
fair skinned people |
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Term
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Definition
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Term
|
Definition
small sandpaper like growth (solar or sctinic keratosis)
crater: can spontaneously involute on its own (dont wait for this! it could spread first!) |
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Term
| prognosis/outcomes of SCC (4) |
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Definition
unreated can spread to vital organs
structural damage to surrounding tissue
90% cure rate when found early
could crater and spontaneously involute |
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Term
| how are basal and SCC treated (4) |
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Definition
surgical excision: abrade, cut out, freeze
mohs micrographic surgery: ensures all cancer removed
topical chemotheraputic agents
biotherapies and laser tx |
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Term
| what is the most deadly form of skin cancer, what is the prevelence |
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Definition
melanoma
4% of skin cancers
80% of skin cancer deats (1p/h) |
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Term
|
Definition
asymmetrical shape or color
borders irregular
colors variegated
diameter >6mm (maybe smaller) |
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Term
| stage 1 melanoma: location, size, tx, prognosis |
|
Definition
outer layer of skin
<2mm
remove it + 1/2 in
if detected early (in situ) it is completely curable |
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Term
| stage 2 melanoma: location, size, tx, prognosis |
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Definition
cancer perpetrated to lower inner layers of skin but no nodes
2-4mm
remove and examine nearby nodes
effective if not spread to nodes |
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Term
| stage 3 melanoma: location, size, tx (4) |
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Definition
cancer in nodes or area between tumor and node
remove tumor, surrounding tissue, affective nodes
drug therapy, radiation therapy, biological therapy |
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Term
| what is biological therapy (3) |
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Definition
melanoma vaccines
IL-2
INFa |
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Term
| stage 4 melanoma: location, size, tx (3) |
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Definition
cancercells in distant area of body
melanoma and surrounding tissue removed
chemotherapy, radiation, biological therapy |
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Term
| what are the classifications of melanoma based on clarks levels |
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Definition
1. confined to epidermis
2. confined to epidermis and reticular dermis
3. penetrates mid-dermis
4. penetrates to deep dermis
5. penetrates to SC fat |
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Term
| what are the tx of melanoma based on clarks levels |
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Definition
1. full thickness surgical excision with 5mm border
2-5...
<1mm: excision to deep fascia + 1cm
>1mm: excision to deep fascia + 1cm + node
>2mm: excision to deep fascia + 2cm + node |
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Term
| what are some of the new tx for melanoma (4) |
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Definition
laser therapy
immunotherapies
monoclonial antibodies
gene therapies |
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Term
| what are the three skin cancers in situ, describe each |
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Definition
malignant melanoma in-situ: malignant melanoma confined to epidermis
SCC in situ: SCC confined to epidermis
Basal cell carcinoma in situ: confined to epidermis ALWAYS BY DEFINITION |
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Term
| explain the steps of a skin cancer self exam |
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Definition
examine body front and back in full length mirror
raise arms and check left and right sides
bend wlbows and look at forearms, upper under arms, palms
check backs of legs, feet, between toes, on soles
examine nack of neck, scalp, genital area with hand held mirrior |
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Term
|
Definition
avoid sun
use sun screen
cover uo
avoid artificial tannin: try bronzer
check skin regularly |
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Term
| what is the number one advice for papulosquamous disease tx |
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Definition
if it is wet dry it
if it is dry wet it |
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Term
| what are the potentcies of topical steroids |
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Definition
1: super
2: high
3-5: medium
6-7: low |
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Term
| in general, describe a papulosquamous disease |
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Definition
| scaly papules and plazues |
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Term
|
Definition
circumscribed, elevaated, superificial, soild lesion
>0.5cm
often formed by confluence of papules |
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Term
| what is the most common inflammatory disease |
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Definition
| eczema/eczematous inflammation |
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Term
| what is the cause of eczema |
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Definition
contact with allergen or chemical causes inflammatory reaction at site or distant site
fungal infection, stasis dermatitis, acute inflammation process |
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Term
| signs of acute eczema (5) |
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Definition
moderate-intense inflammation
itching
bright red plaque
tiny clear serum filled vesicles
evolves in hours |
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Term
| treatment of acute dermatitis (5) |
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Definition
cool wet dressings
topical corticosteroids VI-VII to control localized lesions
oral corticosteroids: to control intense or wide spread inflammation
anti-histamines: relieve itching, inflammation, sedation
antibiotics: oral if seconday infection ONLY or will slow healing |
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Term
| ssigns of subacute eczema (9) |
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Definition
scale
distinct borders
faint-intense redness
scaly
fissured
pearched
scalded
moterate itch
pain/sting/scald |
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Term
| how does eczema become subacute |
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Definition
may be initial stage
may follow inflammation |
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Term
| how does eczema become acute (4) |
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Definition
maybe initial stage
may be subacute that got infection, irritation, allergey |
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Term
|
Definition
cool wet dressings: DC when acute turns subacute
topical corticosteroids: III-V, cream with occlusion, ointment if dry
lubrication
mild soaps
topical immunomodulators |
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Term
| why do we lubricae subacute eczema |
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Definition
| inflammed skin becomes dry and susceptible to infection |
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Term
| what does it mean to use cool wet dressings |
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Definition
| domeboro tabs in sterile water applied for 15-20 min |
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Term
| describe chronic eczema (11) |
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Definition
inflammation constant source of irritation and itch
second lichen simplex chornicus
discolored thick skin, scales, fissures, excoriated
moderate-intense itch
converted to chronic eczematous inflammation with scratching (lichenification)
accenuated skin lines |
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Term
|
Definition
topical steroids II-V sometimes with occlusion, needed eczematous inflammation
intra-lesional injection |
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Term
| signs of hand eczema (14) |
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Definition
common, more in females
embarrasing, uncomfourtable, disabling
mild, red, scaly, vesicular
moderate itch, tender, swelling, long lasting, relapsing |
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Term
| causes of hand eczema (3) |
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Definition
irritant contact dermatitis
atopic hand eczema
allergic contact dermatitis |
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Term
| treatment of hand eczema (4) |
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Definition
corticosteroids (I-III)
systemic corticosteroids: ONLY if diagnosis is accurate and you are VERY careful
lubrication: urea, lactic acid, cream/ointment/lotion
occlusion: make topical steroid stronger by wrapping it up after putting it on |
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Term
| what is nummular eczema (3) |
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Definition
one or several coin shaped patches
nnumber of lesions may increase but once established they remain same size
unknown cause |
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Term
| appearance nummular eczema (5) |
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Definition
thick, chronic, scaling, plaque
looks like psoriasis after scratching a lot |
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Term
| treatment of nummular eczema (3) |
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Definition
depends on stage
acute path: red vesicular lesions
subacute: red scaling plaques
chronic: habitually scratched thick plaque |
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Term
| what does eczema on nipple mean |
|
Definition
| DO BIOPSY it could be paget's disease! |
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Term
| describe winter dermatitis: location, cause, MOA, appearance |
|
Definition
usually on extensors of UE/LE or entire body if susceptible
forms when humidity is low
water is lost from outer most layer of skin
skin becomes cracked and fissured (eczema craquele) |
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Term
| treatment of winter dermatitis (6) |
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Definition
12% lactate lotion
emollients
lubricants
anti-histamines
anti-puritics
topical steroids |
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Term
| how does atopic dermatitis begin |
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Definition
| itchig and dry skin give low threshold |
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Term
| what does atopic dermatitis look like: color, moisture, location, symptoms |
|
Definition
white to red
wet
flexors and face
intense itch and pain
secondary lichen complex chronicus |
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Term
| what is secondary lichen complex chronicus |
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Definition
skin surface modified by scratching causes lichenification
episode resolves and area is darker, thicker, and compormised |
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Term
| what does atopic dermatitis look like in ethnic skin (2) |
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Definition
| loss of pigment, follicular |
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Term
| treatment of atopic dermatitis (9) |
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Definition
eliminate inflammation and infection
emollients: preserve and restore stratum corneum barrier
anti-puritics: reduce self inflicted damage
control exacerbating factors
topical steroids: start with low and increase to higher
antibiotics
immunomodulators
lubrication
antihistamines |
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Term
| cause of seborrhetic dermatitis |
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Definition
common chronic inflammatory disease
different patterns in different ages |
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Term
| seborrhetic dermatitis appearance in adults (6) |
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Definition
fine, dry, white scalp
scaling, moderate itch
remission and exacerbation
dandruff |
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Term
| seborrhetic dermatitis appearance in ethnic skin |
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Definition
| can have same presentation or have annular form |
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Term
| seborrhetic dermatitis appearance in infants |
|
Definition
greasy adherent scale on vertex of scalp (cradle cap)
WATCH OUT looks like tinea |
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Term
| treatment mild seborrhetic dermatitis (8) |
|
Definition
NEVER suggest cradle cap kit: comes with comb to cause irritation
topical steroid
ketoconazole cream
sulfa prep
oral antibiotics: anti-staph
salex: salic acid shampoo
colbed: cholbestaol shampoo
sensun: selenium shampoo
T/gel, reme-T, pentrax: coar tar (BAD, cancerous) |
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Term
| treatment severe seborrhetic dermatitis (4) |
|
Definition
oral corticosteroids: short course
ketoconazole 2x/d
fluconazole: for putyrosporum ovale
phototherapy |
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|
Term
|
Definition
keratinization (rarley entire cutaneous surface)
usually improves with age |
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Term
| ichyosis: color, shape, moisture, symptoms |
|
Definition
brown, red
dry
rectangle scales
moderate itch |
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Term
| what is dominant ichyosis vulgaris, what does it look like, location |
|
Definition
ichyosis in certian ethnicities with atopic dermatitis
small, fine, white, translucent scales
on extensors of arms and legs |
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Term
| treatment of itchyosis (4) |
|
Definition
topical steroids
lubrication
emollients
anti-histamines |
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|
Term
| contact dermatitis- rhus dermatitis: causes |
|
Definition
poison ivy, oak, sumac sap
cashew trees, mango leaves, japanese laquer trees, ginko
contact to metal, rubber, latex, cosmetics, laquer, neosporin, medical patch, lotion
industrial chemicals
systemic: ingestion |
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|
Term
| descirbe contact dermatitis lesions: color, type, shape, symptoms |
|
Definition
red or clear vesicles and bullar
linear distribution
scaling
moderate-intense itch |
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|
Term
| treatment of contact dermatitis (6) |
|
Definition
cold wet compress
colloidal oatmeal (aveeno)
calamine lotion
topical steroid creams
oal steroids(prednisone) 7-10d
anti-histamines |
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|
Term
| how many people have psoriasis |
|
Definition
|
|
Term
|
Definition
autosomal dominant
variable penetrance
begins in childhood after strep pharyngitis |
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|
Term
| initial psoriasis signs (6) |
|
Definition
| thick, silvery, scales, red base, round/irregular, moderate/intense itch |
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|
Term
| describe normal psoriasis lesions (7) |
|
Definition
adherent silver white scale
auspitz sign: pin point bleed with scale removal
guttae: sudden appearance of scaly papules (GAS caused pustular form)
pitted nails
psoriatic arthropathy |
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|
Term
| what is the funny word he used for psoriasis nails that i couldnt make out but is apparently on the test |
|
Definition
| acrozomitnoum dermatitis fulcrum?? |
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|
Term
| non-systemic treatment psoriasis (10) |
|
Definition
UVB
topical steroids
immunomodulators
emollients
lubricants
topical steroids
calcipotriol or anthralin
intra-lesional steroid injection
biologics
tar preperations |
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|
Term
| what are systemic treatments for psoriasis (3) |
|
Definition
photochemotherapy
methotraxate: DOC 12h intervals, 24h a week
cyclosporine |
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|
Term
| what can make psoriasis worse (2) |
|
Definition
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|
Term
| pityrasis rosea: cause, who gets it, |
|
Definition
viral or bacterial origin
higher incidence in colder months |
|
|
Term
| prognosis of pityriasis rosea |
|
Definition
common
benign
usually asymptomatic
self limiting |
|
|
Term
| clinical history of pityriasis rosea (6) |
|
Definition
| hx acute infection, fatigue, headache, sore throat, lymphadenitis, fever |
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|
Term
| appearance of pityriasis rosea |
|
Definition
red macular papular
christmas tree distribution on back
herald patches |
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Term
| herald patch: size, shape, timeline, location |
|
Definition
2-10cm
round/oval
abruptly appear
anywhere on body: usually trunk or extremities proximally
all on same person look exactly same
pt thinks they have ring worm |
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|
Term
|
Definition
topcal steroids
prednisone: rare
anti-histamine
lubricants
ERYTHROMYCIN |
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|
Term
| cause of tinea versicolor |
|
Definition
fungal infection by malassezia furfur
lipophilic yeast
round form: P. orbiculare
oval form: P. ovale
normal skin flora
likes sebaceous glands
heat and humidity lower resistance |
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Term
| describe lesion of tinea versicolor |
|
Definition
milti colored patches
usually asymptomatic, may have mild itch |
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Term
| treatmet of tinea cersicolor |
|
Definition
selenium sulfide 2.5%: used for reoccurrances
ketoconazone: NOT USED ANYMORE, ONLY USE SYSTEMIC STEROIDS IF YOU ARE CERTIAN OF YOUR DIAGNOSIS |
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|
Term
| why should you only use systemic steroids if you are certian of your diagnosis (2) |
|
Definition
YOU CAN ALLOW INFECTION TO PROGRESS
YOU CAN TRANSFORM PSORIASIS INTO PUSTULAR PSORIASIS |
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