Integumentary System D.Dx
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Transcript Integumentary System D.Dx
Signs and Symptoms – objective and subjective
Prevention – “the anticipation and forestallment of
harm” ----what can we do to try not to get “it”
Pathology – “cause of disease, which involves changes
in structure and function” what is causing “it” and what
changes are happening to our body
Diagnosis – “the clinical or scientific methods to
establish the cause and nature of a person’s illness or
injury and the subsequent functional impairment
caused by the pathology” - how do we know it..prove it
Treatment – “procedures to cure or medically manage
a patient” can we do anything about it
Macule
• Flat, cannot be felt, smaller than 1 cm ~ freckle
Papule
• Raised, can be felt, 5 cm or less across ~ elevated nevus
Vesicle
• Fluid filled blister, 10 mm or less across ~ chickenpox -
herpes
Pustule
• Pus-filled raised area, varying sizes ~ acne
Crust
• Crusting is the result of the drying of plasma or
exudate on the skin
Wheal
(hives)
• Itchy, temporarily elevated area with an irregular shape ~
result of localized skin edema
Ulcer
•
Deep loss of skin surface that may extend to the
dermis with occasional bleeding and the formation
of scars, various sizes and depths ~ venous stasis
ulcer, pressure decubitus
Nodule
•
A small mass of tissue which forms in or on the
body, usually in response to injuries; typically hard
and they can be easily felt, greater than 10mm across
~ wart
S/S Inflammation of the sebaceous glands –
erythemia – pustules-papules-blackheads
Prev clean skin
Dx presence of pustules-papules-blackheads;
inspection of the skin
Path Occurs when the hair follicle gets blocked (dirt,
cosmetics, excess oil, bacteria);Most common during
adolescence ~ possibly due to hormonal changes and
increase of sebum production
Tx
• Frequent, Thorough Skin Washing
• Avoiding Creams and Heavy Make-Up
• Antibiotic or Vitamin A Ointments
• Oral Antibiotics
• Ultraviolet Light
S/S
thinning, pattern baldness
Prev ?
Dx thin transparent and for practical
purposes invisible
Path Genetic disorder of loosing hair, or
baldness; stress, poor nutrition, hormones
Tx medications (topical
and oral) and hair
transplants
S/S Itchy skin, blisters, cracks, open sores
Prev Clean, dry feet, avoid public showers etc.
Dx Inspection, skin scrapings
Path contagious, fungal infection
Tx Antifungal medication, keep feet clean & dry
S/S
erythemia, rash, itching
Prev avoid irritants
Dx inspection, skin testing
Path non contagious inflammation of
the skin, irritant; stress may cause skin to
blotch
Tx remove irritant, wash area, topical
ointments to relieve itching and
inflammation
General
term for various inflamed skin
conditions
Most common form of eczema is:
Atopic Dermatitis (or "atopic eczema")
Acute or chronic
S/S dryness, erythema , itching, vesicles,
crusts and scaling
Prev avoid irritants
Dx inspection, skin testing
Path allergic reaction,
common in first year of life
Tx
• Corticosteroids: Reduce the
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inflammatory response
Other anti-inflammatory meds
Cold compresses
Anti-itching medications
Antibiotics
Psoriasis
is a common skin inflammation
(irritation and swelling)
S/Scharacterized by frequent episodes of
erythemia; itching, and thick, dry, silvery
scales on the skin; usually located on the
elbows, knees, trunk, scalp, hands or nails
Prevreduce stress and other triggers ~~infection, trauma
Dxinspection of the skin
Path Chronic, noncontagious, inflammatory
autoimmune skin disease
Tx No definitive treatment at present, testing oral
treatments; moisturizers help keep the skin soft and
reduce scales and cracking
S/S
Raised, itchy, circular patches with
crusts ~skin, scalp, or underneath nails
Prev avoidance, handwashing
Dx inspection, skin scrapping
Path Highly contagious fungal infection
Tx Anti-fungal drugs, topical
and oral
S/S erythemia, pain, pustule
If boil becomes deeply embedded called
• Carbuncle
Prev good skin care
Dx inspection, cultures
Path bacterial infection of the hair follicles
or sebaceous glands
Tx
• Antibiotics
• Excision
• Drainage of infected
area
Healthy-Skin-Guide.com
S/S
Intensely itching wheals/welts; appear
in clusters over body
Prev Avoid allergens or triggers
Dx inspection of the skin and skin testing
Path allergic reaction, stress
Tx Corticosteroids: Reduce the
inflammatory response
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Other anti-inflammatory meds
Cold compresses
Anti-itching medications
Antibiotics
S/S
Itching, erythemia
Prev awareness, treatment
Dx inspection of the skin, skin
scrappings
Path parasitic
Tx medicated creams, treatment of
surroundings
S/S Blister
Prev Viral infection
• 3 Common Types
Herpes Simplex
Occurs around mouth – Fever blister/Cold Sore
Herpes Genital
Genital Area
Spread sexually – Remission/Exacerbation
Danger when infected woman becomes pregnant
Baby can be infected if Dr. is not aware to take precautions
Dx inspection of the skin
Path herpes virus
Tx Anti virals to try to reduce flare ups
Herpes
Zoster – Shingles
• Same virus that causes Chicken Pox in Children
• Viral infection of the nerve endings
Seen on chest and abdomen
Contagious
Dangerous for elderly
Head
lice – Parasitic Insects
• Contagious
• Difficulty to get rid of
Ingrown
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Nails
Common
Great toe most often affected
Painful
Cause improper nail trimming or too tight of shoes
Fungal
Infections
• Makes up 50% of nail disorders
• Most common in toenails
www.medicine.net
Basal cell carcinoma
2.
Squamous cell carcinoma
3.
Malignant carcinoma – Most dangerous form of skin
CA
Causes:
1.
Exposure to the sun
2.
Prolonged use of tanning beds
3.
Irritating chemicals
4.
Radiation
1.
Most
Common
Occurs on face
Abnormal cells in epidermis and extend to
the dermis (Outward to inward)
• Tx
Surgical removal
Radiation
Cryosurgery – Destruction of tissue by freezing by using
liquid nitrogen
Arises from epidermis (surface outwards)
Occurs in scalp/lower lip
• Grows rapidly
• Metastasizes to the lymph nodes
• Affects men more than women
TX
• Surgical removal
• Radiation
Recovery good if found early
WebMD
Melanoma
is a malignant (cancerous)
pigmented tumor of the skin
Involves
the cells that produce pigment
(melanin), responsible for skin and hair
color
Melanoma
is an aggressive type of cancer
that can spread very rapidly
Metastasizes
quickly
Brown/Black
Irregular
shape
Tx
• Surgical Removal
• Chemotherapy
A family history of melanoma
Red or blond hair (and fair skin)
Presence of multiple atypical nevi (birthmarks)
Development of precancerous actinic keratoses
Obvious freckling on the upper back
Three or more episodes of blistering sunburn before
age 20
Three or more years spent at an outdoor summer job
as a teen
High levels of exposure to strong sunlight
Skin lesion or growth
Usually a raised lesion such as a papule, macule or
nodule
Color that varies (brown, black, red or bluish)
Mixture of colors in one lesion
Irregular borders, often asymmetrical
A change in appearance of a pigmented skin lesion over
time
Bleeding from a skin growth
Other symptoms depend on the specific type of
melanoma
Protect yourself from damaging ultraviolet rays at all
times by doing the following:
Applying a good sunscreen -- one with a higher SPF (sun
protection factor) -- daily
Wearing protective clothing, including hats and
sunglasses
Refraining from intentionally lying in the sun or using
tanning devices
Minimizing sun exposure, especially during the summer,
and particularly between the hours of 10:00 a.m. and
2:00 p.m.
• Surgical removal of the tumor, and the normal skin that
surrounds it, is usually required
• Surgical removal of nearby lymph nodes may also be
necessary to see if the cancer has spread (metastasized)
• A skin graft may be necessary after the tumor is removed
if a large area of skin is affected
• Radiation and Chemotherapy
• Plus frequent and planned re-checks
Melanoma may show one or more of typical ABCDE
characteristics:
Asymmetry: one part of the tumor differs from other
parts;
Border of the tumor is irregular;
Color: tumor may be of different colors, often several
colors are present in one tumor;
Diameter above 6 mm (in most cases),
Evolving: lesion growths and changes color and
appearance with time
It grows slowly or rapidly and may spread to other
organs early (especially nodular type) via lymph
vessels and nodes or via blood, so it can be life
dangerous.
Pressure Ulcer/Decubitus Ulcer
• Bedsores
• Preventable
• Major and primary concern for Health Care Professionals
Especially in Long-Term Care Facilities
Cause:
• Person/Resident constantly sitting, lying in the same position
without shifting his or her weight
Areas Affected Most:
• Any tissue that lies over a bone
Spine, Coccyx, Hips, Elbows, Heels
Constant Pressure
• Decrease the blood supply
• Skin tissue dies
• Then decays
Classified According to their
• Stage I Decubitus Ulcer
Surface Reddening
Skin Unbroken
Tx: Relieve Pressure
Severity
Stage
II
• Blistered Areas
• Skin can be broken or unbroken
• Surrounding area red/irritated
• Tx: Protect/Clean Area
Alleviate Pressure
Breaks
through all layers of skin
• Epidermis, Dermis, Subcutaneous Layer
Primary
site for Infection
Medical Tx is necessary
• To prevent infection
• Promote healing
Ulcerated Area extends through all skin layers into the:
• Underlying muscles, tendons, bones
• Can be life-threatening situation
• Tx: Surgical Removal of Necrotic (Dead) or decayed area
Antibiotics
Best Tx:
• Prevention by:
Frequent Turning
Relief of Pressure on bony prominences
If on Homecare – family must be educated in how to prevent the ulcers