chapter 16-skin diseases & disorders 2009]

8/14/2019 Chapter 16-Skin Diseases & Disorders 2009]

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Skin Diseases & Disorders

Chapter 16



Terms

Macule Flat, discolored lesion

Papule

Solid elevated lesion Nodule

Same as macule but larger

Vesicle

Elevated lesion that contains fluid Bulla

A vesicle >0.5 with fluid



Terms

Pustule Raised area that contains pus

Wheal Dome-shaped elevated lesion

Excoriations Abrasion

Fissure Small cracklike sore/break



Common Signs and Symptoms

Skin eruptions

Pruritus

Erythema Pain

Swelling

Inflammation



Psoriasis

Description Chronic noninfectious, inflammation of

epidermis pink/red lesions of skin which appear

cracked, dry, encrusted, and takes on acharacteristic silver scaling.

Occurs more often between ages 15-50

Precipitated by infections, hormonalchanges, stress, climate



Psoriasis

Diagnosis Observation of skin lesions

Careful medical history

Skin biopsy

Treatment No cure

Only palliative treatment

Avoid precipitating factors

Ultraviolet A or B light

Coal tar preparations, corticosteroid creams



How does Acne vulgaris differ

from Psoriasis?



Acne Vulgaris

Description Inflammation of

sebaceous glands, hair

follicles Comedos, papules,

pustules appear on skin

Diagnosis

Observation, client’s age& medical Hx



Acne Vulgaris

Treatment Keratolytic, bacteriostatic, and

antiinflammatory agents--for example,

benzoyl peroxide (Clearasil, Clean &Clear, Fostex ), erythromycin orclindamycin (Cleocin), and tretinoin

Oral antibiotics --tetracycline



Alopecia

Systemic illnesses Lupus erythematous

Cutaneous metastases

Dermatitis Chemotherapy drugs

Radiation therapy

Mechanical pulling (rollers, rubber bandsbraids)

Aging process – natural occurrence



Carbuncle vs Furuncles

Furuncle – an abscess of hair follicles orsubcutaneous tissue

Carbuncle – severalfuruncles developing inadjoining hair follicles withmultiple drainage sinuses

Staphlococcal infections aremost common infection

TX



Decubitus Ulcers

Lesions caused by impairment of theblood supply to skin & subcutaneoustissue

Shiny, reddened skin small blisters

ulcerative lesions.

Culture drainage

TX



Pediculosis

Pediculosis corporis – Body hair

Pediculosis capitis – scalp hair

Pediculosis pubis – pubic hair

http://www.iqb.es/dermatologia/atlas/pediculosis/pediculosis02.jpg



Dermatophytosis (Ringworm)

Chronic fungal skin infection

Types Tinea capitis

Tinea corporis

Tinea unguium

Tinea pedis

Diagnosis – Microscopic evaluation of skin scrapings

using KOH

http://upload.wikimedia.org/wikipedia/commons/3/3a/Ringworm_on_the_arm%2C_or_tinea_corporis_due_to_Trichophyton_mentagrophytes_PHIL_2938_lores.jpg



Scabies (Itch Mite)

Itches, especially at night

Appear between fingers, on wrists,

elbows, waist, nipples, & buttocks Contagious – skin to skin contact or

sexually

Caused by a mite

Microscopic evaluation using mineraloil



Impetigo

Contagious skin infection usuallycaused by staphylococcus orstreptococcus.

Small, fluid-filled blister/vesicle

Caused by poor hygiene

Gram stain/culture vesicle fluid



Scleroderma

Autoimmune disorder

Connective tissue disease characterized byfibrosis of skin & internal organs

Signs Raynaud’s phenomenon

Pain, stiffness, swelling of joints

Cardiac & pulmonary fibrosis

Diagnosis

Positive Antinuclear Antibody Test (ANA) Radiographs for systemic changes

Skin biopsy

Treatment: corticosteroids



Dermatitis

Seborrheic Dermatitis Increased sebaceous secretions

Cradle cap

Contact Dermatitis Hypersensitivity

Latex Allergies

Atopic Dermatitis (Eczema)

Inflammation of skin

Genetic defect



Dermatitis Case Studies

1. A laboratorian who worked in the microbiology lab wasconstantly washing her hands. Her hands became red,irritated, itchy, and developed small oozing, fluid-filledbumps. Testing showed she was not allergic to latex.

2. A six month old baby had patches of dry brown/yellowscaly areas on her skull and in her armpits. The mothertook the child to the pediatrician because she was worriedwhen the areas didn’t disappear with the usualshampoos.

3. A gardener who had been pulling weeds developederythema that changed into blisters on her legs. It rashitched tremendously and over time became hot andswollen.



Herpes-Related Skin Lesions

Cold Sores/Fever blisters HSV-1

Shingles/Herpes zoster Varicella-zoster virus (VZV)



Skin Carcinomas

Basal cell carcinoma Most common

Usually does not metatasize

Squamous cell carcinoma Usually arise from pre-malignant lesions, actinic

keratoses

Malignant Melanoma

Malignancy of pigment-producing cells(melanocytes)

Readily metatasizes



Basal Cell Carcinoma

An open sore thatbleeds, oozes orcrusts and remainsopen for afew weeks.



Squamous Cell Carcinoma

A persistent, scaly red patch withirregular borders that sometimescrusts or bleeds.



Melanoma

Asymmetry - If you draw a line through this mole,the two halves will not match.

Border - The borders of an early melanoma tend tobe uneven. The edges may be scalloped or notched.

Color - Having a variety of colors is another warningsignal. A number of different shades of brown, tan orblack could appear. A melanoma may also becomered, blue or some other color.

Diameter - Melanomas usually are larger in diameterthan the size of the eraser on your pencil (1/4 inch or6 mm), but they may sometimes be smaller whenfirst detected.

Evolving - Any change — in size, shape, color,elevation, or another trait, or any new symptom suchas bleeding, itching or crusting — points to danger.

chapter 16-skin diseases & disorders 2009]

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