Presentation is loading. Please wait.

Presentation is loading. Please wait.

Chapter 46 Disorders of Skin Integrity and Function

Similar presentations

Presentation on theme: "Chapter 46 Disorders of Skin Integrity and Function"— Presentation transcript:

1 Chapter 46 Disorders of Skin Integrity and Function

2 Skin Infections Superficial fungal infections Ringworm, athlete’s foot
Attack the keratinized (dead) cells Inflammatory reaction to toxins causes most signs and symptoms Deep fungal infections Candidiasis, sporotrichosis Attack living tissue May attack other organs

3 Bacterial Skin Infections
Impetigo May lead to post- streptococcal hypersensitivity reactions These can cause glomerulonephritis

4 Viral Skin Infections Verrucae (warts) Benign neoplasms (papillomas)
Herpes simplex (cold sores) Herpes zoster (shingles) Herpes invades dorsal root ganglia Caused when chickenpox herpesvirus is reactivated Travels out nerve to skin and causes a new inflammation

5 Question Which of the following microbes cause warts? Fungus Virus
Bacteria Any of the above may cause warts.

6 Answer Virus Warts are caused by viruses; they’re benign neoplasms (abnormal tissue growths).

7 Scenario Mrs. K is worried about her complexion…
She says she always had good skin, but now her face itches and burns on the right side, and there are red lumps on one side of her forehead Question What are the possible causes?

8 Acne Disorder of sebaceous glands Related to:
Hormonal stimulation of sebaceous glands Increased number of sebaceous cells Increased sebum production Inflammatory response to bacteria in sebum

9 Allergic and Hypersensitivity Dermatoses
Type I allergies Atopic eczema Urticaria (hives)

10 Type I Allergies Type I allergies are mediated by IgE Discussion
What cells must be involved in this process? On the first exposure to the allergen? On repeated exposure? When the allergen binds to IgE? What inflammatory mediators are involved? How?

11 Question Which chemical mediator is released by mast cells as part of the inflammatory response? Histamine Leukotriene Cytokine All of the above

12 Answer Histamine Histamine (stored in mast cells) is one of the first substances to be released during the inflammatory response. Histamine release results in bronchoconstriction, mucosal edema, and increased mucus production.

13 Autoimmune Urticaria In autoimmune urticaria, the client creates anti-IgE antibodies Discussion How would this cause hives? How would a deficiency in complement inhibitor cause hives? Why would antihistamines help? Why would corticosteroids help?

14 Drug-Induced Skin Eruptions
Erythema multiforme Occurs after herpes simplex; self-limiting Stevens-Johnson syndrome Skin detaches from body surface; <10% of body affected Toxic epidermal necrolysis >30% of epidermis detaches 30%–35% mortality rate

15 Papulosquamous Dermatoses
Psoriasis Pityriasis rosea Lichen planus

16 Psoriasis Activated T cells growth attract factors neutrophils and
monocytes keratinocytes enter and blood the vessels grow papules create create papules inflammation

17 Burns First-degree: outer layers of epidermis
Second-degree: epidermis and dermis Partial-thickness: only part of dermis Full-thickness: entire dermis Third-degree full-thickness Extends into subcutaneous tissue May damage muscle, bone, blood vessels

18 Scenario Mr. D was boiling water and the pot tipped over on him…
He has painful, bright pink, blistering burns over most of his left arm and chest Question How would you categorize this burn?

19 Scenario (cont.) His pulses are weak Bowel sounds are absent
Mr. D's burns are pink but the rest of his body looks pale, and he has a rapid heart rate… His pulses are weak Bowel sounds are absent Respiration is rapid Question What has caused these signs?

20 Complications of Burns
Burn shock Respiratory system dysfunction Hypermetabolic response Renal insufficiency Gastric ulceration Sepsis Constriction of areas under circumferential burns Systemic infection

21 Scenario A woman was severely burned and she has been in the hospital for eight days Question Why would she be developing: Increased urine production? Weight loss? Increased temperature? GI bleeding?

22 Question Treatment for third-degree burn patients includes all but which of the following? Fluid replacement Removal of dead tissue/eschar Antibiotics Aloe

23 Answer Aloe Patients suffering from third-degree (full thickness) burns lose fluid through the skin and are prone to infection. They must receive fluid replacement and antibiotics to fight or prevent infection. Dead tissue (eschar) must be removed daily (debridement) in order to prevent infection. Because third-degree burns destroy the epidermis, the application of topical aloe would serve no purpose.

24 Pressure Sores External Shear pressure bends blood
obstructs blood flow Friction vessels ischemia to skin damages dermis/ tissue damage epidermis interface

25 Ultraviolet radiation
melanin oxidized - TAN hits melanocytes more melanin produced - delayed tanning some UV reaches lower skin layers immune DNA cells damage damaged inflammatory mediators released sunburn

26 Sun Exposure Sun exposure increases the risk of skin cancer
Cumulative sun exposure increases risk of: Basal cell carcinoma Squamous cell carcinoma Severe sun exposure with blistering increases risk of: Malignant melanoma

27 Malignant Melanoma Cancers arising from melanocytes Asymmetry
Border irregularity Color variegation Diameter >0.6 cm Evolving change over time

28 Author: Please add title.

29 Types of Melanomas 70% are superficial spreading
Raised edges; grow horizontally and vertically Ulcerate and bleed 15%–30% are nodular Dome-shaped, blue-black 4%–10% are lentigo maligna Slow growing, flat 2%–4% acral lentiginous On palms, soles, nail beds, mucous membranes

30 Question Which type of skin cancer is associated with the worst prognosis? Basal cell Squamous cell Malignant melanoma Ependymal cell

31 Answer Malignant melanoma
Malignant melanoma begins in the melanocytes, and possesses all of the characteristic features associated with cancer (asymmetry, irregular border, many colors, and a diameter >0.6 cm) as defined by the American Cancer Society. Basal cell cancer has the best prognosis, and squamous cell cancer has a good prognosis as long as it is detected early.

32 Skin Conditions of Infancy
Birthmarks Diaper dermatitis Prickly heat Cradle cap Infectious disease rashes Roseola (herpesvirus) Rubeola (measles) Rubella (German measles) Varicella (chickenpox)

33 Skin Disorders of the Elderly
Actinic (solar) damage Keratoses: premalignant lesions Lentigines: liver spots Vascular lesions Angiomas Telangiectases Venous lakes

Download ppt "Chapter 46 Disorders of Skin Integrity and Function"

Similar presentations

Ads by Google