1. NOTES: Other Homeostatic Skin Imbalances:
1. Burns
2. Cancer

2. 1. Burns
Tissue damage inflicted by intense heat, electricity, radiation, or certain chemicals
Denature cell proteins & cause cell death
Threat to life: catastrophic loss of body fluids containing proteins & electrolytes
Leads to renal (kidney) shutdown & circulatory shock
Must replace fluid immediately!

4. In adults, volume loss can be estimated by computing the percentage of body surface burned
Use: Rule of Nines Chart
This chart divides the body surface into areas, each of which represents 9 percent. (generally used for quick assessment)

5. Front of head: 4.5%
Front of arm: 4.5%
Back of leg: 9%

6. After fluids & electrolytes have been replaced, infection is the main threat
Burns are classified according to their severity

7. First Degree Only the epidermis is damaged
Reddening of the skin but no blistering
Painful but does not leave a scar.
Treatment: a topical ointment to keep the injured area from drying out and cracking as it heals.
These burns take a week to ten days to heal and seldom leave a scar.

8. Second Degree Injure the epidermis & the upper region of the dermis
Symptoms mimic 1st degree burns but include blisters
Sufficient numbers of epithelial cells are still present so healing usually results without a scar
                                  

10. Third Degree
involve the entire thickness of skin layers and permanently destroys tissues. A white, black or mottled hard, dry wound, from which hairs are easily pulled out. No pain is present (Why?)
Impossible to wait long enough for skin to heal due to infection
Use synthetic skin grafts & lots of antibiotics
                                                                                    

11. Third Degree Burn (Full thickness)
First Degree Burn
Second Degree Burn
Third Degree Burn (Full thickness)
                                                
                                   

12. WARNING!
The next pictures
are graphic!

13. OUCH!!

14. Example Problem:
Joe burned 47% of the front of both arms. This burn is red, blistering, and is painful.
What type of burn is this?
How much of his body is burned?
Is it a critical burn?
CRITICAL BURN:
25% of the body is covered by 2nd degree burns
10% of the body is covered by 3rd degree burns

15. Homeostatic imbalance:
2. Skin Cancer

16. The major cause of skin cancer is:
UV Radiation

17. Squamous Cell Carcinoma Melanoma
3 basic types of skin cancer:
Basal Cell Carcinoma
Squamous Cell Carcinoma
Melanoma

18. Basal Cell Carcinoma: Right! stratum basale
One of the most common forms of cancer & least malignant
It is the result of sun damaged skin.
It grows slowly and can spread to surrounding tissue but does not metastasize before it is noticed
Question: In what skin layer does Basal Cell Carcinoma occur
Right! stratum basale

19. Basal Cell Carcimoma

20. Squamous Cell Carcinoma:
Also very common.
Arises from keratinocytes of stratum spinosum
Grows rapidly & metastasizes to adjacent lymph nodes if not removed

21. Other images: There isn’t just one way the growths look

22. Here's the Really Bad One...
Melanoma

23. Melanoma: Early diagnosis is essential!!
Look for: changes in size or color of a mole; oozing or bleeding from a mole; or a mole that feels itchy, hard, lumpy, swollen, or tender to the touch.
ABCDE rule:
A: Asymmetry
B: Border Irregularity
C: Color (more than 1)
D: Diameter (6mm +)
E: Evolution
Sometimes called Malignant Melanoma; most dangerous
Only about 5% of cancers but rate is increasing
Melanoma can spread quickly to other parts of the body (metastasize)
It is cancer of the melanocytes in the epidermis.
Can begin wherever there is pigment

24. Melanoma continued: Melanoma can appear on the body as a new mole.
Men most often get melanoma on the trunk, head or neck
Women most often get melanoma on the arms and legs.

25. Ready? Don’t be fooled, these can kill!
These don’t look so bad do they?
Don’t be fooled, these can kill!

26. How to Protect Yourself:
Use sunblock!
SPF 15 ratings will filter out about 90% of the damaging light. *If it takes 20 minutes for your unprotected skin to start turning red, using an SPF 15 sunscreen theoretically prevents reddening 15 times longer — about five hours.
*SPF 30: 97% SPF 50: 98%
UVA: protects against DNA damage
UVB: protects against sunburn
Wear protective clothing.
Long-sleeved, dark fabrics with tight weaves are best. Baseball caps offer some protection, but wide-brimmed hats are better

27. How to Protect Yourself:
Wear sunglasses
block both UVA and UVB radiation; protect the skin around your eyes, also help to prevent cataracts.
Stay out of tanning booths!
Despite merchants' claims that they have blocked out all damaging wavelengths, patrons are typically exposed to 2 to 20 times the amount of UVA that they get in natural sunlight.

28. AGING: Even if sunburn does not occur…
UV rays cause damage to DNA in the epidermal cells as well as to collagen & elastic fibers in the dermis
Also, as we age, our bodies produce less collagen, etc.
Gravity also takes its toll on muscle and skin tissue