Transcript Diseases and Disorders of the Integumentary System

Diseases and Disorders of the
Integumentary System
Conditions
• Some external or superficial conditions
can give the doctor clues as to what is
wrong with the patient
• These are based on color of the condition
Cyanosis
• Certain disease can
cause the skin to take
on a bluish color
– Methomeglobenemia,
from nitrates in the
water
– Tetrology of Fallot
(congenital heart
condition)
– Reduce pulmonary
function, reducing
oxygen availability to
the body
Erythema
Fifth’s Disease
• Redness of the skin
due to
– Rash
– Redness due to
Sulfa drug
allergic reaction
Lyme’s
Disease
•
•
•
•
•
•
heat
Photosensitivity
Ultraviolet radiation
Medications
Birth control pills
Ulcerative colitis,
Crohn’s Disease
• Fifth’s Disease
• Laptop on your lap for
extended period of
time!
Bronzing of Skin
• 19 known diseases can
cause skin bronzing,
which looks like a suntan
• Increased pigmentation
on the elbows, knees,
heels, and palms due to
hyperpigmentation in
those areas
• Can also be caused by
Addison’s Disease,
Chronic Kidney Disease,
Adrenal Hyperplasia,
biliary cirrhosis, and
many diseases
Pallor
• Lack of coloration to the
skin (loss of “pinkness”)
• Usually due to lack of
oxygen to the body
because of shock, stress,
illness, migraine, Vitamin
D deficiency, frostbite,
hypoglycemia, and much
more
• Mucous membranes
appear very pale
Jaundice or Cholestasis
Yellow coloration of eyes,
skin, and mucus
membranes
Usually due to excess
bilirubin in the blood from
excessive erythrocyte
breakdown
liver overloaded or
damaged
bilirubin cannot be
processed for use by gall
bladder and digestive
system
Bronzing
• Bronze color similar
to a tan, but with a
metallic sheen; can
be in form of
hyperpigmentation
spots
• Causes: Addison’s
Disease & Cushing’s
Disease;
overproduction of
cortisol from adrenal
glands
Bruises
• Cause: broken
capillaries under the
skin due to intense
pressure
• Colors range from
deep blue-black,
purple and red to
yellowish-green
Genetic Disorders
Oculocutaneous Albinism
• Cause: loss of genetic
information for
melanin production in
hair, eyes and skin
• Human albinos have
very light blue eyes,
not pink!
• Inherited trait – must
inherit genes from
both parents.
Porphyria
• Cause: inheritance of
genes that cause body to
lack a certain enzyme or
acquired in life
• Red blisters, breakdown of
skin, photosensitivity,
itching, swelling, fine,
lanugo-like hair growing on
forehead and body
• Believed to have given rise
to myth of lycanthropy or
were wolves
Hypertrichosis or “Werewolf
Disease”
• Abnormal growth of
terminal hair
• Congenital or
acquired
Stephen Bibowski, known as
Lionel the Lion-Maned Man
Harlequin ichthyosis
• Congenital skin disorder
caused by thickening of
the keratin in the
epidermis
• Skin contains massive,
diamond-shaped scales
as skin cracks
• Allows bacterial infections
to occur
• associated with a
mutation in the gene for
the protein ABCA12
Rosacea
• Cause is unknown; not
believed to be genetic
• Chronic inflammation and
dilation of capillaries and blood
vessels under the skin
• Exacerbated by heat, food,
alcohol, caffeine, hot spices
• Skin may thicken in these
areas, making skin bumpy,
especially on cheeks and nose
(nose growth called
Rhinophyma)
• Some areas more sensitive
and may develop pustules
• Begins in teen years, gets
worse as age
• Can also occur in the eyes!
Mongolian Spot
• Common in persons of
Latino, Asian, East
Indian and African
heritage; 10% of
Caucausians
• Caused by excess
melanocytes in affected
area; form just before or
just after birth; areas
have a wavy edge
• May fade with age
Port Wine Stain or Hemangioma
• Cause:congenital
feature at birth of
excess caused by
enlarged capillaries
under the skin
• Can be treated with
laser therapy
Microbial Diseases
Virus, Bacterial, or Fungal
Boils and Carbuncles
• Cause: infection of hair
follicles with
Staphylococcus aureus
bacteria
• Enter through a scratch,
cut, or break in skin
• Bacteria encounter white
blood cells and are killed;
forms pus in a painful
nodule under the skin that
rises up
• Boils and carbuncles can
either be lanced or can
be “expressed”
(squeezed) if a white
“head” appears
Cold Sores, Fever Blisters
• Cause: Herpes Simplex 1
virus
• Virus hibernates in the
trigeminal nerves of the
face which ennervates
the nose, eye, lips and
cheek
• In active condition forms
the “cold sore” on the lip
• Person is HIGHLY
contageous!
• In immune-compromised
patients, cold sores can
spread to nose and eyes
Syphilis
• STD caused by
Treponema pallidum
• Highly contageous
• Transmitted congenitally
to fetus
• Primary – active form;
appearance of painless
chancre on genitals
• Secondary – skin rash,
sore throat, fever, swollen
lymph glands,
headaches, weight loss,
patchy hair loss
• Tertiary – affects nervous
system, can cause
insanity
Genital Herpes
• Cause: Herpes Simplex 2 virus
• Contagious when developing
sores or with open sores
• Forms on the genitalia and
anus
• Person will experience
“prodromal symptoms” of
tingling, itching or burning
before lesions appear
– VERY contageous at this point
• Use of Acyclovir or Valtrex,
both which can control
outbreaks
• Use of condom during sex is
recommended between
outbreaks
Impetigo
• Caused by Streptococcus
Group A bacteria or
Staphylococcus aureus
• Bacteria usually infect
area already
compromised by poison
ivy, sunburn
• Scratching affected area
with dirty fingers
• Occurs predominately in
summer
• Occurs predominately in
pre-school or schoolaged children
Psoriasis
• Caused by rapid cell
turnover of the
cutaneous epidermis
due to an immune
system overload to
the skin
• Occurs more often in
adults
• Family history or none
Measles or Rubiola
• Caused by a
paramyxovirus
• Inhaled
• Highly contageous
• Asymptomatic incubation
period of 9-12 days!
• Fever for three days
accompanied by cough,
conjunctivitis and coryza
(head cold symptoms),
along with Koplik’s Spots
(measles of the throat)
Cause not Certain
Vitiligo
Caused by loss of
pigmentation in spots all
over the body when
melanocytes stop
producing melanin in
those areas due to
a. Immune system
destroying the
melanocytes
b. Hyperthyroidism
c. Very severe sunburn
killing off melanocytes
d. Family history
Thrush
• Fungus Candidas albicans
• Normally found in mouth,
throat, intestinal tract, and
genitals
• Kept in balance by body’s
bacteria
• Gets “out of control” in
immunosuppressed patients
and babies, as well as women
who have a bacteria imbalance
• White patches in mouth
• “Cottage cheese” in vagina
• Emits 70 different toxins into
the body if gets into
bloodstream
Skin Cancer
Squamous Cell Carcinoma
•
•
•
•
•
•
•
•
•
•
Non melanoma cancer
Normal skin or skin that has been
inflamed
Earliest form called Bowen’s
Disease
Bump with scaly skin, crusting,
redness
More frequent in light-skinned,
blue or green eyes, blonde or redhaired hair individuals
Long term sun exposure; frequent
sunburns
Also many x-rays or chemical
exposure
Removed by excision, curettage,
burning, freezing
John’s Surgery – removing layer
by layer until no more cancer cells
Easiest to treat
Basal Cell
Carcinoma
• Non-melanoma cancer
• Slow, painless cancer
that originates in the
stratum basale layer of
the epidermis
• skin bump or growth that
is:
– Pearly or waxy
– White or light pink
– Flesh-colored or brown
• In some cases the skin
may be just slightly raised
or even flat.
Other Symptoms
•
•
•
•
•
You may have:
A skin sore that bleeds easily
A sore that does not heal
Oozing or crusting spots in a sore
Appearance of a scar-like sore without having
injured the area
• Irregular blood vessels in or around the spot
• A sore with a depressed (sunken) area in the
middle
Prevention and Treatment
• Prevention - same as for squamous cell
carcinoma
• Treatment – same as for squamous cell
carcinoma