stress of mechanical forces

loss of body fluids

ultraviolet radiaton

microorganisms

• Regulate body temperature
• Assist in the production of vitamin D
• Provide touch and pressure receptors

Epidermis

Dermis

Subcutaneous

keratinocytes

and

 melanocytes

mast cells, histocytes

collagen, elastin

hair follicles

sebaceous and sweat glands

blood and lymphatic vessels

nerves

• macule                         --telangiectasia
• papule                          --scale
• patch                            --lichenification
• wheal                           --keloid
• nodule                          --scar
• tumor                           --excoriation
• vesicle                          --fissure
• bulla                             --erosion
• cyst                              --ulcer
• atrophy

any unrelieved pressure on skin

 shearing forces

 friction

moisture

• Older adults--ECF (extracelluar fluid)
• Immobility (ex. spinal cord injuries or stroke)
• immobilization (ex. traction, surgery,
• exam tables, lack turning)
• Prolonged bed rest
• poor turning skills
• incontinence
• debilitation
• nutritional deficiencies

• elevated, round, firm
• irregular claw-like margins that extend beyond the original site of injury
• result from excessive collagen formation during dermal connective tissure repair
• more common with dark pigment skin and burns

Whick of the following is NOT a factor in keloid formation?

a. light skin

b. burn trauma

c. foreign material in skin

d. poorly aligned wound tension

• venous statis 
• edema
• vascular trauma

• erythema
• pruritis
• scaling
• petechiae
• ulcers

• chronic proliferative skin disorder
• T-cell mediated autoimmune disorder
• increased thickness of dermal and epidermal levels

Describe late manisfestations of

herpes simplex virus and herpes zoster-shinges?

• has pain and paresthesia (burning, itching, tingling, etc) localized to affected dermatomes

• vesicular eruptions along a facial, cervical, or thoracic, lumbar dermatome

an autoimmune disorder that causes

sclerosis (thickening or hardening) of the skin

large amounts of collagen

inflammation

vascular changes

capillary dilation

skin is hard, hypopigmented,

taut, tightly connected to underlying tissue

• facial skin becomes very tight
• mouth may not open completely
• hands have shiny skin
• fingers are tapered and flexed
• fingernails and fingertips can be lost from atrophy

Skin cancer accounts for what percentage

of all cancers?

True of False:

Basal cell carcinoma is most common in

African Americans.

True of False:

Basal cell carcinoma cells don't invade lymph or blood.

True.

What kind of lesion is a squamous cell carcinoma, 

premalignant or malignant lesion?

Premalignant 

Note:

But can become malignant and invasive if not treated

True of False:

Melanoma requires staging.

True of false:

Melanoma has a very poor survival rate with advanced disease.

purplish brown macule

(think Tom Hanks in Philadelphia)

True or False:

Kaposi sarcomas are pruritic (itchy) and painful?

Which of the following masses is not benign?

a. seborrheic keratosis

b. keratoacanthoma

c. actininc keratosis

d. cutaneous melanoma

What are examples 

thermal sources that cause burns?

What is an example of

chemical sources that can cause burns?

True or false:

Burns can cause multisystem injuries.

Burns can cause shock, inflammation,

and immne compromise

True or False:

first degree burns do not cause injury

to underlying dermis or subcutaneous tissues

local pain and erythema (redness)

No blisters initially, may appear lately

superficial partial-thickness injury

and

deep partial-thickness injury

painful thin-walled, fluid filled blisters

that develop with injury

Describe a second degree burn in the

deep partial-thickness injury category.

involves entire dermis, appearance is waxy

takes weeks to heal

destruction of entire epidermis, dermis, and ofter subcutaneous tissue

is a full thickness injury

True or False:

Third degree burns may have muscle or bone involvement.

white appearance, dry and dehydrated tissue

and loss of skin elasticity

True or false:

Third degree burns are painless.

• age
• medical history
• extent of injury
• depth of injury
• body area involved

• celluar
• metabolic response
• immunologic response
• evaporative water loss