Module 9: Skin Disorders

Skin cancers, infections, psoriasis, and acne

What antibiotics is Ca-MRSA resistant to?

It is resistant to (Beta —>) β-lactam antibiotics

Ca-MRSA is NOT resistant to multiple antibiotics. True/False?

✨TRUE✨

What does Ca-MRSA infection look like?

• Looks like a “spider bite” (ITS NOT)

• Skin is firm and red with purple border

• Blisters

• Necrotic/crusted center

• Looks like cellulitis

What are the antibiotics used for Ca-MRSA

• Clindamycin

• Vancomycin

• Daptomycin

• Sulfamethoxazole

• Minocycline

• Linezolid

• Tigecycline IV

Environmental controls of Ca-MRSA

• Hand hygiene

• Contain drainage

• Proper disposal of dressing

• Avoid skin to skin contact

What is Necrotizing Fasciitis?

A rare but serious bacterial infection that destroys the body's soft tissues

What is the cause of Necrotizing Fasciitis?

The most common cause is Group A Streptococcus

How do Group A Streptococcus destroy tissue?

The exotoxins that are created destroy neutrophils and prevent the destroying of bacteria

What is an abscess?

A localized collection of pus (a mixture of dead cells, bacteria, and other debris) that forms in the body as a result of an infection

How to treat abscesses

• Antibiotics

• Warm moist compresses

• Incision & Drainage (I&D)

What is a Verruca Wart?

It is a raised cauliflower-like hyperkeratotic area r/t the human papilloma virus (HPV)

What are Plantar Warts?

They are warts that appear on the soles of the feet and may look like calluses

What are Anogenital Warts?

They are sexually transmitted, pruritic cauliflower-like lesions or warts on the genitalia

How long does it take warts to disappear?

It takes about 12 weeks for warts to be gone

How to treat warts

• Topical peeling agents

• Removal of the dead skin

• Cryotherapy

• Electrodesiccation

• Cimetidine

What is used to treat genital warts?

Topical antiviral medications, specifically Podophyllin

What is Herpes Zoster (Shingles)?

A viral infection caused by varicella (chickenpox) that causes a painful rash,

When should treatment for shingles begin?

Treatment should begin with 3 days to decrease severity and risk of postherpetic neuralgia

What does Candidiasis look like on skin?

It looks like shiny, bright red patches with satellite lesions in skin folds and other moist areas

How to treat candidiasis

• Antifungal creams/meds

• Having clean and dry skin

• Washing with hot water

How to treat Thrush

Use nystatin swish and swallow or spit

What does Tinea mean?

It means ring

What is Tinea Pedis?

It is Athlete’s foot (fungal infection of the foot)

What is Onychomycosis?

It is the infection of the nail where it looks thick, yellow, pitted, or crumbly

How to treat Onychomycosis

• Antifungals

• Vicks VapoRub

• Clean and dry skin

• Wear open-toed shoes

• Nail removal

What is the most common skin cancer?

Basal Cell Carcinoma (BCC) is the most common

What does BCC look like?

• Non-healing sore

• Pearly nodule

• Red patch

• A raised pink growth w/ crust

Squamous Cell Carcinoma

A cancer that affects the outermost layer of the skin, which remains localized but can become invasive

What does Squamous Cell Carcinoma look like?

Either wart-like growth that bleeds and crusts or scaly red patches that bleed and crusts

What does ABCDE stand for in skin cancer?

• Asymmetry

• Border irregularity

• Color

• Diameter

• Evolving or Elevation

When is ‘mole mapping’ used?

• When a pt has more than 50 moles

• Abnormal moles

• History of melanoma

Nevisense is?

A medical device that uses electrical impedance spectroscopy (EIS) to help dermatologists detect and diagnose skin cancer, specifically melanoma

What are the different treatments of skin cancer?

• Curettage (scraping)

• Laser surgery

• Cryosurgery

• Mohs Surgery (layered removal)

• Excision

What is Psoriasis?

A chronic autoimmune condition characterized by skin inflammation and the rapid growth of skin cells, leading to thick, scaly, and itchy patches

What is the most common type of Psoriasis?

Plaque is the most common type of Psoriasis

What does Plaque Psoriasis look like?

It looks like raised red plaques that are covered in silvery scales

Guttate Psoriasis

Small, drop-shaped, scaly patches on the skin, often appearing after a streptococcal infection like strep throat

What are some Psoriasis triggers?

• Damage to the skin

• Infection

• Medications (beta blockers, NSAIDs)

• Stress

• Alcohol

• Smoking

Interventions to help Psoriasis

Warm showers and moisturizers (NO fragrance)

Topicals that help treat Psoriasis

• Keratolytics

• Corticosteroids

• Retinoids

• Vitamin D derivatives

• Coal/Tar derivatives

• Immunomodulators (TIMs)

Acitretin (retinoid)

This medication reduces the multiplication of skin cells and can NOT be used during pregnancy

Cyclosporine PO

Medication is used as an immunosuppressant, and with other meds

Methotrexate PO

Medication that is used to treat different kinds of cancers

Sulfasalazine PO

Used to treat and prevent acute attacks of mild to moderate ulcerative colitis and Crohn’s

Apremilast PO (PDE4 Inhibitor)

Is used to treat plaque and psoriatic arthritis

Biologics

Medications that decrease inflammation, inhibit tumor necrosis, and inhibit interleukins

Psoralen & Ultraviolet Light A (PUVA) Treatments

• Psoralen orally or as a soak sensitizes the skin to Ultraviolet A light

• Treatments are administered in a whole-body cabinet or a hand treatment unit

• Unaffected/sensitive areas are covered & the patient wears UVA protective goggles

What is another name for ‘Open Comedo’?

Another name is Blackhead

What does a ‘Closed Comedo’ look like?

It looks like an acne pustule

Ways to treat acne

• Decrease bacteria (wash face)

• Decrease sebum output

• Normalize skin shedding (salicylic acid)

• Extraction

• Microneedling

Isotretinoin PO

Medication is used to treat severe, disfiguring nodular acne

What is Rosacea?

A skin condition primarily affecting the face, causing redness, small bumps, and visible blood vessels

What is Rhinophyma?

A skin disorder characterized by an enlarged, bulbous nose due to thickened skin and enlarged sebaceous glands

Triggers for Rosacea are?

• Heat

• Stress

• Vasodilating drugs

• Spicy foods

• Alcohol

Treatments for Rosacea

• Cleansing the skin

• Avoid products with alcohol, fragrance, and steroids

• Antibiotics

• Azelaic acid

• Vasoconstricts

What is Stevens-Johnson Syndrome?

A rare but severe (DEADLY) immune system disorder that can cause painful blisters and skin peeling, along with damage to mucous membranes in the body