The Language of Medicine, 12th Ed. by Davi-Ellen Chabner - Chapter 16

adipocyte

fat cell

albinism

Condition of skin deficient in pigment (melanin).

apocrine sweat gland

One of the large dermal exocrine glands located in the axilla and genital areas. It secretes sweat that, in action with bacteria, is responsible for human body odor.

basal layer

Deepest region of the epidermis; it gives rise to all the epidermal cells.

collagen

Structural protein found in the skin and connective tissue.

cuticle

Band of epidermis at the base and sides of the nail plate.

dermis

Middle layer of the skin.

eccrine sweat gland

Most numerous sweat-producing exocrine gland in the skin.

epidermis

Outermost layer of the skin.

epithelium

Layer of skin cells forming the outer and inner surfaces of the body.

hair follicle

Sac within which each hair grows.

integumentary system

The skin and its accessory structures such as hair and nails.

keratin

Hard protein material found in the epidermis, hair, and nails. Keratin means horn and commonly is found in the horns of animals.

lunula

Half-moon-shaped, whitish area at the base of a nail.

melanin

Skin pigment. It is formed by melanocytes in the epidermis. Eumelanin is brown-black pigment, whereas pheomelanin is red-yellow.

paronychium

Soft tissue surrounding the nail border.

pore

Tiny opening on the surface of the skin.

sebaceous gland

Oil-secreting gland in the dermis that is associated with hair follicles.

sebum

Oily substance secreted by sebaceous glands.

squamous epithelium

Flat, scale-like cells composing the epidermis.

stratified

Arranged in layers.

stratum (plural: strata)

A layer (of cells).

stratum corneum

Outermost layer of the epidermis, which consists of flattened, keratinized cells.

subcutaneous layer

Innermost layer of the skin, containing fat tissue.

albin/o

white.

albinism

caus/o

burn, burning.

causalgia - Intensely unpleasant burning sensation in skin and muscles when there is damage to nerves.

cauter/o

heat, burn.

electrocautery - An instrument containing a needle or blade used during surgery to burn through tissue by means of an electrical current. Electrocauterization is very effective in minimizing blood loss.

cutane/o

skin (see derm/o).

subcutaneous - Epidermis and dermis are the cutaneous layers o fthe skin.

derm/o, dermat/o

skin.

epidermoid - An epidermoid cyst is a collection of keratinous debris within the epidermis.,

dermatitis,

dermatologist,

dermabrasion (Abrasion means a scraping away.) - using a sandpaper-like material removes acne scars and fine wrinkles., epidermolysis - Loosening of the epidermis with the development of large blisters; occurs after injury, or with blister-producing diseases.

diaphor/o

profuse sweating (see hidr/o).

diaphoresis - Commonly called sweating.

erythem/o, erythemat/o

redness.

erythema - Flushing; widespread redness of the skin. (Pronunciation is er-ih-THE-mah. ),

Erythematous means pertaining to erythema.

hidr/o

sweat.

anhidrosis (Do not confuse hidr/o with hydr/o (water))

ichthy/o

dry, scaly (fish-like).

ichthyosis - This is usually a hereditary condition in which the skin is dry, rough, and scaly (resembling fish scales) because of a defect in keratinization. Ichthyosis also can be acquired, appearing with malignancies such as lymphomas and multiple myeloma. Greek ""ichthys"" means fish

kerat/o

hard.

keratosis

leuk/o

white.

leukoplakia (The suffix -plakia means plaques)

lip/o

fat.

lipoma,

liposuction - Removal of subcutaneous fat tissue through a tube that is introduced into the fatty area via a small incision. The fat is aspirated (suctioned out).

melan/o

black.

melanocyte,

melanoma - This is a malignant skin tumor.

myc/o

fungus (fungi include yeasts, molds, and mushrooms).

mycosis - An example of a mycosis (fungal infection) is tinea pedis, commonly called "athlete's foot". Another fungal infection is tinea corporis (ringworm).

onych/o

nail (see ungu/o).

onycholysis - Separation of the nail plate from the nail bed in fungal infections or after trauma. Onycholysis is often seen in psoriasis.,

onychomycosis - Fungal infection of the nails, which become white, opaque, thick, and brittle., paronychia (Par- means near or beside.) - inflammation and swelling of the soft tissue around the nail and is associated with torn cuticles or ingrown nails.

phyt/o

plant.

dermatophytosis - Examples are fungal infections (mycoses)

pil/o

hair (see trich/o), hair follicle.

pilosebaceous (Sebace/o indicates a gland that secretes sebum.) - The pilosebaceous unit is the combination of the hair follicle and attached sebaceous gland.

py/o

pus.

pyoderma - Pus within the skin (-derma). Impetigo is a purulent (pus-containing) skin disease caused by bacterial infection.

rhytid/o

wrinkle.

rhytidectomy - Cosmetic plastic surgery to remove wrinkles and excess skin; also called rhytidoplasty or face lift. Laser treatments, Botox Cosmetic (purified botulinum toxin) injections, and injectable fillers are used to soften facial lines and wrinkles.

seb/o

sebum (oily secretion from sebaceous glands).

seborrhea - Excessive secretion from sebaceous glands., Seborrheic dermatitis commonly is known as dandruff.

squam/o

scale-like.

squamous epithelium - Cells are flat and scale-like; "pavement" epithelium.

trich/o

hair.

hypertrichosis

ungu/o

nail.

subungual

xanth/o

yellow.

xanthoma - Nodules develop under the skin owing to excess lipid deposits and can be associated with a high cholesterol level. A xanthoma that appears on the eyelids is a xanthelasma (-elasma = a flat plate)

xer/o

dry.

xerosis - This is very dry skin.

anthrac/o

black (as coal).

anthracosis

chlor/o

green.

chlorophyll

cirrh/o

tawny yellow.

cirrhosis

cyan/o

blue.

cyanosis

eosin/o

rosy.

eosinophil

erythr/o

red.

erythema

jaund/o

yellow.

jaundice

lute/o

yellow.

corpus luteum

poli/o

gray.

poliosis (decrease of melanin in hair, eyebrows, and eyelashes)

crust

Collection of dried serum and cellular debris. A scab is a crust. It forms from the drying of a body exudate, as in eczema, impetigo, and seborrhea.

cyst

Thick-walled, closed sac or pouch containing fluid or semisolid material.

Examples of cysts are the pilonidal cyst, which is found over the sacral area of the back in the midline and contains hairs (pil/o = hair, nid/o = nest); and a epidermoid cyst, a collection of yellowish, cheesy sebum commonly found on the scalp, vulva, and scrotum.

erosion

Wearing away or loss of epidermis.

Erosions do not penetrate below the dermoepidermal junction. They occur as a result of inflammation or injury and heal without scarring.

fissure

Groove or crack-like sore.

An anal fissure is a break in the skin lining of the anal canal.

macule

Flat, pigmented lesion measuring less than 1 cm in diameter.

Freckles, tattoo marks, and flat moles are examples. A patch is a large macule, greater than 1 cm in diameter.

nodule

Solid, round or oval elevated lesion 1 cm or more in diameter.

An enlarged lymph node and solid growths are examples.

papule

Small (less than 1 cm in diameter), solid elevation of the skin.

Skin tags are small benign growths usually attached to the skin via a stalk (pedunculated). Pimples (as in acne) are also examples. Papules may become confluent (run together) and form plaques, which are elevated flat lesions.

pustule

Papule containing pus.

A pustule is a small abscess (collection of pus) on the skin.

ulcer

Open sore on the skin or mucous membranes (deeper erosion).

Decubitus ulcers (bed sores) are caused by pressure that results from lying in one position (Latin decubitus means lying down). Pressure ulcers usually involve loss of tissue substance and pus or exudate formation.

vesicle

Small collection of clear fluid (serum); blister.

Vesicles form in skin after burns and may be seen with allergies and dermatitis. A bulla (plural: bullae) is a large vesicle.

bulla (plural: bullae)

A large vesicle.

wheal

Smooth, edematous (swollen) papule or plaque that is centrally redder than the surrounding skin.

Wheals may be papular, as in a mosquito bite, or may involve a wide area, as in some allergic reactions. Wheals often are accompanied by itching and are seen in hives (urticaria), anaphylaxis, and insect bites.

alopecia

Absence of hair from areas where it normally grows.

Alopecia, or baldness, may be hereditary (usual progressive loss of scalp hair in men) or it may be caused by disease, injury, or treatment (chemotherapy) or may occur with old age. Alopecia areata is an autoimmune disease in which hair falls out in round patches without scarring or inflammation.

ecchymosis (plural: ecchymoses)

Bluish-purplish mark (bruise) on the skin.

Ecchymoses (ec- = out, chym/o = pour) are caused by hemorrhages into the skin from injury or spontaneous leaking of blood from vessels.

petechia (plural: petechiae)

Small, pinpoint hemorrhage.

Petechiae (peh-TE-ke-i) are smaller versions of ecchymoses. Both ecchymoses and petechiae are forms of purpura (bleeding into the skin).

pruritus

Itching.

Pruritus is a symptom associated with most forms of dermatitis and with other conditions as well. It arises as a result of stimulation of nerves in the skin by substances released in allergic reactions or by irritation caused by substances in the blood or by foreign bodies.

acne

Chronic papular and pustular eruption of the skin with increased production of sebum.

Acne vulgaris (Latin vulgaris means ordinary) is caused by the buildup of sebum and keratin in the pores of the skin. A blackhead is called an open comedo or comedone (plural comedones.) It is a sebum plug that partially blocks the pore. If the pore becomes completely blocked, a whitehead (closed comedone) forms. Bacteria in the skin break down the sebum, producing inflammation in the surrounding tissue. Papules, pustules, and cysts can thus form.

Treatment can include antibiotic use and medications to decrease inflammation in the skin. Benzoyl peroxide and tretinoin (Retin-A) are topical medications used to prevent comedone formation; isotretinoin (Accutane) is an oral retinoid used in severe cystic or treatment-resistant acne.

burns

Injury to tissues caused by heat contact.

Burns may be caused by dry heat (fire), moist heat (steam or liquid), chemicals, lightning, electricity, or radiation. Burns usually are classified as follows:

first-degree burns—superficial epidermal lesions, erythema, hyperesthesia, and no blisters.

Second-degree burns (partial-thickness burn injury)—epidermal and dermal lesions, erythema, blisters, and hyperesthesia. Wound is painful and very sensitive to touch and air currents.

Third-degree burns (full-thickness burn injury)—epidermis and dermis are destroyed (necrosis of skin), and subcutaneous layer is damaged, leaving charred, white tissue. The wound itself is insensate (patient does not respond to pinprick).

cellulitis

Diffuse, acute infection of the skin marked by local heat, redness, pain, and swelling.

Abscess formation and tissue destruction can occur if appropriate antibiotic therapy is not given. Areas of poorly mphatic drainage are susceptible to this skin infection.

eczema (atopic dermatitis)

Inflammatory skin disease with erythematous, papulovesicular, or papulosquamous lesions.

This is a chronic or acute atopic dermatitis (rash often begins on face, hands, and at the elbow crease, or back of the knee crease). It is accompanied by intense pruritus and tends to occur in patients with a family history of allergic conditions. Treatment depends on the cause but usually includes the use of corticosteroids and moisturizers. If one parent has atopic dermatitis, asthma, or hay fever, there's about a 50% chance that a child will have at least one of these conditions.

exanthematous viral diseases

Rash (exanthem) of the skin due to a viral infection.

Examples are rubella (German measles), rubeola (measles), and varicella (chickenpox). These conditions are no longer as common in children because of vaccination programs. However, erythema infectiosum (fifth disease) is a common exanthematous viral disease. It is marked by fever and an erythematous rash that has a "slapped cheek" appearance on the face and later involving the arms, buttocks, and trunk. It is caused by a parvovirus. Hand-foot-and-mouth disease is another common viral illness in children and is caused by an enterovirus.

gangrene

Death of tissue associated with loss of blood supply.

In this condition, ischemia resulting from injury, inflammation, frostbite, diseases such as diabetes, or arteriosclerosis can lead to necrosis of tissue followed by bacterial invasion and putrefaction (proteins are decomposed by bacteria).

impetigo

Bacterial inflammatory skin disease characterized by vesicles, pustules, and crusted-over lesions.

This is a contagious pyoderma (py/o = pus) and usually is caused by staphylococci or streptococci. Systemic use of antibiotics combined with proper cleansing of lesions is effective treatment.

psoriasis

Chronic, recurrent dermatosis marked by itchy, scaly, red plaques covered by silvery gray scales.

Psoriasis commonly involves the forearms, knees, legs,and scalp. It is neither infectious nor contagious but is caused by an increased rate of growth of the basal layer of the epidermis. It is an autoinflammatory disease that can run in families. Treatment is palliative (relieving but not curing) and includes topical lubricants, keratolytics, and steroids. Systemic treatments include psoralen-ultraviolet A(PUVA) light therapy and immunomodulators.

scabies

Contagious, parasitic infection of the skin with intensepruritus.

Scabies (from Latin scabere, to scratch) commonly affects areas such as the groin, nipples, and skin between the fingers. Treatment is with topical medicated cream to destroy the scabies mites (tiny parasites).

scleroderma

Chronic progressive disease of the skin and internal organs with hardening and shrinking of connective tissue.

Fibrous scar-like tissue forms in the skin, and the heart, lungs, kidneys, and esophagus may be affected as well. Skin is thick, hard, and rigid, with areas of both depigmentation and hyperpigmentation. It is an autoimmune disease for which palliative treatment consists of immunosuppressive and anti-inflammatory agents, antifibrotics, and physical therapy.

systemic lupus erythematosus (SLE)

Chronic autoimmune inflammatory disease of collagen in skin, joints, and internal organs.

Lupus, meaning wolf-like (the shape and color of the erosive skin lesions and tissue loss resembling a wolf attack), produces a characteristic "butterfly" pattern of redness over the cheeks and nose. In more severe cases, the extent of erythema increases, and all exposed areas of the skin may be involved. Primarily a disease of females, lupus is an autoimmune disorder. High levels of certain auto antibodies are found in the patient's blood. Corticosteroids and immunosuppressive drugs are used to control symptoms.

SLE should be differentiated from chronic discoid lupus erythematosus (DLE), which is a photosensitive, scaling, plaque-like eruption of the skin confined to the face, scalp, ears, chest, arms, and back, which heals with scarring. SLE should also be differentiated from lupus vulgaris, which refers to a cutaneous form of tuberculosis.

tinea

Infection of the skin caused by a fungus.

Tinea corporis, or ringworm, so called because the infection is in a ring-like pattern, is highly contagious and causes severe pruritus. Other examples are tinea pedis (athlete's foot, which affects the skin between the toes), tinea capitis (on the scalp), tinea barbae (affecting the skin under a beard), and tinea unguium (affecting the nails). Treatment for tinea is with antifungal agents.(Latin tinea means worm or moth—apparently the Romans thought that skin affected with tinea looked "moth-eaten.")

urticaria (hives)

Acute allergic reaction in which red, round wheals develop on the skin.

Hives often are a reaction to foods (shellfish, nuts, eggs) or to medication. Histamine is released into the bloodstream, causing pruritus and edema (swelling). Angioedema is swelling around the face. Other substances and events that can trigger hives are animal dander, insect bites and stings, and pollen.

vitiligo

Loss of pigment (depigmentation) in areas of the skin (milk-white patches).

This is a form of leukoderma. The skin changes result from an autoimmune process, and there is an increased association of vitiligo with autoimmune disorders such as thyroiditis, hyperthyroidism, and diabetes mellitus. Epidermal melanocytes are completely lost in depigmented areas through an autoimmune process.

callus

Increased growth of cells in the keratin layer of the epidermis caused by pressure or friction.

The feet and the hands are common sites for callus formation. A corn (clavis) is a type of callus that develops a hard core (a whitish, cone-shaped central kernel).

keloid

Excess hypertrophied, thickened scar developing after trauma or surgical incision.

Keloids result from excessive collagen formation in the skin during connective tissue repair. Keloids extend beyond the boundaries of the original injury. The term comes from the Greek "kelis", meaning blemish. Surgical excision often is combined with intralesional steroid injections or ablative laser treatments.

cicatrix (SIK-ah-trix)

A normal scar left by a healed wound

keratosis

Thickened and rough lesion of the epidermis; associated with aging or skin damage.

Actinic keratosis is caused by long-term ultraviolet light exposure and is a precancerous lesion that can evolve intosquamous cell carcinoma. Seborrheic keratosis is a benign lesion that results from overgrowth of the upper epidermis and is dark in color.

leukoplakia

White, thickened patches on mucous membrane tissue of the tongue or cheek (evolves to squamous cell carcinoma).

One type is a precancerous lesion that is common in smokers and may be caused by chronic inflammation.

nevus (plural: nevi)

Pigmented lesion of the skin.

Nevi are commonly known as moles. Many are present at birth, but some are acquired. Dysplastic nevi are moles that have atypical cells and may progress to form a type of skin cancer called melanoma (see malignant melanoma).

verruca (plural: verrucae)

Epidermal growth (wart) caused by a virus.

Verruca vulgaris (common wart) is the most frequent type of wart. Plantar warts occur on the soles of the feet, juvenile warts occur on the hands and face of children, and venereal warts occur on the genitals and around the anus. Warts are removed with acids, or freezing with liquid nitrogen (cryosurgery), or immune therapy. If the virus remains in the skin, the wart frequently regrows.

basal cell carcinoma

Malignant tumor of the basal cell layer of the epidermis.

This is the most common cancer in humans and the most common skin cancer. It is a slow-growing tumor that usually occurs on chronically sun-exposed skin, especially near or on the nose. It almost never metastasizes.

squamous cell carcinoma

Malignant tumor of the squamous epithelial cells in the epidermis.

This tumor may grow in places other than the skin, wherever squamous epithelium is found (mouth, larynx, bladder, esophagus, lungs). Actinic (sun-related) keratoses are premalignant (precursor) lesions in people with sun-damaged skin. Progression to squamous cell carcinoma may occur if lesions are not removed. Advanced lesions often are nodular and ulcerated. Treatment is removal by surgical excision, cryotherapy, electrodesiccation and curettage, or radiotherapy.

malignant melanoma

Cancerous growth composed of melanocytes.

This malignancy usually occurs after prolonged exposure to sunlight in darkly tanned or sunburned areas of skin. Melanoma usually begins as a mottled, light brown to black macule with irregular borders. The lesion may turn shades of red, blue, and white and may crust on the surface and bleed. Melanomas may arise in preexisting moles (dysplastic nevi) and frequently appear on the upper back, lower legs, arms, head, and neck. Biopsy is required to confirm the diagnosis of melanoma, and prognosis is best determined by tumor thickness and by the presence of spread to lymph nodes. Melanomas often metastasize to the lung, liver, bone, and brain.

Treatment of initial lesions consists of excision of tumors and regional lymphadenectomy. For metastatic disease, patients receive drugs that target B-RAF mutations or immunotherapy

Kaposi sarcoma

Malignant, vascular, neoplastic growth characterized by cutaneous nodules.

Frequently arising on arms and legs, nodules range in color from deep pink to dark blue and purple. One form of this condition is associated with acquired immunodeficiency syndrome (AIDS).

bacterial analyses

Samples of skin are examined for presence of microorganisms.

Purulent (pus-filled) material or exudate (fluid that accumulates) often is taken for examination. Fluid can be stained to determine bacterial morphology and cultured to identify specific species or strain.