Module 14 Part 3: Dermatological Disorders
Herpes Simples Virus 1, 2 & 3
Which can lay dormant in trigeminal nerve(CN5)?
HSV-1: Head- Cold sores or cornea ; Trigeminal nerve
HSV-2: Genital Sores; can be in Spinal Cord
HSV-3: (VZV) Varicella Zoster Virus; Chicken pox or Shingles
What is it?
Where is it usually found?
Normally found on mucous membranes of skin, GI & Vagina
-Locally moist environment, maceration(breaking down of skin), or occlusion
-Hormonal (bc pills or estrogen supplement, pregnancy)
-Low immune system; AIDS(can spread throughout body)
-infants <6month (low immune reactivity)
-Some blood neoplasia
Trichomonas: What type of infection?
Viral, bacterial, fungal, protozoal?
Protozoal Eukaryotic infection
-Grey-green frothy vaginal discharge
-Fishy odor **HINT**
- Edema & pruritis
-males may be asymptomatic
- Slide; "Whiff Test" amines produced by trichomonas **HINT**
- Saline wet prep; protozoa w/ flagella
-Nucleic acid amplification test (NAATs)
Gardnerella: What is it?
Disorder of chemical & biological balance of normal vaginal flora
Metronidazole (flagyl); contains antabuse (non-alcoholic med)
Chlamydia (silent epidemic): *BUG*
What color discharge?
Clear discharge; can be Asymptomatic
Dx: UA, swab
What color discharge?
Green-yellow discharge; Painful intercourse/urination
Genital Warts: *BUG*
What virus is involved?
Condyloma Lata: What disease?
Systemic Lupus Erythematosus(SLE): What is it?
*inflammatory autoimmune disorder; multisystem organ can be affected*
Systemic Lupus Erythematosus(SLE): S/s
-Malar rash; sunlight
**Do not confuse w/ rosacea**
Discoid Lupus Erythematosis(DLE): What is it?
Cutaneous manifestation only
Can progress to SLE
Discoid Lupus Erythematosis(DLE): Causes
-Unknown; could be genetic & environmental
-ultraviolet B wavelengths?
Discoid Lupus Erythematosis(DLE): S/s
1-2cm raised red plaque w/ brownish scale; penetrates hair follicle & cracks it open (carpet tack appearance/cat tongue sign) if removed
-Alopesia, Telangiectasias(spider veins), Urticaria(hives), Raynaud phenomenon
Discoid Lupus Erythematosis(DLE): Testing
-Skin biopsy; lumpy deposit of immunoglobulins (Especially IgM) - immunoflourecent observation
Discoid Lupus Erythematosis(DLE): Tx
-Topical creams (steroids or hydroxychloroquine)
- Avoid sunlight
Eczema: What is it?
*A term for a group of medical conditions that cause the skin to become inflamed or irritated*
-unknown or immune to skin problem
-Filaggrin gene deficiency(codes for proteins which bind to keratin in epidermis)
-low ceramide levels(protective layer hold cells together)
-low antimicrobial peptides
- altered immune response to allergens, irritants & microbes
-intense itchy, burning, dry flaky erythematous skin; often found in bends fo arms, legs, face and neck
- Secondary bacterial infections; danger if pt is immunocompramised
-wound culture & sensitivity
-Autoimmune T-cell reaction to skin
-Rapid epidermal shedding
-Risk: FHx, genetic predisposition, HIV, stress, obesity, smoking, living north of equator, smoking
Triggers: alcohol, stress, infections, injury to skin, cold weather, meds
-Red skin w/ silvery scales & inflammation **HINT**
-Main areas: Knees, elbows, scalpe
- Nail involvment; pitting, onycholysis(separation of nail plate)
-Psoriatic Arthritis of hands, feet & ankle joints
-topical corticosteroids (thin skin risk)
-Salicylic acid (cell turnover), UV light therapy
Types of Skin Cancer: Melanoma
Where does the cell come from?
DEADLIEST FORM OF SKIN CANCER
Caused by UV exposure or genetic predisposed.
Metastasize early. Cell comes from melanocyte
Types of Skin Cancer: Basal Cell Carcinoma
What does it look like?
Where is it usually formed?
MOST COMMON TYPE OF SKIN CANCER
Elevated papule; looks pearly & easy to treat
Form @ outerlayer of skin; never spreads to other parts
Types of Skin Cancer: Squamous Cell Carcinoma
What does it start off as?
Where can it appear? Grading?
If left untreated?
SECOND MOST COMMON TYPE OF SKIN CANCER
starts off as wound, trouble healing. Does not spread quickly
Can appear anywhere in body especially sun exposed areas
If untreated can become deadly
Types of Skin Cancer: Actinic Keratosis (AK)
What can it lead to?
Very common in heavily sun exposed places
Can freeze off; Can lead to Squamous Cell Carcinoma
Scaly crusy growths that form in areas most exposed to sun(scalp, lips, back of hands)
Tinea: What is it?
*Variety of organisms which cause fungal skin infections, passed by touching we floors, pet or infected person*
Dont confuse Tinea w/ what?
- Erythema Marginata (Rheumatic Fever); Looks like ring worm
- Erythema Nodosum (Valley Fever); looks like rash
- Tinea is a little elevated and white scabby
- Scalp Ringworm (Tinea Capitis)
- Body Ringworm ( Tinea Corporis)
- Athletes foot (Tinea pedis)
- Jock itch (Tinea Cruris)
itching, burning, redness, slightly elevated white scabby