Transcript Skin PPT - Dr Magrann

“SKIN”
Integument System
1
 Now everything so far has been just an
introduction. Now Anatomy class begins!
 We’ll discuss the organ systems of the body one
by one.
 For each system, we’ll discuss its function, the
individual organs, its tissues, and clinical
significance.
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Integument System
 Integument System
 Organs
 Skin
 Hair
 Nails
 Glands
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Integument System
 Functions
 Protection
 Abrasion
 Infection
 UV light
 Dehydration
 Thermal Regulation
 Insulation (fat keeps you warm)
 Cooling (sweating cools you down)
 Sensory Reception
 Vitamin D Production
 Communication (raised eyebrows)
4
NOTE
Vitamin D is made in the dermis of the skin, after exposure to sunlight. It’s function is to allow
calcium to be absorbed from the foods you eat so your blood calcium levels are normal.
The Skin
Skin – our largest organ
 Accounts for 7% of body weight…it weighs twice as
much as your brain!
 Divided into three distinct layers
 Epidermis (‘epi” means above something)
 Dermis
 Hypodermis (“hypo” means deep to something)
 A hypodermic needle means a long hollow needle that
reaches all the way from the epidermis to the hypodermis.
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Remember, the term “SKIN” refers to all three
layers: epidermis, dermis, and hypodermis.
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Figure 5.1
EPIDERMIS
 Primarily made up of keratinized stratified
squamous epithelium
 The EPIDERMIS is the layer that gives strength to
the skin.
 Varies in thickness from a few cells (eyelids) to
dozens of cells thick (palms and soles of feet)
 It does not have any vascularization (blood
supply), so it relies on absorbing oxygen and
nutrients from the blood vessels in the dermis deep
to it.
 The nails are made in the epidermis.
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Layers of the Epidermis
 Stratum corneum (most superficial layer of
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epidermis)
Stratum lucidum (only in thick skin)
Stratum granulosum
Stratum spinosum
Stratum basale (the deepest layer of epidermis)
How to remember the layers of the epidermis
 The epidermis has five layers. From deep to superficial, they are the
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stratum basale, stratum spinosum, stratum granulosum, stratum
lucidum, and stratum corneum.
To remember which one is the deepest layer, visualize your
basement. That is the stratum basale.
To get from your basement (deepest layer) to the roof (superficial
layer), walk up your basement stairs...be careful! They are covered
with cactus spines (stratum spinosum).
That leads you to the kitchen, where someone has spilled sugar all
over the floor (stratum granulosum).
Then you go upstairs and stop to put on suntan lotion before you go
to the roof. The stratum lucidum is like a layer of suntan lotion; it
protects from UV rays, but is only present on the palms and soles, so
that's where you picture yourself applying the lotion.
Now you are ready to go to the roof and enjoy a nice corn on the cob
(stratum corneum).
Epidermal Cells and Layers
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Figure 5.3
STRATUM BASALE: has 4 types of cells
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The cell type that makes the epidermis is a
KERATINOCYTE
 Keratin is a protein made by these cells.
 Keratin is waterproof and strong
MERKEL CELLS: used as sensory receptors for the sense
of light touch.
MACROPHAGES: ingest debris
MELANOCYTES produce MELANIN (dark brown
pigment)
 Everyone has the same number of melanocytes
 But they don’t all make the same amount of pigment, so
people have different skin colors.
Melancholy
 Greek "melan " ("black, dark") and "cholē" ("bile").
Medical practitioners once adhered to the system of
humors—bodily fluids that included black bile, yellow
bile, blood, and phlegm. An imbalance of these humors
was thought to lead to disorders of the mind and body.
One suffering from an excess of black bile (believed to be
secreted by the kidneys or spleen) could become sullen
and unsociable—liable to anger, irritability, brooding,
and depression. Today, doctors no longer ascribe physical
and mental disorders to disruptions of the four humors,
but the word "melancholia" is still used in psychiatry as a
"subtype" of clinical depression.
 Melanin is a dark brown pigment, found in the epidermis.
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STRATUM BASALE:
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This is the only layer of the epidermis where the cells are
dividing.
As new cells are made in the S. Basale, the older cells get
pushed up and become the next layer (S. Spinosum)
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Figure 5.3
STRATUM SPINOSUM
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They are now attached to each other by desmosomes, which are
pointy/spiny (“spinosum”)
The cells are still alive, but they no longer divide in this layer
Also contains Langerhan’s cells, which are white blood cells
that function in the immune response. They are made in the red
bone marrow.
The stratum spinosum provides the strength to the epidermis
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Figure 5.3
STRATUM GRANULOSUM
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As more new cells are made in the S. basale, the S.
spinosum layer is pushed up to become the S.
granulosum layer.
The cells in the S. granulosum begin to die because
they are now too far from nutrient source (in dermis).
The cells now have a grainy appearance, so this layer is
called the stratum granulosum.
KERATIN
 Keratin is a waxy protein substance only found in the
epidermis. It makes up the nails, hair, and is also in
each superficial skin cell.
 It can absorb water, so keratin swells when soaking
wet. It makes the skin look wrinkled when you are in
the tub too long.
 The water evaporates when you dry off, and pulls
more water out of your body, so soaking in the tub will
dry your skin out…unless you put lotion on right away
to keep the water in the epidermal layers. Lotions will
not penetrate to the dermis, just water.
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MOISTURIZER CREAMS
 The secret ingredient of all moisturizers is
WATER. They work superficially on the
epidermis. Although keratin is waterproof, it
swells when wet.
 So, if you put a moisturizer on skin, stratum
corneum expands, and hides wrinkles.
 You get the same effect by soaking in the tub and
putting on any lotion, and that’s cheaper than
expensive creams.
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Epidermal Cells and Layers of the
Epidermis
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Figure 5.3
STRATUM CORNEUM
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As more new cells are made in the S. basale, the cells are all
pushed up again, and the S. granulosum layer becomes the S.
Corneum.
In this layer, the dead cells fill up with KERATIN.
The cells lose their nucleus and fuse to squamous (flat)
sheets, which are shed from the surface in about 2 weeks.
This process is called desquamation.
The main difference between thick skin and thin skin relates
to the thickness of the Stratum corneum.
It takes about 15-30 days for a cell to move from the stratum
basale to the stratum corneum and another 2 weeks for it to
shed
We lose half a million cells per hour; 1.5 grams a day
That can be a major source of dust in the house
Dust allergies are actually from the feces and saliva of dust
mites which eat the dead skin. One house has 3 million poops
per day from dust mites!
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Figure 5.3
STRATUM LUCIDUM
This layer is only on the palms and
soles
It is just deep to the S. corneum and
superficial to the S. granulosum
This THIN layer provides protection
from UV radiation.
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 Why do black-skinned people have lighter colored
palms and soles?
 Only the Stratum Basale has pigment-containing
cells, but the stratum lucidum contributes the
color of protein, which is an orange- tan color.
 In the palms and soles, the stratum lucidum is
present. The tan colored protein blocks the
underlying melanocytes from view.
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Conditions of the Epidermis
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If you frequently rub one area of the skin, it stimulates cell
division = callous
 If you rub the skin too hard, the stratum basale
tears away from the basement membrane, and
causes a gap, which fills with fluid: BLISTER.
 The epidermis then dies because it’s too far away
from nutrients. That’s why the top of a blister
dries up.
If the blisters are small (less than 5
mm in diameter), they are known as
vesicles; if they are larger (greater
than 5 mm in diameter), they are
26termed bullae.
Vesicles
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Bullae
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Skin Healing
 Individual skin cells do not have a high metabolic
rate, and construction of scar tissue is more
difficult than making normal skin. You get a scar
only if the dermis is excessively damaged.
 Remember that the epidermis does not have
blood supply and the fibroblasts are only present
in the dermis, and they make the collagen and
repair wounds.
 The skin is capable of repair, even after serious
damage, because stem cells persist in both the
epidermis and the dermis.
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Conditions of the Epidermis
Skin Cancer:
 This is the most common cancer in the USA,
and the major risk factor of all skin cancers is
exposure to ultraviolet light.
Three major types:
1) BASAL CELL CARCINOMA
2) SQUAMOUS CELL CARCINOMA
3) MELANOMA
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The second most common type of cancer is lung cancer.
The least common (of the common cancers) is leukemia.
Conditions of the Epidermis
1) BASAL CELL CARCINOMA: Cancer of the
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blood vessels in the dermis.
The most common type of skin cancer, accounts
for about 75% of the skin cancers.
Almost never metastasizes or crosses the
basement membrane, so is almost never fatal.
It is the most easily cured: surgical removal,
no chemotherapy or radiation usually needed.
Symptoms are minor: shiny nodules, usually on
nose, face, or other sun exposed areas.
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NOTE: signs are what a doctor sees, symptoms are
what a patient experiences.
Conditions of the Epidermis
1)
•
•
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BASAL CELL
CARCINOMA:
Cancer of the blood
vessels.
Almost never
metastasizes or
crosses the basement
membrane
Looks like shiny
nodules
Figure 5.11
Basal Cell carcinoma
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Reconstructive Surgery for Basal
Cell Carcinoma
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 Basal cell
carcinoma,
when left
untreated.
This 74-year-old man developed an
enlarging tumor on his left medial canthus 3
years ago. He had been unable to wear his
glasses for two years and sought medical
attention when this tumor offended other
members of his church. Ulceration,
crusting, and drainage developed recently.
The tumor was 12 centimeters in diameter,
malodorous, and draining a foul serous
fluid. Surgical excision was easier than
expected, because the tumor was attached
by a pedicle which spared the orbit.
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Conditions of the Epidermis
2) SQUAMOUS CELL CARCINOMA
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25% of all skin cancers
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Will metastasize if not treated.
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Actinic Keratosis
 A premalignant condition of thick, scaly, or crusty
patches of skin.
 It is more common in fair-skinned people, in sunexposed areas of skin.
20% of these lesions
progress to squamous
cell carcinoma.
They begin as flat, dry,
scaly areas, and later
grow into tough, wart-like
39lesions.
Conditions of the Epidermis
3) MELANOMA: cancer of the melanocytes of the
epidermis; least common (about 1% of skin cancer)
 Highly metastatic, causes 75% of skin cancer deaths.
 Asymmetrical, sharp but irregular borders and edges
 Not uniform in color.
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The warning signs in moles: ABC's:
A is for Asymmetry, where one side of the mole
looks different than the other side.
B is for Border, where the border is jagged or
irregular instead of smooth and regular.
C is for Color, where the mole contains more than
one color.
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 The medical term for a mole = nevus (plural =
nevi). Moles stick upward from the skin, and can
be pigmented or non-pigmented.
 The medical term for a freckle or any other
pigmented area that is flat and does not stick
upwards from the skin = macula
 Excoriations is the term for scratch marks on
the skin.
 How cancer cells grow:
 http://www.ted.com/talks/mina_bissell_experime
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nts_that_point_to_a_new_understanding_of_can
cer.html
Terminology
 The medical term for dry skin is xerosis.
 There are many things that can cause xerosis.
 The medical term for inflamed skin is
dermatitis.
 There are many things that can cause it.
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Conditions of the Skin
Eczema
 Atopic dermatitis (autoimmune allergy to own
skin)
 Contact dermatitis (allergy to something
touched)
Seborrheic dermatitis
Psoriasis
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Vitelligo
Eczema
 Itchy red skin that comes and goes.
 The most frequently occuring form of eczema is
ATOPIC DERMATITIS.
 Caused by an autoimmune reaction.
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Atopic dermatitis
 Triggered by allergens like soaps, cosmetics,
clothing, detergents, jewelry, or sweat.
 Can be triggered by changes in weather or stress.
 Tends to run in families.
 Treatment is lubricant creams daily and steroid
creams during outbreaks.
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Contact dermatitis
 Localized reaction from
an allergy to something
you touch.
 Common allergens are
plastic shoes, latex
gloves, detergents,
perfume, makeup,
jewelry, etc.
 People with a history of
allergies are more likely
to get contact dermatitis
from these objects.
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Contact Dermatitis
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Seborrheic dermatitis
 In Children, it is called “Cradle Cap”
 In Adults, it is called severe dandruff
 Caused by an allergy to the fungus that we all have
around our hair roots.
 The skin cells proliferate in an attempt to shed the
fungus. The result is severe dandruff that does not
respond to regular dandruff shampoo.
 Treatment is shampoo with ketoconazole (steroid)
or coal tar. Usually works for one year, then you
have to switch to another product for a year, then
switch back.
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Seborrheic dermatitis
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Psoriasis
 An autoimmune disease of the skin (the body’s
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immune system thinks the skin is foreign so it
attacks it).
Causes silvery flaking of skin, especially knees,
elbows, scalp.
It is not itchy
There are treatments, but no cure.
Treatments include shampoo with coal tar or
steroids.
Psoriasis
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 Laser
treatment
for psoriasis
lesions
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Vitelligo
 An autoimmune disease of the skin
 Destroys melanocytes, especially in areas of
friction (eyelids, mouth, hands)
 Causes depigmentation.
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Mongolian Spots
 Mongolian spots are benign, flat, congenital
birthmarks that looks like bruises, usually on the
buttocks and legs.
 They are extremely prevalent among Asians and
Native Americans.
 They normally disappear three to five years after
birth.
 Child care workers need to be informed by the
parents that their child has these spots. Otherwise,
the worker might report the parents for child
abuse.
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Mongolian Spots
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DERMIS:
1) PAPILLARY LAYER (Papillary = “Pimple”.
Has bumps). This is the more superficial layer.
2) RETICULAR LAYER
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Dermis
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Figure 5.1
Dermis
1) PAPILLARY LAYER (Papillary = “Pimple”. Has
bumps)
 The papillary layer of the dermis; LOOSE connective
tissue.
 Has ridges to increase surface area for contact with
the epidermis because the blood vessels and nutrients
from them are only in the dermis.
 The papillary layer in the DERMIS is what forms our
fingerprints.
 Surgeons make incisions on the body based on the
lines of cleavage of the skin formed by the papillary
layer of the DERMIS
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Skin lines of cleavage
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Lines of
cleavage
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Dermis
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Figure 5.1
Dermis
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2) RETICULAR LAYER
 DENSE IRREGULAR Connective Tissue
 Gives the dermis its strength.
 Remember, the epidermis is the strongest layer of
the SKIN, and the stratum spinosum is the strongest
layer of the epidermis. But the reticular layer of the
dermis is the strongest layer of the DERMIS. This
layer has lots of COLLAGEN and ELASTIN (elastic
fibers)
 The DERMIS is where most of the body’s collagen is
found.
 Stretch marks are caused from tiny tears in the
collagen of the DERMIS.
 Leather is made of the dermis.
 The dermis is also the area where all the
glands of the body are located.
 A transdermal patch (nicotine patch, etc) must
diffuse all the way from the epidermis into the
dermis to reach the blood vessels there.
 The blood vessels in the dermis are what gives a
pink color to Caucasian people.
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Dermis
 Meissner's
Corpuscle: nerve
receptors in the
dermis for light
touch
 Pacinian
Corpuscle: nerve
receptors in the
dermis for vibration
and pressure
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NOSE PIERCING
 Let me warn you about nose piercing: There is a region of the
face called the “Danger Triangle” which goes from between
your eyes to your upper teeth. All of the blood in this region
drains into the brain, so infection there can cause meningitis
and death in 24-48 hours.
 A cut on the forehead isn’t so bad, but a cut on the cheek near
the nose is considered very dangerous and needs immediate
antibiotics. A nose piercing can become a serious infection
because some of the worst bacteria in the body is in the
nose…that’s why your mother always told you not to pick your
nose. Can you imagine if you put a hole in your nose and it
got infected?
 A nose piercing that gets infected can cause
meningitis.
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Danger Triangle
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Dermis Conditions
What happens when you get cut?
 Bleed, then clot
 Macrophages eat foreign bodies and dead cells
 Fibroblasts lay down collagen to repair the
wound. If they produce more than normal, you
get a SCAR.
 If skin is cut with the grain (line of cleavage), scar
is not bad; it does not have tension on it. Against
the grain, the scar is worse.
 Some people are more prone to scar tissue than
others.
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Keloid Scars
Keloid Scars
 Thick, red, sometimes painful scars
 More common in African American, Native
American, and Asian races
 Treatment with cortisone injections
 Keloid scar formers can get internal adhesions
also
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Keloid Scars
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 Another type of scar tissue is called an adhesion.
 This is scar tissue in the deeper layers of the body,
such as right outside of the intestines, outside of
the ovaries, etc.
 Some people form adhesions spontaneously from
the organs rubbing against each other.
 If the adhesions cause symptoms, they might
need a surgery to clean them away.
 Here are some photos of deep tissue adhesions.
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Cutting the adhesions away
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Dermis Conditions
Stretch Marks
 Caused by sudden weight gain (pregnancy)
 Expansion of skin, collagen fibers in the dermis
separate = stretch marks.
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Do Lasers Remove Stretch marks?
Claim
 Lasers are used to stimulate new collagen growth and fill the
stretch mark from the bottom up. The laser energy is absorbed in
the dermal layer of the skin stimulating the production of new
collagen. As the new collagen thickens and plumps the skin, it
fills in the stretch mark from below.
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Rebuttal
 Although some physicians claim that lasers are effective in
removing stretch marks, the American Medical Association
states that there is no evidence to support this. Most
plastic surgeons think that lasers are ineffective in treating this
problem.
 Lasers are effective in removing, vaporizing, and breaking down
tissues. They do not generally repair tissues. Stretch marks
represent torn tissue. Hence, improvement should not be
expected from laser treatment. Moreover, clinical studies have
shown no improvement in stretch marks after laser treatment.
WRINKLES
 Over time, collagen fibers align themselves more and
more as they are always being pulled in the same
direction: smile, frown.
 As you age, the skin begins to sag because the body
makes less collagen, and some is lost from sun
exposure. Pinch your grandma’s skin. Does it bounce
back, or ooze back?
 What can be done about wrinkles? Not much. A face
lift clips off extra skin.
 Creams don’t work. Trying to fix a collagen problem
with a cream is like trying to shampoo your carpet by
putting the cleaner on the roof!
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COLLAGEN INJECTION
 Collagen is injected into hypodermis.
 Lasts up to six months if injected into areas that
do not move much. Smile lines need a new
injection every 3 months.
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 The source of collagen for injections is either from
bovine (cow), porcine (pig) or human skin.
 Some people are allergic to the preservatives or to
the animal collagen.
 They can have their own collagen removed from
one part of their body, have it sent to a lab for
purification, and injected into where they want it
(expensive!).
 http://www.doctorgoodskin.com/tp/collagen/sid
eeffects.php
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Complications of collagen
injections
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BOTOX
 This is a deadly poison which paralyses the
muscles, making them sag.
 That releases the tension, and relaxes the skin
line.
 In 3 months, new muscle cells are made, so
wrinkles come back, and need new injection.
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Botox Before and After: scam photos;
the patient was told to crinkle the eyes in the “before” shot.
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Botox Before and After: realistic photos
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Physical Appearance
 What is it like to be disfigured?
 I'm 18 and was born with a cleft lip and palate.
 Your self-esteem can suffer a lot. I know mine did, as a young
teenager. You can feel alone, and trapped, and that no one can
solve these problems.
 It's self-consuming, unhealthy, and depressing.
 However, as you grow older and realize that the world is a much,
much bigger place than yourself, your confidence multiplies.
 You'll still have your 'down' days, but then so does everyone.
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 What is it like to be disfigured?
 It's a blessing in many ways...
 You can see beyond the appearances, understand the kinds of pain
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others experience.
You see beauty everywhere; you appreciate it in all its forms.
You appreciate what you can do, even more.
You learn to live and love without pretense.
You know how to talk to people nicely.
You seize opportunities to learn and develop yourself in other ways,
defining yourself beyond your "deformity".
You just accept the facts of life, the funny ways in which its cards are
dealt.
You find the humor. You take pretty much everything less seriously.
You don't get bogged down following the crowd. You do your own thing what genuinely makes you happy .
And the people who like you... really, really, really do! It's
a massive bonus.
Scurvy
 Scurvy is a disease resulting from a deficiency
of vitamin C, which is required for the
synthesis of collagen in humans.
 The chemical name for vitamin C, ascorbic
acid, is derived from the Latin name of
“scurvy”.
 Scurvy often presents itself initially as
symptoms of malaise (feeling ill) and
lethargy (very tired), followed by formation
of spots on the skin and pale, bleeding gums.
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Scurvy
 Spots are most abundant on the thighs and legs, and a
person with the ailment looks pale.
 As scurvy advances, there can be open, suppurating
(“weeping”) wounds, loss of teeth, and can go on to be
fatal.
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Scurvy
 Scurvy was at one time common among soldiers
and sailors who were unable to obtain perishable
fruits and vegetables.
 Most animals can make their own vitamin C, so
they don’t get scurvy.
 Vitamin C is destroyed by the process of
pasteurization, so babies fed with ordinary bottled
milk sometimes suffer from scurvy if they are not
provided with adequate vitamin supplements.
 Virtually all commercially available baby formulas
contain added vitamin C for this reason.
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 Foods high in vitamin C
 Citrus fruits such as oranges or lemons,
blackcurrants, guava, kiwifruit, papaya, tomatoes,
bell peppers, and strawberries.
 It can also be found in some vegetables, such as
carrots, broccoli, potatoes, cabbage, spinach and
paprika.
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HYPODERMIS:
 This is the fat layer. It varies tremendously in
thickness: Shins = thin; Buttocks = thick. It also
contains fibrous tissue, blood vessels and nerves
and sits on top of the muscles.
Functions
 1) Stores fat
 2) Cushions
 3) Insulation from cold because of heat produced
by the larger blood vessels in this layer.
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Dermis
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Figure 5.1
Hypodermis Conditions
 Hypodermis is not connected to the muscle under it.
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Therefore, exercising muscle will not burn off fat only
in that area. If you have a fat belly, you can’t just
exercise the abdomen to make the fat there go away.
Fat is burned off equally over entire body. Losing 10
lbs is like loosing ¼” off whole body. More noticeable
in face than in hips.
 By the way, there’s no such thing as cellulite.
The term was invented by marketers. It is NOT a
special type of fat. It’s just fat, the same as every other
fat. It looks like wrinkled, “orange peel” skin because
the collagen fibers on top of it bind it down like a net.
There is no such thing as a cream to get rid of adipose.
 (Don’t confuse cellulite with cellulose, a plant fiber)
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Cellulite is just fat, protruding
around fascia fibers
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LIPOSUCTION
 This is a surgical procedure where the patient has
fat sucked out of the hypodermis layer.
 Liposuction is dangerous because hypodermis is
very vascular, can bleed too much.
LIPOSUCTION
SURGERY
VIDEO
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BURNS: Three types:
 FIRST DEGREE: Minor burn to the epidermis;
sunburn
 SECOND DEGREE: Dermis separates from
epidermis; blister
 THIRD DEGREE: Hypodermis is burned. (most
severe type of burn)
 2˚ and 3˚ burns over a large part of the body gives a
survival chance proportional to the amount of skin
left. 60% burn = 60% chance of dying.
96
Estimating Burns Using the Rule
of Nines
97
Figure 5.10a
Third Degree Burn
98
Why are deep burns so dangerous?
1) Infection
2) Dehydration: nothing to keep fluid in body.
 Therefore, they need a skin graft.
 Skin grafts can be from a cadaver, animal, artificial,
or from another part of the same person’s body.
 Skin grafts cause lots of scarring.
99
Skin graft
mesher
100
101
DECUBITUS ULCERS (bed sore)
 Epidermis and dermis are destroyed from pressure,
underlying tissue is exposed.
 How decubitus ulcers form:
 If you’re sitting down, weight of the body presses against
blood vessels, no blood flow to skin of buttocks. In you,
it’s ok, because you’ll be walking around again soon. But if
it goes on longer than a couple of hours because one can’t
move, tissues can’t get oxygen. Ulcer forms, can get
gangrene (tissue death).
 It can also become systemic (bacteria enter the wound,
travel in the blood), which can cause death. Whose fault is
it? The nurse’s, for not moving the patient every couple of
hours.
102
Decubitus Ulcers
103
104
105
Cellulitis
 Cellulitis is inflammation in subcutaneous layers of the skin, due to
infection.
 Cellulitis can be caused by normal skin flora (bacteria) or by exogenous
bacteria, and often occurs where the skin has previously been broken:
cracks in the skin, cuts, blisters, burns, insect bites, surgical wounds,
intravenous drug injection or sites of intravenous catheter insertion.
 Treatment with appropriate antibiotics is needed, and recovery periods
last from 48 hours to six months.
106
SKIN COLOR; Caused by four things:
1) MELANIN: (dark brown pigment). More melanin,
darker the skin.
2) CAROTENE: (a yellowish/orange pigment found
only in plants). Accumulates more in the skins of
Asians and Native Americans.
3) SKIN THICKNESS: thinner skin see blood vessels,
looks pinker
4) HEMOGLOBIN: The DERMIS contains the blood
vessels that give Caucasians the pink color to the skin.
Even veins are red because blood is red. But when
you look at veins through the adipose layer (the
hypodermis), they look blue.
107
Carotene
Dietary sources of carotene (These are also high
in Vitamin A)
 sweet potatoes
 carrots
 cantaloupe melon
 mango
 apricots
 spinach
 broccoli
108
CONTUSION: “Bruise”
 Why does a bruise look black and blue? The vessels in
the hypodermis are ruptured, and the blood leaks out;
looks blue. As it ages, the hemoglobin breaks down to a
green color, then a yellow color.
 The color of the bruise depends on the age of the bruise.
109
CYANOSIS: Bluish color to skin.
 Caused by superficial blood vessel constriction in
the dermis or lack of blood flow to skin
 Occurs for two reasons:
1) Cold
2) Not enough oxygen in body to go around. The
oxygen is conserved for the vital organs, so
oxygen to skin and nails is shut down.
110
Cyanosis
111
TATTOOS
 Pigment is injected into the dermis. If the needle
is sterile, there’s no health risk.
 However, the pigment diffuses with time. What
looks good in your 20’s will look like a blob when
you’re 50.
112
113
 TATTOO REMOVAL
 The tattoo you got years ago seemed like a great idea at the time.
But if you now wish it could disappear, you're not alone: 1 in 8
tattooed Americans now regret getting "inked." Tattoo removal is
a long and laborious process. So now some people are going the
do-it-yourself route.
 "We had a patient once who had used salt to try to scrub the
tattoo off," said dermatologist Dr. Amy Derick. Some have even
tried safety pins to try to poke the pigment out.
 For some, do-it-yourself treatments can cause serious side effects
like infection, scarring and skin discoloration.
 Doctors say successful treatment depends on the size, color,
location, and age of your tattoo. It can take 18 months with laser
treatment to remove the tattoo successfully.
114
Laser Tattoo Removal
•
115
Laser treatment is just burning the ink out of
the dermis; may leave a scar. Depending on
the color of the tattoo ink, it may only cause it
to fade.
Laser Tattoo Removal
116
Laser Tattoo Removal
117
Tattoo Removal
 SC Student:
 I went through a series of 8 treatments about 2 months
apart each lasting less than 5 minutes for both spots.
The laser is focused on the dark pigment and blasts it to
bloody raw skin; then Neosporin is applied until it is
completely healed, then it is blasted with the laser again.
 The laser boils all the water in each cell, turning it to
steam immediately. After many treatments of
penetrating deeper and deeper to get to the dermis, the
cells containing the pigment are eventually all blasted
away.
 The lower back area hurt much more than my shoulder
laser work.
118
119
After 5 treatments
120
Shoulder
Back
After 8 treatments
(16 months)
121
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122
Hemangioma
 Hemangioma: enlargement of the lining of
blood vessels
 Laser treatment works well
123
Strawberry Hemangioma
124
Laser treatment of blood vessel problems
125
HAIR
126
HAIR
127
128
HAIR
 There are about 2 million hairs on the body;
200,000 on the scalp.
Arrector
pillae
Hair root
Hair papilla
129
Hair
matrix
Longitudinal Section of Base of
Follicle
130
Figure 5.5c, d
 ARRECTOR PILLI: tiny muscles that make the hairs
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131
stand up during “goosebumps”.
HAIR PAPILLAE: what is destroyed by electrolysis, so
hair won’t grow back.
The HAIR MATRIX is the leading edge of the papillae. It
is actually skin cells (keratinocytes) which are rapidly
dividing. When they die, the new ones push them out,
forming the hair. Hair is just dead skin cells. The HAIR
ROOT is just the base of the hair.
The hair matrix is the part of the follicle that is the site
of hair growth and the location of the melanocytes that
determine hair color.
Hair that goes grey has lost its melanin pigment.
Differences in uncut hair length result from both
variations in hair growth rate and duration of the hair
growth cycle.
Hair Loss
 Hair loss in men and women is due to the
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132
presence of a male hormone (an androgen) called
DHT.
Men who have gene for baldness show male
pattern baldness.
Women who have the baldness gene don’t have as
much of the male hormone; they just get thinning
of the amount of hair.
Women get the baldness gene from their father,
and men get the gene from their mothers.
A man can tell if he will go bald by looking at his
mother’s father.
Hair Loss
 Hereditary hair loss and premature greying are
some of the most common genetic conditions.
 Hereditary baldness, in men also known as male
pattern baldness, is not exclusively a male
concern.
 An estimated 25% of women suffer from female
pattern baldness but, since their hair loss is
diffuse, it is not as easily recognizable as the male
form.
133
Life Cycle of Hair
 For most hair loss treatments to be effective, the
hair's growth phase has to be interrupted and the
hair shed.
 Only the new budding hair that comes out of a
hair follicle after a short resting period can be of
noticeably better quality than its predecessor.
 This replacement can sometimes come in a shock
wave called shedding and it is frequently
misunderstood by hair loss sufferers as a negative
reaction to the new treatment and so the
treatment is then discontinued.
134
Life Cycle of Hair
•The life cycle of hair is divided into three phases. The
actively growing (anagen) phase, the transitional
(catagen) phase and the resting (telogen) phase.
•Growth phase: 3-6 years, growing 10mm a month.
About 85% of the hair on any head at any given time is in
the growth phase.
•At the end of this period, blood supply to the hair bulb
slows down and eventually stops.
•As a result, the hair ceases to grow and moves into the
transitional phase, which lasts only about two weeks.
•Resting phase:,hair just sits on the head for about three
months. Then, it falls out, to be replaced by the next
budding hair in the growth phase which begins to grow
from the same hair follicle.
135
Life Cycle of Hair
•These replacement hairs get finer and thinner due to an
increase in an androgen hormone (DHT) as a person
ages.
•In most settings of baldness, the hair follicle finally shuts
down and refuses to produce more hair to replace the
ones that have fallen out.
•Good treatment enables you to maintain the hair you
have remaining. The maximum improvement you can
expect is to regain the hair you have lost in the last three
years.
•Do not wait for too long. The later you start treating the
baldness, the less successful your treatment will be. Do
not let your follicles die. You need at least the vellus hair
(peach fuzz) to start with.
136
Hair Loss Medicines
 Current antiandrogen modes of action include
 (a) preventing the creation of DHT
 (b) preventing DHT from binding to the receptor site
 (c) blocking activity in the androgen receptor itself.
 There are two FDA-approved oral medicines for
treating hair loss: Finasteride (Propecia) and
Minoxidil (Rogaine).
137
Hair Loss Medicines
 Finasteride (Propecia)
 It is the first and only FDA-approved pill proven to

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
138
treat male pattern hair loss on the vertex and middle
front of head.
The great majority of dermatologists agree that this
is currently the No.1 cure for hair loss.
In tests, 66% of men grew hair in back and 42% grew
hair up front. Almost all the rest stopped losing hair.
It cannot be used by women.
Dutasteride is another pill that may be receiving FDA
approval soon. It appears to be at least as powerful as
finasteride, but it is more expensive.
 MINOXIDIL (Rogaine) comes as a pill and a topical foam that





139
are both used by the patient. It is available over the counter.
Minoxidil is a vasodilator that was originally used to treat severe
blood pressure. Its bizarre side effects, such as the ability to
reverse or slow down the balding process, were accidentally
discovered in the late 1970s.
Minoxidil promotes enhanced follicular size, resulting in larger
hair shaft diameters. It also stimulates and prolongs the growth
phase of the hair growth cycle. It takes 4 months to notice results
Rogaine's effectiveness is established in front and back for
women but only in back (vertex) for men.
After 1 year of use, 48% reported moderate to dense re-growth of
hair, 36% reported minimal re-growth, and 16% reported no regrowth.
Once started, topical minoxidil treatment is a lifetime
commitment if the treatment proves effective. If regular
application of topical minoxidil is halted, all hair grown in
response to the therapy will be rapidly lost over the next 3 to 6
months.
Hair Loss Medicines
 SPIRONOLACTONE is a diuretic used to lower
high blood pressure. In addition, it possesses
anti-androgenic properties as it binds to the
androgen receptor in the hair follicle and thus
prevents it from interacting with DHT.
 Hence, spironolactone is also used to treat acne,
hirsutism (excess body hair) and hair loss in
women.
 It is not for oral use by men, because it causes
impotence, loss of sex drive, and breast
development.
140
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every day, and it is a MARVELOUS idea for a
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a birthday present.
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BEAUTIFUL paintings for sale as well.
You can also get reprints suitable for framing,
or originals. Here is more info about his work
and a YOUTUBE video.
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141
Split end of hair
142
Head louse
143
Eyelash Mite
144
Eyelash Mites
VIDEO
145
FUN FACTS
 The 'bone' in a rhinoceros' horn is simply a mass
that is not attached to the skull and is made of a
protein found in our hair and fingernails called
keratin.
 At birth, the dolphin arrives into the world with a
moustache. But due to a natural depilatory
process, within a short period of time the
moustache falls off by itself.
 The stripes on a tiger are not found just on its
coat; the skin of this predator is also striped. But
curiously enough, even though the zebra's coat is
striped, its skin is not.
146
Chemotherapy causing hair loss
 Chemotherapy causes hair loss because the drugs
target any cell that is rapidly dividing.
 Since the hair roots divide rapidly, they are killed
off along with the cancer cells.
 The stomach lining is also rapidly dividing, so
they also get nausea.
 Fun fact: Men without hair on their chests are
more likely to keep the hair on their head, but are
more likely to get cirrhosis of the liver. Men with
hairy chests are more likely to go bald.
147
Electrolysis
 Electrolysis involves sticking a fine wire into the

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148
follicle and administering an electrical current to kill
the hair papillae.
Treatments are repeated weekly for up to 18 months.
Hair follicles that are in the telogen phase are more
difficult to destroy than hair follicles in the anagen
phase.
Shaving approximately 3 days before an electrolysis
treatment ensures that the hairs that are visible and
encourage them to enter into the anagen phase.
Finally, side effects can include pain, infection, keloid
formation (for people who are susceptible),
hyperpigmentation, or hypopigmentation.
 Piebaldism: a rare autosomal dominant
disorder of melanocyte development, causing a
congenital white patch of hair.
149
 HAIR FOLLICLES
150
Fun Fact: How does heat straighten hair?
 There are three types of bonds that make up hair. Salt
(hydrogen) bonds are broken by heat. When the heat
hits the hair the salt bonds break. When the hair cools
the bonds rebuild themselves in its new shape. When
the hair gets wet, it goes back to its normal position.
 Chemicals can be applied to hair to straighten it or to
curl it. The chemicals break the stronger (covalent)
bonds in the hair and cause the bonds to reform in the
desired position. When the hair gets wet, it stays in the
new shape.
 Coloring hair strips the color from the shaft and
replaces it with a dye. The new color may fade with
time.
151
Structures Associated With Hair
Follicles
1. SEBACEOUS GLANDS
Each hair has a sebaceous gland.
2. These glands are therefore found all over the body
3. Produce sebum (oil that coats the hair and epidermis)
1.
When you wash it away, the skin gets dry if you don’t put
on lotion right away. The best moisturizer is lanolin,
which is made from sheep sebum.
152
PIMPLES
 Some of the largest sebaceous glands are associated

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153
with the smallest hairs (face).
Pimples begin when oil gland ducts (sebaceous
glands) become blocked by viscous (thick) sebum and
the gland swells. It opens up the pore and the skin
bacteria can get in and start an infection.
The sebum in the gland is exposed to oxygen and
turns black, called a blackhead.
The black part of a blackhead is oxidized sebum.
In puberty, there is an increase in hormones, and an
increase in gland secretion, leading to pimples.
154
 Pimple
155
Sebaceous and Sweat Glands
156
Figure 5.1
 Acne and skin aging:
 http://www.skintactix.com/free_radical_damage.htm

After years and years these cells become more and more damaged. Eventually, the
collective cells that make up organs become so damaged the organ fails to function,
such as the loss of vision or hearing as people age. This process of damage and
dysfunction of the vital organs eventually leads to death.

Most of this damage is caused by free radicals. Free radicals are minute chemical
particles (atoms or groups of atoms) which are frequently the by-products of chemical
processes. For example, when two chemicals join together to form another chemical,
some particles are eliminated and these can be free radicals. Free radicals have at least
one unpaired electron, causing the chemical particle to be unstable. To become
stabilized the particle must obtain an electron from some another chemical. By taking
an electron from another chemical, the free radical becomes a stable chemical, but the
other chemical now becomes a free radical and its chemical structure is changed. It
must then steal an electron. Thus the chain reaction (of atoms stealing electrons)
continues and can be thousands of events long.
 http://www.skintactix.com/acne_&_premature_skin_aging.htm

157
The skin produces hydrogen peroxide to fight each acne infection and this may
continue for weeks, until the infection is resolved. Hydrogen peroxide is a free radical
which causes skin damage and skin aging. Over a period of time the volume of
hydrogen peroxide acts just like continual sun exposure, damaging skin components
such as collagen and causing the skin to sag and wrinkle.
Acne Vulgaris
 Acne develops as a result of blockages in hair
follicles.
 Hyperkeratinization and formation of a plug of
keratin and sebum (a microcomedo) is the earliest
change.
 Enlargement of sebaceous glands and an increase
in sebum production occur with increased
androgen (DHEA-S) production at adrenarche.
 The microcomedo may enlarge to form an open
comedone (blackhead) or closed comedone
(milia).
158
Acne Vulgaris
 Comedones are the direct result of sebaceous
glands' becoming clogged with sebum, a naturally
occurring oil, and dead skin cells.
 In these conditions, the naturally occurring
largely commensal bacterium Propionibacterium
acnes can cause inflammation, leading to
inflammatory lesions (papules, infected pustules,
or nodules) in the dermis around the
microcomedo or comedone, which results in
redness and may result in scarring or
hyperpigmentation.
159
Clinical Manifestations
 Closed comedone (Whitehead): when a pore clogs up
beneath the skin and closes.
 Open comedone (Blackhead): when a pore clogs up
and reaches the surface of the skin, but stays open.
 Papules: inflamed, tender lesions that pop up as
small, pink bumps on the skin.
► Pustules:
pimples topped by
white or yellow pus-filled lesions.
► Cysts
160
and nodules - large,
inflamed, pus filled lesions deep
under the skin that can cause
pain and scarring.
Acne Vulgaris Lesions
 Lesions can be described in 3 categories, as
follows:
1.
Comedonal:
 The open comedo appears as a flat or
slightly raised lesion with a central darkcolored follicular impaction of keratin and
lipid.
Open comedone (blackhead)
 The closed comedo is a pale, slightly
elevated, small papule without a visible
orifice and is a potential precursor for the
larger inflammatory lesions.
161
Closed comedone (whitehead)
Acne Vulgaris Lesions (con’t)
2.
3.
162
Inflammatory: Inflammatory lesions
vary from small papules with an
inflammatory areola to pustules to
large, tender, fluctuant nodules
(nodular).
Scars: These appear as depressed
or hypertrophic papules of varying
sizes and shapes.
Inflammatory
Scars acne
Acne Vulgaris: Cause
 GENETIC
 The tendency to develop acne runs in families.
 PSYCHOLOGICAL
 It is associated with increased stress levels
 DIETARY
 A high glycemic load diet is associated with
worsening acne. There is also a positive association
between the consumption of milk and a greater rate
and severity of acne. Other associations such as
chocolate and salt are not supported by the
evidence. However, products with these ingredients
often contain a high glycemic load.
 HORMONAL
163
Acne Vulgaris: CAUSE
 HORMONAL CAUSES
 Hormonal activity, such as menstrual cycles and
puberty, may contribute to the formation of acne.
 During puberty, an increase in male sex
hormones called androgens cause the follicular
glands to grow larger and make more sebum.
 Use of anabolic steroids may have a similar effect.
164
Acne Vulgaris
 Development of acne vulgaris in later years is
uncommon, although this is the age group for
rosacea, which may have similar appearances.
 True acne vulgaris in adult women may be a
feature of an underlying condition such as
pregnancy and disorders such as polycystic ovary
syndrome or the rare Cushing's syndrome.
165
Acne Vulgaris
 Menopause-associated acne occurs as production
of the natural anti-acne ovarian hormone
estradiol fails at menopause.
 The lack of estradiol also causes thinning hair, hot
flushes, thin skin, wrinkles, vaginal dryness, and
predisposes to osteopenia and osteoporosis as
well as triggering acne (known as acne
climacterica in this situation).
166
Propionibacterium acnes
 When a pore is blocked, P. acnes, an anaerobic
bacterium, overgrows and secretes chemicals that
break down the wall of the pore and form an acne
lesion (folliculitis).
•
•
This leads to the possible spilling of
bacteria such as Staphylococcus aureus
into the broken skin.
Preliminary research shows healthy pores are
only colonized by P. acnes while unhealthy
ones universally include the non-pore-resident
Staphylococcus epidermidis, amongst other
bacterial contaminants.
167
Propionibacterium acnes
 Under normal conditions, P. acnes is beneficial:


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

creates low pH skin environment hostile to pathogens.
P. acnes can be killed by benzoyl peroxide,
tetracyclines, Clindamycin, azithromycin,
Fluoroquinolones such as nadifloxacin, ciprofloxacin,
ofloxacin and levofloxacin.
These are normally prescribed 500 mg by mouth,
three times weekly for 4 to 6 weeks.
There are also many antibacterial preparations,
including clove oil, PCMX, and chlorhexidine
gluconate.
Tetracycline-resistant P. acnes is now quite common.
To decrease acne, wash pillowcases often!
168
Furuncles (BOILS)
 Unlike pimples, boils are caused by bacteria that
enter a gland and invade into the hypodermis.
 They are local infections that swell to a size that is
larger than pimples.
 They are not blackheads.
169
Boil
170
 Most boils run their course within four to ten days.
For most people, self-care by applying a warm
compress or soaking the boil in warm water can help
alleviate the pain and hasten draining of the pus
("bringing the boil to a head").
 Once the boil drains, the area should be washed with
antibacterial soap and bandaged well.
 In serious cases, prescription oral or topical
antibiotics are used.
171
Carbuncles
 A carbuncle is a mass of boils which drains pus onto the skin. It is
usually caused by bacterial infection, most commonly
Staphylococcus aureus, or Streptococcus pyogenes, which can turn
lethal.
 The infection is contagious and may spread to other areas of the
body, or other people; those living in the same residence may
develop carbuncles at the same time (mass of boils)
172
Carbuncle: a mass of furuncles
(boils)
173
WARTS
 Warts are caused from a virus that can only get in if
there is a break in the skin. It starts multiplying itself,
forming a benign local tumor. Therefore they are found
on the hands of people who get a lot of scratches and
the feet of those who go outside without shoes.
That’s it for the organ
called hair; now we’ll
move on to the organ
called NAILS
174
NAILS
 At the nail matrix, there is rapid division of skin
cells, and as they die, the skin moves up and creates
the nail, similar to hair formation.
Taking calcium
does not make
nails stronger
because there is no
calcium in skin cells.
175
2. NAILS
 The EPIDERMIS gives rise to the nails.
 The nails are made of keratin (no collagen or
calcium)
 Taking calcium won’t make the nails any stronger
because there is no calcium in keratinocytes.
 At the nail matrix, there is rapid division of
keratinocytes (cells that make keratin), and as
they die, the skin moves up and creates the nail.
176
Structure of a Nail
177
The proximal nail fold creates the cuticle. The cuticle is
called the eponychium. The white half-moon visible under
the proximal part of a fingernail is the lunula.
Figure 5.9
GLANDS
 ECCRINE (MEROCRINE) SWEAT GLANDS.
 APOCRINE GLANDS
 PUBIC HAIR GLANDS
 MAMMARY GLANDS
 CERUMINUS GLANDS
178
1.
ECCRINE (MEROCRINE) SWEAT
GLANDS. These are found all over the body,
and produce a watery secretion which
evaporates and cools the body.
-Fun Facts: A pair of human feet contains 250,000
sweat glands.
-There is about one trillion bacteria on each of your feet.
-Your body gives off enough heat in 30 minutes to bring
half a gallon of water to a boil.
179
Sebaceous and Sweat Glands
180
Figure 5.1
 Anhidrosis: Lack of sweat glands
 Hyperhydrosis: Excessive sweating
 Microwave removal of sweat glands
 http://miradry.com/patients/what-miradry-
solution
181
2. APOCRINE GLANDS are associated with pubic
hairs in the axilla and pubic region, as well as the
mammary glands.
The ones associated with pubic hairs produce a
secretion to coat the hairs.
The hairs function as a wick to draw the secretions to
the surface.
Apocrine glands also produce a type of protein. The
protein in mammary glands is milk.
The protein in the pubic hair secretions is a
PHEROMONE (which acts as a hormone once it is
inhaled).
182
 Pheromones function for sexual attraction.
183
There is no conscious odor. The smell from
the axilla is from bacteria that are attracted by
the gland. Expensive perfumes have
pheromones. Guess where they get them
from? The anal glands of male cats! They are
designed to attract females. They are used so
women will buy expensive perfume.
 Pheromones also function to regulate
menstrual cycles of females. If you put several
women in one room for months, their
menstrual cycles will all start to occur at the
same time.
3. MAMMARY GLANDS are apocrine glands,
so they secrete by the method of the top of the
cell popping off. These apocrine glands secrete
milk. Each breast has dozens of glands with
their own duct to the surface in the nipple and
areola. In a woman who is not lactating, the
majority of tissue is adipose. To change the size
of breasts, lose or gain weight!
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4. CERUMINUS GLANDS are only found in the
ear, and they produce wax.


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They keep the ear canal from drying out
They discourage insects from crawling in; they
don’t like walking on the wax.
GLANDS
Summary
 EXOCRINE GLANDS secrete substances into a
duct that leads to the surface of the skin or into a
lumen.
 ENDOCRINE GLANDS secrete hormones into
the blood. They are ductless.
 A GOBLET CELL is a unicellular gland that
secretes mucus.
 A PLASMA CELL is a type of blood cell that
secretes antibodies. We’ll talk more about that
when we get to the cardiovascular system.
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CANCER
Cancer starts out as a
mutation in one gene
in one cell. Then the
mutated cell starts
dividing itself rapidly
and taking over the
whole area.
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Cancer
Cancer
 LEUKEMIA is a cancer in blood-forming
cells.
 LYMPHOMA is a tumor developing in
lymphatic tissues.
 CARCINOMA is a tumor developing in any part
of the epithelium.
 MELANOMA is a tumor developing in the
pigment-producing cells of the skin. It is a
particular type of carcinoma.
 SARCOMA is a tumor developing in muscles,
bones, organs, and connective tissues.
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Cancer
CHARACTERISTICS OF CANCER CELLS
 1. LACK DIFFERENTIATION
 Normal cells have specialized functions, but cancer cells do not
differentiate and do not contribute to the function of the body.
 2. ABNORMAL NUCLEI
 They have large or multiple nuclei with mutated chromosomes.
 3. FORM TUMORS
 Cancer cells grow and divide rapidly until they accumulate and
form a lump of cancer cells called a tumor. A BENIGN tumor is
an accumulation of non-cancerous cells because they stay in
their own capsule (encapsulated) and do not invade.
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Cancer
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Cancer
 MALIGNANT tumors are cancerous cells that
spread and invade.
Cancer
4. ANGIOGENESIS (INDUCE BLOOD VESSEL
FORMATION)
 Since these tumors need nutrients, they create new
blood vessels just for them to feed on.
5. METASTASIZE
 Pieces of the tumor break off and travel in the
bloodstream to any new location, invade nearby
tissues and continue their massive cell division and
growth there. If there is a tumor in the lung, it is
biopsied (the doctor surgically takes out a piece). If
the cells are lung cells, it is lung cancer. But if the cells
are pancreas cells, it is pancreatic cancer that has
metastasized.
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NUMBER OF
CANCER
CASES BY
SITE AND
SEX
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Cancer
ORIGIN
 There are many factors that play a role in the
development of cancer, including heredity factors,
carcinogens, and mutagens.
 CARCINOGEN is an environmental agent that
contributes to cancer. Not everyone exposed to it
gets cancer. Examples of a carcinogen are
ultaviolet radiation, toxic chemicals, and viruses.
 MUTAGEN is an agent that increases chances of
DNA change or mutation. Everyone exposed for
long enough will get DNA mutations, and possibly
cancer. Examples are x-rays and some medicines
(thalidimide; caused birth defects).
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Cancer
1. CARCINOGENS
 a) RADIATION is from overexposure to
sunlight.
 b) ORGANIC CHEMICALS include tobacco,
foods (salted pork), and pollutants
2. HEREDITY
 Particular types of cancers run in families, such as
breast, lung, and colon cancer.
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Cancer
DIAGNOSTIC PROCEDURES
 PAP SMEARS detect cervical cancers. They just swab the
cervix and look at the cells under a microscope.
 MAMMOGRAMS are diagnostic procedures to detect
breast cancer. The breast is just placed on a special type of
machine like an x-ray.
 20% of breast cancers are not detected by mammogram
and can only be detected by ultrasound.
 Those at high risk for breast cancer should get an MRI
instead of a mammogram, since the x-ray might induce
cancer.
 COLONOSCOPY is a diagnostic procedure to detect colon
cancer. A scope is inserted into the rectum so the doctor
can look for polyps.
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Cancer
The American Cancer Society says the following are
signs of cancer: C-A-U-T-I-O-N
 Change in bowel or bladder habits (colon cancer)
 A sore that does not heal (skin cancer)
 Unusual bleeding or discharge
 Thickening or lump in breast or elsewhere (breast
cancer)
 Indigestion or difficulty swallowing (GI system
cancer)
 Obvious change in wart or mole (skin cancer)
 Nagging cough or hoarseness (lung cancer)
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PREVENTION OF CANCER
1. BEHAVIORS
 DON’T smoke, sunbathe, drink alcohol, or get too
many x-rays. Smoking cigarettes is associated with
many types of cancers, including cancer of the lung,
larynx, throat, and urinary bladder.
 DO be tested (self-breast exams and testicular self-
exams every month, and Dr. check-ups), be aware of
chemical hazards at work, and be aware that using
estrogen for menopause symptoms must be combined
with progesterone, otherwise there is an increased
risk of cancer.
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PREVENTION OF CANCER
2. DIET
 Avoid fats, salty, smoke-cured, pork, and pickled foods.
 Eat plenty of fiber, green leafy vegetables and fruits, and eat
cabbage, broccoli, Brussels sprouts, and cauliflower, vitamins A
and C.
 For more information on smoke-cured meat, read the articles
posted at the bottom of our Lecture Unit 1 webpage.
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PREVENTION OF SKIN CANCER:
 A. use broad-spectrum sunscreen
 B. stay out of the sun altogether from 10-3
 C. wear protective clothing
 D. wear sunglasses
 E. do not use tanning machines
TREATMENT OF CANCER
1. RADIATION
 When someone has surgery to remove a tumor, it is
often followed by radiation because the cancer cells
may have spread throughout the body. Cells that are
in the process of dividing are the most likely cells to be
killed by exposure to radiation. Since cancer cells are
always in the process of dividing, exposing them to xrays may kill them. The x-ray beam is coned down so
just the tumor is exposed. However, scatter radiation
kills off other cells that rapidly divide (stomach lining
and hair follicles), so the side effects include baldness
and nausea.
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TREATMENT OF CANCER
2. CHEMOTHERAPY
 This is for cancer that has metastasized. It is also
good for cancer of the blood (leukemia). The
drugs are designed to specifically kill just the
cancer cells, but it tends to also kill off the normal
blood cells that are just being formed in the bone
marrow. Thus, bone marrow transplants are also
needed sometimes.
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TREATMENT OF CANCER
3. BONE MARROW TRANSPLANTS
 Someone needs to volunteer to donate a small
piece of bone from the crest of their hip. This
bone marrow will contain healthy new blood cells
that can repopulate the depleted bone marrow of
the sick person. These cells are injected into the
sick person’s vein.
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TREATMENT OF CANCER
4. IMMUNOTHERAPY
 Blood cells are taken from the sick person and are
fused with an antibody that is specifically
designed to seek out and destroy the cancer cell.
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TREATMENT OF CANCER
5. GENE THERAPY
 This is new research, attempting to find a gene
that will shrink tumors.
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TREATMENT OF CANCER
6. COMPLEMENTARY THERAPIES
 This involves natural healing therapies such as
biofeedback, acupuncture, and exotic foods. It’s
worth a try if you’re going to die!
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 Tummy Tuck Surgery VIDEO
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