Integumentary System

Integumentary System

Objectives List the major components of skin anatomy. List five types of noninfectious skin conditions and their treatments. List seven types of infectious skin conditions and their treatments.

Objectives (cont’d) Determine the proper strength of sunscreen necessary to protect skin from ultraviolet rays. Define the various forms of acne. Describe psoriasis and the types of medications used to treat this skin condition.

Objectives (cont’d) List the degrees of a burn and at what depth each one affects. Define the function of the sebaceous and sweat glands, nails, and hair. Identify the conditions that affect the nails and hair and their treatments. Describe the use of immunosuppressants to treat psoriasis.

Introduction Integumentary means covering. System is composed of skin, hair, and nails. It protects the body, regulates temperature, and acts as a sensor to stimuli.

Skin Anatomy Skin is made of various layers that contain nerves, glands, hair, and blood vessels. Function is to protect the body against heat, cold, light, dehydration, and infection. Nerves allow the skin to detect pain, heat. and cold.

Skin Anatomy (cont’d) • Three main layers: • Epidermis • Dermis • Subcutaneous layer

Hair and Nails Made of proteins called keratin Melanocytes: determine color of hair Lunula: the small white portion located at the base of the nail

Glands • Two glands within the layers of the skin: • Sebaceous: secret sebum to provide moisture • Sweat: perspiration to provide cooling

Noninfectious Skin Conditions • Acne, sunburns, and hives • Growths • Cancerous • Noncancerous

Acne Vulgaris • Cause is inflammation of sebaceous glands. • Rise in sebum production due to hormones • Symptoms include: greasy residue on the surface of the skin, lesions on the face, back of the neck, the chest, shoulders, back, and upper arms.

Acne Vulgaris (cont’d) • Five categories of lesions: • Whiteheads • Blackheads • Papules • Pustules • Scars • Cleansing agents to decrease sebum production

Drug Treatment for Acne Vulgaris Topical agents for mild acne: benzoyl peroxide, salicylic acid Severe acne: topical or systemic antibiotics or topical retionoids in addition to keratolytics

Sunburn Symptoms: painful, reddening skin; swelling and blistering of the skin as well as fever, chills, and/or weakness Sunscreens: protectant absorbs ultraviolet rays Sunblocks: reflect ultraviolet rays away from the skin

Sunburn (cont’d) Photosensitivity means burn particularly easily or develop exaggerated skin reactions to sunlight. Years of sun damage can lead to skin cancer.

Drug Treatment for Sunburn Topical OTC agents (Cortaid) Silvadene cream to prevent infection

Urticaria Hives—caused by a hypersensitivity to food, environment, or drugs. May dissipate within several hours. Hives due to allergic exposure may require treatment. Cold wet compress can alleviate itching.

Drug Treatment for Urticaria • Antihistamines • Topical agents to numb itching • Diphenhydramine lotion (Caladryl Pink, Benadryl)

Skin Cancer • Three main types: • Melanoma • Squamous cell • Basal cell • Melanoma most aggressive and severe type

Skin Cancer (cont’d) Risk factors: sun damage, genetics, and exposure to radiation from tanning booths Treatment dependent on the stage or severity of the cancer

Drug Treatment for Skin Cancer Topical chemotherapy: fluorouracil

Stasis Dermatitis and Ulcers • Stasis dermatitis (varicose eczema): This is a condition due to the build up of fluids under the skin. • Open sores are ulcers. • Cause is poor circulation. • May harbor methicillin-resistant Staphylococcus aureus (MRSA).

Stasis Dermatitis and Ulcers (cont’d) Symptoms include itching, pain, skin lesions, swelling. Treatment: Increase circulation and decrease edema.

Drug Treatment for Stasis Dermatitis and Ulcers Topical antibiotics: mupirocin (Bactroban, Centany)

Psoriasis Psoriasis is an inflammatory skin disorder. Most affected areas are around the joints, limbs, neck, and scalp. Often appears as plaques of silvery scales which vary in size. Needs high-quality moisturizer to keep the skin moist and help to control flare-ups.

Drug Treatment for Psoriasis Topical agents: colloidal oatmeal, tar-based shampoos Phototherapy: UVB and sunlight Systemic agents Table 20-6

Burns Burns range in severity from first- to fourth-degree. Burn hospitals require specialized solutions and medications. Patients with severe burns over a large surface area can be at high risk for infection, sepsis, and death.

Drug Treatment for Burns Treatment depends on severity and type of burn. Topical medications include: silver Silvadene (sulfadiazine) cream and bacitracin ointment.

Canker Sores Canker sores are ulcers located in the soft tissue of the mouth, inside the cheeks, lips, base of the gums or under the tongue. Are related to stress, poor nutrition, food allergies, immunosuppression, menstrual periods.

Drug Treatment for Canker Sores Mouth rinses, topical pastes, to oral medications, and nutritional supplements See Table 20-7

Infectious Inflammatory Skin Conditions Some infectious conditions can be treated with OTC drugs; others require physician consult.

Warts Are caused by a virus that causes growths on the skin. Verruca plana commonly seen in children. Plantar warts found on bottom of feet. Genital warts are a different strain of HPV.

Drug Treatment for Warts Common warts: OTC agents that contain salicylic acid or those that freeze the wart Plantar warts: fluorouracil topical (carac. Efudex, fluoroplex Genital warts: Aldara (imiquimod) or podofilox (topical gel or solution)

Athlete’s Foot Tinea pedia is a fungus that causes scaling and blisters between the toes. Severe infections may cause inflammation along with severe itching and pain when walking. It is spread by contact from shower floor surfaces, clothing, and sharing socks.

Drug Treatment for Athlete’s Foot • Topical antifungals • Powder or spray • Oral antifungals for infection • Systemic therapy if infection affects nails

Herpes Outbreak of the skin that causes painful blister-like eruptions Two types: herpes zoster and herpes simplex

Drug Treatment for Herpes Antivirals to lessen symptoms Acyclovir (Zovirax) topical ointment for cold sores Acyclovir - may be given orally, as can valacyclovir (Valtrex), and famciclovir (Famvir)

Impetigo Caused by streptococcal organisms or Staphylococcus aureus Areas affected: face, limbs, abdomen Symptoms: thick yellow crust that is itchy, oozing and blistering

Drug Treatment for Impetigo Topical antibiotics: mupirocin 2% ointment (Bactroban, Centany) or retapamulin 1% ointment (Altabax) Antibiotics: penicillins (e.g., dicloxacillin or Augmentin) or cephalosporins (e.g., Keflex or Ceftin)

Conditions of the Hair: Lice Head lice are caused by the parasite Pediculus humanus capitis. Another type of lice affects the pubic area; spread through sexual contact. Physical removal of all nits is essential to adequately treat lice of any type.

Drug Treatment for Lice • OTC agents • Nix (permethrin) topical cream rinse • Medi-Lice, Pronto, and Tegrin LF (Pyrethrins and piperonyl butoxide) shampoos • Prescription • Ovide (Malathion) topical • Kwell (Lindane) shampoos and lotions

Drug Treatment for Lice (cont’d) Pubic lice: a pediculicide such as permethrin or pyrethrin

Conditions of the Nail: Acute Paronychia and Onychomycosis Acute paronychia: a staphylococcal infection Onychomycosis: infection of the nails Infection normally starts at the tip of one or more toenails; produces thickening of, discoloration, and crumbling of the nail

Drug Treatment for Acute Paronychia and Onychomycosis Topical antifungals: ciclopirox olamine 8% lacquer solution Oral antifungals: terbinafine

Questions?

Integumentary System