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Dermatology

by Sandy Thunell

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Your skin is your body's largest organAn average adult's skin spans 21 square feet, weighs nine pounds, and contains more than 11 miles of blood vessels. The skin releases as much as three gallons of sweat a day in hot weather. The areas that don't sweat are the nail bed, the margins of the lips, the tip of the penis, and the eardrums. Did you know that breasts are actually a modified form of the apocrine sweat gland? Fetuses don't develop dermatoglyphics (the skin ridge patterns in our palms, fingers and soles) until three months' gestation. Some people never develop fingerprints at all. Two rare genetic defects, known as Naegeli syndrome and dermatopathiapigmentosareticularis, can leave carriers without any identifying skin ridges on their skin. Fingerprints increase friction and help grip objects. New World monkeys have similar dermatoglyphic prints on the undersides of their tails, the better to grasp as they swing from branch to branch. Globally, dead skin accounts for about a billion tons of dust in the atmosphere. Your skin sheds 50,000 cells every minute. There are at least five types of receptors in the skin that respond to pain and to touch. (light touch, pressure, vibration, pain, temperature)In blind people, the brain's visual cortex is rewired to respond to stimuli received through touch and hearing, so they literally "see" the world by touch and sound. "In the buff" became synonymous for "nude" in 17th-century England. The term derives from soldiers' leather tunics, or "buffs," whose light brown color apparently resembled an Anglo-Saxon backside. White skin appeared just 20,000 to 50,000 years ago, as dark-skinned humans migrated to colder climes and lost much of their melanin pigment. Albinos are often cast as movie villains, as seen in The Da Vinci Code, Die Another Day, The Matrix Reloaded, and—inexplicably—the 2001 flick Josie and the Pussycats. Robert Lima of Penn State suggests that people associate pale-skinned albinos with vampires and other mythical creatures of the night.More than 2,000 people have radio frequency identification chips, or RFID tags, inserted under their skin. The tags can provide access to medical information, log on to computers, or unlock car doors.
Integument/o skinCutane/o skinAdip/o fatLip/o lipid (fat)Coll/a collagenDerm/a; derm/o; dermat/o skinEx/o outTrich/o or pil/o hairLun/o moon (fingernails)Melan/o dk. brown or blackOnych/o or ungu/o nail (finger or toe)Sebace/o oilSudor/i or hidr/o sweat diaphore/o sweating Myc/o fungusUla small thing-ment action; state-ose full of-oma tumor-osis condition of-dactyly condition of fingers/toes-phyma tumor; growth-iatic pertaining to state or process-graft tissue for implant-tome cutting instrument
Botox is the brand name of a toxin produced by the bacterium Clostridium botulinum. In large amounts, this toxin can cause botulism, which you probably associate with food poisoning. Despite the fact that one of the most serious complications of botulism is paralysis, scientists have discovered a way to use it to human advantage. Small, diluted amounts can be directly injected into specific muscles causing controlled weakening of the muscles. The FDA approved such usage in the late 1980s upon the discovery that Botox could stop ailments like blepharospasm (uncontrolled blinking) and strabismus (lazy eye). Cosmetic physicians have been using Botox for years to successfully treat wrinkles and facial creases. In April 2002, Botox gained FDA approval for treatment of moderate-to-severe frown lines between the eyebrows - called glabellar lines. However, Botox is often used for other areas of the face as well. How Does Botox Work?Botox blocks signals from the nerves to the muscles. The injected muscle can no longer contract, which causes the wrinkles to relax and soften.It is most often used on forehead lines, crow's feet (lines around the eye) and frown lines. Wrinkles caused by sun damage and gravity will not respond to Botox.How Is the Procedure Performed?The procedure takes only a few minutes and no anesthesia is required. Botox is injected with a fine needle into specific muscles with only minor discomfort. It generally takes three to seven days to take full effect and it is best to avoid alcohol at least one week prior to treatment. Aspirin and anti-inflammatory medications should be stopped two weeks before treatment as well in order to reduce bruising.How Long Does a Botox Injection Last?The effects from Botox will last four to six months. As muscle action gradually returns, the lines and wrinkles begin to re-appear and wrinkles need to be re-treated. The lines and wrinkles often appear less severe with time because the muscles are being trained to relax.What Are the Side Effects of Botox?Temporary bruising is the most common side effect. Headaches, which resolve in 24-48 hours, can occur, but this is rare. A small percentage of patients may develop eyelid drooping. This usually resolves in three weeks. This development is usually caused by migration of the Botox and for this reason, you shouldn't rub the treated area for 12 hours after injection or lay down for three to four hours. There have been no allergies associated with Botox to date.Who Should Not Receive Botox Injection?Patients who are pregnant, breastfeeding or have a neurological disease should not use Botox. Since Botox doesn't work for all wrinkles, a consultation with a doctor is recommended.
Collagen injections are used to replenish the skin's natural collagen. The dermis layer of the skin is primarily made up of the protein collagen. Collagen is the main component of the dermis, and acts as the support structure for the skin.In young skin, the collagen framework is intact and the skin remains moisturized and elastic. But, over time, the collagen support structure weakens and the skin loses its elasticity and tone.During collagen injections, CosmoDerm or CosmoPlast, bioengineered human collagen products, are placed just beneath the skin, in the dermis, where the body readily accepts it as its own. As a result your skin feels and looks toned.When you have a collagen injection, you will receive a small injection of local anesthesia to numb the area being treated. There is a possibility of slight bruising, and you may experience puffiness, redness, and tenderness around the treated site.Just like natural collagen, collagen replacements eventually begin to lose form and wear down. In order to keep up appearances, you will need a series of treatments, two to four times a year.
What is cryotherapy and how does it work?Cryotherapy is a pain treatment that uses a method of localized freezing temperatures to deaden an irritated nerve. Cryotherapy is also used as a method of treating localized areas of some cancers (called cryosurgery), such as prostate cancer and to treat abnormal skin cells by dermatologists. In this article we only discuss its use in nerve conditions.In cryotherapy, a probe is inserted into the tissue next to the affected nerve. The temperature of the probe drops to then effectively freeze the nerve. The freezing inactivates the nerve and, as a result, painful nerve irritation is relieved. Cryotherapy is a relatively safe and effective means of treating localized nerve irritation. What conditions can be treated with cryotherapy?Cryotherapy can be used to treat conditions that involve irritation of an isolated nerve. In general, such conditions include benign nerve growths (neuromas) and pinched nerves (nerve entrapments). Specific examples include nerve irritation between the ribs (intercostalneuralgia), cluneal nerve entrapment, ilioinguinalneuroma, hypogastricneuromas, lateral femoral cutaneous nerve entrapment, and interdigitalneuromas. Many forms of nerve entrapment can often be treated with cryotherapy.What are side effects of cryotherapy?While cryotherapy can reduce unwanted nerve irritation, it sometimes can leave the tissue affected with unusual sensations, such as numbness or tingling, or with redness and irritation of the skin. These effects are generally temporary.
Dermabrasion, or surgical skin planing, is an abrasive procedure that "sandblasts" the skin to create a smoother layer of skin. Dermabrasion is used to treat scars, pox marks, age (liver) spots, and skin lesions.In the dermabrasion procedure, the doctor cleans and freezes the skin. To perform the abrasion, the doctor uses a high-speed instrument equipped with a wheel or brush to strip off the top layers of skin.Your skin will feel rough and "burned" after the dermabrasion procedure, and will be pink for a while before the benefits of dermabrasion can be seen. Stay out of the sun for several months and be sure to use sunscreen when you do go outdoors.Risks of dermabrasion can include uneven changes in skin color, scarring, and infection.
Autolysis uses body’s own enzymes and moisture to re-hydrate, soften and liquify hard eschar and slough; selective, only necrotic tissue is liquified (adipocere); can be achieved with occlusive or semi-ooclusive dressingsChemical enzymes fast acting to produce slough of necrotic tissue.Mechanical: allows a dressing to proceed from moist to wet, then manually removing the dressing cases form of non-selective debridement. Hydrotherapy is type of mechanical debridement, which can cause tissue maceration.Surgical uses scalpel or laser (pt. under anesthesia); fast; selective; most painful and costlyMaggot: MDT use of live maggots (fly larvae). Disinfected fly larvae applied for 2-3 days with special dressings to clean wounds by dissolving dead, infected tissue
Chemical peels, also known as chemexfoliation or derma-peeling, are a technique used to improve the appearance of the skin. In this treatment, a chemical solution is applied to the skin, which causes it to "blister" and eventually peel off. The new, regenerated skin is usually smoother and less wrinkled than the old skin. The new skin also is temporarily more sensitive to the sun.What Conditions Do a Chemical Peel Treat?Chemical peels are performed on the face, neck or hands. They can be used to: Reduce fine lines under the eyes and around the mouth Treat wrinkles caused by sun damage, aging and hereditary factors Improve the appearance of mild scarring Treat certain types of acneReduce age spots, freckles and dark patches due to pregnancy or taking birth control pills (melasma) Improve the look and feel of skin that is dull in texture and color Areas of sun damage, which may contain pre-cancerous keratoses that appear as scaly spots, may improve after chemical peeling. How Are Chemical Peels Performed?The skin is thoroughly cleansed with an agent that removes excess oils and the eyes and hair are protected. One or more chemical solutions, such as glycolic acid, trichloroacetic acid, salicylic acid, lactic acid or carbolic acid (phenol), are applied to small areas on the skin. These applications produce a controlled wound, enabling new, regenerated skin to appear.What To Expect After the Chemical PeelDepending upon the type of chemical peel, a reaction similar to sunburn occurs following the procedure. Peeling usually involves redness, followed by scaling that ends within three to seven days. Mild peels may be repeated at one to four-week intervals until the desired clinical effect is achieved.Medium-depth and deep peeling may result in swelling, as well as the presence of water blisters that may break, crust, turn brown and peel off over a period of seven to 14 days. Medium-depth peels may be repeated in six to twelve months, if necessary.After treatment, some peels may require bandages to be placed on part or all of the skin that is treated. Bandages are usually removed in several days and may improve the effectiveness of the treatment. It is important to avoid over-exposure to the sun after a chemical peel since the new skin is fragile and more susceptible to complications. The dermatologic surgeon will prescribe the proper follow-up care to reduce the tendency to develop abnormal skin color after peeling.
Sclerotherapy is a procedure that is used to eliminate varicose veins and "spider veins" (enlarged blood vessels that are visible on the skin, especially on the nose, face, and legs). Sclerotherapy involves an injection of a salt solution directly into the vein. The solution irritates the lining of the blood vessel, causing it to swell and stick together, and the blood to clot. Over time, the vessel turns into scar tissue that fades from view.The procedure itself takes approximately 15 to 30 minutes. The number of veins injected in one session varies, and depends on the size and location of the veins, as well as the general medical condition of the patient.Side effects of sclerotherapy include itching and raised red areas at the injection site and bruising. Other side effects may include the following:Larger veins that have been injected may become lumpy and hard and may require several months to dissolve and fade. Brown lines or spots may appear at the vein site. The temporary development of new, tiny blood vessels. Warning: If you develop inflammation within five inches of the groin, a swollen leg, or small ulcers at the injection site after sclerotherapy, contact your doctor immediately.
Excessive exposure to sunlight is the main cause of skin cancer. Sunlight contains ultraviolet (UV) rays that can alter the genetic material in skin cells, causing mutations. Sunlamps, tanning booths, and X-rays also generate UV rays that can damage skin and cause malignant cell mutations.From the least to most dangerous, skin cancer refers to three different conditions: basal cell carcinoma, squamous cell carcinoma (the first stage of which is called actinic keratosis) and melanoma. The two most common forms of skin cancer are basal cell carcinoma and squamous cell carcinoma. Together, these two are also referred to as nonmelanoma skin cancer. Melanoma is generally the most serious form of skin cancer because it tends to spread (metastasize) throughout the body quickly.
Lupus -- also known as Systemic lupuserythematosus -- is a disease of the immune system. Normally, the immune system protects the body from infection. In lupus, however, the immune system inappropriately attacks tissues in various parts of the body. This abnormal activity leads to tissue damage and illness. According to the Lupus Foundation of America, approximately 1.5 million people in the U.S. have lupus. People of African, Asian, and Native American descent are more likely to develop lupus than are Caucasians. 90% of people diagnosed with the disease are women. Women of childbearing age (14 to 45 years old) are most often affected. What Are the Symptoms of Lupus?The symptoms of lupus differ from one person to another. Some people have just a few symptoms, while others have many. In addition, there are many different symptoms of lupus because the disease can affect any part of the body. Some of the more common symptoms include:Achy joints (arthralgia) Unexplained fever (more than 100 degrees Fahrenheit) Swollen joints ( arthritis) Prolonged or extreme fatigue Skin rashAnkle swelling and fluid accumulation Pain in the chest when breathing deeply (pleurisy) A butterfly-shaped rash across the cheeks and nose Hair loss Sensitivity to the sun and/or other light Seizures Mouth or nose sores Pale or purple fingers or toes from cold or stress (Raynaud's phenomenon) What Problems Can People With Lupus Have?Many people with active lupus feel ill in general and complain of fever, weight loss, and fatigue. People with lupus also develop specific problems when the immune system attacks a particular organ or area in the body. The following areas of the body can be affected by lupus:Skin. Skin problems are a common feature of lupus. Some people with lupus have a red rash over their cheeks and the bridge of their nose -- called a "butterfly" or malar rash. Hair loss and mouth sores are also common. Skin rashes are usually aggravated by sunlight. An uncommon but serious form of lupus rash results in the development of large blisters and is called a "bullous" lupus rash. Joints. Arthritis is very common in people with lupus. There may be pain, with or without swelling. Stiffness and pain may be particularly evident in the morning. Arthritis may be a problem for only a few days or weeks, or may be a permanent feature of the disease. Kidneys. Kidney involvement in people with lupus can be life threatening and may occur in up to half of those with lupus. Kidney problems are more common when someone also has other lupus symptomsBlood. Blood involvement can occur with or without other symptoms. People with lupus may have dangerous reductions in the number of red blood cells, white blood cells, or platelets (particles that help clot the blood). The cause of lupus is unknown. However, there appears to be something that triggers the immune system to attack various areas of the body. That's why suppressing the immune system is one of the main forms of treatmentFactors that may contribute to the development of lupus include viruses, environmental chemicals and a person's genetic makeup.Female hormones are believed to play a role in the development of lupus because women are affected by lupus much more often than men. The observation that lupus may affect more than one member of the same family has raised the possibility that the tendency to develop lupus may be inherited. Drug-induced lupus can occur after the use of some prescription medications

Dermatology Presentation Transcript

Dermatology
Terminology Basics
integument/o orcutane/o
adip/o
lip/o
coll/a
derm/a orderm/o ordermat/0
ex/o
trich/o orpil/o
lun/o
melan/o
onych/o orungu/o
sebace/o
sudor/I or hindr/o
diaphore/o
myc/o
-ula
-ment
-ose
-oma
-osis
-dactyly
-phyma
-iatic
-graft
-tomeSQsubQsubcu
Prescription medication
Toxin produced by bacterium (Chostridiumbotulinum)
Approved by FDA in 2002
Used to relax muscles
Injected into specific muscles
Lasts 4-6 months
Common side effect: temporary bruising
Collagen Injections
Collagen acts as support structure for skin
Collagen injections used to replenish skin’s natural collagen
Bioengineered human collagen injected into dermis
Cryosurgery
Treatment performed with instrument that freezes and destroys tissue
Used in treatment for precancerous changes in the cervix, some types of skin cancer, freckles
Dermabrasion
Skin is frozen then instrument used to sandblast and contour skin layer
Microdermabrasion (power peel) uses tiny crystals sprayed on skin (superficial skin problems, not deep like scars, stretch marks, etc)Dermabrasion: Treatment
Debridement
Autolytic
Enzymatic
Mechanical
Surgical
Maggots
Chemical Peel
Also known as chemexfoliation or derma-peeling
Chemical solution applied to skin to cause blistering and peeling
New regenerated skin smoother & less wrinkled
New skin more sensitive to sun
Sclerotherapy
Used to eliminate varicose veins
Injection of “salt” solution directly into vein
sclerotherapy video
Skin Cancers
The most common warning sign of skin cancer is a change in the appearance of the skin, such as a new growth or a sore that will not heal.
The term "skin cancer" refers to three different conditions. From the least to the most dangerous, they are:
basal cell carcinoma (or basal cell carcinoma epithelioma)
squamous cell carcinoma (the first stage of which is called actinic keratosis)
melanoma
Systemic lupus erythematosus
Autoimmune disease
Symptoms include arthralgia, fever, arthritis, skin rash (butterfly), plurisy, Raynaud’s phenomenon, anemia, DVT
Tx: systemic and immune suppressing

Dermatology

by Sandy Thunell

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Dermatology Presentation Transcript