Skin & Skin Infections

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  • 1. STRUCTURE & FUNCTIONS OF SKIN
  • 2. INTRODUCTION
    • The skin covers the whole of the external surface of the body.It forms the largest and heaviest organ in the body. The skin consists of three main layers.
    • Epidermis (an upper protective layer)
    • Dermis (a lower supporting layer)
    • Hypodermis
  • 3. Epidermis
    • The epidermis is thick, hard and horny in regions, such as on the palms of the hand and soles of the feet.
    • Properties
    • Primary barrier to microbial invasion
    • Impermeability to water and chemicals
    • High capacity of regeneration after damage
  • 4. Dermis
    • The dermis is soft and elastic in all parts but may be very thick.
    • Properties
    • The dermis gives strength to the skin
    • Act as reservoir of elements capable of fighting infections and repairing deep wounds
  • 5. Hypodermis
    • The skin is supported by a layer of fatty subcutaneous tissue sometimes known as the hypodermis.
  • 6. FUNCTION OF SKIN
    • The most obvious function of the skin is to provide the body with physical protection.
    • It forms an outer covering, which defends the body against injury from mechanical, thermal, chemical sources and microorganisms
    • The skin also acts as an organ of sensation to make the body aware of its environment.
  • 7. FUNCTION OF SKIN (Contd…)
    • Another important function of the skin is regulation of body temperature (37-38C).
    • It plays a minor role in excretion of the body’s waste products
  • 8. Bacterial Structure
    • CELL ENVELOPE:
      • Protects cell’s internal structures from its external environment.
      • It comprises cell wall, cell membrane
    • CYTOPLASM:
      • Watery gelatinous substance
      • Contains ribosomes, nucleoids & plasmids
      • Keeps the cell alive
  • 9. Bacterial Structure (Contd…)
    • RIBOSOMES:
      • Produces enzymes and proteins
      • Helps the cell to live and grow
    • NUCLEOIDS:
      • Contains cell’s genetic material.
      • Also called bacterial chromosome
      • Single circular molecule of double stranded DNA
    • PLASMIDS:
      • DNA fragments carrying genetic information
  • 10. MYCOLOGY
    • The study of fungi is called Mycology.
    • There are several widespread human and animal diseases that are due to fungi.
    • There are many beneficial fungi, some used to make antibiotics, bread and foods or used as insecticides.
  • 11. CHARACTERISTICS OF FUNGI
    • The fungi (sing., fungus) are a diverse group of eukaryotic microorganisms, with over 80,000 identifiable species.
    • Fungi were classified as plants, but laboratory studies have revealed a set of four properties that distinguish fungi from plants.
  • 12. Differentiation from Plants
    • Fungi lack chlorophyll, while plants have this pigment.
    • The cell walls of fungal cells contain a carbohydrate called chitin not found in plant cell walls.
    • Fungi are not truly multi-cellular like plants.
    • Fungi are heterotrophic eukaryotes, while plants are autotrophic eukaryotes.
  • 13. GROWTH OF THE FUNGI
    • Fungi are aerobic organism, with the notable exception of the yeasts that multiply in the presence or absence of oxygen.
    • High concentration of sugar is favorable for the growth
    • Most fungi grow best at approximately 25 C
    • fungi grow under acidic conditions at a pH from 5 to 6
  • 14. FUNGAL INFECTIONS OF THE SKIN
    • Superficial Skin Infection
    • Deep Fungal Infection
  • 15. Superficial Skin Infection
    • The superficial fungi live on the dead horny layer of the skin
    • Secrete an enzyme that enables them to digest keratin causing the superficial skin to scale and disintegrate the nails, and the hairs to break off.
    • Fungi are also capable of causing an allergic reaction.
  • 16. CLINICAL CLASSIFICATIONS
    • Tinea of the feet (tinea pedis) - T. mentagrophytes
    • Tinea of the hands (tinea manus) - T. mentagrophytes
    • Tinea of the nails (onychomycosis) T.rubrum, T. mentagrophytes
    • Tinea of the groin (tinea cruris) - E.Floccosum
    • Tinea of the smooth skin (tinea corporis) - T. mentagrophytes
    • Tinea of the scalp (tinea capitis) - T.tonurans, T.verucosum
    • Tinea of the beard (tinea barbae)
    • Dermatophytid (Acute Eruption of Fungal Infection) Pityrosporum
    • Tinea of Chest and Back (Tinea versicolor) Pityrosporum
  • 17. DEEP FUNGAL INFECTION
    • Fungi that invade the skin deeply and go into living tissue
    • Also capable of involving other organs.
  • 18. Types of Deep Fungal Infection
    • Candidiasis
    • Sporotrichosis
  • 19. Deep Fungal Infection
    • Candidiasis :
    • Candidiasis is a fungal infection caused by Candida albicans that produces lesions in the mouth, the vagina, the nails, the lungs, or the gastrointestinal tract or occasionally a septicemia.
  • 20. Deep Fungal Infection
    • Sporotrichosis :
    • Sporotrichosis is a fungal infection of the skin and the subcutaneous tissues that forms a chain of tumors that develop into ulcers
  • 21. Dermatomycosis
    • Fungal infection of the skin ,especially of moist parts covered by clothing.
  • 22. Eczema
    • Eczema is pruritic condition associated with erythema and edema in acute phase
    • It is dominated by thickening and scaling when it becomes chronic
    • The term eczema is broadly applied to a range of skin conditions.
    • Eczema is defined as allergic, pruritic dermatitis
  • 23. Inflammation
    • A protective reaction of tissue to irritation, injury, or infection.
    • Two types of Inflammation:
    • Localized Inflammation
    • Systemic Inflammation
    • Symptoms includes pain, redness, swelling and heat.
  • 24. Localized Inflammation
    • Inflammation is a process in which the body's white blood cells and chemicals can protect us from infection and foreign substances (bacteria and viruses)
    • Symptoms includes pain, redness, swelling and heat.
  • 25. Systemic Inflammation
    • Inflammation may also be associated with general "flu"-like symptoms including:
      • Fever
      • Chills
      • Fatigue/loss of energy
      • Headaches
      • Muscle stiffness & myalgia
      • A norexia (Loss of appetite)
  • 26. ANTIFUNGAL AGENTS
    • CLOTRIMAZOLE
    • Clotrimazole is an imidazole antifungal agent.
    • Clotrimazole is applied topically two or three times daily for 2 to 4 weeks as a 1% cream.
    • Local reactions including irritation and burning may occur in patients treated topically; contact allergic dermatitis has been reported.
  • 27.
    • KETOCONAZOLE
    • Ketoconazole is an imidazole antifungal agent, which interferes with ergosterol synthesis and therefore alters the permeability of the cell membrane of sensitive fungi. It is reported to be fungistatic.
    • After topical administration of Ketoconazole, irritation, dermatitis or a burning sensation has occurred
  • 28.
    • MICONAZOLE
    • Miconazole is an imidazole antifungal agent with similar antimicrobial activity to Ketoconazole.
    • Local irritation and sensitivity reaction may occur with Miconazole nitrate
  • 29. Corticosteroids
    • Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex.
    • Corticosteroids are involved in a wide range of physiologic systems such as stress response, immune response and regulation of inflammation
  • 30. Effects of Corticosteroids
    • Corticosteroids exerts their effects by suppressing:
    • The inflammatory response
    • The immune response
  • 31. Mechanism of Corticosteroids
    • Corticosteroids suppress inflammation by a number of mechanisms:
    • Inhibition of production of prostaglandins, leukotrienes and other inflammatory mediators
    • Inhibition of migration of neutrophils to areas of inflammation
    • Inhibition of accumulation of macrophages in areas of inflammation
  • 32.
    • Hydrocortisone
    • Hydrocortisone is a corticosteroid hormone produced by the adrenal gland.
    • It is usually referred to as the "stress hormone" as it is involved in response to stress.
    • It increases blood pressure and blood sugar, and reduces immune responses.
    • When first introduced as a treatment for rheumatoid arthritis, hydrocortisone was referred to as Compound E
  • 33.
    • Diflucortolone
    • Diflucortolone is a synthetic corticosteroid and is used to decrease inflammation in skin.
    • It works by preventing the release of certain chemicals from the cells. These chemicals are important in the immune system, and are released as a result of allergy or irritation.
    • By decreasing the release of these chemicals in the skin, diflucortolone reduces inflammation and relieves itch.
    • Diflucortolone is classed as a very potent corticosteroid.
  • 34.
    • Betamethasone
    • Betamethasone is a moderately potent corticosteroid with anti-inflammatory and immunosuppressive properties.