Chapter 16 Diseases of the Integumentary System

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 1 Structure and Functions  Skin – Largest organ in the body - Epidermis, dermis, subcutaneous – Protect, insulate, regulates temp, sense pain, water resistant yet prevents dehydration, synthesizes Vitamin D, excretes urea and uric acid  Hair – helps insulate, protect from dust/allergens  Nails –protect finger/toe tips, delicate vessels  Sweat glands – secrete waste through sweat  Sebaceous glands – secrete oils to moisten

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 2 Diagnostic Tests  Visual  Blood and urine – used to rule out underlying diseases  Microscopic:  Skin scrapings  Cultures  DNA  Antibodies to identify cause (organism)

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 3 Diseases of the Skin Signs and symptoms  Epidermoid and pilar cysts – smooth, round lump just beneath the skin surface  Impetigo – Vesicles and pustules that rupture forming a crust, fever, swollen lymph nodes  Cellulitis – Swollen, bright red, hot and tender area of skin, small vesicles, fever, chills, swelling of lymph nodes  Folliculitis – Erythema, follicular-based papules and pustules

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 4  Furuncles, Carbuncles – Furuncles – large tender, swollen, pus-filled lesion; Carbuncles – cluster of furuncles  Herpes – Small, fluid-filled, painful vesicles  Warts – Benign neoplasms with rough, keratinized surface  Tinea – Mild scales, rash, fissures  Seborrheic dermatitis - Adults: Dry or greasy scaling with variable pruritus; Infants: Thick, yellow-crusted scalp lesions  Pediculosis (LICE)– Pruritus, multiple erythematous papules

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 5  Candidiasis – Vaginal: white cottage-cheese discharge, burning, pruritis, erythema; Oral: creamy white, painful patches; Cutaneous: patches of red, moist, weepy skin  Scabies- Pruritis, vesicles, pustules, grayish lines (tunnels)  Urticaria (hives) – wheals with rounded elevations and pale centers, pruritis  Albinism – Absence of melanin  Acne – (vulgaris) Comedones, papules, pustules, nodules

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 6  Hemangioma – Red or purple birth marks  Nevus (mole) – small, dark skin growth  Rosacea – Flushing, persistent erythema, papules, pustules, telangiectasis  Basal Cell Carcinoma – (from sun damage) – Pearly nodule with rolled edges may bleed, form crust  Squamous Cell Carcinoma ( from sun damage ) – Crusted nodule, ulcerates and bleeds  Psoriasis- Red lesions with silvery scales

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 7  Allergic contact dermatitis- Rash with erythema, pruritus, burning  Atopic dermatitis – Red, dry crusted patches on the skin  Decubitus ulcer (pressure sore) – Reddened area, abrasion, vesicle, superficial ulceration, deep erosion  Corns/Calluses – Areas of skin that grow thick  Aeborrheic keratosis – Benign lesions with pasted-on look, flat or slightly elevated with a scaly surface, range in size, pruritus

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. 8 Hypothermia, frostbite – Hypothermia: shivering, cold and pale skin, lack of coordination, disorientation, decrease in HR, RR, BP, loss of consciousness; Frostbite: pain, numbness, tingling, loss of sensation, blistering, tissue death Burns – 1 st degree: Red, swollen, pain; 2 nd degree: Extremely red, blistered, painful; 3 rd degree: White or black skin with a leathery appearance, no pain in the burned area