Physical Therapy for Skin Disorders

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Questions and Answers

What percentage of teenagers are affected by acne vulgaris?

60%

85% (correct)

90%

50%

What is believed to activate acne formation during stress periods?

Increased output of hormones from pancreas

Increased output of hormones from adrenal glands (correct)

Increased output of hormones from pituitary glands

Increased output of hormones from thyroid glands

What is an example of a medication that can cause acne?

Antibiotics

Anti-inflammatory drugs

Barbiturates (correct)

Painkillers

What is the goal of Physiotherapy treatment of acne vulgaris?

To obtain desquamation of skin Signup and view all the answers

What is a dietary factor that can increase the chances of developing acne?

Consuming high amounts of chocolates Signup and view all the answers

What is a hormonal treatment for acne in females?

Combined oestrogen/progestogen methods of hormonal contraception Signup and view all the answers

What is a type of treatment for acne that uses a specific type of light?

UV Laser Signup and view all the answers

What percentage of adult women suffer from adult acne?

30% Signup and view all the answers

What is the primary goal of the UVR treatment in the context of Alopecia Areata?

To improve the condition of the skin and promote hair growth Signup and view all the answers

What is the typical age range affected by Alopecia Areata?

Under 30 years of age Signup and view all the answers

What is the role of T cell lymphocytes in Alopecia Areata?

They cluster around the follicles, causing inflammation and subsequent hair loss Signup and view all the answers

What is the primary cause of Alopecia Areata?

Autoimmune disorder in which the body attacks its own hair follicles Signup and view all the answers

What is the term for the loss of hair from the scalp in patches?

Alopecia areata Signup and view all the answers

What is the prognosis for patients with Alopecia Areata?

Majority of patients recover within a year Signup and view all the answers

What is the purpose of the He-Ne laser treatment in the context of Alopecia Areata?

To burn away the follicle sac from which the hair grows Signup and view all the answers

What is the aim of the physiotherapy treatment for Alopecia Areata?

To improve general health and nutrition to hair follicles Signup and view all the answers

What is the primary goal of treatment for skin involvement in conditions like vitiligo?

To reduce complications of skin involvement into fascia, muscle, or bone Signup and view all the answers

What is the typical age range for the onset of dermatomyositis in adulthood?

40-60 Signup and view all the answers

What is the estimated incidence of vitiligo in the general population?

1-2% of the population Signup and view all the answers

What is the female to male ratio of dermatomyositis?

2:1 Signup and view all the answers

What is the main characteristic of segmental pattern vitiligo?

Depigmentation develops on one side of the body Signup and view all the answers

What is the primary mechanism of muscle damage in dermatomyositis?

Autoimmune mechanism Signup and view all the answers

What is the expected success rate of PUVA therapy in repigmenting the skin?

50-70% chance of returning color Signup and view all the answers

What is the purpose of psoralen in PUVA therapy?

To make the skin sensitive to light Signup and view all the answers

What is the most common systemic manifestation of dermatomyositis?

Proximal muscle weakness Signup and view all the answers

What is the primary goal of physical therapy management in dermatomyositis?

Restore motor function Signup and view all the answers

Who may benefit from skin grafting as a treatment for vitiligo?

Only a small group of vitiligo patients Signup and view all the answers

What is the characteristic skin rash associated with dermatomyositis?

Butterfly rash Signup and view all the answers

What is a common symptom of vitiligo?

Depigmentation and sensitivity to light Signup and view all the answers

What is the potential complication of respiratory muscle weakness in dermatomyositis?

Aspiration pneumonia Signup and view all the answers

What is the typical duration of PUVA therapy to achieve repigmentation?

At least a year of twice weekly treatments Signup and view all the answers

What is the typical location of muscle weakness in dermatomyositis?

Proximal muscles Signup and view all the answers

Study Notes

Skin Disorders

Acne Vulgaris

A skin disease caused by changes in the pilosebaceous units (hair follicles and sebaceous gland)
Commonly occurs during adolescence, affecting more than 85% of teenagers, and frequently continues into adulthood
Causes:
- Family/genetic history
- Hormonal activity (menstrual cycle, puberty)
- Inflammation, skin irritation, or scratching
- Stress
- Hyperactive sebaceous glands
- Accumulation of dead skin cells blocking pores
- Bacteria in pores
- Use of anabolic steroids
- Certain medications (barbiturates, androgen)
- Diet (high consumption of chocolates)
Treatment:
- Oral antibiotics
- Topical antibiotics
- Hormonal treatment (for females)
- Physiotherapy:
  - Goals:
    - Obtain desquamation of skin
    - Increase vascularity
    - Reduce number of micro-organisms
    - Improve general health and hygiene
  - Methods:
    - UVR
    - Laser (He-Ne laser, 632.8nm wavelength)

Alopecia Areata

Defined as premature loss of hair, sometimes leading to total loss of hair from the body
Causes:
- Autoimmune disorder (body attacks its own hair follicles and suppresses hair growth)
- Age: generally affects individuals under 30 years old
- Predisposing factors:
  - Poor health
  - Heredity
  - Anxiety and fatigue
Pathological Changes:
- Hair becomes weak from the root and comes out of follicle
- Atrophy of hair follicle occurs
- Sebaceous glands become inactive or less active
Clinical Features:
- Insidious onset
- Hair starts falling in clumps
- White skin appears after patches of hair fall
- Baldness appears
Classification:
- Alopecia areata: loss of hair from scalp in patches
- Alopecia totalis: scalp hair loss along with eyebrows
- Alopecia universalis: loss of hair all over the body
Prognosis:
- Growth of fine hair may be seen within two months
- Majority of patients recover within a year
- Sometimes patients may not recover
Physiotherapy treatment:
- Aims:
  - Improve general health
  - Improve nutrition to hair follicles
- Means:
  - UVR (sub-erythema or E1 doses) for 5-8 minutes daily, continued for 2-3 months

Dermatomyositis

A systemic connective tissue disease characterized by inflammatory and degenerative changes in muscles and skin
Leading to symmetric weakness and some degree of muscle atrophy in limb girdles, neck, and pharynx
May affect the esophagus, lungs, and heart
Typically appears between ages 40-60, with a female to male ratio of 2:1
Characteristics/Clinical Presentation:
- Onset may be acute or insidious
- Progressive symmetric muscle weakness primarily in muscles of proximal joints and neck and pharynx
- Erythematous skin rash, elevated on the face, neck, shoulders, chest, and back
Causes:
- Unknown etiology
- Potential autoimmune mechanism
- Potentially triggered by a virus
- Potentially drug-induced
Physical Therapy Management:
- Goals:
  - Reduce impaired joint mobility
  - Restore motor function
  - Improve muscle performance
  - Regain range of motion associated with connective tissue dysfunction
  - Reduce complications of skin involvement into fascia, muscle, or bone and scar formation
- Treatment:
  - Patient education on joint preservation
  - Strengthening to prevent atrophy once inflammation is controlled
  - Range of motion exercises to prevent contractures
  - Passive stretching and splinting

Vitiligo

A chronic disorder that causes depigmentation patches in skin
Incidence: 1-2% of the population, affecting both males and females of all races, at any age
Causes:
- Unknown etiology
- Autoimmune disorder (melanocytes destroy themselves)
Symptoms:
- Depigmented patches (milky white) on the skin, common in sun-exposed areas
- Rarely, patches show slight erythema, but typically only depigmentation and sensitivity to light
- Hair may be white or black
Patterns of Vitiligo:
- Focal Pattern: depigmentation limited to one or few areas
- Segmental Pattern: depigmentation develops on only one side of the body
- Generalized Pattern: depigmentation develops on different parts of the body
Treatment:
- Repigmentation Therapy
- Topical Corticosteroids
- PUVA (psoralen and UVA light therapy)
- Narrow Band UVB (NBUVB)
- Grafting (transfer of skin from normal to white areas, useful for a small group of vitiligo patients)

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Description

This quiz covers different skin diseases related to physical therapy, including acne vulgaris, and how to construct a proper PT program for each disease. It also identifies risk factors and matches proper PT modality for each skin disease.