From Textbook (Disease Vocabulary) - Unit 3: The Integumentary System

dermatitis

Any condition caused by disease or injury that results in inflammation or infection of the skin. Treatment: Correct the underlying cause.

edema

Excessive amounts of fluid move from the blood into the dermis or subcutaneous tissue and cause swelling (see Figure 7-5). Localized areas of edema occur with inflammation, allergic reactions, and infections. Large areas of edema occur with cardiovascular or urinary system diseases. Treatment: Correct the underlying cause.

hemorrhage

Trauma to the skin releases a small or large amount of blood. Extravasation is when the blood flows into the surrounding tissues. Petechiae are pinpoint hemorrhages in the skin from ruptured capillaries. A contusion is any size of hemorrhage under the skin that was caused by trauma. An ecchymosis is a hemorrhage under the skin that is 3 cm in diameter or larger. A contusion and an ecchymosis are both commonly known as a bruise. A hematoma is an elevated, localized collection of blood under the skin. Treatment: None.

lesion

Any visible damage to or variation from normal of the skin, whether it is from disease or injury (see Figure 7-6). Treatment: Correct the underlying cause.

Cyst

Elevated circular mound. Skin color or erythema. Semisolid or partly fluid filled. Example: Acne sebaceous cyst.

Fissure

Small, cracklike crevice. Erythema. None; some fluid exudate. Example: Dry, chapped skin.

Macule

Flat circle. Pigmented brown or black. None. Example: Freckle, age spot.

Papule

Elevated. Skin color or erythema. Solid. Example: Acne pimple.

Pustule

Elevated. White top. Pus. Example: Acne whitehead.

Scale

Flat to slightly elevated, thin flake. White. None. Example: Dandruff, psoriasis.

Vesicle

Elevated with pointed top. Erythema with a transparent top. Clear fluid. Example: Herpes, chickenpox, shingles.

Wheal

Elevated with broad, flat top. Erythema with a pale top. Clear fluid. Example: Insect bites, urticaria.

neoplasm

Any benign or malignant new growth that occurs on or in the skin. Treatment: Excision of a benign neoplasm; excision and chemotherapy drugs or radiation therapy for a malignant neoplasm.

pruritus

Itching. Pruritus is associated with many skin diseases. It is also part of an allergic reaction because of the release of histamine. A patient with pruritus is said to be pruritic. Treatment: Topical or oral antihistamine drug or corticosteroid drug.

rash

Any type of skin lesion that is pink to red, flat or raised, pruritic or nonpruritic. Certain systemic diseases (chickenpox, measles) have characteristic rashes. Treatment: Topical or oral antihistamine drug or corticosteroid drug.

wound

Any area of visible damage to the skin that is caused by physical means (such as rubbing, trauma, etc.). Treatment: Apply a protective covering and topical antibiotic drug to prevent infection.

xeroderma

Excessive dryness of the skin. It can be caused by aging, cold weather with low humidity, vitamin A deficiency, or dehydration. The level of hydration can be assessed by testing the skin turgor. A fold of skin pinched between the thumb and fingertips should flatten out immediately when released. Dehydration causes the skin to remain elevated (tenting of the skin) or to flatten out very slowly. Treatment: Correct the underlying cause.

albinism

A lack of pigment in the skin, hair, and iris of the eye. This is a genetic mutation in which there is a normal number of melanocytes, but they do not produce melanin. The patient is said to be an albino. Treatment: None.

cyanosis

Bluish-purple discoloration of the skin and nails due to a decreased level of oxygen in the blood (see Figure 4-10). It is caused by cardiac or respiratory disease. The patient is said to be cyanotic. In healthy persons, areas of skin exposed to the cold temporarily exhibit cyanosis. Treatment: Correct the underlying cause.

erythema

Reddish discoloration of the skin. It can be confined to one area of local inflammation or infection, or it can affect large areas of the skin surface, as in sunburn. The area is said to be erythematous. Treatment: Correct the underlying cause.

jaundice

Yellowish discoloration of the skin, mucous membranes, and whites of the eyes (see Figure 3-20). It is associated with liver disease. The liver cannot process bilirubin, and high levels of unconjugated bilirubin in the blood move into the tissues and color the skin yellow. It is also known as icterus. The patient is said to be jaundiced or icteric. A patient without jaundice is said to be anicteric. Treatment: Correct the underlying cause.

necrosis

Gray-to-black discoloration of the skin in areas where the tissue has died (see Figure 7-7). Necrotic tissue can occur in a burn, decubitus ulcer, wound, or any tissue with a poor blood supply. Necrosis with subsequent bacterial invasion and decay is gangrene, and the area is said to be gangrenous. Treatment: Correct the underlying cause.

pallor

Unnatural paleness due to a lack of blood supply to the tissue (see Figure 7-7). This is caused by blockage of an artery, hypotension, or severe exposure to the cold. Treatment: Correct the underlying cause.

vitiligo

An autoimmune disorder in which the melanocytes are slowly destroyed in irregular and ever-enlarging areas. There are white patches of depigmentation interspersed with normal skin (see Figure 7-8). Treatment: None.

abrasion

Sliding or scraping injury that mechanically removes the epidermis. It is also known as a brush burn. Treatment: Apply a protective covering.

blister

Repetitive rubbing injury that mechanically separates the epidermis from the dermis and releases tissue fluid. A blister is a fluid-filled sac with a thin, transparent covering of epidermis. Blisters often form on the heel from walking in poorly fitting shoes or on the hand from rubbing with constant use of a tool. Treatment: Apply a protective covering before the activity.

burns

Heat (fire, hot objects, steam, boiling water), electrical current (lightning, electrical outlets or cords), chemicals, and radiation or x-rays (sunshine or prescribed radiation therapy) can cause a burn to the epidermis or dermis. Treatment: Topical anti-infective drug to prevent infection. Second-degree burns over a large area and all third-degree burns require debridement and skin grafting.

first-degree burn

This burn involves only the epidermis and causes erythema, pain, and swelling, but not blisters.

second-degree burn

This burn involves the epidermis and the upper part of the dermis. It causes erythema, pain, and swelling. There are small blisters or larger bullae that form as the epidermis detaches from the dermis and the space between fills with tissue fluid (see Figure 7-9). This is also known as a partial-thickness burn.

third-degree burn

This burn involves the epidermis and entire dermis, and sometimes the subcutaneous tissue and muscle layer beneath may be involved. The area is black where the skin is charred. If nerves in the dermis are destroyed, there is local anesthesia (no sensation of pain). This is also known as a full-thickness burn. An eschar is a thick, crusty scar of necrotic tissue that forms on a third-degree burn. Eschar is removed because it traps fluid, delays healing, and can become infected. A fourth-degree burn affects muscles and bones.

callus

Repetitive rubbing injury that causes the epidermis to gradually thicken into a wide, elevated pad. A corn is a callus with a hard central area with a pointed tip that causes pain and inflammation. Treatment: Removal.

cicatrix

Fibrous tissue composed of collagen that forms as an injury heals. It is also known as a scar. A keloid is a very firm, abnormally large scar that is bigger than the original injury. It is caused by an overproduction of collagen (see Figure 7-10). Unlike a scar, a keloid does not fade or decrease in size over time. Treatment: Surgical removal of a keloid, although they often grow back.

decubitus ulcer

Constant pressure to a particular area of the skin restricts the blood flow to those tissues. The epidermis and then dermis break down and slough off, resulting in a shallow or deep ulcer (see Figure 7-11). Decubitus ulcers most often occur at pressure points overlying bony prominences such as the hip or sacrum. They are also known as pressure sores or bed sores. Treatment: Frequent repositioning, increased protein intake to rebuild tissue, and debridement of any necrotic tissue to promote healing.

excoriation

Superficial injury with a sharp object such as a fingernail, animal claw, or thorn that creates a linear scratch in the skin. Treatment: Topical antibiotic drug to prevent infection.

laceration

Deep, penetrating wound. It can have clean-cut or torn, ragged skin edges (see Figure 7-12). Treatment: Layered closure with sutures.

abscess

Localized, pus-containing pocket under the skin caused by a bacterial infection. The infection is usually caused by Staphylococcus aureus, a common bacterium on the skin. A furuncle is a localized, elevated abscess around a hair follicle and the skin is inflamed and painful. It is also known as a boil. A carbuncle is composed of large furuncles with connecting channels through the subcutaneous tissue or to the skin surface. Treatment: Incision and drainage, oral antibiotic drug.

cellulitis

Spreading inflammation and infection of the connective tissues of the skin and muscle. It develops from a superficial cut, scratch, insect bite, blister, or splinter that becomes infected. The infecting bacteria produce enzymes that allow the infection to spread between the tissue layers. There is erythema (often as a red streak), warmth, and pain. Treatment: Oral antibiotic drug.

tinea

Skin infection caused by a fungus that feeds on epidermal cells. It multiplies quickly in the warm, moist environment of body creases and areas enclosed by clothing or shoes. There is severe itching and burning with red, scaly lesions. Because some lesions are round, it was originally thought to be caused by a worm, and was (and still is) called ringworm. Tinea is named according to where it occurs on the body. Tinea capitis occurs on the scalp and causes hair loss. Tinea corporis occurs on the trunk and extremities (see Figure 7-14). Tinea cruris occurs in the groin and genital areas and is known as jock itch. Tinea pedis occurs on the feet and is known as athlete's foot. Treatment: Topical antifungal drug.

verruca

Irregular, rough skin lesion caused by the human papillomavirus. It is usually on the hand, fingers, or the sole of the foot (plantar wart). It is also known as a wart. Treatment: Topical keratolytic drug to break down the keratin in the wart. Cryosurgery or electrosurgery, if needed.

pediculosis

Infestation of lice and their eggs (nits) in the scalp, hair, eyelashes, or genital hair. Lice are easily transmitted from one person to another by combs or hats. Treatment: Shampoo and skin lotion to kill lice.

scabies

Infestation of parasitic mites that tunnel under the skin and produce vesicles that are itchy. Treatment: Shampoo and skin lotion to kill mites.

contact dermatitis

Local reaction to physical contact with a substance that is an allergen or an irritant. Examples: Chemicals (deodorant, soaps, detergents, makeup, urine), metals, synthetic products (latex gloves, Spandex bathing suit or girdle), plants (poison ivy), or animals (see Figure 7-15). The skin becomes inflamed and irritated. Small vesicles may also appear. Treatment: Topical or oral antihistamine drug or corticosteroid drug.

urticaria

Condition of raised areas of redness and edema that appear suddenly and may also disappear rapidly. There is itching (pruritus), and scratching tends to cause the areas to enlarge. Urticaria is caused by an allergic reaction to food, plants, animals, insect bites, or drugs. It is also known as hives. Each individual area is known as a wheal. A large wheal is a welt. Treatment: Topical or oral antihistamine drug or corticosteroid drug.

actinic keratoses

Raised, irregular, rough areas of skin that are dry and feel like sandpaper. These develop in middle-aged persons in areas chronically exposed to the sun. They can become squamous cell carcinoma. They are also known as solar keratoses. Treatment: Avoid more sun exposure.

freckle

Benign, pigmented, flat macule that develops after sun exposure. Freckles contain groups of melanocytes. Freckles fade over time without continued sun exposure. Treatment: None.

hemangioma

Congenital growth composed of a mass of superficial, dilated blood vessels (see Figure 7-16). Treatment: Most hemangiomas disappear without treatment by age 3.

lipoma

Benign growth of adipose tissue in the subcutaneous layer. It makes a soft, rounded, nontender fatty elevation in the skin. Treatment: Excision, if desired.

nevus

Benign skin lesion that is present at birth and comes in a variety of colors and shapes. It is also known as a mole (see Figure 7-17). A port-wine stain is another type of nevus; it is slightly elevated, red to purple, and irregularly shaped. It can cover large areas of skin on the face and neck. Its shape and color resemble a puddle of spilled wine. It is also known as a birthmark. A dysplastic nevus has irregular edges and variations in color. It can develop into a malignant melanoma. Treatment: Excision of a mole if clothing irritates it; laser treatment to remove port-wine stains; observe a dysplastic nevus for change.

papilloma

Small, soft, flesh-colored growth of epidermis and dermis that protrudes outwardly. It comes in a variety of shapes: irregular mounds, globes, flaps, or polyps with rounded tops on slender stalks. It occurs on the eyelid, neck, or trunk of the body. It is also known as a skin tag. Treatment: Removal by cryotherapy, electrocautery, or surgical excision, if desired.

premalignant skin lesions

Abnormal skin lesions that are not yet cancerous. Over time and with continued exposure to sunlight or irritation, these lesions can become cancerous. Treatment: None; observe for changes.

senile lentigo

Light-to-dark brown macules with irregular edges. They occur most often on the hands and face, areas that are chronically exposed to the sun (see Figure 7-18). Treatment: None.

syndactyly

Congenital abnormality in which the skin and soft tissues are joined between the fingers or toes (see Figure 7-19). In some cases the fingernails or toenails are also joined. Polydactyly is a congenital abnormality in which there are extra fingers or toes. Treatment: Surgical correction, if desired.

xanthoma

Benign growth that is a yellow nodule or plaque on the hands, elbows, knees, or feet. It is seen in patients who have a high level of lipids in the blood or have diabetes mellitus. A xanthoma that occurs on the eyelid is known as a xanthelasma. Treatment: Excision, if desired.

cancer of the skin

A cancerous lesion or malignancy in areas of the skin that are chronically exposed to ultraviolet light radiation from the sun. Skin cancer is more common in older adults (because of a lifetime of sun exposure) and in fair-skinned persons (because there is less melanin to absorb radiation). Treatment: Moh's surgery to remove the cancer, chemotherapy drugs, photodynamic therapy.

basal cell carcinoma

Skin cancer that begins in the basal layer of the epidermis. It is the most common type of skin cancer. It often appears as a raised, pearly bump. It is a slow-growing cancer that does not metastasize to other parts of the body.

malignant melanoma

Skin cancer that begins in melanocytes in the epidermis (see Figure 7-20). It grows quickly and metastasizes to other parts of the body. Malignant melanomas have these four characteristics: A Asymmetry. One side of the lesion has a different shape than the other side. B Border or edge is irregular or ragged. C Color varies from black to brown (or to red) within the same lesion. D Diameter is greater than 6 mm (1/4 inch).

squamous cell carcinoma

Skin cancer that begins in the flat squamous cells of the superficial layer of the epidermis. It often begins as an actinic keratosis. It most often appears as a red bump or an ulcer. It is the second most common type of skin cancer, but it grows slowly.

Kaposi's sarcoma

Skin cancer that begins in connective tissue or lymph nodes. Tumors on the skin are elevated, irregular, and dark reddish-blue. This previously rare cancer is now commonly seen in AIDS patients because of their impaired immune response. The cancer involves the skin, mucous membranes, and internal organs. Treatment: Excision of single lesions, radiation therapy for multiple lesions.

psoriasis

Autoimmune disorder that produces an excessive number of epidermal cells. The skin lesions are itchy, red, and covered with silvery scales and plaques. They usually occur on the scalp, elbows, hands, and knees (see Figure 7-21). Illness and stress cause flare-ups, and psoriasis has a hereditary component. Treatment: Topical coal tar drug, vitamin A drug, vitamin D drug, and corticosteroid drug; light therapy with a psoralen drug and ultraviolet light A (PUVA) or ultraviolet light B (UVB).

scleroderma

Autoimmune disorder that causes the skin and internal organs to progressively harden due to deposits of collagen. Treatment: Oral corticosteroid drug.

systemic lupus erythematosus (SLE)

Autoimmune disorder with deterioration of collagen in the skin and connective tissues. There is joint pain, sensitivity to sunlight, and fatigue. Often there is a characteristic butterfly-shaped, erythematous rash over the bridge of the nose that spreads out over the cheeks. Treatment: Oral corticosteroid drug.

acne vulgaris

During puberty, the sebaceous glands produce large amounts of sebum, particularly on the forehead, nose, chin, shoulders, and back. Excess sebum builds up around the hair shaft, hardens, and blocks the follicle. The blocked secretions elevate the skin and form a reddish papule. In other hair follicles, the oily sebum traps dirt and enlarges the pore. The sebum turns black as its oil is oxidized from exposure to the air. This forms a comedo or blackhead. As bacteria feed on the sebum, they release irritating substances that produce inflammation. The bacteria also produce infection, drawing white blood cells to the area and forming pustules or whiteheads (see Figure 7-22 and Table 7-1). In severe cystic acne, the papules enlarge to form deep, pus-filled cysts. Treatment: Topical cleansing drug, topical or oral antibiotic drug to kill skin bacteria; oral vitamin A-type drug for severe cystic acne.

acne rosacea

Chronic skin condition of the face in middle-aged patients. The sebaceous glands secrete excessive amounts of sebum. There is blotchy erythema, dilated superficial blood vessels, and edema that is made worse by heat, cold, stress, emotions, certain foods, alcoholic beverages, and sunlight (see Figure 7-23 and Table 7-1). Men can develop rhinophyma, an erythematous, irregular enlargement of the nose. Treatment: Topical antibacterial or antiprotozoal drug; laser surgery to destroy small, superficial blood vessels.

seborrhea

Overproduction of sebum, particularly on the face and scalp, that occurs at a time other than puberty. In seborrheic dermatitis, oily areas are interspersed with patches of dry, scaly skin and dandruff. There can also be erythema and crusty, yellow exudates from leaking tissue fluids. In adults, seborrheic dermatitis often appears after illness or stress. It can be caused by allergies. It is called cradle cap in infants and eczema in children and adults. Treatment: Topical corticosteroid drug, medicated shampoo.

anhidrosis

Congenital absence of the sweat glands and inability to tolerate heat. Treatment: Avoid overheating.

diaphoresis

Profuse sweating. Although a high fever, emotional stress, strenuous exercise, or the hot flashes of menopause can cause profuse sweating, these are not referred to as diaphoresis. Diaphoresis is caused by an underlying condition such as myocardial infarction, hyperthyroidism, hypoglycemia, or withdrawal from narcotic drugs. The patient is said to be diaphoretic. Treatment: Correct the underlying cause.

alopecia

Acute or chronic loss of scalp hair. Acute alopecia can be caused by chemotherapy drugs that attack rapidly dividing cells, but also affect rapidly dividing hair cells. Skin diseases of the scalp can also cause acute hair loss. Chronic hair loss usually begins in early middle age, although inherited tendencies can make it occur sooner. In men, a decreasing testosterone level and decreased blood flow to the scalp cause the hair follicles to shrink. The hair on the top of the scalp thins and disappears, leaving a fringe of hair at the back of the head. This is known as male pattern baldness. In women, menopause causes the level of estradiol from the ovaries to be lower than the male hormone androgen (produced by the adrenal cortex), and this hormonal change causes the hair to thin. Treatment: Topical drug to dilate the arteries in the scalp or oral drug to block the effect of DHT (substance that is increased in the balding scalp).

folliculitis

Inflammation or infection of the hair follicle. It occurs after shaving, plucking, or removing hair with hot wax. Treatment: Topical corticosteroid or antibiotic drug.

hirsutism

The presence of excessive, dark hair on the forearms and over the upper lip of a woman. It is due to too much of the male hormone androgen caused by a tumor in the adrenal cortex. Treatment: Correct the underlying cause.

pilonidal sinus

An abnormal passageway (fistula) that begins as a large, abnormal hair follicle that contains a hair that is never shed. The follicle is visible as a pit or dimple on the skin in the sacral area of the back. Irritation causes the hair follicle to become infected, eventually creating a sinus into the subcutaneous tissue, with erythema, tenderness, and purulent discharge. Treatment: Incision and drainage of the sinus.

clubbing and cyanosis

Abnormal downward curved and bluish fingernails and stunted growth of the finger associated with a chronic lack of oxygen in patients with cystic fibrosis (see Figure 4-10). Treatment: Correct the underlying cause.

onychomycosis

Fungal infection of the fingernails or toenails. It infects the nail root and deforms the nail as it grows (see Figure 7-24). Treatment: Topical or oral antifungal drug; treatment with a laser.

paronychia

Bacterial infection of the skin next to the cuticle. It can be caused by an injury, nail biting, or a manicure that trims the cuticle. There is tenderness, erythema, and swelling, and sometimes an abscess with pus. Treatment: A topical or oral antibiotic drug