Skin , Hair and Nails - Debbie Kings Graduate Nursing ：皮肤，头发和指甲-戴比国王的护理研究生.ppt

* Distrubution--primarly face, chest, back,neck,upper arms, buttocks Configuration--scattered, discrete Morphology-comedone, pustules, papules, nodules, cysts endocrine-menstrual irregularities, hirsutism D.Dx-rosacea, steroid rosacea, m. contagiousum, folliculitis, endocrine problem-PCOD, adrenal, pituitary\ multiple symmetric deep tender nodules, violaceous cysts, pustules, and comedones Comments:This 18-year-old boy had a 3 year history of severe nodulocystuc acne. He improved dramatically with a 20 week course of oral 13-cis retinoic acid * Herpes Zoster: Dermatomally distributed vesicles in patient with HZV infection L1-L2 dermatome REMEMBER THE BONY LANDMARKS ON THE BACK ; ILIAC CREST IS L4, hip/ buttock is L2, APEX OF SCAPULA IS T7, TOP OF WING IS T3 AND BEND IN NECK IS C7/T1 Zoster: Dermatomally distributed vesicles, many of which have coalesced, in patient with HZV infection * Morphology; bullae, larger than 0.5 cm Distribution:most common in skin folds Configuration: cicular Erythema and crusting are most typical of impetigo, but a bullous form does occur. This form always indicates the presence of a staphylococcus which is resistant to penicillin due to bacteriophage infection. Blistering is caused by a toxin induced by a specific strain of staphylococcal bacteriophage, if bulla is removed, a shallow moist erosion forms (secondary lesion) * Wheal: round or gyrate or irregularly shaped pale red area, change rapidly in size or shape due to shifting papillary edema, will blanch with glass slide presssing, usually disappears witin 24-48 h, may be pruritic, superficial, well defined. urticaria in which a temporary vascular leak leads to edema and induration of the dermis with or without accompanying erythema. Urticaria may produce isolated papules but more typically produces expanding ring-like papules and plaques. * Chronic lichenified atopic dermatitis Atopic dermatitis tx with topical steroids, varying potencies, oral H1 blockers to induce fatig