COMMON SKIN PROCEDURES

COMMON SKIN PROCEDURES

Biopsy

Sometimes, a small piece of tissue is excised through a surgical process for some microscopic examination. This excision is called bi­opsy and such an act is performed with the help of a needle or syringe. The general purpose of getting a biopsy is to arrive at a diagnosis. The different kinds of biopsies per­formed are aspiration or needle biopsy, punch biopsy, shave biopsy, endoscopic biopsy, and chorionic villus biopsy. In aspiration or needle biopsy, the specimen is aspirated through a needle or trocar that penetrates the skin, the outer surface of the organ, or the underlying tissue to be examined. In punch biopsy, the specimen removed is in the form of a cylinder. Shave biopsy is a technique performed with surgical or razor blades, chiefly for the lesions of the dermis or epidermis.

Cryosurgery

Cryosurgery is a kind of operation performed using freezing temperature. This temperature is achieved by employing liquid nitrogen or carbon dioxide. This freezing temperature is used either as an agent or in an instru­ment to destroy tissues.

Dermabrasion

Dermabrasion is a technique to wipe out the acne scars (cicatrix) or the pits (small depres­sions in the skin). The physicians use sand­paper, rotating wire brushes, or other abrasive materials to efface these scars.

Electrocauterization

Scarring, burning, or cutting the skin by means of heat, cold, electric current, ultra­sound, or caustic chemicals is called cauterization. During electrocauterization, a high-voltage current is passed through the tissues or the metal device that has been electrically heated.

Electrodesiccation

Lesions of the skin, sometimes of the mu­cous membranes, are destroyed and blood vessels sealed off by the monopolar high-fre­quency electric current. This process is known as electrodesiccation.

Frozen section

In this process, a thin slice of tissue is excised from a frozen specimen and sent for microscopic examination. This procedure is used for rapid diagnosis of malignancy, while the patient awaits surgery. This generally helps in determining the approach towards the surgery, i.e. conservative or radical.

Incision and drainage

Incision and drainage is a simple procedure to drain the fluids from a wound or cavity, An incision is made to allow the free flow or with­drawal of fluids from the wound or cavity.

Patch test

A small, circumscribed, flat area, not more than 1 cm in diameter, differing in color or structure from the surrounding surface, is called a patch. Patch test is done to ensure the sensitivity of the skin. A small piece of paper or tape is soaked with a non-irritating diluted test fluid and applied on the skin of upper back or upper outer arm and covered. After 48 hours, the covered area is compared with the uncovered area. The presence of erythema and vesicles indicate the allergy towards that substance.

Scratch test

Scratch test is one of the various skin tests performed to diagnose a pathology of the skin. In scratch test, an antigen is applied through a scratch in the skin.

Tzanck smear

Arnault Tzanck was a Russian dermatologist (1886- I 954). Tzanck smear is the examina­tion of fluid from the bullous lesions of the altered epithelial cells, rounded and devoid of intercellular attachments, also known as Tzanck cells. These cells are basophilic in nature, with spherical nucleus and enlarged prominent nucleoli. They are characteristic of lesions due to varicella, herpes, and pem­phigus vulgaris.

Now, lets take a look at the pharmacopoeia of skin.

Chapter IV - PHARMACOLOGY AND VOCABULARY

Acne vulgaris drugs

These drugs control the inflammatory eruptions composed of cysts, papules, and comedos, predominantly on the face, upper back, and chest. The condition occurs in a majority of people during pu­berty and adolescence. Examples: benzoyl peroxide, tretinoin, topical erythromycin, and meclocycline  

Antipsoriatic

Psoriasis refers to the circumscribed discrete, silvery-scaled, confluent reddish lesions that primarily occur on knees, scalp, elbow, and trunk. There are many drugs for treatment of psoriasis like Calcipotriene, coal tar, and etretinate.

Antiseborrheics

These drugs are effective for treatment of seborrheic dermatitis manifested by erythematous and scaly lesions. Examples: sele­nium sulfide, chloroxine, coal tar, and sulfur and sulfacetamide.

Emollients and keratolytics

Emollients are agents used to soothe and hydrate the skin. After application to the skin, emollients prevent evaporation of water by forming a thin greasy layer on the skin surface. Emollients improve the dry­ness of skin but are not to be used on exudative lesions (oils like coconut, ground­nut, etc.). Keratolytics are agents applied to soften the epidermic cells and desqua­mate them, for example, salicylic acid, benzoic acid, propylene glycol, zinc oxide, and dimethicone.

Topical anti-infectives

Topical anti-infectives are used for treatment of bacterial infections of skin, impetigo, eczema, folliculitis, and leg ulcers. They are also used for abrasions, cuts, and as preoperative antiseptics. Example: mupirocin, tetracycline, aminoglycoside, sulfonamides, nitrofurazone, and acy­clovir. The antiseptics used are chloroxylenol, cetrimide, and povidone-iodine.

Topical Antifungals

These agents kill the fungus selectively. These antifungals include scabicides, which kill scabiei that invade the epidermis. Ex­ample: Malathion, lindane, benzyl benzoate. Some other antifungal are miconazole, which has a broad spectrum of antifungal activity and is used for fungal and eczematous infec­tions of tinea, candidiasis of skin and nails and also for eczema with bacterial infection; clotrimazole which is used for Tinea infections, fungal nappy rash, candida vulvitis, candida balanitis, paronychia, and athlete foot; and ­vulvovaginal candidiasis; and ketoconazole for fungal infections of the skin.

Topical steroids

Topical steroids are used to treat various dermatological disorders like contact derma­titis, psoriasis, keloid scars, seborrheic der­matitis, eczema, and vulval pruritus. Example: beclomethasone dipropionate, triamci­nolone acetate, hydrocortisone, methyl prednisolone acetate, and dexamethasone sodium phosphate.

VOCABULARY

1.                  Abrasion: scraping away or excoriation of the superficial layer of the skin or mucous membrane

2.                  Abscess: a pus-filled cavity caused by tissue destruction and associated with swelling

3.                  Acne: papular follicular eruptions characterized by pus and inflamma­tion

4.                  Adenopathy: disease of the glands (lymph nodes)

5.                  Adipose: of or related to fat

6.                  Allograft: a graft between the individu­als of the same species

7.                  Alopecia: falling hair, loss of hair

8.                  Anesthetics: agents which suppress the ability to feel pain or other sensations

9.                  Antibacterial: agents acting against the growth of bacteria

10.              Antifungal: agents acting against fun­gus (syn antimycotic)

11.              Anti-inflammatory: agents to reduce inflammation

12.              Antiseptics: agents that prevent growth of infective agents (syn. Dis­infectives)

13.              Areola: any small area (also used for the areola of nipple)

14.              Atopic: related to hypersensitivity to environmental allergens

15.              Benign: mild, non-malignant

16.              Biopsy: process of taking out a speci­men of tissue for diagnostic purposes

17.              Blemish: unaesthetic circumscribed alteration of the skin

18.              Bulla: a large bubble-like blister

19.              Carbuncle: skin infections of the sub­cutaneous tissue, accompanied by fever

20.              Cellulitis: inflammation of the cellular tissues

21.              Chloasma: skin infections character­ized by irregular brown patches

22.              Cicatrix: scar

23.              Comedo: dilated hair follicle filled with bacteria and sebum

24.              Contusion: injury in which skin does not break

25.              Corium: dermis

26.              Crust: a hard outer layer or covering (sometimes referred to the one formed by pus or blood)

27.              Cyst: a bladder or sac containing some sort of fluid

28.              Debridement: the process of taking out the dead tissues from a wound site

29.              Dermabrasion: operation performed to remove the acne scars

30.              Dermatitis: skin inflammation

31.              Dermatologist: specialist in the study of skin and its diseases

32.              Dermatology: specialty, dealing with skin

33.              Dermatomycosis: fungus infection of the skin

34.              Dermatophytosis: skin abnormality in which vesicles, papules, and/or fis­sures are caused by dermatophytes

35.              Dermatoplasty: surgical repair of the skin

36.              Dermatosis: abnormalities of the skin

37.              Dermatotherapy: treatment of skin pa­thology

38.              Dermis: corium, skin

39.              Desquamation: shedding or peeling of the outer layer or surface

40.              Ecchymosis: a purple spot or patch caused by passing of the blood into the skin

41.              Eczema: inflammatory condition of the skin characterized by erythema­tous edematous papular vesicles of the skin

42.              Electrodesiccation: destroying the le­sions or pathological skin tissues by applying a high frequency electric cur­rent

43.              Epidermis: outer layer of the skin

44.              Eruption: breaking out of the lesions

45.              Erythema: redness of the skin

46.              Eschar: a crust or scar formed after the burn or cauterization of the skin tis­sues

47.              Exanthem: skin eruptions, mostly as a result of viral disease

48.              Excoriation: scraping or peeling of the pathological tissues from the skin

49.              Extravasation: passing out of blood or lymph, into the tissues

50.              Fissure: a narrow opening, cleft, or break in the body parts or between the tissues

51.              Flaking: eruption of small, thin, flat­tened pieces of layer

52.              Frostbite: a condition caused by ex­treme cold or frost in which tissues are killed

53.              Fulguration: the act or process of de­stroying tissues or lesions by applying electric current. Syn. Electrodesiccation

54.              Glandular: relating to a gland

55.              Graft: tissues used for transplantation

56.              Hair follicle: the cavity from which the hair shaft develops

57.              Hair root: part of the hair embedded in the hair follicle

58.              Hair shaft: non-growing portion of hair protruding

59.              Hidradenoma: tumor or neoplasm caused by sweat glands

60.              Hirsutism: excessive hair on the body especially in women

61.              Hives: itching wheals, urticari2,

62.              Hyperhidrosis: abnormal condition of excessive sweating

63.              Hypodermis: the second layer of skin below the dermis

64.              Ichthyosis: abnormal condition char­acterized by hardening, drying, and scaling of the skin

65.              Impetigo: skin pathology character­ized by vesicles which rupture and form thick yellowish crust

66.              In situ: confined in the original place

67.              Integument: skin and related struc­tures

68.              Irritation: inflammation with rough­ness or soreness

69.              Itching: uncomfortable skin condition inducing rubbing or scraping of the af­fected part

70.              Keloid: a firm movable nodule

71.              Keratin: a kind of protein found in hairs or nails

72.              Keratolytics: agents acting against the excessive shedding of the epidermis

73.              Keratosis: lesions on the epidermis characterized by the horny layer

74.              Laceration: a cut

75.              Lactic: relating to milk

76.              Lactiferous: giving milk

77.              Lentigo: freckle-like brown macule

78.              Lesion: a wound, cut, or in jury

79.              Lipocyte: fat cell

80.              Lipoid: resembling fat

81.              Lumpectomy: removal of a lump (mass) from the breast

82.              Lunula: a semilunar pale arched area at the beginning of the nail place

83.              Macule: a small discolored spot

84.              Malignant: spreading and difficult to control (neoplasm)

85.              Mammogram: the radiographic record of breast examination

86.              Mammography: x-ray, ultrasound, mri or any other radiologic examina­tion of the breast

87.              Mammoplasty: plastic surgery of the breast, syn. Mastoplasty

88.              Mastectomy: excision of the breast, syn. Mammectomy

89.              Mastoplasty: surgical repair of the breast, syn. Mammoplasty

90.              Melanocytes: pigment-producing cell. Syn. Melanodendrocyte

91.              Melanoma: malignant neoplasm of the skin

92.              Menarche: beginning of tile menstrua­tion cycle

93.              Metastasize: spread (of the disease) to other areas from the point of origin

94.              Microscope: an instrument used to view extremely small objects

95.              Mole: birthmark, nevus

96.              Neoplasms: abnormal pathological growth of cells

97.              Nevus: birthmark, mole

98.              Nipple: a projection at the apex of the breast where lactiferous ducts open

99.              Nodule: a small circumscribed swelling

100.          Nulliparous: a lady who has not expe­rienced childbirth

101.          Onychocryptosis: ingrown nail pro­ducing a pus-filled granuloma

102.          Onychomalacia: softening of the nails

103.          Pallor: paleness, yellowish coloration of the skin

104.          Papilla: small nipple-like orifice

105.          Papule: small elevation on the skin

106.          Parasiticides: agents that destroy parasites

107.          Pediculosis: lousiness, presence of lice

108.          Pemphigus: a pathological condition of skin blisters

109.          Petechia: small hemorrhagic spots

110.          Pilonidal: relating to the presence of  hair in a sinus opening of the skin. 

111.          Pores: hole, opening

112.          Pruritus: itching

113.          Psoriasis: circumscribed discrete le­sions of macule or papule size which are confluent and silvery-scaled

114.          Purpura: lesions characterizing the hemorrhage into the skin

115.          Pustule: small circumscribed pus­-filled elevation

116.          Rash: skin eruptions

117.          Ringworm: dermatophytosis, fungus infection of the skin, hair or nails

118.          Scabies: vesicular eruptions and in­tense pruritus due to mites

119.          Scale: a small thin plate of hardened epithelium

120.          Scleroderma: hardening of the skin

121.          Sclerosis: abnormal condition of  be­coming too firm or hard

122.          Sebaceous: relating to sebum or fat

123.          Sebum: secretion of the sebaceous glands

124.          Site: place, location

125.          Squamous: scaly, relating to scales

126.          Stage: extent or severity of the disease

127.          Stasis: stagnation, the condition of not changing

128.          Steatoma: tumor or neoplasm related to fat

129.          Stratum: layer

130.          Stratified squamous epithelium: epi­thelium containing scaly keratin cells

131.          Stratum corneum: outer layer of the epidermis

132.          Stratum germinativum: the deepest layer of the epidermis

133.          Subcutaneous: referring to the laver below the dermis

134.          Sudoriferous: of or related to sweats

135.          Suppuration: pyogenesis, pus forma­tion

136.          Thelitis: nipple or nipple-like structure

137.          Tinea: a fungus infection of hair, skin or nails

138.          Trichopathy: diseases associated with hairs

139.          Tumor: neoplasm, swelling

140.          Ulcer: an inflammatory lesion on the skin surface or surface of the mucous membrane

141.          Ungual: relating to nail

142.          Urticaria: itching condition of the skin characterized by wheals

143.          Verruca: circumscribed growth of the papillae

144.          Vesicle: small circumscribed fluid ­filled elevation of skin

145.          Vitiligo: skin condition characterized by white patches of varied sizes

146.          Wart: flesh-colored growth, verruca

147.          Welt: lesions occurring because of ur­ticaria, wheal, hives

148.          Xenograft: graft from an individual of one species to that of another species

149.          Xeroderma: dry scaly skin

150.          Xeromammography: xeroradiogra­phic breast examination

151.          Xeroradiography: radiography using the dry powder in stead of liquid chemicals

ABBREVIATIONS

1.           Bx: biopsy

2.           C&S: culture and sensitivity

3.           derm: dermatology

4.           FS: frozen section

5.           HSV: herpes simplex virus

6.           I&D: incision and drainage

7.           KOH: potassium hydroxide

8.           ung.: ointment

9.           UV: ultraviolet

10.       decub.: decubitus

11.       ID : intradermal

12.       IM: intramuscularly

13.       IV: intravenously

14.       subcu: subcutaneous

15.       Dx: diagnosis

16.       FH: family history

17.       PE: physical examination

18.       SC: subcutaneous

19.       WBC: white blood cell

COMBINING FORMS

1.            adeno: glands

2.            adip/o: fat

3.            lip/a: fat

4.            steat/o: fat

5.            crypt/a: hidden

6.            cutane/o: skin I.

7.            dermat/o: skin

8.            derm/o: skin

9.            hidr/o: sweat

10.        ichthy/o: dry, scaly

11.        kerat/o: hardening

12.        lact/o: milk

13.        mammo/o: breast

14.        mast/o: breast

15.        myc/o: fungus

16.        onych/o: nail

17.        ungu/o: nail

18.        pillo: hair

19.        scler/o: hardening

20.        squam/o: scaly

21.        thel/o: nipple

22.        trich/o: hair

23.        xerlo: dry

SUFFIX

1.          -cyte: cell

2.          -derma: skin

3.          -gram: record

4.          -graphy: process of recording

5.          -logist: specialist in the study of

6.          -logy: study of

7.          -therapy: treatment

PREFIX

1.          epi-: above

2.          hyper-: excessive

3.          hypo: below normal, less

4.          sub: below

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