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Dermatology. Anatomy Skin Infections  Bacterial  Impetigo  Folliculitis  Furuncle  Carbuncle  Cellulitis  Acne  Fungal /Parasitic  Tinea Pedis.

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Presentation on theme: "Dermatology. Anatomy Skin Infections  Bacterial  Impetigo  Folliculitis  Furuncle  Carbuncle  Cellulitis  Acne  Fungal /Parasitic  Tinea Pedis."— Presentation transcript:

1 Dermatology

2 Anatomy

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

4 Skin Infections  Viral  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  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  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  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  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  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  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  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  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  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  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  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  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  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  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  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  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  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  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  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  2 nd ary 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  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  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  Actually freezing of 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: 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  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  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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