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

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!

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)

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

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

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.

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                                   

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                                                                                     

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

WARNING! The next pictures are graphic!

OUCH!!

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

Homeostatic imbalance: 2. Skin Cancer

The major cause of skin cancer is: UV Radiation

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

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

Basal Cell Carcimoma

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

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

Here's the Really Bad One... Melanoma

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

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.

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

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

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.

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