copyright © 2007, 2004 by saunders, an imprint of elsevier inc. all rights reserved. 1 chapter 9...

Copyright © 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 1

Chapter 9Chapter 9

Skin Anatomy and Conditions Skin Anatomy and Conditions


ObjectivesObjectives

List major components of skin anatomy.List major components of skin anatomy. List four types of noninfectious skin List four types of noninfectious skin

conditions and their treatments.conditions and their treatments. List four types of infectious skin conditions List four types of infectious skin conditions

and their treatments.and their treatments.


Objectives Objectives (Continued)(Continued)

Determine the right strength of sunscreen Determine the right strength of sunscreen necessary to protect skin from ultraviolet necessary to protect skin from ultraviolet rays.rays.

Define the various forms of acne.Define the various forms of acne. Describe psoriasis and the types of Describe psoriasis and the types of

medications used to treat this skin medications used to treat this skin condition.condition.


Skin AnatomySkin Anatomy

Skin: theSkin: the integumentaryintegumentary system is the system is the largest organ in the bodylargest organ in the body

Includes skin, hair, subcutaneous tissuesIncludes skin, hair, subcutaneous tissues One of the most abused organs in the One of the most abused organs in the

bodybody Protects the body, regulates temperature, Protects the body, regulates temperature,

is a sensor or stimuliis a sensor or stimuli


Skin Anatomy Skin Anatomy (Continued)(Continued)

KeratinKeratin: top layer of skin; for protection: top layer of skin; for protection Epidermis and dermis: layers beneath Epidermis and dermis: layers beneath

keratinkeratin Below dermis: subcutaneous layer of fatBelow dermis: subcutaneous layer of fat Epidermis: no blood flow of its ownEpidermis: no blood flow of its own


Skin Anatomy Skin Anatomy (Continued)(Continued)

Dermis: much thicker; holds nerves, blood Dermis: much thicker; holds nerves, blood vessels, and other connective tissuevessels, and other connective tissue

Skin: can absorb moisture and medicationsSkin: can absorb moisture and medications Diabetics: inject insulin Diabetics: inject insulin subcutaneouslysubcutaneously Intradermal route: between dermal layerIntradermal route: between dermal layer Intramuscular: into the muscle layerIntramuscular: into the muscle layer


Anatomy of the SkinAnatomy of the Skin

EpidermisEpidermis

DermisDermis

HypodermisHypodermis

AdiposeAdiposeTissueTissue


Conditions Affecting the SkinConditions Affecting the Skin

For a list of common dosage forms and For a list of common dosage forms and types of conditions they treat, see Table types of conditions they treat, see Table 9-14 9-14

For popular antibiotic ointments and For popular antibiotic ointments and creams, see Table 9-15 creams, see Table 9-15


Skin Disorders and MedicationsSkin Disorders and Medications

Proper diagnosis: physical assessment, Proper diagnosis: physical assessment, family history, drug history, lab tests, family history, drug history, lab tests, possible biopsypossible biopsy

Two very common skin conditions: Two very common skin conditions: sunburn sunburn and acneand acne


Miscellaneous Skin ConditionsMiscellaneous Skin Conditions

Two categories:Two categories: Noninfectious inflammatoryNoninfectious inflammatory conditions conditions Infectious inflammatoryInfectious inflammatory conditions conditions

See physician for persistent symptoms See physician for persistent symptoms


Topical AntibioticsTopical Antibiotics

Used to treat abrasions, small cuts, and Used to treat abrasions, small cuts, and scrapesscrapes

Clean wound properlyClean wound properly See the list of agents for treating such See the list of agents for treating such

wounds on the next slidewounds on the next slide


Antibiotic ProductsAntibiotic Products

ProductProduct Trade NamesTrade Names Dosage FormsDosage FormsBacitracinBacitracin BacitracinBacitracin OintOintNeomycinNeomycin NeomycinNeomycin OintOint

MyciguentMyciguent CreamCreamPolymyxin B,Polymyxin B,neomycin,neomycin,bacitracinbacitracin NeosporinNeosporin Oint, creamOint, cream

OintOint, Ointment., Ointment.


Skin Protection Factor GuideSkin Protection Factor Guide

SPF agents: topical form; prevent sunburnSPF agents: topical form; prevent sunburn UVA rays and UVB rays: two main UVA rays and UVB rays: two main

wavelengths of rays that cause concernwavelengths of rays that cause concern UV rays cause premature aging, changes UV rays cause premature aging, changes

in the DNA, erythema, and blistering in the DNA, erythema, and blistering


Sunscreen Skin Protectant FactorSunscreen Skin Protectant Factor

Overexposure to the sun can cause Overexposure to the sun can cause mutations in DNAmutations in DNA

Cancer can occur and discoloration of Cancer can occur and discoloration of prematurely aged skinprematurely aged skin

Melanin: chemical for skin colorMelanin: chemical for skin color


Sunscreen Skin Protectant Factor Sunscreen Skin Protectant Factor (Continued)(Continued)

Two types of protectants:Two types of protectants: SunscreensSunscreens: protect from UVA and : protect from UVA and

UVB raysUVB rays SunblocksSunblocks: reflect UV rays: reflect UV rays

SPF factor importantSPF factor important Choose coverage based on skin typesChoose coverage based on skin types


Skin Protectant Factor Guide for Application Skin Protectant Factor Guide for Application of Sunscreenof Sunscreen

Skin CharacteristicsSkin Characteristics SuggestedSuggestedSkin TypeSkin Type After 10 Min Sun Exposure After 10 Min Sun Exposure Minimum CoverageMinimum CoverageII Burns easily/rarely tansBurns easily/rarely tans 20 to 30 SPF20 to 30 SPF

IIII Burns easily/tans minimallyBurns easily/tans minimally 12 to 20 SPF12 to 20 SPF

IIIIII Burns moderately/tans graduallyBurns moderately/tans gradually 8 to 12 SPF8 to 12 SPF

IVIV Burns minimally/tans wellBurns minimally/tans well 4 to 8 SPF4 to 8 SPF

VV Rarely burns/always tansRarely burns/always tans 2 to 4 SPF2 to 4 SPF

VIVI Never burns/deeply pigmentedNever burns/deeply pigmented NoneNone

SPFSPF, Skin protectant factor., Skin protectant factor.


Acne Development and TreatmentAcne Development and Treatment

Acne affects teenagers and adultsAcne affects teenagers and adults Caused by hormonal changes and geneticsCaused by hormonal changes and genetics Hormones enlarge the glands of the skinHormones enlarge the glands of the skin


Acne Development and Treatment Acne Development and Treatment (Continued)(Continued)

Two productive glands:Two productive glands: Sweat: regulate temperatureSweat: regulate temperature Sebaceous: produce skin oil or Sebaceous: produce skin oil or

sebumsebum Increased sebum traps bacteriaIncreased sebum traps bacteria Keep skin clean and free from bacteriaKeep skin clean and free from bacteria



Acne classified into two groups:Acne classified into two groups: Noninflammatory: treatment is mild Noninflammatory: treatment is mild

medication (keratolytics)medication (keratolytics) Inflammatory: benzoyl peroxide most Inflammatory: benzoyl peroxide most

common OTC product recommendedcommon OTC product recommended



Antibiotics used: tetracycline, Antibiotics used: tetracycline, erythromycin, clindamycinerythromycin, clindamycin

Topical agents: retinoic acid, isotretinoin Topical agents: retinoic acid, isotretinoin (Accutane),(Accutane), and tretinoin (Retin A) and tretinoin (Retin A)


Hives/InflammationHives/Inflammation

Common noninfectious conditions include: Common noninfectious conditions include: urticaria (hives),urticaria (hives), eczema (red skin rash), eczema (red skin rash), psoriasis (plaques, scaly skin), seborrheic psoriasis (plaques, scaly skin), seborrheic dermatitis (rash), and atopic dermatitis dermatitis (rash), and atopic dermatitis (rash)(rash)

Topical agents: used for hives and skin Topical agents: used for hives and skin rashes causing inflammation from severe rashes causing inflammation from severe itchingitching

Psoriasis: consult a doctorPsoriasis: consult a doctor


Infectious Inflammatory Skin ConditionsInfectious Inflammatory Skin Conditions

Warts: viral, contagious, caused by Warts: viral, contagious, caused by papovavirus(Treatment: see Table 9-19)papovavirus(Treatment: see Table 9-19)

Genital warts: see doctorGenital warts: see doctor Tinea infections: caused by fungus; treat Tinea infections: caused by fungus; treat

with powdered antibiotics (Treatment: see with powdered antibiotics (Treatment: see Table 9-20)Table 9-20)

Canker sores: inside cheek of mouth; Canker sores: inside cheek of mouth; small topical ulcers (See Table 9-21)small topical ulcers (See Table 9-21)


Lice: Children come home from school with Lice: Children come home from school with head lice; high risk for catching without body head lice; high risk for catching without body contact; whole family should be treatedcontact; whole family should be treated

HerpesHerpes——two different types:two different types: Herpes simplexHerpes simplex (causes sores) (causes sores) Herpes zoster-Herpes zoster- Shingles (causes lesions) Shingles (causes lesions)

• Treated with antiviral medicationsTreated with antiviral medications

Infectious Inflammatory Skin Conditions Infectious Inflammatory Skin Conditions (Continued)(Continued)


Impetigo: contagious condition caused by Impetigo: contagious condition caused by streptococcal organisms; infection contagiousstreptococcal organisms; infection contagious Treatment: antibiotics and Burrow’s solutionTreatment: antibiotics and Burrow’s solution See Figure 9-6See Figure 9-6

Infectious Inflammatory Skin Conditions Infectious Inflammatory Skin Conditions (Continued)(Continued)


Serious Skin ConditionsSerious Skin Conditions

Require a visit to the hospital or doctorRequire a visit to the hospital or doctor Include skin melanomas, psoriasis, burnsInclude skin melanomas, psoriasis, burns Malignant melanoma: cancerous skin Malignant melanoma: cancerous skin

growth; treatment: removal, skin graftgrowth; treatment: removal, skin graft See Figure 9-7See Figure 9-7


Ulcers: external ulcers caused by bed sores Ulcers: external ulcers caused by bed sores and affect elderly; may harbor MRSAand affect elderly; may harbor MRSA——highly contagioushighly contagious Treatment: antibioticsTreatment: antibiotics

Can be caused by STDsCan be caused by STDs See Figure 9-8See Figure 9-8

Serious Skin Conditions Serious Skin Conditions (Continued)(Continued)


PsoriasisPsoriasis

Genetic skin condition; cannot be cured; Genetic skin condition; cannot be cured; lasts a lifetimelasts a lifetime

Not contagious but looks bad when Not contagious but looks bad when inflamedinflamed

Most affected areas: joints, limbs, neck, Most affected areas: joints, limbs, neck, scalpscalp

Potent drugs used: corticosteroids (require Potent drugs used: corticosteroids (require physician’s prescription) physician’s prescription)

Sunlight treatments Sunlight treatments


BurnsBurns

Range from first degree (least severe) to Range from first degree (least severe) to third degree (most severe)third degree (most severe)

Medications include silver sulfadiazine Medications include silver sulfadiazine (Silvadene)(Silvadene) cream cream

copyright © 2007, 2004 by saunders, an imprint of elsevier inc. all rights reserved. 1 chapter 9...

Documents

skin anatomy skin

slide slide

imprint of elsevier

layer of skin

common skin conditions

skin disorders

miscellaneous skin conditions

acne slide