SKIN PART 1

HAIR, SKIN AND SCALP

SKIN

- major function → body in homeostasis (daily living → assault from the environment e.g. abog)

- synthesize Vitamin D

- body temperature regulation

- protects:

• microorganisms

• harmful substances

• radiation

Three Layers of the Skin

Epidermis

- most superficial layer

- avascular

- dermis-dependent → Nutrition

Wounds

Abrasion - gasgas

Laceration - hiwa

Puncture - penetrate the skin and penetrate up to the deeper tissues with appointed object → natunok (paraphernalia used: Gun Shot Wounds)

Dermis

- vascular

- contains:

• connective tissue

• sebaceous glands

• sweat glands

• hair follicles

Skin Color

Hemoglobin - gives reddish and pinkish pigmentation → it binds on our oxygen

Melanin - darker pigmentation → protection against harmful substances

• Brown - dark skinned people least likely to have skin cancer

Bilirubin - gives yellowish discoloration

• Physiologic Jaundice - 2-7 days

• Pathologic Jaundice - within 24 hours

  • Phototherapy - a form of treatment that uses ultraviolet light to treat skin conditions, such as psoriasis, eczema and jaundice (covers eyes & genitals).

Carotene - gives orange pigmentation (other author says “golden yellow”)

• increased beta-carotene

  • carrots

  • sweet potato

  • squash

  • spices (paprika, parsley, cilantro)

Lighter-skinned people

Reddish

• palms

• soles

• face

• neck

• upper chest

HAIR

Vellus Hair

- fine, short hair

- a.k.a “peach fuzz”

- unpigmented

Terminal Hair

- coarse, thick

- transformation to TH due to testosterone hormone

- more pigmented

NAILS

- protects the distal ends → fingers & toes

- 0.1 mm → daily (fingernails)

slower rate (toenails)

Parts:

Lunula - whitish moon

Nail Plate - site of attachment of nail bed

Cuticle - protects between fold and plate from the external moisture

Lateral nail fold

Proximal nail fold

Free edge (hyponychium)

SEBACEOUS GLANDS

- produce fatty substance secreted → skin surface via hair follicle

- cannot found on palms and soles

Two Parts of Sweat Glands

Eccrine

- widely distributed

- open directly onto skin surface

- help control body temperature

Apocrine

- axillary, genitals and areolae of breasts

- open into hair follicle

- stimulated and emotional stress

- body odor

ASSESSMENT OF THE SKIN

1. Assemble the equipment

a. Ruler (with centimeter markings)

b. Clean Gloves

c. Magnifying Glass

2. Medical Handwashing

3. Provide Privacy

4. Palpate for Temperature (warm to touch / cool to touch)

findings of hypoglycemia (low blood sugar):

• cold clammy hands

• diaphoretic

5. Skin Turgor - hydration status

6. Skin Lesions

Primary Lesions

• Macule and Patch

  • small, flat, nonpalpable skin color change (skin color may be brown, white, tan, purple, red). Macules less than 1 cm with a circumscribed border, whereas patches are greater than 1 cm and may have irregular border.

    • ex. freckles, flat moles, petechia, rubella, vitiligo

      
      

• Papule and Plaque

  • elevated, palpable, solid mass. Papules have a circumscribed border and are less than 0.5 cm; plaques are greater than 0.5 cm and may be coalesced papules with a flat top.

    • ex. elevated nevi, warts, acne and lichen planus (papule)

    • ex. psoriasis, actinic keratosis (plaque)

• Nodule and Tumor

  • elevated, solid palpable mass that extends deeper into dermis than a papule. Nodules are 0.5-2 cm and circumscribed; tumors are greater than 1-2 cm and do not always have sharp borders.

    • ex. keloid, lipoma, squamous cell carcinoma poorly absorbed injection and dermatofibroma (nodule)

    • ex. larger lipoma and carcinoma (tumor)

additional info: polyps → progresses to tumor

• Vesicle and Bulla

  • circumscribed elevated, palpable mass containing serous fluid. Vesicles are less than 0.5 cm; bullas are greater than 0.5 cm.

    • ex. herpes simplex/zoster, varicella (chicken pox), poison ivy & second degree burn (vesicle)

    • ex. pemphigus, contact dermatitis, large burn blisters, poison ivy and bullous impetigo (bulla)

• Wheal

  • elevated mass with transient border that is often irregular, size and color vary. Caused by movement of serous fluid into the dermis; it does not contain free fluid in a cavity (e.g. vesicle).

    • ex. urticaria (hives) and insect bites.