Absite- skin and soft tissue Flashcards
Acidic injury
Coagulative necrosis
Basic injury
Liquifactive necrosis
Hydrofluoride
Calcium gluconate
Superficial spreading melanoma
Most common
Arises from pre existing Nevis
Nodular melanoma
Blue black or blue red
Most aggressive
Vertical growth
Likely metastasis at time of diagnosis
Lentigo maligna
Head and neck
Slow least aggressive
Radial growth
Elevated nodules
Acral lentiginous
Soles palms nail beds
Very aggressive
Asians
Blacks
Melanoma margin
In situ 0.5cm
<1mm deep 1cm
1-4mm 2cm
>4mm 2cm minimum
Basal cell carcinoma appearance
Raised pink pearly papilla
Rolled peripheral edges
Squamous cell carcinoma
Flat rough scaly dry
Non healing ulcer
Erythematous papulonodule
Keratotic crust
Eccrine carcinoma
Sweat gland tumor
Uv exposure
Merkel cell carcinoma
Neuroendocrine carcinoma Red module that ulcerates Dome shaped or subcutaneous nodule Red purple Polymovirus infection in immunosuppressed
Frost bite
1st degree - superficial firm plaque
2nd degree- milky white blisters- drain
3rd degree- hemorrhagic blister- leave intact
4th degree- extends into bone
Dermatofibrosarcoma protuberans
May be mistaken for keloids
Local fascial extension
Finger like projections
High recurrence rate
First degree burn
Painful
Red
Blanches
No scarring
Second degree superficial partial thickness
Erythematous painful
Blanches, blisters
Spontaneously reepithelializes from retained epithelial structures in 1-2 weeks
Infection can convert to deeper burn
Deep second degree burn
More pale, doesn’t blanch
Requires excision and grafting
Full thickness third degree
Through epidermis and dermis into subcutaneous fat
Hard leathery, painless
Will not heal, contracts, needs debridement and grafting
Fourth degree
Charred
Excision and grafting with flap coverage
Parkland formula
For second and third degree burns > 15% in adults, kids <10 with >10% TBSA
4cc/kg x % burns first 24 hrs
Give half in first 8 hrs
LR- UOP 0.5-1cc/kg/hr in adults, 1cc/kg/hr
D5LR - kids <2
Wound healing- inflammation (1)
4-6 days
Neutrophil dependent
Wound healing- proliferation (2)
Macrophages- peak at day 2-3 Attract fibroblasts - angiogenesis Epithelial proliferation Collagen needs vitamin C for cross linking Type 3 collagen predominates Replaced by type 1 Contraction
Wound healing- remodeling (3)
Lymphocytes Fibroblasts recede 50% tensile strength by 6 weeks Collagen replaced by type 1 21 days- 2 years Epithelialization 1-2mm/day