Alterations in the Integumentary System

Herpes  Etiology- herpes virus  Patho o Virus passed by contact of skin  mucous membrane  Latent (trigeminal/ other ganglia)  Two types of Infection of the skin o HSV-1  Above waist  Common  Lips, face, and mouth  Painful  Heals in 10-14 days o HSV-2  Responsible for most infections in genital area  Precipitated by stress, sunlight, menses, injury- 2-10 x/year  Burning/ tingling o Erythematic vesicles  Pustules ulcerates crusts heals  Diagnoses o Blood testing for HSV 1 or 2 o Swab sample site  No cure  Analgesics/ non-pharmacological (cold compress)  Antivirals o Acyclovir o Valacyclovir Varicella Zoster Virus (VZV)  Etiology- herpes virus  Shingles o Acute inflammatory disease o Dermatomal segment of the skin  R/t chicken pox o Reactivation of latent virus  Localized inflammation of skin o Follow dorsal root ganglia  Eruption of painful vesciles o Erythematous bases o Unilateral o Pain and paresthesia  Pressure on/ damage to peripheral nerves o Follow the nerve pathway  New crops 3-5 days o Vesicles clear in 2-3 weeks  Dry and fall of o Long term pain- postherpetic neuralgia  Months to years- especially elderly o Diagnosis- rash o Treatment  Antiviral drugs  Vaccine Fungal Infection  Superficial fungal infections o Etiology- fungus o Three genera infect human skin  Microsporum/ Trichophyton/ Epidermophyton  Patho varies with each o Tinea= infection of cutaneous area (skin/ nails)  Capitis (scalp)  Barbae (beard)  Faciei (face)  Corporis (trunk)  Manus (hand)  Cruris (groin)  Pedis (foot) o Presentation  Erythematous macules/ plaques/ vesicular lesions  Peripheral scaling and central clearing o Diagnosis- microscopy and culture o Treatment  Topical antifungal usually efective  Systemic therapy for resistant infections  Clotrimazole, miconazole  Yeast Infection o Patho  Superficial skin infections  Undiagnosed immunodeficiency disorder o Etiology- candida albicans- common source o Diagnosis  Microscopic/ visual  Location o Manifestations  Thrush (infants)  Intertrigo (inflammatory rash) (infants and bedridden patients)  Mucocutaneous candidiasis (immunocompromised)  Creamy white lesions o Treatment  Oral candidiasis  Nystatin mouth rinse  Clotrimazole troches  Topical antifungals  Systemic antigungla (severe cases)