LUSL 4084 Skin Readings -
Saunders Comprehensive
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LUSL 4084 SKIN 1
Week 4: Integumentary System
1. Anatomy and Physiology
Skin ◻
- Largest sensory organ
- Layers: Epidermis, Dermis, Hypodermis
(subcutaneous fat)
- Epidermal appendages (nail, hair, glands).
- Normal bacterial flora (gram -/+
staphylococci)
Functions ◻ Acts as the first line of defense
against infection, protects underlying tissue
and organs, receives stimuli, regulates body
temp, excretes salt, water, and waste,
synthesizes Vit D3, stores nutrients.
2. Risk factors for Integ Disorders
◻ Exposure to chemical and environmental pollutants
◻ Exposure to Radiation
◻ Race and age
◻ Exposure to sun (indoor tanning)
◻ Harsh skin products and some medications
◻ Repeated injury
◻ Nutritional deficiencies
◻ Systemic injury
3. Psychosocial Impact
◻ Change in body image, decreased well-being and
self-esteem
◻ Social isolation and fear of rejection
◻ Pain
◻ Cost of medication, hospitalizations, follow up
care
4. Phases of Would Healing
1. Inflammatory: Time of injury lasts 3-5 days
(edema, pain, redness, and warmth)
2. Fabroblastic: 4 days after injury lasts 2-4 weeks
(scar tissue)
3. Maturarion: Begins as earl as 3 weeks and lasts
for 1 year (scar tissue thinner)
Healing by Intention:
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1. First intention: Wound edges are approx and held
in place.
2. Second intention: Occurs with tissue loss,
gradual filling in of the dead space with CT.
3. Third intention: Delayed primary closure,
intentionally left open for several days for
irrigation, removal of debris and exudates.
5. Diagnosis Test
◻ Skin biopsy (keep dressing on for 8 hours post
procedure)
◻ Skin and wound cultures, viral culture is placed
immediately on ice
◻ Wood’s light exam (skin viewed under UV
light through glass to identify superficial
infections under the skin)
◻ Diascopy (glass slide over lesion, allows clear
inspection of lesion eliminating erythema)
6. Candida Albicans
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LUSL 4084 SKIN 2
- Superficial fungal infection of the skin and
mucous membrane, also known as YEAST
infection or THRUSH when it occurs in the
mouth. Antibiotic for treatment. Skin is
itchy and may sting with red and white
patches (mouth).
- Risk Factors: Immunosuppression, long term
antibiotic, DM, obesity
7. Herpes Zoster (Shingles)
-Hx of chickenpox, caused by re-activation
of varicella-zoster virus. Located in the
doral nerve of the root ganglia of the
sensory cranial and spinal nerves. Diagnosed
by Tznanck smear and viral culture, nerve
pain can last after lesions are gone.
8. Methicillin –Resistant
Staphylococcus Aurous (MRSA)
-Skin or wound becomes infected with MRSA.
Acquired through skin-skin contact of sharing
equipment. Infection can be mild-severe and
present as folliculitis and furuncles.
9. Eryipelas & Cellulitis
-Eryipelas: An acute, superficial, rapidly
spread inflammation of the dermis and
lymphatic caused by group A streptococcus,
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