Anatomy and Physiology
Skin is largest organ of body
 First line of protection for body against
invading organisms
 Provides sense of touch, heat, cold, and
pain

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Anatomy and Physiology
Helps stabilize temperature and fluid
and electrolyte balance
 Three layers

 Epidermis
 Dermis
 Subcutaneous
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Common Signs and Symptoms
Skin lesions
 Pain
 Pruritus
 Edema
 Erythema
 Inflammation

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Diagnostic Tests
Biopsy
 Culture and sensitivity
 Blood tests
 Microscopic smear examinations
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Herpes
Large family of viruses
 Symptoms: inflammation of the skin,
clusters or fluid-filled vesicles
 Not treatable and remains in affected
individual’s body for life
 Remissions and exacerbations
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Herpes

Common types
 Herpes Simplex I - “fever blisters and “cold
sores”
 Herpes Genitalis, Herpes Simplex II “genital herpes”
 Herpes Varicella - “chickenpox”
 Herpes Zoster - shingles
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Verruca (Warts)
Chronic condition
 Occur in multiples and differ in size,
shape, and appearance
 Often resistant to treatment
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Verruca (Warts)

Common types
 Appear on hands and fingers of children
 Plantar warts appear on sole of the foot
 Genital warts are sexually transmitted
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Impetigo
Streptococcus and staphylococcus
 Affects face and hands of children
 Symptoms: vesicles, pustules that rupture
producing yellow crust over lesions
 Treatment: cleansing and antibiotic ointment
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Folliculitis
Inflammation and infection of the hair
follicle usually by staphylococcus
 Symptoms: small pustules surrounding
hair
 Treatment: antibiotics
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Abscess, Furuncle, Carbuncle
Inflammation, infection, and formation of
a capsule prevent spread of infection
 Treatment: antibiotics
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Cellulitis and Erysipelas
Diffuse or spreading inflammation of
skin and subcutaneous tissue
 Cellulitis is caused by staphylococcus
 Erysipelas is a form of cellulitis caused
by streptococcus, which affects the face
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Cellulitis and Erysipelas

Symptoms
 Fever and chills
 Headache
 Vomiting
 Red, painful edematous skin

Treatment: IV antibiotics
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Lyme Disease
Multisystem infections transmitted to
humans through bite of infected deer
tick
 Symptoms

 Flu-like symptoms
 Arthritis
 Malaise
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Lyme Disease

Symptoms
 Chills and fever
 “Bull’s eye” skin rash

Treatment—antibiotics
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Tinea

Tinea
 Infects warm, moist areas of body
 Feeds on perspiration and dead skin

Symptoms
 Itching, cracking, and weeping of skin

Treatment: Wash and dry, antifungal
agents
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Tinea

Forms of Tinea
 Tinea Corporis: affects smooth skin on arms,
legs, and body
 Tinea Pedis: “athlete’s foot”
 Tinea Cruris: “jock itch”
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Tinea

Forms
 Tinea Unguium: finger or toe nails
 Tinea Capitis: scalp
 Tinea Barbae: bearded areas
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Candidiasis
Fungal infection caused by candida
 Symptoms

 Red, itchy skin with blisters and pustules

Treatment
 Antifungal medications
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Pediculosis
Infestation with lice
 Treatment: bathing and shampooing
with medicated shampoo (Kwell)
 Three types of lice

 Head, Body, Pubic
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Scabies
Caused by tiny mite
 Commonly called “seven year itch”
 Slightly elevated, grayish-white lines,
intense itching, vesicles, and pustules
 Treatment: lindane cream to entire body
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Acne Vulgaris
Inflammation of sebaceous glands and
hair follicles
 Symptoms: comedones
 Treatment: cleansing and OTC
treatments
 Severe cases: antibiotics, steroids, and
retinotic acid preparations
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Seborrheic Dermatitis
Affects the sebaceous glands
 Called “cradle cap in infants”
 Affecting the scalp is “dandruff”
 Symptoms: reddened, itchy areas,
scales
 Treatment: wash and dry, steroid
creams
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Sebaceous Cyst
Sebaceous gland becomes blocked and
sebum collects under skin
 Special type: pilonidal cyst
 Treatment: incising and draining,
surgical removal
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Eczema
Inflammation of skin
 Symptoms: itching, redness, vesicles,
pustules, scales, and crusting
 Treatment: topical cortisone,
antihistamines, and sedatives
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Contact Dermatitis
Acute or chronic allergic reaction of skin
 Causes: cosmetics, laundry products,
jewelry, pain
 Symptoms: small red localized lesions to
vesicular lesions
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Psoriasis
Chronic skin disease
 Symptoms: red, raised lesions with
distinct borders and silvery scales
 Treatment: coal tar medications,
ultraviolet light, and steroids
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Scleroderma
Hardening, thickening, and shrinking of
connective tissues, including skin
 Autoimmune reaction
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Seborrheic Keratosis
Benign overgrowth of epithelial cells
 Treatment

 Curettage
 Scraping off
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Keloid
Raised, firm, irregular-shaped scar
tissue following trauma or surgery
 Treatment: surgical removal
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Hemangioma

Congenital benign tumor of small blood
vessels that form a purplish birthmark
 Common types
○ Port wine stain
○ Strawberry hemangioma
○ Cherry hemangioma
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Actinic Keratosis
Premalignant condition
 Wart-like lesions on sun-exposed areas
 Common in fair-skinned individuals
 Treatment

 Topical medication such as Retin A
 Curettage or cryotherapy
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Squamous Cell Carcinoma
Tends to occur in sun-exposed areas
 Symptoms: firm red nodule with crusts
or slightly elevated plaque
 Treatment: wide surgical excision with
radiation treatments
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Basal Cell Carcinoma
Most common type of skin cancer
 Slow-growing, locally invading tumor
that does not metastasize
 Treatment: surgical removal
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Malignant Melanoma
Most serious type of skin cancer
 Symptoms: change in size and color of
mole
 Rarely occurs before age 20
 May be related to severe sunburn as child
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Malignant Melanoma

Treatment
 Depends on degree of spread
 May include wide surgical excision
 Radiation and chemotherapy
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Kaposi’s Sarcoma
Malignant vascular skin tumor
 Bluish-red cutaneous nodules
 No adequate treatment
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Abnormal Pigmented Lesions

Types
 Ephelis: freckle
 Lentigo: liver spot
 Nevus: mole
 Albinism: decrease or total absence of
pigment in the skin, hair, and eyes
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Abnormal Pigmented Lesions

Types
 Vitiligo: destruction of melanocytes in small
or large patches of skin
 Melasma: dark patches of skin on face,
especially the cheeks
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Diseases of the Nails
Abnormal shape, thickening, and color
 Fungal and bacterial infections are most
common cause
 Bacterial infections treated with antibiotics
 Fungal infections treated with antifungal
medications
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Diseases of the Hair
Hirsutism: excessive growth of hair
 Alopecia: partial or complete hair loss
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Mechanical Skin Injury
Abrasion: scraping away skin surface
 Blunt trauma

 Contusion by items such as a hammer or
club
 Thrown into items such as steering wheel
and wall
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Mechanical Skin Injury
Avulsion: skin or appendage is pulled or
torn
 Crush trauma: tissue is caught between
two hard surfaces
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Mechanical Injuries
Puncture injury: sharp object is forced
into tissue
 Laceration: cut in skin caused by a
sharp object
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Hyperthermia
Hyperthermia: body is overheated due
to excessive exposure to sun or heat
 Types

 Heat exhaustion
 Heat stroke
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Burns
First degree: pain, redness, and
swelling
 Second degree: pain, redness, swelling,
blisters, and open wounds
 Third degree: charred and broken skin
tissue, painless
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Cold Injuries
Not as severe or life threatening as heat
or burn injuries
 Low body temperature
 Symptoms:

 Extreme shivering and mental confusion
 Blue or cyanotic extremities and weak pulse
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Cold Injuries

Treatment
 Remove wet clothing
 Warm body with warm blankets
 Warm liquids

Frostbite: freezing of tissue, usually on
face, fingers, toes, and ears
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Electrical Injury
Unprotected or inadequately insulated
electrical wiring
 Contact with lightning
 Damage has a point of entry and exit
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Decubitus Ulcer
“Bedsore” or “pressure sore”
 Affects bony areas of body such as
heels, sacrum, elbows
 Treatment

 Frequent turning and repositioning
 Massage affected area to improve
circulation
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