How to Approach a Patient With a Rash or Concerning Skin Lesion Grand Strand Advanced Practice Nurse Association September 19, 2014 M. Holly B. Glover,

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How to Approach a Patient With a Rash or Concerning Skin Lesion Grand Strand Advanced Practice Nurse Association September 19, 2014 M. Holly B. Glover, M.D. Grand Strand Dermatology Myrtle Beach, SC

Disclosures I have no financial disclosures nor any conflicts of interest.

Learning Objectives Introduction to skin anatomy Introduction to dermatology terminology Common skin rashes – Recognition and treatment Common skin lesions – Recognition and treatment

Epidermis Epidermis: Major physical barrier of the skin – Made up of 4 distinct cell layers, each with different cell structure and function

Epidermis  Epidermis: Made up of several different cell types  Keratinocyte: major cell that keratinizes to form hard, outer layer  Melanocyte: pigment-producing cell  Langerhans cell: immune cell of skin

Dermis and Hypodermis Dermis: tough, support structure Hypodermis or subcutaneous fat: insulates the body and cushions deep tissues Both contain nerves, blood vessels, hair follicles and sweat glands

Terminology of Skin Lesions MaculePatch VitiligoTinea corporis

PapulePlaque Verruca vulgaris Psoriasis

Bullae Herpes zosterBullous pemphigoid Vesicle

PustuleNodule Acne vulgarisKeloid

ErosionUlcer Basal cell carcinomaPemphigus vulgaris

COMMON RASHES IN DERMATOLOGY Recognition Diagnosis Treatment When to Refer

Eczema Numerous different types: – Atopic dermatitis – Dyshidrotic eczema – Xerotic eczema – Nummular eczema – Allergic contact dermatitis – Irritant contact dermatitis – Stasis dermatitis

Atopic Dermatitis

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