In-growing Toenail

Signs and Symptoms

Pain and tenderness of the flesh covering the forward portion of one or both sides
of a toenail_ usually the nail of the big toe_ are characteristic of an ingrowing
toenail. If the nail is examined, it will be seen to have embedded itself in the flesh.
Causes and Course
Over-growth of the nail, pressure on the flesh, or both, cause the in-growing
condition. This is likely to persist and cause lasting discomfort until the cause is
corrected.
Treatment
1. Apply a strip of adhesive plaster to the flesh only, drawing it around
underneath the toe, so as to pull the flesh away from the edges of the nail.
2. Gently pack a bit of oiled cotton or gauze under the buried edge of the nail.
3. If the toe is inflamed, give alternate hot and cold foot baths twenty minutes
night and morning.
4. Cut a grove in the nail, near the sore side and parallel to it, going as deep as
possible without drawing blood.
5. If home treatments fail, a physician can probably cure the trouble by a
simple operation.







Integumentary System Organs

Integumentary system includes:
Skin
Hair
Nails
Sweat glands
Nerves
Oil glands

Integumentary System Functions

Protection: The most important function of the integumentary system is
protection. The organs of the integumentary system forms a water proof
layer over the body that also works as a physical barrier against
microorganisms entering the body and causing integumentary system
diseases.
Homeostasis: Homeostasis is the way constant conditions in the body are
maintained in spite of changes in the surroundings. For example, our body
temperature remains constant even if the surroundings are hot, or cold.
This is called homeothermy and the skin is mainly responsible. Homeostasis
is controlled by self-regulatory processes in the body. Too much of a
substance in the body triggers a mechanism to get more of it. These
mechanisms work to maintain constant (normal) conditions in the body. It
is important that constant conditions exist in the body, particularly when so
many events in the surroundings try to change them. Should these
homeostatic mechanisms fail, illness will result.
Sensory Organ: The skin has a large number of nerve openings that help us
in perceiving the sense of touch, pressure, pain, and changes in the
temperature.
Excretion: Toxic wastes are excreted by the skin in the form of
perspiration.


















Function of Integumentary Systems Organs

Skin (cutaneous membrane): The skin is the most important organ of the
integumentary system. It is made up of two dermal layers. They are:
Epidermis: This is the outermost layer of the skin that forms the
waterproof barrier over the body. The epidermis consists of dead outer
cells that are constantly shed as new cells move upward from the
dermis. There are no blood vessels in the epidermis, so injury to this
layer does not cause bleeding. Nerve endings reach into it.
Dermis: The dermis or corium, lies below the epidermis. It is connected
to the epidermis by a convoluted layer of cells that produces new cells
for the epidermis. The dermis is composed of bundles of collagen fibres
that act to support the epidermis. It is well supplied with nerves and
blood vessels and contains the sweat glands, sebaceous glands, and hair
follicles.
The skin has many functions that are critical to the wellbeing of the body:
Protection_ forms a continuous membranous covering for the body to
reduce mechanical injury and keep out disease organisms
Prevents water loss
Produces vitamin D when exposed to ultra-violet rays (sunlight)
Regulates body temperature_ evaporation of sweat cools; fat insulates;
vaso-dilation cools, and vaso-constriction retains heat
Storage_ stores fat and vitamins
Eliminations_ loses water (maintains water balance in the body), salts, and
heat through perspiration
Sensory perception_ contains nerve endings that keep us aware of
environmental changes (temperature change, pressure and pain)
Healing_ when the epidermis breaks away due to a minor cut or burn the
cells on the lower layers of the skin migrate upwards as a sheet. When two
ends of the sheet meet, the cells stop growing due to a process called
contact inhibition. Thus, the epidermis is sealed and the skin returns to
normal.
The skin tells us much about the general health of the body.
A fever may be indicated by hot, dry skin.
Unusual redness _ rubra, or flushing of the skin_ often follows strenuous
activity.
Pallor, which is less color than normal, is a sign associated with many
conditions.
The oxygen content of the blood can be noted quickly by the color of the
skin. When the oxygen content is very low, the blood is darker and the skin
appears bluish or cyanotic.
Hair: Hair is derived from the skin. In case of humans, the hair extends to
the surface of the hair roots or hair bulbs present in the dermis. The
functions of the hair includes: protection, prevents the skin from losing
more warmth, acting as an insulator, and sensation to touch. Hair covers all
body surfaces except the palms of the hands and the soles of the feet.
Nails: The nails are horny cell structures found on the dorsal, distal surfaces of
the fingers and toes. The nail is derived from the skin. The nail is highly
keratinized structure of modified epidermal cells. The nail helps in grasping and
holding things, as well as provide protection to the sensitive fingers and toes.
Sweat Glands: Sweat glands have an opening through the skin pores, and they
help in excretion of water and electrolytes. The sweat glands produce
perspiration that reaches the skin surface through tubes or ducts that end in
openings called pores. Heat from deep in the bod is brought to the skin by blood
vessels. This heat is transferred to the perspiration. At the skin surface, the
perspiration and the heat are lost through the pores to the air. The heat of the
body is controlled by changes in the size of the blood vessels in the skin.
When the central opening of a blood vessel becomes enlarged (dilated),
more heat is brought to the body surface.
When the central opening of a blood vessel becomes smaller
(constricted), less heat is brought to the body surface.
Nerves: The complex network of the nerves present all over the skin helps send
and receive important impulses to and from the brain, thus playing a vital role in
the sense of touch. It keeps us in contact with changes in the environment.
Nerves endings called receptors receive information about:
Heat
Cold
Pain
Pressure
Temperature regulations_ regulates body temperature
Oil glands: Oil glands lubricate and keep flexible the hairs found in the skin.



Changes in the Integumentary Organs Due to Aging

As a person ages, changes become evident in the skin and its elements.
These changes include:
Glands are less active
Decreased circulation
Dryness, thinning, and scaling with some roughened areas
Thickening of fingernails and toenails
Skin color changes result from changes in melanin production,
vascular dilation or constriction, changes in hemoglobin and RBCs,
and increased bile pigment
Loss of fat, elasticity and turgor, wrinkles, and loose folds
Loss of hair color (hair becomes gray)
Development of skin irregularities such as skin tabs, moles, and warts

















What is the Integumentary System?

The integumentary system is the organ system that protects the
body from damage, comprising the skin and its appendages
(including hair, nails), sweat glands, nerves, and oil glands. The
integumentary system forms a protective barrier between the
external environment and the inner tissues. Other than that the
integumentary systems serves to waterproof, cushion and protect
the deeper tissues, excrete wastes and regulate temperatures. It is
also the attachment site for sensory receptors to detect pain,
sensation, pressure and temperature. In most terrestrial, vertebrates
with significant exposer to sunlight, the integumentary system also
provides for vitamin D synthesis.




















Common Diseases and Disorders of the Integumentary System

These disorders can get triggered due to many environmental or
internal bodily functions and malfunctions, some of them have been
listed below:
Acne
Definition
Acne is a skin condition (inflammation) common in adolescents and
young adults

Signs and Symptoms

The skin of a person who has acne shows pimples of various sizes,
the larger ones often having yellow centers containing pus. Firm red
nodules may be present, and small skin abscesses are found in severe
causes. These pimples, nodules, and abscesses are most common on
the face, back, upper part of the chest, buttocks, and thighs may also
be involved. Some itching and mild pain may be present, but
generally no real feeling of illness. Years of acne rosacea lead to an
irregular, bulbous thickening of the skin of the distal part of the nose
(rhinophyma), with a red-purple discoloration and dilated follicles.
Severe cases, especially if not given proper attention and treatment,
often leave somewhat disfiguring scars. The damage however, is
more to the persons looks than to his health.

Causes and Course

Most skin specialists mention the acne bacillus as the cause_ or at
least part of the cause,_ of acne . Over the years many causative
factors have been suggested, including bacteria, vitamin deficiency,
hormonal imbalance, alcohol, caffeine, psychological factors (nervous
tensions), heredity, unhygienic habits, the excessive consumption of
greasy foods (fats), fried foods, sweets, much starchy foods, and
chocolate. The changes that come with puberty doubtless have much
to do with acne, since most cases show up first at about the time of
life. And only skin is especially subject to acne. Un-hygienic habits
and the eating of greasy foods; fried foods; sweets; and much starchy
foods.
Treatment
1. Do not eat too much fats, oils, fried foods, greasy foods, pastry,
sweets, starchy food, or chocolate and nuts.
2. Do not drink much tea, coffee, cocoa, or alcoholic liquors
3. Get sufficient rest, and at least eight and a half hours of sleep at
nights, and more if possible.
4. Outdoor exercise in moderation is beneficial, especially if taken in
the sunshine and so that affected skin areas become gradually
tanned.
5. Keep the bowels open, preferably by means of plenty of fruit and
vegetables in the diet, and fresh water.
6. Do not apply any salves or ointments not prescribed by a
physician.
7. Do not squeeze or pick at the pimples at any time_ avoid touching
face with the fingers.
8. Wash the face thoroughly_ preferably with warm water_ two or
three times a day, using a mild soap and tepid water. Washing
with soap removes dirt because the alkali forms an emulsion with
the oily sebum, and the dirt is washed off with it by the water.
Warm baths (temperature 100 degree Fahrenheit) are cleansing
(from secretions and dirt), refreshing , and have a sedative action
due to soothing effect on the nerve endings.
9. Steam face for 15 minutes after washing, once a day.
10. Consult a physician for instructions about opening the ripe
pimples and about X-ray or other special treatments in severe or
persistent cases.































Warts
Definition
Warts are small protuberances on the skin caused by a virus. This
explains why warts can spread over a person`s body, and how one
person can infect another.
A wart is an overgrowth of certain structures in the deeper layers of
the skin. Warts most commonly most commonly appear in the early
years of life. Most of them disappear at some later time without
treatment. Sometimes they persist for many years and occasionally
one becomes malignant. Warts are commonest on the hands, but the
largest and most troublesome warts occur on the soles of the feet or
on the genital organs. Small, slender forms are sometimes seen on
the neck, eyelids, and the bearded area. There is now strong
evidence that warts are caused by a virus.

Treatment
If a wart is large, not easily accessible, or has persisted for a long
time, have it removed by a physician, preferably a skin specialist.


























Alopecia (hair loss)
Alopecia is a noncontagious autoimmune disorder, wherein the immune system
attacks the hair follicles. Hair is lost in some or all regions of the body, mostly the
scalp, thereby resulting into baldness. This condition is also known as spot
baldness as it conduces to bald spots on the scalp in the initial stages. About 0.1
per cent to 0.2 per cent of humans (both males and females) re affected by this
condition and initial occurrence of this disease appears in early childhood, late
teenage or young adulthood, however, the disease can affect people of all ages.
Signs and Symptoms. Baldness has no symptoms. Increasing thinning of the hair,
with the appearance of hairless spots which grow in size, is the usual sign.
Causes and Course. In many cases a hereditary tendency to become bald is the
only detectable cause. In other cases, diabetes, seborrheic dermatitis, typhoid
fever, chronic liver disease, stress, dandruff, syphilis, various other infections,
acute fevers, certain drugs (antimetabolites, heparin) or chemicals taken
internally, burns, sluggishness of the thyroid or pituitary glands, or emotional
shock may be the cause of temporary or permanent baldness of the whole scalp
or of parts of it. Hair loss on the dorsum of the toes may be indicative of
decreased arterial circulation. Hereditary baldness is hard to prevent and usually
impossible to cure. There is more hope in curing baldness from other causes, but
there is no definite period within which success in treatment can be expected.
What Should Be Done
1. Make a careful study to detect the cause or causes of the thinning hair or
the baldness, preferably with the aid of a physician. If the cause proves to
be some disease that can be cured or some condition that can be cured or
some condition that can corrected, proceed accordingly.
2. If the case is one of ordinary hereditary baldness, do not waste your money
on advertised hair growers.
3. The onset and progress of ordinary baldness may sometimes be somewhat
delayed if the scalp is kept clean by washing once or twice a week with mild
soap and warm water. Twice a week is two often except for oily scalps.
After washing, rinse and dry the hair thoroughly. Occasionally use a lemon
or vinegar rinse.
4. Avoid the use of combs or brushes that are being used by other people.
5. Scalp massage may do some good, unless the hair is markedly oily.

Athletes Foot (tinea pedis, epidermophytosis)
Athletes foot or tinea pedis is a highly contagious fungal infection of the
skin that primarily affects the foot, but can also infect the groin and other
parts of the body .
Signs and Symptoms. This disease is characterized by blisters or cracks or
both in the skin of the feet, especially that between and beneath the toes.
Sometimes ulcers or pustules forms. There is considerable scaling, flaking,
itching and burning, which in some cases may amount to actual pain. The
condition is worse in warm weather, and worst of all when the feet are
both warm and moist.
Causes and Course. The specific cause is one or more of several types of
mold-like parasites similar to those which cause ringworm; lack of hygiene,
humid conditions that facilitate the proliferation of the fungus, which is
always present on the feet but becomes infectious when conditions are
right. These organisms are usually picked up by walking barefoot in moist or
water logged places like showers or bathhouses, or swamps and gutters on
the floors in or around swimming pool, s and gymnasiums. The infection
may persist_ better and worse by spells_ for many years if not properly
treated.
Treatment
Treatment depends on the stage of infection. Most persons have a chronic
low-grade infection that is controllable with topical antifungal drugs. When
thick chronic scaling lesions are present, the topical antifungal drugs cannot
penetrate the lesion; therefore, a strong peeling ointment, such as
Whitfields ointment, can be applied thinly to the lesions at bedtime,
followed by an antifungal cream in the morning. If the lesions become
acutely inflamed, they are treated with foot soaks with a bland solution,
such as Burows solution, followed by a topical antimicrobial agent. A
systemic antibacterial agent, such as penicillin or erythromycin, may be
prescribed. Oral griseofulvin is only prescribed for severe infections that do
not respond to local treatment.

The person with tinea pedis needs to carry out meticulous foot hygiene.
After drying the toes thoroughly, a light dusting of antifungal powder is
applied to dryness. Caking of the powder should be avoided. Socks should
be of an absorbent material such as cotton and may need to be changed
more than once daily to promote dryness.

















Burns
Burns are lesions produced in the skin tissue by heat or certain caustic
substances, resulting in loss of skin integrity.
Causes and course
They may be caused by fire, boiling water, steam, chemical substances, electricity,
freezing, friction, radioactivity (radiation), or sunburn. Burns are classified as
partial thickness or full thickness, depending on the degree of injury. Partial-
thickness burns are:
First-degree burns_ involve only the top layer (epidermis) of skin. There is
redness and erythema on the skin, temporary swelling, and pain. There is
usually no permanent scarring. This burn looks like a sunburn. The skin is
not broken or blistered.
Second-degree burns_ involve both epidermis and dermis. The skin color is
may vary from pink or red to white or tan. Blistering, pain, and some
scarring occur.
Full-thickness burns are:
Third-degree burns_ involve epidermis, dermis, and subcutaneous tissue.
The tissue is bright red to tan and brown. There may be no pain initially
because nerve endings have been destroyed. Later, pain and scarring will
result.
Sun burn
When a live tissue is overexposed to ultraviolet (UV) radiation, the condition is
known as sunburn. Sunburn is characterized by red skin that feels very hot and
sensitive to touch. Prolonged overexposure to the suns rays can become a cause
of non-malignant skin tumors. If sunburn is severe, or if large areas of skin are
affected, a physicians help may be needed as sunburn can cause permanent
crippling, or even death.
Management of Burns. Once a burn patient is in the medical facility, the care will
involve:
Assessment of the burn damage
Analgesia for pain
Management of fluids and electrolytes
Prevention of infection
Clean technique using cap, gown, mask, and gloves
Complete reverse isolation technique in some cases
Monitoring the patient for respiratory distress, shock, and anemia
Cleaning of the burned areas and removal of all debris
Application of topical antibiotics
Emotional support
Some hospitals have established burn centers where specially trained
personnel care for burn cases. One of two approaches is in common use:
Open method_ the burns are left uncovered. Sterile technique is used to
care for the patient.
Closed method_ the burns are covered by special ointments, wrapped in
layers of gauze. The body part is checked for circulation distal to the
dressing and maintained in proper alignment.
New techniques, such as keeping the patient submerged in a silicone solution, are
also being used. Heparin is a chemical produced in the bodies of humans and
animals. A synthetic version is used for thinning the blood and preventing blood
clots. Researchers have found that it is also an effective treatment for relieving
pain and healing burns. It helps heal the body from the inside out, and the patient
grows healthy, new skin. Each method of treatment has its advantages and
disadvantages. There are four goals of treatment, whatever method is selected:
1. Replacement of lost fluids and electrolytes to combat shock.
2. Relief of pain and anxiety.
3. Prevention of contractures, deformities, and infections. A contracture is a
shortening of a muscle, which limits motion and causes deformities. Plastic
surgery may also be required.
4. Provision of emotional support and motivation






















Dry Skin
Causes
Dry skin in most cases is as a result of individual conditions, making it very difficult
to establish the actual cause. However, there are some factors that can augment
the problem, such as exaggerated or habitual overexposure to the suns rays. The
following indications are helpful.

















Chicken Pox (varicella)
Chicken pox is a benign but acute contagious disease.
Signs and Symptoms. The disease usually begins from ten to sixteen days after
exposure. There may be mild fever, chilliness, headache, cough, aching of the
back and legs, and some vomiting. Within a day or two the rash appears. At first it
consists of small red spots. Then blisters develop on these spots. The blisters
enlarge. They may become whitish or yellowish, but in any case they soon dry
down into brown crusts, which tend to loosen and drop off in a few days.
Considerable itching is usually present. New spots keep coming for several days,
so that in a fully developed case there can be seen at the same time small spots,
larger spots, spots with blisters, spots with whitish or yellow tops, and brownish
crusts. The spots appear first on the scalp and face, as a rule; but later they are
more abundant on the chest and back then fills different parts of the body. The
scabs fall off and may leave scars if scratched too much.
This disease is rarely contracted more than once.
Treatment
The purpose of treatment is to alleviate the discomfort caused by the eruptive
lesions of the skin and the itching. It also contributes to the drying of the blisters
and reduces the inflammation, thus helping to avoid complications.
What Should Be Done
1. Children with chicken pox should be kept home and out of school until the
last of the blisters have dried down into brown crusts.
2. If possible, the patient should be isolated in a room, to prevent the spread
of the disease to other members of the family.
3. For itching apply calamine lotion, or sponge daily with warm water that has
a strong solution of baking soda. Do not rub the lesions when sponging.
4. Try to keep the patient from scratching the itching skin, as this may
produce infection, with later scarring.
5. Give plenty of fruit juices and water to patient during waking hours.
6. Daily anointing with warm olive oil will cause the crusts to drop off sooner.































Moles (pigmented nevi)

Signs and Symptoms. A mole is an outgrowth from the skin which usually
develop during childhood, becoming more raised and prominent, and often
containing hair. It may be nearly flat, or rounded or threadlike, or in the
form of a knob with a narrow stalk. It may be the same color as normal
skin, some shade of brown, dark, blue or black. Small, evenly colored brown
moles with hair are benign. A blue or greenish-black color does not usually
indicate malignancy if the color is even. Many moles are present from birth.
Others develop later in life. Unless irritated by the clothing or otherwise,
moles are usually free from symptoms. Changes in moles should be seen by
a physician immediately for further diagnosis. These changes include:
1. Development of a ring of new pigment around the base
2. Development of uneven pigmentation
3. Sudden growth
4. Loss of hair in a mole
5. Bleeding in a mole
Causes and Course. Nobody knows what causes moles. They tend to persist
for life. Sometimes they begin to grow, even after remaining he same size
for many years. Sometimes they change in color, usually becoming darker
rather than lighter. Those that are dark colored, or that darken in color, or
that become and remain sore as a result of irritation, may become
malignant. A malignant growth starting in a mole may spread throughout
the body and eventually prove fatal.
What Should Be Done
All moles_ but especially any that are dark-colored, that are darkening in
color, that growing in size, or that are located where they are liable to
become irritated should be removed by a physician. The first treatment
should be thorough enough to destroy the growth and any suspicious tissue
around or underlying it.










Dermatitis
The word dermatitis is a general is a general term used to describe inflammations
of the skin.There are different types of dermatitis, including seborrheic dermatitis
and atopic dermatitis (eczema). This disorder can have scores of causes and can
surface in various forms, starting out as an itchy rash and spreading, to increase
with redness and swelling. This skin disease is not life threatening or contagious,
however, it can cause one to feel really uncomfortable and self-conscious.
Eczema
Includes: Atopic dermatitis, allergic dermatitis, and skin eruptions.
Eczema is an acute or chronic, noncontagious itchy, inflammatory disease of the
skin.
Signs and Symptoms. Typical eczema begins with itching, burning, redness and
swelling of the skin. Blisters usually form on the reddened skin areas. Some or all
of the blisters may become filled with pus. These may burst in a day or two,
releasing a yellow-colored liquid that forms yellowish scabs as it dries.
The liquid stops being produced after a few days, sometimes weeks, leaving the
skin slick and red, or covered with small scales that become thicker as the
infection becomes chronic. It commonly appears on the face, neck, chest, the
back of the knees, and the elbows.










Seborrhea (Greasy dandruff)

A disease of the scalp characterized by dry, yellow scabs either with or
without the reddening of the surrounding skin. It often affects the
eyebrows, eyelashes, mustache, and navel.

































Bibliography

Edith M. Funnell.



















Dangers of Self-Treatment

People should be urged to seek competent medical help when skin
conditions develop. Although skin diseases rarely cause death, they may be
reflections of serious systemic illness and can account for much human
discomfort and for serious interruption of work and other activities. Many
persons are inclined to rely on the advice of friends are the local druggist or
on medications they may have on hand. Each individuals skin reacts
differently to treatment, and the skin that is already irritated or diseased
may respond violently to inexpert treatment. Because of changes in the
skin, medications prescribed even for a similar skin ailment in the same
patient some time previously may not produce a favorable response.
Medications may deteriorate, and for this reason old medications are not
safe. The person may be spared much discomfort and expense by
consulting a specialist when symptoms first develop and before a mild skin
condition becomes a real problem.

































































































































Psoriasis

Psoriasis is a skin disease that occurs frequently and tends to be chronic. It
is especially frequent in adolescents, young adults, and overweight people.
Symptoms
Psoriasis produces round, slightly protruding calluses covered with white
scabs that in about 75 per cent of the cases attack especially the scalp,
knees, elbows, and lower back, though it can affect any part of the body.
Normally it does not cause serious problems.

It can often misdiagnosed unless a careful examination is done. For
example, in the fingernails (where it does corrosive damage) it is often
mistaken for a fungus infection, and in the genitals it may be mistaken for a
yeast infection. Occasionally a case of psoriasis may be complicated by
arthritis.

The development of the ailment tends to be chronic and may produce
problems in the area around the lesions, such as yeast and bacteria
infections and ulcerations. This disease tends to become resistant to
conventional treatment.

Causes
Even though its real cause is still unknown, it is recognized that heredity
and stress are important factors.

Treatment
People with psoriasis should avoid meat and animal fat (sufficient protein
may be obtained by the use of low-fat or soy milk, and consuming garbanzo
beans or other legumes). Spices, alcohol, tobacco, coffee, and tea should
also be avoided. Stress, emotional problems, and tension makes psoriasis
worse. In many cases the consumption of vitamins A and D helps alleviate
the ailment. The lesions should be treated with salve prescribed by a
physician.