Skin By Dr Paulino

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Skin By Dr Paulino

  1. 1. SKIN <ul><li>Heaviest single organ . </li></ul><ul><li>Approx. 16% of BW. </li></ul><ul><li>3 Layers: </li></ul><ul><ul><li>Epidermis – outer horny layer </li></ul></ul><ul><ul><li>Inner cellular layer; melanin,keratin. </li></ul></ul><ul><ul><li>Subcutaneous – fatty layer. </li></ul></ul><ul><li>Appendages: </li></ul><ul><ul><li>Hair, nails, sebaceous & sweat glds. </li></ul></ul>
  2. 2. Hair: <ul><li>Two types – vellus and terminal. </li></ul><ul><ul><li>Vellus – short, fine and relatively unpigmented. </li></ul></ul><ul><ul><li>Terminal – coarser, thicker and usually pigmented; eg. scalp hair & eyebrows. </li></ul></ul>
  3. 3. NAILS: <ul><li>Protects the distal ends of the fingers and toes </li></ul><ul><li>Parts: - nail plate, nail bed, prox. nail fold, lat. nail fold. </li></ul><ul><li>Grows 0.1mm. Daily [finger nail] </li></ul>
  4. 4. Sebaceous Gland: <ul><li>Produce a fatty substance that is secreted thru the hair follicle. </li></ul><ul><li>Present except in the palms & soles </li></ul>
  5. 5. Sweat glands: <ul><li>Control body temperature. </li></ul>
  6. 6. Skin color: <ul><li>Melanin – genetic, sunlight </li></ul><ul><li>Carotene – in foods. </li></ul><ul><li>Oxyhemoglobin – reddish pigment </li></ul><ul><li>Deoxyhemoglobin – bluish pigmnent </li></ul>
  7. 7. Common symptoms: <ul><li>Hair loss [alopecia] </li></ul><ul><li>Changes in skin color.. Rashes </li></ul><ul><li>Swelling, lumps </li></ul><ul><li>Pruritus </li></ul><ul><li>Mole changes </li></ul>
  8. 8. Physical examination: [signs] <ul><li>Techniques: </li></ul><ul><ul><li>Inspection – good lighting </li></ul></ul><ul><ul><li>Palpation </li></ul></ul>
  9. 9. Note: <ul><li>Color – pigmentation [brownness], redness, pallor, cyanosis & yellowing of the skin. </li></ul><ul><ul><li>Pallor- anemia, dec bld flow, art insuffiency. </li></ul></ul><ul><ul><li>Cyanosis [ central] – lung dis, CHD, abn hgb; [peripheral] – CHF, venous obs. </li></ul></ul><ul><ul><li>Jaundice – liver dis or hemolysis </li></ul></ul>
  10. 10. <ul><ul><li>carotenemia – inc carotene in diet </li></ul></ul><ul><li>Moisture – dryness [hypothy], sweating and oiliness [acne] </li></ul><ul><li>Temperature – [use back of the hand] </li></ul><ul><ul><ul><li>gen warmth in fever, hyperthy </li></ul></ul></ul><ul><ul><ul><li>Coolness in hypothy </li></ul></ul></ul><ul><ul><ul><li>Local warmth in inflam.& cellulitis </li></ul></ul></ul>
  11. 11. <ul><li>Texture – roughness in hypothy; smoothness </li></ul><ul><li>Mobility – ease in lifting up the fold of the skin. [dec mobility in scleroderma] </li></ul><ul><li>Turgor – the speed of return into place of a lifted skin fold. [dec in dehydraton] </li></ul>
  12. 12. <ul><li>Lesions – note for their location, distribution, exposed and unexposed areas, skin folds [intertriginous], arrangement [linear, clustered, annular, arc or dermatomal. </li></ul>
  13. 13. Basic Types of Skin Lesions: <ul><li>Primary Lesions – arise from a previously normal skin. </li></ul><ul><ul><li>Macules – up to 1.0 cm in size, flat , eg. freckles and flat nevi </li></ul></ul><ul><ul><li>Patch – flat spot 1.0 cm and larger, eg. vitiligo, measles, senile freckles. </li></ul></ul><ul><ul><li>Papules – elev . Up to 1.0 cm,eg. elev nevi,warts, lichen planus. </li></ul></ul>
  14. 14. <ul><ul><li>4. Plaque – elev 1.0 cm and larger, eg. loc nuerodermatitis. </li></ul></ul><ul><ul><li>5. Nodules – marble like, larger than 0.5 cm, deeper & firmer, eg. ter SY, </li></ul></ul><ul><ul><li>epitheliomas, xanthomas. </li></ul></ul><ul><ul><li>6. Wheal – irreg, superficial, loc edema, eg. hive, mosquito bites. </li></ul></ul>
  15. 15. <ul><ul><li>Circumscribed superficial elev of skin </li></ul></ul><ul><ul><li>formed by free fluid in cavity; </li></ul></ul><ul><ul><li>7. Vessicle – up to 1.0 cm filled w/ serous fld, eg. herpes simplex. </li></ul></ul><ul><ul><li>8. Bulla – larger than 1.0 cm w/ serous fld, eg 2 nd deg burn. </li></ul></ul><ul><ul><li>9. Pustule – filled w/ pus, eg. acne, impetigo. </li></ul></ul>
  16. 16. <ul><li>Secondary Lesions – they resulted from changes in the primary lesions. </li></ul><ul><ul><li>Loss of skin surface. </li></ul></ul><ul><ul><ul><li>1. Erosion - loss of sup epidermis no bleeding, eg. rupture vessicle of chikenpox. </li></ul></ul></ul><ul><ul><ul><li>2. Ulcer – loss incld the dermis, may bleed and scar, eg. SY chancre </li></ul></ul></ul><ul><ul><ul><li>3. Fissure – linear crack, eg. athlete’s foot. </li></ul></ul></ul>
  17. 17. <ul><ul><li>b. Material on the skin surface. </li></ul></ul><ul><ul><ul><li>Crust – dried residue of serum, pus or bld, eg. impetigo </li></ul></ul></ul><ul><ul><ul><li>Scale – thin flake of exfoliated epidermis, eg. dundruff, psoriasis. </li></ul></ul></ul><ul><li>Special Lesions : </li></ul><ul><ul><li>Scars – replacement of dead tiss by fibrous tiss. </li></ul></ul><ul><ul><li>Burrows – tunnels in epidermis, eg. scabies. </li></ul></ul><ul><ul><li>Excoriation – abrasion or scratch mark, linear or rounded, eg. insect bites. </li></ul></ul>

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