16- Diseases of the Integument Flashcards
Color is due to pigments.
- Melanin
- Carotene
- Hemoglobin
- Cyanosis
Skin color
Yellow to black (melanocytes)
Melanin
Yellow
Carotene
Reddish.
Hemoglobin
Bluish color of hemoglobin due to lack of oxygen.
Cyanosis
- Albinism
- Vitiligo (leukoderma)
Defects of skin color
Autosomal recessive inherited genetic defect causing lack of or deficient production of melanin (pigment) in the skin, hair, or eyes.
- Risk of skin cancer and sensitivity to light
- Hypopigmentation in the hair, eyelashes, retina
- Transillumination of the iris
Albinism
Progressive skin disorder manifested by destruction of melanocytes (little or no melanin in certain areas of the body).
- Marked by white patches of skin, colorless hair, abnormalities or inflammation of retina or iris of the eyes.
- It can begin at any age but about 50% of the time it starts before age 20.
- Cause is not known
Vitiligo
- Immune system disorders
- Hereditary
- Sunburn
- Emotional distress
Possible risk factors of Vitiligo
Inflammation of the sebaceous (oil) glands and hair follicles of the skin.
- Blackhead - Whitehead
Acne
Open acne.
Blackhead (oxidized)
Closed acne.
Whitehead (infected)
Most common; affects more than 90% of adolescence in the US.
Acne vulgaris
Endocrine disorder due to increased production of sex hormones. Increase in size and activity of sebaceous glands on face, neck, chest, back, heredity or food allergies.
Etiology of Acne Vulgaris
- Chronic dandruff, cradle cap in infants.
- Common, inflammatory skin disorder affecting areas of the head (scalp, eyebrows, eyelashes, behind ears, sides of nose) and trunk where sebaceous glands are prominent.
- Probably caused by inflammatory response to the body’s normal flora (Pitorosporum ovale yeast)
Seborrheic Dermatitis (Seborrhea)
- Increased production of sebum (oil)
- Inflammation of the skin causes dry to greasy. flaky, white to yellowish to red scales
Symptoms of seborrheic dermatitis (seborrhea)
Specific pathologic structural or functional changes, or both brought about by disease or injury, encapsulated, bacterial skin infection.
- Etiology - staphylococcus
- Need to be open and surgically drained
Inflammatory lesions
- Inflammation
- Infection
- Pain
Inflammatory lesions
- Abscess
- Carbuncle
- Furuncle
Types of inflammatory lesions
Localized, circumscribed accumulation of pus.
Abscess
Abscess or pyogenic (producing pus) infection of sweat gland or hair follicle.
Furuncle (boil)
Several communicating boils of skin and subcutaneous tissues with production and discharge of pus and dead tissue.
Carbuncle
Group of bacterial known as Staph.
- Can cause iillness
- Directly by infection (skin)
- Indirectly through toxins (food poisoning)
Staphylococcus Infections
A genus of gram-positive, nonmotile, opportunistic bacteria which tend to aggregate in irregular, grape-like clusters.
Staph
- Impetigo
Type of staphylococcus infection
Acute, contagious skin infection (staph or strep) with pus-filled lesions on face and hands (children); local
- Usually due to poor hygiene, malnutrition
Impetigo
Gram-positive cocci that occur in chains.
- Often manifested by formation of pus.
- Associated with wound infection or scarlet fever.
Streptococci
- Scarlet fever
Type of streptococcus infection
Highly contagious; spread by sneezing, coughing.
- May result in serious complications (Heart, kidney disease)
Scarlet fever
- Fever
- Lethargy
- Sore throat
- Bumpy rash on skin
- Flushed cheeks
- “Strawberry tongue”
Symptoms of scarlet fever
STD infection.
- Treponema pallidum bacteria penetrates skin and mucous membranes.
- Primary stage
- Secondary stage
- Tertiary stage if untreated
Syphilis
Initially painless, highly contagious lesions (chancres); disappear in 3-6 weeks.
Primary stage of syphilis
3-6 weeks after chancre, skin rash (palms, soles, mouth or whole body), highly contagious, heals within several weeks of months.
Secondary stage of syphilis
Damage to heart, eyes (blindness), brain and nervous system (mental disorders, insanity, deafness, paralysis and death), bones and joints.
Tertiary stage of syphilis
Viral skin infection; causes inflammation of skin and clusters of fluid-filled vesicles
- Herpes simplex virus (HSV-1 or HSV-2)
- Spread by direct skin contact, treated with acylovir
- Cold sores
- Genital herpes
- Herpes varicella zoster virus
Herpes
Mouth and nose (HSV-1)
Cold sores
Lesions on genital area (HSV-2 or HSV-1)
Genital herpes
Cause chicken pox, highly contagious, by direct contact with skin lesion, most common in children.
Herpes varicella zoster virus
Acute inflammation of sensory neurons caused by exposure to or reactivation of herpes zoster virus. (same that cause chicken pox in children)
- Occurs in adults with suppressed immunity,, due to trauma, or aging.
Shingles (Herpes zoster virus)
- Itching
- Red rash
- Small water blisters that follow the course of the affected sensory nerve
- Pain due to neuritis of sensory nerve
Symptoms of Shingles
Bacterial infection by Borrelia burgdorferi
- Untreated infection can spread to joints, heart, and nervous system.
Lyme disease
- Fever
- Headache
- Fatigue
- Skin rash called erythemia (redness) Migrans (spreading)
Lyme disease
- Basal Cell Carcinoma
- Squamous Cell Carcinoma
- Melanocytic Nevus (mole)
- Malignant Melanoma
Neoplasms of the integument
Cells of the epidermis (basal cell layer) invade the dermis (skin) and hypodermis.
- Most common, slow growing, least malignant
- Usually on sun-exposed areas, face, nose, lips
Basal cell carcinoma
- Raised lesions
- May bleed and form a crust
Symptoms of Basal cell carcinoma
More serious than basal cell carcinoma because it grows more rapidly and metastasizes through the lymphatic system.
- Develops in any squamous epithelium including the skin and mucous membranes.
- Often on sun exposed areas: scalp, ears, lower lip and hands.
Squamous cell carcinoma
- Crusted, firm, red nodule, that ulcerates and bleeds.
Symptoms of squamous cell carcinoma
- Actinic kertinosis
- Chronic ulcers
- Exposure to some chemicals
Predisposing factors of squamous cell carcinoma
Small, dark (pigmented) skin growth (epidermis)
- Most are benign, but atypical (dysplasic nevi) may develop into malignant melanoma.
- Usually hereditary
- Most are bigger than a pencil eraser, shape and pigmentation are irregular.
- Congenital nevi
Melanocystic Nevus (mole)
More likely to become cancerous than moles that develop after birth, especially if they are more than eight inches in diameter.
Congenital nevi
Cancer of melanocytes.
- Most dangerous because it metastasizes rapidly to lymph and blood vessels.
- In men, majority of these appear on the back, in women, on the legs.
Malignant melanoma
- Melanocytic nevus
- Exposure to some chemicals (arsenic, radium)
- Related to severe childhood sunburn
- Warning signs - ABCD rule
Predisposing factors for malignant melanoma
Damage inflicted by intense heat, electricity, radiation, or certain chemicals, all of which denature cell proteins and cause cell death.
- Severity depends on:
- Extent (body area)
- Degree - depends on which layer(s) of skin are involved.
Skin burns
Epidermis only
First-degree burn
Epidermis and upper dermis.
Second-degree burn
Full thickness of the skin.
Third-degree burn
Result from: Dehydration (most dangerous) circulatory shock
- Electrolyte and protein imbalance
- Infections
- Renal shut down
- Extensive scarring
Third-degree skin burn complications
- Discolorations
- Dehydration (dryness/scales)
- Lesions
- Pigmentation and depigmented spots
- Swelling
Postmortem conditions
