SKIN DISORDERS Acne Vulgaris Disorder of the sebaceous

SKIN DISORDERS Acne Vulgaris Disorder of the sebaceous glands Sebaceous glands secrete excessive sebum The oily deposit becomes hard and plugs up the opening Area becomes filled with leukocytes (white blood cells) The leukocytes cause the accumulation of pus. Athlete’s Foot Contagious fungal infection Signs include the formation of small blisters between the fingers and the toes. Also have cracking and scaling Can be gotten in public baths, showers, and pools Treatment: Keeping area clean and DRY Antifungal Powders and Creams

Tinea (Ringworm) • Fungal infections, • Infectious, highly contagious • Signs: Raised itchy circular patches with crusts • Found on skin, scalp or underneath nails • Treatment: Griseofulvin (drug)

Dermatitis (Contact Dermatitis) Inflammation of the skin which may be non-specific. A rash may appear after using a particular soap or cosmetic product. Another cause is emotional. Stress may cause a person’s skin to become covered with blotches. Treatment: Discontinue use of product and apply hydrocortisone cream. Herpes (Fever Blisters) Viral infection (Herpes Simplex) Usually seen as a fever blister or cold sore Virus can lay dormant but be activated by stress, fever, trauma, hormonal changes, and exposure to sunlight May be spread through oral contact or through the respiratory route Treatment: Coat the lesion with a protective barrier ointment containing an antiviral agent. Acyclovir Ointment is a popular treatment. There is no cure. Do not squeeze, pinch, or pick at the blister. Wash hand carefully before touching your eyes or genital area, or another person. Avoid mucous membrane contact when a lesion is present.

Genital Herpes Another form of the Herpes Virus Appears as a blister in the genital areas of both men and women Periods of remission and outbreak Spread through sexual contact during an outbreak Treatment: Acyclovir Ointment If a women is pregnant an having an outbreak when it is time for the baby to be delivered, the baby may become infected when passing through the vaginal route for delivery. C-Section is preferred. Herpes Zoster/ Shingles • Viral infection of nerve endings with fever and malaise • Erythema and vesicles along the course of a nerve • Possibly remnant of childhood chickenpox • Treatment: analgesics, calamine lotion, acyclovir (orally)

WARTS Tumors or growths of the skin Caused by the Human Papilloma Virus (More than 70 types) Spread by direct contact or autoinocculation (person scratches their wart, then spreads the viral particles to another area of the skin. ) 50% of warts disappear within 6 months and 90% are gone in 2 years. Treatment: See dermatologist. Chemical treatment include wart paints Cryotherapy - wart frozen with liquid nitrogen Electrosurgery - for large warts, the growth is paired away and the base burned by diathermy or cautery. This is done under local anaesthetic

Impetigo Highly contagious Caused by staphylococcal or streptococcal bacteria Most common in young children Signs: Starts with erythema (reddish discoloration) but soon develops into vesicles with yellow crusts. Hands and face are favorite locations. Treatment: Antibiotics taken by mouth will usually clear it up in 4 -5 days. Can also apply an antibiotic ointment to the vesicles after removing the crusts. Remember- patients are contagious as along as their is crusting or oozing. Keep children home and use separate towels, linens, etc for them.

Scabies “The Itch” • Highly contagious usually associated with poor living conditions. • Caused by the itch mite (Sarcoptes scabiei) • Female mites burrow under the stratum corneum in skin and lays eggs. Eggs hatch causing red papule appear and cycle starts again. Itching from sensitivity to mites • Transmitted by skin-to-skin contact • Treatment: Destroy mites and eggs by hot baths, scrubbing, and medication. Underwear and bedding must be changed often as they harbor eggs

Urticaria • Hives allergy or emotional stress • Signs are raised red lesions called “wheals” caused by leakage of fluid from the skin’s blood vessel • Treatment: steroids, antihistamines

BURNS First Degree Burns Involves only the epidermis Typical sunburn is an example Symptoms: Redness, pain, and small amount of swelling Treatment: First is to apply cold water and then analgesics for pain Second Degree Burn Involves the epidermis and the dermis. Symptoms: pain, swelling, redness, and blistering (Skin may be exposed to infection. ) Treatment: pain medication and dry sterile dressing applied to open skin areas (Do not pop the blisters!)

Third Degree Burns Destruction of the epidermis, and the subcutaneous layer Can involve underlying muscles and even bones Symptoms: loss of skin, eschar, and there may be no pain due to nerves being damaged May be life-threatening damage depending on the amount of skin and fluid loss as well as plasma Treatment: Immediate hospitalization Prevent infection and skin contractures Fluid replacement Skin grafts are done as soon as possible Rule of Nines Treatment and the possibility of recovery from burns depends on the total area involved and the severity of the burn It is used to measure the percent of the body burned Body is divided into 11 areas and each area accounts for 9% of the total body surface. Major Burn = 2 nd degree over 25% adult body surface area (b. s. a. ) or more than 20% child ‘s b. s. a. Also 3 rd degree burn involving more than 10% of b. s. a.

Carcinoma • Basal Cell Carcinoma – Usually occurs on upper face – Least Malignant, Least likely to metastasize, – Begins as Papules that erode in the center to form a bleeding, crusted crater – Most Common • Squamous Cell Carcinoma – – Malignant tumor of the epidermis Common type of skin cancer Hard, raised nodules that are painless If not treated, will metastasize • Malignant Melanoma – Most serious form of skin cancer – Develops from a mole (or brown, irregular patch) to become a dark, spreading lesion. – Can appear suddenly. Watch for changes! Exposure to the sun’s UV radiation is the most common cause of skin cancers

Skin Lesions • • • Excoriation – Abrasion Pustule – Acne Vesicle – Impetigo Wheal – Hives Ulcer – Venous Stasis Ulcer

Eczema • Acute or chronic inflammatory skin disease (most common) • Not a distinct disease but a sign of an underlying condition • Vesicles(blisters) on reddened skin which burst and weep crusts (Dry, red, itchy and scaly) • Treatment: Remove or avoid causative agent and hydrocortisone to help alleviate the symptoms.