Integumentary Disorder English for Nursing

Medical Terminology

Physical examination terms

The skin can provide useful information about the body’s overall condition. Below are terms associated
with a complete skin examination.
Skin color
Decreased hemoglobin level and oxygen in the blood cause changes in skin color. Skin color also
responds to changes in the quality and amount of blood circulating through superficial blood vessels.
1. Cyanosis is a bluish skin color that’s caused by an excess of oxygen-starved hemoglobin
molecules in the blood.
2. Pale skin is called pallor, and pale, cyanotic skin around the lips is known as circumoral pallor.
3. Ecchymosis is a reddish purple skin discoloration that’s caused by hemorrhages in the dermal or
intradermal spaces. Erythema refers to redness or inflammation of the skin resulting from
congestion of the superficial capillaries.
4. Purpura is purple-red or brown-red discoloration on the skin due to hemorrhage in the tissues.
Small (pinpoint) discolored areas are called petechiae, whereas large ones are called
ecchymoses.
5. Yellowing of the skin, known as jaundice, is caused by elevated bilirubin levels.
6. Carotenemia is a yellow-orange skin discoloration that’s caused by excess levels of carotene in
the bloodstream.

Skin Turgor
Turgor is a condition of normal tension in the skin and reflects the skin’s elasticity.
Turgor is assessed by gently grasping and pulling up a fold of skin. Normal skin returns to its flat shape
within 3 seconds. Abnormal (slow) turgor may be a sign of dehydration or connective tissue disorders.

Lesions
Allergens, weather, injury, and various diseases can produce lesions, or abnormal changes in the skin.
Types of lesions include wounds, sores, tumors, and rashes.
Primary lesions are the first lesions of an onsetting disease. Below are examples:
1. A bulla is a fluid-filled lesion, also called a blister or bleb.
2. A cyst is a semisolid encapsulated mass that extends deep into the dermis.
3. A macule is a flat, pigmented area that’s less than 3/8 in diameter; a freckle is an example of a
macule.
4. A papule is a firm, raised lesion up to ¼ in diameter that may be the same color as the skin or
may be pigmented.
5. A plaque is a flat, raised patch on the skin.
6. A pustule is a lesion that contains pus, which gives it a yellow-white color.
7. A tumor is an elevated solid lesion larger than ¾ that extends into the dermal and
subcutaneous layers.
8. A vesicle is a raised, fluid-filled lesion that’s less than ¼ in diameter. Chickenpox produces
vesicles.
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Medical Terminology

9. A wheal is a raised, firm lesion with intense, usually temporary, swelling around the area.
Urticaria, or hives, are a type of wheal.

A secondary lesion results when changes occur in a primary lesion. Below are examples:
1. Atrophy is thinning of the skin surface that may be caused by a disorder or aging.
2. Crust is dried exudate (drainage) covering an eroded or weeping area of skin.
3. An erosion is a lesion that’s caused by loss of the epidermis.
4. Excoriation is a linearly scratched or abraded area.
5. Fissures are linear cracks in the skin that extend into the dermal layer. Chapped skin causes
fissures.
6. A keloid is a hypertrophied scar.
7. Lichenification is characterized by thick, roughened skin with exaggerated skin lines.
8. Scales are thin, dry flakes of shedding skin.
9. Scars are fibrous tissue caused by trauma, deep inflammation, or a surgical incision.
10. An ulcer is an epidermal and dermal destruction that may extend into the subcutaneous tissue.

Disorders
Skin forms a barrier against the environment and also reflects problems within the body, so it’s an easy
target for infection, injury, and infestation.
Bacterial infections
Below are some common bacterial infections:
1. Impetigo is a contagious, superficial skin infection that’s usually caused by Staphylococcus
aureus. Impetigo lesions start as macules, then develop into vesicles that become pustular with a
honey-colored crust. When the vesicle breaks, a thick yellow crust forms from the exudate.
2. Cellulitis is an inflammation of subcutaneous and dermal tissues caused by a bacterial infection. It
often appears around a break in the skin, such as an insect bite or a puncture wound. The
affected area is red, swollen, and warm. Fever, chills, headache, and tiredness commonly
accompany cellulitis.
3. Folliculitis is a bacterial infection of the hair follicles that’s usually caused by S. aureus. A
furuncle, or boil, begins deep in the hair follicles. When a boil spreads to surrounding tissue and
produces a cluster of furuncles, it’s called a carbuncle.
4. A stye is an abscess in the eyelash follicle that’s caused by a taphylococcal infection.

Viral infections
Two common manifestations of viral infections are the sores associated with different types of herpes
and warts.
The word herpes, often used as a singular word, actually refers to a variety of viruses. Below are some
common types of herpes:
1. Herpes simplex virus type 1 causes painful cold sores and fever blisters on the skin and mucous
membranes. After initial infection, patients are susceptible to recurrent bouts with the virus.
Outbreaks are accompanied by burning pain, swelling, redness, and fatigue.
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Medical Terminology

2. Herpes simplex virus type 2, also known as genital herpes, produces lesions in the genital area.
Patients complain of flulike signs and symptoms, including headache, fatigue, muscle pain, fever,
and loss of appetite. Both herpes simplex types 1 and 2 are caused by contact with an infected
lesion.
3. Herpes zoster, also known as shingles, is caused by varicella-zoster, the chickenpox virus. Lesions
called spinal ganglia appear along spinal nerve fibers outside the central nervous system. The
virus is dormant until the patient’s resistance is low, then a row of vesicular skin lesions erupts
along a spinal nerve pathway, accom-panied by severe pain, fever, and weakness.

Verrucae (warts) are common, harmless infections of the skin and mucous membranes. They’re
caused by the human papillomavirus and can be transmitted by direct contact. Diagnosed by their
appearance, warts are divided into the following categories:
1. common (also called verruca vulgaris)—rough, elevated wart appearing most commonly on
extremities, especially hands and fingers.
2. filiform—stalklike, horny projection commonly occurring around the face and neck
3. flat—multiple groupings of up to several hundred slightly raised lesions with smooth, flat, or
slightly rounded tops
4. genital (also called condyloma acuminatum)—sexually transmitted infection appearing on the
penis, scrotum, vulva, and anus
5. periungual—rough wart appearing around the edges of fingernails and toenails
6. plantar—appearing as a singular lesion or in large clusters, primarily at pressure points of the
feet, with lesions that are slightly elevated or flat.

Parasitic infections
Pediculosis results from the infestation of bloodsucking lice. These lice feed on human blood and lay
their eggs, or nits, in body hair or clothing fibers. When a louse bites, it injects a toxin into the skin that
produces mild irritation and a reddened spot. Repeated bites can lead to
serious inflammation. Three types of lice attack humans:
1. Pediculus humanus capitis, or head louse
2. Pediculus humanus corporis, or body louse
3. Phthirus pubis, or pubic louse
The nesting instinct
Scabies, another common parasitic infection, is caused by a female mite that penetrates and burrows
into the skin. Under the skin, the mite lays eggs that mature and rise to the surface. A scabies
infestation produces intense itching and secondary infections from the excoriation caused by
scratching. Wavy, brown, threadlike lines appear on the hands, arms, body folds, and genitals.

Fungal infections
Dermatophytosis is the general name for a fungal infection.
Mushrooms, molds, and yeasts are common fungi (plural of fungus). Fungi are present in the air, soil,
and water, but only a few species of fungi cause disease. One of the most common fungal disorders is
tinea, or ringworm.
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Medical Terminology

Candidiasis, also called moniliasis, is a mild, superficial fungal infection of the skin, nails, or mucous
membranes. The patient develops a scaly, reddened popular rash with severe itching and burning. This
fungus is often the culprit in diaper rash and vaginal infections. It’s diagnosed through skin scrapings.
Thrush is a fungal infection of the oral mucous membranes caused by Candida albicans. This infection
develops most commonly in patients whose defenses are weakened by illness, malnutrition, infection,
or prolonged treatment with antibiotics. White patches develop
on a red, moist, inflamed surface inside the mouth, usually the inner cheeks. Thrush is accompanied by
pain and fever.

Inflammatory disorders
Different types of dermatitis make up the most common inflammatory skin disorders.
Dermatitis. Superficial skin infections are known as dermatitis. Dermatitis can be caused by numerous
things, including drugs, plants, chemicals, and food. Contact dermatitis occurs when direct contact
with an irritant causes the epidermis to become inflamed and damaged. Touching such substances as
poison ivy, poison oak, detergents, and industrial chemicals can lead to pain, burning, itching, and
swelling—signs and symptoms of dermatitis.
Angioedema is characterized by urticaria and edema that occur as an allergic reaction, usually to a
certain food. It occurs in the subcutaneous tissues of isolated areas, such as the eyelids, hands, feet,
tongue, larynx, GI tract, or lips.
Psoriasis is a chronic skin disorder, commonly with unknown causes, that’s characterized by periods of
remission and worsening. Psoriasis usually starts between ages 25 and 30. Lesions appear as reddened
papules and plaques covered with silvery scales; they vary widely in
severity and location.

Skin tumors
Most skin tumors are benign (noncancerous), but they can be a starting point for skin cancer.
1. An angioma is formed by a group of blood vessels that dilate and form a tumorlike mass. A
port-wine birthmark is a typical angioma. Spider angiomas, also called telangiectases, are
made up of tiny, dilated veins that spread outward with a spiderlike appearance.
2. Basal cell carcinoma is a type of skin cancer arising in the basal cell layer of the epidermis.
Commonly found on the face and upper trunk, these tumors are painless and may go unnoticed
by the patient.
3. Squamous cell carcinoma, another form of skin cancer, begins in the epidermis and produces a
firm, nodular (knotlike) lesion covered with a crust or a central ulceration.
4. In malignant melanoma, cancer arises from the melanocytes (pigment cells) of the skin and its
underlying structures.

Cutaneous ulcers
Integumentary Disorder English for Nursing
Medical Terminology

An ulcer is an open sore. Ulcers on the skin are usually caused by a lack of circulation to a vulnerable
area. Ulcers may be superficial, caused by local skin irritation, or deep, originating in the underlying
tissue.
Pressure ulcers are localized areas of cellular death that occur most commonly in the skin and
subcutaneous tissue over bony prominences. Increased pressure impairs circulation.
Stasis ulcers are caused by chronic venous stasis (poor blood flow) due to inefficient or obstructed
veins. Prolonged standing in one position and obesity are predisposing
factors for stasis ulcers.

Burns and cold injury

The skin is an effective protective covering. It can, however, be severely damaged when it
comes in contact with excessive heat or cold.
A burn is an injury to tissue caused by contact with dry heat (fire), moist heat (steam), electricity,
chemicals, lightning, or radiation. Categorized according to depth, burns are referred to as superficial,
partial-thickness, or full-thickness. When named according
to severity, burns are called first, second, third, or fourth degree.

Cold injury, or frostbite, results from overexposure to cold air or water. Upon returning to a warm
place, a person with superficial frostbite experiences burning, tingling, numbness, swelling, and a
mottled, blue-gray skin color. Deep frostbite causes pain, blisters, tissue death,
and gangrene. The skin appears white until it thaws and then appears purplish blue.

First-degree, or superficial, burn

In a first-degree burn, damage is limited to the epidermis, causing redness and pain. The skin is dry,
with no blisters or drainage. A sunburn is a type of first-degree burn.
Second-degree, or partial-thickness, burn
In a second-degree burn, the epidermis and part of the dermis are damaged, producing blisters and
mild-to-moderate edema and pain. Large, moist blisters may occur, and the skin is mottled with dull
white, tan, pink, or cherry-red areas. Spilling a hot cup of coffee on the skin could produce a second-
degree burn.
Third-degree, or full-thickness, burn
In a third-degree burn, the dermis and epidermis are damaged. No blisters appear, but white, brown,
or black leathery tissue and thrombosed vessels are visible. Little or no pain accompanies this burn
because the nerves are damaged. The skin doesn’t blanche with pressure. Contact with hot liquids,
flames, chemical, or electricity may cause a third-degree burn.
Fourth-degree burn
In a fourth-degree burn, damage extends through deeply charred subcutaneous tissue to muscle and
bone.

Other skin disorders

Here are some other common skin disorders:
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Medical Terminology

1. acne—an inflammatory skin eruption caused by plugged sebaceous glands, resulting in papules
and pustules
2. albinism—an inherited condition of defective melanin production, causing lack of pigmentation
to the skin
3. alopecia—hair loss
4. aphthous stomatitis (canker sores)—recurring ulcers on the mucous membrane of the mouth,
with small, white lesions
5. chigger—the larvae of a mite, which attach to the host’s skin, causing severe itching and
dermatitis
6. chilblain—redness, burning, and swelling of the skin caused by exposure to cold, damp
conditions
7. nevus—a benign birthmark
8. rosacea—a chronic skin disease that causes dilated and inflamed surface blood vessels and
reddening of the nose and adjoining areas; commonly is accompanied by acne (acne rosacea)
9. vitiligo—irregularly shaped patches of lighter or white skin caused by the loss of pigment-
producing cells.

Video links for oral test:

Integumentary system
https://www.youtube.com/watch?v=OxPlCkTKhzY
Burn
https://www.youtube.com/watch?v=Dsvtzwp4nG8&t=26s
Acne

https://www.youtube.com/watch?v=lAx5gwhmsdo