Skin is the largest organ or outer protective covering of body. It is composed of three layers: epidermis, dermis or subcutaneous tissues. Skin is the body's defense covering, which protects against heat, light, injury and infection.

1. THE SKIN

2. SUBMITTED TO: SUBMITTED BY:
DR. PALLAVI PATHANIA MS. SABNAM KUMARI
ASSOCIATE PROFESSOR M.Sc. [N] 1ST YEAR
SHIMLA NURSING COLLEGE SHIMLA NURSING COLLEGE
Presentation
on
anatomy and physiology of
the skin

3. INDEX
SR.NO. CONTENT
1. Introduction of Integumentary system
2. Introduction about skin
3. Definition
4. Layers of skin

4. SR. NO. CONTENT
4. Epidermis
5. Dermis
Blood and lymph vessels
 Sensory and nerve endings
 Sweat glands
 Sebaceous glands
 Hairs
 Nails

5. SR . NO. CONTENT
6. Subcutaneous layer
7. Functions of skin
8. Disorders of skin
• viral infections
 Human papilloma
 Herpes virus
Prevention of viral infection
• Bacterial infections
 Impetigo
Candidiasis
 Cellulitis
Prevention of bacterial infection

6. SR.NO. CONTENT
• Fungal infection
 Ringworm
 Tinea Pedis
Prevention of fungal infection
• Non- infective inflammatory conditions
 Dermatitis
 Atopic dermatitis
 Contact dermatitis
 Psoriasis
 Acne vulgaris
• Burns
•Prevention and management of burns
• Pressure ulcers (Decubitus ulcers)
Prevention of pressure ulcers

7. SR.NO. CONTENT
• Malignant tumors
Basal cell carcinoma
 Malignant melanoma
 Kaposi’s sarcoma
Prevention of malignant disorders
•Conclusion
•Summary
•Recapitalization

8. INTEGUMENTARY SYSTEM:
 Integumentary- coverings: covers
outside of the body.
 It comprises the skin and its
appendages, acting as a physical
barrier between the external
environment and the internal
environment that it serves to protect
and maintain.

9. INTEGUMENTARY SYSTEM CONSISTS
 Skin and appendages
 Nails
 Hair Follicles
 Skin Glands

10. STRUCTURE OF THE SKIN

11.  The skin, also known as cutis or integument
that serves as main covering of the body.
 The skin is the largest organ of the body
weighing up to 16% of total body weight.
 For the average adult human, the skin has a
surface area of between 1.5-2.0 sq.meters.
 Thickness:0.5 to 3mm.

12.  The body’s basic defense
covering, which protects
against heat and light, injury
and infection.
 The skin completely covers the
body and is continuous with
the membranes lining the
body orifices.

13. LAYERS OF SKIN
 Epidermis
 Dermis
 Hypodermis(Subcutaneous
layer)

15. EPIDERMIS

16. THE EPIDERMIS
 The epidermis is the outermost layer of the skin.
 The epidermis is composed of the keratinized
squamous epithelium and does not have a blood
supply of its own.

18. LAYERS OF EPIDERMIS
 It is made up of five layers:
 Stratum corneum
 Stratum lucidum
 Stratum granulosum
 Stratum spinosum
 Stratum germinativm

19. LAYERS OF EPIDERMIS
 Stratum corneum- The outer most layer of
the skin. This is made up of scale like cells
that are continuously shed.
 Stratum lucidum- This is made up of small
transparent cells through which light can
pass. This layer only present in the palms of
hands and soles.
 Stratum granulosum- This layer is usually
1-3 layers thick. The cells have distinct
granules and keratin is produced in the layer.

20.  Stratum spinosum- This layer is 3-6 layers
thick and the cells are constantly dividing.
 Stratum germinative- A single basal layer
of cells, which contain the melanocytes
that produce the produce the pigment
melanin. The cells of the epidermis are
produced in the layer and each has a
distinct nuclei. These cells divide
continuously by a process known a mitosis.

21. STRATUM GERMINATUM
CONTAINS
MELANIN
 The melanocytes produce extra
melanin when activated by UV
rays, however they sometimes
hyper-secrete resulting in hyper-
pigmentation i.e. darker patches
of skin color. If the melanocytes
hypo secrete or cease to secrete
melanin hypo pigmentation
occurs, this skin condition is
referred to as vitiligo.

22. DERMIS

23. INTRODUCTION
DERMIS
 The layer is often referred to as the true
skin as it forms the bulk of the skin. The
dermis has a good blood and lymph
supply provided by lymph capillaries,
arterioles and venules.
 It is tough and elastic.

24. CONTINUED
 The dermis is made up of
connective tissue, and the
matrix contains collagen
fibers interlaced with the
elastic fibre.

25. LAYERS OF DERMIS
PAPILLARY LAYER
RETICULAR LAYER

26. LAYERS OF DERMIS
PAPILLARY LAYER
 Lies directly under the epidermis,
it is quite thin and has cone like
projections called papillae. It
provides nutrients and oxygen to
the germinating layer of the
epidermis.

27. RETICULAR LAYER
 This lies below the papillary
layer and is the main section of
the dermis.
 Within the reticular layer
collagen and elastin fibers are
present.

28. RETICULAR LAYER CONSIST OF:
COLLAGEN
 Collagen gives the skin plump
and youthful appearance and is
a white fibrous tissue made up
of proteins.
 Collagen fibers bind water and
give the skin its tensile strength,
but as this ability declines with
age, wrinkles develop.

29. CONTINUED
ELASTIN
 Elastin gives the skin its elastic
properties and is made up of yellow
elastic tissue.
 Rupture of elastic fibers occurs when
the skin is overstretched, resulting in
permanent striae, or stretch marks,
which are typically found in pregnancy
and obesity.

30. STRUCTURES FOUND IN DERMIS
 Small blood and lymph vessels.
 Sensory nerve endings.
 Sweat glands and their ducts.
 Hairs, arrector pilli muscles and
sebaceous glands..

31. STRUCTURES FOUND IN DERMIS
BLOOD AND LYMPH SUPPLY
 Blood is supplied to the skin by small blood
vessels known as blood capillaries.
 Arterioles form a fine network with
capillary branches supplying sweat glands,
sebaceous glands, hair follicles and the
dermis.

32. CONTINUED
BLOOD AND LYMPH VESSELS
 Arterioles supply oxygenated blood
that is rich in nutrients and venules
remove waste products and carbon
dioxide.
 In addition, the capillaries also help to
maintain the body temperature by
dilating and constricting.
 Lymph vessels also form a network
throughout the dermis.

33. CONTINUED
SENSORY NERVE ENDINGS
 Sensory receptors (specialized nerve endings)
sensitive to touch, temperature, pressure, and
pain are widely distributed in the dermis.
 Nerve impulses, generated in the sensory
receptors in the dermis, are transmitted to the
spinal cord by sensory nerves.
 From there, impulses are conducted to the
sensory area of the cerebrum, where the
sensations are perceived.

34. CONTINUED
SENSATIONS SENSORY
RECEPTORS
Touch Meissners corpuscles
Pain Pain corpuscles
Pressure Pacinain corpuscles
Heat Ruffins end corpuscles
Cold Krauses end bulb

35. STRUCTURES FOUND IN DERMIS
SWEAT GLANDS
 The Sweat glands ,which are
sometimes referred to as the
sudoriferous glands.
 Derived from Latin word sudor
'sweat', are small tubular structures
of the skin that produce sweat.

36. CONTINUED
SWEAT GLANDS
 Sweat glands are appendages of
the Integumentary system.
 They extend from the epidermis into
the dermis and are found all over the
body, however they are particularly
numerous in the palms of the hands
and the soles of the feet.
 They regulate the body temperature by
allowing sweat to evaporate from the
body.

37. TYPES OF SWEAT GLAND
ECCRINE GLANDS
APPOCRINE GLANDS

39. TYPES OF SWEAT GLANDS
ECCRINE GLANDS
 These are the more common types of
sweat glands and open on to the skin
surface through tiny pores.
 Found all over the body surface and
secrete in response to heat.
 When the internal temperature of the body
rises, sweat glands release water to the
skin surface. There, it quickly evaporates,
subsequently cooling the skin and blood
beneath.; this is the most effective means
of thermoregulation in humans.
 Eccrine sweat glands also participate in
ion and nitrogenous waste excretion.

40. CONTINUED
APOCRINE GLANDS:
 Larger and deeper glands found in the
groin and underarm regions.
 These glands are under hormonal
control and play a role in sexual
arousal.
 These glands are open into hair follicles
and therefore become active at puberty.
 The apocrine glands produce sweat
that decays to produce an unpleasant
odor.

41. EXAMPLE OF APOCRINE GLAND
 They are large, branched glands, mostly
confined to the axillary and perineal
regions, including the perineal region,
labia majora in women, and the scrotum
and prepuce in men.
 Apocrine sweat glands are also present in
the nipples and areola tissue surrounding
the nipples.
 Modified apocrine sweat glands include
the wax-producing ceremonious glands of
the external auditory meatus, the Moll
glands found at the free margins of the
eyelids, and the mammary glands of the
breast.

42. THE HAIR

43. THE HAIR
 Hair are dead structures that are
made up of a hardened protein
called keratin.
 Keratin provides the body with a
protective toughness for its entire
surface.

44. THE HAIR FOLLICLE
 The hair follicle is a tunnel-
shaped structure in the
epidermis of the skin. Hair
starts growing at the bottom
of a hair follicle.

45. PARTS OF HAIR
SHAFT
 Portion of hair that lies above the
skin surface, but also runs through
the centre of the hair.
ROOT
 Portion of hair that lies
underneath the skin, inside the
follicle.

46. CONTINUED
BULB
 Is the large base at the bottom of the
root and it encases the dermal papilla.
 The matrix is the lower region of the
bulb where the cells divide rapidly to
produce the new hair and follicle
structure.

47. LAYERS OF HAIR
 Cuticle
 Cortex
 Medulla

48.  Cuticle: Thin protective outer
layer that contains the nourishing
portion essential to hair growth.
 It is highly keratinized, composed
of cells shaped like scales that are
layered one over the other,
measuring about 60 micrometers
long and about 6 micrometer wide.

49. CONTINUED
 Cortex: It forms the main bulk and
pigment(color) of the hair. It consists
of long keratin filaments.
 Medulla: innermost layer of the hair
shaft, composed of an amorphous,
soft, oily substance.

50. ARRECTOR PILI MUSCLES
 The muscle is attached to the hair
follicle and it contracts when one
feels cold or gets frightened and in
result the hairs get erect.
 This is stimulated by sympathetic
nerve fibers in response to fear and
cold.
 Erect hair traps air, which acts as an
insulating layer, providing an
efficient warming mechanism,
especially when accompanied by
shivering.

51. SEBACEOUS GLAND
 Secretory glands consist of
secretory epithelial cells derived
from the same tissue as the hair
follicles.
 These glands are found all over the
body except for the palms of the
hands and the soles of the feet and
produce the natural oil of the skin-
sebum.
 They are most numerous in the
scalp, face, axillary and groin
region.

52. CONTINUED
 In regions of transition from one type of
superficial epithelium to another such as
lips, eyelids, nipple, labia minora and
glans penis, therefore they are sebaceous
glands that are independent of hair follicles,
secreting sebum directly on the surface.
 SEBUM: Sebum is the bactericidal and
fungicidal and so prevents against infection,
it also provides protection and prevents the
skin from drying out.

53. THE NAIL

54. INTRODUCTION
 The nails are the extension of the
epidermis and are therefore an
appendages of the skin.
 They are required to help with
grasping and protect the fingertip
and toes.
 The root of nail is embedded in the
skin and covered by the cuticle,
which forms the hemispherical
pale area called the lunula.

55. STRUCTURES OF NAIL
 The structures that define and
produce the nail (nail plate)
include the matrix (sterile and
germinal), the eponychium
(thickened layer of skin at the base
of finger nails and toe nails), the
paronychium (para- next, onyx-
nail i.e. next to nail), and the
hyponychium (skin just under the
free edge of the nail).

56. CONTINUED
 Collectively, the nail bed (sterile matrix), nail
fold, eponychium, paronychium, and
hyponychium are referred to as the
perionychium.

57. ABNORMALITIES OF NAIL
BEAU’S LINE
Depressions that run across your fingernail are called beau’s lines.
These can be a sign of malnourishment.

58. CLUBBING
 Clubbing is when your nails
thicken and curve around your
fingertips, a process that generally
takes years. This can be the result
of low oxygen in the blood and is
associated with:
 cardiovascular diseases
 Inflammatory bowel disease
 Liver diseases

59. KOLIONYCHIA (SPOONING )
 Koilonychia is when your fingernails
have raised ridges and scoop outward,
like spoons. It’s also called “spooning.”
Sometimes the nail is curved enough to
hold a drop of liquid. Spooning can be a
sign that you have:
 iron deficiency anemia
 heart disease
 Hemochromatosis, a liver disorder that
causes too much iron to be absorbed from
food.

60. LEUKONYCHIA
 Non-uniform white spots or lines
on the nail are called
leukonychia.
 They usually the result of a
minor trauma and are harmless in
healthy individuals.
 Sometimes leukonychia is
associated with poor health or
nutritional deficiencies.

61. MEES LINES
 Mees lines are transverse
white lines. This can be a
sign of arsenic poisoning. If
you have this symptom, your
doctor will take hair or tissue
samples to check for arsenic
in your body.

62. PITTING
 Pitting refers to small
depressions, or little pits, in the
nail. It’s common in people
who have psoriasis, a skin
condition that causes the skin
to be dry, red, and irritated.
Some systemic diseases can
also cause pitting.

63. TERRY’S NAILS
 When the tip of each nail has a
dark band, it’s called Terry’s nails.
This is often due to aging, but it
can also be caused by:
 Congestive heart failure
 Diabetes
 Liver disease

64. YELLOW NAIL
 Yellow nail syndrome is when the
nails get thicker and don’t grow as
fast as normal. Sometimes the nail
lacks a cuticle and may even pull
away from the nail bed. This can be
the result of:
 Internal malignancies
 Lymphedema, swelling of the
hands.
 Pleural effusions, fluid buildup
between the lungs and chest cavity.

65. EFFECT OF CHEMOTHERAPY ON NAIL COLOR
 Your nails may look bruised —
turning black, brown, blue, or green.
People with darker complexions notice
the color change more.
 You may develop blemishes on your
nails such as a horizontal or vertical
line, or small indentations.
 Your nails may become thin or
brittle.
 The nail can lift completely off the
nail bed or fall off in some cases.

66. FUNCTIONS OF NAIL
 Nails protect the sensitive tips of
fingers and toes.
 They also protect the fingers and
toes from injury.
 They help us to pick up small
objects.
 The matrix creates new skin cells,
which pushes out the old, dead skin
cells to make your nails.

67. SUBCUTANEOUS LAYER

68. SUBCUTANEOUS LAYER
 This is located under the dermis
and is mainly made up of fat cells
(adipose tissue).
 This fatty layer provides the
plump contours of the body,
protection, insulation, support and
nutrients supply if needed.

69. FUNCTIONS OF SKIN
 Sensation
 Heat regulation
 Absorption
 Protection
 Excretion
 Secretion
 Vitamin D production

70. Disorders of skin

71. VIRAL INFECTIONS
HUMAN PAPILLOMA VIRUS
 Human papillomavirus (HPV) is a
viral infection that's passed between
people through skin-to-skin contact.
 Common sites are the hands, the face
and the soles of the feet.
CAUSE- HPV
SYMPTOMS-
 Common warts, plantar warts, and flat
warts.

72. HUMAN PAPILLOMA VIRUS
DIAGNOSIS
 History collection, Physical examination, Pap smear,
Colposcopy.
TREATMENT
 HPV vaccine, Salicylic acid, Imiquimod,
Trichloroacetic acid.

73. CONTINUED
HERPES VIRUSES
 Herpes is an infection
that is caused by a herpes
simplex virus (HSV).
Oral herpes causes cold
sores around the mouth or
face.
 Genital herpes affects the
genitals, buttocks or anal
area. Genital herpes is a
sexually transmitted
disease (STD).

74. HERPES SIMPLEX VIRUS
CAUSE- Herpes simplex virus
SYMPTOMS
 Blistering sores (in the mouth or on the genitals), Pain during
urination (genital herpes), Itching fever, Swollen lymph nodes,
Headaches, Tiredness, Lack of appetite.
DIAGNOSIS
 History collection , Physical examination, Swab test, Blood
test, Lumbar puncture.
TREATMENT
 Acyclovir, Famciclovir.

75. PREVENTION
 Wash your hands with soap and warm
water frequently.
 Avoid sharing eating utensils and
drinking glasses with other people.
 Avoid direct contact with the skin of
other people who have an infection.
 Consult your dermatologist.

76. BACTERIAL INFECTIONS
IMPETIGO
 This is a highly infectious
condition. It is spread by direct
contact and affects mainly
children and immunosuppressed
individuals.
CAUSE- Staphylococcus aureus
SYMPTOMS
 Superficial pustules develop,
usually round the nose and
mouth, pruritis, fever.

77. IMPETIGO
DIAGNOSIS
 History collection, Physical examination,
Blood test.
TREATMENT
 Antibiotic ointment mupirocin
(Bactroban), Penicillin drug, Cephalexin.

78. CONTINUED
CELLULITIS
 This is a spreading infection, which
enter through a break in the skin.
Cellulitis usually affects the skin on
the lower legs, but it can occur in the
face, arms and other areas
 CAUSES- caused by some anaerobic
bacteria, including streptococcus
pyogenes and clostridium perfringens.
.

79. CELLULITIS
SYMPTOMS
 Red area of skin that tends to expand, Swelling,
Tenderness, Pain, Warmth, Fever, Red spots, Blisters,
Skin dimpling.
DIAGNOSIS
 History collection, Physical examination, Blood test,
Bacterial culture.
TREATMENT
 Dicloxacillin, Cephalexin, Trimethoprim with
sulfamethoxazole, Clindamycin.

80. PREVENTION
 Avoid touching your eyes, nose, or mouth
with your hands to help prevent the spread
of infections.
 Do not squeeze skin sores, it may worsen
the infection and possibly spread it to others.
 Completely and securely cover skin
infections that are not contagious (such as
eczema) before practice, meets, or games.
 Wash hands frequently.
 Consult your dermatologist.

81. FUNGAL INFECTION (MYCOSES)
RINGWORM
 Ringworm is a contagious fungal
infection caused by common mold-like
parasites that live on the cells in the
outer layer of your skin.
 Also known as tinea or dermatophytosis
 Ringworm often spreads by direct,
skin-to-skin contact with an infected
person.

82. MODE OF TRANSMISSION
It get transmitted from an-
 Infected person
 Animal
 Inaminate object
 Soil

83. TYPE OF RINGWORM
Ringworm that affect the-
1. Skin(Tinea corporis)
2. Scalp(Tinea capitis)
3. Feet (Tinea pedis or athlete’s foot
4. Nail(Tinea Unguium)
5. Face( Tenia Faciei)
6. Beard Area( Tenia Barbae)
7. Hans And palm areas9 Tinea manuum)

84. RING WORM
 Symptoms:- Itchy, ring shaped scaly patches that may blister, hair
loss, Dandruff or seborrhea
 Diagnostic evaluation:- Skin biopsy
 Management:- Clotrimazole, miconazole

85. FUNGAL INFECTION
CANDIDIASIS
 Candidiasis is a fungal infection
caused by a yeast (a type of fungus)
called Candida. Candida normally lives
on the skin and inside the body, in
places such as the mouth, throat, gut,
and vagina, without causing any
problems.
CAUSE- most common cause is
Candida albicans.

86. CANDIDIASIS
SYMPTOMS
 Oral Thrush, tiredness and fatigue, Recurring Genital or Urinary
Tract Infections, Sinus Infections, joint pain, Skin and Nail Fungal
Infections.
DIAGNOSIS
 History collection, Physical examination, Blood test, culture.
TREATMENT
 Fluconazole, Clotrimazole.

87. CONTINUED
TINEA PEDIS
 Athlete's foot (tinea pedis) is a fungal
infection that usually begins between the
toes.
 It commonly occurs in people whose feet
have become very sweaty while confined
within tight fitting shoes.
 Signs and symptoms of athlete's foot
include a scaly rash that usually causes
itching, stinging and burning.

88. TINEA PEDIS
CAUSE- Tinea pedis
SYMPTOM
 Athlete's foot may appear as pink-to-red skin, Pain,
Itchy blisters on the arch (instep) and/or the ball of
the foot.
DIAGNOSIS
 History collection, Physical examination, Potassium
hydroxide exam.
TREATMENT
 Luliconazole, an imidazole topical cream.

89. PREVENTION
 Keep your skin clean and dry, particularly the
folds of your skin.
 Wash your hands often, especially after
touching animals or other people.
 Avoid using other people's towels and other
personal care products.
 Wear shoes in locker rooms, community
showers, and swimming pools.
 Consult your dermatologist.

90. NON- INFECTIVE INLAMMTORY CONDITIONS
DERMATITIS (ECZEMA)
 Dermatitis is a common inflammatory
skin condition that may either acute or
chronic.
CAUSE- allergic reaction to:
 Detergents, Cosmetics, Nickel, Stress,
hormonal changes.

91. CONTINUED
SYMPTOMS
 In acute dermatitis there is
redness, swelling and exudation
of serous fluid, usually
accompanied by pruritis (itching),
crusting or scaling.
 In chronic condition the skin
become thickens and may become
leathery due to long- term
scratching, which may cause
infection.

92. CONTINUED
ATOPIC
DERMATITIS (ECZEMA)
 It is a condition that makes your skin
red and itchy.
 It's common in children but can occur
at any age.
 Atopic dermatitis is long lasting
(chronic) and tends to flare
periodically.
 It may be accompanied by asthma or
hay fever.

93. CONTINUED
CONTACT DERMATITIS
 This is caused by direct
contact with irritants, e.g.
cosmetics, soap, detergent,
strong acids or alkalis,
industrial chemicals or a
hypersensitivity reaction to
latex nickel, dyes and other
chemicals.

94. CONTINUED
DIAGNOSIS
 History collection
 Physical examination
 Patch test
TREATMENT
 Antihistamine such as diphenhydramine (Benadryl)
 Phototherapy
 Hydrocortisone, to relieve itchiness and inflammation.
 Creams or lotions for dry skin.

95. CONTINUED
PSORIASIS
 Psoriasis is thought to be an
immune system problem. Triggers
include infections, stress and cold.
 Psoriasis is a common, long-term
(chronic) disease.
CAUSE
 Infections, such as strep throat or
skin infections, Weather, especially
cold, dry conditions, Injury to the
skin, such as a cut or scrape, a bug
bite, or a severe sunburn, Smoking.

96. PSORIASIS
SYMPTOMS
 Psoriasis is a skin disease that causes red, itchy scaly
patches, most commonly on the knees, elbows, trunk and
scalp.
DIAGNOSIS
 History collection, Physical examination, Skin biopsy.
TREATMENT
 Vitamin D analogues, Corticosteroids, Salicylic acid.

97. CONTINUED
ACNE VULGARIS
 Acne vulgaris is a common chronic
skin disease involving blockage and/or
inflammation of pilosebaceous units
(hair follicles and their accompanying
sebaceous gland).
 Acne can present as non inflammatory
lesions, inflammatory lesions, or a
mixture of both, affecting mostly the
face but also the back and chest.

98. ACNE VULGARIS
CAUSE
 Excess oil (sebum) production, Hair follicles clogged by oil and
dead skin cells, Bacteria, Hormonal changes in pregnancy or from
the menstrual cycle.
SYMPTOMS
 Whiteheads (closed plugged pores), Blackheads (open plugged
pores), Small red, tender bumps (papules), Pimples (pustules),
which are papules with pus at their tips, Large, solid, painful lumps
under the skin (nodules), Painful, pus-filled lumps under the skin
(cystic lesions).

99. ACNE VULGARIS
DIAGNOSIS
 History collection, Physical examination, Swab test.
TREATMENT
 Topical antibiotics- benzyl peroxide or a topical retinoid.
 Oral antibiotics- doxycycline and minocycline

100. PREVENTION
 Avoid contact with irritants and
allergens.
 Wear protective clothing or gloves.
 Apply a barrier cream or gel for e.g.
sunscreen.
 Avoid excessive exposure to direct
sunlight.
 Consult your dermatologist.

101. PRESSURE ULCERS
(DECUBITUS ULCERS)
 Pressure ulcers (also known
as pressure sores or bedsores
and decubitus ulcers) are injuries
to the skin and underlying tissue,
primarily caused by
prolonged pressure on the skin.
 They can happen to anyone, but
usually affect people confined to
bed or who sit in a chair or
wheelchair for long periods of
time.

103. CONTINUED
CAUSE
 Caused by sustained pressure being placed on a particular part
of the body.
SYMPTOMS
Part of the skin becoming discolored – people with pale skin tend
to get red patches, while people with dark skin tend to get purple
or blue patches, Pain or itchiness in the affected area.
DIAGNOSIS
 History collection, Physical examination, Braden scale.

104. CONTINUED
TREATMENT
 Removing pressure on the affected area.
 Protecting the wound with medicated gauze or other special
dressings.
 Keeping the wound clean.
 Ensuring good nutrition.
 Removing the damaged, infected, or dead tissue
(debridement).
 Transplanting healthy skin to the wound area (skin grafts).
 Negative pressure wound therapy.
 Medicine (such as antibiotics to treat infections).

106. PREVENTION
 Perform skin assessments every 8
hours using the Braden Scale.
 Reposition the patient every 2
hour to offload pressure using a
pillow or wedge.
 Ensure adequate nutritional
status to improve wound healing.
 Maintain adequate hydration.

107. BURNS
 Burns are tissue damage that
results from heat, overexposure to
the sun or other radiation, or
chemical or electrical contact.
 Burns can be minor medical
problems or life-threatening
emergencies.
CAUSE-
 Hot fluids
 Excessive exposure to radiation
 Chemical burn

108. CONTINUED
SYMPTOMS
 Swelling and red, white or splotchy skin. Blisters may develop, and
pain can be severe.
 Deep second-degree burns can cause scarring.
DIAGNOSIS
 History collection
 Physical examination
 Rule of nine
 Parkland formula

109.  Cool the burn. Hold the burned area under
cool (not cold) running water or apply a
cool, wet compress until the pain eases.
 Assess degree of burn.
 Remove rings or other tight items.
 Don't break blisters.
 Bandage the burn.
 Take a pain reliever.
 Fluid and electrolytes replacement should be
done.
 Apply silver sulfadiazine over the burn area.
 Plastic surgery, skin grafting.
TREATMENT

110. PREVENTION
 Be “alarmed”. Install and maintain
smoke alarms in your home—on every
floor and near all rooms family
members sleep in.
 Have an escape plan. Create and
practice a family fire escape plan, and
involve kids in the planning.
 Cook with care.
 Check water heater temperature.

111. MALIGNANT TUMORS
BASAL CELL CARCINOMA
 Basal cell carcinoma is a type of skin
cancer that most often develops on areas
of skin exposed to the sun.
 Basal cell carcinoma is a type of skin
cancer.
CAUSE- Excessive exposure to sunlight,
Radiation therapy, increased age,
immunosuppressive therapy.

112. CONTINUED
SYMPTOMS
 A pearly white, skin-colored or pink bump, A brown, black or blue
lesion, A flat, scaly, reddish patch, white, waxy, scar-like lesion.
DIAGNOSIS
 History collection, Physical examination, TNM classification,
Biopsy.
TREATMENT
 Chemotherapy, Radiation therapy, Mohs surgery, Topical ointment.

113. CONTINUED
MALIGNANT MELANOMA
 Melanoma, also redundantly known
as malignant melanoma, is a
type of skin cancer that develops
from the pigment-producing cells
known as melanocytes.
 Melanomas typically occur in the
skin but may rarely occur in the
mouth, intestines or eye
(uveal melanoma).

114. CONTINUED
CAUSES
 Excessive exposure to UV radiation, Genetics
SYMPTOMS
 Asymmetry, Borders (irregular with edges and corners), Color
(variegated), Diameter (greater than 6 mm, about the size of a
pencil eraser), Evolving over time.
DIAGNOSIS
 History collection , Physical examination, Biopsy, TNM staging.
TREATMENT
 Chemotherapy, Immunotherapy, Tumor resection.

115. KAPOSI’S SARCOMA
 It is a type of cancer that forms in the
lining of blood and lymph vessels.
 The tumors (lesions) of Kaposi's
sarcoma typically appear as painless
purplish spots on the legs, feet or
face. Lesions can also appear in the
genital area, mouth or lymph nodes.
CAUSE
 Human herpes virus 8 (HHV-8).

116. CONTINUED
SYMPTOMS
 Slightly elevated purple, pink, brown, black, blue, or red
blotches or bumps anywhere on the skin or in the mouth and/or
throat, Lymphedema, which is swelling caused by a blockage
of the lymphatic system, Unexplained cough or chest pain.,
Unexplained stomach or intestinal pain.
DIAGNOSIS
 History collection, Physical examination, occult blood test,
Chest x- ray, Brochoscopy, Colonoscopy.

117. PREVENTION
 Don't get sunburned.
 Avoid tanning, and never use UV tanning
beds.
 Cover up with clothing, including a broad-
brimmed hat and UV-blocking sunglasses.
 Use a broad-spectrum (UVA/UVB)
sunscreen with an SPF of 15 or higher
every day.
 Examine your skin for lesions.
 Consult your dermatologist.

118. CONTINUED
TREATMENT
 Minor surgery (excision)
 Burning (electrodessication) or freezing (cryotherapy).
 Low-dose radiation, which is also helpful for lesions in the mouth.
 Injection of the chemotherapy drug vinblastine directly into lesions.
 Application of a vitamin A-like drug (retinoid).

119. CONCLUSION
 Skin is a tough, relatively impermeable, self-replacing organ
that the body cannot easily live without.
 It provides protection and both sensory stimuli from the external
environment.
 Skin cells which may have a short journey from the stratum
basale to the stratum corneum, but the protective layer they
leave behind lasts for a lifetime, endlessly protecting the body
from injury and infectious organisms.

120. In today’s class we had discussed about
 Integumentary system
 Introduction of skin
 Definition
 Layers of skin
 Functions of skin
 Disorders of skin and their prevention

123. Q. Define skin.
Ans. The body’s basic defense covering,
which protects against heat and light,
injury and infection.

124. Q. Enlist the name of the layers of
skin.
Ans.
 Epidermis
 Dermis
 Hypodermis (subcutaneous layer)

125. Q. Describe the functions of skin.
Ans.
Heat regulation
Sensation
Protection
Absorption
Excretion
Secretion
Vitamin D production

126. Q. Enlist the disorders of skin.
ANS.
 HUMAN PAPILLOMA VIRUS
 Herpes viruses
 Impetigo
 Cellulitis
 Ringworm and tinea pedis
 Dermatitis (atopic and contact)
 Psoriasis
 Burns
 Pressure ulcers
 Malignant tumors

127. Q. Explain about the management of
dermatitis.
ANS.
 Don't get sunburned.
 Avoid tanning, and never use UV tanning beds.
 Cover up with clothing, including a broad-
brimmed hat and UV-blocking sunglasses.
 Use a broad-spectrum (UVA/UVB) sunscreen
with an SPF of 15 or higher every day.
 Examine your skin for lesions.
 Consult your dermatologist.

128. ASSIGNMENT
 Draw the structure of skin and
explain about its function.

129. BIBLIOGRAPHY
 Brannon, H. (2007, April 9). Skin Anatomy . Retrieved July 14,
2012.
 Brouhard, R. (2007, May 7). Layers of the Skin: The Body's
Flowerbed.Retrieved from : Candi, E., Schmidt, R., &Melino, G.
(2005).
 The Conified Envelope: A Model of Cell Death in the Skin. Nature
Reviews Molecular Cell Biology, 6(4), 328-340.
doi:10.1038/nrm1619 .
 King, D. (2012, March 7). Introduction to Skin Histology.
Retrieved.