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Skin Diseases & Disorders
Chapter 16
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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
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Terms
Pustule Raised area that contains pus
Wheal Dome-shaped elevated lesion
Excoriations Abrasion
Fissure Small cracklike sore/break
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Common Signs and Symptoms
Skin eruptions
Pruritus
Erythema Pain
Swelling
Inflammation
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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
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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
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How does Acne vulgaris differ
from Psoriasis?
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How does Acne vulgaris differ
from Psoriasis?
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Acne Vulgaris
Description Inflammation of
sebaceous glands, hair
follicles Comedos, papules,
pustules appear on skin
Diagnosis
Observation, client’s age& medical Hx
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Acne Vulgaris
Treatment Keratolytic, bacteriostatic, and
antiinflammatory agents--for example,
benzoyl peroxide (Clearasil, Clean &Clear, Fostex ), erythromycin orclindamycin (Cleocin), and tretinoin
Oral antibiotics --tetracycline
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Alopecia
Systemic illnesses Lupus erythematous
Cutaneous metastases
Dermatitis Chemotherapy drugs
Radiation therapy
Mechanical pulling (rollers, rubber bandsbraids)
Aging process – natural occurrence
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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
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Decubitus Ulcers
Lesions caused by impairment of theblood supply to skin & subcutaneoustissue
Shiny, reddened skin small blisters
ulcerative lesions.
Culture drainage
TX
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Pediculosis
Pediculosis corporis – Body hair
Pediculosis capitis – scalp hair
Pediculosis pubis – pubic hair
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Dermatophytosis (Ringworm)
Chronic fungal skin infection
Types Tinea capitis
Tinea corporis
Tinea unguium
Tinea pedis
Diagnosis – Microscopic evaluation of skin scrapings
using KOH
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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
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Impetigo
Contagious skin infection usuallycaused by staphylococcus orstreptococcus.
Small, fluid-filled blister/vesicle
Caused by poor hygiene
Gram stain/culture vesicle fluid
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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
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Dermatitis
Seborrheic Dermatitis Increased sebaceous secretions
Cradle cap
Contact Dermatitis Hypersensitivity
Latex Allergies
Atopic Dermatitis (Eczema)
Inflammation of skin
Genetic defect
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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.
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Herpes-Related Skin Lesions
Cold Sores/Fever blisters HSV-1
Shingles/Herpes zoster Varicella-zoster virus (VZV)
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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
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Basal Cell Carcinoma
An open sore thatbleeds, oozes orcrusts and remainsopen for afew weeks.
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Squamous Cell Carcinoma
A persistent, scaly red patch withirregular borders that sometimescrusts or bleeds.
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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.