Integumentary Pathologies

Question 1

Cellulitis

Answer 1

• fast spreading inflammation that occurs as result of bacterial infection of the skin and connective tissues
• can develop anywhere under the skin but typically affects the extremities

Question 2

cellulitis etiology

Answer 2

• caused by particular bacterial infections including streptococci or staphylococci
• predisposing factors include increased age, immunosuppression, trauma, the presence of wounds or venous insufficiency

Question 3

cellulitis s/s

Answer 3

• localized redness that may spread quickly
• skin that is warm or hot to touch
• local abscess or ulceration
• tender to palpation
• chills
• fever
• malaise

Question 4

cellulitis treatment

Answer 4

• should be immediately referred to a physician
• requires pharmacological intervention usin systemic antibiotics
• differential diagnosis should attempt to rule out deep vein thrombosis and contact dermatitis
• can lead to sepsis or gangrene

Question 5

contact dermatitis

Answer 5

• superficial irritation of the skin resulting from the irritation (poison ivy, latex, soap, jewelry sensitivity)
• can be acute or chronic based on exposure
• very common that can occur at any age

Question 6

contact dermatitis etiology

Answer 6

• occurs with exposure to mechanical, chemical, environmental or biological agents
• nickel, rubber, latex, and topical antibiotics are common precipitating agents

Question 7

contact dermatitis s/s

Answer 7

• intense itching
• burning
• red skin in areas of irritation
• edema
• symptoms can expand beyond the initial point of topical irritation

Question 8

contact dermatitis treatment

Answer 8

• should focus on identifying and removing the source of irritation
• topical steroid application is commonly employed

Question 9

eczema

Answer 9

• used to describe a group of disorders that cause chronic skin inflammation typically due to an immune system abnormality, allergic reaction or external irritant

Question 10

eczema etiology

Answer 10

• based on the particular form of the disorder
• infants and children are at higher risk for eczema but outgrow the condition with age
• geriatric population is at an increased risk

Question 11

eczema s/s

Answer 11

• red or brown-gray, itchy, lichenified skin plaques that may be exacerbated by some topical agents such as soaps and lotions
• younger population with experience oozing and crushing of the patchy areas of irritation

Question 12

eczema treatment

Answer 12

• pharmacological vary from topical to oral corticosteroids to oral antibiotics and antihistamines

Question 13

gangrene dry

Answer 13

• loss of vascular supply resulting in local tissue death
• fingers, toes, and limbs are often most affected
• hardened tissue is not painful
• may be significant pain at the line of demarcation
• typically develops slowly and in some cases results in auto amputation

Question 14

gangrene dry etiology

Answer 14

• most commonly in blood vessel disease such as diabetes or atherosclerosis
• develops when blood flow to an affected area is impaired
• infection is not typically present however it can progress to wet gangrene if infection occurs

Question 15

gangrene dry s/s

Answer 15

• presents with dark brown or black nonviable tissue that eventfully becomes a hardened mass
• patient may complain of cold or numb skin and they may present with pain

Question 16

gangrene dry treatment

Answer 16

• may be treated with pharmacological intervention, surgery, and hyperbaric oxygen therapy

Question 17

gangrene wet

Answer 17

• referred as wet if there is an associated bacterial infection in the affected tissue
• may develop as a complication of an infected untreated wound
• swelling resulting from te bacterial infection causes a sudden stoppage of blood flow

Question 18

gangrene wet etiology

Answer 18

• can develop after a severe burn, frostbite, or injury and requires immediate treatment since it can spread quickly and be fatal
• there is a cessation of blood flow that starts a chain of events including invasion by bacteria at the affected site
• as a result of the occluded blood supply, the white blood cells are unable to fight the infection

Question 19

gangrene wet s/s

Answer 19

• swelling and pain at site of infection
• change in skin color from red to brown to black
• blisters that produce pus
• fever
• general malaise

Question 20

gangrene wet treatment

Answer 20

• requires immediate medial intervention
• surgical debridement of the gangrene and intravenous antibiotic treatment are typical
• can be treated via pharmacological intervention, surgery, and hyperbaric oxygen therapy

Question 21

onychomycosis

Answer 21

• fungal infection that primarily affects the toenails and nailbeds
• divided into subtypes but treated fairly the same

Question 22

onychomycosis etiology

Answer 22

• acquiring a fungal infection can be a fairly common
• risk factors include manicures and pedicures with unsteril utensils, possessing nail injuries or deformities, excess skin moisture, wearing closed toe shoes, and an impaired immune response

Question 23

onychomycosis s/s

Answer 23

• yellow or brown nail discoloration

- hyperkeratosis and hypertrophy of the nail causing to partially detach from the nailbed

Question 24

onychomycosis treatment

Answer 24

• manual debridement of nail and topical antifungal medications
• fungal infections may return
• nailbeds may have permanent damage

Question 25

plaque psoriasis

Answer 25

- most common of five types of psoriasis - chronic autoimmune disease of the skin - T cells trigger inflammation of within the skin and produce an accelerated rate of skin cell growth - skin cells accumulate in raised red patches on the surface of the skin

Question 26

plaque psoriasis etiology

Answer 26

- some have genetic predisposition - other factors may trigger psoriasis such as injury to skin, insufficient or excess sunlight, stress, excessive alcohol, HIV infection, smoking, or certain medications

Question 27

plaque psoriasis s/s

Answer 27

- red raised blotches that present in bilateral fashion - appear anywhere on the body and will itch and flake - complications can include arthritis, pain, severe itching, secondary skin infections, and side effects secondary to pharmacological interventions

Question 28

plaque psoriasis treatment

Answer 28

- primary goal for treatment is to control the symptoms and prevent secondary infection - varies widely from topical application to systemic medications and phototherapy - is a life long condition that can be effectively managed

Question 29

tinea pedis

Answer 29

- referred to as athletes foot - superficial fungal infection which causes epidermal thickening and a scaly skin appearance - will rapidly multiply in a warm and moist environment

Question 30

tinea pedis etiology

Answer 30

- risk factors include wearing closed toe shoes that dont allow airflow, prolonged periods of moisture or wetness, excessive sweating, and possessing small nail or skin abrasions - infection is contagious through direct contact or when making contact with a surface containing the tinea pedis

Question 31

tinea pedis s/s

Answer 31

- itching - redness - peeling skin between the toes - pain - odor - and in more severe cases breaks in skin continuity

Question 32

tinea pedis treatment

Answer 32

- pharmacological intervention includes topical or oral antibiotics - may persist or recur - prevention includes thorough drying of feet when bathing or swimming, wearing sandals around public pools or showers, changing socks frequently, proper hygiene, and avoided shoe wear that creates a moist environment