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Derm 1
Lect 1
| Term | Definition |
|---|---|
| Melanocytes | pigment cells in dermis layer |
| Langerhans cells | immune system cells in dermis layer |
| Merkel cells | mechanoreceptors in dermis layer |
| What cells are contained in Dermis? | melanocytes, Langerhans cells, and Merkel cells |
| What are the layers of the skin? | epidermis, dermis, hypodermis |
| Describe the epidermis cells and thickness. | outermost layer composed of stratified squamous epithelium thickness ranges: 0.05mm (eyelid) to 1.5mm (palms and soles) |
| What are the steps in methodical approach for a derm pt? | History, history, history, physical exam, diagnostics, treatments and re-assessment |
| What acronym-based and other methodical questions should you ask when obtaining derm patient history? 8 total | 1. OLDCARTS 2. Associated symptoms 3. FHx 4. Medical Hx 5. Surgical Hx 6. Occupation and hobbies 7. Allergies 8. Current medications and previously attempted |
| Onset | knowing if the symptoms occurred all of the sudden or were they had a gradual onset |
| Location | where is the complaint on skin, do the symptoms radiate |
| Duration | how long has this been bothering you or have you had any previous encounters |
| Character | itching, burning, stabbing pain, etc |
| Aggravating factors | what makes the symptoms worse (ex/ certain lotions, etc.) |
| Relieving factors | what makes the symptoms better |
| Timing | is it better or worse at certain times? Also, what is the timing of the events leading up to symptoms? |
| Severity | 1-10 (10 being severe pain) |
| Why important to ask about associated symptoms or do Review of Symptoms (ROS)? | Many skin symptoms are sequela of other disease processes (heart disease, SLE, etc.) |
| Why important to ask about hobbies work of patient? | the pt may be exposed to certain chemicals or substances that are causing dermatological symptoms |
| What does OLDCARTS stand for? | Onset, Location, Duration, Character, Aggravating factors, Relieving factors, Timing, Severity |
| Why important to ask about current medications or attempted treatments? | failed treatments can exclude other diagnoses ex/ steroids would aggravate a fungal condition |
| Describe methodical approach to dermatological Physical Exam? | 1. Examine where started 2. Identify old/ new lesions to determine if different; are lesions primary or secondary finding 3. Identify the distribution of the rash or lesions by examining pt completely, disrobe if necessary 4. do pertinent physical exam |
| Describe methodical approach to differential diagnoses of derm pt. | Differential diagnoses= a list of possible diagnoses Order: most likely, most deadly, most common, zebras (refers to regionally-based areas and possible diagnosis) |
| What are some Dermatology-specific tests? | biopsy, patch test (allergies), skin scrapings of scaly, or dry lesions (KOH for fungal, gram stain for bacterial), cultures (fungal, bacterial, viral), Tzank smear (herpes virus), Wood's light (fungal, dermatophyte) |
| What are some procedural treatments? | cryotherapy, laser therapy, excision |
| What are medications for treatment? | topical, intralesional (per-cutaneous injection), systemic (oral) |
| What education to provide patient? | advise patient on 1. What to expect (peeling, dryness, or concerning side effects) or things to avoid (ex/ sun or bath w/ stitches) 2. Return precautions (ex/ if worsens with steroid Tx) 3. when to do follow up and why |
Created by:
mrjohnson78
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