CH 5: integumentary System - Disorders, Burns, Growths

How are inflammatory skin disorders characterized?

by the type or level of irritation and inflammation of the skin

Seborrheic Dermatitis

dry or moist, greasy-appearing scales and yellowish crusts on scalp, eyebrows, eyelids, etc.

affects sebaceous glands by altering amount and quality of sebum

What are the symptoms of seborrheic dermatitis?

crusts on the face, sides of nose, behind ears, middle of chest

in adults: called dandruff, in infants: called cradle cap

Seborrheic Keratosis

called age spots, appear during aging

characterized by benign, slightly-raised, tan to black regions

How is seborrheic dermatitis treated?

tar- or sulfur-based shampoos if on the scalp, topical corticosteroids if skin inflammation

Contact Dermatitis

acute inflammatory skin disorder due to irritants or allergens in lotions, latex, poison ivy

What are some symptoms of contact dermatitis?

redness (erythema), edema, pruritis, vesicles

How is contact dermatitis treated?

oral corticosteroid medications (e.g. prednisone, methyl prednisone)

Eczema

inflammation of skin with unknown pathogenesis, may be associated with dry skin

What are some symptoms of eczema?

vesicular rash on face, neck, elbows, behind knees and ears

in young children: may be from food allergies, in older children/adults: flare-ups from stress or extreme temperatures

How is eczema treated?

primary inflammation with topical corticosteroids and antihistamines (e.g. diphenhydramines, cetirizine, fexofenadine)

How are secondary infections commonly caused?

itching from a primary infection/injury is scratched repeatedly, may become infected, which may need treatment, which may lead a scar

How are secondary infections treated?

with antibiotics, mild infections with topical antibiotics, also medications to reduce itching and inflammation

Psoriasis

chronic autoimmine disease characterized by discrete pink/red lesions covered with silvery scales

What causes a build-up of psoriasis patches?

autoimmune reaction leads to rapid cell maturation and stimulates build up of scaly patches

How is psoriasis treated?

palliative, includes UV light exposure to slow cell proliferation, coal tar application to relieve irritation, methotrexate, retinoids, immunosuppressants, low-dose antihistamines, biologic medications

Systemic Lupus Erythematosus (SLE)

chronic autoimmune inflammatory skin disorder that may affect any connective tissue

may cause inflammatory changes in skin, joints, muscles, kidneys

What body systems are commonly affected by SLE?

urinary, skeletal, muscular, etc.

What are some common symptoms of SLE?

erythematous patches and plaques, alopecia, photosensitivity, “butterfly” rash across cheeks and nose

How is SLE treated?

nonsteroidal anti-inflammatory drugs (NSAIDs), low doses of corticosteroids, cytotoxic drugs

What can prolonged cold exposure do?

can lead to tissue damage, can progress to gangrene, which may require amputation

Frostbite

cold injury from exposure to subfreezing temperatures

blood vessels constrict, reduce blood flow to affected area, leading to tissue damage and cell death

What are superficial frostbite symptoms?

burning, tingling, numbness, white/grayish skin color

What are deep frostbite symptoms?

blister formation, affected areas becoming hard, mottled, edematous, blue/gray skin after thawing

Rule of Nines

assessment tool used to help assess total body surface burned and help guide treatment team for fluid resuscitation and further action

major body sections assigned a number in multiples of 9, total area calculated as a %

Superficial (First-Degree) Burn

only the epidermis is affected

characterized by dry skin, erythema (redness without vesicles)

Describe the discomfort and healing process associated with first-degree burns

painful, hyperesthetic, tingling

cooling relieves pain, discomfort for ~48 hours and desquamation in 3-7 days

Partial-Thickness (Second-Degree) Burns

epidermis and dermis affected

large thick-walled blisters (vesiculation), subcutaneous edema with wet, shiny, weeping surface

Describe the discomfort and healing process associated with second-degree burns

painful, hyperesthetic, sensitive to cold air

heal in 10-14 days if superficial, heal in 21-28 days if deep

Full-Thickness (Third-Degree) Burns

tissue disruption involving all three layers of the skin

may appear white, brown, or black with dry, leathery surface

Where are the relative locations of each type of burn?

superficial at outer edges, partial-thickness near center, full-thickness at center

Neoplasm

an abnormal growth, benign or malignant

Benign Tumors

noncancerous tumors that do not show asymmetry or border irregularity

can increase in size but stay in shell (encapsulated)

Malignant Tumors

asymmetry, border irregularity, mole elevation

What are the characteristics of malignant tumors?

local invasion, carcinoma in situ, regional spread, distinct spread or metastasis

Local Invasion

tumor breaks through basement membrane and invades surrounding tissues

Carcinoma In Situ

tumor confined to origin site, no invasion

Regional Spread

malignant cells invade surrounding tissue without lymph node impairment

Distant Spread or Metastasis

malignant cells spread to lymph nodes with development of secondary tumors in other organs

ABCDE Rule

provide early warning signs of malignant melanoma

A

asymmetry, unequal halves of mole

B

border, edges or border irregularity

C

color, appearance of different shades throughout mole (e.g. tan, brown, black, white)

D

diameter, increase in mole size to more than 6mm

E

elevation, raised and elevated mole

Skin Cancer

uncontrolled growth of cells due to exposure to UV radiation or other carcinogenic agents

When does skin cancer typically appear?

often many years after sun damage occurs