Integumentary: Actinic Keratosis, Basal Cell Carcinoma, Squamous Cell Carcinoma, Melanoma, Atypical/Dysplastic Nevus, Viral Skin Infections, Fungal Infections, Allergic Skin Problems, and Benign Skin Problems

What is the most common precancerous lesion on the skin?

actinic keratosis it the most common precancerous lesion

What can cause actinic keratosis?

it is caused by sun exposure

What are some signs and symptoms of actinic keratosis?

• area has irregular shape

• area’s texture is rough

• spot is scaly red or brown

What is a complication of actinic keratosis?

it can turn into Squamous Cell Carcinoma

What are some surgical interventions for actinic keratosis, basal cell carcinoma, and squamous cell carcinoma?

• excision 

• cryotherapy

• laser therapy

What is basal cell carcinoma?

it is a locally invasive cancer arising from epidermal basal cells

What is the most common skin cancer that is least deadly?

basal cell carcinoma is the common skin cancer and is the least deadly

What are some signs and symptoms of basal cell carcinoma?

• area is pearly

• area has rolled borders with depressed center

• telangiectasia

What is squamous cell carcinoma?

it arises from keratinizing epidermal cells

What are some signs and symptoms of squamous cell carcinoma?

• firm nodule with crusting 

• firm nodule with ulceration in the middle

What is melanoma?

it is a tumor arising from melanocytes 

What are some signs and symptoms of melanoma?

• area is asymmetrical 

• area’s borders are irregular

• area has color differences

• diameter is more than 6mm

• area is evolving in appearance

What is a complication of melanoma?

it can metastasize to other organs

What are some treatments for melanoma?

• immunotherapy 

• chemotherapy (advanced disease)

• radiation therapy (lymph node & brain metastases)

• target therapy

What are some labs and diagnostic tests for melanoma?

• dermoscopy

• excisional biopsy

• Breslow measurement to measure thickness

What are some surgical interventions for melanoma?

• full incision biopsy

• wide circle incision

What are some nursing actions and interventions for melanoma?

• preform ABCDEs

-Asymmetry of one side to the other

-Border irregularity

-Color differences 

-Diameter greater than 6mm

-Evolving

What are some sign and symptoms of atypical/dysplastic nevus?

• nevi larger than usual

• nevi have irregular borders

• nevi have various shades of color

What is a complication of atypical/dysplastic nevus?

melanoma is a complication

What are some teachings for atypical/dysplastic nevus?

• tell pt. that they have a 10x the risk to develop melanoma 

• tell pt. to wear sunscreen daily

What are some signs and symptoms of viral skin infection?

• single or group of vesicles

• painful spots on skin

• burning/ itching sensation at affected site

What are some teachings for a patient with viral skin infections?

• tell pt. to do warm compresses on affected area

• tell pt. antivirals can only be used within 72 hours of onset

What are the common types of fungal infections?

• Candidiasis 

• Tinea

What are some labs and diagnostic tests for fungal infections?

• microscopic examination showing hyphae

• Wood light- blue or green

What are some common types of allergic skin problems?

• allergic contact dermatitis

• atopic dermatitis

• drug reaction

• urticaria (hives)

What is the diagnostic test for allergic skin problems?

allergy patch test

What are some nursing actions and interventions for allergic skin problem?

• administer antihistamines

• administer steroids

What are some teachings for patients with allergic skin problem?

• tell pt. to avoid triggers of allergies

• tell pr. they can take antihistamines and steroids

• tell pt. if reaction is from medication(s), stop taking meds immediately

What are some types of benign skin problems?

• psoriasis

• acne vulgaris

• skin Tags

• lipoma

• moles (nevi)

• lentigo (live/age spots)

• seborrheic keratoses

What are some surgical interventions for benign skin problems?

• skin scraping

• electrodessication 

• electrocoagulation

• curettage

• punch biopsy

• cryotherapy

• excision-Mohs Surgery

What are some nursing actions and interventions for benign skin problems?

• administer antibiotics, corticosteroids, antihistamines, topical fluorouracil, or immunomodulators when orders

• apply wet compresses on affected area

• give pt. bathes

What are some teachings for patients with benign skin problems?

• tell pt. treatments can be phototherapy. radiation therapy, and laser therapy

• tell pt. they can take antibiotics, corticosteroids, antihistamines, topical fluorouracil, or immunomodulators

What is a keloid?

it is overgrowth of collagen tissue at site of skin injury

What is Vitiligo?

it is total loss of skin pigment of the skin in certain areas

What is dermatosis papulosa nigra?

it is small, pigmented wart like plaque often seen on face

What is traction alopecia?

it is the loss of hair due to trauma of hair follicles

What picture depicts actinic keratosis?

What picture depicts basal cell carcinoma?

What picture depicts squamous cell carcinoma?

What picture depicts melanoma?

What picture depicts atypical/dysplastic nevus?