Pathology in the integumentary system
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| Burns | tissue damage and cell death caused by intense heat in the form of chemical, thermal, UV radiation, or electrical agents
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| one of the most serious threats to skin | Burn
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| leading cause of death among burn victims | Infection; Dead skin is breeding ground for bacteria; heat/water loss causes electrolyte imbalance which causes kidney failure and lose ability to protect against infection
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| Characteristics of Burns that Threaten life | Dehydration, Electrolyte imbalance, Inadequate circulation, Suppresses immune system, Infection, Open to environment, body temp regulation
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| Rule of Nines | Determines what percentage of the body surface area is burned, Estimates fluid loss; Divides body into 11 areas of 9% plus 1 area of 1%
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| Parts of the Rules of Nine | (1)head 9%, (2) right arm 9%, (3) left arm 9%, front of trunk (counts as two) 18%, back of trunk (counts as two) 18%, right leg (counts as two) 18%, left leg (counts as two) 18%, genitals = 1%
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| What percentage makes up the head | 9%
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| What percentage makes up each arm | 9%
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| What percentage makes up each side of the trunk | 18% front and back, each count as two, 36% total
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| What percentage makes up each leg | 18% both legs together make up 36%
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| What percentage makes up the genitals | 1%
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| Burns are classified according to | severity & depth
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| Critical burns | more than 25% is second degree, or more than 10% is third degree, or burns to face, hands, and/or feet
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| facial burns | associated with inhalation burns & can cause respiratory damage & swelling; limits gas exchange
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| First degree burn | red and swollen skin, only the epidermis is damaged; Temporary discomfort; Partial thickness burn; Sunburn; Regeneration of skin possible
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| Second degree burn | Injury to epidermis and upper level of dermis, skin gets Red, swollen, blisters, and painful; Partial thickness burn; Regeneration of skin possible
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| Third degree burn | Destroys entire thickness of skin “full thickness burn”; Gray-white, black color with nerves destroyed (Not painful); Regeneration not possible; Must receive skin graft
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| Skin Cancer | Most common type of cancer (CA); 1 in 5 Americans have skin CA at some point in their life
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| Greatest risk factor of skin cancer | over-exposure to sunlight (UV radiation)
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| Ways to Prevent skin cancer | Wear sunscreen & protective clothing; limit sun exposure; Annual skin checks with dermatologist
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| Basal Cell Carcinoma (BCC) | Cells of stratum basale effected, Shiny, dome-shaped pearly beaded edge, Rarely metastasize (spread), slow growing, only at sun-exposed areas, requires surgical removal, easy to cure
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| Most common type of skin CA | Basal Cell carcinoma (BCC)
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| Least malignant type of skin cancer | Basal Cell carcinoma
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| Squamous Cell Carcinoma | Arises from stratum spinosum, Scaly, shallow ulcer with firm raised border, Metastasizes to lymph nodes, Rapid growth, Sun induced, Surgically removed, Good chance of complete cure
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| Metastatic (Malignant) Melanoma | Cancer of melanocytes, Arises from pigmented mole, Metastasizes to lymph nodes or blood vessels, Rapid Spreading of brown/black patch, Extensive surgical excision, 50% chance of survival, even if removed it can grow back
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| Which skin cancer can develop into brain cancer | Metastatic (Malignant) Melanoma
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| Examination of Pigmented Areas | ABCDE; Asymmetry, border irregularity, color, diameter, elevation
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| Asymmetry(examining for skin cancer) | two sides of pigment in mole or spot do not match(examining for skin cancer)
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| border irregularity(examining for skin cancer) | borders of lesions are not smooth, have indentions(examining for skin cancer)
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| Color(examining for skin cancer) | the pigmented area contains different colors(examining for skin cancer)
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| Diameter (examining for skin cancer) | spot is >6 mm across (examining for skin cancer)
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| Elevation(examining for skin cancer) | changes in the height of skin surface(examining for skin cancer)
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| Pressure Ulcer | decubitus ulcers; Ischemic necrosis formed from prolonged external pressure over bony prominences; Tissue lacks oxygen (because no bloodflow) for long time
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| Necrosis | tissue death
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| Common areas for pressure ulcers | Sacrum, heels, ischium, hips
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| Risk factors of Pressure ulcers | Decreased ability to move, Decreased sensation (paralyzed), Decreased body fat and muscle tissue (just skin on bone), Decreased cognition, Incontinence, Amount of pressure distributed over surface area
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| Incontinence | Inability to control one’s bowels
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| Contact Dermatitis | Itching, redness, & swelling, May have blisters; Acute or chronic skin inflammation
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| Allergic responses causing contact dermatitis | Poison ivy, Latex, Soaps
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| Psoriasis | Chronic condition, auto-immune disorder that attacks tissues; Overproduction of cells Dry, scaly, cracking, red lesions that Itch and burn, Disfiguring and painful
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| What is psoriasis triggered by | stress, trauma, hormones, infections
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| Scabies | Transmissible parasitic infection; Mite burrows into stratum corneum and burrow eggs; Larva congregate around hair follicles; Associated with very poor hygiene
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| Athlete’s foot | “tinea pedis” itchy red, peeling condition of the sin between the toes, from fungal infection
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| Boils and carbuncles | inflammation of hair follicles and sebaceous glands caused by bacterial infection (staphylococcus aureus)
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| Cold Sores | (fever blisters) fluid-filled blisters that itch and sting, caused by herpes simplex infection
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| Port Wine Stain | Also called Hemangioma, Birthmark, Very large w/ lots of vascular supply (blood vessels) so it looks very red; Hyperplasia vascular lesion of skin and subcutaneous tissue; Flat, Pink-red-purple
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| Keloid Scarring | Excessive proliferation of connective tissue during healing of open skin that causes a Large thick scar on skin surface that looks Shiny, smooth, dome-like, no prevention, can be corrected with pressure guard
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| Keloid Scarring is More common among | those with darker skin, Blacks, Middle eastern
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| Albinism | Rare, Inherited disorder, auto-somal recessive trait, Have melanocytes but Missing enzyme that makes melanocytes produce melanin, causes Pale skin, white hair, and light eyes (blue)
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| Vitiligo | Loss of brown pigment from areas of skin (depigmentation) that look like Irregular white patches caused from Melanocytes that die or are unable to function; Unknown causes either Auto-immune, Genetic, Stress, Viral
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| Allopecia | Hair loss also called Male pattern baldness
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