Integumentary System (add pictures)

Skin

Prevents fluid loss, microorganism entry, protects from environmental damage, enables heat exchange, regulates internal temperature

Epidermis

Avascular outer skin layer with 4–5 layers of keratinized epithelial cells, replaces shed cells

Basement Membrane

Anchors epidermis to dermis and involved in blister formation

Dermis

Inner skin layer with blood vessels and nerves separating epidermis from subcutaneous fat

Keratinocytes

Epidermal cells forming protective barrier against environmental damage

Melanocytes

Cells producing melanin to absorb UV radiation

Merkel Cells

Tactile receptors for light touch

Langerhans Cells

Skin macrophages involved in immune defense

Skin Appendages

Hair, nails, glands (oil, eccrine, apocrine) attached to hair follicles

Eccrine Glands

Sweat glands widely distributed, secrete watery sweat for thermoregulation

Apocrine Glands

Sweat glands in axilla/groin, secrete milky fluid into hair follicles, odor with bacteria

Immune Cells in Dermis

Macrophages, T cells, Mast cells, Fibroblasts

Macule

Flat lesion <0.5 cm, different shade

Patch

Flat lesion >0.5 cm, irregular, different color

Papule

Raised lesion <1 cm

Plaque

Raised lesion >1 cm, rough texture

Nodule

Raised, deeper solid lesion >1 cm

Wheal

Red, allergic reaction lesion

Pustule

Pus-filled lesion

Vesicle

Small fluid-filled blister <1 cm

Bulla

Large fluid-filled blister >1 cm

Callus

Thickened skin from friction

Corn

Painful raised cone from continuous pressure

Xerosis

Dry skin from stratum corneum dehydration, common with aging, causes cracking

Emollients

Moisturizers that soften skin

Humectants

Substances that attract moisture to skin

Occlusives

Substances that prevent water loss from skin

Vitiligo

Autoimmune melanocyte destruction causing white patches

Albinism

Genetic lack of melanin in skin, hair, eyes

Mongolian Spots

Bluish-gray patches of increased melanin

Melasma

Hyperpigmentation, brown facial patches

Blanching Rash

White rash from vasoconstriction

Erythematous Rash

Red rash from inflammation or vasodilation

Hemorrhagic Rash

Purple/brown rash from blood leakage (purpura, petechiae, ecchymosis)

Pigmented Rash

Rash from melanin or pigment change

Tinea Corporis

Fungal ringworm on body

Tinea Faciale/Barbae

Fungal infection under beard/face

Tinea Capitis

Fungal infection on scalp

Tinea Pedis

Fungal infection on feet

Tinea Unguium

Fungal infection under nails

Tinea Versicolor

Fungal infection on back/shoulders causing light patches

Tinea Incognito

Fungal infection worsened by topical steroid use

Impetigo

Superficial bacterial infection causing vesicles or bullae on face

Ecthyma

Ulcerative impetigo

Cellulitis

Deep bacterial infection of skin

HPV

Human papilloma virus causing warts, some strains cancerous

HSV-1

Herpes simplex virus causing cold sores

HSV-2

Herpes simplex virus causing genital herpes

Herpes Zoster/Shingles

Localized vesicular eruption distributed over a dermatomal segment of the skin

Comedones

Noninflammatory clogged hair follicles with sebum and keratin

Inflammatory Acne

Papules, pustules, nodules from ruptured follicles

Rosacea

Chronic inflammatory skin condition with vascular leakage and GI link

Erythemateotelangiectatic Rosacea

Persistent redness with visible vessels

Papulopustular Rosacea

Acne-like bumps with redness

Ocular Rosacea

Affects eyes, dry appearance

Phymatous Rosacea

Thickened, bumpy skin (rhinophyma)

Contact Dermatitis

Type IV hypersensitivity to irritants like poison ivy

Atopic Dermatitis

Chronic eczema, allergic tendency, moisture loss, hypersensitivity

Lichenification

Thickened skin from chronic irritation

Nummular Eczema

Coin-shaped papulovesicular patches on arms/legs

Drug-Induced Eruptions

Generalized or localized drug reaction rashes

Stevens-Johnson Syndrome

Blistering (bullous) skin reaction with mucosal involvement; life-threatening

Toxic Epidermal Necrolysis

Severe epidermal detachment and keratinocyte apoptosis

Nikolsky’s Sign

Easy epidermal detachment with slight pressure

Papulosquamous Dermatoses

Scaling papules and plaques (psoriasis, pityriasis rosea, lichen planus)

Psoriasis

Autoimmune skin condition with scaly plaques

Scabies

Mite infestation under skin

Lice

White eggs on hair shafts, common in children

Ticks

Arthropod causing Lyme disease or RMSF

Erythema from UV

Acute sun effect, reversible skin redness

Chronic UV Damage

Accelerates aging, DNA damage, cancer risk

Photosensitivity

Exaggerated sun response with drugs

Photosensitivity Drugs

Anti-infectives, antihistamines, antipsychotics, diuretics, NSAIDs

First-Degree Burn

Superficial partial-thickness burn of epidermis

Second-Degree Partial Burn

Burn of epidermis and part of dermis

Second-Degree Full Burn

Burn of entire epidermis and dermis

Third-Degree Burn

Burn extending into subcutaneous tissue, muscle, bone

Pressure Ulcers

Ischemic skin lesions from unrelieved pressure

Pressure Ulcer Factors

Pressure, shear, friction, moisture

Pressure Ulcer Prevention

Identify risk, improve tolerance, protect from forces, education

Aging Skin

Less subcutaneous tissue, thinner layers, fewer immune and tactile cells, thicker vessel