Dermatology

Vickie Mickey,CT

Dermatology

• Study of skin, diseases, and treatment• Electrologist encounter the presence of skin

disorders and diseases• Electrologist must be able to identify

dermatology disorders in order to know when to treat or not treat a skin disorder

• Certain skin disorders are contraindicated

Lesion

• Lesions are a structural change in the tissue caused by trauma or disease

• Three types of lesions: 1. Primary 2. Secondary 3. Tertiary or vascular

Primary Lesions

• First to recognize• Flat or non-palpable• Skin color changes may occur• Elevation can occur• Solid mass

Macule

• Small discolored spot or patch on the surface of the skin, flat or level with skin

• A freckle, flat moles, liver spot (chloasma) or leukoderma (loss of pigment)

• Pink or red inflammatory macules – indicative of typhoid, typhus, secondary syphilis, or allergenic drug reaction

• Blue Macules in public regions indicate crab lice

Papule

• Small elevated pimple • Contains no fluid but may develop pus

Common Papular Eruptions

• Pityriasis rosea – self-limited disease of truck, eruptions at time barely evident

• Mucocutaneous syphilis – papules tend to be juicy, easily molded, found in mouth and genital region

• Psoriasis – chronic inflammatory disease of skin, lesions are round, dry papules, covered with coarse slivery scales

Common Papule Eruptions• Warts – verruca• Seborrheic keratois – flat, brown, greasy feeling

papules, waxy texture. Non-malignant• Actinic keratosis – hard, horny papules, results of

sun and wind exposure. May become malignant• Senile keratosis – hard horney papules, old age

spots• Molluscum contagiosum – virus infection, pin-

head sized to pea-sized, wax like papules of a yellowish white or pinkish color

Common Papule

• Acne – different stages • Drug eruptions – may occur in many forms• Scratch a localized reaction to rubbing,

scratching

Wheal

• Itchy, swollen lesion that last only a few hours• Hive or insect bite• Capable of returning

Nodule

• Solid lump, larger than a papule, projects above the surface or may lie below the skin

• Varies in size and color • Of medical significance if nodule appears in

more than one area

Nodules

• Nevis – birthmark• Lipomas – fatty growth cells• Fibromas – benign tumor composed of whorls

of white fibrous connective tissue. May occur in single or in random areas, not indicative of underlying disease

Tumor

• Abnormal swelling or enlargement that can be malignant or benign

• Fluidless lesions

Vesicle/Bulla

• Raised lesion containing fluid derived from serum of blood

• Water fluid collects within epidermis or between epidermis and dermis, ranging color from clear to pink

• Bulla is larger than a Vesicle

Vesicle/Bulla

• Herpes Simplex – virus • Contact Dermatitis – inflammation resulting

from irritation of certain substances• Sun burn – (second degree)• Blister – skin irritation

Pustule• Small round, round, raised area of inflamed skin

filled with pus• Common types: acne • Furuncles and carbuncles – contain infection• Impetigo – highly contagious inflammatory

disease• Eczema• Acute fungal infection of feet and hands• Smallpox, chickenpox, vaccination reaction,

herpes

Secondary Lesion

• Secondary lesions are primary lesion that have progressed to later stage of disease

• Secondary lesions usually characterized by material buildup on the skin and includes:

Scale

• Scale is dry and greasy accumulation of epidermal flakes

• Silvery, stratified scales of psoriasis• Seborrhea dermatitis – yellow greasy scales

caused by excess secretion of sebaceous glands

Crust

• Crust/Scab – dry accumulation of serum and pus, mixed with epidermal material

• Lymph crust – honey colored scab not oozing, evidence of skin healing

• Lymph crust – can appear after electrolysis• Pus Crust – a dirty gray or greenish-yellow

crust indicative of infection• Blood crust is reddish or black crust from dried

blood, indicative of disease of blood

Excoriation

• Skin sore produced from scratching or abrasion

Fissure

• Crack in skin that penetrates the dermis

Ulcer

• Open skin lesion or mucous membrane that is accompanied by pus and loss of skin depth

Keloid

• Skin or film that forms over a wound • Keloids rarely form on face• Keloids appear more in skin of color

Scare

• Specialized growth of tissue that forms during healing of wound or skin condition

Common Skin Diseases

• Herpes Simplex – an acute inflammatory infection of the skin, occurring as swollen vesicle or group

• Appears around mouth or nostrils• DO NOT TREAT AN AREAS With Herpes!

Impetigo

• An acute inflammatory and highly contagious disease

• Usually found in children• Characterized by honey colored crust that

have a “stuck on appearance!• DO NOT TREAT THIS SKIN CONDITION

Psoriasis

• Reddish patches covered by silvery scales• Tiny bleeding points may appear under scales• Not infectious• Electrologist can work on this skin involved

with however, never within the patches

Dermatitis

• Irritation with vesicular eruptions • External on skin• Wait until skin has resolved before treating

with electrolysis

Parasitic Disease of the Skin

• Parasites both animal or vegetable can affect skin

• Very Contagious • Refer to physician • DO NOT TREAT

Scabies

• Very contagious• Itching skin caused by infestation by itch mite• Mites burrow in hands or feet• Skin reacts with eruption of papules on forearms,

underarms, waist, inner thigh, buttocks, and ankles

• If disease is not treated it may manifest into boils and ulcers

• DO NOT TREAT

Pediculosis

• Head lice – Pediculois Capitis • Transmitted from person to person via

infected personal care items• Nit surround hair and passes up out of pore

with growing hair• Body Louse – Pediculosis Corporis• Causes intense itching• Clothing contains nits

Disease of Sebaceous Glands

• Blackheads – comedomes – hardened plug of sebaceous material

• Appears black as the sebum oxidizes and turns black

• Can block mouth of follicle• Can become inflamed

Acne

• Chronic inflammation of the philosebaceous unit• Common on face, back and chest• May present as papules or nodules• Can appear as pustules • Cysts may appear• Acne begins as a blockage of the follicular canal,

develops through leakage of sebum into the dermis

Acne• Once the dermis becomes irritated it can

develop into a red pustule or pimple• Prevalent in adolescence during heightened

androgenic activity stimulates sebaceous activity

• Infected follicles can be treated with electrolysis

Milia

• Whitehead caused by retention cyst of entrapped sebum beneath the epidermis

• Not in follicle pore• Appears on face, neck, shoulders and chest

areas• Not usually associated with hair follicle

Sebaceous Cyst

• Subcutaneous tumor of the sebaceous glands• Composed of sebum• Ranges in size from small pea to an orange• Releasing sebum will not eliminate cyst• Needs to be removed by physician

Seborrhea

• Oily condition of nose, forehead, and scalp • Result of over production of sebaceous glands• Can accompany itching and burning

Asteatosis

• Dry, scaly skin deficient of sebum

Disorder of Sudoriferous Glands

• Hyperidrosis – excessive perspiration • Caused by stimulates or mental depression and

exhaustions • Great condition to treat with laser on underarms• Bromidrosis – foul smelling perspiration• Appears in armpits, or feet• Can be caused by drugs, foods, or rare disease• Result of apocrine sweat glands

Disorders of Sudoriferous Glands

• Anidrosis – lack of perspiration caused by fever or disease

• Miliaria or Heat Rash – an acute inflammatory disorder of the sudoriferous glands

• Lesions consists of vesicles and papules

Pigmentation Irregularities

• Tan – Protective layer of skin • Sunlight barrier for skin • Prevents excessive production of Vitamin D•

Freckles & Lentigines

• Yellowish or brown spots occurring on hands, face, and other exposed body parts

• Result of sun exposure

Chloasma

• Yellow, brown or black deposits in skin • Patches occurring in various shapes and spots• Appears a mask of pregnancy – can result

from birth control pills• If patient displays in area to be treated with

electrolysis , do test spots prior to treatment as it may increase with treatment

• Laser hair removal often removes it

Stains

• Abnormal patches of brown coloration • Round or irregular shapes

Nevus/ Birthmark

• Colored malformation of the skin• Often congenital

Leucoderma

• White patches of skin or all over body• Albinism – a congenital absences of pigment in

skin, hair, eyes• Extremely sensitive to sun• Can be localized • Not a good candidate for laser!• Vitiligo – loss of pigment, occurring mostly in

bands, often on hands and patches in the skin• Do not treat with laser!

Hypertrophies

• Usually and enlargement of skin due to multiplication of cells

• Occurs for many reasons• Keratoma (Callus) – hard thickened patches of

skin due to hypertrophy of horny layer • Caused by irritation , friction, or pressure

Moles

• Small congenital macule• Ranges in color from pale tan to brown to bluish black• True malignant moles is melanoma• Black, blue-black or slate-colored• Lacks hair • Mole that is normal for many years can suddenly

change, increase in size, increase in depth, pigmentation

• Crust can form and may bleed• Inflammatory ring may appear around it

Moles

• When in doubt don’t treat a mole• Have checked by physician prior to treatment• Malpractice insurance may not cover if not

checked prior to treatment• Get release to treat mole

Post Treatment Disorders

• Over treatment can cause eschars (scabs) • Unsanitary practices by patient can result in

infection• Examine skin disorder when confronted • Usually small areas will be related to the

electrolysis treatment, one or two follicles• Good aftercare instruction very important to

patient

Post Treatment Disorder• Transfer of infection to the treated site by patient via

hands from another infected area can occur• Advise patient not to: • Scratch, rub or irritate newly treated areas for 24

hours• Do not wash with soap, water or washcloth for 24

hours• Do not use make-up on treated site for 24 hours• Clean skin with antiseptic (Witch hazel, alcohol, or

Seabreeze) for 24 hours • Do not go into sun or tanning bed for 24 hours• Do not dislodge any scabs, should they appear

Post Treatment Disorders

• Poison ivy and poison oak can be transferred to treatment site

• Do not treat if it is present on skin anywhere!

Contact Dermatitis

• Occasionally a patient may develop dermatitis to the galvanic lye

• Should this occur, use high frequency for future treatments

Dermographia

• Can occur after treatment• A form of urticaria• Congenital sensitivity to any form of

scratching

Post Treatment Inflammation

• Redness – local irritation• Possible infection – due to invasion of bacteria• Pustules – yellow-headed pimples• Folliculitis – infection of hair follicle• Crust formation – not to be removed by

patient