5.4 Diseases, disorders, and injuries of the integumentary system  (Page 5/28)

Sometimes, there is an overproduction of scar tissue, because the process of collagen formation does not stop when the wound is healed; this results in the formation of a raised or hypertrophic scar called a keloid    . In contrast, scars that result from acne and chickenpox have a sunken appearance and are called atrophic scars.

Scarring of skin after wound healing is a natural process and does not need to be treated further. Application of mineral oil and lotions may reduce the formation of scar tissue. However, modern cosmetic procedures, such as dermabrasion, laser treatments, and filler injections have been invented as remedies for severe scarring. All of these procedures try to reorganize the structure of the epidermis and underlying collagen tissue to make it look more natural.

Bedsores and stretch marks

Skin and its underlying tissue can be affected by excessive pressure. One example of this is called a bedsore    . Bedsores, also called decubitis ulcers, are caused by constant, long-term, unrelieved pressure on certain body parts that are bony, reducing blood flow to the area and leading to necrosis (tissue death). Bedsores are most common in elderly patients who have debilitating conditions that cause them to be immobile. Most hospitals and long-term care facilities have the practice of turning the patients every few hours to prevent the incidence of bedsores. If left untreated by removal of necrotized tissue, bedsores can be fatal if they become infected.

The skin can also be affected by pressure associated with rapid growth. A stretch mark    results when the dermis is stretched beyond its limits of elasticity, as the skin stretches to accommodate the excess pressure. Stretch marks usually accompany rapid weight gain during puberty and pregnancy. They initially have a reddish hue, but lighten over time. Other than for cosmetic reasons, treatment of stretch marks is not required. They occur most commonly over the hips and abdomen.

Calluses

When you wear shoes that do not fit well and are a constant source of abrasion on your toes, you tend to form a callus    at the point of contact. This occurs because the basal stem cells in the stratum basale are triggered to divide more often to increase the thickness of the skin at the point of abrasion to protect the rest of the body from further damage. This is an example of a minor or local injury, and the skin manages to react and treat the problem independent of the rest of the body. Calluses can also form on your fingers if they are subject to constant mechanical stress, such as long periods of writing, playing string instruments, or video games. A corn    is a specialized form of callus. Corns form from abrasions on the skin that result from an elliptical-type motion.

Chapter review

Skin cancer is a result of damage to the DNA of skin cells, often due to excessive exposure to UV radiation. Basal cell carcinoma and squamous cell carcinoma are highly curable, and arise from cells in the stratum basale and stratum spinosum, respectively. Melanoma is the most dangerous form of skin cancer, affecting melanocytes, which can spread/metastasize to other organs. Burns are an injury to the skin that occur as a result of exposure to extreme heat, radiation, or chemicals. First-degree and second-degree burns usually heal quickly, but third-degree burns can be fatal because they penetrate the full thickness of the skin. Scars occur when there is repair of skin damage. Fibroblasts generate scar tissue in the form of collagen, which forms a basket-weave pattern that looks different from normal skin.

Bedsores and stretch marks are the result of excessive pressure on the skin and underlying tissue. Bedsores are characterized by necrosis of tissue due to immobility, whereas stretch marks result from rapid growth. Eczema is an allergic reaction that manifests as a rash, and acne results from clogged sebaceous glands. Eczema and acne are usually long-term skin conditions that may be treated successfully in mild cases. Calluses and corns are the result of abrasive pressure on the skin.

References

American Cancer Society (US). Skin cancer: basal and squamous cell [Internet]. c2013 [cited 2012 Nov 1]. Available from: (External Link) .

Lucile Packard Children’s Hospital at Stanford (US). Classification and treatment of burns [Internet]. Palo Alto (CA). c2012 [cited 2012 Nov 1]. Available from: (External Link) .

Mayo Clinic (US). Basal cell carcinoma [Internet]. Scottsdale (AZ); c2012 [cited 2012 Nov 1]. Available from: (External Link) .

Beck, J. FYI: how much can a human body sweat before it runs out? Popular Science [Internet]. New York (NY); c2012 [cited 2012 Nov 1]. Available from: (External Link) .

Skin Cancer Foundation (US). Skin cancer facts [Internet]. New York (NY); c2013 [cited 2012 Nov 1]. Available from: (External Link) .