FUNCTIONS OF THE SKIN SKIN TERMS

Skin is an amazing organ: DESCRIPTIVE APPEARANCE EXAMPLES

NAME
 It covers and protects Flat, well- Freckle, tinea,
Macule
 Prevents excessive water loss demarcated versicolor
 Helps maintain correct temperature lesion (fungus infection)
 Involved in sensory phenomena characterized by
color change
 Barrier against microbial invaders Small, elevated , Warts, cutaneous
Papule
 However, the skin may become infected leading solid bump leishmaniasis
to serious health problems. Maculopapular Flat to slightly Measles, rubella,
Rash raised colored fifth disease,
bump roseola
Plaque Elevated flat- Psoriasis
topped lesion
larger than 1 cm.
(i.e a wider
papule)
Vesicle Elevated lesion Chicken pox
filled with clear
fluid
Bulla Large wide vesicle Blister, gas blister
in gangrene
Pustule Small elevated Acne, smallpox,
lesion filled with mucocutaneous
purulent fluid leishmanisisasis,
(pus) cutaneous anthrax
Cyst Raised, Severe acne
encapsulated
lesion, usually
solid or semisolid
when palated
Purpura Reddish-purple Meningococcal
MICROBIOTA discoloration bloodstream
dueto blood in infection
 Haloterant- the ability of an organism to grow small areas of
tissue ; does not
at salt concentrations higher than those
blanch when
required for growth pressed
 Dense population in the skin folds. Petechiae Small purpura Meningococcal
 Total number determined by location and bloodstream
infection
moisture content. Flaky portions of Ringworm of body
Scale
 May be opportunistic pathogens. skin separated and scalp,
from deeper athlete’s foot
Most skin flora categorized in 3 categories. portions

1. Diptheroids (Carynebacterium and

Propionibacterium)
2. Staphylococci (Staphylococcus epidermis)
3. Yeasts (Candida and Malassezia)
 FOLLICULITIS
 Causative agent
Most commonly caused by Staphylococcus
 Salt tolerant
 Tolerant of desiccation.
SIGNS AND SYMPTOMS
Infection of the hair follicle often called a
pimple.
Called a sty when it occurs at the eyelid base.
Spread of the infection can produce furuncles
or carbuncles.
Furuncles (Boils) extended redness, pus ,
swelling and tenderness
Carbuncles- Numerous sites of draining pus.
Usually occurs in areas of thicker skin.
EPIDEMIOLOGY: Endogenous (
Two species commonly found on the skin
 Staphylococcus epidermis
 Staphylococcus aureus
Transmitted through direct or indirect contact
DIAGNOSIS
Gram positive cocci in grapelike arrangements
isolated from pus, blood or other fluids.
SOME DISEASES CAUSE BY STAPHYLOCOCCUS
AUREUS
Skin disease: folliculitis, sty, furuncle, carbuncle
Staphylococcal scalded skin syndrome- is a
disorder that develops because of a toxin produced by a
staphylococcal infection. A toxin is a harmful substance that
causes disease when it enters tissues of the body. In SSSS the
toxin specifically binds to a target protein very high in the
epidermis (outer layer of the skin) producing total body
reddening of the skin and blistering and sloughing of the skin
resembling a hot water burn or scalding of the skin. The top
layer of the skin may peel off and shed. Affected individuals
may also experience nonspecific symptoms such as fever
(usually low grade), chills, and weakness. Unlike similar
disorders, the mucous membranes are not usually affected.
Infants and younger children are most susceptible, but the
disorder can also occur in certain older children or adults such
as people who have compromised immune systems or
insufficient kidney (renal) function.
Impetigo- is a bacterial skin infection. It causes red
sores that can break open, ooze fluid, and develop a
yellow-brown crust. These sores can occur anywhere on
the body.
Impetigo is one of the most common skin infections in
children. It can occur in adults but is seen far more often
in children. Impetigo is contagious and can be spread to
others through close contact or by sharing towels, sheets,
clothing, toys, or other items. Scratching can also spread
the sores to other parts of the body.
Impetigo is caused by one of two kinds of bacteria-strep
(streptococcus) or staph (staphylococcus). Often these
bacteria enter the body when the skin has already been
irritated or injured because of other skin problems such
as eczema, poison ivy, insect bites, burns, or cuts.
Children may get impetigo after they have had a cold or
allergies that have made the skin under the nose raw.
Staphylococcal toxic shock syndrome- is a rare
complication of Staphylococcus aureus infection in which
bacterial toxins act as superantigens, activating very
large numbers of T cells and generating an overwhelming
immune-mediated cytokine avalanche that manifests
clinically as fever, rash, shock, and rapidly progressive
multiple organ failure, often in young, previously healthy
patients. Symptoms may include fever, rash, skin peeling,
and low blood pressure
Endocarditis- Endocarditis is an infection of the
endocardium, which is the inner lining of your heart
chambers and heart valves.
Endocarditis generally occurs when bacteria, fungi or
other germs from another part of your body, such as
your mouth, spread through your bloodstream and
attach to damaged areas in your heart. If it's not treated
quickly, endocarditis can damage or destroy your heart
valves and can lead to life-threatening complications.
Treatments for endocarditis include antibiotics and, in
certain cases, surgery.
Endocarditis may develop slowly or suddenly, depending
on what germs are causing the infection and whether
you have any underlying heart problems.
Pneumonia- Pneumonia causes inflammation in the
air sacs in your lungs, which are called alveoli. The alveoli
fill with fluid or pus, making it difficult to breathe.

Bacteremia- is the presence of bacteria in the Food poisoning-

bloodstream

Bacteremia may result from ordinary activities (such as

vigorous toothbrushing), dental or medical procedures,
or from infections (such as pneumonia or a urinary tract
infection).

Having an artificial joint or heart valve or having heart

valve abnormalities increases the risk that bacteremia
will persist or cause problems.

Bacteremia usually causes no symptoms, but sometimes

bacteria accumulate in certain tissues or organs and
cause serious infections.

People at high risk of complications from bacteremia are

given antibiotics before certain dental and medical
procedures.

Usually, bacteremia, particularly if it occurs during

ordinary activities, does not cause infections because
bacteria typically are present only in small numbers and
are rapidly removed from the bloodstream by the
immune system. However, if bacteria are present long
enough and in large enough numbers, particularly in
people who have a weakened immune system,
bacteremia can lead to other infections and sometimes
trigger a serious body wide response called sepsis.
 SKIN Thicker and stiffer hair that covers our head. Eyebrows, beard
and mustaches are called terminal hair.
 Also called the integument.
 Elastic durable covering protecting our body. The only totally hairless areas are palms , soles and lips.
 Largest organ
 2 square meters- area of the skin if it is spread Hair grows out of a structure called follicle. It extends into
out. the dermis and even the hypodermis. It is surrounded by a
 4.5 kg thin layer of epidermal cells.
 Grows faster than any organ tissue.
Stem cells divide at the bottom of the follicle and as these
 Constantly renewing itself by growing new skin
cells become keratinized they form a hair shaft inside the
cells and slouching off the old ones.
follicle.
THE INTEGUMENTARY SYSTEM
Above our skin surface , hair consists of dead keratinized cells.
Components: Only the root of the hair inside the follicle is alive.

1. Cutaneous membrane- Skin A sensory nerve fiber connected to the base of each hair
2. Accessory structures- hair, nails, sudoriferous follicle enables us to feel the movement of a single hair. This
(sweat) glands, sebaceous (oil) glands attributes to our skin’s sensitiveness to touch and
temperature.
CUTANEOUS MEMBRANE
Each follicle also possess a tiny muscle that can contract in
Skin’s functions: response to emotions such as fear , rage, to cold which pulls
the hair erect and causes what we called goosebumps on the
1. Protecting the body from bacterial invasion and from surface of our skin. The medical term is anserina or
drying out. horripilation.
2. Regulating body temperature
3. Providing sensory reception On average, 100,000 hair grows on our head at a rate of
4. Synthesizing vitamin D about 1.3 cm per month. These generally live about 3-4 years
5. Excreting waste products. and in some people would grow for nearly 2 meters if left
6. Serving as a reservoir for blood and nutrients. uncut.

LAYERS Adult loses about 100 hair each day. Most of them grow back
except for men growing bald. Many men after the age of 40,
1. Epidermis- upper layer find their hair receding pm the top of their skulls and some
2. Dermis- basement layer men become totally bald. This is caused by the changes in the
3. Hypodermis-connective tissue level of sex hormones in males and is called male pattern
baldness.
5 LAYERS / STRATA OF THE EPIDERMIS
SKIN GRAFTS
1. Statum corneum
2. Statum lucidum Procedure done to repair the badly damage or missing skin by
3. Statum granulosum transplanting healthy skin to the site of damged skin.
4. Stratum spinosum
5. Statum basale In some cases, you skin becomes so damaged that it will not
heal properly, your doctor may recommenbd a skin graft
Firmly attached to the underlying dermis by a membrane procedure to repair the many skin conditions such as
called the basement membrane.
1. Non-healing wounds
ACCESSORY STRUCTURES 2. Severe burn
3. Skin Biopsy
Approximately 5 million hairs are on our body. Fine soft hair
4. Large surgical wound
that covers our limbs and most of our body is called vellus
5. Skin infection
hair
 Before your procedure, you will be given either general
or local anesthesia.
Autograft- patient’s own healthy skin is used.
She may create a split thickness skin graft or a full
thickness skin graft depending on the depth of skin your
graft needs to cover.
Donor site- the area of the healthy skin
Dermatone- instrument that remove very thin slices of
your skin creating a split thickness skin graft.
For full thickness skin graft, your surgeon will use a
scapel to remove all the layers of the skin at the donor
site.
Once your surgeon determines the type of skin graft you
will need, he or she will clean the rea of the damaged
skin and cut out any dead or unhealthy tissue , your
surgon will place the skin graft on the wound site and use
stiches to keep it in place then your surgeon will applt
ointment to the graft and cover itwith gauze. Finally, you
surgeon may use bandages to secure the graft and apply
pressure as the graft adheres to the surrounding skin.
SKIN CANCER
Epidermis contains basal , squamous cells and
melanocytes – cells that contain pigments which allows
skin to tan and which also protect the deeper layer of the
skin from the effects of UV sunlight exposure.
Dermis lies below the epidermis , contains blood vessels,
connective tissue , hair follicle and sweat glands.
subcutaneous – deepest layer of the skin
 -contains fat cells and collagen
Skin cancer occurs when there is uncontrollable growth of
abnormal cells in a layer of the skin.
3 COMMON FORMS OF SKIN CANCER DISTINGUISHED BY
THE TYPE OF CELLS AFFECTED:
1. Basal cell carcinoma- most common form of skin cancer
- Does not typically spread out but require treatment.
- Most often developed in areas of the skin exposed
to the sun.
2. Squamous cells carcinoma- develop in the middle layer
of epidermis
-can spread and can be life threatening if not treated
appropriately.
3. Malignant Melanomas- abnormal growth of
melanocytes.
- most aggressive form of skin cancer
-can spread quickly to other parts of the body and
organs.
-can be fatal if not detected and treated early.
People with fair skin are at increased risk for developing
this form of cancer.
Increased sun exposure and history of sun burns
increase the risk for developing skin cancer.
ACNE
The Pilosebaceous Unit (PSU) of the skin consist of the
sebaceous gland and the hair follicle.
Sebacous glands secretes an oily substance called sebum
which help keep the skin and hair moisturized.
Overproduction of sebum is related to the disease called
acne or commonly called pimple.
Sebum may collect excessively as a result of
1. Poor hygiene
2. Genetic predisposition
3. Accelerated glandular activity especially during
adolescence.
During an acne break out, the pore of the hair follicle is
plugged by a mixture of sebum and cells that line the hair
follicle. The trapped sebum allows bacteria to grow in the
plugged follicle; this forms the primary acne lesion called
comedo.
2 types of comedo
1. White heads
2. Black heads.
When the sebum and bacteria stay below the skin
surface, a white head is formed. A blackhead occurs
when the trapped sebum and bacteria is partially opened
to the surface and turn black due to melanin.
Commonly involved areas are the face, neck, chest,
shoulders and upper back.
Treatment:
- Keratolytes -Retinoids -Antibiotics
- Spirinolactone for women - Isotretinoin in
severe cases