Dermatology Vickie Mickey,CT

Dermatology Study of skin, diseases, and treatment Electrologist encounter the presence of skin disorders and diseases Electrologist must be able to identify dermatology disorders in order to know when to treat or not treat a skin disorder Certain skin disorders are contraindicated

Lesion Lesions are a structural change in the tissue caused by trauma or disease Three types of lesions: 1. Primary 2. Secondary 3. Tertiary or vascular

Primary Lesions First to recognize Flat or non-palpable Skin color changes may occur Elevation can occur Solid mass

Macule Small discolored spot or patch on the surface of the skin, flat or level with skin A freckle, flat moles, liver spot (chloasma) or leukoderma (loss of pigment) Pink or red inflammatory macules – indicative of typhoid, typhus, secondary syphilis, or allergenic drug reaction Blue Macules in public regions indicate crab lice

Papule Small elevated pimple Contains no fluid but may develop pus

Common Papular Eruptions Pityriasis rosea – self-limited disease of truck, eruptions at time barely evident Mucocutaneous syphilis – papules tend to be juicy, easily molded, found in mouth and genital region Psoriasis – chronic inflammatory disease of skin, lesions are round, dry papules, covered with coarse slivery scales

Common Papule Eruptions Warts – verruca Seborrheic keratois – flat, brown, greasy feeling papules, waxy texture. Non-malignant Actinic keratosis – hard, horny papules, results of sun and wind exposure. May become malignant Senile keratosis – hard horney papules, old age spots Molluscum contagiosum – virus infection, pin-head sized to pea-sized, wax like papules of a yellowish white or pinkish color

Common Papule Acne – different stages Drug eruptions – may occur in many forms Scratch a localized reaction to rubbing, scratching

Wheal Itchy, swollen lesion that last only a few hours Hive or insect bite Capable of returning

Nodule Solid lump, larger than a papule, projects above the surface or may lie below the skin Varies in size and color Of medical significance if nodule appears in more than one area

Nodules Nevis – birthmark Lipomas – fatty growth cells Fibromas – benign tumor composed of whorls of white fibrous connective tissue. May occur in single or in random areas, not indicative of underlying disease

Tumor Abnormal swelling or enlargement that can be malignant or benign Fluidless lesions

Vesicle/Bulla Raised lesion containing fluid derived from serum of blood Water fluid collects within epidermis or between epidermis and dermis, ranging color from clear to pink Bulla is larger than a Vesicle

Vesicle/Bulla Herpes Simplex – virus Contact Dermatitis – inflammation resulting from irritation of certain substances Sun burn – (second degree) Blister – skin irritation

Pustule Small round, round, raised area of inflamed skin filled with pus Common types: acne Furuncles and carbuncles – contain infection Impetigo – highly contagious inflammatory disease Eczema Acute fungal infection of feet and hands Smallpox, chickenpox, vaccination reaction, herpes

Secondary Lesion Secondary lesions are primary lesion that have progressed to later stage of disease Secondary lesions usually characterized by material buildup on the skin and includes:

Scale Scale is dry and greasy accumulation of epidermal flakes Silvery, stratified scales of psoriasis Seborrhea dermatitis – yellow greasy scales caused by excess secretion of sebaceous glands

Crust Crust/Scab – dry accumulation of serum and pus, mixed with epidermal material Lymph crust – honey colored scab not oozing, evidence of skin healing Lymph crust – can appear after electrolysis Pus Crust – a dirty gray or greenish-yellow crust indicative of infection Blood crust is reddish or black crust from dried blood, indicative of disease of blood

Excoriation Skin sore produced from scratching or abrasion

Fissure Crack in skin that penetrates the dermis

Ulcer Open skin lesion or mucous membrane that is accompanied by pus and loss of skin depth

Keloid Skin or film that forms over a wound Keloids rarely form on face Keloids appear more in skin of color

Scare Specialized growth of tissue that forms during healing of wound or skin condition

Common Skin Diseases Herpes Simplex – an acute inflammatory infection of the skin, occurring as swollen vesicle or group Appears around mouth or nostrils DO NOT TREAT AN AREAS With Herpes!

Impetigo An acute inflammatory and highly contagious disease Usually found in children Characterized by honey colored crust that have a “stuck on appearance! DO NOT TREAT THIS SKIN CONDITION

Psoriasis Reddish patches covered by silvery scales Tiny bleeding points may appear under scales Not infectious Electrologist can work on this skin involved with however, never within the patches

Dermatitis Irritation with vesicular eruptions External on skin Wait until skin has resolved before treating with electrolysis

Parasitic Disease of the Skin Parasites both animal or vegetable can affect skin Very Contagious Refer to physician DO NOT TREAT

Scabies Very contagious Itching skin caused by infestation by itch mite Mites burrow in hands or feet Skin reacts with eruption of papules on forearms, underarms, waist, inner thigh, buttocks, and ankles If disease is not treated it may manifest into boils and ulcers DO NOT TREAT

Pediculosis Head lice – Pediculois Capitis Transmitted from person to person via infected personal care items Nit surround hair and passes up out of pore with growing hair Body Louse – Pediculosis Corporis Causes intense itching Clothing contains nits

Disease of Sebaceous Glands Blackheads – comedomes – hardened plug of sebaceous material Appears black as the sebum oxidizes and turns black Can block mouth of follicle Can become inflamed

Acne Chronic inflammation of the philosebaceous unit Common on face, back and chest May present as papules or nodules Can appear as pustules Cysts may appear Acne begins as a blockage of the follicular canal, develops through leakage of sebum into the dermis

Acne Once the dermis becomes irritated it can develop into a red pustule or pimple Prevalent in adolescence during heightened androgenic activity stimulates sebaceous activity Infected follicles can be treated with electrolysis

Milia Whitehead caused by retention cyst of entrapped sebum beneath the epidermis Not in follicle pore Appears on face, neck, shoulders and chest areas Not usually associated with hair follicle

Sebaceous Cyst Subcutaneous tumor of the sebaceous glands Composed of sebum Ranges in size from small pea to an orange Releasing sebum will not eliminate cyst Needs to be removed by physician

Seborrhea Oily condition of nose, forehead, and scalp Result of over production of sebaceous glands Can accompany itching and burning

Asteatosis Dry, scaly skin deficient of sebum

Disorder of Sudoriferous Glands Hyperidrosis – excessive perspiration Caused by stimulates or mental depression and exhaustions Great condition to treat with laser on underarms Bromidrosis – foul smelling perspiration Appears in armpits, or feet Can be caused by drugs, foods, or rare disease Result of apocrine sweat glands

Disorders of Sudoriferous Glands Anidrosis – lack of perspiration caused by fever or disease Miliaria or Heat Rash – an acute inflammatory disorder of the sudoriferous glands Lesions consists of vesicles and papules

Pigmentation Irregularities Tan – Protective layer of skin Sunlight barrier for skin Prevents excessive production of Vitamin D

Freckles & Lentigines Yellowish or brown spots occurring on hands, face, and other exposed body parts Result of sun exposure

Chloasma Yellow, brown or black deposits in skin Patches occurring in various shapes and spots Appears a mask of pregnancy – can result from birth control pills If patient displays in area to be treated with electrolysis , do test spots prior to treatment as it may increase with treatment Laser hair removal often removes it

Stains Abnormal patches of brown coloration Round or irregular shapes

Nevus/ Birthmark Colored malformation of the skin Often congenital

Leucoderma White patches of skin or all over body Albinism – a congenital absences of pigment in skin, hair, eyes Extremely sensitive to sun Can be localized Not a good candidate for laser! Vitiligo – loss of pigment, occurring mostly in bands, often on hands and patches in the skin Do not treat with laser!

Hypertrophies Usually and enlargement of skin due to multiplication of cells Occurs for many reasons Keratoma (Callus) – hard thickened patches of skin due to hypertrophy of horny layer Caused by irritation , friction, or pressure

Moles Small congenital macule Ranges in color from pale tan to brown to bluish black True malignant moles is melanoma Black, blue-black or slate-colored Lacks hair Mole that is normal for many years can suddenly change, increase in size, increase in depth, pigmentation Crust can form and may bleed Inflammatory ring may appear around it

Moles When in doubt don’t treat a mole Have checked by physician prior to treatment Malpractice insurance may not cover if not checked prior to treatment Get release to treat mole

Post Treatment Disorders Over treatment can cause eschars (scabs) Unsanitary practices by patient can result in infection Examine skin disorder when confronted Usually small areas will be related to the electrolysis treatment, one or two follicles Good aftercare instruction very important to patient

Post Treatment Disorder Transfer of infection to the treated site by patient via hands from another infected area can occur Advise patient not to: Scratch, rub or irritate newly treated areas for 24 hours Do not wash with soap, water or washcloth for 24 hours Do not use make-up on treated site for 24 hours Clean skin with antiseptic (Witch hazel, alcohol, or Seabreeze) for 24 hours Do not go into sun or tanning bed for 24 hours Do not dislodge any scabs, should they appear

Post Treatment Disorders Poison ivy and poison oak can be transferred to treatment site Do not treat if it is present on skin anywhere!

Contact Dermatitis Occasionally a patient may develop dermatitis to the galvanic lye Should this occur, use high frequency for future treatments

Dermographia Can occur after treatment A form of urticaria Congenital sensitivity to any form of scratching

Post Treatment Inflammation Redness – local irritation Possible infection – due to invasion of bacteria Pustules – yellow-headed pimples Folliculitis – infection of hair follicle Crust formation – not to be removed by patient