CHAPTER 5
Integumentary System
Integumentary System
• Skin
– Integument or cutaneous membrane
– Epidermis
– Dermis
– Subcutaneous layer
• Accessory structures
– Hair
– Nails
– Glands
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Layers and
Structures of the Skin
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Skin Lesions
• Abrasion
– Scraping or rubbing away of skin or mucous
membrane as a result of friction to the area
• Example: carpet burn
• Abscess
– Localized collection of pus in any body part
that results from invasion of pus-forming
bacteria
• Example: pustule = small abscess
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Skin Lesions
• Bedsore
– Ulcer in skin over a bony prominence
– Also known as pressure ulcer
• Example: decubitus ulcer
• Blister
– Small, thin-walled lesion containing clear fluid
– Also known as a vesicle
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Skin Lesions
• Bulla
– Large blister
• Carbuncle
– Circumscribed inflammation of skin and
deeper tissues; contains pus
• Comedo
– Typical lesion of acne vulgaris
• Example: whitehead = closed comedo
• Example: blackhead = open comedo
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Skin Lesions
• Cyst
– Closed sac or pouch in or within the skin;
contains fluid, semifluid, or solid material
• Example: hydrocele = fluid-filled cyst
• Example: sebaceous cyst = solid-filled cyst
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Skin Lesions
• Fissure
– Cracklike sore or groove in the skin or
mucous membrane
• Example: anal fissure
• Fistula
– Abnormal passageway between two tubular
organs; or from an organ to the body surface
• Example: recto-vaginal fistula
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Skin Lesions
• Hives
– Circumscribed, slightly elevated lesions on
skin; paler in center than surrounding edges
– Also called wheals
• Example: mosquito bite
• Laceration
– Tear in skin; torn, jagged wound
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Skin Lesions
• Macule
– Small flat, discoloration of the skin; neither
raised nor depressed
• Example: bruises, freckles
• Nodule
– Small, circumscribed swelling protruding
above the skin
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Skin Lesions
• Papule
– Small, solid, circumscribed elevation on the
skin
– Example: pimple, wart, elevated mole
• Polyp
– Small, stalklike growth, protruding upward or
outward from membrane surface
– Example: nasal polyp
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Skin Lesions
• Pustule
– Small elevation of skin filled with pus
• Example: small abscess on the skin
• Scales
– Thin flakes of hardened epithelium that are
shed from the epidermis
• Ulcer
– Circumscribed, open sore or lesion of skin,
accompanied by inflammation
• Example: decubitus ulcer
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Skin Lesions
• Vesicle
– Small, thin-walled, lesion containing clear fluid
• Example: blister
• Wheal
– Circumscribed, slightly elevated lesion of the
skin
– Paler in center than surrounding edges
• Example: hives
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PATHOLOGICAL CONDITIONS
Integumentary System
Acne Vulgaris
• Pronounced
– (ACK-nee-vul-GAY-ris)
• Defined
– Common inflammatory disorder seen on face,
chest, back, and neck
– Appears as papules, pustules, and comedos
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Albinism
• Pronounced
– (AL-bin-izm)
• Defined
– Condition characterized by absence of
pigment in the skin, hair, and eyes
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Burns
• Defined
– Tissue injury produced by flame, heat,
chemicals, radiation, electricity, or gases
– Extent of damage determined by:
• Mode and duration of exposure
• Thermal intensity or temperature
• Anatomic site of the burn
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Burns
• First-degree or superficial burns
– Example: sunburn
• Second-degree or partial-thickness burns
– Example: flash contact with hot objects
• Third-degree or full-thickness burns
– Example: deep burns from a fire
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Callus
• Pronounced
– (CAL-us)
• Defined
– Common, usually painless thickening of the
epidermis at sites of external pressure or
friction, such as weight-bearing areas of the
feet and on the palmar surface of the hands
• Also known as a callosity
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Carcinoma, Basal Cell
• Pronounced
– (car-sih-NOH-mah BAY-sal sell)
• Defined
– Most common malignant tumor of epithelial
tissue, occurring most often on areas of skin
that are exposed to the sun
• Presents as a slightly elevated nodule with a
depression or ulceration in the center that becomes
more obvious as the tumor grows
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Carcinoma, Squamous Cell
• Pronounced
– (car-sih-NOH-mah SKWAY-mus sell )
• Defined
– Malignancy of the squamous, or scalelike,
cells of the epithelial tissue
– Much faster growing than basal cell
carcinoma
– Greater potential for metastasis if not treated
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Carcinoma, Squamous Cell
• Frequent sites on sun-exposed areas
– Top of nose
– Forehead
– Margin of external ear
– Back of hands
– Lower lip
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Dermatitis
• Pronounced
– (der-mah-TYE-tis)
• Defined
– Inflammation of skin, seen in several different
forms
– Acute or chronic
– Contact or seborrheic
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Eczema
• Pronounced
– (EK-zeh-mah)
• Defined
– Acute or chronic inflammatory skin condition
characterized by erythema, papules, vesicles,
pustules, scales, crusts, scabs, and itching
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Exanthematous Viral Diseases
• Pronounced
– (eks-an-THEM-ah-tus viral diseases)
• Defined
– Skin eruption or rash accompanied by
inflammation, having specific diagnostic
features of an infectious viral disease
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Exanthematous Viral Diseases
• Examples:
– Rubella = German Measles = 3 day measles
– Roseola Infantum
– Rubeola = Red Measles = 7-10 day measles
– Erythema Infectiosum = Fifth disease
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Gangrene
• Pronounced
– (GANG-green)
• Defined
– Tissue death due to loss of adequate blood
supply, invasion of bacteria, subsequent
decay with foul odor
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Herpes Zoster
• Pronounced
– (HER-peez ZOS-ter)
• Defined
– Acute viral infection, characterized by painful,
vesicular eruptions on the skin that follow
along nerve pathways of underlying spinal or
cranial nerves
– Highest incidence in adults over 50
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Herpes Zoster
Image courtesy of Robert A. Silverman,
M.D., Pediatric Dermatology,
Georgetown University
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Impetigo
• Pronounced
– (Im-peh-TYE-goh)
• Defined
– Contagious superficial skin infection
characterized by serous vesicles and pustules
filled with millions of staphylococcus or
streptococcus bacteria
• Usually forming on the face
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