September 29-30, 2014

Skin Disorders: Burns & Skin Cancer

Burns can be caused by: heat, electricity, UV radiation, or chemicals

Burn Causes

Burn Classification

First degree burn: only epidermis is damaged.

Second degree burn:Damage extends partway into dermis.

Third degree burn:Damage extends all the way through dermis.

Burn Classification

First degree burn: only epidermis is damaged.

Second degree burn:Damage extends partway into dermis.

Third degree burn:Damage extends all the way through dermis.

Signs: red, swollen skinExample: most sun burnsWill heal on own

Burn Classification

First degree burn: only epidermis is damaged.

Second degree burn:Damage extends partway into dermis.

Third degree burn:Damage extends all the way through dermis.

Signs: red, swollen skinExample: most sun burnsWill heal on own

Signs: blisteringSkin will heal care

Burn Classification

First degree burn: only epidermis is damaged.

Second degree burn:Damage extends partway into dermis.

Third degree burn:Damage extends all the way through dermis.

Signs: red, swollen skinExample: most sun burnsWill heal on own

Signs: blisteringSkin will heal with care

Signs: blackened or blanched (gray-white) skin, lack of pain due to damaged nervesSkin will not heal; grafts must be done

Burned skin can no longer carry out its functions

Turn & TalkQuick review: What are the functions of the skin? Analyze: Which functions are most critical?

How do burns disrupt homeostasis?

1)Protection from abrasion / chemical damage / UV damage / pathogens / against dessication

2)Excretion of wastes3)Thermoregulation4)Synthesis of Vitamin D

Burned skin can no longer carry out its functions

Most critically, skin can no longerPrevent loss of fluids and electrolytes

Fluid loss and electrolyte imbalance can cause kidneys to shut down and patients to go into shock due to low blood volume.

Happens almost immediately, unless fluids are replaced.

Protect the body from pathogensInfection becomes a major concern within 2-3 days

following severe burns.

How do burns disrupt homeostasis?

Burned skin cannot thermoregulate. Hypothermia becomes a problem.

Burned skin cannot regenerate. Scar tissue forms. If the scar tissue is extensive, mobility may be affected.

Other complications

The severity of burns is determined by both the degree (depth) of the burn and the % of the body covered.

Burns are critical ifMore than 25% of the body has second degree

burnsMore than 10% of the body has third degree

burns

Burn Severity

How to estimate body %?

“Rule of nines”

Estimating % of the body burnedIf the whole anterior right arm is burned …

“Rule of nines”

Estimating % of the body burnedIf the whole anterior right arm is burned … 4.5%

“Rule of nines”

Estimating % of the body burnedIf the whole anterior right arm is burned … 4.5%

If 1/3 of the abdomen is burned …

“Rule of nines”

Estimating % of the body burnedIf the whole anterior right arm is burned … 4.5%

If 1/3 of the abdomen is burned … 3%

“Rule of nines”

Estimating % of the body burnedIf the whole anterior right arm is burned … 4.5%

If 1/3 of the abdomen is burned … 3%

If a whole leg (all sides) is burned …

“Rule of nines”

Estimating % of the body burnedIf the whole anterior right arm is burned … 4.5%

If 1/3 of the abdomen is burned … 3%

If a whole leg (all sides) is burned …18%

“Rule of nines”

Estimating % of the body burnedYou do:

Half of upper back

All of right arm

All of head

“Rule of nines”

Estimating % of the body burnedYou do:

Half of upper back4.5%

All of right arm9%

All of head9%

What are the two most important complications of severe burns and why does each occur?

Quick Review

What are the two most important complications of severe burns and why does each occur?

Loss of fluids & electrolytes (causing kidney malfunction & shock)

Infection

Quick Review

Common Types of Skin CancerThere a three main types of skin cancers, defined by the type of cell from which they arise.

Basal cell carcinoma – arise from the basal edge of the epithelial tissue.

Squamous cell carcinoma –arise from the keratin-producing cells in the middle of the epithelial tissue.

Melanoma – arise from the melanin-producing cells at the basal edge of the epithelial tissue

Excess su

n

exposure

increases the

risk of e

ach of

these cancers

Basal Cell Carcinoma

Most common form of skin cancer

Affects ~2.8 million people in the US each year

Slow-growing and rarely fatal

Squamous Cell Carcinoma

Second most common form of skin cancer

Affects ~700,000 people in the US each year

Grow and invade surrounding tissue quickly

<5% are fatal

Common Types of Skin Cancer

Third most common skin cancer

Affects ~76,000 people in the US each year

Quickly metastasizes (spreads) to blood vessels and lymph nodes – which allows it to spread to other locations in the body

Fatal in more than 10% of cases

Melanoma may be the least common type of skin cancer, but it is by far the most deadly.

Moreover, while rates of most other cancers are declining in the US (due to a reduction of smoking) melanoma rates are increasing.

What were our objectives today? How did we meet them?

What was our learner profile trait and how did we use it?

How does what we did today address our unit objective?

Closure

Homework: Study for Quiz!