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Pathology Exam 1 lecture 7
Integumentary System
50
Pathology
Graduate
07/19/2016

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Term
integumentary system functions
Definition
protection, thermoregulation, fluid regulation
Term
integumentary, % of body weight
Definition
15-20% of BW
Term
causes of skin lesions
Definition
Contact with toxins , chemicals
Contact with infective organisms
Reactions to meds
Physical Trauma
Hereditary Factors
Reaction to allergens
Reaction to Radiotherapies
Systemic Origin ( liver, kidney, GI)
Burns
Neoplasm
Term
signs and symptoms of skin disease
Definition
-pruritis - itching
- Uticaria - hives
- rash
- blisters - fluid
- Xeroderma - dry skin
- edema
- changes in nail appearance
Term
overall skin structure
Definition
-epidermis: surface
- dermis: hair follicle, sebaceous gland
- subcutaneous tissue: blood vessels, fat,
Term
skin changes with aging
Definition
-decreased sensation
-decreased vascularity
-decreased langerhorn cells (weakened immune response)
-decreased collagen = wrinkles
Term
common types of dermatitis
Definition
aka: eczema
1. atopic
2. contact
3. stasis
Term
atopic dermatitis
Definition
cause unknown, associated with allergic, hereditary
Term
contact dermatitis
Definition
causes: exposure to chemical, mechanical, physical, biological agent (modalities)
-immune system recognizes the irritant as toxic
Term
stasis dermatitis
Definition
Skin inflammation in the lower legs caused by fluid buildup. indicative of venous insufficiency
Term
stages of dermatitis
Definition
- Acute Dermatitis: red, exudate, crusting
- Subacute Dermatitis: red , scaling, papules ( small solid Raised Spot)
- Chronic Dermatitis: thickened skin, fibrotic papules and nodules hyperpigmentation
Term
treatment of dermatitis
Definition
- Medical – topical or systemic anti--inflammatory
- Hydration and lubrication of the skin
- Caution with modalities
- Avoid shearing
Term
types of skin infection
Definition
Bacterial
Viral
Fungal
Parasitic
Term
bacterial skin infections
-transmission
- types
Definition
transmission - usually enter through the skin
types:
-impetigo: Staph or Strep
-CEllulitis: S. pyogens or Strep
Term
Viral skin infection types
Definition
Herpes 1 - cold sores
Herpes 2 - genital
Herpes 3 - chicken pox/shingles
Term
fungal skin infections
Definition
- live in superficial layers
- transmission via contact
- types:
ringworm (Tinea corporis)
athletes foot (Tinea pedis)
-Treated with OTC topical MEDS
Term
Parasitic Infections
Definition
-Causes - insects & animals
- Transmission contact
- Types: Scabies(mites), Pediculosis(lice)
- Treatment: scabicide lotion
Term
Skin cancer causes
Definition
-causes: Exposure to UVB
-Types:
*benign
*premalignant
*Malignant
Term
types of malignant skin cancer
Definition
1. Basal cell carcinoma – high cure rate
2. Squamous cell carcinoma
3. Malignant Melanoma -worst
Term
Method of early Melanoma detection
Definition
ABCDEFGH
-Asymmetry, lopsided
-Border irregularity
-Color: black, brown, red, white, pink, blue
-Diameter: larger than pencil eraser
-Elevation (raised)
-Fragile (tender to touch, bleeds easily)
-Growing (change in size)
-Hair, growth or falling out, changes in thickness
Term
Seborrheic Keratosis
Definition
a benign skin cancer
raised lesion from basal cells
Term
Nevi
Definition
moles
aggregation of melanocytes
Term
actinic keratosis
-What is it? structural
-Cause
-risk
Definition
precancerous skin cancer
-flat, dry, round or irregular
-caused by sun overexposure
-can progress into squamous cell carcinoma
Term
Basal cell carcinoma
-what is it?
-Causes
-Treatment
Definition
malignant skin cancer
-slow growing epithelial basal cells
-rarely metastisizes-can damage surrounding
-Causes: prolonged UV exposure,
-Treatment: Mohs
Term
Squamous cell carcinoma
Definition
-DANGEROUS Malignant skin cancer
-grows quickly,
-Types: In situ(confined to site) & Invasive(invades surrounding tissue)
-Cause: Exposure to UV, presence of precancerous lesions
-Treatment: biopsy and excision
Term
Malignant melanoma
-characterisitcs
-types
Definition
-originates from melanocytes, agressively spread
1.Superficial spreading melanoma (most common)
2. Nodular melanoma
3. Lentigo maligna melanoma
4. Acral lentiginous melanoma
Term
Malignant melanoma
-risk factors and treatment
Definition
---RISK FACTORS---
Fair skin ( blonde or red hair)
UV exposure ( especially intense exposures)
Family history

---TREATMENT---
Biopsy and Excision
Term
Kaposi's sarcoma
-what is it?
-who's susceptible?
-where in the body? Showing?
-treatment?
Definition
-malignancy of vascular tissue
-common in Asian and AIDS
-Usucally metastisizes the lymphs of lower extremeties (red, dark blue or purple macules that progress to nodules or ulders)
-Treatment: Chemo or Antiviral therapies
Term
Psoriasis - characteristics
Definition
- chronic, inherited, , recurrent, inflammatory but non-infective dermatosis
- shows as itchy, painful, dry cracked skin
Term
psoriasis causes, triggers, and treatment
Definition
-cause unknown, but there is a hereditary component
-triggers: UV, stress
-Treatment - management
Term
psoriatic arthritis
-who's affected?
-symptoms
-treatment
Definition
- affects 10% of people with psoriasis
- shows as joint pain, effusion, stiffness. (the pain is worse when immobilized)
- treated with management and long wave UV
Term
seal's skin disorder
Definition
Cutaneous Lupus Erythematosus
Term
Cutaneous Lupus Erythematosus
what is it?
-cause?
Definition
-chronic skin rash on sun exposed skin, autoimmune
-cause unknown
Term
Cutaneous Lupus Erythematosus
-symptoms
-treatment
Definition
-malaise, fever, arthralgia, fatigue, hair loss

-treat: management and corticosteroid creams
Term
Systemic sclerosis
-what is it?
-Mortality rate
Definition
immune disorder of the skin, diffuse disease of the connective tissue causing fibrosis of skin , joints, blood vessels , and internal organs
30% die within 5 years
Term
Systemic sclerosis
-symptoms
-stages
-treatment
Definition
-symptoms: skin firm, taut, bound to the subcutaneous tissues
-Stages:
1. Edamatous: edema in the extremities
2. sclerotic: edema turns sclerotic
3. atrophic

Treatment: pain control, avoid contractures (stay mobile, keep stretched)
Term
Raynaud Phenomenon
Definition
-response to stress or exposure to cold
- blood vessels spasm (hands and feet)
-blood can't get through. blanching, cyanosis
-usually return to normal after being rewarmed
Term
frostbite
Definition
thermal injury to the integumentary, occurring at temperatures below 35.6 degrees

treat by heating up slowly
Term
first degree burn
-depth
-cause
-appearance
-pain?
Definition
-depth: epidermis
-cause: UV light, brief exposure to flash, flame, or hot liquids
-appearance: erythema, blanches with pressure, no blisters
-yes pain
Term
second degree burn
-depth
-cause
-appearance
-pain?
Definition
-depth: into the dermis
-Cause: scalding liquids or solids. Deep burn is from immersion scald or flame.
-yes pain
-appearance: blisters, edema, wet shiny surface
Term
thirds or fourth degree burn
-depth
-cause
-appearance
-pain
Definition
-depth: into the subcutaneous tissue
-cause: prolonged exposure/scalding, chemical, steam
-appearance: variable color, dry surface, edema, fat exposed, tissue disrupted
-no or little pain
Term
rule of nines
Definition
quick way of describing extent of burn
-arm = 9%
-leg = 18%
-anterior thorax = 18%
-face = 9%
Term
Burn complications and treatment
Definition
-risk infection and pulmonary dysfunction with pulmonary burns
-treatment: debridement, dressing changes, positioning, continued ROM
Term
Pressure ulcer risk factors
Definition
-Unrelieved pressure
-More prominent over bony prominences
-Friction /Shearing
-Maceration
-Poor nutrition/ blood supply
-Decreased sensation
Term
pressure ulcers, treatment
Definition
-Prevention – most important!
-Removing causative agent
-Keeping the wound clean
-Topical antibiotics
-Wound dressings/debridement
-Modalities
Term
stage 1 pressure ulcer
Definition
-intact skin
-localized redness/discoloration, usually over bony prominence
Term
Stage 2 pressure ulcers
Definition
-partial thickness loss of dermis/shallow opening.
-red/pink wound bed
Term
Stage 3 pressure ulcer
Definition
-full thickness tissue loss
-subcutaneous fat may be visible
-may include undermining and tunneling
Term
stage 4 pressure ulcer
Definition
-full thickness tissue loss with exposed tendon or muscle. Slough or eschar may be present.
-may include undermining and tunneling
Term
Braden Scale for
-use
-components
Definition
Predicting Pressure Ulcer Risk
-sensory perception
-moisture
-activity
-mobility
-nutrition
-friction and shear
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