PHYSIOLOGICAL AND ANATOMICAL ABNORMALITIES I. thermal injury caused by: a.

contact of the skin with some hot object of fire b. overexposure to UV c. contact with an electric current or corrosive chemicals depth of a burn injury depends on the tissue layers of the skin that are involved Classification of Burns Type of Burn Surface area Depth of tissue Major effects Affected damage Partial-Thickness Burn 1. Minor (1st < 10% of body Epidermis is -mild swelling Degree), typical surface damaged but not -reddening sunburn destroyed -minor discomfort -injured layer peels off -heals w/o scarring (2 wks) 2. Serious (2nd >15% for an Adult Epidermis and Part -reddening Degree) 10% for a Child of the Dermis is -edema destroyed -blisters -new skin may -swelling regenerate -greater pain than 3rd degree burn Full-Thickness Burn 3. Severe (3rd >20% of body All skin layers White or charred Degree) surface, burns of destroyed appearance face, eyes, hands, -May involved -insensitive to pain feet, genitals underlying fascia, immediately after muscles, bone injury bec. Of the -Skin cannot be destruction of nerve regenerated endings -scarring is a serious problem (surgery and skin grafts needed) LESIONS NAME 1. Bleb, bulla 2. Macule EXAMPLE 2nd Degree burn Freckle, flat pigmented mole DESCRIPTION Fluid-filled elevation of the skin Discolored spot, neither elevated or sunken BURN -

3. Papule 4. Pustule 5. Vesicle 6. Wheal

Acne, measles Acne vulgaris, small pox Blister Chicken pox, herpes simplex Mosquito bite Hives

Raised, small pimples Raised, pus-filled pimple Small sac filled with serous fluid Local swelling, itching

SOME COMMON SKIN DISORDERS A. Acne vulgaris (common acne) - most common among teenagers (high hormone levels; high oil production) - oil clogs a follicle - Clogs are called either whiteheads or blackheads a. Closed Comedones (whiteheads)- do not protrude, covered by the epidermis b. Open Comedones (blackheads)- protrude from the follicle, not covered by the epidermis - blocked follicle may become infected with bacteria - bacteria converts sebum into free fatty acids - acids irritate the follicle lining - eventually, follicle will burst a. when acid and sebum seep into the dermis, they will cause inflammation b. appears as pus-filled pimple - scratching will spread the infection - appears mostly on the face, chest, upper back, shoulders - more severe in teenage males bec. of testosterone Bedsores/Decubitus Ulcers- common in bed-ridden patients - weight of the body causes poor circulation - may 1st appear as red spots which may become purplish (indicates that blood vessels are being blocked) - Skin may break (lack of nutrients and oxygen will eventually kill the tissue) - If left untreated, 2nd bacterial infection is common - Sol: a. Maintain cleanliness and dryness of surroundings b. Change the position of the patient frequently (promote blood circulation) B. Birthmarks (Vascular Nevus) 1. Nevus flammeus (Port-wine Stain) - Pink to bluish-red lesion - Cause is unknown 2. Hemangioma (Strawberry Mark) - Affects the superficial blood vessels - Usually present at birth but may also appear anytime after birth

May grow slowly May become smaller May disappear as the individual grows older

C. Mole (Nevus) - in most cases, is a benign lesion that usually appears before the age of 5 or 6 - May appear anytime up to about 30 yrs of age - Moles that darkens, enlarge, bleed or appear after the person is 30 should be checked (it maybe transformed into a cancerous growth) - Inherited Psoriasis inherited attacks can be brought on by pregnancy, hormonal changes, emotional stress, cold weather, trauma (PHECT) Physiology a. Occurs when basal cells move to the S. corneum before they mature (4 days instead of the usual 28) b. S. corneum becomes flaky, lesions are red, dry, elevated, covered with scaly patches Usual sites: elbows, knees, scalp, face, face, lower back allergens may sip through the skin or maybe inhaled will trigger plasma cells to produce antibodies against the allergen Antibodies will trigger mast cells to produce histamine w/c would initiate the inflammatory response

Allergic responses -

D. Warts (Verrucae) - caused by papilloma viruses - usually not pigmented except for plantar warts (yellowish) - contagious - usually disappear after a year - maybe removed through surgery Bruises hard blow to the surface of the skin may break underlying capillaries releases blood to the dermis black and blue color is because skin reflects blue light and absorbs other colors

may turn green/yellow after several days (indicates that spilled blood begun to decompose, hemoglobin decays to hemosiderin {yellowish})