Skin diseases and disorders - Beautique Academy · Skin diseases and disorders Dermatology Study of...
Transcript of Skin diseases and disorders - Beautique Academy · Skin diseases and disorders Dermatology Study of...
THREADING Skin Diseases & Disorders
Skin diseases and disorders
Dermatology Study of skin, its nature, structure, functions, diseases and treatment
Dermatologist Skin specialist
Pathology Study of disease
Trichology Study of hair and it’s diseases
Etiology Study of cause of disease
Diagnosis Recognition of a disease from its symptoms
Prognosis Foretelling of probable course of disease
Symptoms subjective objective
Signs of disease refers to symptoms that can be felt as itching, burning or pains refers to symptoms that can be seen as pimples, pustules or inflammation
Disease Implies an illness. Requires medical or surgical intervention, and should preferably not be touched by a therapist
Disorder Implies some abnormality, which is not an illness, eg. hyperpigmentation of the skin, or post acne scarring
Acute disease Manifested by symptoms of a more or less violent character and of short duration. Disease is severe
Chronic disease
Long duration, usually mild but recurring
Infectious disease
Due to pathogenic germs taken into body as a result of contact with contaminated object or lesion
Contagious disease
Communicable by contact. Caused by pathogenic organisms that invade body through contact with an infected person or contaminated object. Organism could invade body through skin, mucous membrane, digestive system or respiration system
Communicable disease
Transmitted through contact with an infected person or animal
Congenital disease
Present in infant at birth
Seasonal disease
Influenced by weather, such as prickly heat in summer, and forms of eczema, which are more prevalent in cold weather
Occupational disease
Contracted while engaging in certain kinds of employment, and is caused by coming in contact with cosmetics, chemicals or tints
Parasitic disease
Caused by vegetable or animal parasites, such as pediculosis or ringworm
Disease-producing bacteria
Such as staphylococcus and streptococcus, cause pus forming bacteria pathogenic disease
Systemic disease
Due to under or over functioning of internal glands. May be caused by an inadequate diet
Venereal disease
Contagious disease commonly acquired by contact with a infected person during sexual intercourse
Epidemic Manifestation of a disease that attacks simultaneously a large number of persons living in a particular locality
Allergy Sensitivity, which certain persons develop to normally harmless substances. Skin allergies are quite common. Contact with certain types of cosmetics, medicines, and tints or eating foods, may all bring about an itching eruption, accompanied by redness, swelling, blisters, oozing and or scaling
Inflammation Sign of skin disorder characterized by redness, pain, swelling and heat
Infection Invasion of body by pathogenic organisms
Infestation Invasion by animal parasites
Benign Mild, non cancerous
Malignant Very virulent, cancerous
Primary lesions – refers to first sign of skin disorder/disease
Papule
Clearly marked superficial elevated solid lesion, less than 5mm in diameter eg mole and blind pimple
Pustule
Commences as a papule, then accumulates puss in center ad appears as an elevated inflamed red area
Nodule
Larger papule – solid or oedematous raised lesion. Larger than 5mm in diameter
Macule
Clearly marked flat area of pigmented skin which cannot be felt eg ephelides (freckles) and some birthmarks which darken on sun exposure
Plague
Superficial, elevated, palpable flat topped patch – 5mm in diameter, primarily epidermal in nature
Vesicle
Fluid-filled elevated bladder – 5mm in diameter. Small blister with clear fluid. Appear below or within epidermis
Bulla
Fluid filled lesion – 1cm in diameter eg large blister, classified as sub-epidermal or sub-corneal
Cyst
Nodule consisting of an epithelial lined cavity containing thick smelly mucus or fluid
Wheal
Red/white lesion which is raised above the skin. Some oedema in dermis and slight urticaria. Associated with contact irritation such as poison iv or certain food or lashes of a whip
Comedo/comedones
Blackheads, dried plug or sebum and keratin blocking entrance of a sebaceous gland. Black colour is due to development of sulphide in keratinized cells at surface and melanin pigment
Erythema
Superficial redness of skin
Secondary lesions
Atrophy
Wasting away of epidermal or dermal cells due to degeneration from disuse or ageing (skin thin, translucent and wrinkled)
Crust
Scab of dry excretion, which may have been blood, serum, pus or thick keratin cells
Erosion
Superficial break in epidermal tissue caused by ulceration. Does not bleed or scar
Excoriation
Shallow excavation/abrasion in epidermis due to scratching or scraping eg carpet burn
Fissure
Painful linear crack in skin. May extend down to entire epidermis eg cracked heels, or chapped lips
Keloid
Hard, whitish, raised scar. Occurs in a healed wound. Due to overgrowth of fibrous connective/scar tissue
Lichenification
Thickening of prickle cell and horny layer of epidermis with underlying inflammation giving skin a dry leather-like appearance
Scales/flakes
Abnormal accumulation of loose keratin layers on epidermis. Silvery/white or grey in colour
Scar
Mark left by connective tissue formation at site of healed injury
Telangiectasia
A group of dilated blood vessels
Ulcer
Erosion of epidermis and some dermal tissue due to lack of nutrient supply. Bleeds and leaves scars
Descriptive terms
Keratosis
Rough thickening of horny layer on sun exposed skin
Hyperkeratosis
Refers to hypertrophy in horny layer
Parakeratosis
Nuclei of cells in horny layer persist instead of disappearing
Acanthosis
Increase in depth of prickle cell layer
Spongiosis
Oedema between cellular regions
Pruritus
Skin inflammation that causes itching
Milia
White keratin containing cysts in upper dermis
Necrosis
Death of cells in tissue/an organ due to lack of blood supply
Oedema
Excess amount fluid in body tissue
Haemangioma
Benign blood vessel tumour
Hirsute
Excessive hair growth in men
Hypertrichosis
Excess hairiness in areas not usually bearing prominent hair
Papiloma
Simple tumour arising from non grandular epithelial surface
Purpura
Purple spots, occur when red blood cells leak into skin from dermal blood vessels
Scleroderma
Extra deposition of collagen hardening, atrophy and ulceration of skin
Seborrhoea
Disease of sebaceous glands
Skin tags
Fibro-epithelial polyp mostly found on neck and in body folds
Stria
Band of skin (white, pink/purple) as result of connective tissue changes.
Urticaria
Hives, itchy rash due to food/nettle stings
Diseases caused by bacteria
Furuncle
Localised red lump, occurs around hair follicle
Impetigo
Skin appears red and itchy, small blisters appear
Abscess
Acute bacterial infection, localised collection of pus
Cellulites
Acute inflammation of connective tissue, skin appear dark red, swollen and feels hot
Folliculitis
Large number of hair follicles in a region becomes infected with staphylococci
Hordeola/styes
Infection of sebaceous gland of eyelash hair follicle
Conjunctivitis/ pink eyes
Inflammation of mucous membrane that covers eye and lines eyelids
Diseases caused by viruses
Herpes simplex
Blisters commencing as itchy patch of erythema
Herpes zoster
Shingles, acute infection of nerve root, producing groups of vesicles along section of skin served by infected nerve
Warts/verrucae
Localised growths of epidermis
Verruca vulgaris
Hands, firm papule with rough horny surface
Verruca plana
Flat topped, occurs on face and back of hands, pearly elevation
Verruca plantaris
Soles of feet, yellowish-white
Diseases caused by fungi
Ringworm/ tinea
Tinea pedis (feet)
Occurs on soles between toes in presence of excess sweating
Tinea unguim (nails)
Appears on toe nails
Tinea cruris (groin)
Occurs on males, spread by sharing bath towels
Tinea corporis (body)
Superficial rash with slight inflammation
Tinea barbae (beard)
Deep infection of hair follicles forming small pustules and abscesses on skin
Tinea capitis (scalp)
Scaly patches of different sizes containing broken hairs
Candida
Yeast fungi, infect skin, nails and mucous membranes of mouth and vagina
Pityriosis versicolor
Chronic, asymptomatic superficial fungal infection
Infestation caused by animal parasites
Pediculosis
Infestation by lice that live on human blood that’s obtained from biting skin
Pediculosis capitis
Head lice
Pediculosis corporus
Body lice
Pediculosis pubis
Pubic lice
Scabies
Contagious disease, caused by scabies itch mite
Insects
Can also damage skin
Skin diseases and disorders caused by allergic phenomena
Dermatitis
Inflammatory skin disorder, skin becomes red, itchy and swollen. Blisters may appear. Primary dermatitis = skin is irritated by action of a substance upon skin, leads to skin inflammation. Allergic contact dermatitis = problem is caused by intolerance of skin to a particular substance/group of substances. On exposure to substance skin quickly becomes irritated and an allergic reaction occurs.
Eczema
Inflammation of skin cased b contact, internally/externally with an irritant
Urticaria/nettle rash/hives
Sudden eruption of wheals of varying sizes. Rash occurs rapidly. Burning and itching is intense.
Drug rashes
Allergic in origin, start as a sudden, widespread, itchy rash which affects body symmetrically. Rash usually clears up a short time after stopping drug.
Skin disorders of keratinazation/abnormal growth
Psoriasis
Well-defined papules/plagues of various sizes. Lesions are red, covered with silvery scales
Itchyoisis
Group of inherited skin disorders of keratinisation characterized by dryness and a fish scale appearance of skin
Keratosis pilaris
Multiple small horny follicular plugs found mainly on upper arms and thighs
Calluses and corns
Hyperkeratosis plagues which develop at friction/pressure points. Corns are more deeply situated
Disorders of connective tissue
Solar elastosis
Damage to collagen fibres, thickened, wrinkle, furrowed skin on sun exposed parts
Stretch marks/stria
Dermal tearing by extreme stretching of skin
Keloid
Hard, raised, whitish scar formed due to an over growth of fibrous tissue in a healed scar
Generalised pruritus (itching)
Modified form of pain, common skin complaint Causes: dry skin, pressure, chafing in obese persons, iron deficiency, liver disease, renal failure
Xanthelasma/ xanthomas
Deposits of lipids in skin
Skin disorder due to disturbances of pigmentation
Hyper pigmentation
Melanocytic naevi/moles
Benign tumours of melanocyte cells
Intradermal naevus
Dome shaped, papillomatous/pedunculated, vary from skin tone to shades of brown
Junctional naevus
Hairless, flat, slightly raised, light brown to black, often speckled
Compound neavus
More raised than papillomatous, coarse dark hairs
Freckless/ ephelides
Small to light brown macules. Darken in sun exposure
Lentigines/ lentigo
Evenly pigmented black/brown macules. Do not darken with sun exposure
Chloasma/ melasma
Result of taking contraceptive pills
Café-au-lait spots
Multiple light brown macular patches varying in size
Ochronosis
Due to skin lightening creams
Berloque dermatitis/ perfume dermatitis
Caused by perfume
Mongolian spots
Bluish patches, result from disfunctional melanocytes deep in dermis
Hypo pigmentation
Vitiligo
Patches of completely white skin which lost their pigment
Tinea versicolal/ pityriosis versicolor (depigmentation)
Depigmented macules with/without fine scales
Albinism (lack of pigmentation)
Skin unable to produce melanin pigment and skin, hair and eyes lack colour
Disorders of pigmentation caused by blood vessels
Port-wine stain
Localised, red-purple macule, found on face since birth
Strawberry naevus
Pin-red compressible vascular swelling, develops during first 6 months of life
Spider naevus
Small superficial arteriole giving rise to localised telangiectasia angioma
Compbell de morgan spots
Benign capillary growths, bright red papules
Skin disorders of pilo-sebaceous unit
Acne vulgaris
Chronic inflammatory disease of pilo-sebaceous unit
Acne lesions
A comedo, or basic acne lesion, is a hair follicle that has become clogged with oil and dead skin cells. Comedones (the plural of comedo) can develop into bumps called whiteheads and blackheads.
Micro comedone
Smallest for of black head
Closed comedone
Impaction in hair follicle, hardened over cap of stratum corneum cells
Hard closed comedones
Found around eye area
Soft closed comedones
Due to comedogenic ingredients in products/make-up
Open comedone
Non-inflamed impartion of dead skin cells, sebum, bacteria, exposed to air
Papule
High break of follicle wall, empties impaction into dermis, white blood cells attack and a sore red lesion is felt
Pustule
Papule develops and white blood cells attack, pus is produced, yellow cap of pus visible on surface of skin
Nodule
Deep break in follicle wall, empties impaction into lower dermis, thus infects adjoining follicles
Cysts
Membrane forms around lesions in dermis, traps it as a soft, fluid-filled lump, has to be incised and treated by a doctor/dermatologist
Rosacea (acne rocacea)
Chronic inflammatory facial dermatosis characterised by an erythematous eruption of papules and pustules, dilated blood vessels and a flushed appearance on forehead, nose, cheeks and chin
The development of a pustule:
“SAPI”
S: Excessive sebum production:
• Acne is a genetic condition –clients with the condition has larger and more sebaceous glands which produce more sebum than normal.
• Androgens are the main hormonal drive of the sebaceous follicles = causing sebum production (puberty – when the sebaceous gland matures),
• Hyper response of the sebaceous follicles to normal levels of circulating androgens occur.
• Emotional stress may aggravate acne (pituitary-adrenal hormones)
A: Abnormal keratinization
• Increase in the production of keratinocytes lining in the follicle
• Retention of these cells within the follicle
• Excess sebum build up within the follicle and form a microcomedone.
• The micrcomedo enlarges and forms a closed comedo or open comedo.
P: Multiplication of propionibacterium acnes
• Anaerobic conditions in the follicle causes the p-acne in the follicular flora to become active.
• P-acne produce many enzymes (lipase, phosphatases, proteases, and hyaluronate lyase)
I: Inflammation
• The enzymes that are produced by the p-acne causes inflammation. Lipase liberate free fatty acids which may in turn lead to marked inflammation.
• White blood cells invade the area causing inflammation.
• A Papule is formed proceeding into a pustule.
• This cause follicular damage and inflammation
Isotretinoin (Roaccutane) Drug derived from VitaminA. Acne medication that was launched in South Africa in 1984. (Used for 20 years now) Dermatologist have vast experience of its use but still has managed to remain controversial. Indications Chronic acne conditions, nodulocystic acne, adult acne, seborrhea, gram folliculitis, rosacea and scarring from any degree of acne(does not treat scars but prevent scars-relative indication). Failure to respond either to antibiotics or hormonal treatment.( 4 months) Contra-Indications: Pregnancy, Hypovitamine A treatments, and hypersensitivity to the drug. Sometimes people with depression, and psychological problems. Dosage: Optimal dose: 120 to 150 mg/kg body weight at a dose as close as possible to 1mg and not below 0,75 mg/kg body weight/day.
• Dayly dose: 0,75 -1 mg per kg body weight per day
• Acumative dose 120mg x body weight
e.g. 60 kg will take 60 mg per day (1200 days – 4 months)
Length of course: 4-5 months Despite this, some GPs still use small doses: The patient cannot expect a optimal outcome! ( it is expensive) Used correctly clients can anticipate a 75 – 80% rate of not having to use acne treatment again. For maximal absorption it needs to be taken at or just after a meal as it is absorbed best in the presence of fat. Blood tests: Monthly lipid studies and liver function tests seems to have dropped away. If there is a specific problem such as diabetes or a history of familial hypercholesterolaemia, many dermatologists no longer insist on blood tests. Levels usually return to the baseline level within one month after the end of the course. Side-effects: Side-effects tend to be at their worst during the first 6-8 weeks of treatment. Usually the side-effects do not require lowering the dose.
• Dryness of the lips, skin and eyes (Duratears for the eyes)
• Nose bleeding
• Eczema on the hands
• Headaches
• Joint pains
• Photosensitivity
• Skin fragility and erithema (red appearance)
• Hair loss
• The connection between Roaccutane and either depression or suicide has not been proved.
* The taking of vit A supplements concurrently with Roaccutane will increase the severity of side-effects. * Tetracycline drugs should not be taken during the therapy owing to a theoretical increase in the likelihood of the development of hypertension. Precautions a therapist can take when performing a facial treatment on a Roaccutane user:
• No harsh products should be uses.
• No exfoliation
• No AHA products
• Aim to rehydrate the skin
• Avoid overstimulation (massage, frimator)
Advice that can be given to the client that is using Roaccutane:
• Adhere to dr’s advice
• Use sunblock/ stay out of the sun
• Drink 8 glasses of water a day/ prevent further dehydration by drinking too much coffee/alcohol
• Use a good water based moisturizer
• Use moisturizing lip balm and eyedrops
• Use green base for vascular appearance.
Extra interesting facts: Roaccutane is not stored in the body – after 2 weeks all the traces will be out of the body, and women can become pregnant 1 month after stopping the drug. But rather proceed with a wax treatment 3 months after use – to be save!
Disorders of sweat glands
Anidrosis
Absence of sweat, due to break down of sweat glands and congenital factors
Hyperhidrosis
Secretion of excessive amount of sweat, which may have an offensive odour
Bromidrosis
Condition in which sweat has a particularly offensive odour
Miliara rubra/prickly heat
Caused by sweat-duct blockage induced by temperature change