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Burns and Skin Pathology Burns 1st Degree Burn Reddening and swelling of skin Only upper layers of epidermis are damaged Caused by Sun exposure Chemicals Steam Burns 2nd Degree Burn Blisters, swelling, fluid buildup under skin Stratum Basale and Dermis damaged Caused by same factors except longer duration Burns 3rd Degree Burn Entire epidermis is charred or lost Dermis and Subcutaneous layer are damaged Requires Skin Grafting Transplant of new skin Assessment of Burns The Rule of 9’s Skin Grafting A transplant of skin covering area of burn A dermatome slices an area of good skin The epidermis and the upper portion of the dermis is cut The graft is meshed to: Allow for drainage of fluid Cover a larger area Allow graft to reach all the corners of the cut Skin grafting procedure Three Types of Disorders Degenerative Genetic Progressive deterioration of tissue Mutations that diminish skin function and structure Infectious disease Microorganisms damage tissues and organs Basal Cell Carcinoma • • • Uncontrolled growths or lesions that arise in the skin’s basal cells Often look like open sores, red patches, pink growths, shiny bumps, or scars Caused by a combination of cumulative UV exposure and intense, occasional UV exposure Squamous Cell Carcinoma • • • • Second most common form of skin cancer Uncontrolled growth of abnormal cells arising in the squamous cells, which compose most of the skin’s upper layers (the epidermis) Often look like scaly red patches, open sores, elevated growths with a central depression, or warts; they may crust or bleed Caused by cumulative UV exposure over the course of a lifetime. Malignant Melanoma • • • • Uncontrolled growth of pigment cells called melanocytes The most dangerous form of skin cancer Originate in the pigmentproducing melanocytes in the basal layer of the epidermis Often resemble moles; some develop from moles Prevention • • • • • • • • • • Seek the shade, especially between 10 AM and 4 PM Do not burn Avoid tanning and UV tanning booths Cover up with clothing, including a broad-brimmed hat and UV blocking sunglasses Use a broad spectrum (UVA/UVB) sunscreen with an SPF of 15 or higher daily. For extended outdoor activity, use a water-resistant, broad spectrum (UVA/UVB)sunscreen with an SPF of 30 or higher Re-apply every two hours or immediately after swimming or excessive sweating Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months Examine your skin head-to-toe every month See your physician every year for a professional skin exam. Decubitus Ulcer An area of skin and tissue that becomes injured or broken down Also known as a bed sore or pressure ulcer De- = down Cubit/o = to lie Literal meaning = pertaining to lying down Decubitus Ulcer Decubitus Ulcer with Autograft Decubitus Ulcers Sebaceous Hyperplasia Hyperplasia = Abnormal multiplication of cells Sebaceous Glands become enlarged Glands form small yellow bumps Syringomas Tumors in the ducts of sweat glands Mostly found clustered on eyelids Yellowish firm rounded bumps Degenerative Skin Disorders Moles Flat squamous-cell tumors Heavily pigmented with melanocytes Genetic origin Genetic Disorders Psoriasis 1) Stem cells in the stratum basale are over active 2) This causes Hyperkeratosis The excessive production of keratin Protein that strengthens skin 3)Causes toughening of skin causing a scaly surface Vitiligo White spots caused by hypopigmentation Localized decrease in melanin production Immune system attacks destroy melanocytes in the skin Albinism This occurs due to lack of pigment NOT the destruction of existing pigment Infectious Skin Disorders Staphylococcus aureus (S. aureus) The most common bacteria causing infections Impetigo Pustules form on skin, dry, and become yellow crusts Skin pigment may not reappear Ringworm Red to brown raised patch of skin Usually lighter in the center – A “ring” shape Type of fungus Thrives in warm moist areas Feeds on keratin Therefore only found on the outer dead skin layer Furuncle (A Boil) NOT a PIMPLE Inflammation of hair follicles due to bacterial infection Red pus-filled lumps Pus = protein rich fluid + dead cells A Pimple is a blockage of oil in the skin pore