Skin functions
-protective covering
-waterproof due to keratin
-barrier to bacteria and other invading organism
-protects underlying tissues from thermal, chemical, and mechanical injury
-regulates body temp
-converts ultraviolet rays to vitamin d
-melanin protects tissue from UV light
-nerve receptors transmit feelings of heat, cold, pain, touch, and pressure
age related changes in skin and structure
-decreased elastic fibers
-loss of collagen fibers
-skin becomes thinner and more transparent
-reduced sebaceous gland activity
-reduction in melanocyte activity
-decrease in hair follicles
-some areas of melanocytes increase (senile lentigines/ age spots)
prevention of integumentary system
hygiene, diet, age, environment
-coumadin can make skin brittle
dx of integumentary system
-skin biopsy
-c/s
-microscopic test
-special light inspection
-diascopy
-skin patch testing
Braden Scale
Pressure ulcers
lower the number, higher the risk
4-23
less than 17 = risk for pressure ulcers
risk factors for skin tears
-dehydration
-ecchymoses
-friction, shearing, pressure from bed or chair
-impaired sensory perception or mobility
-medications like corticosteroids
-renal disease, CHF, stroke
-incorrect removal of adhesive dressings
-rough handling when being moved
Payne-Martin Classification System
-Category I: a skin tear without tissue loss
-Category II: a skin tear with partial tissue loss
-Category III: a skin tear with complete tissue loss in which the epidermal flap is missing
, Skin Tear Protocol
-Continuously cleanse the wound
-Conform to the wound
-Absorb exudates
-Keep the wound bed moist and reduce pain and discomfort
inflammatory infections examples
Dermatitis, Acne, Psoriasis,Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis
bacterial infection examples
Cellulitis, Furuncles, Carbuncles
viral infection examples
Herpes Simplex, Herpes Zoster
fungal infection examples
tinea pedis (athletes foot)
tinea cruris (jock itch)
tineacapitis (ringworm)
tinea barbae (barber's itch)
moniliasis (thrush)
onychomycosis (nail fungus)
parasitic infection examples
Pediculosis, Scabies
dermatitis types and tx
-contact dermatitis: local skin irritation. Redness welling and itching
-atopic dermatitis: eczema
-Stasis dermatitis: Due to venous stasis. Redness, itching, and hyperpigmentation
-Seborrheic dermatitis: Inflammation of the scalp and other areas. Lesions are scaly
white or yellowing plaques and itching
tx: avoid contact irritant or allergen, good lubrication, preserve skin moisture, control
inflammation and itching, corticosteroids
acne
etiology, patho,s/s
- papules and pustules
- acne vulgaris and acne rosacea
dx and tx (VADAR)
-Retinoic acid (tretinoin)
-Azelaic acid (azelex)
-dermabrasion
-Veltin Gel
-Antibiotics topically and orally
Psoriasis