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Chapter 9
Skin Anatomy and Conditions
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Objectives
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List major components of skin anatomy.
List four types of noninfectious skin
conditions and their treatments.
List four types of infectious skin conditions
and their treatments.
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Objectives (Continued)
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Determine the right strength of sunscreen
necessary to protect skin from ultraviolet
rays.
Define the various forms of acne.
Describe psoriasis and the types of
medications used to treat this skin
condition.
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Skin Anatomy
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Skin: the integumentary system is the
largest organ in the body
Includes skin, hair, subcutaneous tissues
One of the most abused organs in the
body
Protects the body, regulates temperature,
is a sensor or stimuli
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Skin Anatomy (Continued)
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Keratin: top layer of skin; for protection
Epidermis and dermis: layers beneath
keratin
Below dermis: subcutaneous layer of fat
Epidermis: no blood flow of its own
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Skin Anatomy (Continued)
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Dermis: much thicker; holds nerves, blood
vessels, and other connective tissue
Skin: can absorb moisture and medications
Diabetics: inject insulin subcutaneously
Intradermal route: between dermal layer
Intramuscular: into the muscle layer
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
6
Anatomy of the Skin
Epidermis
Dermis
Adipose
Tissue
Hypodermis
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
7
Conditions Affecting the Skin
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For a list of common dosage forms and
types of conditions they treat, see Table
9-14
For popular antibiotic ointments and
creams, see Table 9-15
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Skin Disorders and Medications
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Proper diagnosis: physical assessment,
family history, drug history, lab tests,
possible biopsy
Two very common skin conditions: sunburn
and acne
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Miscellaneous Skin Conditions
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Two categories:
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Noninfectious inflammatory conditions
Infectious inflammatory conditions
See physician for persistent symptoms
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Topical Antibiotics
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Used to treat abrasions, small cuts, and
scrapes
Clean wound properly
See the list of agents for treating such
wounds on the next slide
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
11
Antibiotic Products
Product
Bacitracin
Neomycin
Polymyxin B,
neomycin,
bacitracin
Trade Names
Bacitracin
Neomycin
Myciguent
Dosage Forms
Oint
Oint
Cream
Neosporin
Oint, cream
Oint, Ointment.
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
12
Skin Protection Factor Guide
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SPF agents: topical form; prevent sunburn
UVA rays and UVB rays: two main
wavelengths of rays that cause concern
UV rays cause premature aging, changes
in the DNA, erythema, and blistering
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Sunscreen Skin Protectant Factor
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Overexposure to the sun can cause
mutations in DNA
Cancer can occur and discoloration of
prematurely aged skin
Melanin: chemical for skin color
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Sunscreen Skin Protectant Factor (Continued)
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Two types of protectants:
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Sunscreens: protect from UVA and
UVB rays
 Sunblocks: reflect UV rays
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SPF factor important
Choose coverage based on skin types
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Skin Protectant Factor Guide for Application
of Sunscreen
Skin Type
I
II
III
IV
V
VI
Skin Characteristics
After 10 Min Sun Exposure
Burns easily/rarely tans
Burns easily/tans minimally
Burns moderately/tans gradually
Burns minimally/tans well
Rarely burns/always tans
Never burns/deeply pigmented
Suggested
Minimum Coverage
20 to 30 SPF
12 to 20 SPF
8 to 12 SPF
4 to 8 SPF
2 to 4 SPF
None
SPF, Skin protectant factor.
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Acne Development and Treatment
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Acne affects teenagers and adults
Caused by hormonal changes and genetics
Hormones enlarge the glands of the skin
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Acne Development and Treatment (Continued)
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Two productive glands:
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Sweat: regulate temperature
 Sebaceous: produce skin oil or
sebum
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Increased sebum traps bacteria
Keep skin clean and free from bacteria
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Acne Development and Treatment (Continued)
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Acne classified into two groups:
 Noninflammatory:
treatment is mild
medication (keratolytics)
 Inflammatory: benzoyl peroxide most
common OTC product recommended
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Acne Development and Treatment (Continued)
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Antibiotics used: tetracycline,
erythromycin, clindamycin
Topical agents: retinoic acid, isotretinoin
(Accutane), and tretinoin (Retin A)
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Hives/Inflammation
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Common noninfectious conditions include:
urticaria (hives), eczema (red skin rash),
psoriasis (plaques, scaly skin), seborrheic
dermatitis (rash), and atopic dermatitis
(rash)
Topical agents: used for hives and skin
rashes causing inflammation from severe
itching
Psoriasis: consult a doctor
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Infectious Inflammatory Skin Conditions
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Warts: viral, contagious, caused by
papovavirus(Treatment: see Table 9-19)
Genital warts: see doctor
Tinea infections: caused by fungus; treat
with powdered antibiotics (Treatment: see
Table 9-20)
Canker sores: inside cheek of mouth;
small topical ulcers (See Table 9-21)
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Infectious Inflammatory Skin Conditions
(Continued)
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Lice: Children come home from school with
head lice; high risk for catching without body
contact; whole family should be treated
Herpes—two different types:
 Herpes
simplex (causes sores)
 Herpes zoster- Shingles (causes lesions)
• Treated with antiviral medications
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Infectious Inflammatory Skin Conditions
(Continued)
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Impetigo: contagious condition caused by
streptococcal organisms; infection contagious
 Treatment:
antibiotics and Burrow’s solution
 See Figure 9-6
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Serious Skin Conditions
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Require a visit to the hospital or doctor
Include skin melanomas, psoriasis, burns
Malignant melanoma: cancerous skin
growth; treatment: removal, skin graft
See Figure 9-7
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Serious Skin Conditions (Continued)
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Ulcers: external ulcers caused by bed sores
and affect elderly; may harbor MRSA—
highly contagious
 Treatment:
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antibiotics
Can be caused by STDs
See Figure 9-8
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Psoriasis
Genetic skin condition; cannot be cured;
lasts a lifetime
 Not contagious but looks bad when
inflamed
 Most affected areas: joints, limbs, neck,
scalp
 Potent drugs used: corticosteroids (require
physician’s prescription)
 Sunlight treatments
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Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Burns
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Range from first degree (least severe) to
third degree (most severe)
Medications include silver sulfadiazine
(Silvadene) cream
Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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