Download Integumentary Diseases

Integumentary System
Altered Functions
Vocabulary
DermaMelan/oPachySubtrich/oCyan/oOnych/o-
Xer/oHidr/oKerat/oXanth/oFollicul/oDactyl/oIntra-
Integumentary Regions
Skin
– Epidermis
– Dermis
Hypodermis
Sensory receptors
Muscle
Adnexa
– Hair and follicle
– Glands
• Sweat
• Sebaceous
– Nails
Epidermis Histology Overview
Epidermis Strata Histology
C = corneum
G = granulosum
S = spinosum
B = basale
Underlying Disorders
Genetic
Connective tissue
Blood supply
Neoplasia
Drug Reactions
Immune
Primary Lesions
Macules: colored circumscribed flat area, size varies, < 1cm
Papules: discolored raised area, < 2cm
Plaques: raised flat top area, > 1cm
Patches: circumscribed flat area of discoloration, < 1cm
Nodules: solid raised area, above or below skin, <1 cm
Tumor: discolored raised area, > 2cm
Wheals: slightly raised area with edema, size varies
Vesicles/Blister: fluid filled raised area < 0.5cm
Bulla/Cyst: fluid filled raised area, > 0.5cm
Pustules: pus-filled raised area, size varies
Macule
Nodule
Papule
Bulla
Secondary Lesions
Erosions
Ulcers
Fissures
Cracks
Scales
Excoriation
Keloid
Scar
Lichenification
Cracks and Fissures
Ulcer and Erosion
Excoriation
Lichenification
Scar Formation
Keloid
Epidermal Cells
Keratinocytes
Keratinocyte Hypertrophy
Melanocyte location and function
Melanosomes with Melanin
Melanin
Melanosis
Langerhans Dendritic Cells
Skin Cancers
Skin Cancer ABCD and E (evolving)
Etiology
UV exposure
– UV A
– UV B
Genetic
Prevention
– Sun block
• UVA
• UVB
– Clothing
– Window tinting
Skin Tumors
Benign
–
–
–
–
Seborrheic keratitis
Keratocanthoma
Verucae (warts)
Actinic keratitis
Malignant
– Basal Cell carcinoma
– Squamous Cell
carcinoma
– Dysplastic nevi
– Malignant melanoma
Seborrheic Keratosis
Keratocanthoma
Verrucae
Actinic Keratitis
Basal Cell Carcinoma
Squamous Cell Carcinoma
Epidermal Cancers Compared
Malignant Melanoma
Merkel Cell Carcinoma
Dermis
Dermal Papilla and Reticular Dermis
Lines of Cleavage
Aging = Wrinkles?
Skin changes
– Chronological aging
– Photo-aging (sun damage)
– Chemical toxins
Cause
– Decrease in collagen
(inactive fibroblasts)
– Increase in proteolytic
activity due to collagenase
Hypodermis
Subcutaneous tissue
Clinical Application
Dermatitis (Eczema)
Atopic
Contact
Seborrheic
Drug eruption
Photo-eczematous
Dermatitis reactions
Presentation
Papulovesicular
Oozing with crusts
Scaling plaques
Contact Dermatitis
Seborrheic Dermatitis
Dandruff; Cradle Cap
Drug Eruption
Photoeczematous
UV
Genetic: Porphyria
Drug Induced
– Oral
– Topical
Lupus
Venous Stasis Dermatitis
Cutaneous Membrane
Insect Bites
Chiggers
Biting Flies
Mosquitoes
Spider Bites
Bacterial Lesion Appearance/ Causes
Furunculosis
Folliculitis
Impetigo
Cellulitis
Staph aureus
Pseudomonas
Gram (-) enterics
Beta hemolytic Strep
Mycobacterium
Clostridium
MRSA
Bacteria: Staph. aureus
Disease: Pyodermas
Transmission:
– Direct, topical
– Open wound entry
Culture and Sensitivity ID
Drug Resistance
– Beta lactamase
– Alternate method of cell
wall synthesis
VRE
Vancomycin
Risk factors
–
–
–
–
–
Hospitalization
Immunocompromised
Neutropenia
ICU
Dialysis
Impetigo
Staph; Strep
Cut or scratch
Honey colored oozing
sores
Lip / nose region
After a cold
Scratching can spread
to other areas
Cellulitis
Gangrene
Streptococcus
Leprosy
Erysipelas
Group A Strep
Cellulitis
Necrotizing Fasciitis
Strep pyogenes
Fascial planes
Source
– Skin
– Bowel
Aka, Streptococcal
gangrene
Post op concern
Scarlet Fever
Fungal Infections
Microsporum
Trichophyton
Epidermophyton
Microsporum
Trichophton
Tinea Capitus
Tinea corpus
Tinea pedis
Epidermatophyton
Candida albicans
Viral Infections
Papilloma
Herpes
Morbillivirus
Rubella
Parvovirus
HPV
Papilloma
Herpes: HSV-1, HSV-2
Herpes: Varicella Zoster Virus
Shingles
Rubeola
Paramyxovirus
5 day or hard measles
Respiratory spread
Exanthem rash
– White spots in red
Fever; cough
Neurological
Rubella
Erythema Infectiosum
(Fifth Disease)
Parvovirus B19
Mild rash (slapped
cheek
– Face
– Limbs
– Trunk
Respiratory secretions
– direct contact spread
Pain, fever, itching
Idiopathic/Immune
Acne
Psoriasis
Rosacea
Pemphigus
Scleroderma
Erythema multiforme
Vitiligo
Acne Vulgaris
Propionibacterium acnes
Staph epidermidis
Psoriasis
Rosacea
Pemphigus
Autoimmune
Blistering
Scleroderma
Erythema Muliforme
Vitiligo
Urticaria
Porphyria
Genetic Enzyme Deficiency
Adnexa
Sweat Glands
Hair and Follicle
Hair/ Follicle Disorders
Alopecia
Genetic: baldness
– Male
– Female
Hirsutism
Parasitic
Infectious
– Bacterial
– Fungal
Folliculitis
Scabies
Pediculosis
Head Louse
Body Louse
Nail Disorders
Clubbing
Paronchyma
Onchomycosis
Clubbing
Fungal Infections
Sensory
Burn Classification
Skin Layers Affected
Rule of 9’s
Artificial Skin
Hormone
EGF:
Epidermal
Growth
Factor
Frostbite
Injury
Blunt force trauma: blows, impact injury
Contusion
Abrasion
Laceration
Sharp Force
– Incised wound
– Stab wound
– Puncture wound
GSW
Puncture Wound
Laceration
Wounds compared
GSW
Entrance Wound
Exit Wounds
Summary
Process and Timeframe
Histology of Repair
Suture
Questions?
Fish Spa