- synthesis of cholecalciferol (Vit. D3) in skin from cholesterol - dependent on UVB radiation from sunlight - 5 to 20 minutes per day - darker skin = more time; food sources - salmon, sardines, tuna, eel, mushrooms, eggs
-Vitamin D
Convection
The transfer of thermal energy by the circulation or movement of a liquid or gas
Conduction
The direct transfer of heat from one substance to another substance that it is touching.
known as true skin
�Contains:
�blood and lymphatic vessels
�nerves and nerve endings
�glands
�hair follicles
�network of elastic and COLLAGEN fibers (gives skin elasticity and toughness)
dermis
superficial redness of skin
; Peripheral - fingers and toes; Central - mucous membranes, tongue; Carbon monoxide posioning - CO has higher affinity to Hgb than O2 (fire smoke, exhaust, natural gas, paint and varnish fumes)
Jaundice - liver disease which i
Erythema
Rash - irritated or swollen skin
...
Cyanosis - deoxygenation
...
circular, flat discoloration - red, brown, blue (Mongolian spot) or hyopigmented - Epstein Barr virus, syphilis, HIV, German measles, rubella
Macule
raised skin < 0.5cm, solid, skin color, red, white - impacted oil gland
Papule
raised skin > 1cm, solid, flat - psoriasis
Plaque
raised > 1 cm, extends into dermis - irregular growth of skin cells, may be tumorous
Nodule
sac filled with fluid, blood, serous, purulent, or gas - abscess, ganglion cyst, ovarian cyst, bartholin gland cyst
Cyst
loss of epidermis after ruptured bulla or vesicle
Erosion
Thinning of skin, appears shinier or translucent - arterial insufficiency
Atrophy
loss of epidermis and dermis layer - venous stasis, diabetes, pressure
Ulcer
linear opening in epidermis, skin splits - dry skin, cracking - heel fissures,
Fissure
thickened or roughened skin - rubbing, scratching - Eczema, chronic dermatitis
Lichenification
red or purple spots, minor bleeding into skin - broken capillary vessels, use of blood pressure cuff
Petechiae
purple-colored spots, damaged blood vessels, blood
Purpura
ITP - Idiopathic Thrombocytopenic Purpura - low Platelets
pooling
swollen blood vessel in epidermis, contains central red spot. It is a vascular lesion characterized by anomalous dilatation of end vasculature found just beneath the skin surface. The lesion contains a central, red spot and reddish extensions which radiat
Spider angioma
collection of small blood vessels - Also known as senile angioma or Campbell de Morgan spot
Cherry angioma
dilated veins due to increased intravenous pressure
Venous Star
autoimmune disease that affects skin
Treat with Corticosteroids (Prednisone) Immunosuppressive drugs (Cyclosporine) and Antihistamines (Hydroxyzine)
Linear appearance and is a flat rash
Lichen Planus
Herpes simplex can cause Bell's palsy - facial symptoms mimic a stroke - speech and swallowing can be altered - the eye of affected side may need eye patch; extremity strength equal with no other neurological deficits - virus has affected facial nerve - t
...
is a very contagious disease caused by the varicella-zoster virus (VZV). It causes a blister-like rash, itching, tiredness, and fever.
Chickenpox
�Chickenpox can be prevented by a vaccine
�Varicella-zoster
�Treatment usually involves relieving symptoms
�Pain relievers
�Anti-itch
�Colloidal Oatmeal
...
Follows a dermatone usually linear along the nerve route
Treat with Antiviral (Acyclovir)and Corticosteroid (Prednisone)
Shingles (Herpes Zoster)
Treat with Insecticide (Permethrin)
topical
itchy mite
scabies
Treat with
Immunosuppressive
-Hydroxychloroquine
(used to treat malaria
Erythema gyratum repens (EGR)
first signs/sympstoms are: fever, unexplained widespread skin pain, red or purple skin rash that spreads blisters on your skin and the mucous membranes of your mouth, nose, eyes and genitals. Shedding of your skin within days after blisters form.
Steven-Johnson Syndrome
About half the cases of Stevens-Johnson syndrome and nearly all the cases of toxic epidermal necrolysis are caused by a reaction to a drug, most often sulfa and other antibiotics; anticonvulsants, such as phenytoin and steven carbamazepine; and certain ot
...
is a potentially life-threatening dermatologic disorder characterized by widespread erythema, necrosis, and bullous detachment of the epidermis and mucous membranes, resulting in exfoliation and possible sepsis and/or death
Toxic epidermal necrolysis (TEN)
are severe cutaneous hypersensitivity reactions. Steven-Johnson Syndrome (SJS) has skin changes that affect less than 10% of body surface area while greater than 30% of body surface area in toxic epidermal necrolusis (TEN); involvement of 15 to 30% of bod
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)
Polycyclic lesions
Treat with
Corticosteroids
Anti-inflammatories
NSAIDS
Immunosuppressive (Enbrel)
Psoriasis
hives; an eruption of wheals on the skin accompanied by itch
hypersensitivity (allergic Rx)
epipen and corticosteroids treatment if severe
uticaria
Viral Infection that presents with a painful rash that can form blisters
Very Contagious
reatment: NSAIDs, supportive care for symptoms
Hand-Foot-Mouth (Coxsackievirus)
nail fungus (onychomycosis)
�Treat with Antifungal (Lamisil)
�Treat with
�Fluconazole
�Oral Nystatin (swish and swallow)
Candida Albicans (Oral Thrush)
candida albicans is Common after course of broad spectrum antibiotics - why
because broad spectrum antibiotics kills normal flora. normal flora is our good bacteria that helps us fights pathogens.
chronic low levels of oxygen in blood for prolong periods of time.
COPD
Nail clubbing
resistant to several antibiotic
Treat with
Bactrim DS
Clindamycin
Doxycycline
Vancomycin
MRSA
�Treat with
�Doxycycline
�Chloramphenicol
�Rifampin
�High dose Ampicillin
�Nitrofurantoin
�Linezolid
�Unasyn
VRE (Vancomycin-Resistant Enterococci)
Which can cause hyperpigmentation of the skin?
Sun injury
Hyperpigmentation can be a result of sun injury.
Hypopigmentation may be caused by
a fungal infection, eczema, or vitiligo.
What would be considered a normal finding in the skin assessment of an older adult?
A.Elastic skin
B.Uneven pigmentation
C.Cherry angiomas
D.Petechiae
Uneven pigmentation
Older adults have thin, nonelastic skin that is fragile and easily injured. Uneven pigmentation is an expected finding from sun damage and the normal aging process.
Skin biopsy
detect cancer
Immunofluorescence
detect antibodies
Tzanck smear
blistering skin conditions
Patch testing
allergies
Skin scrapings
collect skin cells
Wood's light examination
black light illuminates bacteria and fungus
Is the following statement true or false?
Tzanck smear is a test used to examine cells from blistering skin conditions.
True
Tzanck smear is a test used to examine cells from blistering skin conditions.