Altered Skin Integrity
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Describe the epidermis
Outler layer of skin made of dead squamous cells and melanocytes which gives us pigmentation.
Describe the dermis
Provides support for the epidermis and gives it flexibility and strength.
Made of fat and collagen fibers
Eccrine sweat glands
- Provides heat regulation, found on the :
- palms and soles of feet
Apocrine Sweat Glands
Causes body odor and found in the axillary and genital areas
flat spot less than 1 cm that changes color(freckle or mole)
Larger than 1 cm flat, changes color (Cafe au Lait)
warts, elevated mole....less than 1 cm
larger than 1 cm, superficial and elevated, plateau like
Lipoma or fatty tumor
Large nodule filled with liquid or semi solid material
Hive, insect bite, TB skin test
oozing, scraping surface, loss of superficial structure of skin
Loss of deeper layers...scooped out
small, flat, round purplish, red spot.
Interadermal or submucosal hemorrhage
Discoloration, reddish purple, escape of blood in to tissues
Black and Blue marks
When assessing dark skin remember:
- Take a picture, it shows variations better.
- Color change is less obvious
- Palpate for warm, smooth or hard spots
dark skin turning purple/gray with inflammation
How do I tell if a black person has jaundice?
Check their palate...cuz sclera always looks yellowish.
What does skin of a dark person look like if they are in trouble perfusion wise?
- white, grey.
- Lips, mucous membrane, conjunctiva and nail beds ashen grey or yellow brown.
How to you confirm shock with a black person?
Vital signs and O2 saturation
Whats a discrete, individual or separate lesion?
What's it called when a lesion merges or they run together?
Measles, chicken pox, roseola
Whats it called when lesions are arranged in a circular pattern?
Whats it called when you have lesions scattered all over the body?
What's it called when you have acluster of lesions in one spot?
Whats it called when lesions form a line?
Poison Ivy and Oak
Whats it called when lesions are arranged in concentric circles?
Whats it called when there's a linear arrangement along a nerve root?
Herpes Zoster, Shingles, Chicken Pox
Signs of Squamous Cell Carcinoma
- slightly elevated
Dangers of Squamous Cell Carcinoma
Can change to malignancy if get it on ear, nose, lips
Signs of Basal Cell Carcinoma
- plaque like macule on the trunk
- RARELY METASTASIZES
LEAST LIKELY TO SPREAD!! MOst COMMON SKIN CANCER
Both Basal Cell and Squamous Cell carcinoma effect:
Malignant Melanoma is
abnormal growth of melanocytes
Where do you find melanoma?
Comes from a mole on the head, trunk or legs
What puts a person at greatest risk for melanoma?
- Ultraviolet Radiation
- blistering sunburns at a young age (3 or more)
- working outdoors
- sunlamps and tanning beds
SCC and BCC comes from?
they are both CARCINOMAS that are found on surface epithelium in areas covering organs
Malignant Melanoma comes from?
CANCER in melanocytes of the skin
Malignant Melanoma is most common in....
light skinned people with blue green eyes, freckles and those that sunburn easily
ABCD warning signs of Malignant Melanoma
- A=asymmetry (irregular surface or larger on one side than the other
- B= Border Irregularity
- C=Color changes (many colors in 1 mole)
- D=Diameter Large (or sudden growth in size)
unusual mole that is larger than 5 mm that is likely to progress to malignant melanoma
What does age have to do with skin cancer?
Skin cant repair its DNA any more
How do you prevent skin cancer?
- Inspect all moles....especially for Pigmented Nevi
- Avoid unnecessary sun exposure
- Use broadspectrum sun protection of SPF 15 or higher
Treatment of skin cancer:
- Wide excision to fascia and lymph node eval.
- Skin graft
How do you treat skin after intervention of skin cancer?
- Change, clean and redress wound
- Watch for bleeding and infection
- Emollient cream to decrease drying
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