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U N I T 1 3
Integumentary Function
R E V I EW E X E R C I S E S
1.
The mother of a 7-year-old boy notices that
he is scratching his head frequently. On close
examination she notices a grayish, round, and
roughened area where the hair has broken off.
Examination by the child’s pediatrician produces a
diagnosis of tinea capitis.
A.
Explain the cause of the infection and propose
possible mechanisms for spread of this infection
in school-age children, particularly during
winter months.
B.
Referring to Chapter 14, explain the preference
of the superficial mycoses (dermatophytoses) for
the skin-covered areas of the body.
C.
What methods are commonly used in the
diagnosis of superficial fungal infections?
2.
A 75-year-old woman presents with severe burning
pain and a vesicular rash covering a strip over the
rib cage on one side of the chest. She is diagnosed
with herpes zoster or shingles.
A.
What is the source of this woman’s rash and
pain?
B.
Explain the dermatomal distribution of the
lesions.
3.
Psoriasis is a chronically recurring papulosquamous
skin disorder, characterized by circumscribed red,
thickened plaques with an overlying silvery-white
scale.
A.
Explain the development of the plaques in terms
of epidermal cell turnover.
SUMMARY CONCEPTS
■■
Some skin problems occur in specific age groups.
Common in infants are diaper rash, prickly heat,
and cradle cap. Nevi, hemangiomas, and port-
wine stains may be present at birth. Infectious
childhood diseases that are characterized by
rashes include roseola infantum, rubella, rubeola,
and varicella. Vaccines are available to protect
against rubella, rubeola, and varicella.
■■
With aging, there is thinning of the dermis and
the epidermis, diminution in subcutaneous tissue,
loss and thickening of blood vessels, and slowing
of hair and nail growth. Dry skin is common
among the elderly, becoming worse during the
winter months. Among the skin lesions seen in
the elderly are skin tags, keratoses, lentigines,
and vascular lesions.
B.
Persons with psoriasis are instructed to refrain
from rubbing or scratching the lesions. Explain
the rationale for these instructions.
C.
Among the methods used in the treatment of
psoriasis are the use of topical keratolytic agents
and corticosteroid skin preparations. Explain
how these two different types of agents exert
their effect on the plaque lesions.
4.
During the past several decades there has been an
alarming increase in the incidence of skin cancers,
including malignant melanoma, that has been
attributed to increased sun exposure.
A.
Explain the possible mechanisms whereby
ultraviolet radiation promotes the development
of malignant skin lesions.
B.
Cite two important clinical signs that aid
in distinguishing a dysplastic nevus from a
malignant melanoma.
R E F E R E N C E S
1. Likeness LO. Common dermatologic infections in athletes
and return-to-play guidelines.
J Am Osteopath Assoc.
2011;111(6):373–379.
2. Wolff K, Johnson RA, Saavedra AP, eds.
Fitzpatrick’s Color
Atlas and Synopsis of Clinical Dermatology
. 7th ed. Chicago, IL:
McGraw-Hill; 2013:607–610.
3. Goodheart HP.
Goodheart’s Photoguide to Common Skin
Disorders
. Philadelphia, PA: Wolters Kluwer Health | Lippincott
Williams & Wilkins; 2009:167–187.
4. DermNet NZ.
Mycology of Dermatophyte Infections
. 2013.
Available at:
.
Accessed September 25, 2013.
5. Patel GA, Schwartz RA. Tinea capatitis: still an unsolved
problem?
Mycoses.
2011;51:183–188.
6. Grover C, Arora P, Manchada V. Comparative evaluation of
griseofulvin, terbenafine, and fluconazole in the treatment of
tinea capitis.
Int J Dermatol.
2012;51:455–458.
7. Gonzalez U, Seaton T, Bergus G, et al. Systemic antifungal
therapy for tinea capitis in children: a summarized Cochrane
review.
Clin Exp Dermatol.
2010;36:826–827.
8. Graham LVD, Elewski BE. Recent updates in oral terbenafine:
its use in onychomycosis and tinea capitis in the US.
Mycoses.
2011;54:e679–e685.
9. Wolff K, Johnson RA, Saavedra AP, eds.
Fitzpatrick’s Color
Atlas and Synopsis of Clinical Dermatology
. 7th ed. Chicago, IL:
McGraw-Hill; 2013:591.
10. Wolff K, Johnson RA, Saavedra AP, eds.
Fitzpatrick’s Color
Atlas and Synopsis of Clinical Dermatology
. 7th ed. Chicago, IL:
McGraw-Hill; 2013:524.
11. Wolff K, Johnson RA, Saavedra AP, eds.
Fitzpatrick’s Color
Atlas and Synopsis of Clinical Dermatology
. 7th ed. Chicago, IL:
McGraw-Hill; 2013:534.
12. Goodheart HP.
Goodheart’s Photoguide to Common Skin
Disorders
. Philadelphia, PA: Wolters Kluwer Health | Lippincott
Williams & Wilkins; 2009:140–150.
13. Goodheart HP.
Goodheart’s Photoguide to Common Skin
Disorders
. Philadelphia, PA: Wolters Kluwer Health | Lippincott
Williams & Wilkins; 2009:155–161.
