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acute/chronic skin
patho exam 3
| Question | Answer |
|---|---|
| acute skin conditions | bacterial or fungal infection, contact with offending organism or allergen, medications |
| acute skin conditions have a possible transition to... | chronic skin conditions |
| acute skin disorders pain from... | damage to first layer of skin |
| immune system and intact skin... | protect body |
| impaired tissue integrity leads to? | immune response |
| immune response from allergy and inflammation can? | lead to lack of tissue integrity |
| alterations in tissue perfusion can lead to... | damage or necrosis |
| cellulitis | diffuse painful inflammation of skin and subcutaneous layers induced by a bacterial infection that enters through a break in the skin |
| what population does cellulitis occur in? | adult population |
| cellulitis clinical manifestations | painful, red, swollen area of skin; hot, tender to touch. fever and chills. vesicles, bullae, plaques (with Staphylococcus). tachycardia, hypotension, confusion, headaches, lymphadenitis, and lymphangitis |
| impetigo | superficial acute, highly contagious skin infection |
| impetigo etiology and pathogenesis | colonization facilitated by high temperature, humidity, preexisting skin disorders, ages 2-5, recent antibiotic treatment |
| furuncle | extension of folliculitis or infection of sebaceous gland. spreads down hair shaft through follicle and into dermis |
| carbuncle | cluster of infected hair follicles. the cluster coalesces to form lesion filled with pus, dead tissue, fluid |
| candidiasis | infection of skin or mucous membranes with any species of Candida (c. albicans most common); usually secondary condition |
| where does candidiasis occur | mouth, throat, lungs, vagina, folds of skin, bowel |
| candidiasis etiology and pathogenesis | normal in skin and mucous membranes; warmth, moisture, breaks in epidermis can cause infection; life threatening if in bloodstream |
| candidiasis clinical manifestations: thrush | white covering of tongue, mouth, throat |
| candidiasis clinical manifestations: vaginal yeast infection | itching, foul odor, white discharge |
| candidiasis clinical manifestations: balanitis | flattened pustules, edema, burning, tenderness |
| candidiasis clinical manifestations: diaper rash | dark red patches in skin folds, fluid filled spots |
| tinea | contagious infection by different types of fungus; superficial infections called dermatophytoses |
| how is tinea named? | by location on body |
| tinea pedis | athlete's foot, which affects the feet with symptoms like itching, scaling, and blisters between the toes |
| tinea cruris | jock itch, a rash in the groin area |
| tinea capitis | ringworm of the scalp. cause itchy, red patches and hair loss |
| tinea corporis | ringworm on the body, appearing as a ring-shaped rash |
| tinea versicolor | discolored, scaly, and dry patches on the skin |
| necrotizing fasciitis | flesh eating disorder, rapidly spreading infection caused by aerobic and anaerobic bacteria |
| necrotizing fasciitis etiology and pathogenesis | starts from contagious ulcer, wound, untreated skin infection, complication of surgery, abscess; occlusion of small subcutaneous vessels; tissue ischemia, infarction, necrosis |
| stevens-johnson syndrome | rare disorder of skin and mucous membranes- cell death causes epidermis to separate from dermis |
| stevens-johnson syndrome etiology | more than 200 medications, infectious causes, delayed hypersensitive reaction |
| stevens-johnson syndrome clinical manifestations | flulike symptoms, symmetric burning rash; red; purple |
| toxic epidermal necrolysis (TEN) | inflammation of skin caused by poison |
| TEN with spots | widespread with detachment of epidermis, erosion |
| what percent of body surface area is TEN with spots? | 30% |
| TEN without spots | widespread with erythema, no lesions |
| what percent of body surface area is TEN without spots? | 10% |
| toxic epidermal necrolysis etiology | reactions to drugs; bacterial infection; malignancy; graft-versus-host disease; vaccinations |
| toxic epidermal necrolysis (TEN) clinical manifestations | flulike symptoms, rash; large blisters in center rash; ruptures; skin peels off |
| examples of common causative organisms of chronic viral skin infections | herpes simplex virus, varicella-zoster virus, human papillomavirus |
| herpes simplex virus type 1 (HSV-1) affected body regions | herpes labialis, herpes keratitis, herpetic whitlow, herpes gladiatorum, herpetic sycosis |
| most common HSV-1 infection | herpes labialis |
| where is herpes labialis? | lips, cold sores |
| where is herpes keratitis? | eye |
| where is herpes whitlow? | digits or hands |
| where is herpes gladiatorum? | torso of wrestlers |
| where is herpes sycosis? | beard follicles |
| why does HSV-1 occur? | because of stress and weakened immune system |
| when is HSV-1 usually contracted? | during childhood |
| Recurrences of HSV-1 persist into? | old age |
| Herpes simplex virus type 2 (HSV-2) causes? | most sexually transmitted angiogenital herpes; lesions on genitals, perineum, or anus |
| HSV-2 may cause? | cold sores (less common cause than HSV-1) |
| HSV-2 is likely to be contracted via? | sexual contact, typically in adolescence or young adulthood |
| fifth most common U.S. sexually transmitted infection | HSV-2 |
| 1 in _ adolescents and adults of both genders have HSV-2 | 6 |
| How does HSV enter skin or mucous membrane? (HSV etiology and pathogenesis) | via microscopic tear |
| Once HSV enters skin or mucous membrane where does it travel to? (etiology and pathogenesis) | sensory root ganglion |
| HSV 1 and 2 etiology and pathogenesis | virus become dormant and permanent resident of sensory root ganglion, cell-mediated immune system triggered, viral activation, travels from neuron to skin innervated by neuron, enters dermal and epidermal cells, replication causes recurrent rash outbreak |
| HSV-1 and HSV-2 usually begins with? | prodrome- fever or flu-like symptoms |
| clinical manifestations of HSV-1 and HSV-2 | may have asymptomatic herpes or mild fever; red, swollen area of skin or mucous membrane develops, eruption of painful vesicles, regional lymph nodes swell, lesions open and form painful ulcers that crust and begin healing |
| primary genital herpes clinical manifestations | may cause dysuria and urinary retention, especially in women |
| herpes zoster | chronic viral skin condition |
| how many people does herpes zoster affect? | about 1 million |
| what is herpes zoster also known as? | shingles |
| What is herpes zoster caused by? | varicella zoster virus |
| Varicella zoster virus (VSV) also causes? | chicken pox |
| first VZV infection causes? | chicken pox |
| First VZV infection | each skin lesion contains viral particles, viral particles travel to other structures (sensory dorsal-root ganglia or a cranial nerve), viral particles become dormant for life |
| cell mediated immunity herpes zoster | prevents virus reactivation in the form of HZ, decreases with aging |
| cell mediated immunity decreasing with aging causes increased risk for? | reactivation of VZV as HZ |
| potential complications of HZ | postherpetic neuralgia (PHN), TIA and stroke, encephalitis and aseptic meningitis, chronic eye disorders and retinal necrosis, bacterial superinfection of lesions, cranial or peripheral nerve palsies, pneumonitis, hepatitis |
| most common complication of herpes zoster | postherpetic neuralgia (PHN) |
| diagnosis of HZ | history and physical examination, laboratory testing |
| diagnosis of HZ history and physical examination usually sufficient for? | diagnosis after rash appears |
| diagnosis of HZ: atypical or recurrent rashes (more than episodes) may require? | laboratory testing to identify cause |
| diagnosis of HZ laboratory testing | direct immunofluorescent assay, PCR assay |
| warts cause | various types of Human papillomavirus (HPV) |
| sites of occurrence of warts | anywhere on skin or mucous membranes |
| warts malignancy: most lesions caused by HPV are? | benign |
| warts malignancy: some HPV types are linked to? | dysplasia and cancer |
| What is an example of HPV linked to dysplasia and cancer? | genital HPV |
| most frequently occurring sexually transmitted infection in U.S. | genital HPV |
| pathogenesis of warts | HPV, viral replication occurs in cell nuclei, HPV causes nuclear atypia, nuclear atypia triggers epidermal cell changes, wart develops |
| Pathogenesis of warts: HPV | enters skin via small openings, infects epidermal basal layer |
| pathogenesis of warts: HPV causes nuclear atypia | structural abnormality in a cell |
| pathogenesis of warts: nuclear atypia triggers epidermal cell changes | replication and hyper proliferation of keratinocytes |
| most important risk factor for certain chronic skin diseases | family history |
| examples of chronic skin disorders with a genetic component | atopic dermatitis, psoriasis, hidradenitis suppurativa |
| eczema | general term, describes inflammatory skin disorders |
| eczema includes? | atopic dermatitis |
| most severe form of eczema | atopic dermatitis |
| atopic dermatitis | chronic, recurring, itchy, inflammatory disorder |
| atopic dermatitis is associated with? | increased serum IgE |
| affected individuals with atopic dermatitis often have? | other atopic disorders (ex. asthma, allergic rhinitis) |
| atopic dermatitis most often affects? | children |
| atopic dermatitis may persist into? | adulthood |
| AD and susceptibility to infection? | dysfunctional epidermal barrier |
| clinical manifestations of AD | exacerbation and remission of dry, itchy, red skin; constant pruritis; skin excoriations and lichenification, negative impact on overall quality of life |
| AD begins in? | infancy |
| clinical manifestations of AD: constant pruritis | prevailing symptom, precedes eczematous rash |
| clinical manifestations of AD: negative impact on overall quality of life | sleep disturbances, depression |
| psoriasis etiology | immune-mediated disease, genetic and environmental causation |
| psoriasis pathogenesis | hyperproliferation of keratinocytes, decreased epidermal cell turnover rate, inflammation, proliferation of keratinocytes, thickening of dermis and epidermis |
| psoriasis manifestations | plaque psoriasis- skin lesions usually round or oval, well-demarcated plaques |
| hidradenitis suppurativa etiology | genetic, immunologic, hormonal, and environmental factors |
| hidradenitis suppurativa pathogenesis | occlusion of hair follicle via infundibular kyperkeratosis, hyperplasia follicular epithelium, collection cell wastes, cyst form apocrine sweat gland next to follicle, nodule under skin, spreads laterally, abscess/ sinus tract forms, keloid-like scarring |
| hidradenitis suppurativa manifestations | painful nodules, abscesses, and sinus tract formations; lesions develop in skinfold areas |
Created by:
camrynfoster