Milady - Chapter 11 - Disorders and Diseases of the Skin

How many types of pigmentation disorders are there?

2

ABCDE's of melanoma detection

A - asymmetry: the two sides of the lesion are not identical B - border: the border is irregular on these lesions. C - Color: melanomas are usually dark and have more than one color or colors that fade into one another. D - diameter: the lesion in a melanomas is usually at least the size of a pencil eraser. E - Evolving: melanomas as a lesion often changes appearance.

Impetigo

A bacterial infection of the skin that often occurs in children; characterized by clusters of small blisters or crusty lesions filled with bacteria. It is extremely contagious.

acne

A chronic inflammatory skin disorder of the sebaceous glands characterized by comedones and blemishes. There are many types. Common acne is known as acne Simplex or acne vulgaris. Inflammation of the sebaceous glands results from retained oil secretions, cells, and excessive Propionibacterium acne (P. acne) bacteria.

Atopic dermatitis

A chronic, relapsing form of dermatitis. Irritants and allergens trigger reactions that include dry, cracking skin. The redness, itching, and dehydration of the dermatitis make the condition worse. Use of humidifiers and lotion can help keep the skin more hydrated. Topical corticosteroids can relieve the symptoms.

Scar

A discolored, slightly raised mark on the skin formed after an injury or lesion of the skin has healed. The tissue hardens to heal the injury. Thick, elevated scars are hypertrophic.

lentigo

A flat, pigmented area similar to a freckle; small, yellow brown spots. Freckles are tiny round or oval pigmented skin on areas exposed to the sun, referred to as macules, the small flat colored spots of the skin.

retention hyperkeratosis

A hereditary factor in which dead skin cells build up because they do not shed from the follicles as they do on normal skin.

tumor

A large nodule; an abnormal cell mass resulting from excessive cell multiplication, varying in size, shape, and color.

Tinea versicolor

A non-contagious fungal infection that inhibits melanin production. It is not contagious because it is caused by yeast, a normal part of the human skin. It is characterized by white, brown, or salmon colored flaky patches from the yeast of the skin. This sun fungus can be treated with antifungal cream or medication. Selenium sulfide shampoos can also treat the condition. High humidity and summer heat stimulate the condition. It usually fades in the cold winter seasons and recurs in the warm seasons.

comedo

A non-inflamed build up of cells, sebum, and other debris inside follicles.

vitiligo

A pigmentation disease characterized by white irregular patches of skin that are totally lacking pigment. The condition can worsen with time and sunlight. The disease can occur at any age and is believed to be an autoimmune disorder causing an absence of melanocytes.

Mole

A pigmented nevus; a brownish spot ranging in color from tan to bluish black. Some are flat, resembling freckles; others are raised and darker. Most are benign, but changes in color or shape should be checked by a physician. Hairs in them are common and should not be removed unless by a physician because it may irritate or cause structural changes

Albinism

A rare genetic condition characterized by the lack of melanin pigment in the body including the skin, hair, and eyes. The person is at risk for skin cancer, is sensitive to light, and ages early without normal melanin production. The technical term is congenital leukoderma or congenital hypopigmentation.

steatoma

A sebaceous cyst or subcutaneous tumor filled with sebum and ranging in size from a pea to an orange.

anaphylactic shock

A severe reaction that occurs when an allergen is introduced to the bloodstream of an allergic individual. Characterized by bronchoconstriction, labored breathing, widespread vasodilation, circulatory shock, and sometimes sudden death.

seborrheic dermatitis

A skin condition characterized by inflammation, dry or oily scaling or crusting, and/or itchiness. The red, flaky skin often appears in the eyebrows, in the scalp and hairline, the middle of the forehead, and along the sides of the nose. One cause is an inflammation of the sebaceous glands. This condition is sometimes treated with Cortizone cream. Severe cases should be referred to the dermatologist. It is also a common form of eczema.

Vesicle

A small blister or sac containing clear fluid. Poison ivy and poison oak produce them.

Hyperpigmentation appears in the following forms:

Chloasma, hyperpigmentation, lentigo, melasma, nevus, stain, tan

stain

Abnormal brown or wine colored skin discoloration with a circular or irregular shape. A port wine stain is a birthmark, which is a vascular type of nevus. Stains may also occur after certain diseases.

Dyschromia

Abnormal pigmentation

List the notable sebaceous gland disorders:

Acne, asteatosis, comedo, furuncle, carbuncles, Millia, sebaceous hyperplasia, seborrhea, seborrheic dermatitis, steatoma

Perioral dermatitis

Acne-like condition around the mouth, consisting mainly of small clusters of papules. It may be caused by toothpaste or products used on the face. It is not contagious. Antibiotics can help treat the condition.

Common medication used to treat acne:

Adepalene (Differin) Azelaic acid (Azelex) Clindamycin Isotretinoin (Accutane) Tazarotene (Tazorac) Tretinoin (Retin-A)

Hypopigmentation occurs in the following forms:

Albinism, leukoderma, vitiligo

nevus

Also known as birthmark. A malformation of the skin from abnormal pigmentation or dilated capillaries.

urticaria

Also known as hives; an allergic reaction by the body's histamine production.

Conjunctivitis

Also known as pink eye; inflammation of the mucous membrane (conjunctiva) around the eye due to chemical, bacterial, or viral causes; very contagious; treated with antibiotics.

Miliaria rubra

Also known as prickly heat; an acute inflammatory disorder of the sweat glands, characterized by the eruption of small red vesicles and accompanied by burning, itching skin.

Pseudofolliculitis

Also known as razor bumps, resembles folliculitis without the pus or infection.

Tinea corporis

Also known as ringworm; highly contagious; it forms a ringed red pattern with elevated edges.

herpes zoster

Also known as shingles; a painful skin condition from the reactivation of the chickenpox virus; also known as the varicella zoster virus (VZV). A viral infection of the sensory nerves characterized by groups of red blisters the form of rash that occurs in a ring or a line. The rash is typically confined to one side of the body. Can cause nerve and organ damage and severe pain that can last for months or years. Treated with antiviral drugs.

verruca

Also known as wart; a hypertrophy of the papillae and epidermidis caused by a virus. Infectious and contagious, they can spread.

hypertrophy

An abnormal growth; many are benign, used to describe the thickening of a tissue, the opposite is atrophy which means wasting away or thinning. Keloids are an example

Tubercle

An abnormal rounded, solid lump; larger than a papule.

Keratoma

An acquired, thickened patch of epidermis. A callus caused by pressure or friction. If the thickening also grows inward, it becomes a corn.

pustule

An inflamed papule containing pus.

Rosacea

An inflammation of the skin characterized by extreme redness, dilation of blood cells, and in severe cases the formation of papules and pustules. It is chronic congestion primarily on the cheeks and nose. Certain factors are known to aggravate the condition. Vasodilation of the blood vessels makes it worse. Spicy foods, alcohol, caffeine, temperature extremes, heat, sun, and stress can aggravate it. Soothing and calming ingredients and treatments will help calm the skin and decrease the inflammation.

contact dermatitis

An inflammatory skin condition caused by an allergic reaction from contact with a substance or chemical. Make up, skin care products, detergent, dyes, fabrics, jewelry, and plants can all cause red, itchy skin.

eczema

An inflammatory, painful, itching disease of the skin; acute or chronic in nature, with dry or moist lesions. This should be referred to a physician. Avoid contact and skin care treatments if a client has eczema.

Psoriasis

An itchy skin disease characterized by red patches covered with white silver scales; caused by an over proliferation of skin cells that replicate too fast. Usually found in patches on the scalp, elbows, knees, chest, and lower back. If patches are irritated, bleeding can occur. It is not contagious but can be spread by irritating the affected area.

Hyperpigmentation

An over production of pigment. Increased melanin causes excess pigment. Sun exposure, acne, medication, and post inflammatory hyperpigmentation from skin damage can cause darkened pigmentation.

wheal

And itchy, swollen lesion caused by a blow, insect bite, skin allergy reaction, or stains. Hives and mosquito bites are examples.

List the disorders of the sudoriferous glands:

Anhidrosis, bromhidrosis, hyperhidrosis, miliaria rubra

Sebaceous hyperplasia

Benign lesions frequently seen in oilier areas of the face. They are often white, yellow, or flesh colored. Described as donut shaped with an indentation in the center. They are harmless lesions and cannot be removed by extraction, only surgically.

furuncle

Boil; a subcutaneous abscess filled with pus. Caused by bacteria in glands or hair follicles.

What are the primary lesions of the skin:

Bulla, cyst, macule, nodules, papule, pustule, tubercle, tumor, vesicle, wheal

Telangiectasia

Commonly called couperous skin and is characterized by redness. A vascular lesion; describes capillaries that have been damaged and are now larger, or distended blood vessels.

The following are examples of contagious diseases:

Conjunctivitis, herpes simplex virus 1, herpes simplex virus 2, herpes zoster, impetigo, tinea, tinea corporis, wart

Examples of secondary lesions:

Crust, excoriation, acne excoriee, fissure, keloid, scale, scar, ulcer

Acne excoriee

Disorder where clients purposely scrape off acne lesions, causing scarring and discoloration

Asteatosis

Dry, scaly skin from sebum deficiency; can be due to aging, internal disorders, alkalies of harsh soaps, or cold exposure.

Milia

Epidermal cysts that are small, firm white papules. They are whitish, pearl like masses of sebum and dead cells under the skin with no visible opening often mistakenly called whiteheads. Hardened and closed over, more common in dry skin types and may form after skin trauma, such as a laser resurfacing or chronic exposure to UV radiation. Needs to be lanced to extract.

hyperhidrosis

Excessive perspiration caused by heat, genetics, medication, or medical conditions.

Scale

Excessive shedding of dead skin cells; flaky skin cells; anything plate of epidermal flakes, dry or oily. Examples are dandruff or psoriasis.

Tan

Exposure to the sun causes tanning, a change in pigmentation due to melanin production as a defense against UV radiation that damages the skin. It is basically visible skin and cell damage.

Comedogenic

Fatty ingredients such as waxes and some oils can clog or irritate follicles

Herpes simplex virus 1

Fever blisters or cold sores; recurring viral infection. A vesicle or group of vesicles on a red, swollen base. The blisters usually appear on the lips or nostrils. Causes cold sores and lesions around the mouth; it is a contagious disease.

Melasma

Hyperpigmentation triggered by hormonal changes, often during pregnancy or with birth control use. Referred to as pregnancy mask. It usually fades with time, but is worsened by sun exposure. A type of chloasma.

Hypertrophies are defined as abnormal growths and include the following forms:

Hypertrophy, actinic keratoses, hyperkeratosis, keratoma, Keratosis, keratosis pilaris, mole, skin tag, verruca

hypopigmentation

diminished pigment in the skin

Bromhidrosis

Foul-smelling perspiration, usually noticeable in the armpits or on the feet. Caused by bacteria and yeast that break down the sweat on the surface of the skin.

tinea

Fungal infections; fungi feed on proteins, carbohydrates, and lipids in the skin. Tinea pedis, athletes foot, is a fungal infection.

Grades of acne:

GRADE I: minor breakouts,mostly open comedones,some closed comedones and a few papules. GRADE II: many closed comedones,more open comedones and occasional papules and pustules. GRADE III: Red and inflamed,many comedones, papules and pustules. GRADE IV: Cystic acne. Cyst with comedones, papules, pustules and inflammation are present. Scar formation from tissue damage is common.

Causes of acne include the following:

Genetics/heredity Clogged follicles Bacteria Triggers include hormones, stress, cosmetics, skin care products, and foods

herpes simplex virus 2

Genital herpes; never work on clients with a current herpes lesion. Peels, waxing, or other stimuli may cause a breakout, even if the condition is not currently active. The virus can be spread to other areas on the person that is infected or to other people. Understanding a clients health history from her intake form may prevent potential problems.

carbuncle

Groups of boils

Chloasma (liver spots)

Increased pigmentation; from sun exposure or pigmentation from other causes. Melasma is a type of chloasma, which appears during pregnancy. They can be helped by exfoliation treatments or can be treated by a dermatologist.

primary lesions

Lesions that are in the early stages of development or change. Characterized by flat, non-palpable changes in skin color or by elevations formed by fluid in a cavity, such as vesicles or pustules.

anhidrosis

Lack of perspiration due to a failure of the sweat glands; often results from a fever or skin disease. Requires medical treatment.

Bulla

Large blister containing watery fluid.

leukoderma

Loss of pigmentation; light, abnormal patches of depigmented skin; congenital, acquired due to immunological and post inflammatory causes. Vitiligo and albinism are leukoderma's.

squamous cell carcinoma

More serious condition than basal cell carcinoma; characterized by red or pink scaly papules or nodules; sometimes they are characterized by open sores or crusty areas that do not heal and may bleed easily. Can grow and spread to other areas of the body.

Nodules

Often referred to as tumors, but they are smaller bumps caused by conditions such as scar tissue, fatty deposits, or infections.

Hyperpigmentation

Overproduction of pigment

Pruitis

Persistent itching

Actinic keratoses

Pink or flesh colored pre-cancerous lesions that feel sharp or rough that are a result of sun damage and should be checked by a dermatologist.

Treating Acne

Products rich in emollients and occlusive products are too heavy for problem skin types. Moisturizers and sunscreens should be lighter formulas such as oil-in-water (O/W) emulsions, not water- in- oil (W/O) emulsions. Physicians may prescribe medication to treat grade III and IV acne.

keratosis pilaris

Redness and bumpiness in the cheeks and upper arms; caused by blocked follicles. Exfoliation can help unblock follicles and alleviate the rough feeling.

erythema

Redness caused by inflammation

Crust

Scab, Dead cells formed over a wound or blemish while it is healing, resulting in an accumulation of sebum and pus, sometimes mixed with epidermal material.

seborrhea

Severe oiliness of the skin; an abnormal secretion from the sebaceous glands.

Sebaceous filaments

Similar to open comedones, are mainly small, solidified impactions of oil without the cell matter. These filaments also block the follicle and can cause an acne breakout. They are often found on the news.

secondary lesions

Skin damage, developed in the later stages of disease, that changes the structure of tissues or organs.

Excoriation

Skin sore or abrasion produced by persistent scratching or scraping.

Skin tag

Small outgrowths or extensions of the skin that look like flaps; they are benign and are common under the arms or on the neck from friction or where skin is rubbed together.

Lesions

Structural changes in the tissues caused by damage or injury. Any mark, wound, or abnormality. There are three types: primary, secondary, and tertiary.

edema

Swelling from a fluid imbalance in the cells or from a response to injury, infection, or medication.

dermatology

The branch of medical science that studies and treats the skin and its disorders and diseases.

pilosebaceous unit

The hair unit that contains the hair follicle and appendages: the hair root, bulb, dermal papilla, sebaceous appendage, and arrector pili muscle.

basal cell carcinoma

The most common and least severe type of carcinoma. Typical characteristics include open sores, reddish patches, or a smooth growth with an elevated border. It often appears as shiny bumps that are either colored or as light, pearly nodules. Sometimes blood vessels run through the nodules. The cells do not spread as easily as squamous or melanoma cells. Caused primarily by over exposure to UV radiation. They can be removed by surgery or other medical procedures.

malignant melanoma

The most serious form of skin cancer; black or dark patches on the skin are usually uneven in texture, jagged, or raised. It can be tan and even white. May have surface crust or bleed. Many appear in pre-existing moles. It is not always found on areas exposed to sunlight and is often found on feet, toes, backs, and legs. More deadly because it can spread (metastasize) throughout the body into internal organs via the lymphatics and bloodstream. Early detection and regular check ups are vital. Many young people can die from this dangerous cancer. Infrequent, intense UV exposure may cause a higher risk for this than chronic continuous exposure does. Caucasians who have a tendency to burn are more susceptible to skin cancer.

keloid

Thick scar resulting from excessive growth of fibrous tissue.

Hyperkeratosis

Thickening of the skin caused by a mass of keratinocytes.

varicose veins

Vascular lesions that are abnormally dilated and twisted veins which can occur anywhere in the body. Do not wax over or do scrubs.

fissure

a crack in the skin; chapped lips or hands.

contagious disease

a disease that is easily spread from one host to another; do not perform services on anyone with a contagious disease.

dermatologist

a physician who specializes in diagnosing and treating disorders of the skin

Allergic contact dermatitis

an allergy to an ingredient or a chemical, usually caused by repeated skin contact with the chemical. Initial exposure to an allergen does not always cause an allergic reaction. The development of hypersensitivity is the result of repeated exposure to an allergen over time. It may take months or years depending on the allergen and the intensity of exposure. Different people develop allergies to different allergens.

open comedo

blackhead; follicle filled with excess sebum; it is dark because it is exposed to oxygen and oxidation occurs.

malignant

cancerous

carcinoma

cancerous tumor

Propionibacterium

causes acne

Acnegenic

causing across

Macule

flat, colored spot on the skin, Such as a freckle or a red spot, left after a pimple has healed

vasodilation

increase in diameter of a blood vessel

Folliculitis

inflammation of the hair follicles, Causing a bacterial infection. These ingrown hairs are common in men, usually from shaving. Also known as barber's itch.

dermatitis

inflammatory condition of the skin; various forms include lesions such as eczema, vesicles, or papules. The three main categories are atopic, contact, and seborrheic.

acne

inflammatory disease of the skin involving the sebaceous glands and hair follicles; Ranges from mild breakouts to disfiguring cysts and scarring.

papule

small, solid skin elevation

benign

not harmful

Irritant contact dermatitis

occurs when irritating substances temporarily damage the epidermis. In acute cases, symptoms are noticed immediately or within just a few hours. Symptoms range from redness, swelling, scaling, and itching to serious, painful chemical burns. Irritating substances will temporarily damage the epidermidis. Caustic substances are examples of irritants. The immune system releases histamines, which enlarge the vessels around the injury and can cause the itchy feeling that often accompanies contact dermatitis.

Ulcer

open sore or lesion in the skin or mucous membrane accompanied by pus or loss of skin depth; a deep erosion or depression in the skin, normally due to infection or cancer. Requires medical referral. Examples are canker sores and bed sores.

cyst

sac containing fluid, infection, or matter above or below the skin

What is the biggest external cause of pigmentation disorders?

sun exposure

Contraindicate

to prohibit

closed comedo

whitehead; forms when the openings of the follicles are blocked with debris and white cells.