Transcript Pearson`s Comprehensive Medical Assisting

Pearson's Comprehensive
Medical Assisting
Administrative and Clinical Competencies
Second Edition
CHAPTER
CHAPTER
22
The Integumentary
System
Lesson 2:
Pathology of the Integumentary
System
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Lesson Objectives
Upon completion of this lesson, students
should be able to …
• Define and spell the terms to learn for this
chapter.
• Identify and explain common disorders
associated with the integumentary system.
• Identify and describe forms of skin care
treatments that are used to help reverse
the signs of aging.
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Facts About Skin Cancer
Skin cancer is the most common of all
cancers.
Skin cancer affects more than 1 million
people each year in the United States.
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How Skin Cancer Occurs
• Occurs when normal skin cells undergo a
change during which they grow and multiply
without normal controls
• As the cells multiply, they form a mass called
a tumor
• Tumors of the skin are often referred to as
lesions
• Malignant tumors encroach on neighboring
tissues, especially lymph nodes, due to their
uncontrolled growth
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Three Major Types of Skin
Cancer
• Basal cell carcinoma
• Squamous cell carcinoma
– The vast majority of skin cancers are either basal
cell or squamous cell carcinomas
• Malignant melanoma
– A small but significant number of skin cancers are
malignant melanomas. Malignant melanoma is a
highly aggressive cancer that tends to spread to
other parts of the body.
– These cancers may be fatal if not treated early
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Basal Cell Carcinoma
• Most common form of skin cancer
• Most often caused by overexposure to the sun
• May often appear as a change in the skin, such
as a growth, an irritation, or a sore that does not
heal, or a change in a wart or mole
• Though the nose is the most common site, it
usually affects the head, neck, back, chest, or
shoulders
• Exposure to sunlight is the most common cause
of this, and most cancers
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Signs and Symptoms of Basel
Cell Carcinoma
• Firm, pearly bump with tiny blood vessels
in a spiderlike appearance
(telangiectasias)
• Red, tender, flat spot that bleeds easily
• Small, fleshy bump with a smooth, pearly
appearance, often with a depressed center
• Smooth, shiny bump that may look like a
mole or cyst
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Signs and Symptoms of Basel
Cell Carcinoma
• Scarlike patch of skin, especially on the
face, that is firm to the touch
• Bump that itches, bleeds, crusts over, and
then repeats the cycle and has not healed
in 3 weeks
• Change in the size, shape, or color of a
wart or mole
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Treatments for Basal Cell
Carcinoma
• Most common treatment is surgery to
destroy or remove the entire skin growth
• Mohs micrographic surgery, originally
known as chemosurgery
– Microscopically controlled surgery to remove
skin cancer is very effective, with cure rates
higher than 90 percent
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Squamous Cell Carcinoma:
Indicators and Risks Factors
• Indicators:
– Changes to an existing wart, mole, or other skin
lesion
– Development of a new growth that ulcerates and
does not heal well
• Risk factors include:
– Genetic predisposition
– Chemical pollution
– Overexposure to X-rays or other forms of
radiation
– Exposure to arsenic
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Signs and Symptoms of
Squamous Cell Carcinoma
• Any skin lesion, growth, or bump that is
small, firm, reddened, nodular, coned, or
flat in shape
• If the surface is scaly or crusted and the
lesion or growth is located on the face,
ears, neck, hands, or arms
• Occasionally the growth may occur on the
lip, mouth, tongue, or genitals
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Treatment Options for Squamous
Cell Carcinoma
• Surgical removal of the tumor, which may
include removal of the skin around the
tumor
• Microscopic shaving (Mohs micrographic
surgery) may remove small tumors
• Skin grafting may be needed if wide areas
of skin are removed
• Radiation treatments
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Malignant Melanoma
• Originates in the melanocytes of the skin
• Develop when the cells do not respond to the
normal control mechanisms of cellular growth
• The primary tumor begins in the skin
• Once it becomes invasive, it may progress
beyond the site of origin to the regional lymph
nodes or travel to other organ systems in the
body
• Usually diagnosed by using the ABCDE rule
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The ABCDE Rule
• A–Asymmetry - The mole does not have
two halves that match each other
• B–Border - The border is ragged, notched,
or blurred together
• C–Color - Color is uneven; shades of
black, brown, or tan are present; there
may be areas of white, red, or blue
present
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The ABCDE Rule
• D–Diameter - There may be a change in
size, and the mole is typically greater than
6 mm in diameter
• E–Elevation - The mole sits above the
surrounding tissue
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Signs and Symptoms of
Malignant Melonoma
•
•
•
•
•
•
•
Change in size
Change in shape
Change in color
Inflammation
Crusting and bleeding
Sensory change
Diameter greater than
7 mm (0.28 in.)
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Acne Vulgaris
• Occurs when oil and dead skin cells clog the
skin’s pores
• Most often affects teens, with more than 85
percent of them developing at least a mild
form
• While mild acne is merely annoying, severe
acne can lead to emotional and physical
scars
• Most people outgrow acne by the time they
are in their 40s and 50s
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Signs and Symptoms of Acne
Vulgaris
• Skin blemishes are often red and swollen
• With mild case of acne, only whiteheads
and blackheads may be present
• Severe acne can mean hundreds of
pimples or sores that can cover the face,
neck, chest, and back
• Cystic lesions are pimples that are large
and deep. These lesions are often painful
and can leave scars on your skin.
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Treatment of Acne Vulgaris
Courtesy of Jason L. Smith, M.D.
The severity of acne will determine the most useful
and beneficial treatment. Sometimes treatments
will be combined to get the best results and to
avoid developing drug resistant bacteria.
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Alopecia
Courtesy of Jason L. Smith, M.D.
The condition of baldness or loss of hair.
The most common form is male-pattern baldness,
also known as androgenic alopecia.
Women may also experience alopecia.
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Alopecia Areata
• Affects about 1 in 100 people, mostly
teenagers and young adults
• Causes patches of baldness that are
about the size of a large coin
• Usually appear on the scalp but can occur
anywhere on the body, including the
beard, eyebrows, and eyelashes
• Usually no other symptoms
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Critical Thinking Question
1. Why are some individuals more
susceptible to going bald?
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Male-Pattern Baldness
• Hereditary
• Called male-pattern baldness because it
tends to follow a set pattern
– The first stage is usually a receding hairline
– Followed by thinning of the hair on the crown and
temples
– When these two areas meet in the middle, there
is a horseshoe shape of hair around the back and
sides of the head
– Eventually the person may be completely bald
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Treatments to Address Baldness
• Drugs that treat both male and female
baldness
– These do not work for everyone and the
effects are typically not long lasting
• Lotions that can be rubbed on the scalp
– These do not work for everyone, nor do they
have long-lasting effects.
• Shampoos and formulas are available for
improving circulation to the scalp
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Cellulitis
Courtesy of Jason L. Smith, M D.
An acute spreading bacterial infection below the
surface of the skin. A cut, an abrasion, or ulceration
may precede cellulitis. Commonly appears in areas
where there is a break in the skin. Can be due to
local trauma, such as an animal bite.
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Signs, Symptoms, and
Treatments of Cellulitis
• Signs and symptoms include:
– Erythema (redness), warmth, swelling, and
pain. Fever, chills, and enlarged lymph nodes
may also accompany this infection.
• Treatments:
– Antibiotics, such as derivatives of penicillin,
that are most effective against the staph germ
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Contact Dermatitis
• An allergic reaction of
the skin caused by
irritating substances
coming in contact with it
• Causes include
exposure to poison ivy,
poison oak, nickel
(especially on jewelry
or jean snaps), lotions,
detergents, or other
chemicals
Courtesy of Jason L. Smith, M.D.
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Signs, Symptoms, and Treatments
for Contact Dermatitis
• Signs and symptoms:
–
–
–
–
Red and irritated skin
Vesicles (small blisters) and rash may appear
Itching and pain may be present
Serious allergic reactions may result in urticaria
• Treatments:
– Antihistamines (antiallergy medicines)
– Topical corticosteroid creams to reduce the
inflammation
– Systemic corticosteroids (oral medications)
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Calluses and Corns
• Excessive growths of the stratum corneum
layer of the epidermis that often occur on
the hands and feet
• Can be caused by physical bone
deformities or by other factors such as illfitting shoes and unprotected hands during
manual labor
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Signs and Symptoms of Calluses
and Corns
• Signs and symptoms of a callus:
– An area of thickened skin that does not have
an identifiable border
– May appear grayish-yellow, brown, or even
red; may cause no pain or it may produce
tenderness, throbbing, or burning
• Signs and symptoms of a corn:
– A distinct border with various textures that
appear most often on the feet
– May be hard or soft, and are generally painful
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Treatment of Calluses and Corns
• Treatment becomes necessary when the corns
or calluses become burdensome or painful
• Although patients with diabetes need to be
treated by a podiatrist to decrease the risk of
infection and increase wound healing, most
patients can treat these conditions by
themselves
• Placing a bandage on the corn or callus to
reduce friction is beneficial, as well as applying
lotions or creams to rough or hardened corns or
calluses
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Decubitus Ulcers
• Also called pressure sores or bedsores
• Refer to an area of skin and tissue that breaks
down
• Typically occur when constant pressure is
maintained on a specific area of the skin
• The constant pressure on the area decreases
the blood supply, causing death to the affected
tissue
• Common locations include hips, heels, ankles,
shoulders, back, and the back of the head
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Four Stages of Decubitus Ulcers
• Stage I – Reddened area on the skin that
does not blanch (turn white) when pressed.
• Stage II – Skin has a blister or an open sore.
The area around the site may be red and
irritated.
• Stage III – Skin breakdown looks like a crater
with damage to the tissue below the skin.
• Stage IV – The wound becomes so deep that
there is damage to the tissues beneath the
initial ulcer, including damage to bone and
muscle.
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Treatment of Decubitus Ulcers
• Begins with relieving pressure
• Special pillows, cushions, and sheepskin
are frequently used to ensure that there is
no pressure on the area. Repositioning
must be routine.
• Decubitus ulcers are typically debrided,
that is, cleaned of all the toxins, and then
medicated and covered with special gauze
dressings to help in healing
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Treatment of Decubitus Ulcers
• Protecting the wound from any further
injury is essential in order to protect the
patient from infections and other serious
complications and systemic sepsis
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Eczema
• Called atopic dermatitis
• Chronic skin condition caused by an
allergic-type reaction on the skin
• Heredity tends to play a role
• Most common in infants, and about half of
the cases disappear by age 3
• Signs and symptoms include scaling,
itching, and rashes
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Treatment of Eczema
• Lesions may appear dry or scaly, as well
as have a “weeping” appearance
• Weeping lesions are treated with mild
soaps and dressings
• Severe cases and dry scaly lesions may
be treated with mild, anti-itch lotions or
low-potency topical corticosteroids
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Treatment of Eczema
• Very severe cases may require systemic
corticosteroids and topical
immunomodulators (TIMs)
• Sometimes short periods of time in a
tanning bed are useful to dry up lesions
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Furuncles and Carbuncles
• Furuncles
– Also known as boils
– Abscesses of hair follicles and the adjacent
subcutaneous tissues
• Carbuncle
– A collection of furuncles
• The microbe involved in the disease
process is usually Staphylococcus aureus,
which lives harmlessly on the skin
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Signs and Symptoms
• Furuncles can appear red to purple in
appearance and are generally painful
• The area surrounding the furuncle tends to
become tender to the touch
• The center is generally white or yellow,
and is filled with pus
• Carbuncles can be anywhere from the size
of a pea to the size of a golf ball and are
similar in color to furuncles
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Folliculitis
• An infection or
inflammation of the hair
follicles
• Can occur anywhere
there is body hair
• Most often appears in
areas that become
irritated by shaving, the
rubbing of clothes, or
where follicles and pores
are blocked by oils and
dirt
• Common sites include the
face, the scalp, armpits,
and the legs
Courtesy of Jason L. Smith, M.D.
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Signs and Symptoms of
Folliculitis
• A reddened rash
• Raised, red, often pus-filled lesions around
hair follicles
• Pimples that eventually crust over and
occur in areas of a high concentration of
hair follicles such as the face under the
arms, on the scalp, and in the groin
• Itching at the site of the rash and pimples
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Treatment of Folliculitis
• Generally involves taking steps to
minimize damage to hair follicles by
avoiding clothing that will rub against the
skin
• Shaving with an electric razor as opposed
to a blade razor
• Keeping the skin clean using soap and
water and skin cleansers
• Application of antibiotic ointments
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Herpes Simplex Virus Type 1
(HSV-1)
• Usually affects the face
including the lips and
mouth
• Acquired during
childhood, it is the most
common herpes simplex
virus
• Characterized by lesions
inside the mouth or on
the lips including fever
blisters
• Antibodies are acquired
by 90 percent of
individuals by the time
they reach adulthood
Courtesy of Jason L. Smith, M.D.
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Herpes Simplex Virus Type 2
(HSV-2)
• Sexually transmitted
• Oral and genital lesions are common
• Some people do not display any signs or
symptoms
• Left untreated the virus can lead to
complications such as meningoencephalitis
or cause an infection of the eye
• Cross-infection of type 1 and 2 viruses may
occur from oral–genital contact
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Signs and Symptoms of Herpes
Simplex
• Mouth sores
• Burning or tingling sensation that is followed
by genital lesions
• Blisters or ulcers occurring on the mouth, lips,
gums or genitalia
• Fever blisters
• Fever—may be present especially during the
first episode
• Lymph node enlargement in the neck or groin
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Treatment of Herpes Simplex
• Mild cases of herpes simplex may not
require any form of treatment. In
prolonged cases, however, antiviral
medications may be used.
• In situations of prolonged occurrence or
frequent recurrence, individuals may
become immunosuppressed.
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Herpes Zoster
• Caused by the varicella-zoster virus
• Once a person has been infected with
chickenpox, the virus lies dormant in the
nerves
• After the virus reactivates, it is diagnosed
as shingles or herpes zoster
• Herpes zoster can be very painful
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Signs and Symptoms
• Pain, a burning, tingling, and itchy feeling
may be exhibited
• Red rash with fluid-filled blisters begins to
develop and numbness or sensitivity in a
certain part of the body may occur
• In serious conditions the skin can remain
painful and sensitive to the touch
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Signs and Symptoms
• Most symptoms occur on one side of the
body, wrapping around from the back to
the sternum, following the path of the
nerve where the virus had been dormant
• Headache, fever, chills
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Treatment of Shingles
• Early treatment can help shorten a shingles
infection and reduce the risk of complications
• Oral antiviral medications generally
prescribed within 48 to 72 hours of the first
sign of the rash
• Corticosteroids are sometimes prescribed in
order to reduce swelling and pain
• When pain is severe, oral analgesics or a
skin patch that contains a pain-relieving
medication may be required
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Hirsutism
• A condition of thick abnormal hair growth
that affects men and women
• Women are more commonly affected by
and diagnosed with the disorder
• Often with this skin disorder, women have
a pattern of hair growth that is typically
found on males
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Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Signs, Symptoms, and Treatment
of Hirsutism
• Sign and symptoms:
– Women will develop thick and dark hair growth
– Common areas for the excessive hair growth
include the face and chest
– Often linked to endocrine disorders such as
problems with the ovary or adrenal glands
• Treatments:
– Removing the unwanted hair
– Physicians may also prescribe medications that
block androgen hormones, helping to decrease
the amount of hair growth
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Impetigo
Courtesy of Charles Stewart,
M.D. and Associates.
Courtesy of Jason L. Smith, M.D.
A skin infection caused by bacteria.
Most common in children and is very contagious.
Can originate in intact skin, but also can be secondary to a
preexisting skin condition or trauma.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Signs, Symptoms, and Treatment
of Impetigo
• Signs and symptoms:
– Round, crusted oozing spots that grow larger day
by day. A honey-colored crust often develops
from blisters that burst and ooze fluid.
– Commonly occurs around the nose and mouth.
• Treatment
– Mild cases of impetigo often resolve through mild
cleansing, removal of crust formations, and
topical antibiotic ointment.
– More severe cases may require the use of oral
antibiotics.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Keloids
• Often referred to as
hypertrophic scars
• Typically appear
following a surgery or
injury
• Burns and piercings
have been known to
produce keloids
Courtesy of Jason L. Smith, M.D.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Signs and Symptoms and
Treatment of Keloids
• Signs and symptoms:
– Can appear thickened and raised while being
red or pink in color
– Tend to be itchy and bothersome, as well as
tender to the touch
• The most common treatments include:
cortisone injections, surgery, laser
removal, cryosurgery, interferon injections,
and the usage of silicone sheets
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Pediculosis
An infestation of the eggs, larvae, or adult lice.
Forms of pediculosis include: Pediculus humanus capitis
(head louse), Pediculus humanus corporis (body louse),
and Pthirus pubis (pubic louse).
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Signs and Symptoms of
Pediculosis
• The most common symptom among all
forms of lice is itching
• Head lice tends to cause itching around
the back of the head or around the ears
• Itching surrounding the genitals is an
indicator of pubic lice
• Body lice tend to travel to the body to feed
on skin and then return to clothing
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Treatment of Pediculosis
• Pyrethrins found in over-the-counter medicated
shampoos and cream rinses is preferred for the
treatment of head lice
• Nit combs are available to help remove nits from
hair
• Lindane-based shampoos are another form of
medicated treatments. Unlike pyrethrin-based
shampoos, lindane-based shampoos require a
prescription.
• In order to ensure that eggs have not survived,
retreatment after 7 to 10 days is recommended
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Psoriasis
• Affects an estimated
7.5 million Americans
• Most commonly
between ages 30-50
• Condition has genetic
and autoimmune
characteristics
• Thought to be caused
by a buildup of dead
skin cells
Courtesy of Jason L. Smith, M.D.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Signs and Symptoms of
Psoriasis
• Episodes of redness, itching, and thick dry
scales on the skin
• Onset can be gradual or abrupt
• Flare ups have been attributed to infections,
obesity, lack of sunlight as well as sunburn,
stress, poor health, and cold climate
• When the case is severe and widespread,
large quantities of fluid can be lost, causing
dehydration and severe secondary infections
that can be serious
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Treatment of Psoriasis
• Analgesics, sedation, intravenous fluids,
retinoids and antibiotics
• Mild cases are treated at home with topical
medications such as prescription or
nonprescription dandruff shampoos,
cortisone or other corticosteroids, and
antifungal medications
• Severe lesions may require hospitalization
for proper treatment
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Rosacea
•
•
•
•
A disorder primarily of the facial skin
Often characterized by flare-ups and remissions
Affects an estimated 14 million Americans
Signs and symptoms include:
– Redness on the cheeks, nose, chin, or forehead
– Small visible blood vessels on the face, bumps on the
face, and watery or irritated eyes.
– Over time, the redness becomes ruddier and more
persistent
• Therapies and medications are available to treat
the symptoms associated with rosacea
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Scabies
• A highly contagious disorder of the skin
• Caused by the human or scabies itch mite
• Spread by personal contact, such as by
shaking hands, sleeping together, or by
close contact with infected articles such as
clothing, bedding, or towels
• Common among schoolchildren,
roommates, and sexual partners, scabies
is usually found where people are crowded
together
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Scabies
• Sides of the fingers, backs of the hands,
wrists, heels, elbows, armpits, inner
thighs, and the waist line are common
locations for scabies
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Scabies
Courtesy of Jason L. Smith, M.D.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Signs, Symptoms, and Treatment
of Scabies
• Signs and symptoms include:
– A very small zigzag blister
– Intense itching and a red rash that occurs
around the area
• Treatment includes:
– Sulfur in a lotion or cream with a 6 to 10
percent concentration
– Corticosteriods and antihistamines are often
used to relieve itching
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Seborrheic Dermatitis
• An inflammatory condition of sebaceous or
oil glands caused by an increase in sebum
• Most common in infants and children and
is frequently known as “cradle cap”
• Signs and symptoms include:
– Yellow or white scales that attach to the hair
shaft, thick or patchy crusts on the scalp,
itching or soreness, as well as dandruff
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Seborrheic Dermatitis
• Treatment includes
– Low-strength creams
– Shampooing the scalp daily with medicated
shampoo
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Tinea Corporis
• Sometimes called ringworm
• Not actually a worm but an integumentary
disorder caused by a fungus
• Can appear anywhere on the body.
• If the fungus is on the head, it is called
tinea capitis
• On the foot, it is known as tinea pedis or
athlete’s foot
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Tinea Corporis
• When found in the genital area, it is
referred to as tinea cruris. Tinea cruris is
more commonly referred to as jock itch.
• Elsewhere on the body, the fungus is
called tinea corporis
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Ringworm
Courtesy of Jason L. Smith, M.D.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Urticaria
• Known as hives
• A severe itching due to
acute hypersensitivity to
medications or
environmental stimuli
• Major concern is that it
can obstruct the
pharyngeal airway.
Because of the possibility
of airway constriction, it is
important to observe all
patients after an injection
or allergy tests.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Signs, Symptoms and Treatment
of Urticaria
• Signs and symptoms include:
– Localized areas of pink, itchy swollen patches of skin
– Common for burning or stinging sensations also to be
felt
– Hives may vary in size from the diameter of a pencil
eraser to the diameter of a cereal bowl
– Many times, the hives may overlap, forming even
larger areas of irritation and swelling
• Treatment consists of:
– Removing the causative allergens and treating with
antihistamine and epinephrine
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Vitiligo
• Known as leukoderma
• A disorder that causes white patches and large
areas of decreased pigmentation to form on the
skin
• Patches form due to the destruction of
melanocytes, which are cells that produce
melanin
• Disease often linked to the immune system such
as Addison's disease or pernicious anemia
• Affects those with thyroid disorders
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Treatment of Vitiligo
• Aimed at evening skin tone and color
• Done by cosmetic, medical, or surgical means
• Avoiding tanning and the use of sunscreen helps
make the depigmentation less noticeable
• Makeup and self tanning lotions may also be
used to even out the skin tone
• Medical treatments may include the use of
topical corticosteroid therapy as well as a form of
topical ultraviolet therapy
• Skin grafting as well as a form of tattooing called
micropigmentation may also be successful
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Warts or Verruca
• Type of infection caused by viruses in the
human papillomavirus (HPV) family
• There are at least 60 types of HPV viruses
• Warts can grow on all parts of the body,
including the skin, the inside of the mouth,
the genitals, and the rectal area
• A common wart is the plantar wart which is
located on the soles of the feet
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Signs, Symptoms, and Treatment
• Signs and symptoms include:
– The appearance and texture of a wart will vary based
on its location
– Warts may appear grainy, fleshy, and may vary in
color from flesh-toned to red, pink, or white
– Warts may also appear as raised or flat skin lesions
• Types of wart treatments include:
– Over-the-counter medicines containing salicylic acid
– Cryotherapy which freezes the wart
– Various prescription medications
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Medical Skin Care Treatments
• Performed due to the desire to capture a
youthful skin radiance and appearance
• Many of the procedures are performed in a
dermatologist’s office, or in a medical spa
setting by trained and experienced
professionals
• Patients should always use discretion
when choosing a health care professional
that specializes in this area of expertise
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
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Botox
• Popular procedure that is indicated for
reducing wrinkle lines
• Most often used for frown lines, the
forehead, and wrinkles around the eyes
• A very small, diluted amount of the toxin
Clostridium botulinum is injected into the
wrinkle lines
• Toxin causes wrinkles to relax and soften,
therefore diminishing their visibility
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Botox
• Procedure is usually repeated every four
to six months
• Side effects include headaches, bruising,
and eyelid drooping, all of which are
temporary
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Light Chemical Peel
• Purpose is to reduce the size of pores,
make the skin appear softer, and produce
more coloring in the skin
• During a light chemical peel only the top
layer of the skin is stripped
• The procedure is complete in about an
hour and it leaves the skin mildly red,
which disappears as time progresses
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Medium Chemical Peel
• Purpose of a medium chemical peel is to
reduce wrinkles and result in a much
smoother skin than that of the light chemical
peel
• Peel will result in the top layer and some
underlying cells being stripped, causing
collagen and elastin to be stimulated
• Recovery from a medium chemical peel can
last up to 10 days due to peeling, swelling,
and redness that occurs after the treatment
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Deep Chemical Peel
• An aggressive treatment that can affect
the layers of skin down to the dermal layer
• Results are aimed at reducing all signs of
aging with the exception of certain areas
of the face
• With this level of a chemical peel, skin
conditions such as pigmentation disorders
and precancerous lesions can be removed
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Deep Chemical Peal
• Healing process includes considerable
pain, often felt up to 12 hours post surgery
• Analgesic medications are required. It may
take weeks for additional peeling, swelling,
and redness to subside.
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Laser Resurfacing
• Newer treatment to reduce the signs of
aging
• Short, pulsated laser beams are used to
vaporize damaged or troublesome areas
of the skin
• Full-face laser resurfacing takes
approximately 1-2 hours; partial-face
resurfacing lasts 30-45 minutes
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Laser Resurfacing
• Resurfacing results in the stimulation and
production of new collagen and skin cells
• Immediately following the procedure
antibiotic ointment and sterile dressings
are applied to reduce the incidence of
infection
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
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Microdermabrasion
• Involves removing the top layer of dead
skin cells
• Tiny crystals are used to work with
abrasion and suction devices to produce
healthier-looking skin
• This noninvasive and non-chemical
approach is appealing to many patients
who do not wish to pursue more
aggressive skin-freshening treatments
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Microdermabrasion
• Candidates for microdermabrasion include
those who wish to erase signs of aging
including fine lines, wrinkles, and sun
damaged skin
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Questions?
Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e
Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.