Dermatology 001

7/23/2019 Dermatology 001

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Dermatology



Anatomy



Skin Infections Bacterial

Impetigo Folliculitis Furuncle

Carbuncle Cellulitis Acne

Fungal /Parasitic Tinea Pedis

Tinea Cruris Tinea Versicolor Tinea Corporis Toenail fungus Pediculosis Scabies



Skin Infections Viral

Herpes Simplex Herpes Zoster Verruca olluscum Contagiosum

Allergic/Irritation conditions !ermatitis Hi"es #c$ema Psoriasis

Sebacous C%sts Frostbite

&t'er S(in c'ec(s ) moles Sunburn Striae



Impetigo



Impetigo Superficial bacterial infection of t'e s(in

ost commonl% Stap' or Strep

T'in "esicles *it' 'one% colored crusting

+suall% on face, 'ands, nec( - extremities

Spread occurs "ia contact from fingers,to*els, clot'ing

Tx. Topical antibiotics, se"ere infectionsneed oral



Folliculitis



Folliculitis Superficial or deep infection of t'e 'air

follicle Barbae, 'ot tub0

+suall% result of Stap' infection

a% also occur as a result ofcontact/plugging *it' oil, dirt, s*eat, etc

1as' appears as small, dome s'aped

%ello* pustules *it' a 'air s'aft in t'ecenter

Tx. good '%giene, topical antibotics



Furuncle



Furuncle (Boil) !eep extension of superficial folliculitis

into t'e dermis and subcutaneous tissue

Cause 2 Stap'

3)4 cm red/tender nodule *'ic' ma%contain pus

Tx.

Simple lesions) *arm compress Se"ere infections 2 drainage - antibiotics



Carbuncle



Carbuncle 5arge deep abscess t'at is a progression

of a furuncle

a% be 6)37 cm in si$e

Can present c fe"er/c'ills Tx. drainage - antibiotics



Cellulitis



Cellulitis An acute inflammation of t'e s(in S/S. redness, s*elling, *armt', - tenderness of

affected area *it'in 3)8 da%s of in9ur% Cause Stap' or Strep, complication of

*ound/trauma T'e borders are *ell defined and c'ange rapidl% Immediate attention blood test, IV antibiotics0 Facial cellulitis can cause "isual damage if

spreads to t'e e%es

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Acne



Acne &bstruction of sebaceous follicles oil glands0

&pen comedones or closed comedones

+suall% on t'e face, c'est, bac(

Causes. Stressful e"ents 'ormonal c'anges0

Friction acne

&il based cosmetics

:& correlation bet*een c'ocolate, c'ips or colas

Tx. topical </or oral antibiotics



MRSA



MRSA et'icillin)resistant Stap'%lococcus aureus =super)bug> 2 caused b% stap', unnecessar% antibiotic use &ut*its all but t'e most po*erful of drugs 2 "ancom%cin #nters t'roug' cuts - *ounds T%pes. CA communit% ac?uired0 or HA Hospital ac?uired0 S/S. small red bumps t'at resememble pimples, ?uic(%

turn to painful abscesses t'at can burro* deep into t'ebod%, s*elling, redness, pus

1is( Factors. recent 'ospitali$ation, long)term care, recentantiobiotic use, %oung age, contact sports, s'aring to*els,*ea( immune s%stem, li"ing in groups, 'ealt')care *or(ers

!x. Tissue sample 2 @'rs Tx. trial - error c strong antiobiotics Pre"ention. ASH HA:!S, surfaces, co"er *ounds, use

onl% personal items



Tinea e!is



Tinea e!is Fungal infection ) Athlete’s Foot

1as' presents as "esicles/erosions on t'esoles of t'e foot as *ell as bet*een toes

!x. examine scraping under microscope Tx. antifungal cream/po*ders

microna$ole0, (eep feet dr%



Tinea Cruris



Tinea Cruris Fungal infection 2 Jock itch

1ed/scal% ras' on inner t'ig's/inguinalcreases occasionall% t'e buttoc(, not

scrotum or labia Common in obese patients - at'letes in

tig't fitting clot'es

Common in 'ot/'umid *eat'er Tx. topical antifungal creams



Tinea "ersicolor



Tinea "ersicolor Fungal infection of t'e s(in ultiple patc'% lesions o"al s'ape c fine scales0

eit'er lig't in color or bro*n

T%picall% occurs on t'e bac(, nec(, c'est,s'oulders

ore prominent in t'e summer *'en t'e affectedareas do not tan

1ecurrence is common Tx. Topical antifungal



Tinea Corporis



Tinea Corporis Fungal infection of s(in ) Ring Worm ell defined circular patc'es *it' scal% borders

Found on non)'air% surfaces 2 face, arms, legs,

truc( &ccurs after contact c anot'er person/ob9ect t'at

is carr%ing t'e fungus

Common confused c ec$ema

Tx. topical antifungals icrona$ole, (etocona$olenot :%statin0



Toenail Fungus



Toenail Fungus S/S.%ello*, t'in( nails, painful, brittle, more li(el% in

toenails d/t dar(, moist en"ironment

Tx. 5amisil, "ic(s, ta(es D)38 mont's



e!iculosis



e!iculosis Lice; six)legged *ingless insect T'e louse is a gra%is'/blac( colored insect E@mm

long T'e nits are gelatinous *'ite color Emm long Can be found in t'e 'ead, bod% or pubic 'air T'e% pierce t'e s(in and secrete sali"a *'ic'

causes itc'ing, la% eggs close to scalp Spread b% s'ared 'ats, to*els, combs, bedding,

clot'ing, up'olster% - 'eadp'ones Tx. S'ampoo 2 :ix, 1id fine toot' comb, boil

clot'ing/bedding, dr% cleaning



Scabies

Ver% contagious ST! Intense itc'% ras', *it' linear burro*s

Tx. G*ell or #limite topical creams0 as' bedding/clot'ing in H&T *ater -

stored for 8)6 da%s



#erpes Simple$



#erpes Simple$ Viral infection eit'er T%pe I &1 T%pe II

=ou cant (ill it and it *ont (ill %ou> Clear papules c superficial ulcerations/erosions

a% cause fe"er, l%mp' node enlargement,burning pain

5esions *ill crust o"er in 4)3@ da%s

Tx. analgesic for pain, oral anti"iral ac%clo"ir0



#erpes %oster



#erpes %oster Shingles, a reacti"ation of "aricella $oster

C'ic(en pox0 "irus It remains in t'e cells of ner"e roots in an

inacti"e state after exposure as a %out'0

+n(no*n reasons for reacti"ation 1e)exposure to "irus

Immunosuppressant issue

Some drugs

1esult in "esicles on a red base in a band)li(e

distribution Painful ras', pric(l% ner"e pain Tx. s%mptomatic, pain, calamine lotion



"erruca



"erruca arts caused b% 'uman papilloma"irus

Verruca plantaris 2

Verruca "ulgaris 2

1ound, fles' colored and gro* to be%ello*)is' tan

3cm or more *ide

D4J *ill resol"e spontaneousl% Tx. destruction of epidermal cells t'at

contain "irus cr%ogenicall%, c'emicall%



Molluscum Contagiosum



Molluscum Contagiosum Viral infection of s(in/mucous membrane

Single or multiple fles' colored, domes'aped papules c central umbilication

Found on face, trun(, extremities,lips/tongue, genitals

Ver% contagious 2 self and ot'ers

Common in s*immers/*restlers Tx. curettage, sil"er nitrate to c'emicall%

burn t'e lesions



Dermatitis



Dermatitis Inflammation of t'e superficial dermis/epidermis

Atopic !ermatitis. Heriditar% disorder 2 ma% also 'a"e Hx of ast'ma, allergic r'initis, ras'

+suall% along c'ee(s, face, trun(, extensor surfaces of extremities

!r% and papular ras', scratc'ing ma(es it *orse, d/t loss of naturaloils in s(in

Aggra"ated b% stress, anxiet%, dr% conditions

Tx. good lotions - re'%dration of s(in

Contact !ermatitis. Papular and itc'% ras' resulting from contact c an allergen Commonl% 2 nic(el c'eap 9e*elr%, buc(les0, soaps, perfumes,

cosmetics, posion i"%/oa(

Tx. Cortisone cream anti)inflammator% agent0



#i&es



#i&es An allergic reaction resulting in 'istamine release

ell defined *'eals solid ele"ations c centralclearing0

#xtremel% itc'% - ma% result in angioedema

Allerg% can be to "irtuall% an%t'ing

Tx. anti'istamines



'cema



'cema !r%ness of t'e epidermis

+suall% seen on extremities/trun(

orse in *inter or *'en bat' too muc'

1as' is itc'%, red, scal%, patc'% c acrac(ed appearance

8ndar% bacterial infections d/t scratc'ing

Tx. lotion/creams to '%drate, topicalcorticosteroids



roper Skin Care Fre?uenc% of s'o*ers

:ot so muc' soap/appropriate t%pe

+se creams, not lotions



soriasis



soriasis In'erited s(in disorder of increased epidermal cell

turno"er - t'ic(ening of t'e epidermis

T'ic( sil"er% scales

Common on t'e elbo*s, (nees - feet

Tx. +V lig't or 'ig' potenc% corticosteroids

Se"ere cases need to be 'ospitali$ed for a tar ointmentor met'otrexate



Sebaceous Cysts



Sebaceous Cysts Solitar% s(in nodules as a result of proliferation of

epidermal cells t'at secrete protein called (eratin

Contains past%, c'ees% loo(ing secretion

Common on e%elids, nec(, face, trun(, scalp

Benign slo* gro*ing lesions :o treatment necessar% unless problems c A!5s



Frostbite



Frostbite Actuall% free$ing of tissue K cold temps

Lenerall% affects t'e exposed area Toes, feet,fingers, nose, c'ee(s, ears0

S(in becomes cold, *ax%, *'ite, gra%, blac(

#arl% stages 2 c'illblaines)redness, painful

5ate stages 2 c%anosis, gangrene, edema, nopain

Tx. co"er c *arm compress, rapid re)*arming in*ater, 'ands bet*een legs, armpits

A"oid pressure on tissue, e"en lig't



Skin Cecks *Moles+Cancer



Moles+Cancer 5oo( for.

3 :o bigger t'an an eraser tip

8 Stand out mole on t'e bac(

6 Irregular border @ different colors

T'in( of outdoor sports Tennis, golf, soccer

ales 2 c'ec( t'e 'ead

Females 2 c'ec( t'e ears and lips



Sunburn



Sunburn Superficial burn 2 onl% epidermis

M34 suncreen

37)8pm is most intese 'ours, *orse in

sno*%, *ater% en"ironments #"er% time %ou burn c blistersNincreases

%our c'ances of getting s(in cancer @x

Tx. analgesic spra%s, lotionNnot oilbased



Striae



Striae A strea( or a linear scar

1esults from rapidl% de"eloping tension int'e s(in

Common in pregnanc% or *'en %ou gain*eig't fastNsteroid use

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Dermatology 001