geriatric skin disorders; hair and nail disorders
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22 terms
Terms | Definitions |
|---|---|
 most common areas affected by seborrheic dermatitis | the scalp, eyebrows, nasolabial fold, behind the ear, gluteal cleft, umbilicus and genital area |
| treatment of seborrheic dermatitis | Shampoo with antiproliferative agents (tar, selenium) or keratolytics (salicylic acid) three times a week Nizoral shampoo - apply 10 to 60 minutes before showering |
| rosacea | Chronic, intermittent eruption that starts as a flush which may lead to papules, telangiectasia, sebaceous hyperplasia and rhinophyma in severe cases. Most common areas affected are nose and cheeks although eruptions have been found on the chest, neck, scalp and back. Eventually the skin may become thickened and edematous to the point of disfigurement. 1/5 of patients will have ophthalmologic complaints such as conjunctivitis, blepharitis or keratitis. |
| treatment of rosacea | Avoidance of sun exposure, hot beverages (to avoid flushing), and alcohol Topical treatment- steroid preparations should be avoided Metronidazole Gel or cream applied twice a day with reduction to once daily for maintenance Sulfacetamide Avoid in pts sensitive to sulfa antibiotics Clindamycin Gel or lotion not approved for treatment of rosacea in the US but occasionally used "off-label" Systemic therapy Tetracycline 250-500 mg bid given 1 hour before or 2 hours after eating for maximum absorption Doxycycline 50-100 mg bid. Beware of extreme photosensitivity Minocycline (minocin) 50-100 mg twice daily Erythromycin 500-1000 mg/day in divided doses Metronidazole (Flagyl) 500 mg/d orally in divided doses Isotretinoin (Accutane) Reserved only for those patients with severe disease unresponsive to other systemic therapy Other therapies Laser - treats telangiectasia Surgery - to cosmetically reduce the size of rhinophyma Electrosurgery, dermabrasion to reduce hypertrophic areas |
| pemphigous vulgars vs bullous pemphigoid | 50% of pemphigous vulgaris have oral mucosal involvement while few with bullous pemphigoid have oral lesions |
| etiology of pemphigus vulgaris | Formation of autoantibodies to the intercellular layers of the epidermis, leading to spontaneous blistering or fissures resulting from minor trauma Numerous stages exist |
| etiology of bullous pemphigoid | Histologically, bullae are subepidermal but are also caused by an antigen-antibody reaction along the basement membrane |
| most frequent cause of all blistering disease in elderly | bullous pemphigoid |
| pyoderma gangrenosum | Lesions begin as painful, furuncle-like nodules that rapidly expand, become fluctuant, and ulcerate. Disease is usually chronic with remissions and exacerbations. *****Unknown etiology |
| mycosis fungoides | AKA cutaneous T-cell lymphoma |
| individuals most likely to get necrotizing fascitis | alcoholics and diabetics |
| treatment options for male pattern baldness | Efficacy of treatment is difficult to assess since come spontaneous regrowth can occur in alopecia areata. Intralesional injection can be effective temporarily; oral steroids can induce regrowth, but alopecia recurs on discontinuation. Oral PUVA therapy may help some (up to 30%) but carries its own risks Minoxidil - twice a day; may take up to 8-12 months to regrow Finasteride - oral medication taken daily; may decrease libido and cause erectile dysfunction. Contraindicated in women Hair transplants or hair weaves can be used |
| common causes of hirsutism | Causes Adrenal- Cushing's syndrome, adrenal tumors, congenital adrenal hyperplasia Ovarian - ovarian hyperthecosis, neoplasm (however, only 1% of all ovarian tumors cause virilization), polycystic ovarian syndrome, insulin resistance Anabolic steroid use |
| beau's lines | Transverse lines or grooves in the nail plate caused by various systemic and/or local traumatic factors. |
| leukonychia (terry's nails) | Proximal 2/3 of nail plate is white - seen more commonly in cirrhosis |
| kolionychia | thin, spoon shaped nail which may be normal or a sign of iron deficiency or related to occupational factors |
| oncycholysis | separation of the nail from the nailbed more common in women with long nails (and in Elizabeth's dreams) causes include psoriasis, trauma from long nails, contact with chemicals, prolonged immersion, or infection from Candida or Pseudomonas |
| habit-tic deformity | sharply defined band of "rippling" down the center of the nail plate most commonly seen on the thumb from repeated trauma by the index finger |
| longitudinal ridging | seen most ommonly w/ aging but may be seen as a normal variant in younger people |
| acute paronychial infection | -bacterial infection of the proximal and lateral nail fold causing rapid-onset pain and swelling |
| ingrown toe nail | nail plate penetrates the lateral nail fold secondary to trauma, poorly fitting shoes, or by excess trimming of the lateral nail plate |
| subungual hematoma | trauma is to the nail plate causing immediate bleeding and pain puncturing the nail surface relieves much of the pain |
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