NR 283 PATHO TEST 2 EXAM REVIEW
Malignant skin lesions (Melanoma, box 8-1, warning signs of skin cancer p 154)
Warning signs of skin cancer:
Melanoma is suspected in any nevus that shows (ABCD’S):
Change in appearance
Change in border
Change in color
Increase in diameter
1.A sore that does not heal.
2.A change in size, shape, color, or texture of a lesion.
3. New mole, or odd shape lesion that develops.
4. A lesion that bleeds repeatedly, oozes fluid, or itches.
Kaposi’s sarcoma 155-156
-Occurs in those with HIV/AIDS and other immunodeficiency’s
-May affect viscera as well as skin (Viscera is internal intestines)
-Malignant cells arise from endothelium in small blood
-Purplish macules, Nonpruritic, non-painful
-In immunocompromised patients, lesions develop rapidly over upper body.
-Combination of radiation, chemotherapy, surgery, biological therapy
Inflammatory Disorders of the skin (Contact dermatitis, urticaria, Atopic dermatitis (eczema), Psoriasis,
Pemphigus, Scleroderma) p 145-148
Contact Dermatitis:
-Exposure to an allergen (Metals, cosmetics, soaps, chemicals, plants)
-Sensitization occurs on first exposure.
-pruritic rash develops at site a few hours after exposure.
-Direct chemical or mechanical irritation
-Does not involve immune response
-Is inflammatory because of direct exposure
-Removal of irritant
-Reduction of inflammation with topical glucocorticoids
,Urticarial (Hives):
-Result of type I hypersensitivity
-Ingestion of substances
-Examples: shellfish, drugs, certain fruits
-Lesions are highly pruritic.
-Hives are often part of anaphylaxis!
-Check for swelling around mouth and check airway.
-Administer EpiPen or other first aid as required.
Atopic Dermatitis (Eczema):
-Atopic—inherited tendency
-Common problem in infancy
-Rash is erythematous, with serous exudate.
-Commonly occurs on face, chest, and shoulders
-In adults, rash is dry, scaly, and pruritic, often on joints
-Chronic inflammation results from response to allergens.
-Eosinophilia and increased serum IgE levels
-Potential complication—secondary infections
-Treatment: Topical glucocorticoids, antihistamines
Psoriasis:
-Chronic inflammatory skin disorder
-Onset usually in the teenage years
-Psoriasis results from abnormal T cell activation.
-Excessive proliferation of keratinocytes
-Cellular proliferation is greatly increased.
-Lesions found on face, scalp, elbows, knees
-Itching or burning sensations
-Treatment: Glucocorticoids, tar preparations, antimetabolites
, Pemphigus:
-Autoimmune disorder
-Autoantibodies disrupt cohesion between epidermal cells.
-Causes blisters (bullae) to form
-Skin sheds, leaving area painful and open to secondary infection.
-May be life-threatening if extensive (e.g., Stevens-Johnson
syndrome)
-Systemic glucocorticoids and immunosuppressants
Scleroderma:
-May occur as skin disorder
-May be systemic and affect viscera
-Primary cause unknown
-Increased collagen deposition is observed in all cases.
-inflammation and fibrosis with decreased capillary networks
-Hard, shiny, tight, immovable areas of skin
-Impaired movement of mouth and eyes
-May cause renal failure, intestinal obstruction, respiratory failure caused by distortion of -tissues
Skin infections (Impetigo, Herpes, Cellulitis, Scabies, Pediculosis -lice) p 148-150, 152-153
Impetigo:
-Common infection in infants and children
-May also occur in adults
-S. aureus—highly contagious in neonates
-Lesions commonly on face
-Transmission may occur through close physical contact or
through fomites
-Pruritus common
-Leads to scratching and further spread of infection
-Treatment: Topical antibiotics in early stages &Systemic
administration if lesions are extensive
Cellulitis (erysipelas):
-Infection of the dermis and subcutaneous tissue
-Usually secondary to an injury
-May be iatrogenic (caused medical intervention)
-Causative organism is usually Staphylococcus aureus,
Sometimes Streptococcus
-Frequently in lower trunks and legs (Especially in individuals with
restricted circulation in the extremities; also in immunocompromised individuals)
-Area becomes red, swollen, and painful
-Red streaks may develop, running along lymph vessels proximal to infected area
Malignant skin lesions (Melanoma, box 8-1, warning signs of skin cancer p 154)
Warning signs of skin cancer:
Melanoma is suspected in any nevus that shows (ABCD’S):
Change in appearance
Change in border
Change in color
Increase in diameter
1.A sore that does not heal.
2.A change in size, shape, color, or texture of a lesion.
3. New mole, or odd shape lesion that develops.
4. A lesion that bleeds repeatedly, oozes fluid, or itches.
Kaposi’s sarcoma 155-156
-Occurs in those with HIV/AIDS and other immunodeficiency’s
-May affect viscera as well as skin (Viscera is internal intestines)
-Malignant cells arise from endothelium in small blood
-Purplish macules, Nonpruritic, non-painful
-In immunocompromised patients, lesions develop rapidly over upper body.
-Combination of radiation, chemotherapy, surgery, biological therapy
Inflammatory Disorders of the skin (Contact dermatitis, urticaria, Atopic dermatitis (eczema), Psoriasis,
Pemphigus, Scleroderma) p 145-148
Contact Dermatitis:
-Exposure to an allergen (Metals, cosmetics, soaps, chemicals, plants)
-Sensitization occurs on first exposure.
-pruritic rash develops at site a few hours after exposure.
-Direct chemical or mechanical irritation
-Does not involve immune response
-Is inflammatory because of direct exposure
-Removal of irritant
-Reduction of inflammation with topical glucocorticoids
,Urticarial (Hives):
-Result of type I hypersensitivity
-Ingestion of substances
-Examples: shellfish, drugs, certain fruits
-Lesions are highly pruritic.
-Hives are often part of anaphylaxis!
-Check for swelling around mouth and check airway.
-Administer EpiPen or other first aid as required.
Atopic Dermatitis (Eczema):
-Atopic—inherited tendency
-Common problem in infancy
-Rash is erythematous, with serous exudate.
-Commonly occurs on face, chest, and shoulders
-In adults, rash is dry, scaly, and pruritic, often on joints
-Chronic inflammation results from response to allergens.
-Eosinophilia and increased serum IgE levels
-Potential complication—secondary infections
-Treatment: Topical glucocorticoids, antihistamines
Psoriasis:
-Chronic inflammatory skin disorder
-Onset usually in the teenage years
-Psoriasis results from abnormal T cell activation.
-Excessive proliferation of keratinocytes
-Cellular proliferation is greatly increased.
-Lesions found on face, scalp, elbows, knees
-Itching or burning sensations
-Treatment: Glucocorticoids, tar preparations, antimetabolites
, Pemphigus:
-Autoimmune disorder
-Autoantibodies disrupt cohesion between epidermal cells.
-Causes blisters (bullae) to form
-Skin sheds, leaving area painful and open to secondary infection.
-May be life-threatening if extensive (e.g., Stevens-Johnson
syndrome)
-Systemic glucocorticoids and immunosuppressants
Scleroderma:
-May occur as skin disorder
-May be systemic and affect viscera
-Primary cause unknown
-Increased collagen deposition is observed in all cases.
-inflammation and fibrosis with decreased capillary networks
-Hard, shiny, tight, immovable areas of skin
-Impaired movement of mouth and eyes
-May cause renal failure, intestinal obstruction, respiratory failure caused by distortion of -tissues
Skin infections (Impetigo, Herpes, Cellulitis, Scabies, Pediculosis -lice) p 148-150, 152-153
Impetigo:
-Common infection in infants and children
-May also occur in adults
-S. aureus—highly contagious in neonates
-Lesions commonly on face
-Transmission may occur through close physical contact or
through fomites
-Pruritus common
-Leads to scratching and further spread of infection
-Treatment: Topical antibiotics in early stages &Systemic
administration if lesions are extensive
Cellulitis (erysipelas):
-Infection of the dermis and subcutaneous tissue
-Usually secondary to an injury
-May be iatrogenic (caused medical intervention)
-Causative organism is usually Staphylococcus aureus,
Sometimes Streptococcus
-Frequently in lower trunks and legs (Especially in individuals with
restricted circulation in the extremities; also in immunocompromised individuals)
-Area becomes red, swollen, and painful
-Red streaks may develop, running along lymph vessels proximal to infected area
