2. 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

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

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

6. Epidermis Epidermis: Major physical barrier of the skin – Made up of 4 distinct cell layers, each with different cell structure and function 1 2 3 4

7. 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

8. 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

9. Terminology of Skin Lesions MaculePatch VitiligoTinea corporis

10. PapulePlaque Verruca vulgaris Psoriasis

11. Bullae Herpes zosterBullous pemphigoid Vesicle

12. PustuleNodule Acne vulgarisKeloid

13. ErosionUlcer Basal cell carcinomaPemphigus vulgaris

14. COMMON RASHES IN DERMATOLOGY Recognition Diagnosis Treatment When to Refer

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

17. Atopic Dermatitis