Dermatology Problems & Solutions:

Dermatology Description Papule Macule Nodule Patch Vesicle Bulla Plaque Papule Small palpable circumscribed lesion <0.5cm         Macule Flat, circumscribed non-palpable lesion             Pustule Yellowish white pus-filled lesion       Nodule Large papule >0.5cm     Plaque Large flat topped elevated palpable lesion     Patch Large macule       Vesicle Small fluid filled blister       Bulla A large fluid filled blister       ECZEMA Synonymous with dermatitis Large proportion of skin disease in developed world 10% of population at any one time 40% of population at some time Features of Eczema Itchy Erythematous Dry Flaky Oedematous Crusted Vesicles   Contact and Irritant Eczema Exogenous Unusual Worse at workplace History of exacerbations Can occur in any individual Repeated exposure to irritants Common in housewives, hairdressers, nurses Psoriasis Affects 2%of population Well-demarcated red scaly plaques Skin inflamed and hyperproliferates Males and females equally Two peaks of onset (16- 22) and later (55-60) Usually family history Chronic Plaque Extensor surfaces Sacral area Scalp Koebners phenomenon Erythrodermic & Pustular Psoriasis More severe Need dermatologist! Usually need oral therapy     Rosacea Onset middle age Facial flushing / erythema Inflammatory papules Pustules No comedones Telangectasia Blepharitis Rhinophyma       Melasma Macular hyper pigmentation of the skin patch. Etiology: Photo-exposure, Female hormonal fluctuation during pregnancy or usage of birth control pills.   Seborrheic Keratosis Benign light tan to dark brown pigmented smooth stuck-on appearance plaque, most of cases, rarely before 30 years of age and more common with skin maturing process. Theses lesions are hereditary with Autosomal dominant inheritance. Keloid Etiology :unknown Incidence: Equal in males and females Prevalence: More common in blacks than whites Diagnosis: are made by clinical presentation and biopsy usually not warranted.   Warts (Human Papillomavirus Infections) Types of Warts Verruca Vulgaris (common wart), hyperkeratotic papules on skin Plantar & Palmar wart, Thick hyperkeratotic plaques affecting Soles and palms, maybe painful upon applying of pressure Verruca Planae (flat wart), Small flat surfaced hyper pigmented multiple papules affecting face, hands and knees Condyloma Acuminatum (Anogenital) Condyloma Accuminatum HPV type 6, 11, 42-44 Sexually transmitted Increase risk of developing cervical dysplasia in female patients, strongly recommend Pap-smear Genital Herpes (Simplex type II) HSV 2 is considered to be STDs usually involving genital areas, although HSV1 and HSV2 can affect both oral and genital areas. Educate HSV 2 patients on routine use of condom, asymptomatic shedding and suppression treatment. Herpes Simplex HSV is transmitted by direct contact of the infected surface skin from one individual to the other. HSV I is usually associated with oral herpes (fever blisters, cold sores). Diagnosis is made by presence of multi-nucleated giant cell under the Tzanck prep Varicella (Chicken Pox) Chicken pox is the primary infection with varicella zoster virus. It is very contagious. Clinical presentation is characterized by the appearance of diffused mildly pruritic vesicles, papules and scabs all at once. The incubation period is about 10 days and the patients are considered to be contagious 4 days prior to the onset of lesions until all lesions have crusted over with the scabs which can take up to 1 week.   Chicken Pox Burns A burn is tissue damage inflicted by intense heat, electricity, radiation, or certain chemicals, all of which denature cell proteins and cause cell death to infected areas. The most immediate threat to a burn patient is dehydration and electrolyte imbalance due to fluid loss. Leads to renal shutdown and circulatory shock (inadequate blood circulation due to reduced blood volume). To save the patient, the lost fluids must be replaced immediately. Critical Burns Burns are considered critical if any of the following conditions exists: Over 25% of the body has second-degree burns Over 10% of the body has third degree burns There are third-degree burns of the face, hands, or feet Facial burns introduce the possibility of burned respiratory passageways, which can swell and cause suffocation Burns at joints are also troublesome because scar tissue formation can severely limit joint mobility Skin Cancer Most tumors that arise in the skin do not spread (metastasize) to other body areas Some tumors are malignant, or cancerous, and invade other body areas A crucial risk factor for the skin cancers is over-exposure to the UV radiation in sunlight, which appears to disable a tumor suppressor gene However, frequent irritation of the skin by infections, chemicals, or physical trauma seems to be a predisposing factor Sunburned skin accelerates its production of a protein that causes genetically damaged skin cells to commit suicide, thus decreasing the risk of mutations that will cause sun-linked skin cancer It is the death of these gene-damaged cells that causes the skin to peel after a sunburn NEW lotions are being produced that will fix damaged DNA before the involved cells can develop into cancer cells These lotions contain tiny oily vesicles (liposomes) filled with enzymes that initiate repair of the DNA mutations most commonly caused by sunlight Acne … Causes Common facial rash Usually adolescents May occur in early and mid adult life Blockage of pilosebaceous unit with surrounding inflammation Androgens lead to increase sebum production Increased colonisation by propionibacterium acnes Acne … Types A skin disease due to oil glands. The acne vulgaris is known to be a chronic inflammatory type of acne that has over active oil glands. The hair follicles are filled with oil that cannot escape. Starts at an early age and affects mainly the face and other parts of the body with blackheads, pimples and cysts. Another type of acne is called acne excoriee. It happens due to a nervous situation. It starts out small but can worsen if it is scratched or picked at a lot. One more type of acne is called cystic acne. It is a severe type of acne that happens when a pimple breaks open under the skin and not on top of the skin. This acne can cause pain and swelling as the body fights the infection. It