Class 5 Flashcards
What is skin?
• link to internal & external environments
• own pathologies
• judge general health
What art the functions of human skin?
- Protection
- Immunity
- Thermoregulation
- Storage/reservoir
- Flexible/resilient
- Sensation
- Role in vitamin D synthesis
- Healing/repair
- Excretion
What are the skin layers?
- Epidermis
- Dermis
- Subcutaneous
Melanocytes produce melanin, which has what 2 purposes?
- Giving the skin colour (pigmentation)
- Protecting basal cells from UV damage
What are some of the general guidelines for manual practitioners?
➤ Research
➤ Avoid treating an undiagnosed lesion
➤ Hygiene care to area of inflamed, irritated or disrupted
skin
➤ Ask about type of treatment(s)
➤ Good reason to treat vulnerable skin?
➤ Patch test
➤ Modify heat hydro
What are examples of contraindications when it comes to skin?
➤ Infection or risk of spreading
➤ Acute inflammation or flare up present
➤ Vesicles/blisters
➤ Risk of promoting bleeding
➤ Broken or eroded skin
➤ Stretching friable tissue
When it comes to skin what are some of the key questions you should ask yourself?
➤ What is it? Has it been diagnosed?
➤ Is it a solitary lesion or circumscribed tissue area or is it
widespread?
➤ Is it contagious? can it be spread by contact?
➤ Is it inflamed?
➤ Is the skin surface broken/disrupted?
➤ Is there blistering, bleeding, oozing, crust or scabbing?
➤ Is there a secondary infection risk?
➤ Are there any applicable restrictions from the doctor?
➤ Any prescribed or medically approved cream or lotion?
What are some common manifestations of skin disorders?
➤ Lesions
➤ Rashes
➤ Blisters
➤ Calluses
➤ Corns
➤ Pruritis
➤ Xerosis
What are examples of lesions?
➤ Macule
➤ Patch
➤ Papule
➤ Nodule
➤ Pustule
➤ Vesicle
➤ Plaque
➤ Crust
➤ Lichenification
➤ Keloid
➤ Fissure
➤ Ulcer
➤ Erosion
What is a Macule?
SMALL, FLAT circumscribed lesion of DIFFERENT COLOUR than normal skin
What is a Patch?
Vitiligo, port wine stain. DIFFERENCE IS >1CM
What is a Papule?
Small, firm, ELVATED lesion
What is a Nodule?
ELEVATED LESION LARGER than papule
What is a Pustule?
ELEVATED, ERYTHEMATOUS lesion, usually contains PURULENT exudate
What is a Vesicle?
Elevated, THIN WALLED lesion containing CLEAR FLUID
What is a Plaque?
Large, SLIGHTLY ELEVATED lesion with flat surface, often TOPPED by SCALE
What is a Crust?
Dry, rough surface or DRIED EXUDATES or BLOOD
What is a Lichenification?
Thick, dry, rough skin surface (LEATHER LIKE)
What is a Keloid?
Raised, irregular mass of collagen from EXCESSIVE SCAR FORMATION
What is a Fissure?
SMALL, DEEP CRACK or tear in skin
What is an Ulcer?
CAVITY with loss of tissue from EPIDERMIS & DERMIS, OFTEN WEEPING or BLEEDING
What is an Erosion?
SHALLOW, MOIST CAVITY in EPIDERMIS
What are rashes?
➤ general term meaning skin outbreak that changes it’s appearance & texture
➤ temporary eruptions of skin
➤ associated with childhood diseases, heat, irritation (ex. diaper rash), drug induced reactions
What are the 4 types of rashes?
• blanched/ white
• erythematous/ red
• hemorrhagic/ purpuric/ containing blood
• pigmented/ coloured
What is a blister?
➤ vesicle of fluid filled papule (aka BULLA)
➤ degeneration of epidermal cells & disruption of intercellular junctions that causes layers to separate & fluid to accumulate
How should you deal with blister?
• bandage or gauze
• DO NOT BREAK
What is a callus?
➤ hyperkeratotic plaque of skin due to chronic pressure or
friction
➤ increased cohesion & decreased shedding
How should we deal with callus?
• can be filed down
What are corns?
➤ small, defined perimeter, cone shaped, keratinous thickening
➤ common to toes & hands
➤ can reoccur if cause is not addressed
How should you deal with corns?
• paring (slicing to reduce size)
• pressure or friction (MOI) removal
• keratolytic agents (chemical debridement)
• laser
• injections
• surgically removed
Differences between corns vs. callus?
• Calluses develop from forces distributed over broad area of skin whereas
• Corns develop from more localized forces
• Corns can occur within an area of callus, such as on plantar surface.
What is pruritis (Itch)?
➤ itch sensation originates in free nerve endings in skin
(nociceptors)
➤ different ranges of severity
➤ can signal an internal disorder
➤ warmth, touch & vibration will irritate/make it worse
➤ scratching an itch is spinal reflex
How to deal with pruritis (Itch)?
• treatments are non specific
Pruritis = __________
Itch
Xerosis = __________
Dry Skin
What is Xerosis (dry skin)?
➤ dehydration of stratum corneum
➤ may be primary sign of sign disorder or systemic disease
➤ appears rough, scaly, wrinkled, lined
➤ predisposed to itching which could lead to cracking &
fissuring
➤ commonly affects extremities, back, abdomen, waist
How to deal with Xerosis (dry skin)?
• moisturizing agents
What are key features of darker skin presentations and evaluation?
➤ darker skin provides better protection against skin cancer,premature wrinkling, aging of skin associated with sun exposure
➤ may be more difficult to evaluate pallor, cyanosis &
erythema
What is Vitiligo?
➤ depigmented macule with definite, smooth border
➤ white, pale or greyish blue
➤ 3 ways this would occur: (etiology unknown)
• decreased number of melanocytes
• absence of melanocytes
• melanocytes that don’t produce melanin
➤ affects skin, mucous membranes & retina - common to face, neck, axillae, extremities
➤ affected area can enlarge over time
➤ these areas are prone to sunburn
➤ can be asymptomatic or pruritic
How to deal with Vitiligo?
• no cure but range of treatments to manage
What is Albinism?
➤ genetic disorder
➤ complete or partial congenital absence of pigment
➤ affects skin, showing as pale to pink hues, hair as white to yellow & eyes light or pink
➤ most common type is recessively inherited oculocutaneous albinism
➤ sensitivity to light, refractive errors and nystagmus
What is Chloasma (Melasma)
➤ darkened macules on face
➤ brown hyperpigmentation macules or patches usually to face - cheeks, temple & forehead
➤ more common in women, especially if pregnant, anyone of Aboriginal, German, Russian and Jewish descent or dark
skinned people
➤ exacerbated by sun exposure
How to deal with Chloasma (Melasma)?
• limit sun exposure, bleaching
What is Tinea/Mycosis/Ringworm?
➤ relatively common fungal infection - invades dead keratinized tissue
➤ name differs based on where on body it’s occurring
➤ fungus releases enzyme that allows it to digest keratin & results in skin scaling, nail degeneration, hair breakage or loss
➤ can become deeper in immunocompromised individuals & caused by inflammation due to toxins released by fungi
➤ Appears: itchy, scaly, red rash, sometimes bald patches
How to deal with Tinea/Mycosis/Ringworm?
• antifungal creams
What are bacterial infections?
➤ There are several types of bacteria that are present on skin as part of normal microflora.
➤ in certain environments or on certain occasions they can cause superficial or systemic reactions
Primary infections are _________________
usually superficial
Secondary infections usually _____________________________.
usually occur in preexisting lesion & may be deeper
Diagnosis of bacterial infection -> ____________
by culture
How to deal with bacterial infection?
• antibiotics
What are Furuncles (Boils)?
➤ infection of hair follicle which spreads to surrounding
dermis
➤ face, back, neck are common sites
➤ progresses from firm, red + painful nodule to large, painful mass
➤ filled with purulent exudate
➤ spread by AUTOINNOCULATION
What are Carbuncles?
➤ collection of furuncles
➤ join together into bigger mass & may drain through
different sinuses or develop into abscess.
What is Impetigo?
➤ superficial infection caused by Staph
➤ common in infants & young children
➤ easily contracted in warm + moist climates
➤ starts as small vesicle or pustule or as large bulla then ruptures & forms roughened area that discharges honey coloured liquid that crusts
➤ new vesicles appear within hours
➤ scratching can spread it
What is Impetigo?
➤ superficial infection caused by Staph
➤ common in infants & young children
➤ easily contracted in warm + moist climates
➤ starts as small vesicle or pustule or as large bulla then ruptures & forms roughened area that discharges honey coloured liquid that crusts
➤ new vesicles appear within hours
➤ scratching can spread it
How to deal with Impetigo?
• systemic antibiotics
What is Ecthyma?
➤ caused by Staph/Strep
➤ ulcerative form of Impetigo
➤ frequently seen in children, usually on buttocks & thighs
➤ when extensive cause present with fever, can spread to other organs
How to deal with Ecthyma?
• systemic antibiotics
What is Cellulitis?
➤ deep infection of dermis & subcutaneous tissue
➤ caused by Staph & Beta Hemolytic Strep
➤ portals of entry: pre-existing wound & tinea
pedis
➤ legs, hands & ears most commonly affected
➤ presents: expanding red, tender, swollen plaque with indefinite border. frequently fever & acute inflammation
s/s
➤ often involve lymph system- septicaemia, nephritis, death
How to deal with Cellulitis?
IV & oral antibiotics
