Integumentary disorders Instructor – Cindy Quisenberry Integumentary disorders

Macule – flat spots (light or dark)

Macule – flat spots (light or dark)

Papule – small, firm, raised area (example: pimple)

Vesicle – small blister (example: chickenpox

Bulla – large blister

Bulla – large blister

Pustule – small elevation with WBC’s, sometimes bacteria or other cells (pus filled sacs – example: pimple)

Wheal – itchy, elevated areas with an irregular shape (example – insect bite)

Ulcer – deep loss of skin surface that may extend into the dermis; may cause periodic bleeding and the formation of scars (Individuals at risk are Diabetics, Peripheral Vascular Disease, Decreased Mobility, etc.)

DECUBITUS Ulcer – CAUSED FROM POOR NUTRITION, PRESSURE ON THE SKIN (over bony prominences, POOR CIRCULATION (ie: Diabetes Mellitus, PVD, etc. ) Prevention Turn at least every 2 hours Lotion skin Heel/elbow protectors, air mattress, egg crate mattress, etc. Pillow between bony prominences Elevate bony prominences off of mattress

Ulcer staging

Fissure – crack in the skin

Furuncle (boil) – localized, originating in hair follicle

carbuncle – An abscess of the skin, formed by the merger of two or more boils

abscess – A localized collection of pus in any body part that results from invasion of a pyogenic bacterium or other pathogen

Gangrene – necrosis or death of tissue

Bed positions

Bed positions

Bed positions

Bed positions

Bed positions

Burn classifications

Second DEGREE BURN

Second DEGREE BURN

THIRD DEGREE BURN

THIRD DEGREE BURN

Rule of NInes The rule of nines is a standardized method used to quickly assess how much body surface area (BSA) has been burned on a patient. This rule is only applied to partial thickness (2nd degree) and full thickness (3rd degree) burns.

FOURTH DEGREE BURN

Rule of nines The diagram depicts BSA percentages for adults and infants of one year or less.

Rule of nines For children over the age of one year, for each year above one, add 0.5% to each leg and subtract 1% for the head. This formula should be used until the adult rule of nines values are reached. For example, a 5-year old child would be +2% for each leg and -4% for the head

SKIN GRAFT

SKIN GRAFT

SKIN GRAFT

Impetigo – caused by Staph or strep Treatment – Oral and/or Topical Antibiotics

Rubella Everyone should be immunized – Dangerous to non-immunized pregnant women

Ringworm – caused by fungus Treatment – Topical antifungal medication

Chicken pox– caused by Herpes varicella Vaccine available for prevention

shingles – caused by herpes zoster Treatment – Zovirax /Acyclovir – antiviral med. Vaccine available for prevention

pediculosis – Lice Treatment – pediculicide

Scabies – contagious skin eruption caused by mites Treatment – Permethrin (scabicidal)

psoriasis – Chronic skin disorder; etiology unknown, but possible immune dysregulation; possible genetic predisposition to this disorder Treatment – Biologic, Systemic meds., Phototherapy, Topicals (corticosteriods, coal tar derivatives)

Skin Cancer characteristics Basal A - Asymmetry B - Border C - Color D - Diameter E - Evolving Squamous Melanoma