1. Chapter 18 Integumentary System Diseases and Disorders

2. 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

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

4. Common Signs and Symptoms
Skin lesions
Pain
Pruritus
Edema
Erythema
Inflammation

5. Diagnostic Tests Biopsy Culture and sensitivity Blood tests
Microscopic smear examinations

6. 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

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

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

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

10. 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

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

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

13. 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

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

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

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

17. 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

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

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

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

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

22. 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

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

24. 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

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

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

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

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

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

30. Seborrheic Keratosis Benign overgrowth of epithelial cells Treatment
Curettage
Scraping off

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

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

33. 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

34. 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

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

36. 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

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

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

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

40. 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

41. 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

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

43. 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

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

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

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

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

48. 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

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

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

51. 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