integumentary system disorder Flashcards
sweats contain
antimicrobial proteins
sebum and defensins
kill bacteria
three major region of skin
epidermis, dermis, hyposdermis
epidermis
outermost region of the skin, consists of epithelial tissue and is avascular
dermis
middle region of the skin
mostly fibrous connective tissue, vascular
hypodermis (superficial fascia)
subcutaneous layer deep to skin, not part of skin but shares some functions, mostly adipose tissue and muscles
cells of epidermis
keratinocytes, melanocytes, langerhans’ cell , Merkel (tactile) cells
keratinocytes produces
keratine > gives skin its protective property
keratinocytes are made by
stratum basale, 새로운 cell 들이 만들어질 때마다 위로 밈, 늙은 애들은 shed
melanocytes produces
melanosomes and melanin
melanocytes found in the
deepest layer of the epidermis
melanocytes are taken up by
keratinocytes
melanocytes form
a shield around the nucleus to protect it from UV radiation
langerhans’ cells
epidermal macrophages
key activators of the immune system
langerhans’ cells acts as
antigen presenting cell
langerhans’ cells made in
bone marrow and migrate to the epidermis
merkel cell found at
the epidermal-dermal junction
merkel cell function
touch receptors in association with sensory nerve endings
layers of the epidermis
stratum basale, stratum spinosum, stratum granulosum, stratum lucidum (only in thick skin), stratum corneum
causes of skin lesions
local irritants, burns, liver disease, systemic infections: chicken pox, measles, allergies
angioedema
allergic rxn, swelling of oral mucosa, tongue, mouth > blocks airway
macule
flat, redness, round shaped (circumscribed)
papule
small (less deeper than nodule) , solid elevation, no pus
ex. hives
vesicle/bliser
thin (translucent) wall, raised, yellow/clear fluid-filled
ulcer
cavity in tissue
nodule
firm (can feel the solid) , raised, deep
pustule
raised, has a “head”, filled w/ pus ex. 뾰루지
plaque
slightly elevated, flat, “scale” -like white lesion
fissure
crack in tissue
pressure sores
decubitus ulcers
pruritus
severe itching, usually a response to exposure to allergens/irritants
cause of pruritus
unknown but may be due to histamine
treatment for pruritus
antihistamine, topical anti-inflammatory agents, systemic anti-inflammatory agents, topical administration of colloidal oatmeal
inflammatory disorder of the skin
contact dermatitis, urticaria (hives), atopic dermatitis (eczema), psoriasis, discoid (cutaneous) lupus erythematosus, scleroderma
contact dermatitis
exposure to allergen/irritant
results in a localized rash+itching
contact dermatitis type of skin lesions
macule: flat, circular, red
urticaria (hives)
type 1 systemic hypersensitivity reaction, usually spread throughout the body
hive type of skin lesion
papule: raised, red, itchy
treatment for urticaria (hives)
systemic agent ex. antihistamine, corticosteroid (epi pen) bc mass histamine release > risk of hypotension
treatment for contact dermititis
topical agent corticosteroid/histamine
atopic dermatitis (eczema)
persistent inflammation of the upper layers of the skin, type 1/4 hypersensitive reaction
eczema characterized by
itching, erythema, swelling
how is eczema type 4 hypersensitive reaction
antigen presenting cell+ t lympocytes > sensitized t lymphocyte> release cytokines> activates macrophages>granuloma formation
(delayed response)
process of type 1 hypersensitivity reaction
dendritic cell/macrophages + T cell > release interleukins> release b cell > release plasma cell > release sensitized mast cells > release histamine
atopic dermatitis symptoms
skin dryness, inflammation
Treatment of eczema
topical corticosteroids and antihistamine, cool, moisturize
psoriasis
chronic, inflammatory, autoimmune
psoriasis skin leison
plaque: raised, red
but covered with white silvery scales which itch, crack, burn, and bleed > infection
treatment of psoriasis
UV light, immune modulators, chemotherapy
discoid (cutaneous) lupus erythematosus
inflammatory+autoimmune
symptoms for lupus erythematosus
butterfly pattern appears over nose > alopecia
treatment for discoid lupus eruthematosus
suppress immune syst
scleroderma leads to
collagen deposition, inflammation, fibrosis > internal organs suffer, loss of facial expression, loss of movement of mouth and eyes
bacterial skin infections
acne vulgaris, cellulitis, impetigo, acute necrotizing fasciitis
acute vulgaris
inflammation and blockage of sebaceous glands and associated hair follicles stimulated by androgen > pimples (pustules or cysts)
> can lead to proliferation of bacteria > staphylococcus aureus
acne vulgaris sebaceous glands are stimulated by
androgens
acne vulgaris skin lesion
comedones or pustule
acne vulgaris comedones
non inflammatory collection of sebum, no scarring
acne vulgaris pustule lesion
severe inflammatory response to a bacterial infection, scarring
treatment for acne vulgaris
frequent cleansing with non-irritating soaps, agents with anti-bacterial properties: benzoyl peroxide, salicylic acid, tetracycline, minocycline, doxycycline + erythromycin, aczone gel, vit A derivatives, laser treatments, agents to control hormones, microderm abrasion
cellulitis
infection of the dermis and subcutaneous tissue of S. aureus, follows trauma and/or a break in the skin, lower trunk, common problem in diabetics
signs and symptoms for cellulitis
redness, swelling, pain, red streaking across the lymph vessels
treatment for cellulitis
systemic antibiotics may require amputation
impetigo cause
staph aureus infection/ group A beta hemolytic strep
T/F impetigo is highly contagious
true and it can spread systemically and cause glomerulonephritis
impetigo leads to
pruritus
impetigo can spread through
towels, scratching
impetigo looks like
yellow, brown crust, with moist yellow liquid
treatment for impetigo
topical antibiotics or systemic antibiotics
acute necrotizing fasciitis
“flesh eating bacteria”
mixture of aerobic and anaerobic bacteria present
main culprit for acute necrotizing fasciitis
group A beta hemolytic strep pyogenes
acute necrotizing fasciitis secretes
proteases and penetrates deep into the tissue
acute necrotizing fasciitis leads to
subcutaneous fascia and the fascia surrounding skeletal muscle, edema, necrosis, vulus (pockets of purple liquids)
acute necrotizing fasciitis process
bacteria produces a toxin and can cause toxic shock if it spreads to the systemic circulation
risk factor for acute necrotizing fasciitis
trauma, compromised immune syst, chronic health condition, chicken pox infection
treatment for acute necrotizing fasciitis
debridement, amputation, aggressive systemic antibiotic, fluid replacement, pain management
viral skin infections
herpes simplex, cold sores, herpes zoster (shingles), verrucae (warts)
herpes simplex virus type 1
fever blister/cold sores
herpes simplex virus type 2
genital herpes
cold sores
asymptomatic at first, virus has a latent phase in the trigeminal (5) nerve
process of cold sores
invades epithelial cell> taken up by sensory neurons > hides in the nerve terminals neurons > 그래서 reinfection이 쉬움
cold sores reoccurrences can be triggered by
common cold, sun exposure, stress
signs and symptoms of reoccurence
tingling sensation, burning sensation, painful blister > ruptures > forms a crust > heals spontaneously
cold sores virus is spread by
direct contact with the fluid from the lesion
treatment for cold sores
topical antiviral
herpes zoster (shingles)
reactivation of varicella-zoster virus infection (chicken pox)
herpes zoster development
painful blister develop in a line unilaterally
herpes zoster leads to
burning sensation, paresthesias
treatment for herpes zoster
systemic antivirals (not a cure), pain medication
verrucae (warts) caused by
human papilloma viruses (HPV)
plantar warts caused by
HPV 1-4 > painful
genital warts caused by
HPV 6+11
HPV 16+18 causes
cervical cancer
treatment for verrucae
laser, freezing w/ liquid nitrogen and excising
fungal skin infection
mycoses of skin or nails, tinea (ringworm)
mycoses of skin or nails are dignosed by
scraping the skin and observing under a microscope
mycoses of skin or nails caused by
superficial infections of the keratocytes
mycoses can lead to
pruritus or asymptomatic
nail fungal infection treatment require
systemic antifungals and months of treatment
tinea (ringworm)
fungal infection of the skin, scalp, nails
tinea is treated with
antifungals
scabies
mite infection= sarcoptes scabiei
female mite burrows into
epidermis and lays her eggs
areas affected with scabies are
wrists, fingers, elbows, and waist
scabies are transmitted through
close contact
treatment for scabies
lindane
3 types of pediculosis (lice)
corporis (body), pubis (genital), capitis (head)
pediculosis feed off of
human blood
female lice does what
lays eggs on hair shaft =nit
3 types of skin cancer
basal cell carcinoma, squamous cell carcinoma, melanoma
basal cell carcinoma
stratum basale cells proliferate and invade the dermis and hypodermis, slow growing, not often metastasize so mostly curable
squamous cell carcinoma
arises from keratinocytes of stratum spinosum, usually on scalp ears and lower lips, grows rapidly and metastasizes if not removed
treatment for squamous cell carcinoma
radiation therapy or removed surgically
melanoma
cancer of melanocytes
melanoma is dangerous because
highly metastatic, resistant to chemotherapy
melanoma characteristic
Asymmetry
Border
Color
Diameter
Elevation
treatment for melanoma
wide surgical excision, immunotherapy, chemotherapy
kaposi’s sarcoma
rare form of skin cancer associated with HIV and or immnocompromised
what may cause kaposi’s sarcoma
herpes virus, malignant cells arise from endothelial cells
treatment of Kaposi’s sarcoma
radiation and chemotherapy
burns
tissue damage caused by heat, electricity, radiation, certain chemicals that denatures proteins
how can severe burns threatens life
bc it causes loss of body fluids, dehydration, electrolyte imbalance
the rule of nines
estimate % of body effected by the burn
treatment for burns
IV fluids, large amounts of calories in the form of proteins and fats, prophylactic antibiotics, debridement (removal). of burned skin, temporary covering, skin graft
first degree burn
only the epidermis is damaged, no blister
second degree burns
epidermis and upper regions of dermis is affected , blister appear, skin regeneration occur, care needed to avoid infections
third degree burns
all layers affected, no initial edema or pain bc nerve endings are destroyed, skin grafting is usually necessary, extensive scar tissue forms
stevens johnson’s syndrome (toxic epidermal necrosis)
looks and feels like a burn but hypersensitivity reaction from certain drugs
detachment of epidermis and mucous membranes
pathophysiology of stevens Johnson’s syndrome
apoptotic cell death of epidermis, mediated by cytotoxic CD8+ cells and NK cells
treatment for stevens Jhonson’s syndrome
immediate discontinuation of the drug, fluid replacement, prophylactic antibiotics, skin grafts
