1. Dermatology
Vickie Mickey,CT

2. 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

3. 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

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

5. 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

6. Papule
Small elevated pimple
Contains no fluid but may develop pus

7. 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

8. 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

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

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

11. 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

12. 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

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

14. 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

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

16. 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

17. 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:

18. 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

19. 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

20. Excoriation
Skin sore produced from scratching or abrasion

21. Fissure
Crack in skin that penetrates the dermis

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

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

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

25. 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!

26. 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

27. 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

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

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

30. 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

31. 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

32. 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

33. 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

34. 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

35. 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

36. 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

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

38. Asteatosis
Dry, scaly skin deficient of sebum

39. 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

40. 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

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

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

43. 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

44. Stains
Abnormal patches of brown coloration
Round or irregular shapes

45. Nevus/ Birthmark
Colored malformation of the skin
Often congenital

46. 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!

47. 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

48. 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

49. 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

50. 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

51. 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

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

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

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

55. 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