Disorders and Diseases of the Skin

By Danielle Strok

PRIMARY LESIONS

• Also called an initial lesion• Onset of a disease• may be present from birth (i.e. birth marks) or

may develop later in life (i.e. moles). Characteristics:

- flat, unfelt-color - elevated

Bulla

• A large blister containing watery fluid• Similar to a vesicle, but larger• More than 5 mm or 0.5 cm• Latin for ‘bubble’

Cysts

• Closed, abnormal developed sac• Contains fluid, infection, and other matter

above or below the skin• Can be go away on its own or surgically

removed

Macule

• A flat spot or discoloration on the skin• Called a patch if greater than 1 cm• Latin for ‘small spot’ or ‘blemish’• Impalpable

Nodules

• Often referred to as tumors• Small, solid collection of tissue • 1.0 cm – 2.0 cm• Caused by scar tissue, fatty deposits, or

infection

Papule

• A small elevation that contains no fluid• May develop into a pustule• Usually less that 1 cm• Papula is Latin for ‘pimple’

Pustule

• An inflamed papule• White/ yellow pus in center • Consists of white blood cells, bacteria, and

other debris produced from an infection

Tubercle

• Abnormal rounded, solid lump• Larger than a papule

Tumor• A large nodule• An abnormal cell mass resulting from

excessive cell manipulation• varies in size, shape, and color• Can be cancerous (malignant) or

noncancerous (benign)

Vesicles

• A small blister/ sac • Contains clear sirus fluid• Can be produces from poison ivy or oak

Wheal

• An itchy, swollen lesion• Caused usually by insect bites, stings, or skin

allergy reactions• Urticaria – hives

Secondary Lesions

Develop in the later stages of disease

Crust

• Dead cells formed over a wound or blemish while it is healing

• An accumulation of sebum and pus (sometimes mixed with epidermal material)

• Scab on a sore

Excoriation

• Skin sore or abrasion • Produced by scratching or scraping• Can cause scarring and discoloration

Fissure

• A crack in the skin• May penetrate into the dermis • Chapped lips or hands

Keloid

• Thick scar from excessive growth of fibrous tissue (collagen)

• May occur following an injury or surgery

Scale

• Shredding of dead skin cells• Any thin plate of epidermal flakes• Dry or oily • Dandruff or psoriasis

Ulcer

• An open lesion on the skin/ mucous membrane• Accompanied by pus and loss of skin depth• Deep depressions due to infection or cancer

Sebaceous (Oil) Gland Disorders

Acne

• A chronic inflammatory skin disorder of the sebaceous glands

• Characterized by comedones and blemishes • Acne simplex or acne vulgaris• Propionibacterium acnes

Asteatosis

• Dry, scaly skin • From sebum deficiency • Can be due to aging, body disorders, alkalis of

harsh soap, or cold exposure

Comedone

• Non-inflamed buildup of cells, sebum, and other debris inside the follicle

• Open comedone = blackhead; oxidized • Closed comedone = whitehead; no oxidized

Furuncle

• A subcutaneous abscess filled with pus• Caused by bacteria in the glands of the follicle• Also called boils

Carbuncles

• Groups of boils

Milia• Whitish, pearl-like masses of sebum and dead

cells • under the skin; no visible opening• More common with dry skin types• May form from trauma (laser resurfacing or

UV radiation

Sebaceous Hyperplasia• Benign lesions frequently seen in oilier areas

of the face • Open comedones are similar in appearance • Often doughnut shaped, with sebaceous

material in the center• Can only be surgically removed

Seborrhea• Severe oiliness of the skin• An abnormal secretion from the sebaceous

gland

Seborrheic Dermatitis

• Caused by an inflammation of the sebaceous glands

• Inflammation, dry or oily scaling or crusting, and/or itchiness

• Severe cases should be referred to a dermatologist

Steatoma

• A sebaceous cyst or subcutaneous tumor • Filled with sebum • Ranges is size: from a pea to an orange • Usually appears on the scalp, neck, and back• Also called wen

Sudoriferous (Sweat) Glands

Anhidrosis

• A deficieny in perspiration due to failure of the sweat glands

• Often results from a fever or skin disease • Requires medical treatment

Bromhidrosis

• Foul-smelling perspiration • Usually in the armpits or the feet• Caused by bacteria and yeast that break down

the sweat on the surface of the skin

Hyperhydrosis

• Excessive perspiration caused by heat, genetics or body weakness

• Medical treatment required

Miliaria Rubra

• Prickly heat • Acute inflammatory disorder of the sweat

glands• Results in the eruption of red vesicles and

burning, itching skin from excessive heat exposure

Inflammation of the Skin

Atopic Dermatitis

• Atopic means “excess inflammation from allergies”

• The redness, itching, and dehydration of the dermatitis make the condition worse

Contact Dermatitis

• An inflammatory skin condition caused by contact with a substance or chemical

• Makeup, skin care products, detergents, fabrics, jewelery, and plants

• Allergic contact dermatitis caused by exposure to allergens

• Irritant contact dermatitis caused by exposure to caustic irritants

Dermatitis

• An inflammatory condition of the skin, various forms of which include lesions

• Eczema, vesicles, or papules

Eczema

• An inflammatory, painful, itching disease of the skin

• Acute or chronic in nature• Dry or moist lesions• Should refer to a physician

Seborrheic Dermatitis

• Common form of Eczema • Mainly affects oily areas

Edema

• Swelling from a fluid imbalance in the cells • Or from a response to injury or infection

Erythema

• Redness caused by inflammation

Folliculitis

• Hair grows under the surface instead of growing up and out of the follicle

• Causes a bacteria infection • Most common in men that shave often• Pseudofolliculitis – razor bumps without pus

Perioral Dermatitis

• An acne-like condition around the mouth • Consists mainly of small clusters of papules• May be caused by toothpaste or products

used on the face• Not contagious; treated with antibiotics

Pruritus

• The medical term for itching

Psoriasis

• A skin disease characterized by red patches covered with white-silver scales

• Caused by over-proliferation of skin cells that replicate too fast

• Can only be spread by irritating the affected area

Rosacea• Redness, dilation of blood vessels, and the

formation of papules and pustules• Chronic congestion primarily on the cheeks

and nose• Cause is unknown • Vasodilation makes it worse

Telangiectasia

• A vascular lesion• Capillaries that have been damaged and are

now larger• Commonly called couperose skin

Urticaria

• An allergic reaction by the body’s histamine production

• Also know as hives

Pigmentation Disorders

Hyperpigmentation

Chloasma

• Increased pigmentation; liver spots

Hyperpigmentation

• An overproduction of pigmentation • Increased melanin = excess pigment• Sun exposure, acne, medications, and post-

inflammitory hyperpigmentation

Lentigo/Lentigenes

• Lentigo – one freckle• Lentigenes – multiple freckles• Small, yellow-brown spots

Melasma

• A term for hyperpigmentation • Pregnancy mask is triggered by hormonal

changes• May fade with time

Nevus

• A birthmark or mole• Malformation of the skin from abnormal

pigmentation or dilated capillaries

Stain

• Brown or wine-colored discoloration• Occur after certain diseases or after moles,

freckles, or liver spots disappear• Port wine stain – vascular type of birthmark

Tan

• Caused by exposure to the sun • Change in melanin production as a defense

against UV rays that damage skin

Pigmentation Disorders

Hypopigmentation

Albinism

• The absence of melanin pigment in the body• Hair, skin, and eyes can be affected • Risk of cancer development runs higher, is

sensitive to light, and ages early• Congenital leukoderma

Hypopigmentation

• Lack of pigment

Leukoderma

• Light, abnormal patches caused by a congenital disease

• Destroys the pigment-producing cells• Albinism and vitiligo

Vitiligo

• White spots or areas on the skin from a lack of pigment cells

• The condition can worsen with time and sunlight

Hypertrophies

Hypertrophy

• An abnormal growth• Can be cancerous • Hypertrophic – thickening of a tissue

Keratoma

• An acquired, thickened patch of epidermis • A callus caused by pressure or friction• If thickening also grows inward, it becomes a

corn

Keratoses

• An abnormal thick buildup of cells

Hyperkeratosis

• Thickening of the skin caused by a mass of keratinized cells (keratinocytes)

• Actin keratoses – pink or flesh-colored precancerous lesions that feel sharp or rough

• Are a result of sun damage; should be checked by a dermatologist

Keratosis Pilaris

• Redness and bumpiness in the cheeks or upper arms

• Caused by blocked follicles• Exfoliation can help unblock follicle

Mole

• A brownish spot ranging in color from tan to bluish black

• Some are flat, resembling freckles; others are raised and darker

• Sometimes cancerous • Changes should be noted and checked

regularly by a dermatologist

Skin Tag

• Small outgrowths or extensions of the skin • Looks like a flap• Benign and common under arms or neck

Verruca

• A wart• Hypertrophy of the papillae and epidermis

caused by a virus • Infectious/contagious

Skin Cancer

Basal Cell Carcinoma

• Is the most common and least severe type of carcinoma

• Often appears as light, pearly nodules• Not easily spread • Removed surgically

Squamous Cell Carcinoma

• Is a more serious condition that basal cell carcinoma• Red or pink scaly papules or nodules• Sometimes open sores or crusty areas that do not

heal and may bleed easily • Can spread to other parts of the body

Malignant Melanoma

• Most serious form of skin cancer• Black or dark patches • Usually uneven in texture, jagged, or raised • Spread throughout the body and to internal

organs

ABCDE’s of Melanoma Detection

A for Asymmetry

B for Border

C for Color

D for Diameter

E for Evolution

Contagious Diseases

Bacterial Conjunctivitis

• Commonly called pinkeye • Very contagious

Herpes Simplex Virus 1

• Fever blisters or clod sores• Recurring viral infections• A vesicle or group of vesicles on a red, swollen

base• Blisters usually appear on the lips or nostrils

Herpes Simplex Virus 2

• Genital herpes • Virus can be spread to other areas of the

person infected or to other people

Herpes Zoster

• Or Shingles• A painful skin condition from the chickenpox

virus• Groups of blisters that form a rash

Impetigo

• A bacterial infection of the skin • Often occurs in children • Clusters of small blisters or crusty lesions filled

with bacteria

Tinea

• A fungal infection• Fungi feed in proteins, carbohydrates, and

lipids in the skin• Tinea pedis – athlete’s foot

Tinea Corporis

• Highly contagious ringworm• Forms a ringed red pattern with elevated edges

Tinea Versicolor

• Also called pityriasis versicolor • Fungal infection that inhibits melanin

production • Not contagious

Acne

And the its causes

Causes of Acne:

• Genetics/ hereditary• Clogged pores• Bacteria• Hormones • Stress• Cosmetics and skin care products• Diet

Genetics and Clogged Pores

• Retention Hyperkeratosis - dead skin cells do not shed from the follicles- excessive sebum production

• Sebaceous filaments- similar to open comedones- solidified impactions oil without cell matter

Bacteria

• Is anaerobic - can live without oxygen

• P. Bacteria (Propionibacterium)- Proliferation happens when follicles are

blocked with sebum and dead skin build up, and oxygen cant reach the bottom of the follicle

Hormones

• Male hormones, known as androgens, stimulate sebaceous glands

• The advent of puberty • Adult acne is more common in females, but not

as severe• Hormonal fluctuations from birth control,

menstruation, pregnancy and menopause• Hormone caused acne will often present itself

on the chin

Stress

• Causes hormonal fluctuations and increased sebum production

• The adrenal gland responds to stress and secretes adrenalin

• The male hormone androgen is also produced by the adrenal gland and stimulates the sebaceous gland

Cosmetics and Products

• Certain ingredients in products can aggravate acne

• Fatty ingredients such as waxes and oils can clog pores or irritate follicles

• Comedogenic – growth of comedones• Acnegenic –products that cause inflammation

Diet

• Food may not affect acne directly• Excessive iodine, MSG, kelp, cheese,

processed and packaged foods (especially fast food), and minerals obtained from an ocean source found in vitamins can irritate the skin

Other Irritations

• Pressure or friction from rubbing or touching the face

• Phone use • Wearing hats • Dirty pillows• Makeup brushes • Prolonged pressure or heat

Grades of Acne

Grade I Acne

• Minor breakouts, mostly open comedones, some closed comedones, and a few papules

Grade II Acne

• Many closed comedones, more open comedones, and occasional papules and pustules

Grade III Acne

• Red and infalmed, many comedones, papules and pustules

Grade IV Acne

• Cystic acne. Cysts with comedones, papules, pustules, and inflammation are present. Scar formation from tissue damage is common.

Burn Types

1st Degree Burn• red and very sensitive to touch• skin will appear blanched when light pressure

is applied• minimal tissue damage and they involve the

epidermis

2nd Degree Burn

• affect both the outer-layer (epidermis) and the under lying layer of skin (dermis)

• causing redness, pain, swelling and blisters• often affect sweat glands and hair follicles

3rd Degree Burn• Third-degree burns affect the epidermis,

dermis and hypodermis• charring of skin or a translucent white color,

with coagulated vessels visible just below the skin surface

• Healing from third-degree burns is very slow due the skin tissue and structures being destroyed

• result in extensive scarring