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The Pharmacy Technician FOUNDATIONS AND PRACTICES Chapter 21 The Skin The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 21.1 Structure of the Skin. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Skin • Epidermis—outermost layer of skin – Contains melanocytes, where pigment is stored – Thinnest skin layer The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Skin (cont.) • Dermis—middle layer of skin tissue – Contains fibroblasts responsible for secreting collagen and elastin – Contains immune cells, hair follicles, blood vessels, and sweat and oil glands – Location of the sensory receptors for touch, pain, heat, and cold – Helps maintain body temperature The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Skin (cont.) • Subcutaneous layer (hypodermis)— deepest layer of skin – Outermost part of the muscle is located here – Stores fat tissue – Contains connective tissue The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Functions of the Skin • Acts as a mechanical barrier to infection • Provides for the sense of touch • Regulates body temperature • Excretes waste products and salt from the • body Synthesizes vitamin D (with sunlight) for the absorption of calcium The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Diseases of the Skin—Rash • Area of red, inflamed skin, or a group of • • red spots Caused by irritation, allergy, infection, or defects in the skin’s structure Pharmaceutical treatment: antihistamines, topical corticosteroids The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Diseases of the Skin—Eczema • Skin inflammation with red, pimple-like • • bumps Characterized by itching, blistering, or oozing areas that progress to scaly, brownish, or thickened skin Pharmaceutical treatment: topical immunomodulators The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Diseases of the Skin—Psoriasis • Chronic immune disorder • Specific immune cells become overactive • • and release excessive amounts of proteins called cytokines Causes inflammation and painful, often disfiguring plaques Pharmaceutical treatment: topical steroids, oral antibiotics, immunosuppressants The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 21.2 Psoriasis of the abdomen. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Diseases of the Skin—Viral Infection • Occurs when a virus infects the inner • • layers of the skin Examples: herpes simplex, warts, shingles Pharmaceutical treatment: antiinflammatory steroids or antihistamines The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Diseases of the Skin—Bacterial Infection • Occurs when bacteria penetrate the skin • • • • and cause opportunistic infection Most common bacterial infections: staphylococci, streptococci, and pseudomonas If left untreated, may spread throughout the body, causing systemic infections Examples: cellulitis, impetigo, folliculitis Pharmaceutical treatment: oral antibiotics The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Diseases of the Skin—Fungal Infection • Occurs when harmless fungi gain entry • • • into the skin Usually external, affecting the skin, hair, and nails Examples: athlete’s foot, jock itch, ringworm Pharmaceutical treatment: topical antifungals The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Diseases of the Skin—Acne • Bacterial infection • Results in an overproduction of sebum, • • which clogs the hair follicles Categorized as noninflammatory or inflammatory Pharmaceutical treatment: topical antiseptics The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Diseases of the Skin—Cellulitis • Acute, deep infection of the connective • • tissue Accompanied by inflammation Pharmaceutical treatment: oral or IV antibiotics The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Diseases of the Skin—Parasitic Infestations • Caused by insects or worms that burrow • • into the skin to live and/or lay eggs Examples: scabies, lice Pharmaceutical treatment: antiparasitic topical agents The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 21.3 Parasitic infestation—head lice. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Diseases of the Skin—Tumors and Cancerous Growths • Occur when skin cells multiply or • • • reproduce faster than normal Cells without mutation are noncancerous or benign Tumors or skin growths with mutation are cancerous or malignant Pharmaceutical treatment: topical chemotherapeutic agents, immunomodulators, NSAIDs for precancerous actinic keratosis The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 21.4 Basal cell carcinoma. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 21.5 Malignant melanoma. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Diseases of the Skin—Pigmentation Disorders • Skin color is determined by the amount of • melanin produced by the body Hypopigmentation—loss of skin pigmentation – Example: vitiligo • Hyperpigmentation—excess skin pigmentation – Examples: freckles, age or “liver” spots • Pharmaceutical treatment: none The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Table 21.1 Drugs Used to Treat Various Skin Diseases The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Table 21.1 (continued) Drugs Used to Treat Various Skin Diseases The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Table 21.1 (continued) Drugs Used to Treat Various Skin Diseases The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Table 21.1 (continued) Drugs Used to Treat Various Skin Diseases The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Table 21.1 (continued) Drugs Used to Treat Various Skin Diseases The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Table 21.1 (continued) Drugs Used to Treat Various Skin Diseases The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.