Shortcut to SKIN LESIONS2.Ppt

8/8/2019 Shortcut to SKIN LESIONS2.Ppt

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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!

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