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Background material by Professor Omar Hasan Kasule Sr. for Year 2 Semester 1 PPSD session on 08th October 2008
SKIN DISORDERS
Overview
Skin abnormalities are most often secondary to metabolic, malignant, and endocrine disorders. The disorders may be inflammatory, neoplastic, traumatic, or degenerative. Skin disorders manifest as skin rash, hyperplasia, inflammation, and color change. Skin disease causes itching, pain,
Hereditary diseases
Psoriasis and atopic eczema are hereditary disorders triggered by sunlight and emotional stress. Nevi may be beingn or may undergo malignant transformation. A nevus may be due to melanocyte concentration (melanocytic nevus) or may be due to capillary concentration (capillary nevus). Epidermolysis bullosa is a blistering and scrring disorder. Albinism is generalized lack of skin pigment. Xeroderma pigmentosa is a pre-cancerous lesion in which sun-induced skin damage cannot be repaired enzymatically.
Dermatitits, and psoriasis
The two terms are used interchangeably. They denote unflammation in the dermis and epidermis. Dermatitis is classified as contact dermatitis (allergic and non-allergic), atopic dermatitis, and seborrhoeic dermatitis. Psoriasis is an autosomal dominant trait with proliferative and inflammatory features.
Skin cancer
Basal cell carcinoma is due to sub exposure. It rarely metastasizes. Squamous cell carcinoma has a higher rate of metastasis. It follows sun exposure, chronic scarring, chronic ulceration, and radiation. Malanomas arise from skin melanin and may be beinign or malignant. Malignant melanomas metastasize frequently. Mycoides fungoides is a malignant tumor of T lymphocytes in the dermis. Kaposi’s sarcoma may also develop in the skin.
Skin infections
Impetigo or boil is due to acute bacterial infection. Mycobacterrium tuberculosis, treponema pallidum, and mycobacterium leprae cause chronic granulomatous infections. Epidermotropic viruses cause viral warts, varicella (chickenpox), herpes zoster (shingles), and herpes simplex. Dermatophyte fungi such as candida albicans cause skin infections. In crowded unhygienic conditions parasitical infestations of the skin occur, Pediculoses are by crabs, lice, and nits. Scabies is caused by Sarcoptes scabei.
Urticaria
Urticaria is due to release of histamine accompanied by itching. It is due to allergy to shellfish, strawberry, nuts, certain drugs, sunlight exposure, cold exposure, and exercise.
Skin vascular disorders
Increased blood viscosity due to polycythemia vera and hyperglobulinemia disturbs skin blood flow. Vascular spasm as in Raynaud’s disease is due to cold exposure. Vascular dilatation increases skin blood flow (flushing). Blood vessel damage is seen in atherosclerosis, autoimmune inflammation.
Disorders due to ageing
Skin problems common in the elderly are fungal infections, excessive dryness, benign tumors, seborrhoiec dermatitis, seborhhoeic warts, solar keratosis, and hirsuitism. Sunlight exposure causes skin aging faster than normal. Skin aging manifests as skin laxity leading to wrinkles, dryness, itching, increased pigmentation, and telangiectasis (visible dilatation of blood vessels). Moles, seborrhoiec warts, and hemangiomas (de Morgan’s spots) occur in the elderly. Reproduction of epidermal cells does not change with age but degenerative changes in connective tissues lead to wrinkling and loss of elasticity.
HUKUM ON SKIN DISORDERS
Skin lesions such as eczema, dermatitis, itch, discharges, rashes, and chronic ulcer are a reason for tayammum instead of using water. If the skin is bandaged, the bandage is wiped with the wet hand.