Skin conditions

Atopic DermatitisHyperkeratotic DisordersFungal InfectionsWound Management
Dermatitis:

Inflammation of the skin by irritating or allergenic substances (typically soaps, certain fabrics, plants, etc) or clinical conditions such as eczema or psoriasis. Dermatitis often results in redness, itching, local swelling, and lesions.

Treatment Options:

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Eczema:

A chronic, itchy, relapsing rash that develops on the flexure regions of the body (inside of elbow, behind the knees, etc) throughout the lifespan and on the head and neck in adults. It usually starts during childhood but may begin during early adulthood. The cause is unknown, although a link with abnormal immune function has been suggested.

Treatment Options:

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Psoriasis:
A chronic recurring inflammatory disease of the skin, scalp, and joints characterized by pruritic erythematous lesions appearing as well-circumscribed, dry, scaling patches covered by grayish, silvery, lamellar scales and varying in size and shape. Both genetic and environmental factors may contribute to the pathophysiology of this disease.

Treatment Options:

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Pruritic dermatoses:
An unpleasant sensation that triggers the urge to scratch. Pruritis may be a sign of an inflammatory dermatologic condition (eg, excema), dry skin, or aging, as well as several systemic conditions (eg, pregnancy, chronic renal disease, or malignancy).

Treatment Options:

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Radiation dermatitis:

Inflammation of the skin caused by exposure to ionizing radiation (eg, x-rays). Damage is due to the molecular changes that follow the breakdown of molecular bonds within body cells. Both inflammatory and cell-killing effects are seen.

Treatment Options:

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Rough skin:

Skin may take on a rough appearance in the presence of surface lesions, such as those associated with psoriasis, keratosis and dry skin.

Treatment Options:

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Seborrheic dermatitis:
A common relapsing inflammation of the skin characterized by poorly defined, scaling, erythematous lesions in areas with a high concentration of sebaceous glands, such as the face, upper chest, back, and especially the scalp.

Treatment Options:

Atrapro-skin-conditionTersi Foam

Xerosis:

Abnormally dry, scaly, itchy, erythematous skin seen mainly on the legs and arms. It is common among the elderly and tends to worsen in winter. Severe cases can lead to xerotic eczema or eczema craquele (severe form of eczema characterized by fissured, cracked, and extremely itchy skin), which may affect the patient’s quality of life.

Treatment Options:

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Corn:

A well-circumscribed area of thickened skin with a translucent center caused by hyperkeratosis in response to continual excessive irritation or pressure on non-weight-bearing areas of the foot. The corn may be “hard” (heloma durum)–a dry mass on the top or side of the fifth toe or on the top of the other toes or “soft” (heloma molle) — a very painful mound between the toes, where moisture increases the risk of torn tissue and the establishment of a secondary bacterial or fungal infection.

Treatment Options:

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Callus:

A hardened accumulation of skin on the weight-bearing areas of the hands, knees, and soles of the feet that develops in response to continual excessive irritation or pressure. Although the cause is similar to that to corns, calluses are usually larger and vary in size and shape.

Treatment Options:

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Damaged Nails:

Nail damage is indicated by a change in color, shape, texture, or thickness following trauma, infection, illness, or systemic poisoning. These changes include Beau’s lines (depressions across the nail); brittle nails; ridges, including koilonychia (thin nails that curve inward and have raised ridges), leukonychia (nails with white streaks or spots), pitting, and crumbling (loosening and loss of the nail).

Treatment Options:

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Devitalized Nails:

Nails lacking the requirements for normal growth and health, which include a healthy matrix and nail bed to ensure normal neurological and vascular support, protection from damaging agents (eg, infection), and a nutritious diet.

Treatment Options:

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Hyperkeratotic lesions:

Lesions seen in conditions characterized by hyperkeratosis (hypertrophy of the stratum corneum the horny layer of skin due to abnormal desquamation of the skin1). These include corns, calluses, warts, eczema, and keratoses.

Treatment Options:

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Ichthyosis:

A group of hyperkeratotic conditions which, as is suggested by the name of this disorder (Greek: ichthys = “fish”), are characterized by lesions resembling the scales of fish. These conditions are either genetic (rare) or acquired. Acquired ichthyotic lesions are often signs of systemic disease.

Treatment Options:

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Keratoderma:

Overgrowth of the stratum corneum (horny layer) of the skin. Keratoderma may develop on the palms and on the soles of the feet as a result of a genetic condition (palmoplantar keratoderma) in which excess keratin in the skin results in fissures in the skin that evolve into painful lesions. This condition is also known as keratosis palmaris et plantaris.

Treatment Options:

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Keratosis:
Growth of keratin on the skin. Some of these lesions are precancerous (eg, actinic keratosis).

Treatment Options:

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Keratosis pilaris:
A genetic condition in which keratin accumulates around hair follicles in the upper arms, thighs, and (sometimes) buttocks, where they form small, benign bumps or papules. The keratinized skin cells slough off relatively slowly and clog the follicles.

Treatment Options:

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Keratosis palmaris et plantaris (KPP):
Thickening of the palms or soles that appears in one of 3 patterns: uniform distribution over both surfaces; focal distribution over pressure points; or as punctate hyperkeratotic lesions on both surfaces.

Treatment Options:

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Pilaris:
Latin for “pilary,” related to the hair,1 eg, keratosis pilaris, which is characterized by an accumulation and eventual blockage of hair follicles by excessively keratinized skin.

Treatment Options:

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Plantaris:
Plantar, ie, of or related to the sole of the foot,1 eg, keratosis palmaris et plantaris, which refers to a condition characterized by lesions on the palm of the hand (palmaris) and soles of the feet (plantaris).

Treatment Options:

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Pityriasis rubra:
A group of keratinization disorders involving accelerated turnover of the epidermal layer that may be due to abnormal vitamin A metabolism. Patients may exhibit reddish-orange scaly plaques, KPP, keratotic follicular papules, and erythroderma with distinct areas of uninvolved skin (islands of sparing).

Treatment Options:

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Tinea Versicolor:
Chronic infection of the skin by the fungus Malassezia furfur (previously known as Pityrosporum versicolor) characterized by oval, hyper- or hypopigmented pruritic lesions covered with fine scales that appear mainly on the upper portion of the neck, arms, and trunk. In children, they also commonly appear on the face.

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Seborrheic dermatitis:
A common relapsing inflammation of skin characterized by poorly defined, scaling, erythematous lesions in areas with a high concentration of sebaceous glands, such as the face, upper chest, back, and especially the scalp.

Treatment Options:

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Pressure ulcers:

A focal lesion in which the epidermis (outermost layer of skin) and part of the underlying dermis is lost. Also known as decubitus ulcers or bedsores, pressure ulcers commonly arise over bony structures, eg, over pelvic bones (sacrum and ischia), hip bones (the greater trochanters), external malleoli (rounded bony projections, eg, from the lateral side of the ankle), and heels. Dead tissue serves as a breeding ground for bacteria, leading to infections such as cellulitis (caused by the streptococcal or staphylococcal organisms that normally reside on the skin).

Treatment Options:

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Stage 1 ulcer Discolored (reddened) but intact skin. The lesion does not blanch when pressed.

Stage 2 ulcer Partial loss of thickness of the outer (epidermal) layer of skin or the dermal layer beneath it. The lesion has the appearance of a superficial abrasion, blister, or shallow crater.

Stage 3 ulcer Damage or necrosis extends to the fascia (connective tissue) underlying the dermis. The lesion usually resembles a deep crater and may involve tissue adjacent to the ulcer.

Stage 4 ulcer Damage involves muscle, bone, or other supporting structures as well as the skin and may lead to osteomyelitis or septic arthritis.

Partial- and full-thickness wounds
The thickness of the wound refers to the depth of tissue involvement. A partial-thickness wound damages either the epidermis alone or the epidermis and the underlying dermis. A full-thickness wound may also disrupt the fascia underlying the dermis or even deeper structures, such as muscle and bone.

Treatment Options:

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Diabetic foot ulcers
Approximately half of all individuals with long-term or poorly controlled type 1 or type 2 diabetes mellitus develops some form of neuropathy. Peripheral neuropathy is marked by a loss of feeling in the feet, which puts the patient at risk for undetected lesions.

Treatment Options:

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First- and second-degree burns:
The degree of a burn indicates the depth of the burn. A first-degree burn involves the epidermis, only. It is extremely painful, red, and sometimes edematous, but never develops a blister. A second-degree burn is a partial-thickness burn affecting the epidermis (superficial) and dermis (deep).

Treatment Options:

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Grafted and donor sites:

Grafted and donor sites A graft may be desired to improve the appearance and function of an area affected by a wound or to speed up the healing process. The graft tissue may be harvested from various types of donor sites on the patient’s body.

Treatment Options:

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References:

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Szepietowski JC, Balaskas E, Taube K-M, Taberly A, Dupuy P, on behalf of the Uraemic Xerosis Working Group. Quality of life in patients with uraemic xerosis and pruritus. Acta Derm Venereol. 2011;91:313-317.

Saadia ZM, Alzolibani AA, Al Robaee A, Al Shobaili H, Settin AA. Cutaneous manifestations of hypothyroidism amongst gynecological consultations. Int J Health Sci. 2010;4:168-177.

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Onumah N. Nail Surgery—Essential Anatomy. Available at: http://emedicine.medscape.com/article/1126725-overview#a04. Accessed August 4, 2011.

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