Module 14 Part 3: Dermatological Disorders

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1

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

2

Candidiasis: *BUG*

What is it?

Where is it usually found?

Candida Albicans

Yeast infection

Normally found on mucous membranes of skin, GI & Vagina

3

Candidiasis: Causes

-Locally moist environment, maceration(breaking down of skin), or occlusion

-Hormonal (bc pills or estrogen supplement, pregnancy)

-Obesisty, Anibiotics

-DM

-Low immune system; AIDS(can spread throughout body)

-infants <6month (low immune reactivity)

-Some blood neoplasia

4

Trichomonas: What type of infection?

Viral, bacterial, fungal, protozoal?

Protozoal Eukaryotic infection

5

Trichomonas: S/s

**KNOW**

-Grey-green frothy vaginal discharge

-Fishy odor **HINT**

- Edema & pruritis

-males may be asymptomatic

6

Trichomonas: Testing

**KNOW**

- Slide; "Whiff Test" amines produced by trichomonas **HINT**

- Saline wet prep; protozoa w/ flagella

-Nucleic acid amplification test (NAATs)

-R/o Gardnerella

7

Gardnerella: What is it?

Disorder of chemical & biological balance of normal vaginal flora

8

Trichomonas: Tx

Metronidazole (flagyl); contains antabuse (non-alcoholic med)

9

Chlamydia (silent epidemic): *BUG*

What color discharge?

Dx? Tx?

Chlamydia Trachomatis

Clear discharge; can be Asymptomatic

Dx: UA, swab

Tx: Antibiotics

10

Gonorrhea: *BUG*

What color discharge?

Neisseria Gonorrhea

Green-yellow discharge; Painful intercourse/urination

11

Genital Warts: *BUG*

What virus is involved?

Condyloma Acuminata

HPV

12

Condyloma Lata: What disease?

Secondary Syphilis

13

Systemic Lupus Erythematosus(SLE): What is it?

*inflammatory autoimmune disorder; multisystem organ can be affected*

14

Systemic Lupus Erythematosus(SLE): S/s

-Malar rash; sunlight

"Butterfly rash"

**Do not confuse w/ rosacea**

15

Discoid Lupus Erythematosis(DLE): What is it?

Cutaneous manifestation only

Can progress to SLE

16

Discoid Lupus Erythematosis(DLE): Causes

-Unknown; could be genetic & environmental

-ultraviolet B wavelengths?

17

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

18

Discoid Lupus Erythematosis(DLE): Testing

-Skin biopsy; lumpy deposit of immunoglobulins (Especially IgM) - immunoflourecent observation

19

Discoid Lupus Erythematosis(DLE): Tx

-Topical creams (steroids or hydroxychloroquine)

- Avoid sunlight

20

Eczema: What is it?

*A term for a group of medical conditions that cause the skin to become inflamed or irritated*

21

Eczema: Causes

-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

22

Eczema: S/s

-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

23

Eczema: Testing

-clinical

-wound culture & sensitivity

24

Psoriasis: Causes

-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

25

Psoriasis: S/s

**KNOW**

-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

26

Psoriasis: Testing

-Clinical

-R/o RA

27

Psoriasis: Tx

-topical corticosteroids (thin skin risk)

-Salicylic acid (cell turnover), UV light therapy

-Methotrexate, Cyclosporin

28

Types of Skin Cancer: Melanoma

Cause

Where does the cell come from?

DEADLIEST FORM OF SKIN CANCER

Caused by UV exposure or genetic predisposed.

Metastasize early. Cell comes from melanocyte

29

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

30

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

31

Types of Skin Cancer: Actinic Keratosis (AK)

MC where?

Tx?

What can it lead to?

PRECANCEROUS GROWTH

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)

32

Tinea: What is it?

*Variety of organisms which cause fungal skin infections, passed by touching we floors, pet or infected person*

33

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

34

Tinea: causes

- Scalp Ringworm (Tinea Capitis)

- Body Ringworm ( Tinea Corporis)

- Athletes foot (Tinea pedis)

- Jock itch (Tinea Cruris)

35

Tinea: S/s

itching, burning, redness, slightly elevated white scabby

36

Tinea: Testing

Clinical