Common Adult Skin Conditions

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Common Adult Skin Conditions

• Cheryl Cavalli,DO.
• Family Practice,
• St Peters Medical Group

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Skin Flicks

• Relax
• Have fun
• Learn something new
• Take off your clothes???
• (Put on sunscreen )
• Show and tell???

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By The End of This Discussion Youll be able to

• Understand age-related changes of the skin
• Become familiar with common diseases of skin,
  nails and hair
• Understand how to inspect your
• (or your loved ones) skin
• Know when to see your doctor, or have your doctor
  see YOU!

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• Skin is the bodys largest and heaviest organ
• Barrier /protection from /to the environment
• Defense against infection
• Cant live without it
• Healthy skin is sign of good health
• Young skin is beautiful but boring for our
  purposes, so we wont talk about it today

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Types of conditions

• Benign/hypersensitivity
• Infectious
• Precancerous
• Cancerous
• How to inspect your skin
• Skin conditions associated with systemic or
  underlying disease

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Topic Three

• Details about this topic
• Supporting information and examples
• How it relates to your audience

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Real Life

• Give an example or real life anecdote
• Sympathize with the audiences situation if
  appropriate

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• Atopic Dermatitis /Eczema-goes along with
  allergies/hypersensitivity
• Worse in winter, prolonged dehydration
• Moisture, avoid prolonged exposure to
  water/allergens
• Stop scratching, antihistamines,topical steroids

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Infectious/inflammatory

• Cellulitis
• Carbuncles/furuncles
• Absesses

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MRSA-Methicillin resistant Staph aureus

• The infamous spider bite
• Bacteria commonly found in nasal cavities
• Transmitted through contact with colonized
  surfaces ,i.e., wrestling mats, exercise
  equipment, day care toys.
• Presents with angry inflamed appearing raised
  bumps that look like spider bites

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MRSA (cont)

• Recurrent
• Doesnt usually get into healthy skin
• Dangerous can get into the blood stream and
  seed bones and joints, can sit around (dormant)
  for a long time
• Dont do surgery on yourself!!!! Needles , pins
  etc inoculate with the bacteria on the skin
  gives the bacteria a way INTO the skin ! No
  pickey pokey!!!

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Nails

• Fungal opportunistic nail plate lifts off the
  nail bed- trauma debris gets under the nail -
  great place for fungus to grow.
• Treatment is long-term ,expensive
• Diabetics

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Sun damage /UV exposure

• Actinic keratosis, solar elastosis, giant
  comedones, thickened skin
• Solar lentigoes

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Actinic chelitis
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• Some look-alikes-
• chondrodermatitis

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Ditzels

• Over 40
• Ugly
• Benign
• Your insurance doesnt care HOW you feel about
  them

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Cherry Angiomas
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Seborrheic Keratosis

• Ugly usually after 4th decade
• Rough
• Stuck on appearance
• Can be pigmented or not
• In areas of friction, face, trunk

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Epidermal inclusion cysts

• Ingrown hair filled with smelly caseous
  material- benign but dramatic appearing.

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Dermatofibroma

• Firm
• Pigmented
• Pretibial and extensor surfaces
• Recur if removed
• Dimple the overlying skin if skin is pinched over
  top of the lesion

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Baldness
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Skin Cancer

• Squamous cell
• Basal cell
• Malignant Melanoma

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Squamous Cell

• Arises out of actinic Keratoses
• (sun exposed skin) and areas of scar/burns
• Can metastasize to lymph nodes
• Most common on skin of face,scalp, arms, hands
  trunk
• Excision usually curative by itself

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Basal Cell Cancer

• Similar to squamous cell- arises out of sun
  damaged skin
• Looks pearly, waxy, with vessels present, face
  nose eyes ears
• No mets- infiltrates locally
• Mouse- bitten appearance
• Mohs Microsurgery to cure

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Moles- benign

• Atypical
• Dysplastic
• If several of these present can be precancerous

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What to watch for

• Color change
• Size change
• Shape change
• bleeding
• ulceration
• new itch or pain
• sudden appearance

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ABCDEs

• Asymmetric in 2 planes
• Border- changing, stellate, not smooth and round
• Color- more than one color? Changing color?
  darker?
• Diameter- greater than 6 mm
• Enlarging, elevating

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Malignant Melanoma

• Hyperpigmented- usually
• 8,800 deaths annually ,death rate unchanged in
  spite of efforts aimed at early detection,
  prevention
• Rates increasing such that by next year incidence
  will be on in 50 people with get melanoma
• In 1985 1/150
• 1965 1/300

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Malignant Melanoma

• The most deadly cancer in young people
• Linked to INTERMITTENT intense sun exposure
• More common closer to equator
• USUALLY on sun exposed skin
• Rates HIGHEST in men over the age of 50.

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Malignant Melanoma

• Best if found and EXCISED early
• Not a lesion which should be frozen
• Elevated risks if family member with it, blue
  eyes, red hair ,more than 3 blistering burns
  prior to adolescence,, more than 10 dysplastic
  nevi, or more than 100 atypical nevi any of
  these alone can increase lifetime risk up to to
  20

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Malignant Melanoma

• Even if shallow- recurrence is common to
  prevent more skin cancer limit exposure to UV
  irradiation and skin exams every 6 months
• To me, as your doctor, it is never really gone-
  it will always be in my brain that it COULD be
  there. And show up in some new place, several
  years later.

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Cutaneous Manifestations of Systemic Disease
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Other- Rosacea
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The End
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Questions?Skin checks yearly???

• Sunscreen??? SPF 30 or greater and reapply
  frequently get UVA and B sunscreen.
• Wear make up, physical barrier