How are Stage one (National Pressure Ulcer Classification) pressure ulcers be staged and treated?
Stage one pressure ulcers appear as non-blanchable erythema of intact skin, the heralding lesion of skin ulceration. Often seen over a bony prominence from prolonged pressure or shoe irritation. Discoloration of the skin, warmth edema, induration, hyperkeratosis or hardness may also be indicators. Paring of hyperkeratosis and/or pressure relief are apropriate management measures
How are stage two (National Pressure Ulcer Classification) pressure ulcers be staged and treated'!
Stage two pressure ulcers have partial-thickness skin loss involving epidermis, dermis or both. The ulcer is superficial and presents clinically as an abrasion, blister or shallow crater. Pressure relief, topical antibiotic and simple dressing are indicated.
How are stage three (National Pressure Ulcer Classification) pressure ulcers be staged and treated?
Stage three pressure ulcers represent full-thickness skin loss involving damage to, or necrosis of the subcutaneous tissue that may extend down to but not through the underlying fascia. The ulcer presents clinically as a deep crater withorwithoutunderminingofadjacenttissue. Vascularworkup,systemicantibiosis,pressurereliefandwound care should be considered.
How are stage four (National Pressure Ulcer Classification) pressure ulcers staged and treated?
Stage four pressure ulcers represent full-thickness skin loss with extensive destruction, tissue necrosis, or damage to muscle, bone, tendon, joint capsule. Undermining and sinus tracts also may be associated with Stage Four pressure ulcers. Hospitalization for vascular workup, operative surgical debridement, systemic antibiosis and wound care should be considered.
How is a keloid defined?
Keloid is aggressive scar tissue that extends beyond the area of original trauma.
What is lichenification?
Lichenification is thickening o f the skin with exaggeration o f the normal skin lines. Hyperpigmentation scaling and pruritusoftenaccompany.
ichenification favors ? and suggests ?
anterior ankles and suggests repetitive rubbing and scatching
What are telangiectasias?
Telangiectasia are visible dilated superficial blood vessels seen in connection with certain heritable diseases, e.g. familial telangiectasia; associated with liver diseases and pregnancy and as a sequel to x-ray treatment. Often seen about the ankles in the elderly.
How is a KOH examination performed?
Scrape epidermal flakes to glass slide, apply 20% KOH, warm or use dimethyl sulfoxide solvent (DMSO), wait ten minutes, examine under low power and reduced light.
What is the diagnostic finding on a KOH examination in chronic tinea pedis?
Segmented branching hyphae.
What are Koen's tumors?
Multiple firm periungual fibromas associated with tuberous sclerosis.
Describe the clinical findings in epidermolysis bullosa (EB) simplex.
EB presents as spontaneous blisters of the fingers toes knees or elbows from minor trauma beginning at birth or early childhood. The blisters heal without scarring. The disease is due to defects in keratins 5 and 14 and is an autosomal dominant trait.
Any of a number of erythematous or purple papules and plaques topped with scales.
Which papulosquamous diseases can be seen on the foot or ankle?
Psoriasis, lichen planus, lichen nitidus and pityriasis rubra piiaris can be seen on the foot and ankle.
Describe the characteristic rash of pityriasis rosea.
Pink to erythematous maculo-papular rash of the chest and or back t()J\owing a viral infection. Spares the soles. Starting with a single 2-4 cm sharply defined thin oval plaques with a characteristic collarette o f scale then within a few days to weeks, crops of similar but smaller lesions follow and resolve spontaneously.
What is pompholyx?
Pompholyx is an episodic vesiculobullous eczema o f the palms and soles especially edges o f fingers. Multiple deep- seated pruritic nits and evolving vesicles.
What is an id reaction and how is it managed?
Immune mediated, sympathetic response to acute tinea. Sterile eruptions distant from the acute site i.e.: fingers palms chest or back. Treat the primary tinea and the id reaction will resolve with it.
Explain the pathogenesis of allergic contact dermatitis.
Name the two types of contact dermatitis.
Primary irritant and allergic contact dermatitis.
How is patch testing done?
How is contact dermatitis managed?
Identify and remove allergen. Protection measures. Cool compresses and topical steroids.
How are the bullous diseases classified/defined'?
Bullous diseases are classified by the depth of involvement, either within the epidermis or below the epidermis.
What are several intra-epidermal bullous diseases?
Allergic contact dermatitis, epidermal bullosa simplex, bullous diabeticorum, herpes simplex and zoster are all examples o f intra-epidermal bullous diseases.
What are several sub-epidermal bullous diseases?
Bullous pemphigoid, dystrophic epidermal bullosa and porphyria cutanea tarda are a few examples o f sub-epidermal bullous diseases.
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