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Layers of the skin?
Epidermis is made of?
What are keranotinocytes?
- Majority of the cells of the epidermis
- Provides barries to skin
What are melanocytes?
- at basal layer ( bottom line of the epideris layer)
- make pigment melanin that get transferred to the keratinocytes in the basal cell layer
- malignancy of melanocytes
- suggests central cyanosis
- arises in non-sun exposed areas
- ass. w/ intermittent and intense sun exposure
- blistering sunburns in childhood
- - family hx of melanoma
- - light skin
- - presence of atypical moles (dysplastic nevi) or > 50 common moles
- - immunosuppression
What are Langhern's cells?
- 3rd type of epidermal cells
- dendritic cells at mid-epidermis
- bind to antigen entering skin and transport them to lymph nodes
Characteristics of the dermis?
- thicker than the epidermis
- Made of fibroblasts and mast cells
- - blood
- - lymphatic vessels,
- - nerves supplying the skin
- - sweat glands
- - hair follicles
What are fibroblasts?
Ex: keloids ( dermal injury)
- resp. for synthesis and degradation of connective tissue protein
- imp in wound healing, scaling
- specialized cells resp for immediate type hypersensitivity reaction in skin
- Ex: Urticaria, wheals
What is the subcutaneous layer?
- fat layer that separates dermis from muscles
- Ex: erythema nodosum ( inflammed nodules on sheen)
What are the characteristics of basal cell carcinoma?
- ulcerated in the center nodules w/ shiny surfaces
- erythematous papules and plaques
- most common cancer
- margin well defined
- almost never spreads
What are the characteristics of squamous cell carcinoma?
- affects outer layer of skin ( keratinocytes)
- firmer and redder
- hard scalling papules, nodules ot plaques that sometimes ulcerate and bleed
Atopic Dermatitis / Exzema
- Genetic ( astham and rhinitis)
- Chronic eruption of:
- - pruritic erythematous, oozing papules and plaques
- - w/ 2nd lichenification and excoriation
- - Infants : extensor surface, diaper area, head
- - Adults: flexor surface, upper chest, face, neck
Patient education about skin care to avoid cancer?
- avoid unecessary sun exposure
- use sunscreen, at SPF of 15 - water resistent if possible
- inspect skin frequently
ACS recommendation about skin inspection?
- self -->monthly
- q3 years --> clinician exam for people 20 - 39 yo
- q1yr --> > 40
ABCDEs of melanoma?
- A - asymetry
- B - border irregularity
- C - color ( variation/ change)
- D - diameter ( larger than 6 cm)
- E - deviation
Refer suspicious lesions to dermatologist
Palor due to decreased redness
- decreased blood flow
- arterioles insufficiency
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