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Dermatology.

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Presentation on theme: "Dermatology."— Presentation transcript:

1 Dermatology

2 Anatomy

3 Skin Infections Bacterial Fungal /Parasitic Impetigo Folliculitis
Furuncle Carbuncle Cellulitis Acne Fungal /Parasitic Tinea Pedis Tinea Cruris Tinea Versicolor Tinea Corporis Toenail fungus Pediculosis Scabies

4 Skin Infections Viral Allergic/Irritation conditions Other
Herpes Simplex Herpes Zoster Verruca Molluscum Contagiosum Allergic/Irritation conditions Dermatitis Hives Eczema Psoriasis Sebacous Cysts Frostbite Other Skin checks - moles Sunburn Striae

5 Impetigo

6 Impetigo Superficial bacterial infection of the skin
Most commonly Staph or Strep Thin vesicles with honey colored crusting Usually on face, hands, neck & extremities Spread occurs via contact from fingers, towels, clothing Tx: Topical antibiotics, severe infections need oral

7 Folliculitis

8 Folliculitis Superficial or deep infection of the hair follicle (Barbae, hot tub) Usually result of Staph infection May also occur as a result of contact/plugging with oil, dirt, sweat, etc Rash appears as small, dome shaped yellow pustules with a hair shaft in the center Tx: good hygiene, topical antibotics

9 Furuncle

10 Furuncle (Boil) Deep extension of superficial folliculitis into the dermis and subcutaneous tissue Cause – Staph 1-5 cm red/tender nodule which may contain pus Tx: Simple lesions- warm compress Severe infections – drainage & antibiotics

11 Carbuncle

12 Carbuncle Large deep abscess that is a progression of a furuncle
May be 3-10 cm in size Can present c fever/chills Tx: drainage & antibiotics

13 Cellulitis

14 Cellulitis An acute inflammation of the skin
S/S: redness, swelling, warmth, & tenderness of affected area within 1-2 days of injury Cause Staph or Strep, complication of wound/trauma The borders are well defined and change rapidly Immediate attention (blood test, IV antibiotics) Facial cellulitis can cause visual damage if spreads to the eyes NEVER MISS THIS ONE!!!!

15 Acne

16 Acne Obstruction of sebaceous follicles (oil glands)
Open comedones or closed comedones Usually on the face, chest, back Causes: Stressful events (hormonal changes) Friction acne Oil based cosmetics NO correlation between chocolate, chips or colas Tx: topical +/or oral antibiotics

17 MRSA

18 MRSA Methicillin-resistant Staphylococcus aureus
“super-bug” – caused by staph, unnecessary antibiotic use Outwits all but the most powerful of drugs – vancomycin Enters through cuts & wounds Types: CA (community acquired) or HA (Hospital acquired) S/S: small red bumps that resememble pimples, quicky turn to painful abscesses that can burrow deep into the body, swelling, redness, pus Risk Factors: recent hospitalization, long-term care, recent antiobiotic use, young age, contact sports, sharing towels, weak immune system, living in groups, health-care workers Dx: Tissue sample – 48hrs Tx: trial & error c strong antiobiotics Prevention: WASH HANDS, surfaces, cover wounds, use only personal items

19 Tinea Pedis

20 Tinea Pedis Fungal infection - Athlete’s Foot
Rash presents as vesicles/erosions on the soles of the foot as well as between toes Dx: examine scraping under microscope Tx: antifungal cream/powders (micronazole), keep feet dry

21 Tinea Cruris

22 Tinea Cruris Fungal infection – Jock itch
Red/scaly rash on inner thighs/inguinal creases; occasionally the buttock, not scrotum or labia Common in obese patients & athletes in tight fitting clothes Common in hot/humid weather Tx: topical antifungal creams

23 Tinea Versicolor

24 Tinea Versicolor Fungal infection of the skin
Multiple patchy lesions (oval shape c fine scales) either light in color or brown Typically occurs on the back, neck, chest, shoulders More prominent in the summer when the affected areas do not tan Recurrence is common Tx: Topical antifungal

25 Tinea Corporis

26 Tinea Corporis Fungal infection of skin - Ring Worm
Well defined circular patches with scaly borders Found on non-hairy surfaces – face, arms, legs, truck Occurs after contact c another person/object that is carrying the fungus Common confused c eczema Tx: topical antifungals (Micronazole, ketoconazole not Nystatin)

27 Toenail Fungus

28 Toenail Fungus S/S:yellow, think nails, painful, brittle, more likely in toenails d/t dark, moist environment Tx: Lamisil, vicks, takes 6-12 months

29 Pediculosis

30 Pediculosis Lice; six-legged wingless insect
The louse is a grayish/black colored insect ~4mm long The nits are gelatinous white color ~.8mm long Can be found in the head, body or pubic hair They pierce the skin and secrete saliva which causes itching, lay eggs close to scalp Spread by shared hats, towels, combs, bedding, clothing, upholstery & headphones Tx: Shampoo – Nix, Rid; fine tooth comb, boil clothing/bedding, dry cleaning

31 Scabies Very contagious STD Intense itchy rash, with linear burrows
Tx: Kwell or Elimite (topical creams) Wash bedding/clothing in HOT water & stored for 2-3 days

32 Herpes Simplex

33 Herpes Simplex Viral infection either Type I OR Type II
“You can’t kill it and it won’t kill you” Clear papules c superficial ulcerations/erosions May cause fever, lymph node enlargement, burning pain Lesions will crust over in 5-14 days Tx: analgesic for pain, oral antiviral (acyclovir)

34 Herpes Zoster

35 Herpes Zoster Shingles, a reactivation of varicella zoster (Chicken pox) virus It remains in the cells of nerve roots in an inactive state (after exposure as a youth) Unknown reasons for reactivation Re-exposure to virus Immunosuppressant issue Some drugs Result in vesicles on a red base in a band-like distribution Painful rash, prickly nerve pain Tx: symptomatic, pain, calamine lotion

36 Verruca

37 Verruca Warts; caused by human papillomavirus Verruca plantaris –
Verruca vulgaris – Round, flesh colored and grow to be yellow-ish tan 1cm or more wide 65% will resolve spontaneously Tx: destruction of epidermal cells that contain virus; cryogenically, chemically

38 Molluscum Contagiosum

39 Molluscum Contagiosum
Viral infection of skin/mucous membrane Single or multiple flesh colored, dome shaped papules c central umbilication Found on face, trunk, extremities, lips/tongue, genitals Very contagious – self and others Common in swimmers/wrestlers Tx: curettage, silver nitrate to chemically burn the lesions

40 Dermatitis

41 Dermatitis Inflammation of the superficial dermis/epidermis
Atopic Dermatitis: Heriditary disorder – may also have Hx of asthma, allergic rhinitis, rash Usually along cheeks, face, trunk, extensor surfaces of extremities Dry and papular rash, scratching makes it worse, d/t loss of natural oils in skin Aggravated by stress, anxiety, dry conditions Tx: good lotions & rehydration of skin Contact Dermatitis: Papular and itchy rash resulting from contact c an allergen Commonly – nickel (cheap jewelry, buckles), soaps, perfumes, cosmetics, posion ivy/oak Tx: Cortisone cream (anti-inflammatory agent)

42 Hives

43 Hives An allergic reaction resulting in histamine release
Well defined wheals (solid elevations c central clearing) Extremely itchy & may result in angioedema Allergy can be to virtually anything Tx: antihistamines

44 Eczema

45 Eczema Dryness of the epidermis Usually seen on extremities/trunk
Worse in winter or when bath too much Rash is itchy, red, scaly, patchy c a cracked appearance 2ndary bacterial infections d/t scratching Tx: lotion/creams to hydrate, topical corticosteroids

46 Proper Skin Care Frequency of showers
Not so much soap/appropriate type Use creams, not lotions

47 Psoriasis

48 Psoriasis Inherited skin disorder of increased epidermal cell turnover & thickening of the epidermis Thick silvery scales Common on the elbows, knees & feet Tx: UV light or high potency corticosteroids Severe cases need to be hospitalized for a tar ointment or methotrexate

49 Sebaceous Cysts

50 Sebaceous Cysts Benign slow growing lesions
Solitary skin nodules as a result of proliferation of epidermal cells that secrete protein called keratin Contains pasty, cheesy looking secretion Common on eyelids, neck, face, trunk, scalp Benign slow growing lesions No treatment necessary unless problems c ADLs

51 Frostbite

52 Frostbite Actually freezing of tissue @ cold temps
Generally affects the exposed area (Toes, feet, fingers, nose, cheeks, ears) Skin becomes cold, waxy, white, gray, black Early stages – chillblaines-redness, painful Late stages – cyanosis, gangrene, edema, no pain Tx: cover c warm compress, rapid re-warming in water, hands between legs, armpits Avoid pressure on tissue, even light

53 Skin Checks – Moles/Cancer

54 Moles/Cancer Look for: Think of outdoor sports Males – check the head
1. No bigger than an eraser tip 2. Stand out mole on the back 3. Irregular border 4. different colors Think of outdoor sports Tennis, golf, soccer Males – check the head Females – check the ears and lips

55 Sunburn

56 Sunburn Superficial burn – only epidermis >15 suncreen
10-2pm is most intese hours, worse in snowy, watery environments Every time you burn c blisters….increases your chances of getting skin cancer 4x Tx: analgesic sprays, lotion…..not oil based

57 Striae

58 Striae A streak or a linear scar
Results from rapidly developing tension in the skin Common in pregnancy or when you gain weight fast…..steroid use


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