Chapter 18 Integumentary System Diseases and Disorders

1. Chapter 18Integumentary System Diseases and Disorders

2. Anatomy and Physiology • Skin is largest organ of body • First line of protection for body against invading organisms • Provides sense of touch, heat, cold, and pain

3. Anatomy and Physiology • Helps stabilize temperature and fluid and electrolyte balance • Three layers • Epidermis • Dermis • Subcutaneous

4. Common Signs and Symptoms • Skin lesions • Pain • Pruritus • Edema • Erythema • Inflammation

5. Diagnostic Tests • Biopsy • Culture and sensitivity • Blood tests • Microscopic smear examinations

6. Herpes • Large family of viruses • Symptoms: inflammation of the skin, clusters or fluid-filled vesicles • Not treatable and remains in affected individual’s body for life • Remissions and exacerbations

7. Herpes • Common types • Herpes Simplex I - “fever blisters and “cold sores” • Herpes Genitalis, Herpes Simplex II - “genital herpes” • Herpes Varicella - “chickenpox” • Herpes Zoster - shingles

8. Verruca (Warts) • Chronic condition • Occur in multiples and differ in size, shape, and appearance • Often resistant to treatment

9. Verruca (Warts) • Common types • Appear on hands and fingers of children • Plantar warts appear on sole of the foot • Genital warts are sexually transmitted

10. Impetigo • Streptococcus and staphylococcus • Affects face and hands of children • Symptoms: vesicles, pustules that rupture producing yellow crust over lesions • Treatment: cleansing and antibiotic ointment

11. Folliculitis • Inflammation and infection of the hair follicle usually by staphylococcus • Symptoms: small pustules surrounding hair • Treatment: antibiotics

12. Abscess, Furuncle, Carbuncle • Inflammation, infection, and formation of a capsule prevent spread of infection • Treatment: antibiotics

13. Cellulitis and Erysipelas • Diffuse or spreading inflammation of skin and subcutaneous tissue • Cellulitis is caused by staphylococcus • Erysipelas is a form of cellulitis caused by streptococcus, which affects the face

14. Cellulitis and Erysipelas • Symptoms • Fever and chills • Headache • Vomiting • Red, painful edematous skin • Treatment: IV antibiotics

15. Lyme Disease • Multisystem infections transmitted to humans through bite of infected deer tick • Symptoms • Flu-like symptoms • Arthritis • Malaise

16. Lyme Disease • Symptoms • Chills and fever • “Bull’s eye” skin rash • Treatment—antibiotics

17. Tinea • Tinea • Infects warm, moist areas of body • Feeds on perspiration and dead skin • Symptoms • Itching, cracking, and weeping of skin • Treatment: Wash and dry, antifungal agents

18. Tinea • Forms of Tinea • Tinea Corporis: affects smooth skin on arms, legs, and body • Tinea Pedis: “athlete’s foot” • Tinea Cruris: “jock itch”

19. Tinea • Forms • Tinea Unguium: finger or toe nails • Tinea Capitis: scalp • Tinea Barbae: bearded areas

20. Candidiasis • Fungal infection caused by candida • Symptoms • Red, itchy skin with blisters and pustules • Treatment • Antifungal medications

21. Pediculosis • Infestation with lice • Treatment: bathing and shampooing with medicated shampoo (Kwell) • Three types of lice • Head, Body, Pubic

22. Scabies • Caused by tiny mite • Commonly called “seven year itch” • Slightly elevated, grayish-white lines, intense itching, vesicles, and pustules • Treatment: lindane cream to entire body

23. Acne Vulgaris • Inflammation of sebaceous glands and hair follicles • Symptoms: comedones • Treatment: cleansing and OTC treatments • Severe cases: antibiotics, steroids, and retinotic acid preparations

24. Seborrheic Dermatitis • Affects the sebaceous glands • Called “cradle cap in infants” • Affecting the scalp is “dandruff” • Symptoms: reddened, itchy areas, scales • Treatment: wash and dry, steroid creams

25. Sebaceous Cyst • Sebaceous gland becomes blocked and sebum collects under skin • Special type: pilonidal cyst • Treatment: incising and draining, surgical removal

26. Eczema • Inflammation of skin • Symptoms: itching, redness, vesicles, pustules, scales, and crusting • Treatment: topical cortisone, antihistamines, and sedatives

27. Contact Dermatitis • Acute or chronic allergic reaction of skin • Causes: cosmetics, laundry products, jewelry, pain • Symptoms: small red localized lesions to vesicular lesions

28. Psoriasis • Chronic skin disease • Symptoms: red, raised lesions with distinct borders and silvery scales • Treatment: coal tar medications, ultraviolet light, and steroids

29. Scleroderma • Hardening, thickening, and shrinking of connective tissues, including skin • Autoimmune reaction

30. Seborrheic Keratosis • Benign overgrowth of epithelial cells • Treatment • Curettage • Scraping off

31. Keloid • Raised, firm, irregular-shaped scar tissue following trauma or surgery • Treatment: surgical removal

32. Hemangioma • Congenital benign tumor of small blood vessels that form a purplish birthmark • Common types • Port wine stain • Strawberry hemangioma • Cherry hemangioma

33. Actinic Keratosis • Premalignant condition • Wart-like lesions on sun-exposed areas • Common in fair-skinned individuals • Treatment • Topical medication such as Retin A • Curettage or cryotherapy

34. Squamous Cell Carcinoma • Tends to occur in sun-exposed areas • Symptoms: firm red nodule with crusts or slightly elevated plaque • Treatment: wide surgical excision with radiation treatments

35. Basal Cell Carcinoma • Most common type of skin cancer • Slow-growing, locally invading tumor that does not metastasize • Treatment: surgical removal

36. Malignant Melanoma • Most serious type of skin cancer • Symptoms: change in size and color of mole • Rarely occurs before age 20 • May be related to severe sunburn as child

37. Malignant Melanoma • Treatment • Depends on degree of spread • May include wide surgical excision • Radiation and chemotherapy

38. Kaposi’s Sarcoma • Malignant vascular skin tumor • Bluish-red cutaneous nodules • No adequate treatment

39. Abnormal Pigmented Lesions • Types • Ephelis: freckle • Lentigo: liver spot • Nevus: mole • Albinism: decrease or total absence of pigment in the skin, hair, and eyes

40. Abnormal Pigmented Lesions • Types • Vitiligo: destruction of melanocytes in small or large patches of skin • Melasma: dark patches of skin on face, especially the cheeks

41. Diseases of the Nails • Abnormal shape, thickening, and color • Fungal and bacterial infections are most common cause • Bacterial infections treated with antibiotics • Fungal infections treated with antifungal medications

42. Diseases of the Hair • Hirsutism: excessive growth of hair • Alopecia: partial or complete hair loss

43. Mechanical Skin Injury • Abrasion: scraping away skin surface • Blunt trauma • Contusion by items such as a hammer or club • Thrown into items such as steering wheel and wall

44. Mechanical Skin Injury • Avulsion: skin or appendage is pulled or torn • Crush trauma: tissue is caught between two hard surfaces

45. Mechanical Injuries • Puncture injury: sharp object is forced into tissue • Laceration: cut in skin caused by a sharp object

46. Hyperthermia • Hyperthermia: body is overheated due to excessive exposure to sun or heat • Types • Heat exhaustion • Heat stroke

47. Burns • First degree: pain, redness, and swelling • Second degree: pain, redness, swelling, blisters, and open wounds • Third degree: charred and broken skin tissue, painless

48. Cold Injuries • Not as severe or life threatening as heat or burn injuries • Low body temperature • Symptoms: • Extreme shivering and mental confusion • Blue or cyanotic extremities and weak pulse

49. Cold Injuries • Treatment • Remove wet clothing • Warm body with warm blankets • Warm liquids • Frostbite: freezing of tissue, usually on face, fingers, toes, and ears

50. Electrical Injury • Unprotected or inadequately insulated electrical wiring • Contact with lightning • Damage has a point of entry and exit