PATHOLOGY

1. INTEGUMENTARY SYSTEM
PATH-321
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KHAWAJA TAIMOOR SHAHID
By

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COMMON DERMATOLOGIC TERMS
• Lichenification: distinctive thickening of skin
• Crust: dried exudate of body fliuds
• Erusion: epithelial deficiet
• Ulcer: epithelial deficient (disruption of deep skin
integrity)
• Atrophy: an acquired loss of substance
• Scar: change in the skin secondery to trumas or
inflammation

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Description of skin lesions (primary
lesion)
I. circumscribed , flat , nonpalpable changes in skin color
• Macule = small upto 1 cm, eg. petechia
• Patch = larger than 1 cm , egg Vitiligo
II. Palpable elevated solid masses
– Papule: up to 0.5cm egg. elevated nevus
– Plaque: elevated surface > 0.5 cm
– Nodule: deeper & firmer than papule
=> 0.5 -1-2cm egg tumor
– Wheal: irregular, superficial area of localized
skin edema

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Secondary lesion
IV.Loss of skin surface
• Erusion => loss of superficial epidermis
• Ulcer => deep loss of skin surface
=> May bleed & scar,
• Fissure => linear crack in the skin
e.g. Athelet's foot
On skin surface:
• curst = dried residue of serum ,pus or blood, eg Impetigo
• Scale = a thin flake of exfoliate epidermis e.g. dandruff,
Dry skin, Psoriasis

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Vascular skin lesions
• a lesion that originated from a blood vessel
– Petechia/Purpura
– Ecchymosis
– venous star

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Skin lesion configuration
• Linear- in line
• Annular and arciform –circular or arcing
• Zosteriform- linear along a nerve route.
• Grouped -clustered lesion
• Discrete -separate and distinict
• Confluent- lesions that run together or join
• Generalized- widespread eruption
• Localized- lesions on distinct area

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Assessing the skin
• Assessment includes a thorough
- history taking,
-inspection and
-palpation of the skin.

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Assessing the general appearance of
the skin
• The general appearance of the skin is assessed by observing
(Inspection) colour, skin lesions, and vascularity.
• On palpation skin turgor and mobility, possible edema,
temperature, moisture, dryness, oiliness, tenderness, and
skin texture (rough and smooth).

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Color change: can be hyperpigmentation, hypopigmentation or
depigmentation
1. Redness- fever, alcohol intake, local inflammation due to increased
blood flow to the skin.
3. Bluish color (cyanosis) - decreased oxygen supply due to chronic
heart and lung disease, exposure to cold, and anxiety.
4. Yellowish color (jaundice)- increased serum bilirubin concentration
due to liver disease or red blood cell hemolysis
-Uremia- renal failure.
-5 Brown-tan- Addison’s disease: cortisol deficiency stimulates
increased melanin production and sun exposure
6. Pale: Albinism- total absence of pigment melanin
7. Vitiligo- destruction of the melanocytes in
circumscribed areas of the skin

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Disorder of the skin
I . Inflammatory and allergic skin disorders
A. Acne (is a skin condition that occurs
when your hair follicles become
plugged with oil and dead skin cells.
It causes whiteheads, blackheads or
pimples.)
B. Psoriasis (is a skin condition that
causes flaky patches of skin which
form scales.

11. I . Inflammatory and allergic skin disorders
C. Atopic dermatitis (eczema) ( is a
condition that makes your skin
red and itchy.)
D. Contact dermatitis (is a type of eczema triggered by contact
with a particular substance. Eczema
is the name for a group of conditions
that cause skin to become dry and
irritated.)
Disorder of the skin

12. II. Bacterial infections
A. Impetigo (In general, impetigo is a
mild infection that can occur
anywhere on the body. It most
often affects exposed skin, such
as around the nose and mouth or
on the arms or legs)
B. Boil (furuncle) (are painful pus-filled
bumps on the skin resulting from
the deep infection of a hair follicle.
The infection is usually caused by a
type of bacteria called
Staphylococcus aureus.
Disorder of the skin

13. II. Bacterial infections
C. Carbancle (is a cluster of boils
— painful, pus-filled bumps —
that form a connected area of
infection under the skin)
D. Cellilitis (is a common bacterial
skin infection that causes redness,
swelling, and pain in the infected
area of the skin.)
Disorder of the skin

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Disorder of the skin…
III. fungal infections
A. Candidiasis (a fungal infection caused by
a yeast (a type of fungus) called Candida.
Some species of Candida can cause infection
in people; the most common is Candida albicans.
Candida normally lives on the skin and inside
the body, in places such as the mouth, throat,
gut, and vagina, without causing any problems.)
B. Tinea captis (Ringworm of the scalp
(tinea capitis) is a rash caused by a fungal
infection. It usually causes itchy, scaly,
bald patches on the head.)

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Disorder of the skin…
III. fungal infections
C. Tinea corporis (Ringworm of the body
(tinea corporis) is a rash caused by a fungal
infection. It's usually an itchy, circular rash
with clearer skin in the middle.)
D. Tinea pedis (athlete's foot)(is a fungal
skin infection that usually begins between the toes. It
commonly occurs in people whose feet
have become very sweaty while confined
within tight-fitting shoes.)

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Disorder of the skin…
IV. Viral infections
A. Herpes simplex (cold - sore) (are
caused by certain strains of the herpes
simplex virus (HSV). HSV -1 usually
causes cold sores. HSV -2 is usually
responsible for genital herpes.)
B. Herpes zoster (shingles) (is caused
by the varicella-zoster virus, the same
virus that causes chickenpox. There are
treatments for shingles symptoms, but
there is no cure. There are vaccines
against shingles and postherpetic neuralgia.)

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Disorder of the skin…
IV. Viral infections
C. Warts (Warts are a type of skin infection caused by the human
papillomavirus (HPV). The infection causes rough, skin-colored
bumps to form on the skin. The virus is contagious. You can get
warts from touching someone who has them.)

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Inflammatory and allergic condition
A. Eczema/Dermatitis
- It is a chronic pruritic inflammatory disorder affecting the
epidermis, and dermis commencing in infancy, often persisting
throughout child hood but eventually remitting and some
times recurring in adult life.
• They are a non-infectious inflammation of the skin and it can
be acute, sub-acute or chronic.
KHAWAJA TAIMOOR SHAHID

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• Causes
– The exact cause is unknown
– Imbalance of the immune system with an increase in the
immunoglobulin “E” activity and deficient of cell
mediated delayed hypersensitivity.
• Can be exacerbated by infection, bites, pollen, wool, silk, fur,
ointments, detergents, perfume, certain foods, temperature
extremes, humidity, sweating and stress
KHAWAJA TAIMOOR SHAHID

21. Hypersensitivity
reactions
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Sign and symptom
• An acute stage eczema shows redness, swelling, papules,
blisters, oozing and crusts.
• In the sub-acute stage the skin is still red but becomes drier
and scalier and may show pigment change.
• In the chronic stage
-lichenification,
-excoriation,
-scaling and cracks are seen

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Types of eczema
Atopic eczema
- is a chronic relapsing skin disorder that usually begins in infancy
and is characterized principally by dry skin and pruritis,
consequent rubbing and scratching lead to lichenification
• This patient has a genetic predisposition for hypersensitivity
reactions such as asthma, allergic rhinitis, and chronic
urticaria.
– The eczema comes and goes
– The eczema triggered by dryness of the skin, infections,
heat, sweating, contact with allergens or irritants and
emotional stress.
– Mostly affected sites are elbow and knee folds, wrists,
ankles, face, and neck; in some cases it can be generalized.

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Seborrhoic eczema
- is a very common chronic dermatitis characterized by
redness and scaling that occurs in regions where the
sebaceous glands are most active, such as:
– Scalp, border of forehead/scalp
– Behind ears, above and in between eyebrows
– In nasolabial folds, Sternum
– In between the shoulder blades, in axillae.
– Under the breast , umbilicus and in body folds
– Patient often complains of oily skin
– The eczema comes and goes
– In HIV patients, the eczema can become very widespread and
easily super infected.

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Infective eczema
• which occurs as a response to an oozing skin
infection.
• Common sites are the foot, and ankle region
• Causative organisms are usually staphylococci/
streptococci
• Vaseline use aggravates this condition
KHAWAJA TAIMOOR SHAHID

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Sign and symptom of eczema
• Itching
• Redness, dry skin, lichenification, excoriation, scaling skin
• Papules, blisters, oozing and crusts
• Color change

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Acne
- Is a common disorder of the sebaceous gland associated with
excess production of sebum and blockage of the duct
resulting in a variety of inflammatory manifestations.
• Common in puberty and usually regresses in early adult hood
• Patient complain of oiliness of the skin.
- Occurs on the face, upper trunk and shoulders
• - Appears to be multiple inflammatory papules, pustules
and nodules
• It can be very mild to be very severe: - they blend together
to form large inflammatory areas with cysts and scar
formation.
Cause
genetic, hormone and bacteria play a role

28. Sign and symptom
• Red nodules, cyst,
red papules, scars,
pustules, keloids
• There may be mild soreness,
pain or itching
• Inflammatory papules,
pustules, pores acne cyst,
scarring.

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Psoriasis
• Is a chronic recurrent, hereditary, non infectious disease of the
skin caused by abnormally fast turn over of the epidermis.
• The turn over may be up to 40 times than normal and as a
result the epidermis is not able to develop normally, therefore
it doesn’t allow formation of the normal protective layer of
the skin.
• Skin become red, inflamed, and the scales are thicker than
normal.
• It produces a so called candle-wax phenomenon, when you
scratch such a patch it becomes silvery white.
• Sites can be extensor areas of extremities especially elbow,
knees, buttocks, shoulder.

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• Cure is there but it reoccurs
• Occurs at any age but 10-35 years is common mostly.
• Periods of emotional stress and anxiety aggravate
the condition.
Sign and symptom.
• May itch severely in body folds covered with silvery scales
• Finger and toenails may show pitting and thickening
• Associated arthritis.
KHAWAJA TAIMOOR SHAHID
SUPERIOR COLLEGE
M.B.DiN
0306-0746125