Skin & Skin Infections

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<ul><li>1.STRUCTURE &amp; FUNCTIONS OF SKIN</li></ul> <p>2. INTRODUCTION </p> <ul><li>The skin covers the whole of the external surface of the body.It forms the largest and heaviest organ in the body. The skin consists of three main layers. </li></ul> <ul><li>Epidermis (an upper protective layer) </li></ul> <ul><li>Dermis (a lower supporting layer) </li></ul> <ul><li>Hypodermis </li></ul> <p>3. Epidermis </p> <ul><li>The epidermis is thick, hard and horny in regions, such as on the palms of the hand and soles of the feet.</li></ul> <ul><li>Properties </li></ul> <ul><li>Primary barrier to microbial invasion </li></ul> <ul><li>Impermeability to water and chemicals </li></ul> <ul><li>High capacity of regeneration after damage </li></ul> <p>4. Dermis </p> <ul><li>The dermis is soft and elastic in all parts but may be very thick.</li></ul> <ul><li>Properties</li></ul> <ul><li>The dermis gives strength to the skin </li></ul> <ul><li>Act as reservoir of elements capable of fighting infections and repairing deep wounds </li></ul> <p>5. Hypodermis </p> <ul><li>The skin is supported by a layer of fatty subcutaneous tissue sometimes known as the hypodermis. </li></ul> <p>6. FUNCTION OF SKIN </p> <ul><li>The most obvious function of the skin is to provide the body with physical protection.</li></ul> <ul><li>It forms an outer covering, which defends the body against injury from mechanical, thermal, chemical sources and microorganisms </li></ul> <ul><li>The skin also acts as an organ of sensation to make the body aware of its environment.</li></ul> <p>7. FUNCTION OF SKIN (Contd) </p> <ul><li>Another important function of the skin is regulation of body temperature (37-38C). </li></ul> <ul><li>It plays a minor role in excretion of the bodys waste products</li></ul> <p>8. Bacterial Structure </p> <ul><li>CELL ENVELOPE: </li></ul> <ul><li><ul><li>Protects cells internal structures from its external environment.</li></ul></li></ul> <ul><li><ul><li>It comprises cell wall, cell membrane </li></ul></li></ul> <ul><li>CYTOPLASM:</li></ul> <ul><li><ul><li>Watery gelatinous substance</li></ul></li></ul> <ul><li><ul><li>Contains ribosomes, nucleoids &amp; plasmids</li></ul></li></ul> <ul><li><ul><li>Keeps the cell alive </li></ul></li></ul> <p>9. Bacterial Structure (Contd) </p> <ul><li>RIBOSOMES:</li></ul> <ul><li><ul><li>Produces enzymes and proteins</li></ul></li></ul> <ul><li><ul><li>Helps the cell to live and grow </li></ul></li></ul> <ul><li>NUCLEOIDS:</li></ul> <ul><li><ul><li>Contains cells genetic material.</li></ul></li></ul> <ul><li><ul><li>Also called bacterial chromosome </li></ul></li></ul> <ul><li><ul><li>Single circular molecule of double stranded DNA </li></ul></li></ul> <ul><li>PLASMIDS: </li></ul> <ul><li><ul><li>DNA fragments carrying genetic information </li></ul></li></ul> <p>10. MYCOLOGY </p> <ul><li>The study of fungi is called Mycology. </li></ul> <ul><li>There are several widespread human and animal diseases that are due to fungi. </li></ul> <ul><li>There are many beneficial fungi, some used to make antibiotics, bread and foods or used as insecticides.</li></ul> <p>11. CHARACTERISTICS OF FUNGI </p> <ul><li>The fungi (sing., fungus) are a diverse group of eukaryotic microorganisms, with over 80,000 identifiable species. </li></ul> <ul><li>Fungi were classified as plants, but laboratory studies have revealed a set of four properties that distinguish fungi from plants. </li></ul> <p>12. Differentiation from Plants </p> <ul><li>Fungi lack chlorophyll, while plants have this pigment. </li></ul> <ul><li>The cell walls of fungal cells contain a carbohydrate called chitin not found in plant cell walls. </li></ul> <ul><li>Fungi are not truly multi-cellular like plants.</li></ul> <ul><li>Fungi are heterotrophic eukaryotes, while plants are autotrophic eukaryotes.</li></ul> <p>13. GROWTH OF THE FUNGI </p> <ul><li>Fungi are aerobic organism, with the notable exception of the yeasts that multiply in the presence or absence of oxygen. </li></ul> <ul><li>High concentration of sugar is favorable for thegrowth </li></ul> <ul><li>Most fungi grow best at approximately 25 C </li></ul> <ul><li>fungi grow under acidic conditions at a pH from 5 to 6</li></ul> <p>14. FUNGAL INFECTIONS OF THE SKIN </p> <ul><li>Superficial Skin Infection </li></ul> <ul><li>Deep Fungal Infection </li></ul> <p>15. Superficial Skin Infection </p> <ul><li>The superficial fungi live on the dead horny layer of the skin</li></ul> <ul><li>Secrete an enzyme that enables them to digest keratin causing the superficial skin to scale and disintegrate the nails, and the hairs to break off.</li></ul> <ul><li>Fungi are also capable of causing an allergic reaction. </li></ul> <p>16. CLINICAL CLASSIFICATIONS </p> <ul><li>Tinea of the feet (tinea pedis) - T.mentagrophytes</li></ul> <ul><li>Tinea of the hands (tinea manus) -T. mentagrophytes </li></ul> <ul><li>Tinea of the nails (onychomycosis)T.rubrum, T. mentagrophytes </li></ul> <ul><li>Tinea of the groin (tinea cruris) - E.Floccosum</li></ul> <ul><li>Tinea of the smooth skin (tinea corporis) -T. mentagrophytes </li></ul> <ul><li>Tinea of the scalp (tinea capitis) -T.tonurans, T.verucosum</li></ul> <ul><li>Tinea of the beard (tinea barbae) </li></ul> <ul><li>Dermatophytid (Acute Eruption of Fungal Infection) Pityrosporum</li></ul> <ul><li>Tinea of Chest and Back (Tinea versicolor) Pityrosporum</li></ul> <p>17. DEEP FUNGAL INFECTION </p> <ul><li>Fungi that invade the skin deeply and go into living tissue </li></ul> <ul><li>Also capable of involving other organs.</li></ul> <p>18. Types of Deep Fungal Infection </p> <ul><li>Candidiasis </li></ul> <ul><li>Sporotrichosis </li></ul> <p>19. Deep Fungal Infection </p> <ul><li>Candidiasis : </li></ul> <ul><li>Candidiasis is a fungal infection caused by Candida albicans that produces lesions in the mouth, the vagina, the nails, the lungs, or the gastrointestinal tract or occasionally a septicemia. </li></ul> <p>20. Deep Fungal Infection </p> <ul><li>Sporotrichosis :</li></ul> <ul><li>Sporotrichosis is a fungal infection of the skin and the subcutaneous tissues that forms a chain of tumors that develop into ulcers </li></ul> <p>21. Dermatomycosis </p> <ul><li>Fungal infection of the skin ,especially of moist parts covered by clothing. </li></ul> <p>22. Eczema </p> <ul><li>Eczema is pruritic condition associated with erythema and edema in acute phase </li></ul> <ul><li>It is dominated by thickening and scaling when it becomes chronic</li></ul> <ul><li>The termeczemais broadly applied to a range of skin conditions.</li></ul> <ul><li>Eczema is defined as allergic, pruritic dermatitis </li></ul> <p>23. Inflammation </p> <ul><li>Aprotective reaction of tissue to irritation, injury, or infection. </li></ul> <ul><li>Two types of Inflammation: </li></ul> <ul><li>Localized Inflammation </li></ul> <ul><li>Systemic Inflammation </li></ul> <ul><li>Symptoms includes pain, redness, swelling and heat. </li></ul> <p>24. Localized Inflammation </p> <ul><li>Inflammation is a process in which the body's white blood cells and chemicals can protect us from infection and foreign substances (bacteria and viruses) </li></ul> <ul><li>Symptoms includes pain, redness, swelling and heat. </li></ul> <p>25. Systemic Inflammation </p> <ul><li>Inflammation may also be associated with general "flu"-like symptoms including:</li></ul> <ul><li><ul><li>Fever</li></ul></li></ul> <ul><li><ul><li>Chills</li></ul></li></ul> <ul><li><ul><li>Fatigue/loss of energy</li></ul></li></ul> <ul><li><ul><li>Headaches</li></ul></li></ul> <ul><li><ul><li>Muscle stiffness &amp;myalgia </li></ul></li></ul> <ul><li><ul><li>A norexia(Loss of appetite) </li></ul></li></ul> <p>26. ANTIFUNGAL AGENTS </p> <ul><li>CLOTRIMAZOLE </li></ul> <ul><li>Clotrimazole is an imidazole antifungal agent. </li></ul> <ul><li>Clotrimazole is applied topically two or three times daily for 2 to 4 weeks as a 1% cream.</li></ul> <ul><li>Local reactions including irritation and burning may occur in patients treated topically; contact allergic dermatitis has been reported. </li></ul> <p>27. </p> <ul><li>KETOCONAZOLE </li></ul> <ul><li>Ketoconazole is an imidazole antifungal agent, which interferes with ergosterol synthesis and therefore alters the permeability of the cell membrane of sensitive fungi. It is reported to be fungistatic. </li></ul> <ul><li>After topical administration of Ketoconazole, irritation, dermatitis or a burning sensation has occurred </li></ul> <p>28. </p> <ul><li>MICONAZOLE </li></ul> <ul><li>Miconazole is an imidazole antifungal agent with similar antimicrobial activity to Ketoconazole. </li></ul> <ul><li>Local irritation and sensitivity reaction may occur with Miconazole nitrate</li></ul> <p>29. Corticosteroids </p> <ul><li>Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex.</li></ul> <ul><li>Corticosteroids are involved in a wide range of physiologic systems such as stress response, immune response and regulation of inflammation </li></ul> <p>30. Effects of Corticosteroids </p> <ul><li>Corticosteroids exerts their effects by suppressing: </li></ul> <ul><li>The inflammatory response </li></ul> <ul><li>The immune response </li></ul> <p>31. Mechanism of Corticosteroids</p> <ul><li>Corticosteroids suppress inflammation by a number of mechanisms: </li></ul> <ul><li>Inhibition of production of prostaglandins, leukotrienes and other inflammatory mediators </li></ul> <ul><li>Inhibition of migration of neutrophils to areas of inflammation </li></ul> <ul><li>Inhibition of accumulation of macrophages in areas of inflammation</li></ul> <p>32. </p> <ul><li>Hydrocortisone </li></ul> <ul><li>Hydrocortisoneis a corticosteroid hormone produced by the adrenal gland.</li></ul> <ul><li>It is usually referred to as the "stress hormone" as it is involved in response to stress.</li></ul> <ul><li>It increases blood pressure and blood sugar, and reduces immune responses.</li></ul> <ul><li>When first introduced as a treatment for rheumatoid arthritis, hydrocortisone was referred to asCompound E </li></ul> <p>33. </p> <ul><li>Diflucortolone </li></ul> <ul><li>Diflucortolone is a synthetic corticosteroid and is used to decrease inflammation in skin.</li></ul> <ul><li>It works by preventing the release of certain chemicals from the cells. These chemicals are important in the immune system, and are released as a result of allergy or irritation. </li></ul> <ul><li>By decreasing the release of these chemicals in the skin, diflucortolone reduces inflammation and relieves itch.</li></ul> <ul><li>Diflucortolone is classed as a very potent corticosteroid.</li></ul> <p>34. </p> <ul><li>Betamethasone </li></ul> <ul><li>Betamethasoneis a moderately potent corticosteroid with anti-inflammatory and immunosuppressive properties.</li></ul>