Alterations to integumentary function Flashcards
Overview of skin cancers and key characteristics
Skin cancer, one of the most common forms of cancer, typically develops due to unrepaired DNA damage that triggers mutations. These mutations lead skin cells to multiply rapidly and form malignant tumors. The major types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma, each with distinct characteristics:
1. Basal Cell Carcinoma (BCC)
Incidence: Most common type of skin cancer.
Characteristics: Often appears as a pearly or waxy bump on sun-exposed areas of the skin, such as the face, ears, and neck. It can also present as a flat, flesh-colored or brown scar-like lesion.
Risk Factors: Long-term exposure to ultraviolet (UV) radiation, fair skin, age, and personal history of skin cancer.
Growth: BCC grows slowly and rarely metastasizes (spreads to other parts of the body), but it can be locally invasive and destructive to surrounding tissues if not treated early.
2. Squamous Cell Carcinoma (SCC)
Incidence: The second most common type of skin cancer.
Characteristics: Typically appears as a firm red nodule, or a flat lesion with a scaly, crusted surface. Commonly occurs on sun-exposed areas such as the face, bald scalp, ears, and backs of hands.
Risk Factors: Prolonged exposure to UV radiation, having light-colored skin, older age, and a history of sunburns or precancerous skin lesions known as actinic keratoses.
Growth: SCC is more aggressive than BCC and can metastasize if not treated.
3. Melanoma
Incidence: The most dangerous form of skin cancer due to its high likelihood of metastasis if not caught early.
Characteristics: Melanoma often develops in a mole or suddenly appears as a new dark spot on the skin. It’s crucial to recognize the warning signs, which can be remembered with the ABCDEs:
Asymmetry: One half of the mole doesn’t match the other.
Border: Edges are irregular, ragged, notched, or blurred.
Color: The color is not uniform and may include shades of brown or black, sometimes with patches of pink, red, white, or blue.
Diameter: Typically larger than 6 mm (about the size of a pencil eraser), though they can be smaller.
Evolving: The mole is changing in size, shape, or color.
Risk Factors: Intense, occasional UV exposure (frequent sunburns), having fair skin, a family history of melanoma, and having numerous moles or unusual moles.
Overview of some common skin infections
Bacterial Infections
Impetigo: Highly contagious, especially among children. Caused by Staphylococcus aureus or Streptococcus pyogenes. Presents as red sores that rupture and ooze, forming a yellow-brown crust. Treated with topical or oral antibiotics.
Cellulitis: A deeper skin infection often appearing as a red, swollen, and painful area, usually on the lower legs. It can spread rapidly and may cause fever. Treatment typically involves oral or intravenous antibiotics.
Viral Infections
Herpes Simplex: Causes cold sores or genital herpes through HSV-1 or HSV-2. Lesions are painful blisters that eventually crust over. Antiviral medications like acyclovir can manage outbreaks.
Warts: Caused by human papillomavirus (HPV). Warts are typically benign skin growths that can appear anywhere on the body. Treatment options include cryotherapy, salicylic acid, and other topical treatments.
Fungal Infections
Athlete’s Foot (Tinea Pedis): A fungal infection that leads to itchy, red, cracked skin, especially between the toes. Treated with antifungal creams or oral medications.
Ringworm (Tinea Corporis): Characterized by a ring-shaped, red, itchy rash with a clear center. Treated with topical or oral antifungal medications.
Parasitic Infections
Scabies: Caused by the mite Sarcoptes scabiei, which burrows into the skin causing intense itching and a pimple-like rash. Treatment involves topical scabicides or oral ivermectin.
Overview of inflammatory skin disorders
Eczema (Atopic Dermatitis)
A chronic skin condition marked by itchy, red, and dry skin. Flare-ups may be triggered by environmental factors or allergens. Treatments include moisturizers, topical steroids, and newer biologic drugs.
Psoriasis
An autoimmune disorder characterized by thick, red, silvery, scaly patches on the skin. It can be associated with psoriatic arthritis. Treatments range from topical treatments (corticosteroids, vitamin D analogs) to phototherapy and systemic medications, including biologics.
Contact Dermatitis
Can be irritant or allergic. It occurs when the skin comes into contact with a substance that triggers an allergic reaction (allergic contact dermatitis) or damages the skin (irritant contact dermatitis). Treatment involves avoiding the irritant or allergen, topical steroids, and soothing lotions.
Rosacea
A chronic inflammatory skin disorder that affects the face, causing redness, pimples, swelling, and dilated blood vessels. The exact cause is unknown. Treatment may include topical and oral medications to control flare-ups and reduce symptoms.
Acne
Caused by the plugging of hair follicles with oil and dead skin cells, leading to whiteheads, blackheads, and pimples. It is most common among teenagers but can persist into adulthood. Treatments include topical retinoids, antibiotics, and more severe cases may require isotretinoin.
Different stages of pressure injuries
Stage 1: The earliest stage; the skin is not broken but is red and does not blanch (turn white) when pressed. The area may be painful, firm, soft, warmer, or cooler compared to adjacent tissue.
Stage 2: The injury involves partial thickness loss of skin appearing as a shallow, open ulcer with a red-pink wound bed without slough. Alternatively, it can present as an intact or ruptured serum-filled blister.
Stage 3: Full thickness loss of skin, in which fat may be visible in the ulcer and slough may be present but does not obscure the depth of tissue loss. Bone, tendon, or muscle are not exposed.
Stage 4: Full thickness tissue loss with exposed bone, tendon, or muscle. Slough or eschar may be present on some parts of the wound bed. Often include undermining and tunneling.
Unstageable Pressure Injury: Full thickness skin and tissue loss in which the extent of tissue damage within the ulcer cannot be confirmed because it is obscured by slough or eschar.
Deep Tissue Pressure Injury: Intact or non-intact skin with localized area of persistent non-blanchable deep red, maroon, or purple discoloration or epidermal separation revealing a dark wound bed or blood filled blister.
Some sources/causes of burns
Thermal Burns: Caused by exposure to flames, hot liquids (scalds), steam, or hot objects.
Chemical Burns: Result from contact with household or industrial chemicals in a liquid, solid, or gas form.
Electrical Burns: Occur from electric current passing through the body.
Radiation Burns: Caused by prolonged exposure to ultraviolet rays of the sun or to other sources of radiation like x-rays.
Friction Burns: Result from contact with hard surfaces such as roads (“road rash”) or carpets, essentially a combination of an abrasion and a heat burn.
Explain the different zones of burn injury
A burn injury typically affects tissues in three zones:
Zone of Coagulation: The area of greatest damage where the cells are irreversibly injured and tissue death occurs; it is at the center of the burn.
Zone of Stasis: Surrounding the zone of coagulation, this area has less severe injury that may potentially recover, but can quickly convert to more severe damage without proper treatment.
Zone of Hyperemia: The outermost zone where tissue is inflamed but not permanently damaged and recovery is likely.
What are different depths of burn injuries?
Burns are classified according to the depth of skin damage:
First-Degree Burns (Superficial Burns): Affect only the outer layer of the skin (epidermis). Signs include redness, minor inflammation, and pain. Usually heal within 3-7 days.
Second-Degree Burns (Partial Thickness Burns): Extend into the second layer of skin (dermis). Characterized by intense redness, swelling, blistering, and severe pain. They heal in 2-3 weeks but may require skin grafting depending on severity.
Third-Degree Burns (Full Thickness Burns): Go through the dermis and affect deeper tissues, potentially damaging nerves, which can result in reduced sensation. The skin may appear white, charred, or leathery. These burns usually require surgical treatment, such as skin grafting, and are susceptible to infection.
Fourth-Degree Burns: Extend into muscle and bone with severe damage and potential loss of function, often requiring amputation or leading to significant disability.
What are the local and systemic effects of burns?
Local Effects:
Tissue Damage: Direct damage to the skin and underlying tissues.
Infection: The skin’s barrier is compromised, allowing microorganisms to invade.
Fluid Loss: Damaged blood vessels may leak fluid, leading to dehydration and edema.
Systemic Effects:
Shock: Caused by fluid loss leading to decreased blood volume and acute hypotension.
Infection: Burned areas are highly susceptible to infection, which can spread systemically.
Metabolic Rate: Increases as the body tries to heal and maintain temperature, leading to significant caloric needs.
**Immune Response: **The body’s immune system is compromised, making it difficult to fight infections.
Respiratory Problems: Inhalation injuries from hot air or smoke can cause respiratory issues, complicating recovery.
