shortcut to skin lesions2.ppt
TRANSCRIPT
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MaculeMacule- small flat lesion
with altered color(0.5 cm)
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PatchPatch
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PapulePapule- elevated, well-
circumscribedlesion (0.5 cm)
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N oduleN odule
- mass located indermis or SQ fat
- May be solid or soft
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T umorT umor
- Large nodule
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V esicleV esicle
- Blister withtransparent fluid
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BullaeBullae
- Large V esicle
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PRIMARY LESIO N SPRIMARY LESIO N SCircumscribed, flat,non-palpable
Palpable elevatedsolid masses
Circumscribed superficialelevations formed by freefluid in a cavity w/in skinlayers
1. m acule- up to 1cm
1. papule - up to 0.5cm
1. vesicle - up to 0.5cm, filled w/ serous
fluid2. patch- larger than1 cm
2. plaque -flat,elevated surfacelarger than 0.5cm
2. bullae- >0.5cm
3. nodule - largerthan 0.5cm,
3. pustule - filled w/pus
4. tu m or - largenodule
5. wheal - irregular
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ScaleScale
- A small, thin plateof horny epithelium
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PustulePustule
A well-circumscribedelevated lesion filled
with pus
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CrustCrustExudative mass
consisting of blood,scale and pus fromskin erosions orrupturedvesicles/pustules
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U lcerU lcer
Erosion of dermis and cutis with clearly
defined edges
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ScarScarFormation of new
connective tissueafter damage toepidermis and cutisleaving apermanent changein skin
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ExcoriationExcoriation
Surface marks often linear secondary
to scratching
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FissureFissure
Linear skin crackwith inflamationand pain
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W artW art
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FreckleFreckle
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1. S cales ( squa m ae) are shedding, deadepidermal cells that maybe either dry or greasy
eg. Dandruff and psoriasis
2 . C rusts - variously colored masses of skinexudates
eg. Impetigo and infected dermatitis
3 . Ex coriations - abrasions of the skin, they areusually superficial and traumatic
eg. Scratched insect bites and scabies
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4 . F issures - linear breaks in the skin that aresharply defined and have abrupt walls
eg. Congenital syphilis and athletes foot5 . U lcers - irregularly sized and shaped evcavations
in the skin that extend into the dermis orcorium
eg. V aricose ulcers of the leg and cutaneoustuberculosis
6 . S cars - formation of connective tissue that replacethe normal tissue lost through injury or
disease7 . K eloids - hypertrophic scars8 . L ichenification - diffuse thickening and scaling
with a resulting increase in skinlines and markings
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Atopic DermatitisAtopic Dermatitis
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Atopic DermatitisAtopic Dermatitis Acute : Erythe m atous papules, vesicles, plaques, e x coriations,
crusting, scalingChroni c: Erythe m atous to hyperpig m ented lichenified
papules/ plaquesAreas of Predilection :I nfancy : Face and scalp, e x tensors, trunk Childhood : F le x orsD x :M AJOR CR IT ER I A :
1. T ypical m orphology and distribution2 . Pruritus3 . Personal or fa m ily h x of atopy : chronic or chronically
relapsing h x
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MIN OR CR IT ER I A :1. X erosis2 . Periauricular fissures3 . I chthyosis4 . H yperlinear pal m s5 . K eratosis pilaris6 . I g E reactivity7 . H and/foot der m atitis8 . C heilitis9 . S calp der m atitis10. S usceptibility to cutaneous infections11. Perifollicular accentuation
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M AN AG EM ENTM AN AG EM ENT
1. Proper bathing techniques2 . L iberal use of e m olients- petrolatu m is the best3 . Avoidance of irritants4 . M edications : T opical/ syste m ic steroids; sedating anti
hista m ines; antibiotics; topical anti- pruritics
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ScabiesScabies
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S cabiesS cabiesT rans m ission : fro m hu m ansM orphology : Erythe m atous papules, vesicles, plaques + /-
e x coriations, crusting linear burrows, nodulesAreas of Predilection : Older children : I nterdigital webs,
a x illae, fle x ures of ar m s/ wrists, beltline, genitalia, buttocks
I nfants and younger children : Above + pal m s, soles, head, face, trunk
Assocd Features : intense pruritus; si m ilar eruptions in other fa m ily m e m bers
D x : De m onstrate scabies m ite, ova or feces using m ineral oil prep
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MAN AGEMENTMAN AGEMENT -- Proper useProper use of Topical of Topical ScabicidesScabicides
1. Apply to whole body, fro m neck down proble m areas, u m bilicus, underneath the fingernails
2 . I f scalp and face involved, apply but be wary of the eyes and m outh
3 . All household contacts should be treated within sa m e 2 4 -4 8 hr period
4 . After the prescribed contact ti m e elapses, m ake sure the scabicide is washed off thoroughly with soap and water .
Ex a m ples :
1. Per m ethrin 5% crea m2 . 1 % Lindane lotion3 . 5- 10 % precipitated sulfur in petrolatu m ( sulder m )
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Seborrheic DermatitisSeborrheic Dermatitis
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Seborrheic DermatitisSeborrheic Dermatitis
M orphology : T hin, dry whitish scales or sharply definedraised or oval patches covered by thick, yellowish browngreasy crusts +/- underlying erythema
Areas of Predilection : scalp, central face, ears, flexures,
umbilicus, trunk, diaper area
Associated Features : pruritus if (+) usually mild
M anage m ent :1.Mineral oil2. Keratolytics: 1-2% salicylic acid in petrolatum3. Anti- sebborrheic shampoos4. Low potency topical steroids5. Antifungals
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ImpetigoImpetigo
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I m petigoI m petigo
M orphology : erythematous macules- thin roofed vesicles orbullae surrounded by halo of erythema honey coloredcrusts
Areas : face, trunk, extremitiesE tiology : S. aureus, GABHS
Assocd Features : fever, regional adenopathy, mild pruritus,may occur on intact or previously injured skin
M anage m ent :
1. Antibiotics: T opical: mupirocin, fucidin2. Systemic: PC N , cloxa, cefalexin, erythromycin,
clindamycin3. W arm compresses: 400 ml + tsp salt
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Erythema T oxicumErythema T oxicum- MC rash in infants- w/in 1-2 days after birth- Blotchy erythematous plaquew/ central vesico-pustules seen
on trunk and face-resolve in 5 daysPathology :
- peripheral blood eosinophiliaT x :
- N o need
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Acne N eonatorumAcne N eonatorumPathogenesis :
-seen in 50% of N B w/in 1 st mo.of life
-inc. of circulating androgens w/cis transient
CP :
-comedopapules seen on face,trunk and even in groin
Pathology :
-pilosebaceous canal is filled w/keratin & sebaceous glandsare hypertrophied
T x : -drying, keratolytic lotions
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Acne V ulgarisAcne V ulgarisAcne is the result of obstruction
of sebaceous follicles, locatedprimarily in the face andtrunk, by excessive amountsof sebum and desquamated
epithelial cells. T he residentanaerobic organism,Propionibacterium acnes ,proliferates and produceschemotactic and inflammatorymediators that lead to
inflammation.
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T hank You!T hank You!