Skin lesions assessment

Immediate withdrawal of suspected causative agents appears to improve outcome and survival in SJS. The condition is treated similarly to OCR Although still controversial, the use of systemic steroids and, in some instances of severe disease, immunosuppressive agents has been successful. Tetracycline and fluoroquinolone antibiotics may be used to combat any secondary infections of the bullous regions of the epidermis. Fluid and electrolyte levels must be monitored to assess potential dehydration secondary to the skin lesions, and intravenous fluids should be administered as necessary. 

The influence on metals such as copper and zinc may be difficult to assess, since penicillamine not only increases the excretion but also the absorption of these metals (140). A zinc deficiency syndrome, with skin lesions, alopecia, granulocytopenia, and eye damage, has been described in association with penicillamine (141). 

Before administration Establish baseline electrolytes, particularly serum and urine calcium. Obtain history of the onset of skin lesions note whether there is a family history of lesions. Assess the psychological effects of skin lesions and changes in body image. Obtain a culture of purulent draining skin lesions. Obtain baseline vital signs report any elevation in temperature. 

Before a treat-or-refer recommendation can be made, the pharmacist or other health professional must make a reasoned assessment of the problem and make a presumptive diagnosis (or at least rule out some of the many skin disorders). Several factors affect this decision, including patient age and hormonal status, patient complaint and history, and lesion assessment. 

Blatter, C., et al. In situ structural and microangiographic assessment of human skin lesions with high-speed OCT. Biomedical Optics Express 3(10), 2636-2646 (2012)... 

Aberg, R, Nicander, I., Holmgren, U., Geladi, R., OUmar, S., 2003b. Assessment of skin lesions and skin cancer using simple electrical impedance indices. Skin Res. Technol. 9, 257—261. 

Diagnosis. Dermatologists obtain the patient s medical history and assess his or her status. They examine the affected skin and adjacent areas to determine the nature and extent of the lesions. A frequently used method is dermoscopy (or epiluminescent microscopy), which employs a quality magnifying lens and a powerful lighting system to allow a close examination of the skin s structure. It is useful in evaluating pigmented skin lesions and can facUitate the dk nosis of melanoma. 

A wart is a skin lesion caused by infection with human papillomavirus (HPV). Contact immunotherapy is one of the many therapeutic options that has been used to treat warts however, the effectiveness of contact immunotherapy differs from patient to patient, and the cause of this variaHon in clinical response is unclear. To assess cytokine changes in patients after contact immunotherapy with squaric acid dibutylester (SADBE), a total of 21 patients with warts and nine healthy control subjects were enrolled in this study [Ib ]. The frequencies of CD3+ T cells expressing interleukin (IL)-4 IL-10, lL-12, tumour necrosis factor-alpha (TNF-a) and interferon-gamma were measured by flow cytometry analysis of peripheral blood at baseline in both patients and controls, and after SADBE treatment in patients. 

Patients with skin cancer generally present with a lesion that may be located anywhere on the body. The most common sites are the head, neck, trunk, and extremities. Changes in any characteristics of a lesion are important danger warning signals. Abnormal presentations of a mole/lesion indicate the need for further assessment. 

Assess for improvement of skin conditions, relief of pruritus, and healing of lesions... 

Some information on structure-promotion relationships for PBBs is available from studies that used two-stage liver and skin carcinogenesis models. In the liver promotion studies, development of enzyme-altered hepatic foci (putative preneoplastic lesions) was assessed in rats that were partially hepatectomized, initiated with diethylnitrosamine and promoted with PBBs (Buchmann et al. 1991 Dixon et al. 1988 ... 

After administration Assess skin for irritation, erythema, worsening of psoriasis. If irritation of lesions or surrounding uninvolved skin develops or if serum calcium level increases outside normal range, medication should be discontinued. 

There is a definite association between the size of a primary melanoma lesion and the likelihood of metastases. The prognostic factor originally used to determine survival was based on the cross-sectional profile of the primary tumor. The cross-sectional profile could be evaluated if the deepest invasive tumor cells lay above or below the sweat glands. This assessment was further clarified by Clark, who described the relationship of depth of invasion of the cancer cells to the standard anatomic landmarks of the skin (Table 133-3). Clark s classification is a practical approach for patients with more superficial tumors, because tumors classified as Clark levels I through III seldom metastasize. That classification system has been criticized because of problems associated with practical measurements. Melanoma lesions that occur in the presence of lymphoid infiltration, fibrosis, or even the cells of preexisting nevi are difficult to assess with classic reference landmarks. 

---