Transcript Integumentary System D.Dx

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