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PATHOLOGY & PATHOPHYSIOLOGY

DISORDERS OF THE INTEGUMENTARY SYSTEM

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SKIN DISORDERS

Skin takes 28 days to repair itself

The skin is often a reflection of our internal environment

“If the old fashioned physician should now destroy the local

symptom by the topical application of external remedies,

under the belief that he thereby cures the whole disease, nature

makes up for its loss by rousing the internal malady and other

symptoms that previously existed in a latent state… that is to

say she increases the internal disease. When this occurs it is

usually to say, though incorrectly, that the local affection has

been driven back into the system…” Dr S Hahnemann

Learner Study Guide – Pathology & Pathophysiology, Chapter 16, pages 119-125


ACNE VULGARIS

Aetiology:

Genetic predisposition

Increased sebaceous cell activity

(stimulated by testosterone)

Increased androgens

Bacteria: Propionibacterium

acnes


Inflammation of the pilosebaceous unit

Prevalence in teenagers is approximately 100%


ACNE VULGARIS

Treatment:

Topical creams

Antibiotics

Oral contraceptive pill

Roaccutane



DERMATITIS

2 types: Contact dermatitis and Atopic dermatitis

Contact dermatitis is skin irritation or allergy due to something

it was in contact with

Atopic dermatitis = eczema



ECZEMA/ATOPIC DERMATITIS

Usually a family/personal history of hay fever, eczema or

asthma

Aetiology: Allergy to something in the environment or food




Signs and symptoms:

The skin is red, swollen, itchy, can become thickened, can

form blisters and ooze. Secondary infections can occur.

Infants are often affected in the face and tend to get oozing

eczema

Adults are often affected in the “creases”, e.g. antecubital

area and popliteal area. Adults tend to get dry eczema.




Treatment:

Allergen control: Try to avoid exposure to allergens

Skin care: Rehydrate

Medication: Histamine, tricyclic antidepressants, cortisone,

immune suppressors



URTICARIA

Also called hives

Allergic skin reaction

Signs and symptoms:

Pink/red swelling of the skin

The lesions blanch with pressure

There may be angioedema as well

Treatment: Antihistamines



PSORIASIS

It is a chronic T-cell mediated autoimmune disease

Signs and symptoms: Red, thick plaques with overlying silver-

white scales. Lesions tend to occur on the extensor surfaces.

Age of onset: Usually in the 30’s. Its prevalence increases with

age.

Associated symptoms: Arthritis (especially in the hands), nail

thickening and pitting



PSORIASIS

Aetiology: Autoimmune (T-cells). Increased epidermal cell

turnover.

Precipitating factors: Skin trauma, stress, infections, medications



PSORIASIS

Treatment:

Keratolytic agents, e.g. salicylic acid

Coal tar

Corticosteroids

UVB radiation

Sunlight

Methotrexate



VITILIGO

Patches of depigmentation of the skin

Can appear at any age


Aetiology: Idiopathic. May be

autoimmune, may be nervous system

mediated etc.

Treatment: Cosmetic treatments, e.g.

self-tanning lotions, cortisone helps

some people


SKIN INFECTIONS

Bacterial: Impetigo

Viral: Warts, herpes simplex

Fungal: Athlete’s foot,

ringworm, cradle cap

Arthropod: Scabies



IMPETIGO

Bacterial skin infection caused by streptococci or staphylococci

Common among infants and children

Signs and symptoms: Vesicles which erupt and oozes a honey-

coloured serous fluid that remains stuck on the skin. Pruritis.

Complications: Glomerulonephritis

Treatment: Topical/systemic antibiotics



WARTS/VERRUCAE

Benign growths caused by the Human Papilloma Virus (HPV)

Usually transmitted through breaks in the skin



WARTS

Usually disappear on their own within a few years

Conventional treatment: Keratolytic agents (e.g. salicylic acid),

freezing, laser surgery etc.

Alternative treatment: Reflexology and homeopathy works, but

takes about 3 months. Also putting “duck tape” on the wart

works - apply duck tape on a wart for 6 and ½ days, remove for

12 hours, reapply. Do this for approx. 2 months.



FUNGAL INFECTIONS/MYCOTIC INFECTIONS

Tinea corporis

Tinea capitis

Tinea pedis

Tinea unguium

Candida infections



SKIN CANCER

A - Asymmetry

B - Border

C - Colour

D - Diameter

E - Elevation/Evolving



SKIN CANCER

Basal cell carcinoma

Squamous cell carcinoma

Malignant melanoma



SKIN CANCER

Malignant melanoma



QUESTIONS

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