1. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. The Language Of Medicine 8 th edition Davi-Ellen Chabner

2. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Chapter 16 Skin

3. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Learning Objectives  Name the layers of the skin and the accessory structures associated with the skin.  Build medical words using the combining forms that are related to the specialty of dermatology.  Identify lesions, sign and symptoms, and pathologic conditions that relate to the skin.

4. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Learning Objectives (cont’d)  Describe laboratory tests and clinical procedures that pertain to the skin and recognize relevant abbreviations.  Apply your new knowledge to understanding medical terms in their proper contexts, such as medical reports and records.

5. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Chapter 16 Lesson 16.1

6. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. INTRODUCTION Skin: Integumentary system  weighs 8-10 lbs.  covers 22 sq. ft. in average adult

7. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Functions of Skin  Provides protective membrane  Skin glands lubricate and cool the skin  Receptor for sensations  Helps Maintains body temperature

8. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Functions of Skin (cont’d) Produces sweat: sweat glands produce watery secretion that evaporates and cools Produces sebum: sebaceous glands produce oily secretion that lubricates skin and hair Receives sensation: pain, temperature, pressure, and touch Thermoregulates: interprets message from heat center in the brain

9. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. STRUCTURE OF THE SKIN Epidermis : outermost, thin cellular membrane Dermis : next layer; dense fibrous, connective tissue Subcutaneous tissue (hypodermis): thick, fat-containing tissue

10. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Structure of the Skin (cont’d)

11. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Structure of the Skin (cont’d)

12. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. HAIR: cells filled with the hard protein; keratin  Hair follicles: shafts that hold the hair  Five million hairs on body; 100,000 on head  Melanocytes at the root form the color  Grow.5 inch (1.3 cm) per month  Cutting does not affect growth ACCESSORY ORGANS OF THE SKIN

13. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. ACCESSORY ORGANS OF THE SKIN

14. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Accessory Organs of Skin (cont’d) NAILS : hard keratin plates covering toes and fingers  lunula  cuticle  paronychium

15. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Accessory Organs of Skin (cont’d) GLANDS: Sebaceous and Sweat  Sebaceous glands secrete oily sebum into hair follicle to lubricate  Sweat glands secrete into pores to moisten and cool  Both subject to bacterial growth

16. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Accessory Organs of Skin (cont’d) Sebaceous gland, eccrine sweat gland, and apocrine sweat gland.

17. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS AND TERMINOLOGY COMBINING FORMS  adip/ofat  albin/owhite  caus/oburn, burning  cauter/oheat, burn  cutane/o skin  derm/o/skin Combining FormMeaning

18. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS  dermat/oskin  diaphor/oprofuse sweating  erythem/oredness  erythemat/oredness  hidr/osweat  ichthy/oscaly, dry Combining FormMeaning COMBINING FORMS AND TERMINOLOGY

19. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS  kerat/ohard, horny tissue  leuk/owhite  lip/ofat  melan/oblack  myc/ofungus  onych/onail Combining FormMeaning COMBINING FORMS AND TERMINOLOGY

20. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS  phyt/oplant  pil/ohair, hair follicle  py/opus  rhythid/owrinkle  seb/osebum  squam/oscale-like Combining FormMeaning COMBINING FORMS AND TERMINOLOGY

21. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS  steat/ofat  trich/ohair  ungu/onail  xanth/oyellow  xer/odry Combining FormMeaning COMBINING FORMS AND TERMINOLOGY

22. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. QUICK QUIZ: QUICK QUIZ: 1.Which combining form refers to white? A.chlor/o B.jaund/o C.melan/o D.albin/o

23. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. QUICK QUIZ: QUICK QUIZ: 2.Which combining form refers to the same color as jaund/o? A.xanth/o B.chlor/o C.erythr/o D.cyan/o

24. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COLORS

25. Chapter 16 Lesson 16.2

26. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Cutaneous Lesions LABEL the following lesions:

27. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. REVIEW the following lesions: Cutaneous Lesions

28. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Signs and Symptoms Alopecia: absence of hair where it normally grows

29. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Signs and Symptoms (cont’d.) Ecchymosis: blue-black marks on the skin

30. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Petechia: small pinpoint hemorrhage Signs and Symptoms (cont’d.)

31. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Urticaria: acute allergic reaction with red, round wheals on skin Signs and Symptoms (cont’d.)

32. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Abnormal Conditions Acne: papular and pustular eruption of skin with increased production of sebum

33. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Burns: injury to tissue due to heat, chemical, electric shock, lightning or radiation. Image shows (A), Second degree burn and (B) shows Third degree burn. Abnormal Conditions (cont’d.)

34. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Abnormal Conditions (cont’d.)  Cellulitis: diffuse acute infection of skin  Eczema: inflammation of skin with erythematous and papulovesicular lesions caused by allergy  Exanthematous viral diseases: rash due to virus (e.g. rubella)  Gangrene: death of tissue with loss of blood supply

35. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Abnormal Conditions (cont’d.)  Impetigo: contagious pyoderma caused by staph or strep  Psoriasis: chronic recurrent dermatosis with silver gray scales that itch  Scabies: parasitic (tiny mites) and infectious pruritus  Scleroderma: chronic and progressive disease of skin with hardening of connective tissue

36. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Abnormal Conditions (cont’d.)  Systemic lupus erythematosus (SLE): inflammatory disease of collagen in skin, joints, and internal organs

37. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Abnormal Conditions (cont’d.) Tinea corporis Tinea unguium Tinea—infection of the skin caused by fungus.

38. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Abnormal Conditions (cont’d.) vitiligo Vitiligo—Loss of pigment in areas of skin.

39. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Chapter 16 Lesson 16.3

40. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Skin Neoplasms (Benign) CallusKeloid

41. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Skin Neoplasms (Benign) (cont’d.)  Keratosis: thickened area of epidermis  Leukoplakia: white thickened patches on tongue or cheek  Nevus: pigmented lesion  Verruca: warts caused by virus

42. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Skin Neoplasms (Cancerous) Basal cell carcinoma Malignant tumor of the basal cell layer of the epidermis

43. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Skin Neoplasms (Cancerous) Malignant tumor of the squamous epithelial cells of the epidermis. Squamous cell carcinoma

44. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. The ABCDs of malignant melanoma. A. Asymmetry B. Border, irregular or circumscribed D. Diameter, usually larger than 6mm C. Color variation Skin Neoplasms (Cancerous) (cont’d.)

45. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Skin Neoplasms (Cancerous) Malignant, vascular, neoplastic growth characterized by cutaneous nodules. Kaposi sarcoma

46. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Laboratory Tests Bacterial analyses: pus or fluid samples examined to detect microorganisms Fungal tests: scrapings for culture and microscopic examination after treatment with KOH.

47. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Clinical Procedures Cryosurgery: destroy tissue with subzero temperatures using liquid nitrogen Curettage: scrape lesion with sharp curet Electrodesiccation: destroy tissue by burning with electric spark

48. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Clinical Procedures (cont’d.) Mohs surgery: remove thin layers of growth to examine under microscope (basal and squamous cell) Skin biopsy: punch and shave to remove for examination in path lab Skin test: test reaction of body to allergen with skin test (scratch or patch tests)

49. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.  ABCD asymmetry, border, color, diameter — characteristics associated with skin cancer.  bxbiopsy  Derm.dermatology  DLE discoid lupus erythematosus  PPDpurified protein derivative  PUVApsoralen-ultravoilet A light therapy  SLEsystemic lups erythematosus  SCsubcutaneous Abbreviations

50. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. REVIEW SHEET COMBINING FORMS  adip/o ___________  albin/o ___________  caus/o ___________  cauter/o ___________  cutane/o ___________  derm/o ___________ Combining Form Meaning

51. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS  adip/o fat  albin/o white  caus/o burn, burning  cauter/o heat, burn  cutane/o skin  derm/o skin Combining Form Meaning REVIEW SHEET

52. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS  dermat/o ___________  diaphor/o ___________  erythem/o ___________  erythemat/o ___________  hidr/o ___________  ichthy/o ___________ Combining Form Meaning REVIEW SHEET

53. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS  dermat/o skin  diaphor/o profuse sweating  erythem/o redness  erythemat/o redness  hidr/o sweat  ichthy/o scaly, dry Combining Form Meaning REVIEW SHEET

54. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS  kerat/o ___________  leuk/o ___________  lip/o ___________  melan/o ___________  myc/o ___________  onych/o ___________ Combining Form Meaning REVIEW SHEET

55. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS  kerat/o hard, horny tissue  leuk/o white  lip/o fat  melan/o black  myc/o fungus  onych/o nail Combining Form Meaning REVIEW SHEET

56. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS  phyt/o ___________  pil/o ___________  py/o ___________  rhythid/o ___________  seb/o ___________  sabace/o ___________  squam/o ___________ Combining Form Meaning REVIEW SHEET

57. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS  phyt/o plant  pil/o hair, hair follicle  py/o pus  rhythid/o wrinkle  seb/o sebum  squam/o scale-like Combining Form Meaning REVIEW SHEET

58. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS  steat/o ___________  trich/o ___________  ungu/o ___________  xanth/o ___________  xer/o ___________ Combining Form Meaning REVIEW SHEET

59. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. COMBINING FORMS  steat/o fat  trich/o hair  ungu/o nail  xanth/o yellow  xer/o dry Combining Form Meaning REVIEW SHEET

60. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. SUFFIXES  -algia ___________  -derma ___________  -esis ___________  -lysis ___________  -ose ___________ Suffix Meaning REVIEW SHEET

61. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. SUFFIXES  -algia pain  -derma skin  -esis condition  -lysis breakdown; separation; destruction; loosening  -ose full of; pertaining to; sugar Suffix Meaning REVIEW SHEET

62. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. SUFFIXES  -osis ___________  -ous ___________  -plakia ___________  -plasty ___________  -rrhea ___________ Suffix Meaning REVIEW SHEET

63. Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. SUFFIXES  -osis condition, usually abnormal  -ous pertaining to  -plakia plaque  -plasty surgical repair  -rrhea flow; discharge Suffix Meaning REVIEW SHEET REVIEW SHEET