Chapter 18 Integumentary System Diseases and Disorders

Anatomy and Physiology Skin is largest organ of body First line of protection for body against invading organisms Provides sense of touch, heat, cold, and pain

Anatomy and Physiology Helps stabilize temperature and fluid and electrolyte balance Three layers Epidermis Dermis Subcutaneous

Common Signs and Symptoms Skin lesions Pain Pruritus Edema Erythema Inflammation

Diagnostic Tests Biopsy Culture and sensitivity Blood tests Microscopic smear examinations

Herpes Large family of viruses Symptoms: inflammation of the skin, clusters or fluid-filled vesicles Not treatable and remains in affected individual’s body for life Remissions and exacerbations

Herpes Common types Herpes Simplex I - “fever blisters and “cold sores” Herpes Genitalis, Herpes Simplex II - “genital herpes” Herpes Varicella - “chickenpox” Herpes Zoster - shingles

Verruca (Warts) Chronic condition Occur in multiples and differ in size, shape, and appearance Often resistant to treatment

Verruca (Warts) Common types Appear on hands and fingers of children Plantar warts appear on sole of the foot Genital warts are sexually transmitted

Impetigo Streptococcus and staphylococcus Affects face and hands of children Symptoms: vesicles, pustules that rupture producing yellow crust over lesions Treatment: cleansing and antibiotic ointment

Folliculitis Inflammation and infection of the hair follicle usually by staphylococcus Symptoms: small pustules surrounding hair Treatment: antibiotics

Abscess, Furuncle, Carbuncle Inflammation, infection, and formation of a capsule prevent spread of infection Treatment: antibiotics

Cellulitis and Erysipelas Diffuse or spreading inflammation of skin and subcutaneous tissue Cellulitis is caused by staphylococcus Erysipelas is a form of cellulitis caused by streptococcus, which affects the face

Cellulitis and Erysipelas Symptoms Fever and chills Headache Vomiting Red, painful edematous skin Treatment: IV antibiotics

Lyme Disease Multisystem infections transmitted to humans through bite of infected deer tick Symptoms Flu-like symptoms Arthritis Malaise

Lyme Disease Symptoms Treatment—antibiotics Chills and fever “Bull’s eye” skin rash Treatment—antibiotics

Tinea Tinea Symptoms Treatment: Wash and dry, antifungal agents Infects warm, moist areas of body Feeds on perspiration and dead skin Symptoms Itching, cracking, and weeping of skin Treatment: Wash and dry, antifungal agents

Tinea Forms of Tinea Tinea Corporis: affects smooth skin on arms, legs, and body Tinea Pedis: “athlete’s foot” Tinea Cruris: “jock itch”

Tinea Forms Tinea Unguium: finger or toe nails Tinea Capitis: scalp Tinea Barbae: bearded areas

Candidiasis Fungal infection caused by candida Symptoms Treatment Red, itchy skin with blisters and pustules Treatment Antifungal medications

Pediculosis Infestation with lice Treatment: bathing and shampooing with medicated shampoo (Kwell) Three types of lice Head, Body, Pubic

Scabies Caused by tiny mite Commonly called “seven year itch” Slightly elevated, grayish-white lines, intense itching, vesicles, and pustules Treatment: lindane cream to entire body

Acne Vulgaris Inflammation of sebaceous glands and hair follicles Symptoms: comedones Treatment: cleansing and OTC treatments Severe cases: antibiotics, steroids, and retinotic acid preparations

Seborrheic Dermatitis Affects the sebaceous glands Called “cradle cap in infants” Affecting the scalp is “dandruff” Symptoms: reddened, itchy areas, scales Treatment: wash and dry, steroid creams

Sebaceous Cyst Sebaceous gland becomes blocked and sebum collects under skin Special type: pilonidal cyst Treatment: incising and draining, surgical removal

Eczema Inflammation of skin Symptoms: itching, redness, vesicles, pustules, scales, and crusting Treatment: topical cortisone, antihistamines, and sedatives

Contact Dermatitis Acute or chronic allergic reaction of skin Causes: cosmetics, laundry products, jewelry, pain Symptoms: small red localized lesions to vesicular lesions

Psoriasis Chronic skin disease Symptoms: red, raised lesions with distinct borders and silvery scales Treatment: coal tar medications, ultraviolet light, and steroids

Scleroderma Hardening, thickening, and shrinking of connective tissues, including skin Autoimmune reaction

Seborrheic Keratosis Benign overgrowth of epithelial cells Treatment Curettage Scraping off

Keloid Raised, firm, irregular-shaped scar tissue following trauma or surgery Treatment: surgical removal

Hemangioma Congenital benign tumor of small blood vessels that form a purplish birthmark Common types Port wine stain Strawberry hemangioma Cherry hemangioma

Actinic Keratosis Premalignant condition Wart-like lesions on sun-exposed areas Common in fair-skinned individuals Treatment Topical medication such as Retin A Curettage or cryotherapy

Squamous Cell Carcinoma Tends to occur in sun-exposed areas Symptoms: firm red nodule with crusts or slightly elevated plaque Treatment: wide surgical excision with radiation treatments

Basal Cell Carcinoma Most common type of skin cancer Slow-growing, locally invading tumor that does not metastasize Treatment: surgical removal

Malignant Melanoma Most serious type of skin cancer Symptoms: change in size and color of mole Rarely occurs before age 20 May be related to severe sunburn as child

Malignant Melanoma Treatment Depends on degree of spread May include wide surgical excision Radiation and chemotherapy

Kaposi’s Sarcoma Malignant vascular skin tumor Bluish-red cutaneous nodules No adequate treatment

Abnormal Pigmented Lesions Types Ephelis: freckle Lentigo: liver spot Nevus: mole Albinism: decrease or total absence of pigment in the skin, hair, and eyes

Abnormal Pigmented Lesions Types Vitiligo: destruction of melanocytes in small or large patches of skin Melasma: dark patches of skin on face, especially the cheeks

Diseases of the Nails Abnormal shape, thickening, and color Fungal and bacterial infections are most common cause Bacterial infections treated with antibiotics Fungal infections treated with antifungal medications

Diseases of the Hair Hirsutism: excessive growth of hair Alopecia: partial or complete hair loss

Mechanical Skin Injury Abrasion: scraping away skin surface Blunt trauma Contusion by items such as a hammer or club Thrown into items such as steering wheel and wall

Mechanical Skin Injury Avulsion: skin or appendage is pulled or torn Crush trauma: tissue is caught between two hard surfaces

Mechanical Injuries Puncture injury: sharp object is forced into tissue Laceration: cut in skin caused by a sharp object

Hyperthermia Hyperthermia: body is overheated due to excessive exposure to sun or heat Types Heat exhaustion Heat stroke

Burns First degree: pain, redness, and swelling Second degree: pain, redness, swelling, blisters, and open wounds Third degree: charred and broken skin tissue, painless

Cold Injuries Not as severe or life threatening as heat or burn injuries Low body temperature Symptoms: Extreme shivering and mental confusion Blue or cyanotic extremities and weak pulse

Cold Injuries Treatment Remove wet clothing Warm body with warm blankets Warm liquids Frostbite: freezing of tissue, usually on face, fingers, toes, and ears

Electrical Injury Unprotected or inadequately insulated electrical wiring Contact with lightning Damage has a point of entry and exit

Decubitus Ulcer “Bedsore” or “pressure sore” Affects bony areas of body such as heels, sacrum, elbows Treatment Frequent turning and repositioning Massage affected area to improve circulation