1. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar The Pharmacy Technician FOUNDATIONS AND PRACTICES Chapter 21 The Skin

2. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Figure 21.1 Structure of the Skin.

3. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar The Skin Epidermis—outermost layer of skin –Contains melanocytes, where pigment is stored –Thinnest skin layer

4. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar The Skin (cont.) Dermis—middle layer of skin tissue –Contains fibroblasts responsible for secreting collagen and elastin –Contains immune cells, hair follicles, blood vessels, and sweat and oil glands –Location of the sensory receptors for touch, pain, heat, and cold –Helps maintain body temperature

5. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar The Skin (cont.) Subcutaneous layer (hypodermis)— deepest layer of skin –Outermost part of the muscle is located here –Stores fat tissue –Contains connective tissue

6. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Functions of the Skin Acts as a mechanical barrier to infection Provides for the sense of touch Regulates body temperature Excretes waste products and salt from the body Synthesizes vitamin D (with sunlight) for the absorption of calcium

7. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Diseases of the Skin—Rash Area of red, inflamed skin, or a group of red spots Caused by irritation, allergy, infection, or defects in the skin’s structure Pharmaceutical treatment: antihistamines, topical corticosteroids

8. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Diseases of the Skin—Eczema Skin inflammation with red, pimple-like bumps Characterized by itching, blistering, or oozing areas that progress to scaly, brownish, or thickened skin Pharmaceutical treatment: topical immunomodulators

9. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Diseases of the Skin—Psoriasis Chronic immune disorder Specific immune cells become overactive and release excessive amounts of proteins called cytokines Causes inflammation and painful, often disfiguring plaques Pharmaceutical treatment: topical steroids, oral antibiotics, immunosuppressants

10. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Figure 21.2 Psoriasis of the abdomen.

11. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Diseases of the Skin—Viral Infection Occurs when a virus infects the inner layers of the skin Examples: herpes simplex, warts, shingles Pharmaceutical treatment: anti- inflammatory steroids or antihistamines

12. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Diseases of the Skin—Bacterial Infection Occurs when bacteria penetrate the skin and cause opportunistic infection Most common bacterial infections: staphylococci, streptococci, and pseudomonas If left untreated, may spread throughout the body, causing systemic infections Examples: cellulitis, impetigo, folliculitis Pharmaceutical treatment: oral antibiotics

13. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Diseases of the Skin—Fungal Infection Occurs when harmless fungi gain entry into the skin Usually external, affecting the skin, hair, and nails Examples: athlete’s foot, jock itch, ringworm Pharmaceutical treatment: topical antifungals

14. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Diseases of the Skin—Acne Bacterial infection Results in an overproduction of sebum, which clogs the hair follicles Categorized as noninflammatory or inflammatory Pharmaceutical treatment: topical antiseptics

15. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Diseases of the Skin—Cellulitis Acute, deep infection of the connective tissue Accompanied by inflammation Pharmaceutical treatment: oral or IV antibiotics

16. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Diseases of the Skin—Parasitic Infestations Caused by insects or worms that burrow into the skin to live and/or lay eggs Examples: scabies, lice Pharmaceutical treatment: antiparasitic topical agents

17. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Figure 21.3 Parasitic infestation—head lice.

18. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Diseases of the Skin—Tumors and Cancerous Growths Occur when skin cells multiply or reproduce faster than normal Cells without mutation are noncancerous or benign Tumors or skin growths with mutation are cancerous or malignant Pharmaceutical treatment: topical chemotherapeutic agents, immunomodulators, NSAIDs for precancerous actinic keratosis

19. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Figure 21.4 Basal cell carcinoma.

20. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Figure 21.5 Malignant melanoma.

21. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Diseases of the Skin—Pigmentation Disorders Skin color is determined by the amount of melanin produced by the body Hypopigmentation—loss of skin pigmentation –Example: vitiligo Hyperpigmentation—excess skin pigmentation –Examples: freckles, age or “liver” spots Pharmaceutical treatment: none

22. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Table 21.1 Drugs Used to Treat Various Skin Diseases

23. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Table 21.1 (continued) Drugs Used to Treat Various Skin Diseases

24. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Table 21.1 (continued) Drugs Used to Treat Various Skin Diseases

25. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Table 21.1 (continued) Drugs Used to Treat Various Skin Diseases

26. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Table 21.1 (continued) Drugs Used to Treat Various Skin Diseases

27. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. The Pharmacy Technician: Foundations and Practices Mike Johnston, Karen Davis, and Jeff Gricar Table 21.1 (continued) Drugs Used to Treat Various Skin Diseases