Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 1
Structure, Function, and Disorders
of the ...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 2
Layers of the Skin
 Epidermis
 Dermis
 ...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 3
Layers of the Skin (cont’d)
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 4
Layers of the Skin (cont’d)
 Dermal appen...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 5
Nails
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 6
Aging and Skin Integrity
 The integumenta...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 7
Aging and Skin Integrity (cont’d)
 The in...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 8
Clinical Manifestations of Skin
Dysfunctio...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 9
Pressure Ulcers
 Pressure ulcers result f...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 10
Pressure Ulcers (cont’d)
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 11
Pressure Ulcers (cont’d)
 Stages:
 I. N...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 12
Keloids
 Elevated, rounded, and firm
 C...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 13
Keloids (cont’d)
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 14
Pruritus
 Itching
 Most common symptom ...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 15
Pruritus (cont’d)
 Pain stimuli at lower...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 16
Disorders of the Skin
 Inflammatory diso...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 17
Inflammatory Disorders
 Allergic contact...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 18
Allergic Contact Dermatitis
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 19
Inflammatory Disorders
 Atopic dermatiti...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 20
Inflammatory Disorders (cont’d)
 Irritan...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 21
Inflammatory Disorders (cont’d)
 Stasis ...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 22
Inflammatory Disorders (cont’d)
 Seborrh...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 23
Stasis and Seborrheic Dermatitis
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 24
Papulosquamous Disorders
 Psoriasis
 Ch...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 25
Papulosquamous Disorders
(cont’d)
 Psori...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 26
Psoriasis
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 27
Papulosquamous Disorders
 Psoriasis (con...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 28
Papulosquamous Disorders
(cont’d)
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 29
Papulosquamous Disorders
(cont’d)
 Pityr...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 30
Papulosquamous Disorders
(cont’d)
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 31
Papulosquamous Disorders
(cont’d)
 Liche...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 32
Lichen Planus
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 33
Papulosquamous Disorders
 Acne vulgaris
...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 34
Papulosquamous Disorders
(cont’d)
 Lupus...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 35
Discoid Lupus Erythematosus
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 36
Vesiculobullous Disorders
 Pemphigus
 R...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 37
Vesiculobullous Disorders (cont’d)
 Pemp...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 38
Vesiculobullous Disorders (cont’d)
 Bull...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 39
Bullous Pemphigoid
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 40
Vesiculobullous Disorders
 Erythema mult...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 41
Vesiculobullous Disorders (cont’d)
 Eryt...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 42
Infections
 Bacterial infections:
 Foll...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 43
Furuncle
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 44
Infections
 Viral infections
 Herpes zo...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 45
Herpes Simplex Virus
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 46
Warts
 Benign lesions caused by the huma...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 47
Fungal Infections
 Fungi causing superfi...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 48
Tinea Pedis
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 49
Fungal Infections
 Candidiasis
 Caused ...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 50
Vascular Disorders
 Cutaneous vasculitis...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 51
Vascular Disorders (cont’d)
 Urticaria
...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 52
Vascular Disorders (cont’d)
 Scleroderma...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 53
Vascular Disorders (cont’d)
 Scleroderma...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 54
Scleroderma
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 55
Insect Bites
 Bees
 Mosquitoes
 Flies
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 56
Benign Tumors
 Seborrheic keratosis
 Ke...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 57
Seborrheic Keratosis
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 58
Cancer
 Basal cell carcinoma
 Squamous ...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 59
Basal Cell Carcinoma
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 60
Squamous Cell Carcinoma
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 61
Malignant Melanoma
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 62
Kaposi Sarcoma
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 63
Burns
 Partial-thickness burns
 First d...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 64
Superficial Partial-Thickness Burn
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 65
Axillary Burn Scar Contracture
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 66
Deep Partial-Thickness Burn
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 67
Full-Thickness Burn
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 68
Estimating Burn Injury
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 69
Burns
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 70
Hypertrophic Scarring
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 71
Cultured Epithelial Autograft
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 72
Frostbite
 Skin injury caused by exposur...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 73
Disorders of the Hair
 Male-pattern alop...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 74
Disorders of the Hair (cont’d)
 Female-p...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 75
Disorders of the Hair (cont’d)
 Alopecia...
Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 76
Disorders of the Nail
 Paronychia
 Acut...
Upcoming SlideShare
Loading in …5
×

Structure and function of the integument

652 views

Published on

  • Be the first to comment

Structure and function of the integument

  1. 1. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 1 Structure, Function, and Disorders of the Integument
  2. 2. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 2 Layers of the Skin  Epidermis  Dermis  Hypodermis
  3. 3. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 3 Layers of the Skin (cont’d)
  4. 4. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 4 Layers of the Skin (cont’d)  Dermal appendages:  Nails  Hair  Sebaceous glands  Eccrine and apocrine sweat glands  Blood supply  Papillary capillaries
  5. 5. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 5 Nails
  6. 6. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 6 Aging and Skin Integrity  The integumentary system reflects numerous changes from genetic and environmental factors  The skin becomes thinner, drier, wrinkled, and demonstrates a change in pigmentation  Shortening and decrease in the number of capillary loops  Fewer melanocytes and Langerhans cells
  7. 7. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 7 Aging and Skin Integrity (cont’d)  The integumentary system reflects numerous changes from genetic and environmental factors (cont’d)  Atrophy of the sebaceous, eccrine, and apocrine glands  Changes in hair color  Fewer hair follicles and growth of thinner hair
  8. 8. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 8 Clinical Manifestations of Skin Dysfunction  Macule  Papule  Patch  Plaque  Wheal  Nodule  Tumor  Vesicle  Bulla  Pustule  Cyst  Telangiectasia  Scale  Lichenification  Keloid  Scar  Excoriation  Fissure  Erosion  Ulcer  Atrophy
  9. 9. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 9 Pressure Ulcers  Pressure ulcers result from any unrelieved pressure on the skin, causing underlying tissue damage  Pressure  Shearing forces  Friction  Moisture
  10. 10. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 10 Pressure Ulcers (cont’d)
  11. 11. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 11 Pressure Ulcers (cont’d)  Stages:  I. Nonblanchable erythema of intact skin  II. Partial-thickness skin loss involving epidermis or dermis  III. Full-thickness skin loss involving damage or loss of subcutaneous tissue  IV. Full-thickness skin loss with damage to muscle, bone, or supporting structures
  12. 12. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 12 Keloids  Elevated, rounded, and firm  Clawlike margins that extend beyond the original site of injury  Excessive collagen formation during dermal connective tissue repair  Common in darkly pigmented skin types and burn scars  Type III collagen is increased
  13. 13. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 13 Keloids (cont’d)
  14. 14. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 14 Pruritus  Itching  Most common symptom of primary skin disorders  Itch is carried by specific unmyelinated C- nerve fibers and is triggered by a number of itch mediators  The CNS can modulate the itch response
  15. 15. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 15 Pruritus (cont’d)  Pain stimuli at lower intensities can induce itching  Chronic itching can result in infections and scarring due to persistent scratching
  16. 16. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 16 Disorders of the Skin  Inflammatory disorders  The most common inflammatory disorders of the skin are dermatitis or eczema  There are various types of dermatitis  The disorders are generally characterized by: • Pruritus • Lesions with indistinct borders • Epidermal changes
  17. 17. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 17 Inflammatory Disorders  Allergic contact dermatitis  Caused by a hypersensitivity type IV reaction  The allergen comes in contact with the skin, binds to a carrier protein to form a sensitizing antigen; Langerhans cells process the antigen and carry it to T cells, which become sensitized to the antigen  Manifestations: • Erythema • Swelling • Pruritus • Vesicular lesions
  18. 18. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 18 Allergic Contact Dermatitis
  19. 19. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 19 Inflammatory Disorders  Atopic dermatitis  Type I hypersensitivity: activation of mast cells, eosinophils, T-lymphocytes, and other inflammatory cells  Causes red, weeping crusts and chronic inflammation, lichenification
  20. 20. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 20 Inflammatory Disorders (cont’d)  Irritant contact dermatitis  Nonimmunologic inflammation of the skin  Chemical irritation from acids or prolonged exposure to irritating substances  Symptoms similar to allergic contact dermatitis  Treatment: remove stimulus
  21. 21. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 21 Inflammatory Disorders (cont’d)  Stasis dermatitis  Occurs in the legs as a result of venous stasis, edema, and vascular trauma  Sequence of events: • Erythema • Pruritus • Scaling • Petechiae • Ulcerations
  22. 22. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 22 Inflammatory Disorders (cont’d)  Seborrheic dermatitis  Inflammation of the skin involving the scalp, eyebrows, eyelids, nasolabial folds, and ear canals  Scaly, white, or yellowish plaques
  23. 23. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 23 Stasis and Seborrheic Dermatitis
  24. 24. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 24 Papulosquamous Disorders  Psoriasis  Chronic, relapsing, proliferative skin disorder  T cell immune- mediated skin disease  Scaly, thick, silvery, elevated lesions, usually on the scalp, elbows, or knees caused by a high rate of mitosis in the basale layer
  25. 25. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 25 Papulosquamous Disorders (cont’d)  Psoriasis (cont’d)  Shows evidence of dermal and epidermal thickening  Epidermal turnover goes from 26 to 30 days to 3 to 4 days  Cells do not have time to mature or adequately keratinize
  26. 26. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 26 Psoriasis
  27. 27. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 27 Papulosquamous Disorders  Psoriasis (cont’d)  Plaque psoriasis  Inverse psoriasis  Guttate psoriasis  Pustular psoriasis  Erythrodermic psoriasis
  28. 28. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 28 Papulosquamous Disorders (cont’d)
  29. 29. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 29 Papulosquamous Disorders (cont’d)  Pityriasis rosea  Benign, self-limiting inflammatory disorder  Usually occurs during the winter months  Herald patch • Circular, demarcated, salmon-pink, 3- to 4-cm lesion
  30. 30. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 30 Papulosquamous Disorders (cont’d)
  31. 31. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 31 Papulosquamous Disorders (cont’d)  Lichen planus  Benign, inflammatory disorder of the skin and mucous membranes  Unknown origin, but T cells, adhesion molecules, inflammatory cytokines, and antigen presenting cells are involved  Nonscaling, violet-colored, 2- to 4-mm lesions  Wrists, ankles, lower legs, genitalia
  32. 32. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 32 Lichen Planus
  33. 33. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 33 Papulosquamous Disorders  Acne vulgaris  Inflammatory disease of the pilosebaceous follicles  Acne rosacea  Inflammation of the skin that develops in adulthood  Lesions • Erythematotelangiectatic, papulopustular, phymatous, and ocular • Associated with chronic, inappropriate vasodilation resulting in flushing and sensitivity to the sun
  34. 34. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 34 Papulosquamous Disorders (cont’d)  Lupus erythematosus  Inflammatory, autoimmune disease with cutaneous manifestations  Discoid lupus erythematosus • Restricted to the skin • Photosensitivity • Butterfly pattern over the nose and cheeks  Systemic lupus erythematosus
  35. 35. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 35 Discoid Lupus Erythematosus
  36. 36. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 36 Vesiculobullous Disorders  Pemphigus  Rare, chronic, blister-forming disease of the skin and oral mucous membranes  Blisters form in the deep or superficial epidermis  Autoimmune disease caused by circulating IgG autoantibodies • The antibodies are against the cell surface adhesion molecule, desmoglein in the suprabasal layer of the epidermis
  37. 37. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 37 Vesiculobullous Disorders (cont’d)  Pemphigus (cont’d)  Tissue biopsies demonstrate autoantibody presence  Types: • Pemphigus vulgaris (severe) • Pemphigus foliaceus • Pemphigus erythematosus
  38. 38. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 38 Vesiculobullous Disorders (cont’d)  Bullous pemphigoid  More benign disease than pemphigus vulgaris  Bound IgG and blistering of the subepidermal skin layer  Subepidermal blistering and eosinophils distinguish pemphigoid from pemphigus
  39. 39. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 39 Bullous Pemphigoid
  40. 40. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 40 Vesiculobullous Disorders  Erythema multiforme  Acute, recurring disorder of the skin and mucous membranes  Associated with allergic or toxic reactions to drugs or microorganisms  Caused by immune complexes formed and deposited around dermal blood vessels, basement membranes, and keratinocytes
  41. 41. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 41 Vesiculobullous Disorders (cont’d)  Erythema multiforme (cont’d)  “Bull’s-eye” or target lesion • Erythematous regions surrounded by rings of alternating edema and inflammation  Bullous lesions form erosions and crusts when they rupture  Affects the mouth, air passages, esophagus, urethra, and conjunctiva  Severe forms: • Stevens-Johnson syndrome (bullous form) • Toxic epidermal necrolysis
  42. 42. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 42 Infections  Bacterial infections:  Folliculitis  Furuncles  Carbuncles  Cellulitis  Erysipelas  Impetigo
  43. 43. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 43 Furuncle
  44. 44. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 44 Infections  Viral infections  Herpes zoster and varicella
  45. 45. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 45 Herpes Simplex Virus
  46. 46. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 46 Warts  Benign lesions caused by the human papillomavirus (HPV)  Diagnosed by visualization  Condylomata acuminata  Venereal warts
  47. 47. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 47 Fungal Infections  Fungi causing superficial skin lesions are called dermatophytes  Fungal disorders are called mycoses; mycoses caused by dermatophytes are termed tinea  Tinea capitis (scalp)  Tinea pedis (athlete’s foot)  Tinea corporis (ringworm)  Tinea cruris (groin, jock itch)  Tinea unguium (nails) or onychomycosis
  48. 48. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 48 Tinea Pedis
  49. 49. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 49 Fungal Infections  Candidiasis  Caused by Candida albicans  Normally found on the skin, in the GI tract, and in the vagina  Candida albicans can change from a commensal organism to a pathogen • Local environment of moisture and warmth • Systemic administration of antibiotics • Pregnancy • Diabetes mellitus • Cushing disease • Debilitated states • Age younger than 6 months • Immunosuppression • Neoplastic diseases
  50. 50. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 50 Vascular Disorders  Cutaneous vasculitis  Results from immune complexes in the small blood vessels • Develops from drugs, bacterial infections, viral infections, or allergens  Lesions • Palpable purpura progressing to hemorrhagic bullae with necrosis and ulceration
  51. 51. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 51 Vascular Disorders (cont’d)  Urticaria  Caused by type I hypersensitivity reactions to allergens  Histamine release causes endothelial cells of the skin to contract • Causes leakage of fluid from the vessels  Treatment • Antihistamines and steroids
  52. 52. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 52 Vascular Disorders (cont’d)  Scleroderma  Sclerosis of the skin that can progress to the internal organs  The disease is associated with several antibodies  Lesions exhibit massive deposits of collagen with inflammation, vascular changes, and capillary dilation  Skin is hard, hypopigmented, taut, and tightly connected to underlying tissue
  53. 53. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 53 Vascular Disorders (cont’d)  Scleroderma (cont’d)  Facial skin becomes very tight  Fingers become tapered and flexed; nails and fingertips can be lost from atrophy  Mouth may not open completely  50% of patients die within 5 years
  54. 54. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 54 Scleroderma
  55. 55. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 55 Insect Bites  Bees  Mosquitoes  Flies
  56. 56. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 56 Benign Tumors  Seborrheic keratosis  Keratoacanthoma  Actinic keratosis  Nevi (moles)
  57. 57. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 57 Seborrheic Keratosis
  58. 58. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 58 Cancer  Basal cell carcinoma  Squamous cell carcinoma  Malignant melanoma  Kaposi sarcoma
  59. 59. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 59 Basal Cell Carcinoma
  60. 60. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 60 Squamous Cell Carcinoma
  61. 61. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 61 Malignant Melanoma
  62. 62. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 62 Kaposi Sarcoma
  63. 63. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 63 Burns  Partial-thickness burns  First degree  Superficial and deep partial  Second degree  Full-thickness burns  Third degree  “Rule of nines”
  64. 64. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 64 Superficial Partial-Thickness Burn
  65. 65. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 65 Axillary Burn Scar Contracture
  66. 66. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 66 Deep Partial-Thickness Burn
  67. 67. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 67 Full-Thickness Burn
  68. 68. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 68 Estimating Burn Injury
  69. 69. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 69 Burns
  70. 70. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 70 Hypertrophic Scarring
  71. 71. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 71 Cultured Epithelial Autograft
  72. 72. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 72 Frostbite  Skin injury caused by exposure to extreme cold  Usually affects fingers, toes, ears, nose, and cheeks  The “burning reaction” is caused by alternating cycles of vasoconstriction and vasodilation  Inflammation and reperfusion are both part of the pathophysiology
  73. 73. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 73 Disorders of the Hair  Male-pattern alopecia  Genetically predisposed response to androgens  Androgen-sensitive and androgen-insensitive follicles
  74. 74. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 74 Disorders of the Hair (cont’d)  Female-pattern alopecia  Associated with elevated levels of the serum adrenal androgen dehydroepiandrosterone sulfate  No loss of hair along the frontal hairline
  75. 75. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 75 Disorders of the Hair (cont’d)  Alopecia areata  Autoimmune T cell-mediated inflammatory disease against hair follicles that results in baldness  Hirsutism  Androgen-sensitive areas • Abnormal growth and distribution of hair on the face, body, and pubic area in a male pattern that occurs in women
  76. 76. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 76 Disorders of the Nail  Paronychia  Acute or chronic infection of the cuticle  Onychomycosis  Fungal or dermatophyte infection of the nail plate

×