Transcript Skin Pathology with Clinical Considerations Chapter 3

Skin Pathology with Clinical
Considerations
Chapter 3-UNIT 2
CLASSES OF 2018 AND 2016
Medical Terminology
Dr. Gray
Skin Pathology
• Acne• Two varieties:
– - Acne rosacea- Occurs in adults with redness,
macules (pimples), and ruptured blood vessels.
This is found mainly on the face.
– - Acne vulgaris- Occurs in adolescents, consits of
papules and pustules.
Skin Pathology
• Tumors arising from the basal cell layer of the
epidermis: Two common types– (a) Basal cell carcinoma- Frequent type of skin
cancer which results from excessive exposure to
the sun. Rarely metastizises or spreads.(p. 59)
– (b) Malignant melanoma- Malignant form of skin
cancer which arises from uncontrolled growth of
the melanocytes. Quickly metastizises and
spreads to internal organs. (p. 62)
Skin Pathology
• Squamous Cell Carcinoma- Malignant cancer
of the epidermis layer of the skin. May invade
deeper tissue. Very aggressive. (p. 62)
• Kaposi’s sarcoma- Skin cancer variant found
mainly in the AIDS patient population.
Brownish-purple papules that spread from the
skin and attack internal organs.
Skin Pathology
• SLE-systemic lupus erythematosus: Chronic
inflamation of connective tissue which affects
many of the structures containing connective
tissue. Patients have a characteristic
“butterfly rash” across the face. (p. 62)
Skin Pathology
• Fungal infections:
• Tinea- Fungal skin disease characterized by
pruritis (itching) and sca.
• There are several specific types of fungal tinea
lessions depending on body location:
a. Tinea Capitis-Fungal infection of the
scalp area (ringworm)
•
b. Tinea Pedis-Fungal infection of the
foot (athletes foot)
Skin Pathology
• Viruses of the skin:
• Varicella and Rubella (German measels)
1. Varicella appears as a rash on the trunk
which spreads to the limbs. Associated with
scab formation. This was very common before
the introduction of the varicella zoster virus
vaccine (VZV). This is a form of the herpes
family of viruses (Chicken pox).
Skin Pathology
• Rubella- Contagious viral skin infection.
• Tx of varicella and rubella lessions- Usually
with the antiviral class of medications
(valacyclovir (Valtrex), acyclovir (Zovirax),
famcyclovir).
Skin Pathology
• Gangrene:
• Destruction and wasting of skin and underlying
structures due to the absence of blood supply.
Seen commonly in diabetic patients and patients
with chronic blood problems.
• -Two varieties:
• Wet Gangrene-secondary bacterial infection.
• Dry Gangrene- w/o the secondary bacterial
infection
Skin Pathology
• Tx of gangrene lessions:
• Surgical debridement of the dead or
damanged tissue in the area of the wound or
for severe gangrene-surgical amputation.
• Wet gangrene-in a mild form-could be
approached by a surgical debridement and
course of antibiotic therapy (bacitracin,
neomycin, polymixinB)
Skin Pathology
• Pediculosis• Lice-common in elementary school children
and areas with very poor sanitation and
hygiene.
Combination therapy
Tx of pediculosis- Antiparasitic (lindane,
permethrin)
ALSO, for the treatment of the pruritis• Antipruritic- (diphenhydramine, Benadryl)
Skin Pathology
• Graft Procedures:
• Allograft-skin graft from one patient to
another.
Autograft-graft from a person’s own body
• Heterograft-skin graft from anothr species or
animal
• (Xenogaft)-graft from an animal (feotal pig is
common for skin grafts for humans)
Xenografts come from animals-usually
fetal pigs.
Skin Pathology
• BURNS- first, second, third degree.
• Severity of a burn is determined by the amount
of body surface (skin) involvement and the depth
of involvement of tissue destruction.
• Rule of nines (p. 61) is often used to assess the
extent of damage.
• -Superficial (first degree burn)
• Partial Thickness (second degree burn)
• Full Thickness (third degree burn)
Skin Pathology
• Laboratory tests:
• Culture and sensitivity- allows for the
controlled laboratory growth and
identification of an unknown colony of
bacteria for the purpose of determining drug
sensitivity. What drug will kill the bug.
Skin Pathology
• Biopsy-Removal of tissue by several different
means (knife, punch, or brush) to be prepared
by surg path as a specimen for histology prep
and microscopic exam. Tissue sample which
eventually ends up on a glass histology slide.
Skin Pathology
• Exfoliative cytology• Cell scrapings which are prepared for microscopic
examination.
• Frozen section- rapid slide prep from a quickly
frozen tissue sample-ready in 5 minutes or less
for report to surgeon from the surgical
pathologist.
• Fungal scrappings- Fungal colony from a tissue or
lession scrapping which is observed and
examined for ID of fungal growth.
Skin pathology
• Surgical Procedures:
• Cauterization- Destruction of tissue by using caustic
chemicals, electricity, heat, and extreme cold.
• Cryosurgery-Use of extreme cold to destroy tissue.
• Curettage- Removal of superficial skin lessions with a
scrapper shapped like a spoon.
• Debridement-Removal of dead tissue from a wound area.
• Electrocautery- Destroying tissue with an electric current.
• Incision and drainage- Making an incision for the removal of
infectious pus material.