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INTEGUMENTARY SYSTEM Characteristics and Treatment of Common Skin Disorders • OPEN BOOK TO PAGE 79 AND KEEP OPEN TO USE AS REFERENCE ACNE • Acne vulgaris • Common and chronic disorder of the sebaceous glands • Secrete excessive oil which is deposited at the openings of the glands; eventually the oily deposit becomes hard (keratinized), plugging up the opening • The openings become filled with leukocytes (WBC) which cause the accumulation of pus • Occurs most often in adolescence and is marked by blackheads, cysts, pimples, and scarring Albinism • Absence of melanin (partial or total lack) • Congenital hereditary condition • Total albinos have pale skin that does not tan, white hair, pink eyes, nystagmus (movements/jerking of the eyes), astigmatism (blurred vision), and photophobia (abnormal sensitivity to light, especially by the eyes) • All are prone to severe sunburn, actinic dermatitis (rash from sun exposure), and skin cancer ALOPECIA • Baldness; permanent hair loss • Genetic predisposition in some males • The normal hair is replaced by a very short hair which is transparent • Males typically experience more hair loss than women and at a younger age (women can have it) • Treatment included medications (topical and oral) and hair transplants ATHLETE’S FOOT • Contagious fungal infection • Infects the superficial skin layer and leads to skin eruptions • Characterized by the formation of small blisters between the fingers and most often the toes; accompanied by cracking and scaling • Usually contracted in public baths or showers • Treatment involves thorough cleaning and drying of the affected area along with special anitfungal agents DERMATITIS • Inflammation of the skin which may be nonspecific • Rash: can be a reaction to soap, plants, etc.; considered contact dermatitis • Treat contact dermatitis by removing the irritant, wash the area, and apply topical ointments to reduce inflammation and itching • Skin blotches: can be caused by stress ECZEMA • Acute or chronic noncontagious inflammatory skin disease • Skin becomes dry, red, itchy, and scaly • Most common type is atopic eczema: an allergic reaction that usually occurs in the first year of life • Treatment: removal or avoidance of the causative agent, as well as application of topical medications containing hydrocortisone • Medication only helps to alleviate the symptoms IMPETIGO • Acute, inflammatory, and contagious skin disease seen in babies and young children • Caused by staphylococcus or streptococcus organism • Characterized by the appearance of vesicles that rupture and develop distinct yellow crusts • Treatment: topical antibacterial cream and oral anitbiotics PSORIASIS • Chronic inflammatory skin disease characterized by the development of dry reddish patches which are covered with a silvery –white scales • Affects the skin surface over the elbows, knees, shins, scalp, and lower back • Cause is unknown; onsets may be triggered by stress, trauma, or infection • Treatment: none definitive at present; moisturizers help keep the skin soft and reduce scales and thus the pain of cracking skin RINGWORM • Highly contagious fungal infection marked by raised, itchy, circular patches with crusts • May occur on the skin, scalp, and underneath the nails • Treatment: anti fungal drugs URTICARIA/HIVES • Skin condition recognized by the appearance of intensely itching wheals or welts • Have an elevated, usually white center, with a surrounding pink area • Appear in clusters distributed over the entire body surface • Last 1-2 days • Generally a response to an allergen (such as a food or drug) • Complete avoidance and elimination of the causative factor(s) alleviate the problem BOILS • Painful bacterial infection of the hair follicles or sebaceous glands usually caused by the staphylococcus organism • If it becomes more extensive and is deeply embedded, it is called a carbuncle • Treatment: antibiotics and an excision and drainage of the affected area ROSACEA • Common inflammatory disorder characterized by chronic redness and irritation to the face • Most often affects fair-skinned adults • If s/s worsen, small blood vessels on the nose and cheeks enlarge and become visible, small red bumps or pustules may appear and spread across the face • Treatment: avoid triggers that aggravate the condition and use of a topical or oral antibiotic medication HERPES • Viral infection that is usually seen as a blister • Most common types: herpes simplex, genital herpes, and herpes zoster (shingles) • Involves periods of remission and exacerbation • HERPES SIMPLEX – Occurs around the mouth and is known as a fever blister or cold sore – May be spread through oral contact HERPES • GENITAL HERPES – May appear as a fever blister in the genital area – Usually spread through sexual contact – Treatment: antiviral medication such as acyclovir – Can be passed from mother to baby during vaginal delivery HERPES • HERPES ZOSTER (SHINGLES) – Skin eruptions due to a virus infection of the nerve endings – Same virus as the one that causes chicken pox – Commonly seen on the chest or abdomen, accompanied by severe pain known as herpetic neuralgia – Serious in people who are elderly or debilitated – Treatment consists of medication for pain and itching and protecting the area SKIN CANCER • Associated with exposure to UV light • Most common type of cancer in people • Basal cell carcinoma – Most common and least malignant, usually occurs on the face – Treatment: surgical removal, radiation, or cryosurgery • Cryosrugery: destruction of tissue by freezing, using liquid nitrogen – Full recovery occurs in 99% of the cases continued • Squamous cell carcinoma – Arises from the epidermis and occurs most often on the scalp and lower lip – Grows rapidly and metastasizes to the lymph nodes – Treated by surgical removal or radiation – Chances are good if found early …. • Malignant melanoma – Occurs in pigmented cells of the skin called melanocytes – Metastasize to other areas quickly – May appear as a brown or black irregular patch which occurs suddenly – A change in a preexisting wart or mole may also indicate melanoma – Treatment: surgical removal of the melanoma and the surrounding area and chemotherapy BURNS (pg 84) • Traumatic injury as the result of radiation from the sun (sunburn), a heat lamp, or contact with boiling water, steam, fire, chemicals, or electricity • When the skin is burned, dehydration and infection may occur • Referred to as first, second, or third degree depending on the skin layers affected and the symptoms FIRST DEGREE BURNS • • • • • Also called superficial burns Involve only the epidermis Symptoms are redness, swelling, and pain Treatment: application on cold water Healing occurs within one week SECOND DEGREE BURNS • Also called partial thickness burns • May involve the epidermis and dermis • Symptoms include pain, swelling, redness, and blistering • Treatment: may include pain medication and dry sterile dressings applied to open skin areas • Healing generally occurs within 2 weeks THIRD DEGREE BURNS • Full thickness burns • Involve complete destruction of the epidermis, dermis, and subcutaneous layers • Symptoms include loss of skin, eschar (blackened skin), yet possibly no pain (WHY?) • May be a life-threatening situation depending on the amount of skin damaged, and fluid and plasma lost • Requires immediate hospitalization • Treatment: prevention of infection, contracture, and fluid replacement • Skin grafting is done as soon as possible RULE OF NINES • Measures the percent of the body burned • The body is divided into 11 areas and each area accounts for 9% of the total body surface. • For example, each arm is 4.5%; the perineal area accounts for 1% • SEE FIGURE 5-7 pg 83.