NR 283 STUDY GUIDE EXAM 2.
Chapter 8
Functions of the Skin:
• Acts as the first line of defense
• Prevents excess fluid loss
• Controls body temperature
• Active in sensory perception
• Synthesizes vitamin D
Pruritus:
• Itching
o Allergic responses, Type I sensitivity
o Chemical irritation caused by insect bites
o Parasite infestations
Pruritus Causes:
• Release of histamine in a hypersensitivity response
Effects of Pruritus:
• Redness and itching – inflammation
• Risk of infection due to scratching
Causes of Contact Dermatitis:
• Allergic contact dermatitis
o Exposure to an antigen
o Sensitization occurs on first exposure
▪ Type IV cell-mediated hypersensitivity
o Pruritic rash develops at site a few hours after exposure
• Irritant Contact Dermatitis
o Inflammatory because of direct exposure
o Does not involve immune response
o Removal of irritant
o Reduction of inflammation with topical glucocorticoids
Urticaria (hives) Causes:
• Ingestion of substances, release histamine
• Examples: shellfish, drugs, certain fruits
• Result of type I hypersensitivity
Urticaria Effects:
• Eruption of hard, raised erythematous lesion
• Often scattered all over the body
• Highly pruritic
• Check for pharyngeal mucosa and check airway
o Administer EpiPen or other first aid required
,Psoriasis Causes:
• Chronic inflammatory skin disorder
o Onset usually in the teenage years
o Psoriasis results from abnormal T cell activation
• Psoriasis results from abnormal T cell activation
o The rate of cellular proliferation is increased
o Thickening of the dermis and epidermis
Effects of Psoriasis:
• A silvery plaque while the base remains erythematous
• Lesions on face, scalp, elbows, knees
• Itching or burning sensations
Treatment of Psoriasis:
• Glucocorticoids, tar preparations, antimetabolites
Cellulitis (erysipelas):
• Infection of the dermis and subcutaneous tissue
Cellulitis Causes:
• Secondary to an injury
• Staphylococcus aureus or streptococcus
Effects of Cellulitis:
• Frequently in lower trunks and legs
• Area becomes red, swollen and painful
• Red streaks may develop; running along lymph vessels proximal to infected area
Herpes Simplex Type 1:
• Oral herpes
o Cold sores or fever blisters
Effects of HSV-1:
• Painful oral ulcer
Herpes Simplex Type 2:
• Genital herpes
Effects of HSV-2:
• Genital vesical ulcer
Herpes Simplex Virus:
• Virus remains latent in sensory ganglia
• Recurrence may be triggered by
o Common cold, sun exposure, stress
, • Spread by direct contact with fluid from lesion
Herpes Zoster (Shingles) Cause:
• Varicella-zoster virus in adults
• Can occur years after primary infection of varicella (chicken pox)
• Usually affects one dermatome
Effects of Herpes Zoster:
• Pain, vesicular rash
• Postherpetic pain may persist for months to years in some cases
Treatment of Herpes Zoster:
• Vaccine available for those 60 years or older
Verrucae (Warts):
• Human Papillomavirus (HPV)
o Types 1-4, harmless
o Frequently develop in children and young adults
o Spreads by viral shedding of skin surface
o May resolve spontaneously with time
• Genital Warts: HPV types 6 and 11
o STD
o No cure
▪ Recurrences are common
Fungal Infections (Mycoses):
• Most are superficial
o Fungi live off of the dead, keratinized cells of the epidermis
Tinea Capitis:
• Infection of the scalp
Tinea Corporis:
• Infection of the body
Tinea Pedis:
• Athletes foot
Tinea Unguium:
• Infection of the nails
Scabies:
• Invasion by mite Sarcoptes scabiei
• Female burrows into epidermis and laying eggs
• Intensively pruritic
• Close contact transmission
, Pediculosis:
• Lice
• Female lice lays eggs on hair shafts
• After hatching, louse bites human host, sucking blood for production of ova
• Excoriations result from scratching
• Close contact transmission
Squamous Cell Carcinoma:
• Painless, malignant tumor of the epidermis
• Lesions most commonly found on exposed areas of the skin but also in oral cavity
o Face and neck
o Base of tongue
• Tumor gros sloly
• Rarely metastasize to distant site
Malignant Melanoma:
• Highly metastatic form of cancer
• Develops in melanocytes
o From a nevus (mole)
• Often appear as multicolored lesion with irregular border
o Grow quickly
o Change in shape, size, color and texture
o May bleed
Treatment of Malignant Melanoma:
• Surgical removal and radiation plus chemotherapy
ABCD of Melanoma:
• Appearance
• Border
• Color
• Diameter
• Evaluation
Kaposi’s Sarcoma:
• Occur in those with AIDS and other immunodeficiency
• May affect viscera as well as skin
• Malignant cells arise from endothelium in small blood vessels
o Purplish macules
o Nonpruritic, nonpainful
• Immunocompromised patients
o Lesions develop rapidly over upper body
Chapter 8
Functions of the Skin:
• Acts as the first line of defense
• Prevents excess fluid loss
• Controls body temperature
• Active in sensory perception
• Synthesizes vitamin D
Pruritus:
• Itching
o Allergic responses, Type I sensitivity
o Chemical irritation caused by insect bites
o Parasite infestations
Pruritus Causes:
• Release of histamine in a hypersensitivity response
Effects of Pruritus:
• Redness and itching – inflammation
• Risk of infection due to scratching
Causes of Contact Dermatitis:
• Allergic contact dermatitis
o Exposure to an antigen
o Sensitization occurs on first exposure
▪ Type IV cell-mediated hypersensitivity
o Pruritic rash develops at site a few hours after exposure
• Irritant Contact Dermatitis
o Inflammatory because of direct exposure
o Does not involve immune response
o Removal of irritant
o Reduction of inflammation with topical glucocorticoids
Urticaria (hives) Causes:
• Ingestion of substances, release histamine
• Examples: shellfish, drugs, certain fruits
• Result of type I hypersensitivity
Urticaria Effects:
• Eruption of hard, raised erythematous lesion
• Often scattered all over the body
• Highly pruritic
• Check for pharyngeal mucosa and check airway
o Administer EpiPen or other first aid required
,Psoriasis Causes:
• Chronic inflammatory skin disorder
o Onset usually in the teenage years
o Psoriasis results from abnormal T cell activation
• Psoriasis results from abnormal T cell activation
o The rate of cellular proliferation is increased
o Thickening of the dermis and epidermis
Effects of Psoriasis:
• A silvery plaque while the base remains erythematous
• Lesions on face, scalp, elbows, knees
• Itching or burning sensations
Treatment of Psoriasis:
• Glucocorticoids, tar preparations, antimetabolites
Cellulitis (erysipelas):
• Infection of the dermis and subcutaneous tissue
Cellulitis Causes:
• Secondary to an injury
• Staphylococcus aureus or streptococcus
Effects of Cellulitis:
• Frequently in lower trunks and legs
• Area becomes red, swollen and painful
• Red streaks may develop; running along lymph vessels proximal to infected area
Herpes Simplex Type 1:
• Oral herpes
o Cold sores or fever blisters
Effects of HSV-1:
• Painful oral ulcer
Herpes Simplex Type 2:
• Genital herpes
Effects of HSV-2:
• Genital vesical ulcer
Herpes Simplex Virus:
• Virus remains latent in sensory ganglia
• Recurrence may be triggered by
o Common cold, sun exposure, stress
, • Spread by direct contact with fluid from lesion
Herpes Zoster (Shingles) Cause:
• Varicella-zoster virus in adults
• Can occur years after primary infection of varicella (chicken pox)
• Usually affects one dermatome
Effects of Herpes Zoster:
• Pain, vesicular rash
• Postherpetic pain may persist for months to years in some cases
Treatment of Herpes Zoster:
• Vaccine available for those 60 years or older
Verrucae (Warts):
• Human Papillomavirus (HPV)
o Types 1-4, harmless
o Frequently develop in children and young adults
o Spreads by viral shedding of skin surface
o May resolve spontaneously with time
• Genital Warts: HPV types 6 and 11
o STD
o No cure
▪ Recurrences are common
Fungal Infections (Mycoses):
• Most are superficial
o Fungi live off of the dead, keratinized cells of the epidermis
Tinea Capitis:
• Infection of the scalp
Tinea Corporis:
• Infection of the body
Tinea Pedis:
• Athletes foot
Tinea Unguium:
• Infection of the nails
Scabies:
• Invasion by mite Sarcoptes scabiei
• Female burrows into epidermis and laying eggs
• Intensively pruritic
• Close contact transmission
, Pediculosis:
• Lice
• Female lice lays eggs on hair shafts
• After hatching, louse bites human host, sucking blood for production of ova
• Excoriations result from scratching
• Close contact transmission
Squamous Cell Carcinoma:
• Painless, malignant tumor of the epidermis
• Lesions most commonly found on exposed areas of the skin but also in oral cavity
o Face and neck
o Base of tongue
• Tumor gros sloly
• Rarely metastasize to distant site
Malignant Melanoma:
• Highly metastatic form of cancer
• Develops in melanocytes
o From a nevus (mole)
• Often appear as multicolored lesion with irregular border
o Grow quickly
o Change in shape, size, color and texture
o May bleed
Treatment of Malignant Melanoma:
• Surgical removal and radiation plus chemotherapy
ABCD of Melanoma:
• Appearance
• Border
• Color
• Diameter
• Evaluation
Kaposi’s Sarcoma:
• Occur in those with AIDS and other immunodeficiency
• May affect viscera as well as skin
• Malignant cells arise from endothelium in small blood vessels
o Purplish macules
o Nonpruritic, nonpainful
• Immunocompromised patients
o Lesions develop rapidly over upper body
