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Skin Cancer, Burns, & Wounds

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1 Skin Cancer, Burns, & Wounds
Hair shaft Pore Dermal papillae (papillary layer of dermis) Epidermis Meissner's corpuscle Free nerve ending Reticular layer of dermis Sebaceous (oil) gland Dermis Arrector pili muscle Sensory nerve fiber Eccrine sweat gland Pacinian corpuscle Hypodermis (superficial fascia) Artery Vein Hair root Adipose tissue Hair follicle Eccrine sweat gland Hair follicle receptor (root hair plexus) Figure 5.1

2 Skin Cancer Most skin tumors are benign* and do not metastasize* A crucial risk factor for nonmelanoma skin cancers is the disabling of the p53 gene Newly developed skin lotions can fix damaged DNA *Benign = not likely to result in death *Malignant = likely to result in death *Metastasis = Cancer cells break off of tumor, and get carried by bloodstream to another part of the body where they grow into a new tumor

3 The three major types of skin cancer are:
Basal cell carcinoma Squamous cell carcinoma Melanoma

4 Basal Cell Carcinoma Least malignant and most common skin cancer Stratum basale cells proliferate and invade the dermis and hypodermis Slow growing and do not often metastasize Can be cured by surgical excision in 99% of the cases

5 Squamous Cell Carcinoma
Arises from keratinocytes of stratum spinosum Arise most often on scalp, ears, and lower lip Grows rapidly and metastasizes if not removed Prognosis is good if treated by radiation therapy or removed surgically

6 Genetic Component: If a family member has had it, your risk increases
Melanoma Cancer of melanocytes is the most dangerous type of skin cancer because it is: Highly metastatic Resistant to chemotherapy Genetic Component: If a family member has had it, your risk increases

7 Skin Cancers Figure 5.7a–c

8 Melanomas ofhave the following characteristics (ABCDE rule)
A: Asymmetry: the two sides of the pigmented area do not match B: Border is irregular and exhibits indentations C: MultiColored (pigmented area) is black, brown, tan, and sometimes red or blue D: Diameter is larger than 6 mm (size of a pencil eraser) E: Evolving: the mole changes over time, usually growing larger

9 Melanoma Treated by wide surgical excision accompanied by immunotherapy Chance of survival is poor if the lesion is over 4 mm thick

10 Primary Risk Factor for Cancer: El Sol!
Primary risk factor is exposure to UV light from sun or tanning beds Most sun exposure occurs in youth – sunburns that peel linked to increased likelihood of melanoma 1 in 5 people in US get skin cancer, odds increase to 1 in 3 in “sunbelt” states Exposure to UV light increases at higher elevations, when on the water, and when on snow Avoidance: clothing, sunscreen, time of day, check-ups

11 Burns, Wounds, and Aging of the Skin

12 First-degree – only the epidermis is damaged
Burns First-degree – only the epidermis is damaged Symptoms include localized redness, swelling, and pain

13 Second-degree – epidermis and upper regions of dermis are damaged
Burns Second-degree – epidermis and upper regions of dermis are damaged Symptoms mimic first degree burns, but blisters also appear

14 Third-degree – entire thickness of the skin is damaged
Burns Third-degree – entire thickness of the skin is damaged Burned area appears gray-white, cherry red, or black; there is no initial edema or pain (since nerve endings are destroyed)

15 Estimates the severity of burns
Rule of Nines Estimates the severity of burns Body mapped into regions that are multiples of 9% of the surface Burns considered critical if: Over 25% of the body has second-degree burns Over 10% of the body has third-degree burns There are third-degree burns on face, hands, or feet

16 Rule of Nines Figure 5.8a

17 Healing of Wounds and Burns 1
A. Inflammation, in which blood vessels dilate and become more permeable, which causes tissues to become red and swollen, is the body's normal response to injury. The increased blood flow brings extra nutrients (to assist growth of new cells) and white blood cells (to attack bacteria) to the wound. B. Superficial cuts are filled in by reproducing epithelial cells – mitosis occurs in the stratum basale.

18 Healing of Wounds and Burns 2
C. Deeper cuts are closed off by clots, covered by scabs, and eventually filled in by fibroblasts, making connective tissue. Blood vessels extend into the area, injured tissues are replaced, and the scab falls off. D. Large wounds leave scars and healing may be accompanied by the formation of granulations (bumpy regions).

19 Developmental Aspects of the Integument: Fetal
Epidermis develops from ectoderm Dermis and hypodermis develop from mesoderm Lanugo – downy coat of delicate hairs covering the fetus Vernix caseosa – substance produced by sebaceous glands that protects the skin of the fetus in the amnion

20 Developmental Aspects of the Integument: Adolescent to Adult
Skin and hair become oilier and acne may appear Skin shows the effects of cumulative environmental assaults around age 30 Scaling and dermatitis become more common

21 Developmental Aspects of the Integument: Old Age
Epidermal replacement of cells slows and skin becomes thinner Skin becomes dry and itchy Subcutaneous fat layer diminishes, leading to intolerance of cold Decreased elasticity and loss of subcutaneous tissue leads to wrinkles Decreased numbers of melanocytes and Langerhans’ cells increase the risk of skin cancer


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