Dermatology
Vickie Mickey,CT
Dermatology
• Study of skin, diseases, and treatment
• Electrologist encounter the presence of skin
disorders and diseases
• Electrologist must be able to identify
dermatology disorders in order to know when
to treat or not treat a skin disorder
• Certain skin disorders are contraindicated
Lesion
• Lesions are a structural change in the tissue
caused by trauma or disease
• Three types of lesions:
1. Primary
2. Secondary
3. Tertiary or vascular
Primary Lesions
•
•
•
•
•
First to recognize
Flat or non-palpable
Skin color changes may occur
Elevation can occur
Solid mass
Macule
• Small discolored spot or patch on the surface
of the skin, flat or level with skin
• A freckle, flat moles, liver spot (chloasma) or
leukoderma (loss of pigment)
• Pink or red inflammatory macules – indicative
of typhoid, typhus, secondary syphilis, or
allergenic drug reaction
• Blue Macules in public regions indicate crab
lice
Papule
• Small elevated pimple
• Contains no fluid but may develop pus
Common Papular Eruptions
• Pityriasis rosea – self-limited disease of truck,
eruptions at time barely evident
• Mucocutaneous syphilis – papules tend to be
juicy, easily molded, found in mouth and
genital region
• Psoriasis – chronic inflammatory disease of
skin, lesions are round, dry papules, covered
with coarse slivery scales
Common Papule Eruptions
• Warts – verruca
• Seborrheic keratois – flat, brown, greasy feeling
papules, waxy texture. Non-malignant
• Actinic keratosis – hard, horny papules, results of
sun and wind exposure. May become malignant
• Senile keratosis – hard horney papules, old age
spots
• Molluscum contagiosum – virus infection, pinhead sized to pea-sized, wax like papules of a
yellowish white or pinkish color
Common Papule
• Acne – different stages
• Drug eruptions – may occur in many forms
• Scratch a localized reaction to rubbing,
scratching
Wheal
• Itchy, swollen lesion that last only a few hours
• Hive or insect bite
• Capable of returning
Nodule
• Solid lump, larger than a papule, projects
above the surface or may lie below the skin
• Varies in size and color
• Of medical significance if nodule appears in
more than one area
Nodules
• Nevis – birthmark
• Lipomas – fatty growth cells
• Fibromas – benign tumor composed of whorls
of white fibrous connective tissue. May occur
in single or in random areas, not indicative of
underlying disease
Tumor
• Abnormal swelling or enlargement that can be
malignant or benign
• Fluidless lesions
Vesicle/Bulla
• Raised lesion containing fluid derived from
serum of blood
• Water fluid collects within epidermis or
between epidermis and dermis, ranging color
from clear to pink
• Bulla is larger than a Vesicle
Vesicle/Bulla
• Herpes Simplex – virus
• Contact Dermatitis – inflammation resulting
from irritation of certain substances
• Sun burn – (second degree)
• Blister – skin irritation
Pustule
• Small round, round, raised area of inflamed skin
filled with pus
• Common types: acne
• Furuncles and carbuncles – contain infection
• Impetigo – highly contagious inflammatory
disease
• Eczema
• Acute fungal infection of feet and hands
• Smallpox, chickenpox, vaccination reaction,
herpes
Secondary Lesion
• Secondary lesions are primary lesion that have
progressed to later stage of disease
• Secondary lesions usually characterized by
material buildup on the skin and includes:
Scale
• Scale is dry and greasy accumulation of
epidermal flakes
• Silvery, stratified scales of psoriasis
• Seborrhea dermatitis – yellow greasy scales
caused by excess secretion of sebaceous
glands
Crust
• Crust/Scab – dry accumulation of serum and
pus, mixed with epidermal material
• Lymph crust – honey colored scab not oozing,
evidence of skin healing
• Lymph crust – can appear after electrolysis
• Pus Crust – a dirty gray or greenish-yellow
crust indicative of infection
• Blood crust is reddish or black crust from dried
blood, indicative of disease of blood
Excoriation
• Skin sore produced from scratching or
abrasion
Fissure
• Crack in skin that penetrates the dermis
Ulcer
• Open skin lesion or mucous membrane that is
accompanied by pus and loss of skin depth
Keloid
• Skin or film that forms over a wound
• Keloids rarely form on face
• Keloids appear more in skin of color
Scare
• Specialized growth of tissue that forms during
healing of wound or skin condition
Common Skin Diseases
• Herpes Simplex – an acute inflammatory
infection of the skin, occurring as swollen
vesicle or group
• Appears around mouth or nostrils
• DO NOT TREAT AN AREAS With Herpes!
Impetigo
• An acute inflammatory and highly contagious
disease
• Usually found in children
• Characterized by honey colored crust that
have a “stuck on appearance!
• DO NOT TREAT THIS SKIN CONDITION
Psoriasis
•
•
•
•
Reddish patches covered by silvery scales
Tiny bleeding points may appear under scales
Not infectious
Electrologist can work on this skin involved
with however, never within the patches
Dermatitis
• Irritation with vesicular eruptions
• External on skin
• Wait until skin has resolved before treating
with electrolysis
Parasitic Disease of the Skin
• Parasites both animal or vegetable can affect
skin
• Very Contagious
• Refer to physician
• DO NOT TREAT
Scabies
•
•
•
•
Very contagious
Itching skin caused by infestation by itch mite
Mites burrow in hands or feet
Skin reacts with eruption of papules on forearms,
underarms, waist, inner thigh, buttocks, and
ankles
• If disease is not treated it may manifest into boils
and ulcers
• DO NOT TREAT
Pediculosis
• Head lice – Pediculois Capitis
• Transmitted from person to person via
infected personal care items
• Nit surround hair and passes up out of pore
with growing hair
• Body Louse – Pediculosis Corporis
• Causes intense itching
• Clothing contains nits
Disease of Sebaceous Glands
• Blackheads – comedomes – hardened plug of
sebaceous material
• Appears black as the sebum oxidizes and turns
black
• Can block mouth of follicle
• Can become inflamed
Acne
•
•
•
•
•
•
Chronic inflammation of the philosebaceous unit
Common on face, back and chest
May present as papules or nodules
Can appear as pustules
Cysts may appear
Acne begins as a blockage of the follicular canal,
develops through leakage of sebum into the
dermis
Acne
• Once the dermis becomes irritated it can
develop into a red pustule or pimple
• Prevalent in adolescence during heightened
androgenic activity stimulates sebaceous
activity
• Infected follicles can be treated with
electrolysis
Milia
• Whitehead caused by retention cyst of
entrapped sebum beneath the epidermis
• Not in follicle pore
• Appears on face, neck, shoulders and chest
areas
• Not usually associated with hair follicle
Sebaceous Cyst
•
•
•
•
•
Subcutaneous tumor of the sebaceous glands
Composed of sebum
Ranges in size from small pea to an orange
Releasing sebum will not eliminate cyst
Needs to be removed by physician
Seborrhea
• Oily condition of nose, forehead, and scalp
• Result of over production of sebaceous glands
• Can accompany itching and burning
Asteatosis
• Dry, scaly skin deficient of sebum
Disorder of Sudoriferous Glands
• Hyperidrosis – excessive perspiration
• Caused by stimulates or mental depression and
exhaustions
• Great condition to treat with laser on underarms
• Bromidrosis – foul smelling perspiration
• Appears in armpits, or feet
• Can be caused by drugs, foods, or rare disease
• Result of apocrine sweat glands
Disorders of Sudoriferous Glands
• Anidrosis – lack of perspiration caused by
fever or disease
• Miliaria or Heat Rash – an acute inflammatory
disorder of the sudoriferous glands
• Lesions consists of vesicles and papules
Pigmentation Irregularities
• Tan – Protective layer of skin
• Sunlight barrier for skin
• Prevents excessive production of Vitamin D
•
Freckles & Lentigines
• Yellowish or brown spots occurring on hands,
face, and other exposed body parts
• Result of sun exposure
Chloasma
• Yellow, brown or black deposits in skin
• Patches occurring in various shapes and spots
• Appears a mask of pregnancy – can result
from birth control pills
• If patient displays in area to be treated with
electrolysis , do test spots prior to treatment
as it may increase with treatment
• Laser hair removal often removes it
Stains
• Abnormal patches of brown coloration
• Round or irregular shapes
Nevus/ Birthmark
• Colored malformation of the skin
• Often congenital
Leucoderma
• White patches of skin or all over body
• Albinism – a congenital absences of pigment in
skin, hair, eyes
• Extremely sensitive to sun
• Can be localized
• Not a good candidate for laser!
• Vitiligo – loss of pigment, occurring mostly in
bands, often on hands and patches in the skin
• Do not treat with laser!
Hypertrophies
• Usually and enlargement of skin due to
multiplication of cells
• Occurs for many reasons
• Keratoma (Callus) – hard thickened patches of
skin due to hypertrophy of horny layer
• Caused by irritation , friction, or pressure
Moles
•
•
•
•
•
•
Small congenital macule
Ranges in color from pale tan to brown to bluish black
True malignant moles is melanoma
Black, blue-black or slate-colored
Lacks hair
Mole that is normal for many years can suddenly
change, increase in size, increase in depth,
pigmentation
• Crust can form and may bleed
• Inflammatory ring may appear around it
Moles
• When in doubt don’t treat a mole
• Have checked by physician prior to treatment
• Malpractice insurance may not cover if not
checked prior to treatment
• Get release to treat mole
Post Treatment Disorders
• Over treatment can cause eschars (scabs)
• Unsanitary practices by patient can result in
infection
• Examine skin disorder when confronted
• Usually small areas will be related to the
electrolysis treatment, one or two follicles
• Good aftercare instruction very important to
patient
Post Treatment Disorder
• Transfer of infection to the treated site by patient via
hands from another infected area can occur
• Advise patient not to:
• Scratch, rub or irritate newly treated areas for 24 hours
• Do not wash with soap, water or washcloth for 24
hours
• Do not use make-up on treated site for 24 hours
• Clean skin with antiseptic (Witch hazel, alcohol, or
Seabreeze) for 24 hours
• Do not go into sun or tanning bed for 24 hours
• Do not dislodge any scabs, should they appear
Post Treatment Disorders
• Poison ivy and poison oak can be transferred
to treatment site
• Do not treat if it is present on skin anywhere!
Contact Dermatitis
• Occasionally a patient may develop dermatitis
to the galvanic lye
• Should this occur, use high frequency for
future treatments
Dermographia
• Can occur after treatment
• A form of urticaria
• Congenital sensitivity to any form of
scratching
Post Treatment Inflammation
•
•
•
•
•
Redness – local irritation
Possible infection – due to invasion of bacteria
Pustules – yellow-headed pimples
Folliculitis – infection of hair follicle
Crust formation – not to be removed by
patient