Dermatology

1. Dermatology Vickie Mickey,CT

2. Dermatology • Study of skin, diseases, and treatment • Electrologist encounter the presence of skin disorders and diseases • Electrologist must be able to identify dermatology disorders in order to know when to treat or not treat a skin disorder • Certain skin disorders are contraindicated

3. Lesion • Lesions are a structural change in the tissue caused by trauma or disease • Three types of lesions: 1. Primary 2. Secondary 3. Tertiary or vascular

4. Primary Lesions • First to recognize • Flat or non-palpable • Skin color changes may occur • Elevation can occur • Solid mass

5. Macule • Small discolored spot or patch on the surface of the skin, flat or level with skin • A freckle, flat moles, liver spot (chloasma) or leukoderma (loss of pigment) • Pink or red inflammatory macules – indicative of typhoid, typhus, secondary syphilis, or allergenic drug reaction • Blue Macules in public regions indicate crab lice

6. Papule • Small elevated pimple • Contains no fluid but may develop pus

7. Common Papular Eruptions • Pityriasis rosea – self-limited disease of truck, eruptions at time barely evident • Mucocutaneous syphilis – papules tend to be juicy, easily molded, found in mouth and genital region • Psoriasis – chronic inflammatory disease of skin, lesions are round, dry papules, covered with coarse slivery scales

8. Common Papule Eruptions • Warts – verruca • Seborrheic keratois – flat, brown, greasy feeling papules, waxy texture. Non-malignant • Actinic keratosis – hard, horny papules, results of sun and wind exposure. May become malignant • Senile keratosis– hard horney papules, old age spots • Molluscum contagiosum – virus infection, pin-head sized to pea-sized, wax like papules of a yellowish white or pinkish color

9. Common Papule • Acne – different stages • Drug eruptions – may occur in many forms • Scratch a localized reaction to rubbing, scratching

10. Wheal • Itchy, swollen lesion that last only a few hours • Hive or insect bite • Capable of returning

11. Nodule • Solid lump, larger than a papule, projects above the surface or may lie below the skin • Varies in size and color • Of medical significance if nodule appears in more than one area

12. Nodules • Nevis – birthmark • Lipomas – fatty growth cells • Fibromas – benign tumor composed of whorls of white fibrous connective tissue. May occur in single or in random areas, not indicative of underlying disease

13. Tumor • Abnormal swelling or enlargement that can be malignant or benign • Fluidless lesions

14. Vesicle/Bulla • Raised lesion containing fluid derived from serum of blood • Water fluid collects within epidermis or between epidermis and dermis, ranging color from clear to pink • Bulla is larger than a Vesicle

15. Vesicle/Bulla • Herpes Simplex – virus • Contact Dermatitis – inflammation resulting from irritation of certain substances • Sun burn – (second degree) • Blister – skin irritation

16. Pustule • Small round, round, raised area of inflamed skin filled with pus • Common types: acne • Furuncles and carbuncles – contain infection • Impetigo – highly contagious inflammatory disease • Eczema • Acute fungal infection of feet and hands • Smallpox, chickenpox, vaccination reaction, herpes

17. Secondary Lesion • Secondary lesions are primary lesion that have progressed to later stage of disease • Secondary lesions usually characterized by material buildup on the skin and includes:

18. Scale • Scale is dry and greasy accumulation of epidermal flakes • Silvery, stratified scales of psoriasis • Seborrhea dermatitis – yellow greasy scales caused by excess secretion of sebaceous glands

19. Crust • Crust/Scab – dry accumulation of serum and pus, mixed with epidermal material • Lymph crust – honey colored scab not oozing, evidence of skin healing • Lymph crust – can appear after electrolysis • Pus Crust – a dirty gray or greenish-yellow crust indicative of infection • Blood crust is reddish or black crust from dried blood, indicative of disease of blood

20. Excoriation • Skin sore produced from scratching or abrasion

21. Fissure • Crack in skin that penetrates the dermis

22. Ulcer • Open skin lesion or mucous membrane that is accompanied by pus and loss of skin depth

23. Keloid • Skin or film that forms over a wound • Keloids rarely form on face • Keloids appear more in skin of color

24. Scare • Specialized growth of tissue that forms during healing of wound or skin condition

25. Common Skin Diseases • Herpes Simplex – an acute inflammatory infection of the skin, occurring as swollen vesicle or group • Appears around mouth or nostrils • DO NOT TREAT AN AREAS With Herpes!

26. Impetigo • An acute inflammatory and highly contagious disease • Usually found in children • Characterized by honey colored crust that have a “stuck on appearance! • DO NOT TREAT THIS SKIN CONDITION

27. Psoriasis • Reddish patches covered by silvery scales • Tiny bleeding points may appear under scales • Not infectious • Electrologist can work on this skin involved with however, never within the patches

28. Dermatitis • Irritation with vesicular eruptions • External on skin • Wait until skin has resolved before treating with electrolysis

29. Parasitic Disease of the Skin • Parasites both animal or vegetable can affect skin • Very Contagious • Refer to physician • DO NOT TREAT

30. Scabies • Very contagious • Itching skin caused by infestation by itch mite • Mites burrow in hands or feet • Skin reacts with eruption of papules on forearms, underarms, waist, inner thigh, buttocks, and ankles • If disease is not treated it may manifest into boils and ulcers • DO NOT TREAT

31. Pediculosis • Head lice – Pediculois Capitis • Transmitted from person to person via infected personal care items • Nit surround hair and passes up out of pore with growing hair • Body Louse – Pediculosis Corporis • Causes intense itching • Clothing contains nits

32. Disease of Sebaceous Glands • Blackheads – comedomes – hardened plug of sebaceous material • Appears black as the sebum oxidizes and turns black • Can block mouth of follicle • Can become inflamed

33. Acne • Chronic inflammation of the philosebaceous unit • Common on face, back and chest • May present as papules or nodules • Can appear as pustules • Cysts may appear • Acne begins as a blockage of the follicular canal, develops through leakage of sebum into the dermis

34. Acne • Once the dermis becomes irritated it can develop into a red pustule or pimple • Prevalent in adolescence during heightened androgenic activity stimulates sebaceous activity • Infected follicles can be treated with electrolysis

35. Milia • Whitehead caused by retention cyst of entrapped sebum beneath the epidermis • Not in follicle pore • Appears on face, neck, shoulders and chest areas • Not usually associated with hair follicle

36. Sebaceous Cyst • Subcutaneous tumor of the sebaceous glands • Composed of sebum • Ranges in size from small pea to an orange • Releasing sebum will not eliminate cyst • Needs to be removed by physician

37. Seborrhea • Oily condition of nose, forehead, and scalp • Result of over production of sebaceous glands • Can accompany itching and burning

38. Asteatosis • Dry, scaly skin deficient of sebum

39. Disorder of Sudoriferous Glands • Hyperidrosis – excessive perspiration • Caused by stimulates or mental depression and exhaustions • Great condition to treat with laser on underarms • Bromidrosis – foul smelling perspiration • Appears in armpits, or feet • Can be caused by drugs, foods, or rare disease • Result of apocrine sweat glands

40. Disorders of Sudoriferous Glands • Anidrosis – lack of perspiration caused by fever or disease • Miliaria or Heat Rash – an acute inflammatory disorder of the sudoriferous glands • Lesions consists of vesicles and papules

41. Pigmentation Irregularities • Tan – Protective layer of skin • Sunlight barrier for skin • Prevents excessive production of Vitamin D

42. Freckles & Lentigines • Yellowish or brown spots occurring on hands, face, and other exposed body parts • Result of sun exposure

43. Chloasma • Yellow, brown or black deposits in skin • Patches occurring in various shapes and spots • Appears a mask of pregnancy – can result from birth control pills • If patient displays in area to be treated with electrolysis , do test spots prior to treatment as it may increase with treatment • Laser hair removal often removes it

44. Stains • Abnormal patches of brown coloration • Round or irregular shapes

45. Nevus/ Birthmark • Colored malformation of the skin • Often congenital

46. Leucoderma • White patches of skin or all over body • Albinism – a congenital absences of pigment in skin, hair, eyes • Extremely sensitive to sun • Can be localized • Not a good candidate for laser! • Vitiligo – loss of pigment, occurring mostly in bands, often on hands and patches in the skin • Do not treat with laser!

47. Hypertrophies • Usually and enlargement of skin due to multiplication of cells • Occurs for many reasons • Keratoma (Callus) – hard thickened patches of skin due to hypertrophy of horny layer • Caused by irritation , friction, or pressure

48. Moles • Small congenital macule • Ranges in color from pale tan to brown to bluish black • True malignant moles is melanoma • Black, blue-black or slate-colored • Lacks hair • Mole that is normal for many years can suddenly change, increase in size, increase in depth, pigmentation • Crust can form and may bleed • Inflammatory ring may appear around it

49. Moles • When in doubt don’t treat a mole • Have checked by physician prior to treatment • Malpractice insurance may not cover if not checked prior to treatment • Get release to treat mole

50. Post Treatment Disorders • Over treatment can cause eschars (scabs) • Unsanitary practices by patient can result in infection • Examine skin disorder when confronted • Usually small areas will be related to the electrolysis treatment, one or two follicles • Good aftercare instruction very important to patient