Skin Pathology with Clinical Considerations Chapter 3-UNIT 2 CLASSES OF 2018 AND 2016 Medical Terminology Dr. Gray

Skin Pathology Acne- Two varieties: – - Acne rosacea- Occurs in adults with redness, macules (pimples), and ruptured blood vessels. This is found mainly on the face. – - Acne vulgaris- Occurs in adolescents, consits of papules and pustules.

Skin Pathology Tumors arising from the basal cell layer of the epidermis: Two common types- – (a) Basal cell carcinoma- Frequent type of skin cancer which results from excessive exposure to the sun. Rarely metastizises or spreads.(p. 59) – (b) Malignant melanoma- Malignant form of skin cancer which arises from uncontrolled growth of the melanocytes. Quickly metastizises and spreads to internal organs. (p. 62)

Skin Pathology Squamous Cell Carcinoma- Malignant cancer of the epidermis layer of the skin. May invade deeper tissue. Very aggressive. (p. 62) Kaposi’s sarcoma- Skin cancer variant found mainly in the AIDS patient population. Brownish-purple papules that spread from the skin and attack internal organs.

Skin Pathology SLE-systemic lupus erythematosus: Chronic inflamation of connective tissue which affects many of the structures containing connective tissue. Patients have a characteristic “butterfly rash” across the face. (p. 62)

Skin Pathology Fungal infections: Tinea- Fungal skin disease characterized by pruritis (itching) and sca. There are several specific types of fungal tinea lessions depending on body location: a. Tinea Capitis-Fungal infection of the scalp area (ringworm) b. Tinea Pedis-Fungal infection of the foot (athletes foot)

Skin Pathology Viruses of the skin: Varicella and Rubella (German measels) 1. Varicella appears as a rash on the trunk which spreads to the limbs. Associated with scab formation. This was very common before the introduction of the varicella zoster virus vaccine (VZV). This is a form of the herpes family of viruses (Chicken pox).

Skin Pathology Rubella- Contagious viral skin infection. Tx of varicella and rubella lessions- Usually with the antiviral class of medications (valacyclovir (Valtrex), acyclovir (Zovirax), famcyclovir).

Skin Pathology Gangrene: Destruction and wasting of skin and underlying structures due to the absence of blood supply. Seen commonly in diabetic patients and patients with chronic blood problems. -Two varieties: Wet Gangrene-secondary bacterial infection. Dry Gangrene- w/o the secondary bacterial infection

Skin Pathology Tx of gangrene lessions: Surgical debridement of the dead or damanged tissue in the area of the wound or for severe gangrene-surgical amputation. Wet gangrene-in a mild form-could be approached by a surgical debridement and course of antibiotic therapy (bacitracin, neomycin, polymixinB)

Skin Pathology Pediculosis- Lice-common in elementary school children and areas with very poor sanitation and hygiene. Combination therapy Tx of pediculosis- Antiparasitic (lindane, permethrin) ALSO, for the treatment of the pruritis- Antipruritic- (diphenhydramine, Benadryl)

Skin Pathology Graft Procedures: Allograft-skin graft from one patient to another. Autograft-graft from a person’s own body Heterograft-skin graft from anothr species or animal (Xenogaft)-graft from an animal (feotal pig is common for skin grafts for humans)

Xenografts come from animals-usually fetal pigs.

Skin Pathology BURNS- first, second, third degree. Severity of a burn is determined by the amount of body surface (skin) involvement and the depth of involvement of tissue destruction. Rule of nines (p. 61) is often used to assess the extent of damage. -Superficial (first degree burn) Partial Thickness (second degree burn) Full Thickness (third degree burn)

Skin Pathology Laboratory tests: Culture and sensitivity- allows for the controlled laboratory growth and identification of an unknown colony of bacteria for the purpose of determining drug sensitivity. What drug will kill the bug.

Skin Pathology Biopsy-Removal of tissue by several different means (knife, punch, or brush) to be prepared by surg path as a specimen for histology prep and microscopic exam. Tissue sample which eventually ends up on a glass histology slide.

Skin Pathology Exfoliative cytology- Cell scrapings which are prepared for microscopic examination. Frozen section- rapid slide prep from a quickly frozen tissue sample-ready in 5 minutes or less for report to surgeon from the surgical pathologist. Fungal scrappings- Fungal colony from a tissue or lession scrapping which is observed and examined for ID of fungal growth.

Skin pathology Surgical Procedures: Cauterization- Destruction of tissue by using caustic chemicals, electricity, heat, and extreme cold. Cryosurgery-Use of extreme cold to destroy tissue. Curettage- Removal of superficial skin lessions with a scrapper shapped like a spoon. Debridement-Removal of dead tissue from a wound area. Electrocautery- Destroying tissue with an electric current. Incision and drainage- Making an incision for the removal of infectious pus material.