Unit 5 – 4. Dermatological Conditions

Dermatological Conditions: Chapter 29
For the purposes of this lecture, we will discuss different skin disorders including
their definition, the signs and symptoms of the condition, and the mode of transmission. All skin conditions should be referred to
a physician for examination and treatment. A macule is a change in surface color without
elevation or depression. They come in various sizes, usually 5-10 millimeters
in diameter. They are most common on the back, chest, arms,
and face. They can be hypopigmented or hyperpigmented
skin tissue. A birthmark may be considered if it is small. Rashes may also be considered if the color
of the rash is varied from the skin, for example in café au lait spots. If they’re lesions, they may spread. Vitiligo is a disease that causes the loss
of skin color in blotches. This may also include skin cancers, or ultraviolet
light exposures, also called age spots. A papule is an area of abnormal skin tissue. There are typically less than 1 centimeter,
they have distinct borders, and come in a variety of shapes. They may have skin lesions and essentially
are changes in the skin color or texture of your skin. Papules can cluster together to form a rash. They are caused by a number of skin conditions
most commonly dermatitis, chicken pox, and eczema. They can be relieved with home treatments. Papules appear sometimes with new medication
and you should consult your doctor. A papule may also appear from a tick bite;
you need to consult the doctor to determine if you have Lyme disease. A nodule is a growth of forms under the skin. They may be filled with inflamed tissue or
a mix of tissue and fluid. They may have colored fluid within the nodule
which may indicate an infection. Inflamed tissues that collect together may
form a lump. They can grow within any level of the skin,
either the subcutaneous layer, the dermal, or the epidermal layer. There are sometimes found on the body’s organs
as well. They range in size, they can be cancerous
or non-cancerous, but most are benign. Common areas for nodules include the thyroid
glands, lungs, underarms, and groin. A tumor is any mass lesion or abnormal growth
of body tissue. It’s generally larger than a nodule. It may either be malignant, cancerous, or
benign (non-cancerous) signs and symptoms include weight loss, persistent headaches,
chronic fatigue, nausea, and vomiting. Different things that can affect the modes
of transmission of tumors include diet, genetics, which include a family history, the environment,
excessive sunlight exposure, obesity, and radiation. Some tumors are more common in one gender
than another. A plaque is a usually well circumscribed lesion
with a large surface area and slight elevation. Signs and symptoms include red and scaly skin,
crusting of the scalp, discoloration the fingernails. Causes or transmission of the disease include
stress or trauma from streptococcal infections, abnormality to immune systems, certain medications
and drugs may aggravate the condition, this may also be genetic. A wheal is an elevation of the skin with smooth
surfaces, sloping borders, and light pink coloring. They’re caused by acute areas of edema in
the skin. They may appear, disappear, or change form
abruptly within hours or minutes. Their size ranges from three to twenty centimeters. Signs and symptoms may be an allergic reaction,
they’re typically red or pink in color, smooth elevations around the surrounding skin. Itchiness or irritation may occur; they may
occur frequently or unpredictably. The mode of transmission for a wheal is pain
medication, scratching, temperatures either too hot or too cold, stress, sunlight, and
sometimes exercise. A vesicle is a raised lesion less than 1 centimeter
in diameter. They are typically filled with clear fluid. Signs and symptoms may include allergic reactions
to drugs, atopic dermatitis or eczema, autoimmune disorders, chicken pox, poison ivy, herpes
simplex, or shingles. For the mode of transmission, they are possibly
contagious when the blisters pop and may spread to other areas. A bulla is a large blister on the skin; it’s
often filled with clear fluid. Signs and symptoms include insect bites, infections,
burns, the herpes simplex virus, or allergic skin reactions. Mode of transmission is very similar. It may be contagious if they break open and
leak on the surrounding skin tissue. A pustule is a small pus filled sac. It’s commonly seen in acne; this is an infection
on the skin. Signs and symptoms include chicken pox, yeast
infection, and a herpes viral infection, such as cold sores, or genital herpes. The mode of transmission may also be contagious
if they break open and leak on the surrounding skin. An erosion is a loss of some or all of the
epidermis or the outer layer of the skin. The signs and symptoms include eating away
of the surface layer by chemical or physical process such as inflammation. The mode of transmission is not contagious,
so if somebody has an erosion you are not likely to catch it from them. An ulcer is a sore on the skin or mucous membrane;
it is a disintegration of tissue. It can result in a complete loss of the epidermis,
and often portions of the dermis, and even subcutaneous fat. The signs and symptoms of ulcers is they appear
is open craters, often round, with layers of skin that have eroded. The skin around the ulcer may be red, swollen,
and tender. Patients may feel pain on the skin around
the ulcer and fluid may ooze from the ulcer. The mode of transmission for ulcers may be
contagious if they’re oozing. A fissure is a crack in the skin, it is most
commonly the result of skin dryness. Ichthyosis is a genetic disorder where there’s
often severe skin cracking. Signs and symptoms are linear like cleavages
of the skin, sometimes defined as extending into the dermis. They’re smaller than skin lacerations, a fissure
is not contagious, and there is no mode of transmission. Atrophy of the skin is a thinning of the upper
layer of the skin, which is often caused by aging or topical steroids. Signs and symptoms of atrophy include tension
or tightness of the skin, pain, pitting, dryness, or a papery texture of the skin. Again atrophy is not contagious and there
is no mode of transmission. Excoriation or neurotic excoriation are skin
lesions produced by repetitive scratching. There is no known underlying physical pathology. Patients dig at their skin to relieve itching,
to extract imaginary objects that they believe are embedded or extruding from the skin. Signs and symptoms include clear, linear erosions,
scabs and scars that are hypopigmented or hyperpigmented. All lesions are usually of similar size and
shape. Common sites include exterior surfaces the
extremities, the face, and the upper back. There is no mode of transmission and excoriation
is not contagious. A crust or scab is serum, blood, or purulent
exudate which dries and is a hallmark of a pyogenic. Signs and symptoms of a crust can be yellow
when they have arisen from dried serum, green or yellow– signs and symptoms of crusts can
be yellow when they have arisen from dried serum, green or yellow-green when formed from
purlin exudate, brown or dark-red when form from blood, and the mode of transmission is
none, so these are not contagious either. A scale is dry, itchy, or red flaky skin. Signs and symptoms include that dry itchy
or red flaky skin; they can look like fish scales or alligator skin. Associated conditions are psoriasis, dermatitis,
eczema and ichthyosis which is fish-scale disease. Scales are not contagious and therefore do
not have a mode of transmission. Lichenification is a thickening of the skin
due to continuous scratching or rubbing. The skin will have a leathery appearance and
is associated with skin conditions in which the skin is continuously irritated, such as
eczema. There is no mode of transmission and lichenification
is not contagious. A scar is a patch of skin that grows over
a wound. It forms after the body heals itself from
cuts, scrapes, and burns. It can also be caused by surgery, chicken
pox, acne, and tuberculosis test. Scars, too, are not contagious, and therefore
do not have a mode of transmission. A keloid is a growth of excessive scar tissue
in which the skin is healed after an injury. Signs and symptoms may include areas that
may be flesh colored, pink, red, or purple. A lumpy rigid area skin, itchy patches of
skin, and the scar tissue may continue to grow larger over a period of time. Keloids are not contagious, but the exact
cause is unknown and maybe most common in darker skin toned people. Due to injury, either avulsion or surgical
trauma and piercing. Uticaria is also known as hives. They are raised, often itchy, red welts on
the surface of the skin. It’s usually an allergic reaction to food
or medicine. Signs and symptoms include slightly raised
pink or red swelling on the skin, welts that occur alone or in a group or connect over
a large area, skin swelling that subsides or goes away within 24 hours at one spot,
but may appear in another spot, itching, and burning. The mode of transmission can be allergies
to food, dust, animal and insect bites, infections to illness such as the cold or the flu, exposure
to Sun, stress, pressure on the skin or scratching, and contact with chemicals. Dermotrographism is one of the most common
types of uticaria or hives, in which the skin becomes raised or inflamed when stroked, scratched,
rubbed, or sometimes even slapped. This is also known as skin writing. Signs and symptoms include red, raised lines,
swelling, infection, hive-like welts, and itching. There is no exact cause and the mode of transmission
is not contagious. This occurs mostly from rubbing of clothes
or bed sheets. Dementrographism may also proceed from an
infection, stress, or medications such as penicillin. Cholinergic Uticaria is four to six millimeter
hives which develop after exposure to heat exercise or stress. This is sometimes referred to as an exercise
allergy. Signs and symptoms include itching, burning,
tingling, and warmth of the skin. It may last minutes to hours; it is not contagious
but exposure to Sun, heat, and exercise will increase the welts. Cold Uticaria is hives which occur after exposure
to cold. Many occur after infections, medications,
or emotional stress, and is most common in patients 18 to 25 years of age. The signs and symptoms include hives, which
usually develop within five minutes of exposure, and may last one to two hours after exposure
to cold. The mode of transmission is exposure to cold,
but cold uticaria is not contagious. Solar uticaria is hives that occur within
minutes of being exposed to UV light. This is also known as a Sun allergy. Signs and symptoms include hives after exposure
to Sun, which resolves within one to three hours. The mode of transmission is exposure to UV
light or the Sun. Solar Uticaria is not contagious. A sebaceous cyst is a closed sack under the
skin that is filled with a cheesy like or oily material. Signs and symptoms include a small, non painful
lump beneath the skin. This usually grows slowly and is not typically
painful. Warmth of the skin may occur in an infected
area. The cyst may have a grayish-white, cheesy,
foul-smelling material that drains from the cyst. Most commonly they are found on the face,
neck, and trunk. If the lump becomes infected or inflamed,
other symptoms may include skin redness, and tender or sore skin. The mode of transmission is not contagious,
however, draining the sebaceous cyst is very important to prevent future infections. Eczema is a generic term for a skin inflammation. It affects 10-20% of infants and about 3%
of adults. Most infants outgrow this condition into adulthood. Signs and symptoms include itchy skin. Stress tends to cause the condition to worsen. Modes are transmission include family history
and other allergies or asthma. Psoriasis is a skin redness and irritation. Most people have thick red skin with flaky,
silver-white patches or scales. Signs and symptoms can be acute or chronic;
this includes scales and other symptoms may include general sores in males, joint pain
or aching, nail changes, severe dandruff on the scalp, and is most often seen at the elbows,
knees, and the middle of the body. The mode of transmission is not contagious
for psoriasis. A melanoma is the most dangerous type of skin
cancer. It is the leading cause of death from all
skin diseases. It can involve the colored part of the eye
as well. Signs and symptoms include a mole, sore, lump,
or growth on the skin, a sore or growth that bleeds or changes in color. The ABCDE system can help you remember the
possible symptoms of a melanoma. “A” stands for asymmetry: one half of
the abnormal area is different from the other half. “B” stands for border: the edges of the
growth are irregular. “C” stands for color: color changes from
one area to another with shades of tan, brown, or black, or sometimes white, red, or blue;
a mixture of colors may appear within one sore. “D” stands for diameter: the spot is usually
(but not always) larger than six millimeters in diameter, or about the size of a pencil
eraser. “E” stands for evolution: does the mole
keep changing in appearance? Melanomas are not contagious, and therefore
have no mode of transmission. Impetigo is a skin infection. It is usually caused by the streptococcus
or Staphylococcus bacteria. It can also be caused by methicillin-resistant
staph aureus or MRSA. Signs and symptoms include blisters that are
filled with pus and are easy to pop; they may be reddish or raw looking where a blister
has broken; skin sores on the face, lips, arms, and legs spread to other areas; and
swollen lymph nodes near the area of the infection. For the mode of transmission, the skin normally
has many types of bacteria. The skin breaks, can allow bacteria in, and
breaks in the skin can occur with animal bites, human bites, injury and other trauma to the
skin, and insect bites. Impetigo may also occur on the skin where
there is no visible break. It is most common in children who live in
unhealthy conditions. In adult, it may occur following another skin
problem, and may develop after a cold or another virus. Impetigo can spread to others. You can catch the infection if the fluid that
oozes from the blisters touches an open area on your skin. Cellulitis is a common skin infection caused
by bacteria. Signs and symptoms include fever, pain, or
tenderness in the affected area, skin redness or inflammation that gets bigger as the infection
spreads, skin sores or rash that grows quickly or suddenly in the first 24 hours, tight,
glossy stretched appearance of the skin, warm skin in the area of redness. There is no mode of transmission and cellulitis
is not contagious. Folliculitis is an inflammation of the hair
follicles; this is typically from a bacterial infection. Common sites include the chest, face, axilla,
buttocks, groin, and legs. The S. aureus bacteria can occur when shaving
with a razor blade. Possible opening in the skin from nicks from
shaving can allow the bacteria in. It can also be caused by friction as well. There is no skin to skin transmission. Pseudomonas aeruginosa or “hot tub folliculitis”
is from a poorly maintained contaminated water. There is no skin to skin transmission. Signs and symptoms of S. aureus are small,
tender red papules or bumps which can occur in multiple areas. Pseudomonas aeruginosa is red, itchy papules
most commonly under the areas covered by swimsuits. Folliculitis is not contagious, and therefore
does not have a mode of transmission. Furunculosis is deeper in the hair follicle
cavity. The S aureus bacteria can contain strands
of MRSA and can be difficult to treat. A furuncle is a type of furunculosis that
is similar to folliculitis, which is a boil or abscess containing pus that develops in
a pre-existing site of folliculitis. More commonly after puberty, these sites occur
with trauma or friction at the waistline, beltline, axilla, groin, thighs, and buttocks. A carbuncle is a type of furunculosis; it
is a collection of several furuncles. They are common among wrestlers and can be
transmitted from skin to skin contact. Signs and symptoms begin with tender, deep,
firm, papula that enlarge and become painful. They may fluctuate over a period of days. Abscesses remain deep and reabsorb or drain
through the skin. Acne is a condition affecting the pilosebaceous
unit that causes inflammatory lesions. The appearance is red papules, pustules, or
deep cysts. They’re typically non-inflammatory lesions
(blackheads or whiteheads). The transmission: acne is not considered contagious. A paronychia is an infection affecting the
proximal and lateral nail fold that separates the nail from the skin. Signs and symptoms include bright red swelling
in the folds of the tissue surrounding the nail. Paronchias are not contagious, but if they
are draining, personal protective equipment should be used. An onychia is an infection of the nail matrix. Signs and symptoms of an onychia include a
purulent look underneath the nail. It can also look like pus is underneath the
nail. Onychias are not contagious, but if draining
is occurring, personal protective equipment should be used. Herpes simplex is a viral infection. It presents as cold sores, fever blisters,
genital herpes, and herpes gladiatorum. It is transmitted through skin that has been
previously injured, such as cuts, abrasion, and damage. Treatment includes oral antiviral medications
including Acyclovir, Valacyclovir, Famciclovir. Athletes should be withheld from sports until
they are asymptomatic. 22% of people who are 12 or older are infected
with a herpes simplex-2 virus. 80-90% of the population have herpes simplex-1
which is commonly chicken pox. Signs and symptoms include flu-like symptoms,
fever, sore throat, malaise, vesicles on the erythema–vesicles on the erythematous base,
grouped vesicles in the same shape and age, tingling and pain occasionally, and they are
usually reoccurring. Varicella is also known as “chickenpox”. It is a common childhood disease. It is transmitted through respiratory droplets
or skin to skin contact. Patients are contagious two days before symptoms
have appeared and until all lesions have crusted over. Treatment includes lotions, antihistamines,
and antibiotics for secondary bacterial infections. Signs and symptoms include low grade fever,
headache, malaise, papular vesicular rash, lesions will vary in size shape and age, and
will rupture and form crust. Varicella is extremely contagious and should
be treated as such. If an individual does not have chicken pox
as a child but gets the disease in older age, this can actually turn into shingles, which
can be very, very painful. It is recommended for people who did not have
chicken pox as a child that they get the shingles vaccination. Herpes zoster is also known as shingles. Shingles is a reaction of the herpes zoster
virus involving the skin along the dermatomal distribution. Shingles may occur as the result of advanced
age, immunosuppression, lymphoma, stress, and radiation therapy. Treatment includes high doses of medication
that should be given within 72 hours of onset, narcotic analgesics, they should be withheld
from play, physical activity, and physical contact with others until all lesions have
crusted, so that they do not receive a secondary infection. Signs and symptoms include pain, tingling,
burning, and itching. Symptoms may mimic myocardial infarction,
pleurisy, acute abdominal pain, and migraine headache. Patients may also have preceding outbreaks
of fever, malaise, headache, and lymphadenopathy. Herpes zoster is extremely contagious, and
therefore the mode of transmission is high. Molluscum contangiousum is a disease of the
skin and mucous membranes which is caused by the poxvirus. Signs and symptoms are characterized by small,
smooth, flesh-colored tone or white dome-shaped papules, with a central point. They may be red, inflamed, or small and itchy. The mode of transmission is spread by direct
contact from person to person and through contaminated objects. The human papillomavirus or HPV is a DNA virus. It is an infection of the keratinocytes of
the skin or mucous membranes. Usually results in warts on the hands or feet. There are 65 different types of the HPV virus. Signs and symptoms include small smooth skin
colored papules that may progress to a rough surface; they sometimes have a flat top surface. The mode of transmission is skin to skin contact
and can occur at sites that have trauma, abrasions, or eczema. Taniya corpus is a common fungal infection
characterized by scaly, erythematous lesions on the skin or ringworm. Signs and symptoms are scaly areas that vary
in size. They may be itchy or they may be asymptomatic. Mode of transmission is high, through skin-to-skin
contact. Tinea Cruris is also known as jock itch or
ringworm of the groin. It is an infection of the groin area caused
by a fungus. Signs and symptoms include red, raised, scaly
patches that may blister or ooze. Patches often have sharply defined edges. Patches can be redder around the outside with
normal skin tone on the center, and abnormally darker light-skinned. Sometimes these changes in pigmentation are
permanent. The mode of transmission for tinea cruris
can be triggered by friction from clothes or prolonged wetness in the groin area such
as from sweating. This can be passed from one person to the
next by direct skin to skin contact or contact with unwashed clothing. Tinea Unguium is often referred to as onychomycosis. It is an infection of the nail tissue of the
hands or feet. There are possible seven signs and symptoms
which include infected, thickened, cloudy, brittle, brown, lifted nails, and destruction
of the tissue underneath the nails. The mode of transmission for tinea unguium
occurs by transmission of an infectious agent by one person to another through one or more
of the following: saliva, air, coughing, fecal-oral route, surfaces, blood, needles, blood transfusion,
sexual contact, or mother to fetus, among other modes of transmission. Tinea Pedis is athlete’s foot. It is an infection of the feet caused by a
fungus. Athletes foot may last for short or long time
and may come back after treatment. The most common symptom is cracked, flaking,
peeling skin between the toes are on the side of the foot. It may also include red and itchy skin, burning
or stinging pain, blisters that ooze or get crusty, and if the fungus spreads to the nails,
they can become discolored, thick and even decay. Athletes foot may occur at the same time as
other fungal skin infections such as jock itch. Athletes foot is the most common type of tinea
fungal infection. The fungus thrives in warm moist areas. Athletes foot is easily spread and can be
passed through direct contact or contact with items such as shoes, stockings, and the shower
or pool surfaces. Tinea capitis is a fungal infection of the
scalp. This is also called ringworm of the scalp. Signs and symptoms include bald patches with
small black dots due to hair that is broken off, scaly areas of the skin that are red
and swollen, pus-filled sores called kerions, low-grade fever around 100 swollen lymph nodes,
itchy scalp. The modes of transmission or causes are most
likely mold-like fungi called dermatophytes. The fungi grow well in warm, moist areas. It is not uncommon to have minor skin or scalp
injuries. This can also happen in people who do not
like to bathe like teenagers. It can also occur if you have a wet scalp
for long periods of time or a sweaty scalp for long periods of time. Tinea Veriscolor is a fungal infection of
the skin. It is caused by the type of yeast that naturally
lives on your skin. When the yeast grows out of control, the skin
disease, which appears as a rash, is the result. Signs and symptoms include patches that may
be white, pink, red, or brown, and can be lighter or darker than the skin around them,
areas that do not tan, most commonly seen on the neck, arms, and hands. Modes of transmission or causes can include
if you have oily skin, hotter climate, if you’re sweating a lot, if you have a weak
immune system, basically if you live in Corpus Christi you have a higher risk, it’s not contagious,
and it usually affects teens and adults. Head lice are parasites that are found on
the human head. They are spread by person-to-person contact
or the sharing of combs, brushes, caps, and other clothing. They are with preschool and schoolchildren. Up to 1 in every 10 children in school acquires
head lice at some point. Signs and symptoms include tickling or feeling
like something is moving through the hair, itching caused by an allergic reaction to
the bites, sores on the head, sores on the head can sometimes become infected. The mode of transmission is contact with an
already infested person, wearing infested clothing, and head lice are most frequently
located on the scalp, behind the ears, near the neckline at the back of the neck. Body and pubic lice are blood sucking insects. Lice are 3 millimeters long, they have three
pairs of legs the end and powerful claws. Females live for one two three months and
can lay up to 300 eggs. Three species of lice have adapted to live
on humans. Head louse, crabs, and body or pubic lice. Signs and symptoms include diagnosis that
is based on finding adult lice or eggs, red itchy papules or itching that is worse at
night, blue macules may be visible at the feeding sites, minute dark brown specks of
lice excreta, or lice poop are sometimes seen in the skin and underwear. Modes of transmission is person-to-person
contact. Scabies are an infestation of the skin by
a human itch mite. Microscopic scabies mites burrow into the
upper layer of the skin where it lives and lays eggs. Signs and symptoms include intense itching,
pimple-like skin rash, and the mode of transmission is direct prolonged skin to skin contact with
a person who has scabies. Chigger bites are tiny members of the arachnoid
family–you probably won’t see them. However, their bites pack a powerful punch. Signs and symptoms include intense itching
and the desire to scratch. Bites can appear in clusters and can form
a rash. Sugar bytes in the male genitalia can cause
severe itching, swelling, and painful urination. Modes of transmission: chiggers live in tall
weeds and grass, sometimes in berry patches in wooded areas. These chiggers quickly attach to your skin
if you walk by or brush up against vegetation. They are temperature sensitive, so if the
temperature is below 60° Fahrenheit, the chiggers become inactive. If it’s below 42° Fahrenheit, chiggers die. We can see that chiggers live mostly in the
southern part of the United States; Texas is among that. A leukoplakia or keratosis are thick and white
patches. They form on the gums, inside the cheeks,
at the bottom of the mouth, and tongue. Patches cannot be scraped off. Signs and symptoms include white or grayish
in patches that can’t be easily wiped away. They may be irregular or flattened texture,
thickened or hardened in areas, they may also be associated with red, raised lesions or
erthroplakia, which is more likely to show precancerous changes. The cause of leukoplakia is unknown. Tobacco use including smoking and chewing
appears to be responsible for most cases. Squamous cell carcinoma is a common form of
skin cancer. It develops in the thin flat squamous cells
at the outer layer of the skin. Signs and symptoms include a firm red nodule,
a flat red sore with scaly crusts, a new sore or raised area on an old scar or ulcer, a
rough scaly patch near lip that may evolve to an open sore, a red sore or rough patch
inside your mouth, a red raised patch or wart-likes or in or on the anus or on your genitals. The mode of transmission is prolonged exposure
to UV or ultraviolet radiation, most commonly from sunlight, or tanning beds, or lamps. Kaposi’s Sarcoma is a cancerous tumor on
the connective tissue. It is often associated with AIDS. Signs and symptoms include a blue-red or purple
bumps on the skin, which are rich in blood vessels. Lesions may first appear on the feet, ankles,
thighs, arms, hands, or face. Other symptoms may include bloody sputum,
shortness of breath. Modes of transmission in people with AIDS,
Kaposi’s sarcoma is most commonly caused by an interaction between HIV, a weakened immune
system, and the human herpesvirus -8 or HHV-8. Kaposi sarcoma has been linked to the spread
of HIV and HHV-8 through sexual activity.

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