Lecture-15

Brig (R) Ali Nasre Alam

Prevention for
Integumentary Disorders
 15 - INTEGUMENTARY DISORDERS

Lifespan Changes of the integumentary System

Skin Care
 The Integumentary System
Consists of a major organ, skin, and many accessory

structures, which include hair follicles, sebaceous

glands, sweat glands, and nails.
Functions that these tissues collectively perform are

many, including the following:

Protection

• Physical barrier
• Water loss barrier
• Injury protection
• Chemical barrier
• Preventing microorganism growth
 Excretion of urea and uric acid, although minimal; most
is through kidneys.
 Regulation of body temperature
 Cutaneous Sensation:
• 1. Light touch detection by tactile corpuscles.
• 2. Pressure detection by lamellated corpuscles.
 Vitamin D Synthesis activated by UV rays in sunlight.
 Blood Reservoir as the dermis houses about 10% of the
body's blood vessels, but only requires 1-2% of the
body’s blood.
 Immunity with Langerhan’s cells (macrophages)
 General Structure
Two distinct regions or layers compose the skin i.e.
Epidermis and Dermis.
Subcutaneous (hypodermis) layer is the adipose tissue layer
beneath skin

Epidermis = outermost layer keratinized stratified

squamous epithelium
 Main Function = Protection (keratin):

•a. prevents moisture loss (waterproof)

•b. prevents injury by penetration
•c. prevents microorganisms/chemicals entry
Pigment = Melanin determines skin color is produced

Depends on Genetic and environmental factors

 Genetic Factors: People of different races have the same

number of melanocytes, but the amount of melanin

produced varies.
 Environmental Factors affect melanin production, by

affecting gene expression

• a. UV rays
• b. chemicals
• c. drugs (antihistamines & antibiotics)
Main Functions of Dermis is nourishment of epidermis and
strength of skin.

Dermis inner layer of skin binds epidermis to underlying

tissues

keratinized epithelium (hair follicles)

glandular epithelium (sweat, sebaceous glands)

dense irregular CT (collagen)

smooth muscle tissue

nervous tissue (tactile and lamellated corpuscles)

blood vessels
Two layers of Dermis: Papillary and Reticular

Upper Papillary layer (20%) is below epidermis:

Composed of loose areolar CT

Surface forms dermal papillae (finger-like projections into

the epidermis) that form fingerprints in thick skin.

Tactile (Meissner’s) corpuscles, the sensory receptors for

fine touch.
Lower Reticular layer (80%) made of dense irregular CT
Bundles of collagen fibers

Elastic fibers

Reticular fibers which together give skin its strength and

resiliency.
Lamellated (Pacinian) corpuscles, the sensory receptors for

pressure.
 The skin’s proteins
Collagen:
Most abundant protein in the skin. 75% of skin.

Collagen and elastin are responsible for warding off

wrinkles and fine lines.

Elastin:
This protein is found with collagen in the dermis.

Responsible for giving structure to your skin and organs.

Diminished levels cause skin to wrinkle and sag.

Keratin:
This dominant protein in your skin makes up hair, nails and

the surface layer of the skin.

Forms the rigidity of skin.
 LIFE-SPAN CHANGES
Aging skin exhibits:

• Wrinkling
• Sagging
• Age spots

 Efficient regulation of body temperature declines:

• The number of sweat glands changes.
• Capillary beds in the skin shrink.

 Synthesis of vitamin D declines

 Decreased dermal thickness, blood vessels, nerve
endings, elastin fibres and collagen leads to altered
• Sensation
• Thermoregulation,
• Rigidity
• Moisture retention
 Cumulative effects of exposure to the environment
 Drugs
• Corticosteroids
• Anticoagulants
 Decreased pain perception
 Dehydration
 Site-specific atrophy of subcutaneous tissue
• Face
• dorsal aspect of the hands
• Shins
• plantar aspects of the foot.
Skin Hygiene Care
• pH balanced soaps with out perfumes
• Tepid water temperatures
• Dry well in skin folds
• Regular use of emollients
• Good nail and callus care
Sun protection
Protecting your skin from the sun is important because the

sun emits ultraviolet radiation (UVR).*

UVR exposure causes many changes in the skin including

wrinkles, discoloration, age spots, benign growths and pre-

cancerous, or cancerous growths.
Most skin cancers are related to sun exposure.

Avoid midday sun between 10 a.m. and 3 p.m.

Wear hats, long-sleeved shirts, and pants

Use sunscreen < SPF-30 (sun protection factor)

*Protecting the skin from excessive sun exposure may

decrease vitamin D levels.

Facial skin care for mature skin
Photoaging refers to the damage that is done to the skin

from prolonged exposure to UV radiation

Roughness, wrinkling, irregular pigmentation, inelasticity,

enlarged sebaceous glands, precancerous and cancerous

lesions are associated with photoaging.
Sunscreens and sun protection are important to prevent

further progression of photoaging.

Smoking has been shown to accelerate aging of skin, so

stopping smoking is important for good skin health.

A well-balanced diet allows the skin get the nutrition it

needs to help repair ongoing damage from the sun and other
environmental elements.
 Tretinoin exfoliates the skin, helps even out pigmentation,
and minimizes fine lines.
 Alpha hydroxy acids (AHAs) may help with fine lines,
irregular pigmentation, age spots, and may help decrease
enlarged pores.
 Beta hydroxy acid (salicylic acid) exfoliates skin, and can
improve the texture and color of the skin.
 It penetrates oil-laden hair follicle openings and, as a
result, also helps improve acne.
 Hydroquinone is a bleaching agent that is used to remove
hyperpigmentation.
Dry skin
Many older people suffer from dry skin, often on their

lower legs, elbows, and lower arms.

There are many possible reasons for dry skin, such as:

Not drinking enough liquids

Staying out in the sun

Being in very dry air

Smoking

Having stress

Losing sweat and oil glands (common with age)

Dry skin also can be caused by health problems, such as

diabetes or kidney disease.

Dry skin care
Dry skin is flaking or scaling of the skin when there is no evidence of

dermatitis (inflammation).
Common during the winter months, when humidity is low

Treatment is important can lead to dermatitis or eczema.

Dry skin may be prevented or treated by:

Taking lukewarm baths or showers

Limiting baths/showers to 5 to 10 minutes

Applying a moisturizer right after drying off from a shower or

washing your hands

Using a moisturizing body soap and hand soap

Using heavier creams or ointments during the winter months and

lighter lotions in the summer.

Wrinkles

Over time, skin begins to wrinkle.

UV light from the sun, make the skin less elastic.

Gravity can cause skin to sag and wrinkle.

Certain habits like frowning also wrinkle the skin.

Not smoking is a great way to prevent wrinkles.

Age spots (Liver Spots)

Flat brown spots are caused by years in the sun.

They are bigger than freckles

Show up on face, hands, arms, back, and feet.

Age spots are harmless.

Sunscreen may prevent more sun damage.

Skin tags

Skin tags are small, usually flesh-colored growths of

skin that have a raised surface.
Common problem as people age.

Specially for women.

Found on the eyelids, neck, and body folds such as the

arm pit, chest, and groin.

Skin tags are harmless, but they can become irritated.

Can remove them if they bother you.

Skin cancer
The main cause of skin cancer is the sun.

People with fair skin are at greatest risk.

Basal cell carcinoma and Squamous cell carcinoma, grow

slowly and rarely spread to other parts of the body.

Found mostly on parts of the skin exposed to the sun, like

the head, face, neck, hands, and arms

Melanoma is the third and most dangerous type.
 Check your skin regularly for things that may be cancer.
 Skin cancer isn’t usually painful.

 Look for changes such as a new growth, a sore that

doesn’t heal, or a bleeding mole.

ABCDE
 Asymmetry. Growth looks different from the other half.

 Borders are irregular

 Color changes or more than one color

 Diameter greater than the size of a pencil eraser

 Evolving, meaning changes in size, shape, symptoms

(itching, tenderness), surface (especially bleeding), or

shades of color
Thank You