Pathophysiology of Skin Alterations

Pathophysiology of Skin AlterationsSkin AlterationsBeverly PhelpsAbstractHuman undress is the largest multifunctional organ of the body, and knowledge of its structure and function is essential to clinicians and researchers. The peel off has cardinal layers, the epidermis and dermis, obscure by a basement membrane zone. It provides protection, sensation, ther moregulation, biochemical/metabolic, and immune functions. Key and emerging concepts important to understanding pathophysiological mechanisms for practicing clinicians atomic number 18 knowledge of differences between acute and continuing aggravates ability to evaluate depth and extent of injury and understanding stages of healing versus zones of activity.Discussion Explain pathophysiology of broad categories of clamber alterations (e.g., low, traumatic, burns, benign, para placeic, pressure ulcers, genus Cancerous, infectious, and inflammatory). Also discuss abortifacient agents, assessment data (what it looks like, pathophysiological changes, and presenting symptoms).Skin AlterationsThis paper will cover minor piques, burns, pressure injury, and cancer with variations in skin color, as well as the motive(prenominal) agents and assessment data. small fry WoundsMinor skin traumas occur as the result of unanticipated trauma and may include lacerations, abrasions, blisters and more serious wounds such as skin tears and bites.Lacerations be often irregular shaped wounds with ragged skin edges and typically have deeper skin victimize and bruising noned. Abrasions be cognise as grazes and are more superficial wounds in which the top layer of the skin is remove by sliding across a rough lift and usually contains some territory and sometimes even particles of what scraped it. Blisters are the result of friction of between the top two layers of the skin, or coming in affect with something hot, removing the top of the blister, puncturing the blister, or draining the fluid will ca-ca the area to heal more quickly, and will require a protective dressing afterwards. A cut or incision usually has reasonable edges as a result of the cause of injury, for example a sharp knife. If it is a deep wound it can bleed profusely and nerve and muscle damage can occur. Human and animal bites are of special concern, especially in puncture wounds, as bacteria from the mouth can enter the wound resulting in an increased essay of tetanus and infection. Most animal bites are from pets, usually dogs and cats, and can cause abrasions, deep scratches, and lacerations as well as puncture wounds. Cat bites and scratches are conside red-faced more serious due to the high incidence of infection due to the germs that are in their mouth and under their claws.Infection is the largest stake of minor traumatic wounds as they often contain debris and bacteria from the cause of the injury.The handling from a minor traumatic wound is to clean the wound and surrounding skin, removing any debris and oth er foreign material. Abrasions require thorough irrigation as ground dirt is frequently embedded in these wounds. Apply an antiseptic solution to cleanse the wound using chlorhexidine, povidone-iodine and normal saline.Surgical wounds that have been stitched together, just clean the old blood prior to the application of a dry dressing.The most important thing is to try to determine the cause of the injury or the determination which caused the injury and when the injury occurred. Wounds greater than six to eight hours old have an increased stake of infection. With all traumatic injuries assess the patients tetanus status and ensure they have adequate coverage. Following this an assessment of the wound can be made for the military position, size, and depth and any additional trauma to cardinal structures such as muscle, tendon, nerve, vascular and bone. Animal bites must be monitored for 24-48 hours for signs of infection. Precautionary antibiotic may be administered.BurnsBurns ca n be sustain in a number of ways with children and the elderly where it is the most common. Scalds involving hot liquids are the most common type of burns. In adults, flame burns are more prevalent and other causes can include chemical contact, electrical, friction damage, and temperatenessburn.The seriousness of a burn injury depends on some(prenominal) factors including the size, depth of the burn, the location of the burn, and the age and general medical precedent of the burn patient. Clinical studies suggest that to the highest degree 95% of all burns are relatively minor, however about 5% require hospitalization and highly specialized manipulation. The severity of a burn determines the type of treatment it requires. on that point are 5 recognized grades of burns, minor/superficial, superficial partial heaviness, mid dermal partial thickness, deep dermal partial thickness, and climb thickness, which has replaced the origin, second and third degree terminology used befor e.Minor/Epidermal is characterized by red, painful, usually not blistered, and will heal within approximately 7 days with no scarring. Superficial dermal is characterized by blistered with discolor pink base, very painful and usually heals by epithelialization in 10 14 days with no scarring. Mid Deep dermal is characterized by blotchy, red or white base +/- blisters, no capillary return, predominantly painless(prenominal), prolonged healing with possible scarring and contracture, and heal in 14 28 days. Full thickness is characterized by leathery, white or charred, painless, and prolonged healing with scarring and possible loss of function.The clinical objectives for management of burns are stabilize the patient, cool the wound, debride devitalized (necrotic) meander, protect from infection, and confining the wound by first or second intention healing or by grafting.The impact of first aid cannot be overemphasized with rapid, effective first aid helping to prevent further dama ge and deeper tissue loss. Burn wound conversion refers to the process whereby tissue damage can extend to deeper layers resulting in prolonged healing. This increases the risk of complications post healing such as contraction and keloid or hypertrophic scarring.Pressure Ulcers. A Pressure Injury is a wound caused by unrelieved pressure of tissue compressed between a bony prominence and an external surface which is classified according to the extent of tissue damage. Synonymous terms include pressure sores, bedsores, and decubitus ulcers. As a result of unrelieved pressure, the network of vascular and lymph vessels supplying oxygen and nutrients to the tissues can be occluded. several(prenominal) factors are involved in determining if a Pressure Injury will develop and include duration of pressure, intensity of pressure, and the ability of tissue to admit pressure (tissue tolerance). However, there is no universal agreement as to the length of time and the intensity of pressure bef ore tissue damage occurs. Other major factors include shear, friction forces, and moisture. Pressure Injuries affect people who are largely immobile. They are most common amongst the elderly, but can effect anyone who is confined to a bed or wheel chair. On average 10% of hospitalized patients can develop a pressure ulcer during their stay. Recent prevalence studies undertaken in several major Australian teaching hospitals identified the prevalence rate of pressure ulcers as being between 5.4% and 15.6%. The most common positions for pressure ulcers are Sacrum/ tramp bone, Heel, Ischia/buttocks, and Greater trochanters/hipPressure injury classification are classified according to the level of tissue damage that has been sustained and staging system is used. There are 4 stages of pressure injuries, and are as follows. Stage one is described as intact skin with observable changes including areas of persistent redness. Stage two is described by partial thickness skin loss involving ep idermis and or dermis. Stage three is described by full thickness involving damage or necrosis of subcutaneous tissue that may extend down to, but not through, underlying fascia. Stage four is described as full thickness skin loss with extensive tissue destruction to muscle, bone, or supporting structures, tendon, and joint capsule, and may have undermining or sinus formation.The primary treatment and objective for management of pressure injuries are reduction of pressure and shear forces, management of exudate, prevention of contamination leading to infection, creation of a moist wound environment, and to minimize the frequency of dressing changes, which is generally more cost effective, and provide more rapid healing and less disruption to the patient.Skin Cancer.Skin cancer occurs when errors occur in the DNA of skin cells. The mutations cause the cells to grow out of control and form a mass of cancer cells. Cells involved in skin cancer begin in your skins epidermis. The epiderm is provides a protective cover of skin cells that your body continually sheds. The epidermis contains three main(prenominal) types of cells the squamous cells that lie just below the outer surface and function as the skins inner lining, the basal cells, which produce new skin cells, sit beneath the squamous cells, and melanocytes which produce melanin, the pigment that gives skin its normal color, and are located in the lower part of your epidermis. Melanocytes produce more melanin when youre in the sun to help protect the deeper layers of your skin. Where skin cancer begins, is determined by its type and will also determine the treatment options. Skin cancer is the abnormal fruit of skin cells that most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight.There are three major types of skin cancer basal cell carcinoma, squamous cell carcinoma and melanoma.You can reduce your risk of skin cancer by limiting or avoiding exposure to ultraviolet (UV) radiation. Checking your skin for suspicious changes can help detect skin cancer at its earliest stages. Early detection of skin cancer gives you the greatest chance for successful skin cancer treatment.Skin cancer develops primarily on areas of sun-exposed skin, including the scalp, face, lips, ears, neck, chest, arms and hands, and on the legs in women. But it can also form on areas that rarely see the light of day like your palms, beneath your fingernails or toenails, and your genital area.Skin cancer affects people of all skin tones, including those with darker complexions. When melanoma occurs in people with dark skin tones, its more likely to occur in areas not normally exposed to the sunUltraviolet light and other potential causesMuch of the damage to DNA in skin cells results from ultraviolet (UV) radiation implant in sunlight and in the lights used in tanning beds. But sun exposure doesnt explain skin cancers th at develop on skin not ordinarily exposed to sunlight. This indicates that other factors may contribute to your risk of skin cancer, such as being exposed to toxic substances or having a condition that weakens your immune system.Risk factorsFactors that may increase your risk of skin cancer includeFair skin.Anyone, regardless of skin color, can get skin cancer. However, having less melanin in your skin provides less protection from damaging UV radiation. If you have blond or red hair and light-colored eyes, and you freckle or burn up easily, youre much more likely to develop skin cancer than is a person with darker skin.A narrative of sunburns.Having had one or more blistering sunburns as a child or teenager increases your risk of developing skin cancer as an adult. Sunburns in adulthood also are a risk factor.Excessive sun exposure.Anyone who spends considerable time in the sun may develop skin cancer, especially if the skin isnt protected by sunscreen or clothing. Tanning, inclu ding exposure to tanning lamps and beds, also puts you at risk. A tan is your skins injury response to excessive UV radiation.Sunny or high-altitude climates.People who live in sunny, warm climates are exposed to more sunlight than are people who live in colder climates. Living at higher elevations, where the sunlight is strongest, also exposes you to more radiation.Moles.People who have many moles or abnormal moles called dysplastic nevi are at increased risk of skin cancer. These abnormal moles which look irregular and are generally larger than normal moles are more likely than others to become cancerous. If you have a history of abnormal moles, watch them regularly for changes.Precancerous skin lesions.Having skin lesions known as actinic keratosis can increase your risk of developing skin cancer. These precancerous skin growths typically appear as rough, leprose patches that range in color from brown to dark pink. Theyre most common on the face, head and hands of fair-skinned people whose skin has been sun damaged.A family history of skin cancer.If one of your parents or a sibling has had skin cancer, you may have an increased risk of the disease.A personal history of skin cancer.If you true skin cancer once, youre at risk of developing it again.A weakened immune system.People with weakened immune systems have a greater risk of developing skin cancer. This includes people living with HIV/AIDS and those taking immunosuppressant drugs after an organ transplant.Exposure to radiation.People who received radiation treatment for skin conditions such as eczema and acne may have an increased risk of skin cancer, particularly basal cell carcinoma.Exposure to trusted substances.Exposure to certain substances, such as arsenic, may increase your risk of skin cancerReferenceshttp//www.sh.lsuhsc.edu/policies/policy_manuals_via_ms_word/wocn/wocn_08.pdfhttp//www.medscape.com/viewarticle/562489_4http//annonc.oxfordjournals.org/content/16/9/1425.fullhttp//www.ncbi.nlm. nih.gov/pubmed/17523178http//www.mayoclinic.com