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PHM 114
Chapter 5
| Question | Answer |
|---|---|
| Integumentary System | Refers to the dermatologic tissue that covers the body and includes skin, nails, and hair |
| Skin | Is the largest body organ that accounts for 10 % of body weight. |
| What are the 3 layers of the skin? | Epidermis. Dermis. Subcutaneous tissue |
| Epidermis | The outermost layer |
| Dermis | The living functioning layer of skin where hair follicles and nail beds form. Contains sweat, sebaceous, and ceruminous glands |
| Melanocytes | Provide skin pigmentation |
| Sweat Glands | Found all over the body and produce watery secretions, including pheromones and other odorous material |
| Sebaceous Glands | Secrete oil for hair and skin lubrication |
| What does natural skin aging involve? | loss of collagen and elastin in the dermis |
| What are the different types of skin cancer? | Squamous cell carcinoma. Basal cell carciinoma. Melanoma |
| What are the 4 signs of skin cancer with legions? Also referred to as the "ABCDs" | 1. Asymmetry(one half unlike the other half 2. Border irregularity(edges are jagged, not smooth in shape 3. Color variation(patches of tan,brown,black,red,and/or white) 4. Diameter(larger than 6 mm or the top of a pencil eraser |
| What products are encountered often to treat sun exposure? | Sunscreen and Sunblock |
| What drug therapy for sun exposure has to be applied in a physicians office by trained personnel? | Products for skin damage such as actinic keratosis or products for skin cancer |
| How does sunscreen and sunblock work? | By limiting ultraviolet radiation in the case of sunscreens or completely occluding ultraviolet light from reaching the dermis with sun blocks |
| SPF | Sun Protection Factor. Estimates the amount of resistance to burning that a product provides. The number estimates how much longer a person can be in the sun and receive the same amount of radiation effects |
| What does SPF of 8 generally mean? | Patient can spend 8 times longer in the sun than the normal time it would take to burn |
| Acne | Most common skin condition. Initiated by the overproduction of sebum |
| Sebum | Produced from glands around hair follicles |
| What appear as pores and follicles clog with oily material, dead skin cells, and dirt from the skins surface? | Pimples.Blackheads.Whiteheads |
| What can severe forms of acne such as nodular acne and acne vulgaris cause? | Deep cysts that permanently damage the dermis layer. Visible scars and pockmarks can form |
| What type of medication is needed for severe acne? | Prescription. Mild can be treated with OTC drugs |
| Rosacea | Is categorized as acne. It is a chronic inflammatory disorder seen in adults and characterized by redness, visible surface blood vessels, and raised bumps or pustules on the face and cheeks. Sunlight or extreme temps worsen condition |
| Dandruff | A malfunction of the oil producing glands around hair follicles on the scalp. Layers of epidermis sticking together and flaking off |
| What is the first line treatment for mild to moderate acne? | To cleanse the affected area daily. 2 times a day. |
| What does treating repeated acne lesions start with? | OTC products such as benzoyl peroxide. |
| What type of agents are used for severe acne? | Starts with topical then progresses to oral agents when needed |
| What oral agents are used to treat acne? | Erythromycin,Tetracyclin,Doxycycline,Minocycline,Clindamycin (antibiotics) |
| What is used for Rosacea? | Metronidazole and azelaic acid |
| What agents when treating acne has more side effects? | Oral |
| What are the mainstays of treatment for mild acne? | Benzoyl perozide and salicylic acid |
| What is benzoyl peroxide? | Bleaching agent that promotes cell turnover in follicles. It produces oxygen, which is toxic to the bacteria that cause pimples |
| Is benzoyl peroxide avaliable for both OTC and Prescription? | Yes |
| What is salicylic acid? | Keratolytic agent that breaks down and peels off dead skin cells, preventing them from clogging pores. |
| What is benzoyl peroxide and salicylic acid found in? | Facial cleansers.Washes.Masks in a variety of strengths |
| What are some common side effects to topical acne products? | Dryness, redness, burning, and flaking or peeling skin. Moisturizers can be applied to control these side effects. Less frequent use is recommended if side effects are bothersome |
| What are some cautions and considerations for acne products? | For external use only.Some topical antibiotic products are flammable |
| Retinoids | Vitamin A derivatives that work by increasing cell turnover in follicles, which pushes clogged material out of the pores |
| What do retinoids do for acne vulgaris? | Alter cell development and inflammatory processes to reduce swelling and redness |
| What are retinoids used for? | Severe acne as well as to reduce appearance of fine lines and wrinkles from aging |
| What drug is used exclusively for psoriasis? | Acitretin |
| What are some common side effects of retinoids? | Burning.Peeling.Dry Skin.Redness.Itching. Dont apply to close to the eyes or around the mouth. Sensitive skin may be more prone to these effects |
| What are some cautions and considerations of retinoids? | Isotretinoin cannot be used by women who are or might become pregnant because of severe birth defects that can occur |
| What is iPLEDGE? | Program that prescribes and dispenses isotretinoin. Woman must agree to use effective contraception and submit to regular pregnancy test. And should not donate blood for up to 1 month after taking it |
| What is the active ingredients used most in dandruff products? | Selenium sulfide and Pyrithione zinc. Available OTC in shampoo such as head and shoulders and selsun blue |
| What are coal tar shampoos? | Shampoos including Neutrogena T/Gel. Also available OTC but most used in severe cases |
| Which dandruff product is both OTC and prescription? | Nizoral Shampoo |
| What causes fungal infection of the skin? | Dermatophytes and Candida albicans which is a yeast. They infect skin, nail beds, and even mucous membranes such as those inside the mouth |
| What causes ringworm, athletes foot, and jock itch? | Tinea |
| Herpes Simplex virus | Type 1. Causes cold sores |
| Herpes Zoster | Causes shingles |
| Shingles | Inflammation and reemergence of a systemic viral infection but it affects nerve pathways near the skin and manifests as painful skin lesions |
| Genital Herpes | Secually transmitted disease that manifests in chancre sores on the skin |
| Human Papillomavirus | HPV- Particularly problematic. Causes genital warts and has been linked to cervical cancer |
| Impetigo | An example of a skin infection cause by S. aureus. Typpically occurs in children and is characterized by pus filled blisters that break to form a yellow crust |
| What are some common side effects of skin infection antibiotics? | Burning.Stinging.Pain.Rash.Dry skin.Swelling.Redness. If used near nose:Headache.Runny nose.Respiratory congestion.Sore throat. Keep away from eyes and other mucous membranes |
| What are cautions and considerations of skin infection antibiotics? | For external use only |
| What are 2 types of parasitic insects that use the human body as a host? | Lice and Scabies |
| Lice | Feed on human blood which cause intense itching. Lifespan is 40-45 days. Lay eggs on hair follicles next to skin which hatch in about 8 days |
| What are the 3 different types of lice? | Head lice. Body lice. Crabs (pubic lice) |
| Head lice | Passed form person to person through direct contact or by sharing hats, hairbrushes,clothing, or bedding |
| Pubic lice | Very small and passed only through sexual contact. Symptoms include intense itching that may resemble dermatitis |
| Scabies | Insects that burrow into the epidermal layer of the skin and feed on cellular material there. Very small and difficult to see. Burrows are visible as grayish/white wavy lines. Slightly raised |
| What are some common side effects for lice and scabies medication? | Pyrethrin and permethrin include mild itching.burning.tingling.numbness.rash in are of application.headache.dizziness.diarrhea.nausea.vomiting |
| What are the side effects of lindane used for lice and scabies? | Possibly life threatening. Follow instructions carefully. Seizures and even death have occurred when used incorrectly |
| How much lindane should be used? | No more than 2 ounces. Should wash product off in eight to twelve hours to reduce systemic absorption |
| What are the 2 major types of hair loss? | Androgenic alopecia and Alopecia areata |
| Androgenic alopecia | More common. Hair follicles shrink in size and produce finer hair |
| Alopecia areata | Chronic inflammatory disorder affecting hair follicles and may cause areas of complete hair loss. Can affect nail beds |
| What is the most common drug used for hair loss? | Minoxidil(rogaine). Improves blood flow to the scalp and stimulates resting hair follicle. OTC. Takes 4 months or longer to work |
| Dermatitis | Itchy inflamed skin that can be caused by a variety of factors. Severe cases can result in blisters and oozing erosions on the skin. Symptoms include redness, dry flaky skin, raised bumpy skin, and pruritus |
| Contact Dermatitis | Occurs in response to exposure to irritants or allergenic substances. Rash appears whenever skin has come into contact with offending substance such as soaps, detergents, or poison ivy |
| Cradle Cap | A greasy, scaly area on the skin that is sometimes colored red, brown, or yellow. Usually first shows up in infants and occurs in areas where sebaceous follicles are concentrated, such as the scalp, ears, upper trunk, eyebrows, and around the nose |
| Eczema | A chronic condition that usually occurs first in childhood and can continue into adulthood. Atopic dermatitis is not well understood but has an immunologic component in that patients tend to have elevated levels of IgE in their blood |
| Psoriasis | Immunologic condition affecting T cell activity in the skin. Manifests on skin as patches that are raised, silvery or white, flaky, and pruritic. Any where on body.Has cycles of remission |
| Diaper rash | Most frequently occurs in children who are not yet toilet trained but can occur in adults who wear absorbent undergarments |
| What is usually the first choice of therapy for dermatitis, eczema, and psoriasis? | Corticosteroids |
| Immunomodulators include biological therapies such as what? | Adalimumab(humira) and Etanercept(enbrel) |
| Calamine | Relieves mild itching from insect bites, rashes, hives, poison ivy or oak, and other allergic reactions. |
| What are topical corticosteroids used for? | Contact dermatitis,eczema,psoriasis,allergic reactions |
| What are some common side effects of corticosteroids? | Burning,Itching.Dryness.Hair growth.Dermatitis.Acne.Hypopigmentation.Skin thinning |
| What are cautions an considerations of corticosteroids? | Super potent corticosteroid products are restricted in the length of treatment or total amount used in order to reduce the potential for systemic absorption and HPA suppression. Should not be used for longer than 2 consecutive weeks |
| Calcuneurin Inhibitors | Medications that are immmunomodulators that work by inhibiting T cell activity |
| What is used for severe eszema, especially when topical corticosteroids have not worked? This is available in cream, ointment, solution, and capsules | Elidel |
| Decubitus Ulcers | Pressure sores which are severe wounds that involve tissue damage through the epidermis and dermis layers. Caused by constant pressure applied to an area of skin usually from lying down in one position to long. |
| Bedsores | prominent in patients who are bedridden. Appear in areas where skin covers bony protrusions that receive constant pressure when lying or sitting down or from frequent friction and rubbing on sheets, casts, or braces |
| What are burns caused by? | heat and thermal injury or by elecrical and chemical sources. When burns are extensive, treatment and prognosis depend on the severity and amount of body surface area affected |
| What is the most prominent sign of allergy? | Skin rash |
| What is a frequent side effect of many drug therapies? | photosensitive |
| Photosensitive | Excessive response to solar exposure, wherein skin easily burns after a short time in the sun |
| What do rashes from drug allergies appear as? | Urticaria(hives) and pruritus or redness |
| When an allergic reaction occurs while taking a drug what should the patient do? | Alert pharmacist immediately because it could be life threatening if you continue to take drug |
| What drugs are used to treat allergic reactions? | Antihistamines, corticosteroids, and epinephrine |
| Stevens-Johnson Syndrome | Rare but life threatening skin reaction. Begins as localized rash but if not treated can progress to skin sloughing off. Severe infection and temp regulation problems can occur |
| What herbal and alternative therapies are added as moisturizers to creams and lotions? | lanolin,cocoa butter,vegetable or seed oils |
| What herbal and alternative therapies are emollients added to moisturizers to promote skin health and healing? | Vitamins E,A,D |
| Aloa vera | Mostly used for mild psoriasis and burn wound healing. |
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Tara3184
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