DOCSLIB.ORG

Purpose and Instructions for the Interdisciplinary Diabetic/Neuropathic Foot Ulcer Assessment Form

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

Purpose and Instructions for the Interdisciplinary Diabetic/Neuropathic Foot Ulcer Assessment Form Purpose The Interdisciplinary Diabetic/Neuropathic Foot Ulcer Assessment Form was developed by members of the SWRWCP as an assessment tool to be used for individuals with peripheral neuropathy +/- diabetes and wounds on their feet. The form is intended to: Be utilized by health care professionals when assessing and individual with peripheral neuropathy +/- diabetes and an ulcer on their foot Be completed at the point of entry to the health care system for individuals with peripheral neuropathy +/- diabetes and an ulcer on their foot, or when such a wound is identified in an individual already in the system Be completed by a generalist health care provider, such as an RN, RPN, etc. or by a Wound Care Specialist or ET Nurse if they are the first person to assess the wound/edema at the time of admission into the health care system Follow the individual as they move through the health care system, providing all subsequent health care providers access to the initial information Instructions To be used in addition to the Initial Wound Assessment Screen when a diabetic/neuropathic foot ulcer is identified: Demographics: Before beginning the tool, ensure the individuals name, ID number (or identifying number) and dates are added to every page (at the top of the first page and the header space of subsequent pages). Medical History: Document the year the person was diagnosed with diabetes (to the best of the person’s memory). You may consider asking the family physician for a formal diagnosis and date if needed. Choose the most appropriate eating and physical activity patterns descriptions (may choose more than one) and the most appropriate diabetes education description based on conversation with the person. Current Diabetes Treatment and Response: Choose the oral and hypoglycemic agents currently used and input medication names and dosages as per pharmacy labels. Also choose the appropriate glycemic control indicators (more than one may be applicable – NOTE: you may request the most recent HgbA1c from the family physician if the person is unaware or if this information has not been provided by a reliable source). Frequency of Self-Glucose Monitoring: Review the condition list and choose the most appropriate condition for the person. Investigate if the person has been monitoring their glucose levels as per best practice expectations, choosing yes or no. Diabetes Related Complications: Review the person’s medical chart, ask them, and if required approach the person’s family physician/nurse practitioner re diagnoses of diabetes related complications, checking the appropriate boxes on the form as South West Regional Wound Care Program indicated. Considering this information and the information obtained earlier in the form, consider referrals or advocating for referrals to the appropriate health professionals. Foot Examination: Assess the person’s feet and nails for the following physical characteristics, documenting with a check mark in the appropriate boxes: Descriptor Examples (unless otherwise indicated photos from dermnetnz.org) Hammer toes From Google Images Claw toes From Google Images Dropped Metatarsal Heads (MTH) From Google Images Hallux Valgus From Google Images SWRWCP: B.8.2_Purpose and Instructions for the Diabetic/Neuropathic Foot Ulcer Assessment Form_Jan_2014 2 South West Regional Wound Care Program Dropped Arch From Google Images Callus – a.k.a. tyloma An area of hard thickened skin that is most often painless Caused by friction/shear/repetitive injury over a broad area Corns – a.k.a. clavus, heloma A localized area of thickened skin that is often painful and inflamed Caused by friction/shear/repetitive injury over a very localized area Taylor Bunion From Google Images Fixed Ankle Joint No image available Hallux Rigidus No image available Fissures – cracks in the heel tissue due to dryness SWRWCP: B.8.2_Purpose and Instructions for the Diabetic/Neuropathic Foot Ulcer Assessment Form_Jan_2014 3 South West Regional Wound Care Program Thick Nails: Onychogryphosis - Thick hard curved nail plate in the shape of a ram's horn due to aging (image), psoriasis or trauma Onychauxis - Thick nail due to psoriasis, trauma, or fungal nail infection Onychogryphosis Oxychauxis Brittle Nails Typical of fungal infection or psoriasis Fungal Nails – a.k.a. onychomycosis Can be due to: o Dermatophytes o Yeasts o Moulds Can involve one or many nails Dermatophyte onychomycosis Abnormal Nails, i.e.: Abnormalities of the nail plate surface: o Pitting – eczema, psoriasis, alopecia areata o Transverse ridging - Consider eczema, paronychia, psoriasis, parakeratosis pustulosa, Beau's line o Longitudinal ridging - lichen planus, psoriasis, fungal Psoriasis of Nails Eczema Beau’s Line nail infection, Darier o Longitudinal groove - Median canaliform dystrophy due to Myxoid cyst or wart o Angel-wing deformity - Nail plate thinning due to lichen planus o Onychoschizia - Distal lamellar splitting/brittle nails Alopecia areata Median canaliform dystrophy due to water/detergent damage o Longitudinal splitting - An extension of ridging seen in SWRWCP: B.8.2_Purpose and Instructions for the Diabetic/Neuropathic Foot Ulcer Assessment Form_Jan_2014 4 South West Regional Wound Care Program psoriasis, fungal nail infection or lichen planus o Distal notching - Consider Darier and lichen planus o Trachyonychia - Rough nails. If all nails affected, known as Twenty Nail Dystrophy, probably due to lichen planus o Erosion - Consider trauma or malignant tumour e.g. SCC or melanoma Nail discoloration: Trachyonychia Nail erosion o Yellow – due to fungal infection, lymphatic obstruction, onychomycosis, psoriasis o Green – pseudomonas o Brown - onycholysis, external staining, chemotherapy or other medications, renal failure, Benign melanocytic naevus, Laugier-Hunziker Syndrome, Peutz-Jeghers syndrome Onychomycosis Psedomonas Staining (urea) o White – Vitiligo, trauma to nail, hypoalbuminaemia, chronic renal failure, thyrotoxicosis, liver cirrhosis, arsenic toxicity o Red – liver cirrhosis, trauma, glomus tumor o Blue – systemic medication o Purple/black – hematoma, pseudomonas, Benign melanocytic naevus. Liver cirrhosis Renal disease Hematoma Abnormalities of the cuticles and nail folds: o Ragged (connective tissue disease) o Hang nail o Nail fold telangiectases (connective tissue disease) o Distal digital infarcts (vasculitis) o Subungual hyperkeratosis (psoriasis, scabies, onychomycosis) Melanocytic naevus Melanoma Vasculitis o Pterygium (lichen planus, Stevens-Johnson syndrome) SWRWCP: B.8.2_Purpose and Instructions for the Diabetic/Neuropathic Foot Ulcer Assessment Form_Jan_2014 5 South West Regional Wound Care Program o Acute paronychia (staph infection, herpes simplex) o Chronic paronychia (candida or pseudomonas infection) o Retronychia (Embedding of the nail into the nail fold and subsequent inflammation) Abnormalities of nail shape: Lichen planus Acute herpetic Acrodermatitis o Enlarged - Osteoid osteoma (bone tumour) paronychia continua o Long or short o Over curvature o Clubbing - Due to hypertrophic osteoarthropathy or thryoid disease (acropachy) o Koilonychia - Thin spoon-shaped nail associated with iron deficiency anaemia & acitretin treatment o Pachyonychia - Wedge-shaped nails o Onychocryptosis - in-growing nail with granuloma formation. Aggravated by retinoids such as isotretinoin or acitretin Loss of nails: Lichen planus Warts Melanocytic naevus o Traumatic o Scarring - Due to tumour or erosive lichen planus o Onychomadesis - Nail shedding may arise in severe or bullous lichen planus or acute and severe systemic illness o Nail patella syndrome Lesions around nails: Subungual melanoma Fibroma Cyst o Warts o Melanocytic naevus o Subungual melanoma o Squamous cell carcinoma o Corn o Fibroma SWRWCP: B.8.2_Purpose and Instructions for the Diabetic/Neuropathic Foot Ulcer Assessment Form_Jan_2014 6 South West Regional Wound Care Program o Cyst o Onychomatricoma o Subungual exostosis o granuloma Subungual exostosis Pyrogenic granuloma Ingrown Nails – a.k.a. onychocryptosis Where the sides or corners of a nail digs into skin Most commonly caused by ill-fitting shoes, improper nail care, nail injury, and fungal nail infection Footwear9: Assess all footwear the person is currently using. Place a check in the most appropriate box(es) on the form. Consider the following properties of good footwear when making your selection: Shoe Part Property Length Should be at least ½” between end of longest toe and end of shoe when standing Toe box depth Toe box should allow toes to wiggle There should be no stitching inside the toe box rubbing on any part of the foot Width Widest part of the shoe should fit the widest part of the foot (forefoot) Heel height ½-1” heel height recommended for walking shoe Max 2” height for evening or dress shoes The wider the heel, the better Heel Should fit snugly or heel may slip Heels should not be worn down – can throw off gait If open heel shoe – should have instep strap and sling back strap Heel counter Should be firm enough to hold foot in place Arch Should accommodate a high arch Should not gap on the inner side of the foot SWRWCP: B.8.2_Purpose and Instructions for the Diabetic/Neuropathic Foot Ulcer Assessment Form_Jan_2014 7 South West Regional Wound Care Program Material There should be no wrinkles, loose linings, tacks, ridges between the inner sole and sides of the shoes Any decorative pattern
Recommended publications
  • Pediatrics-EOR-Outline.Pdf

    Pediatrics-EOR-Outline.Pdf

    DERMATOLOGY – 15% Acne Vulgaris Inflammatory skin condition assoc. with papules & pustules involving pilosebaceous units Pathophysiology: • 4 main factors – follicular hyperkeratinization with plugging of sebaceous ducts, increased sebum production, Propionibacterium acnes overgrowth within follicles, & inflammatory response • Hormonal activation of pilosebaceous glands which may cause cyclic flares that coincide with menstruation Clinical Manifestations: • In areas with increased sebaceous glands (face, back, chest, upper arms) • Stage I: Comedones: small, inflammatory bumps from clogged pores - Open comedones (blackheads): incomplete blockage - Closed comedones (whiteheads): complete blockage • Stage II: Inflammatory: papules or pustules surrounded by inflammation • Stage III: Nodular or cystic acne: heals with scarring Differential Diagnosis: • Differentiate from rosacea which has no comedones** • Perioral dermatitis based on perioral and periorbital location • CS-induced acne lacks comedones and pustules are in same stage of development Diagnosis: • Mild: comedones, small amounts of papules &/or pustules • Moderate: comedones, larger amounts of papules &/or pustules • Severe: nodular (>5mm) or cystic Management: • Mild: topical – azelaic acid, salicylic acid, benzoyl peroxide, retinoids, Tretinoin topical (Retin A) or topical antibiotics [Clindamycin or Erythromycin with Benzoyl peroxide] • Moderate: above + oral antibiotics [Minocycline 50mg PO qd or Doxycycline 100 mg PO qd], spironolactone • Severe (refractory nodular acne): oral
  • C.O.E. Continuing Education Curriculum Coordinator

    C.O.E. Continuing Education Curriculum Coordinator

    CONTINUING EDUCATION All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or C.O.E. professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. Page 1 of 199 Click Here To Take Test Now (Complete the Reading Material first then click on the Take Test Now Button to start the test. Test is at the bottom of this page) 5 hr. Nail Structure and Growth & TCSG Health and Safety Outline Why Study Nail Structure and Growth? • The Natural Nail • Nail Anatomy • Nail Growth • Know Your Nails Objectives After completing this section, you should be able to: C.O.E.• Describe CONTINUING the structure and composition of nails. EDUCATION • Discuss how nails grow. • Identify diseases and disorders of the nail All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O. E. Continuing Education. The course provided was prepared by C.O.E. Continuing Education Curriculum Coordinator. It is not meant to provide medical, legal or professional services advice. If necessary, it is recommended that you consult a medical, legal or professional services expert licensed in your state. 1 CONTINUING EDUCATION All Rights Reserved. Materials may not be copied, edited, reproduced, distributed, imitated in any way without written permission from C.O.
  • Nutritional Dermatoses in the Hospitalized Patient

    Nutritional Dermatoses in the Hospitalized Patient

    HOSPITAL CONSULT IN PARTNERSHIP WITH THE SOCIETY FOR DERMATOLOGY HOSPITALISTS Nutritional Dermatoses in the Hospitalized Patient Melissa Hoffman, MS; Robert G. Micheletti, MD; Bridget E. Shields, MD Nutritional deficiencies may arise from inadequate nutrient intake, abnormal nutrient absorption, or improper nutrient PRACTICE POINTS utilization.4 Unfortunately, no standardized algorithm for • Nutritional deficiencies are common in hospitalized screening and diagnosing patients with malnutrition exists, patients and often go unrecognized. making early physical examination findings of utmost • Awareness of the risk factors predisposing patients importance. Herein, we present a review of acquired nutri- to nutritional deficiencies and the cutaneous manifes- tional deficiency dermatoses in the inpatient setting. tations associated with undernutrition can promote copy early diagnosis. Protein-Energy Malnutrition • When investigating cutaneous findings, undernutri- tion should be considered in patients with chronic Protein-energy malnutrition (PEM) refers to a set of infections, malabsorptive states, psychiatric illness, related disorders that include marasmus, kwashiorkor and strict dietary practices, as well as in those using (KW), and marasmic KW. These conditions frequently are certain medications. seen in developing countries but also have been reported 5 • Prompt nutritional supplementation can prevent patient in developed nations. Marasmus occurs from a chronic morbidity and mortality and reverse skin disease. deficiencynot of protein and calories. Decreased insulin pro- duction and unopposed catabolism result in sarcopenia and loss of bone and subcutaneous fat.6 Affected patients include children who are less than 60% ideal body weight Cutaneous disease may be the first manifestation of an underlying nutri- 7 tional deficiency, highlighting the importance of early recognition by der- (IBW) without edema or hypoproteinemia.
  • Nails Develop from Thickened Areas of Epidermis at the Tips of Each Digit Called Nail Fields

    Nails Develop from Thickened Areas of Epidermis at the Tips of Each Digit Called Nail Fields

    Nail Biology: The Nail Apparatus Nail plate Proximal nail fold Nail matrix Nail bed Hyponychium Nail Biology: The Nail Apparatus Lies immediately above the periosteum of the distal phalanx The shape of the distal phalanx determines the shape and transverse curvature of the nail The intimate anatomic relationship between nail and bone accounts for the bone alterations in nail disorders and vice versa Nail Apparatus: Embryology Nail field develops during week 9 from the epidermis of the dorsal tip of the digit Proximal border of the nail field extends downward and proximally into the dermis to create the nail matrix primordium By week 15, the nail matrix is fully developed and starts to produce the nail plate Nails develop from thickened areas of epidermis at the tips of each digit called nail fields. Later these nail fields migrate onto the dorsal surface surrounded laterally and proximally by folds of epidermis called nail folds. Nail Func7on Protect the distal phalanx Enhance tactile discrimination Enhance ability to grasp small objects Scratching and grooming Natural weapon Aesthetic enhancement Pedal biomechanics The Nail Plate Fully keratinized structure produced throughout life Results from maturation and keratinization of the nail matrix epithelium Attachments: Lateral: lateral nail folds Proximal: proximal nail fold (covers 1/3 of the plate) Inferior: nail bed Distal: separates from underlying tissue at the hyponychium The Nail Plate Rectangular and curved in 2 axes Transverse and horizontal Smooth, although
  • Georgia TCSG Health and Safety

    Georgia TCSG Health and Safety

    Chapter 1: Georgia TCSG Health and Safety 3 CE Hours Copyright ©October 2002-2015 State of Georgia All rights reserved. Georgia. Developed for the Georgia State Board of Cosmetology No part of this manual may be reproduced or transmitted in any form and the Georgia State Barber Board by the Technical College System or by any means, electronic or mechanical, including photocopying, of Georgia Formerly the Georgia Department of Technical and Adult recording, or by any information storage and retrieval system, Education (DTAE) Publication #C121002, Published December without written permission from the Technical College System of 2002, Revised November 2008. COURSE TABLE OF CONTENTS SECTION 1: SKIN, DISEASES, DISORDERS ● Anatomy and Histology of the Skin ○ Nerves of the Skin ○ Glands of the Skin ○ Nourishment of the Skin ○ Functions of the Skin ○ Terminology ● Diseases and Disorders ○ Skin Conditions/Descriptions ○ Nail Diseases/Disorders ○ Hair Disease/Disorders ○ Skin Conditions/Descriptions SECTION 2: BLOODBORNE PATHOGENS ● What are Bloodborne Pathogens? ● Hepatitis B Virus (HBV) ● Human Immunodeficiency Virus (HIV) ● Signs and Symptoms ● Transmission ● Transmission Routes ● Risk Factors and Behaviors ● Personal Protective Equipment SECTION 3: DECONTAMINATION & STERILIZATION ● Common Questions ● HIV ● Precautions SECTION 4: DECONTAMINATION AND INFECTION CONTROL ● Professional Salon Environment ● Safety Precautions ● Material Safety Data Sheet (M.S.D.S.) ● Organizing an M.S.D.S. Notebook SECTION 5: GEORGIA STATE BOARD OF COSMETOLOGY SANITARY
  • Nail Involvement in Alopecia Areata

    Nail Involvement in Alopecia Areata

    212 CLINICAL REPORT Nail Involvement in Alopecia Areata: A Questionnaire-based Survey on DV Clinical Signs, Impact on Quality of Life and Review of the Literature 1 2 2 1 cta Yvonne B. M. ROEST , Henriët VAN MIDDENDORP , Andrea W. M. EVERS , Peter C. M. VAN DE KERKHOF and Marcel C. PASCH1 1 2 A Department of Dermatology, Radboud University Nijmegen Medical Center, Nijmegen, and Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands Alopecia areata (AA) is an immune-mediated disease at any age, but as many as 60% of patients with AA will causing temporary or permanent hair loss. Up to 46% present with their first patch before 20 years of age (4), and of patients with AA also have nail involvement. The prevalence peaks between the 2nd and 4th decades of life (1). aim of this study was to determine the presence, ty- AA is a lymphocyte cell-mediated inflammatory form pes, and clinical implications of nail changes in pa- of hair loss in which a complex interplay between genetic enereologica tients with AA. This questionnaire-based survey eva- factors and underlying autoimmune aetiopathogenesis V luated 256 patients with AA. General demographic is suggested, although the exact aetiological pathway is variables, specific nail changes, nail-related quality of unknown (5). Some studies have shown association with life (QoL), and treatment history and need were evalu- other auto-immune diseases, including asthma, atopic ated. Prevalence of nail involvement in AA was 64.1%. dermatitis, and vitiligo (6). ermato- The specific nail signs reported most frequently were Many patients with AA also have nail involvement, D pitting (29.7%, p = 0.008) and trachyonychia (18.0%).
  • NAIL CHANGES in RECENT and OLD LEPROSY PATIENTS José M

    NAIL CHANGES in RECENT and OLD LEPROSY PATIENTS José M

    NAIL CHANGES IN RECENT AND OLD LEPROSY PATIENTS José M. Ramos,1 Francisco Reyes,2 Isabel Belinchón3 1. Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain; Associate Professor, Department of Medicine, Miguel Hernández University, Spain; Medical-coordinator, Gambo General Rural Hospital, Ethiopia 2. Medical Director, Gambo General Rural Hospital, Ethiopia 3. Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain; Associate Professor, Department of Medicine, Miguel Hernández University, Spain Disclosure: No potential conflict of interest. Received: 27.09.13 Accepted: 21.10.13 Citation: EMJ Dermatol. 2013;1:44-52. ABSTRACT Nails are elements of skin that can often be omitted from the dermatological assessment of leprosy. However, there are common nail conditions that require special management. This article considers nail presentations in leprosy patients. General and specific conditions will be discussed. It also considers the common nail conditions seen in leprosy patients and provides a guide to diagnosis and management. Keywords: Leprosy, nails, neuropathy, multibacillary leprosy, paucibacillary leprosy, acro-osteolysis, bone atrophy, type 2 lepra reaction, anonychia, clofazimine, dapsone. INTRODUCTION Leprosy can cause damage to the nails, generally indirectly. There are few reviews about the Leprosy is a chronic granulomatous infection affectation of the nails due to leprosy. Nails are caused by Mycobacterium leprae, known keratin-based elements of the skin structure that since ancient times and with great historical are often omitted from the dermatological connotations.1 This infection is not fatal but affects assessment of leprosy. However, there are the skin and peripheral nerves. The disease causes common nail conditions that require diagnosis cutaneous lesions, skin lesions, and neuropathy, and management.
  • Sick and Woundedi

    Sick and Woundedi

    FM 8-45 WAR DEPARTMENT MEDICAL FIELD MANUAL RECORDS OF MORBIDITY AND MORTALITY (SICK AND WOUNDEDI FM 8-45 MEDICAL FIELD MANUAL RECORDS OF MORBIDITY AND MORTALITY (SICK AND WOUNDED) Prepared under direction of The Surgeon General UNITED STATES GOVERNMENT PRINTING OFFICE WASHINGTON : 1940 For sale by the Superintendent of Documents, Washington, D. C. - Price 25 cents WAR DEPARTMENT, Washington, October 1, 1940. FM 8-45, Medical Field Manual, Records of Morbidity and Mortality (Sick and Wounded), is published for the in- formation and guidance of all concerned. [A. G. 062.11 (6-15-40).] order of the Secretary of War: G. C. MARSHALL, Chief of Staff. Official : E. S. ADAMS, Major General, The Adjutant General, TABLE OF CONTENTS Section I. General. Paragraph Page Purpose of records of morbidity and mortality 1 1 II. Register of Sick and Wounded. General 2 1 Method of keeping 3 2 Personnel to be registered 4 2 Initiation of 5 4 Recording 6 5 Register number 7 5 Name 8 5 Army serial number 9 6 Grade, company, regiment, or arm or service 10 6 Age, years 11 6 Race 12 6 Nativity 13 7 Service, years 14 7 Date of admission 15 7 Source of admission 16 7 Cause of admission 17 8 Line of duty 18 12 Injury code 19 15 Change of diagnosis 20 15 Complications 21 15 Intercurrent diseases 22 15 Surgical operations 23 15 Treatment in hospital, dispensary, or quarters 24 16 Disposition of patients 25 16 Date of disposition 26 19 Name of hospital, etc 27 19 Month of report 28 19 Days of treatment 29 19 Responsible officer, who signs or initials cards 30 19 Information to be furnished by commanding officer 31 20 Alterations and additions to regis- ter cards 32 20 How filed 33 21 III.
  • Atypical Steatocystoma Multiplex with Calcification

    Atypical Steatocystoma Multiplex with Calcification

    International Scholarly Research Network ISRN Dermatology Volume 2011, Article ID 381901, 3 pages doi:10.5402/2011/381901 Case Report Atypical Steatocystoma Multiplex with Calcification Muhammad Hasibur Rahman,1 Muhammad Saiful Islam,2 and Nazma Parvin Ansari3 1 Cosmoderma Skin Cure Center 96/G, Nirmalabas, Sheora Road, Mymensingh 2200, Bangladesh 2 Department of Orthopedics, Community Based Medical College, Mymensingh 2200, Bangladesh 3 Department of Pathology, Community Based Medical College, Mymensingh 2200, Bangladesh Correspondence should be addressed to Muhammad Hasibur Rahman, dr [email protected] Received 17 January 2011; Accepted 7 March 2011 Academic Editors: A. Alomar, M. Feinmesser, C.-C. Lan, and W. Vanscheidt Copyright © 2011 Muhammad Hasibur Rahman et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. A 60-year-old male reported to us with an atypical case of giant steatocystoma multiplex in the scrotum with calcification. There was no family history of similar lesions. Yellowish, creamy material was expressed from a nodule during punch biopsy. The diagnosis was based on clinical as well as histological findings. Successful surgical excision was done to cure the case without any complications. 1. Introduction steatocystoma multiplex with extensive calcification and firm adhesion to the scrotum. Steatocystoma multiplex occurs as numerous, epithelial- lined, sebum-filled dermal cysts with characteristic seba- 2. Case Report ceous glands in the cyst walls [1]. Usually it begins in adoles- A 60-year-old male presented to us with asymptomatic cence or early adult life.
  • Dermatological Indications of Disease - Part II This Patient on Dialysis Is Showing: A

    Dermatological Indications of Disease - Part II This Patient on Dialysis Is Showing: A

    “Cutaneous Manifestations of Disease” ACOI - Las Vegas FR Darrow, DO, MACOI Burrell College of Osteopathic Medicine This 56 year old man has a history of headaches, jaw claudication and recent onset of blindness in his left eye. Sed rate is 110. He has: A. Ergot poisoning. B. Cholesterol emboli. C. Temporal arteritis. D. Scleroderma. E. Mucormycosis. Varicella associated. GCA complex = Cranial arteritis; Aortic arch syndrome; Fever/wasting syndrome (FUO); Polymyalgia rheumatica. This patient missed his vaccine due at age: A. 45 B. 50 C. 55 D. 60 E. 65 He must see a (an): A. neurologist. B. opthalmologist. C. cardiologist. D. gastroenterologist. E. surgeon. Medscape This 60 y/o male patient would most likely have which of the following as a pathogen? A. Pseudomonas B. Group B streptococcus* C. Listeria D. Pneumococcus E. Staphylococcus epidermidis This skin condition, erysipelas, may rarely lead to septicemia, thrombophlebitis, septic arthritis, osteomyelitis, and endocarditis. Involves the lymphatics with scarring and chronic lymphedema. *more likely pyogenes/beta hemolytic Streptococcus This patient is susceptible to: A. psoriasis. B. rheumatic fever. C. vasculitis. D. Celiac disease E. membranoproliferative glomerulonephritis. Also susceptible to PSGN and scarlet fever and reactive arthritis. Culture if MRSA suspected. This patient has antithyroid antibodies. This is: • A. alopecia areata. • B. psoriasis. • C. tinea. • D. lichen planus. • E. syphilis. Search for Hashimoto’s or Addison’s or other B8, Q2, Q3, DRB1, DR3, DR4, DR8 diseases. This patient who works in the electronics industry presents with paresthesias, abdominal pain, fingernail changes, and the below findings. He may well have poisoning from : A. lead. B.
  • Download PDF Subungual Exostosis of the Big Toe

    Download PDF Subungual Exostosis of the Big Toe

    Romanian Journal of Morphology and Embryology 2009, 50(3):501–503 CASE REPORT Subungual exostosis of the big toe LIGIA STĂNESCU1), CARMEN FLORINA POPESCU2), CARMEN ELENA NICULESCU1), DANIELA DUMITRESCU3), S. S. MOGOANTĂ4), IULIANA GEORGESCU5) 1)Department of Pediatry, “Filantropia” University Hospital, Craiova 2)Department of Pathology and Cytopathology, Emergency County Hospital, Craiova 3)Department of Radiology and Medical Imaging 4)Department of Surgery University of Medicine and Pharmacy of Craiova 5)Division of Dermatology, “Mediplus Diagnostica” Clinical Center, Craiova Abstract The subungual exostosis is a benign bone tumor on the distal phalanx of a digit, beneath or adjacent to the nail, often bringing in discussion many differential diagnosis. We present a 14-year-old boy with a cutaneous nodular lesion, painful to the easy touch on the latero-internal half of the nail of right big toe with extension in the cutaneous part of this. He suffered many treatments, especially cauterization, but with recurrence. In the present, the radiological findings of the affected finger and the histopathological ones from the fragment excised confirmed the diagnosis of subungual exostosis. The local excision of the entire region with the removal of the cartilaginous cap has been followed by a silent period without recurrences of almost two years when he as revised. Keywords: subungual, exostosis, lesion, osteoid. Introduction pyogenic granuloma, the patient suffered many repeated surgical interventions after that the tumor reapers. Subungual exostosis is a benign bone tumor. He not recognizes a significant symptomatology before This lesion is not a true exostosis, but an outgrowth of the apparition of the lesion, excepting an easy normal bone tissue [1].
  • 9 Nail Problems You Shouldn't Ignore

    9 Nail Problems You Shouldn't Ignore

    menshealth.com http://www.menshealth.com/health/nail-problems-you-shouldnt-ignore 9 Nail Problems You Shouldn’t Ignore Next Your eyes may offer a glimpse of your soul—but for a view of your internal organs, check your fingers and toes instead. “Your nails can tell a tremendous amount of information about your general health,” says Dana Stern, M.D., a dermatologist and nail specialist in New York City. “Certain nail changes can indicate issues with the kidneys, infections of the heart, anemia, lung disease, and even exposure to certain poisons.” That’s because diseases that affect your whole body can change the blood flow, growth patterns, or shape of your fingernails and toenails in ways you may notice long before any other symptoms, says Chris Adigun, M.D., a board certified dermatologist and nail specialist in Chapel Hill, N.C. So if you spy something new or unusual on the ends of your digits, check in with your primary care doctor or a dermatologist, she advises. Treating the underlying condition often can save your nails—and maybe even your life. Advertisement Daily Dose You may unsubscribe at any time. menshealth.com http://www.menshealth.com/health/nail-problems-you-shouldnt-ignore/1-koilonychia-or-spoon-nails 9 Nail Problems You Shouldn’t Ignore 1. Koilonychia or “spoon nails" PrevNext You could hold a drop of liquid inside these nails’ concave shape, says Al D’Angelantonio III, D.P.M., who sees and treats toenail problems as a foot and ankle surgeon at Penn Medicine. Spoon nails can serve as a red flag for iron- deficiency anemia, low blood oxygen levels from not taking in or absorbing enough iron.