Alterations in the integumentary System

### Pressure Ulcers

• Open sores caused by prolonged pressure, shearing forces, friction, and moisture.
• Risk factors: Prolonged immobility, moisture due to incontinence, poor nutrition, dehydration, and impaired perfusion.
• Staging:
  • Stage 1: Non-blanchable erythema of intact skin.
  • Stage 2: Partial-thickness skin loss involving the epidermis and/or dermis.
  • Stage 3: Full-thickness skin loss involving damage to subcutaneous tissue.
  • Stage 4: Full-thickness skin loss with exposure of muscle, bone, or supporting structures.
  • Unstageable: Full-thickness tissue loss covered by slough or eschar.
• Prevention: Frequent repositioning, moisture management, pressure reduction techniques, and ensuring adequate nutrition and hydration.

Dermatitis

• Allergic Contact Dermatitis: Hypersensitivity to allergens such as metals or chemicals.
• Irritant Contact Dermatitis: Prolonged exposure to irritating chemicals like soaps or acids.
• Atopic Dermatitis: Common in children with a family history of allergies; presents with pruritus, scaling, and thickening of the skin.
• Stasis Dermatitis: Caused by venous stasis and manifests as erythema, scaling, and ulcers on the lower legs.
• Seborrheic Dermatitis: Scaly, yellowish plaques on the scalp, eyebrows, and other areas.

Psoriasis

• Chronic inflammatory disorder characterized by the rapid turnover of epidermal cells, resulting in scaly, erythematous plaques.
• Treatment: Topical treatments, systemic therapies, and light therapy.

Cellulitis

• Infection of the dermis and subcutaneous tissue.
• Presents as warm, swollen, and painful areas, usually in the lower extremities.
• Treatment: Antibiotics and pain management.

HSV and Shingles

• Herpes Simplex Virus (HSV-1): Causes cold sores and oral infections.
• Herpes Zoster (Shingles): Caused by reactivation of the varicella-zoster virus (chickenpox).
  • Symptoms include pain, paresthesia, and vesicular eruptions along the dermatome.
• Treatment: Antiviral medications, pain management, and supportive care.

Chickenpox (Varicella)

• Highly contagious disease caused by the varicella-zoster virus.
• Presents with fever, itching, and vesicular lesions.
• Treatment: Typically self-limiting, but vaccines are available.

Warts

• Benign lesions caused by the human papillomavirus (HPV).
• Types: Common warts (on fingers), plantar warts (on feet), and genital warts (sexually transmitted).
• Treatment: Cryotherapy or salicylic acid.

Hives (Urticaria)

• Circumscribed areas of erythema and edema, typically caused by allergic reactions.
• Treatment: Antihistamines and avoidance of triggers.

Skin Cancer

• Basal Cell Carcinoma (BCC): The most common form of skin cancer; usually not metastatic.
• Squamous Cell Carcinoma (SCC): Arises from the epidermis; also common, with metastasis being rare.
• Kaposi Sarcoma: A vascular malignancy associated with immunodeficiency; characterized by purple, brown lesions.

Burns

• First-Degree Burns: Involve only the epidermis; present with redness and pain (e.g., sunburn).
• Second-Degree Burns: Affect the epidermis and part of the dermis; with blisters.
• Third-Degree Burns: Full thickness burns that involve the entire dermis; appear dry and leathery.
• Fourth-Degree Burns: Extend into deeper tissues like muscles and bones.

Rule of 9's (Burns)

• Used to estimate the total body surface area (TBSA) affected by burns.
• Each arm = 9%, each leg = 18%, torso = 36%, head = 9%, and genitalia = 1%.

Burn Shock

• A combination of hypovolemic and cellular shock due to fluid shifts from the vasculature into the interstitial space after a burn.
• Treatment: Fluid resuscitation.

Cold Injuries

• Frostbite: Freezing of tissues, leading to numbness and tissue damage.
• Treatment: Rewarming, pain management, and possible surgical intervention for severe cases.

Pediatric Issues

• Acne: Inflammatory and non-inflammatory types; commonly treated with topical or systemic therapies.
• Impetigo: A bacterial infection in children, characterized by honey-colored lesions; treated with topical or oral antibiotics.
• Rubella: Viral infection causing a rash, lymphadenopathy, and fever; typically managed with supportive care.

This quiz covers the essential aspects of pressure ulcers and dermatitis, including risk factors, staging, and prevention techniques. Understand the differences between allergic and irritant contact dermatitis. Test your knowledge on crucial concepts related to skin health and care.