Skin Pathologies Flashcards
Skin Lesion Terms:
bulla
large distinct elevation with fluid (large friction or burn blister)
Skin Lesion Terms:
crust
dried residue of exudates (residue of impetigo)
Skin Lesion Terms;
cyst
enclosed cavity that contains a semisolid or liquid.
Skin Lesion Terms:
fissure
linear crack in the skin (Athlete’s foot)
Skin Lesion Terms:
lichenification
is a diffuse area of thickening and scaling skin with an increase in skin lines abd markings
Skin Lesion Terms:
macule
flat, discoloured spot on skin with sharp borders (mole)
Skin Lesion Terms:
scale
thin or thick flake of skin varying in colour, usually secondary to desquamated, dead epithelium (dandruff)
Skin Lesion Terms:
papule
solid elevations without fluid with sharp borders (mole)
Skin Lesion Terms:
plaque
large, flat, elevated, solid surface (psoriasis)
Skin Lesion Terms:
Pruritis
Pruritis is severe itching.
Skin Lesion Terms:
pustule
vesicle or bulla filled with purulent fluid (acne, carbuncles)
Skin Lesion Terms::
telangiectasia
telangiectasia is an area of dilated superficial blood vessels.
Skin Lesion Terms:
tumour
tumour is a large nodule. It may be neoplastic, or new, abnormal tissue formation which grows at the expense of other tissues and serves no useful function.
Skin Lesion Terms:
ulcer
opening in the skin caused by sloughing of necrotic tissue, extending past the epidermis (pressure ulcer, stasis ulcer)
Skin Lesion Terms:
vesicle
small distinct elevation with fluid (blister caused by herpes simplex)
Skin Lesion Terms:
wheal
localized area of edema, often irregular and of variable size and colour (hive, insect bite)
Skin Lesion Assessment
A = Asymmetric shape
B = Irregular border
C = Multiple Colours
D = Diameter more than 7mm
E = Change in elevation
F = Feeling of itching or tingling
Viral Infections
- Herpes Simplex
- Varicella (Chicken pox)
- Herpes Zoster (Shingles)
- Verruca (Warts)
Viral Infections:
- Herpes Simplex
A cold sore, highly contagious viral infection.
Herpes simplex 1 (non-genital)
Herpes simplex 2 (genital)
Virus able to survive up to 3 days on moist gauze and toilet seats, but cannot survive in extremely chlorinated water
Transmitted by direct skin contact during vesicular stage
Enters body through mucous membranes, cuts and scrapes
Virus lies dormant and recurring episodes are usually less severe than initial
Massage is locally contraindicated
Viral Infections:
- Varicella (Chicken pox)
contagious infection that produces vesicles and papules over the trunk, face and limbs
spread by airborne droplets
Children require no treatment
Adults the condition is more systemic and severe. Pregnant women and those
persons who are immunosuppressed require immediate medical referral
Vaccines are available
Massage is completely contraindicated until the symptoms disappear.
Viral Infections:
- Herpes Zoster (Shingles)
Virus lies dormant in a nerve root ganglion until reactivation of the varicella virus when the person is fatigued, under stress, immunosuppressed, elderly, or experiencing trauma or surgery
Lesions occur along dermatome, healing within 3 weeks
Mostly strikes those over 50 years of age if not vaccinated
Massage is locally contraindicated
Viral Infections:
- Verruca (Warts)
contagious papules or nodules of the epidermis
caused by human papillomavirus
- common warts: found on hands and trauma sites
- plantar and palmar warts: found on soles of feet and palms of hands
- flat warts: found on face & hands
- filiform: finger-like projections often occurring on the face
Massage is locally contraindicated
Acute Bacterial Infections
- Impetigo
- Cellulitis
Acute Bacterial Infections:
- Impetigo
Superficial skin condition, usually caused by a staphylococcal infection
Highly contagious and commonly transmitted by direct contact
Red sore (can blister and crust) on affected areas such as around mouth, legs, hands, genitalia and scalp
Easily spread from a localized lesion to other skin surfaces of the body in a few days
Massage locally CI’d
Gloves should be worn by the therapist if massage is to be performed on the area not affected (only possible if the client has a localized outbreak)
Acute Bacterial Infections:
- Cellulitis
Deep inflammatory condition affecting the superficial to subcutaneous skin layers
Caused by staphylococcal or streptococcal infection
Usually affects the face or the limbs, especially the legs, where there is lymphedema or a break in the skin integrity such as an ulcer or wound
Painful, with diffuse swelling and redness observed over the infected part.
Medical attention is required as soon as possible. Massage is safe to perform once the condition has resolved, be aware recurring outbreak
Fungal Infections
- Ringworm & Athlete’s Foot
- Candidiasis
Fungal Infections:
- Ringworm & Athlete’s Foot
- Fungus grow in a warm, moist environment
- Infected ring-like patches of skin are itchy and flaky, affecting multiple areas of the body
- Tinea pedis (athlete’s foot) is the most common:
+ Prevention includes wearing cotton socks and changing them frequently, keeping the feet dry, wearing well ventilated shoes and avoiding walking barefoot in public places
- Tinea corporis (ringworm of the body) affects the chest, back, shoulders, neck, arms or legs
+ Often affects children from pets
+ Multiple lesions are observed that are fairly similar in size. They vary from pustules to scaly patches
- Tinea capitis (ringworm of the scalp)
+ affects primarily children, boys 5x more often than girls
+ pink, scaly patches on the scalp and some local hair loss
Fungal Infections:
- Candidiasis
- Common fungal infection caused by a yeast (candida albicans)
- Normally resides in the GI tract, genital tract, mouth, esophagus and throat
- Cutaneous candidiasis affects the skin
- Candidal paronychia:
painful, red swollen skin around nail bed. If condition chronic, nails thicken and harden - Candidal intertrigo:
red eroded patches, scaly pustular lesions with an undefined border of satellite papules. Often areas of large skin folds are affected - Oral candidiasis (thrush)
affects oropharyngeal cavity. White flakes, described as looking like cottage cheese, appear over red and inflamed buccal membrane, tongue, gingiva, palate and pharynx. Over time, erosions or ulcers may develop
Massage is locally CI’d
Infestations:
Scabies
Result of mite infestation
Contagious condition which can be transmitted through prolonged direct contact with an infected person but may also be transmitted through contact with clothing, linens or towels
Intense itching is a classic symptom of a scabies infestation
Massage completely CI’d
If contact occurs before medical diagnosis, the therapist should seek treatment. Linens and towels should be washed in hot water and dried on a hot cycle to effectively kill any mites
Premalignant and Malignant Neoplasms
A malignant neoplasm is a new, abnormal formation of tissue that grows at the expense of the healthy organism
A premalignant neoplasm has not yet become malignant, however has the potential for malignancy
- Actinic Keratosis
- Basal Cell Carcinoma
- Malignant Melanoma
- Squamous Cell Carcinoma
Premalignant and Malignant Neoplasms:
- Actinic Keratosis
Plaque, scale or papule occurring as a result of chronic sun exposure.
Are found on the face, scalp and backs of the hands
Common in fair skinned people
Removed by cryosurgery
Massage is not generally contraindicated. However, techniques which rub or torque the skin, such as frictions or fascial spreading, are avoided directly over the lesion
Premalignant and Malignant Neoplasms:
- Basal Cell Carcinoma
Often found in sun exposed areas such as the face
Most commonly in men aged 40-80
Nodular basal cell carcinoma
waxy, translucent papule has a central ulceration and a raised border.
Other forms of basal cell carcinomas are in ulcerus forms; hyperpigmentation or erythema may be present
Massage locally CI’d
Premalignant and Malignant Neoplasms:
- Malignant Melanoma
Proliferation of melanocytes
3% of all cancers, and increase at a fast rate
affect fair skinned persons more frequently than darker skinned people
Different types
Superficial spreading
Lentigo maligna
Nodular
If a melanoma is medically diagnosed, massage is locally contraindicated and maybe generally contraindicated
Premalignant and Malignant Neoplasms:
- Squamous Cell Carcinoma
Tumour of malignant keratinocytes
The most common skin cancer in Black persons; it is often found in non-sun-exposed areas of the body
In white persons, squamous cell carcinoma is often found in sun-exposed areas, or may develop from actinic keratosis
If a carcinoma is medically diagnosed, massage is locally contraindicated and maybe generally contraindicated
Benign Neoplasms
New proliferations of cells that are not life-threatening
*Massage not CI’d, however some require technique modifications
- Venous Lake
- Cherry Angioma
- Dermatofibroma
- Epidermal Inclusion Cyst
- Hemangioma
- Lipoma
- Nevus (Mole)
- Seborrheic Keratosis
- Skin Tags
- Solar Lentigo
Benign Neoplasms:
- Venous Lake
Dark blue, soft, compressible area of dilated capillaries on the lips, face and ears of elderly people
Either may be removed by laser or cauterization
Benign Neoplasms:
- Cherry Angioma
Superficial capillary proliferation, usually affecting middle-aged to elderly people
Either may be removed by laser or cauterization
Benign Neoplasms:
- Dermatofibroma
Benign proliferation of fibroblasts
Firm, discrete papules or nodules me not tender
Darker-skinned people they are hyperpigmented
Lighter skinned people they are reddish
Usually found on the legs but may appear elsewhere.
Idiopathic, may also result from trauma or insect bites
Benign Neoplasms:
- Epidermal Inclusion Cyst
Raised nodules filled with odiferous white material, often a central pore is visible
May become inflamed
Avoid frictions or fascial spreading over top
Benign Neoplasms:
- Hemangioma
superficial proliferation of blood vessels, or telangiectasis
- Nevus Flammus (port-wine stain):
red to purple macule or papule on the face or head; it is present at birth and usually resolves by five years of age - Salmon Patches (Stork bite):
red macules, usually on the back of the neck; they occur in up to 10% of fair skinned infants
usually disappear by puberty - Capillary hemangiomas (strawberry marks):
telangiectatic macules that may develop into soft nodules or tumours
develop in the first few days or months of life and usually resolve by puberty
Benign Neoplasms:
- Lipoma
a benign proliferation of fatty tissue below the dermis and epidermis
mobile, soft, slightly compressible tumours are from one to several centimetres in size
Often occur in 40+ yr olds around the back, shoulders, arms and legs
Benign Neoplasms:
- Nevus (Mole)
- Melanocytic nevus - macule of melanocytes, or dark pigmentation cells, that occurs in childhood
- Congenital nevus - present at birth; it may extend down into the subcutaneous fat
- Nevus of Ota - affects the dermal layer of the face in the distribution of the trigeminal nerve; primarily affecting Asian and Black persons
- Junctional nevus - macule of melanocytes in the junction of the epidermis lind the deeper dermis.
- Compound nevus is a papule of melanocytes that extends deeper than the junction, into the dermis itself.
- Dermal nevus - papulp that occurs only in the dermis and it lacks melanocytes
- Dysplastic nevi :
- irregulary shaped, pigmented macules with raised areas.
- > 1 cm diameter than most nevi
- Pigmentation may be brown, tan, red-pink or sometimes black
- Atypical, isolated lesions have a low risk of developing melanoma
- Halo nevus:
* pigmented nevus with a surrounding lighter coloured halo
- common and benign in adolescents, in adults they may indicate melanoma or skin cancer
Both usually removed for risk of cancer
Benign Neoplasms:
- Seborrheic Keratosis
Benign proliferation of keratinocytes (cells that produce the tough protein keratin)
Pigmented, scaly plaque with well-defined borders; the raised lesion appears stuck on the skin
Range up to 2 centimetres in size, occasionally larger.
Commonly found on the trunk, arms and face
Most common in those over 50 years of age
Benign Neoplasms:
- Skin Tags
Outgrowth of normal skin
May have darker pigmentation than the surrounding skin
Forms a papule or nodule on a narrow stalk, often in areas of friction such as the axilla
May be numerous skin tags in one area
Benign Neoplasms:
Solar Lentigo
Commonly called liver or age spots
Benign proliferations of normal melanocytes as a result of chronic sun exposure and damage
Have darker pigmentation that is even throughout
Found in areas of chronic sun exposure, such as the hands, face and shoulders
Non-Infectious Inflammatory Disorders:
- Acne
- Dermatitis and Eczema
- Contact & Allergic Contact Dermatitis
- Atopic Dermatitis
- Hand and Foot Eczema
- Venous (Stasis) Eczema
- Xerotic Eczema
- Psoriasis Vulgaris
Non-Infectious Inflammatory Disorders:
- Acne
Disorder of the sebaceous gland
Overproduction of oil may block the hair follicle allowing bacteria to multiply and cause inflammation
Black heads, white heads, pustules and cysts may be present; scarring may occur
Acne vulgaris occurs during puberty
Acne conglobata is chronic and occurs later in life.
Acne rosacea exhibits erythema, usually on the face, and occurs in middle-aged adults
Avoid massaging local lesions if likely to rupture and spread bacteria
Non-Infectious Inflammatory Disorders:
- Dermatitis and Eczema
Dermatitis: general term used to describe a wide variety of non-contagious, inflammatory skin disorders
Itchy, red, scaly and inflamed skin
Acute and severe: edema, vesicles and bullae
Subacute: scaling plaques
Chronic: lichenification, scales and changes in pigmentation
Massage avoided locally only if open and oozing lesions
Avoid the use any oils/lotions or fragrances that could aggravate (ask the client)
Non-Infectious Inflammatory Disorders:
- Contact & Allergic Contact Dermatitis
From direct contact with an irritating substance
Primary irritant contact dermatitis: toxic agent causing injury through skin contact
Allergic contact dermatitis: delayed hypersensitivity reaction because of an allergy to the substance or agent
Massage is CI’d over areas affected by contact and allergic dermatitis, specifically, open lesions, blisters or if it is uncomfortable for the client
Substances irritating for that client are avoided
Non-Infectious Inflammatory Disorders:
- Atopic Dermatitis
Chronic form of dermatitis in those people with familial predisposition to dermatitis, allergic rhinitis and asthma
Likely due to a combination of immunological response, epidermal dysfunction and genetic susceptibility
Lesions are very itchy
Cutaneous hypersensitivity, chronic redness, scaling, skin eruptions, plaques and papules are present
Massage locally CI’d if open lesions or uncomfortable to client
Non-Infectious Inflammatory Disorders:
- Hand and Foot Eczema
Chronic, often pruritic, inflammatory skin disorder ranging from an acute to chronic presentation
Redness, vesicles, papules and plaques are present
People affected are those with their hands frequently immersed in water
Usually, the palms of the hands including the sides of the fingers or the soles of the feet are symmetrically affected
Massage locally CI’d if open lesions or uncomfortable to client
Non-Infectious Inflammatory Disorders:
- Venous (Stasis) Eczema
Women are more often affected and persons 50+ years of age
Affects the lower limbs of people with chronic venous stasis
- Early stage:
hyperpigmentation, sensations of itchiness, aching or burning
Red, scaly and itchy patches become vesicular and crusty due to scratching
Calf edema
- Chronic:
thickened brownish-red plaques over dystrophic skin
generally asymptomatic, but acute flare-ups occur
- Lymphatic Massage proximal to affected area if no ulcerations or infections
Non-Infectious Inflammatory Disorders:
- Xerotic Eczema
An inflammatory disorder of severely dry skin, with plaques, scales, redness and fissures into the skin
Legs, hands and arms are often affected
Common disorder of dry skin may be caused by a decrease in surface skin lipids
Nummular eczema: coin-shaped, extremely itchy xerotic lesions
Massage locally CI’d if open lesions or uncomfortable to client
Non-Infectious Inflammatory Disorders:
- Psoriasis Vulgaris
An inherited, chronic, hyper proliferating, scaling, inflammatory condition affecting the skin and occasionally the mucous membranes
Lesions are well demarcated red papules and plaques with silver-white scales
May involve only a few coin-sized lesions or extensive, thick lesions covering much of the body
Exacerbation and remission cycle
Massage locally CI’d if open lesions or uncomfortable to client
Pigmentation Disorders:
- Vitiligo
- Post-inflammatory Hyperpigmentation
Pigmentation Disorders:
- Vitiligo
An acquired skin depigmentation condition affecting 1% of population, usually slow and progressive
Well-defined depigmented macules of varying size
usually on the face and on the skin surrounding joints, such as the hands and knees
Massage needs no modification
Pigmentation Disorders:
- Post-inflammatory Hyperpigmentation
Overproduction of melanin granules as a result of the inflammatory process
More common and severe in darker skinned people
Causes: trauma (cuts, burns), acne, eczema and a response to certain medications. Phytophotodermatitis (exposure to sunlight after exposure of the skin to certain plant juices or essential oils)
Dark macules occur either in the epidermis (a brownish colour) or the dermis (a bluish or greyish colour)
