Chapter 32 Dermatology

Major functions of skin

• first line of defense

• regulate temp

• ssist synthesis of vitamin D

• eliminate waste prod from body

Epidermis

first layer part of skin, ‘‘what we can see’’, keratinocytes migrate to basal layer

Dermal-epidermal junction

where two layers of skin meet

Dermis

middle layer, collagen and elastin fibers

Subcutaneous tissue

inner layer, fat cells provide insulation and store reserve calories

Five functions of integumentary system

•Protection

•Sensory organ activity

•Temperature regulation

•Excretion

•Synthesis of vitamin D

Impetigo

• children

• strep/staph

• spread by scratching

• highly contagious

• antibiotics topical treatment

Acne vulgaris

hair follicle and sebaceous gland unit

Rosacea

inflammation and pustule formation

Furuncle (boil)

• staph

• inflamation of hair follicle/ gland

• purulent drainage

Carbuncle

collection of furuncles that have joined

Cellulitis (erysipelas)

• by stapgh or strept

• from skin injury

Tinea pedis

athletes foot

Tinea corporis

ringworm

Tinea cruris

jock itch

Warts

• by HPV

• hyperplasia of the epidermis and a raised, cauliflower-like appearance

• in fingers and soles of feet

Herpes simplex (Cold Sores)

• by herpes simplex type 1

• •Hyperplasia of the epidermis and a raised, cauliflower-like appearance

• Virus remains dormant in the trigeminal nerve and can be reactivated at any point

Scabies

by sarcoptes scabiei

Pediculosis

on head, pubic area, body

seborrheic dermatitis

• inflammation of the sebaceous glands

• dry greasy scales

• yellow crusts on scalp, eyebrows, eyelids and sides of nose..

• dandruff, and cradle cap

contact dermatitis

inflammatory response to a skin irritant, redness, edema, pruritus, vesicles

eczema (atopic dermatitis)

• food allergies, stress, extreme temperatures

• vesicular rash

• treat w/ corticosteroids and oral antihistamines

psoriasis

• pink/red lesions covered w/scales

• autoimmune reaction that speeds maturation rate of skin cells

• no cure

discoid lupus erythematosus

• chronic cutanepous lungs

• sores w/inflammation and scarring

• skin biopsy may be done

• sunscreen, sun exposure avoidance, corticosteroid creams/injections

superficial burns (first-degree)

affect the epidermis

partial-thickness burns (second-degree)

destroy epidermal layer and parts of the dermis

full-thickness burns (third-degree)

destroy all layers of skin

deep full-thickness burns (fourth-degree)

extends beyond subcutaneous tissue into muscle and bone

cold injuries

• prolonged exposure to cold temperatures

• infection, gangrene, amputation, death

• warm the area w/immersion in warm water

• monitor vital signs

basal cell carcinoma

on sun-exposed areas, pearly or waxy bump/flat flesh, colored or brown scarlike lesion

squamopus cell carcinoma

on sun-exposed areas as a firm, red nodule or flat with scaly/crusted surface

melanoma (malignant melanoma)

can develop anywhere and affect any skin color

excision biopsy

entire lesion removed for analysis

punch biopsy

removal of small section (usually the center of lesion)

shave biopsy

with scapel or razor, cut/shave off growth/lesion for thin specimen of combined epidermis and upper dermis cells

treating first-degree burns

immerse affected area in cool to cold water, analgesics for pain

treating second-degree burns

rinse with cool waterfor pain, additional cool compresses

treating third-four degree

immediate ongoing medical attention

mohs surgery

remove skin cancer lesions until no cancerous cells are seen

Psoralen Plus Ultraviolet (PUVA) Therapy

treat different diseases, commonly psoriasis

chemical peel

minimize or remove skin features

dermabrasion

even the layers of dermal tissue

laser resurfacing (photothermolysis)

used for fine lines, wrinkles, pigmented areas, shallow scars, tattoo removal

botox injections

paralyze facial muscles that cause wrinkles

ABCDE

Asymetry

Border

Color

Diameter

Elevation