Integumentary Definitions

Here is information on the dermatological terms you listed, based on the provided sources:

• Acne Vulgaris: This is a common inflammatory disorder of the pilosebaceous gland contiguous with the hair follicle. It is most common in adolescents and has multifactorial causes, including genetic influences and increased sebum production related to androgenic hormones. The pilosebaceous follicles, where lesions develop, are primarily located on the face, upper chest, and back. Lesions can be inflammatory (pustules, papules, & nodules) or non-inflammatory (comedones - hair follicle filled with debris). Closed comedones are whiteheads, and open comedones are blackheads. Treatment depends on the severity and aims to prevent scarring by suppressing inflammation, using systemic (oral antibiotics like tetracycline and erythromycin, sex hormones, corticosteroids, isotretinoin) and topical medications (benzyl peroxide, salicylic acid, tretinoin, antibiotics), as well as non-pharmacological methods and surgery (comedo extraction, intralesional steroids, cryosurgery, dermabrasion, chemical peel for severe scarring).

• Autograft: This is a type of permanent skin substitute used to replace the full thickness of skin layers. It is formed from the patient's own skin cells, obtained by taking a small biopsy and allowing it to grow for 2-3 weeks. Epicel (Cultured Epithelial Autograft - CEA) is an example used for large burns.

• Bulla: A bulla is a large vesicle, which is a small fluid-filled lesion. Bullae are seen in conditions like herpes simplex and herpes zoster, where they contain exudate. In pemphigus vulgaris, flaccid bullae rupture easily and can be foul-smelling.

• Candidiasis: This is an overgrowth of the fungus Candida albicans. It thrives in warm, moist environments and can be a precursor to infection in individuals with immunosuppression, who are elderly, diabetic, pregnant, using oral contraceptives or antibiotic therapy, undergoing chemotherapy/radiation therapy, obese, or on steroid therapy. Common sites include the vagina, mouth, esophagus, lungs, skin, rectum, and under breasts. Symptoms vary by location, including white spots and red lesions in the mouth, and cheesy or milky discharge, itching, and burning in the vagina. Treatment includes vaginal creams (Mycelex), oral medications (Diflucan, Nystatin), topical creams (Nystatin, Monistat), and systemic antifungals (IV Diflucan). Risk factors include living in hot climates, poor nutrition, poor hygiene, immunosuppression, debilitating disease, occlusive footwear, and skin or nail injuries.

• Carbuncle: A carbuncle is a cluster of furuncles (boils). It is a bacterial infection, often caused by Staph aureus, and can present with fever, leukocytosis, pain, and nodules containing foul-smelling yellow drainage. Risk factors include diabetes mellitus, animal bites, human bites, trauma to the skin, insect stings, ulcers, and lymphedema. Treatment may involve IV antibiotics and incision and drainage (I & D).

• Comedones (open & closed): These are hair follicles filled with debris, a characteristic lesion of acne vulgaris. Closed comedones are whiteheads and are more superficial. Open comedones are blackheads.

• Curettage: This is a procedure where abnormal tissue is scraped away. It is used in the treatment of skin cancer and is often combined with electrodesiccation.

• Cryosurgery: This involves the use of liquid nitrogen gas to freeze and destroy tissue. It can be used to destroy lesions like warts and is a treatment option for various skin cancers. Local anesthetic may be used.

• Debride: This refers to the process of removing skin debris to promote healing. An UNNA Boot, involving soaks, can aid in debridement. Debriding also helps in increasing the absorption of topical medications and decreasing the risk of infection and pruritus.

• Dermabrasion: This is a surgical procedure used for severe acne scarring.

• Dermatitis: This is a general term for inflammation of the skin. The sources mention several types, including:

  • Contact Dermatitis: An eczema-like condition caused by a skin reaction to irritating or allergenic materials. It can be primary irritant contact dermatitis (non-allergenic reaction to an irritant) or allergic contact dermatitis (resulting from exposure of sensitized individuals to allergens).

  • Atopic Dermatitis: A common chronic relapsing pruritic type of eczema, often with a genetic component and associated with asthma and allergic rhinitis.

  • Seborrheic Dermatitis: A common chronic inflammation of the skin affecting areas like the scalp (dandruff), eyebrows, eyelids, and nasolabial folds.

• Dermatophytes: These are plant-like organisms that feed on organic matter and cause fungal skin infections. They thrive on keratin. Examples of infections include tinea pedis (toes/feet), tinea manus (hand), tinea cruris (groin), tinea capitis (scalp), tinea corporis (body), tinea barbae (beard), and tinea unguum (toenails).

• Electrodesiccation: This is a procedure where a low voltage electrode is used to abrade the tumor base and kill cells. It is used in the treatment of skin cancer and warts, often combined with curettage.

• Fissure: While the term "fissure" is not explicitly defined on its own, cracks between the toes are mentioned as a symptom of tinea pedis (athlete's foot).

• Folliculitis: This is a bacterial infection of the hair follicle. Examples include styes and shaving bumps. The causative organism is often Staph aureus. Precipitating factors include friction, blockage, or injury to the follicle. Symptoms include small pustules or papules with surrounding erythema, and potentially abscess development. Treatment involves topical antibiotics, saline soaks, warm moist packs, and keeping the area clean.

• Furuncle: A furuncle is a bacterial infection or deep folliculitis, also known as a boil. It is commonly caused by Staph aureus. Precipitating factors include immunodeficiency and hot climates. Common sites include the neck, axillae, buttocks, face, and thigh. Symptoms include a deep, firm, erythematous, painful nodule that develops a yellow/white core and may rupture spontaneously. Treatment involves systemic or local antibiotics, warm moist compresses, and potentially incision and drainage.

• Heterograft: This is a temporary skin substitute formed from synthesized materials or natural sources from a different species. Pig xenograft (specifically treated pig skin dermis) is an example, used for partial thickness burns/excised wounds prior to skin grafting.

• Herpes Zoster: Also known as "Shingles," this is an acute vesicular eruption along a nerve pathway. It is caused by the reactivation of the varicella-zoster virus (the same virus that causes chickenpox). Risk factors include older age, AIDS, childhood cancer, chemotherapy, Hodgkin's disease, and immunosuppressant medications. Symptoms include a cluster of vesicles along the course of peripheral sensory nerves (unilateral, often affecting the face, neck, trunk, chest), pain, malaise, fever, erythema, and itching. The crust develops and drops off in 10-14 days. Treatment aims for symptomatic relief with acyclovir, analgesics, rest, calamine lotion, steroids (to decrease neuralgia), and cool compresses. Zostavax is a vaccine for prevention in adults > 60 years old. Complications can include postherpetic neuralgia, ophthalmic involvement (blindness), facial/auditory nerve involvement, and visceral dissemination.

• Homograft: This is a temporary skin substitute formed from natural sources of live human cells. Human allograft (human skin taken from cadavers, including epidermis and dermis) is an example, used for temporary coverage of large wounds. Human amnion (from the placenta) is another natural homograft effective for healing partial thickness burns.

• Hyperkeratosis: This refers to the thickening of the stratum corneum (outer horny layer of the epidermis). It is seen in conditions like warts (benign growth made up of keratin), psoriasis (profuse scales and plaques accumulate), and can be a feature of seborrheic keratoses (greasy appearing with hyperkeratotic scale) and mycosis fungoides (hyperkeratosis palms & soles).

• Macule: A macule is a flat skin lesion. It has a color different from the surrounding skin and is not raised or depressed. Solar lentigo (pigmented spots) and the early stages of actinic keratosis (slight erythema macule) can present as macules.

• Melanoma: This is a malignant tumor of the skin originating from melanocytes (pigment-producing cells). It is highly malignant and metastatic. Causative factors include genetic predisposition, sun exposure, and fair skin. Precursor lesions include congenital nevi and dysplastic nevi (atypical moles). Types include superficial spreading melanoma, lentigo maligna melanoma, primary nodular melanoma, and acral-lentiginous melanoma. Diagnosis involves biopsy of the lesion and potentially lymph nodes, bone scan, chest x-ray, CT or MRI brain, and liver function tests. Prognosis depends on the depth of invasion. Treatment is primarily surgical excision, but may also include chemotherapy and radiation therapy. Key warning signs (ABCDEs) include asymmetry, border irregularity, color not uniform, diameter greater than 6 mm or sudden increase in size.

• Nevi: These are commonly known as moles. Dysplastic nevi are atypical moles that can be precursor lesions for melanoma. Congenital nevi are present at birth.

• Nodule: A nodule is a solid, raised lesion. It is larger than a papule. Examples include the deep, firm lesion in folliculitis/furuncle and the dome-shaped lesion in nodular basal cell carcinoma, as well as nodules that develop in acral-lentiginous melanoma.

• Papule: A papule is a small, solid, raised lesion. Examples include the lesions seen in folliculitis, warts, acne, rosacea, and actinic keratosis.

• Pediculosis: While the exact term "pediculosis" is not used, the sources describe lice as blood-sucking parasites that cause itching and purpuric spots due to toxins released into the skin. They lay eggs (nits) on body hair and clothing. Transmission occurs through direct contact, bedding, clothing, and linens. Symptoms include severe pruritus and matted hairs. Treatment includes medications like Kwell (Lindane) and Nix/RID (Elimite).

• Photochemotherapy: This refers to Psoralen and Ultraviolet A (PUVA) therapy, used in the treatment of psoriasis. It involves the use of oral or topical psoralen, a chemical that increases the absorption of UV light, followed by exposure to UVA. It helps in blocking the immune response in the skin.

• Pruritus: This is itching, a subjective sensation that produces an urge to scratch. It is a common symptom associated with many primary skin lesions and can also result from systemic diseases, medications, allergies, and insect bites. Chronic itching can lead to skin trauma, infection, and scarring. Management involves identifying and eliminating the cause, using drug therapy (antihistamines, corticosteroids), and nursing care like trimming nails, maintaining a cool environment, and avoiding irritants.

• Pustule: A pustule is a small, raised lesion filled with pus. It is seen in conditions like folliculitis and acne.

• Scabies: This is an infestation caused by the female itch mite burrowing under the skin to lay eggs. The mite creates a "zigzag" blister as it lays eggs. Transmission occurs through direct contact, including clothing and bedding. Diagnosis is made by skin scrapings. Treatment involves topical medications like Lindane (Kwell) for all household members simultaneously, corticosteroids for itching, and washing clothing and linens in hot water. The main symptom is severe itching, especially at bedtime, and wavy (zigzag) brownish, threadlike lines are seen mostly on hands, arms, fingers, wrists, heels, body folds, and genitalia. Symptoms may take about 4 weeks to appear after contact.

• Scale: A scale is a thin plate of hardened epithelium shed from the epidermis. Scaling is seen in conditions like psoriasis (silvery scales), seborrheic dermatitis (scaly plaques), actinic keratosis (hard keratotic scale), and fungal infections (scaly center of lesions).

• Topical: This refers to a route of medication administration where the treatment is applied directly to the surface of the skin. Examples include steroid creams for dermatitis, antifungal creams for fungal infections, and antibiotics for folliculitis.

• Tumor: In the context of the skin, a tumor refers to an abnormal growth of tissue, which can be benign, premalignant, or malignant (skin cancer). Examples include basal cell carcinoma, squamous cell carcinoma, and melanoma.

• Ultraviolet-A (UVA): This is a type of ultraviolet radiation from the sun. It is relatively ineffective unless combined with psoralen in PUVA therapy, which is used for psoriasis and other skin conditions by increasing the skin's absorption of UV light.

• Ultraviolet-B (UVB): This is another type of ultraviolet radiation from natural sunlight. It is used in the Goeckerman Therapy for psoriasis, which involves tar baths and topical tar application followed by UVB light exposure. UVB therapy is also mentioned as a treatment for mycosis fungoides.

• Verrucae: These are commonly known as warts, which are benign growths made up of keratin. They are caused by the Human Papillomavirus (HPV), with more than 60 types. Transmission occurs through direct skin contact. Types include plantar warts (soles of feet), condylomata acuminata (anogenital warts), periungual warts (around fingernails), and verrucae vulgaris (hands, arms, legs). Treatment involves removal by electrodessication or cryosurgery, or topical colloidal solutions containing salicylic and lactic acid.

• Vesicle: A vesicle is a small, fluid-filled lesion (blister). Vesicles erupt in conditions like herpes simplex and herpes zoster. The fluid within vesicles in herpes infections can be used for Tzanck's smear to diagnose viral skin infections. Vesicular lesions are also seen in tinea pedis and scabies.

• Wheal: A wheal is a raised, itchy area of skin, such as in hives or allergic reactions. Wheals are also mentioned as a symptom of pediculosis (lice infestation).

• Xerosis: While the term "xerosis" is not explicitly defined, the sources mention dry skin as a characteristic associated with atopic dermatitis.