Skin Disorders: Burns & Skin Cancer

1. Skin Disorders: Burns & Skin Cancer September 29-30, 2014

2. Burn Causes Burns can be caused by: • heat, • electricity, • UV radiation, or • chemicals

3. 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.

4. Burn Classification Signs: red, swollen skin Example: most sun burns Will heal on own 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.

5. Burn Classification Signs: red, swollen skin Example: most sun burns Will heal on own Signs: blistering Skin will heal care 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.

6. Burn Classification Signs: red, swollen skin Example: most sun burns Will heal on own Signs: blistering Skin will heal with care Signs: blackened or blanched (gray-white) skin, lack of pain due to damaged nerves Skin will not heal; grafts must be done 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.

7. How do burns disrupt homeostasis? Burned skin can no longer carry out its functions Turn & Talk Quick review: What are the functions of the skin? Analyze: Which functions are most critical? Protection from abrasion / chemical damage / UV damage / pathogens / against dessication Excretion of wastes Thermoregulation Synthesis of Vitamin D

8. How do burns disrupt homeostasis? Burned skin can no longer carry out its functions Most critically, skin can no longer • Prevent 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 pathogens • Infection becomes a major concern within 2-3 days following severe burns.

9. Other complications • 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.

10. Burn Severity The severity of burns is determined by both the degree (depth) of the burn and the % of the body covered. Burns are critical if • More than 25% of the body has second degree burns • More than 10% of the body has third degree burns How to estimate body %?

11. Estimating % of the body burned “Rule of nines” If the whole anterior right arm is burned …

12. Estimating % of the body burned “Rule of nines” If the whole anterior right arm is burned … 4.5%

13. Estimating % of the body burned “Rule of nines” If the whole anterior right arm is burned … 4.5% If 1/3 of the abdomen is burned …

14. Estimating % of the body burned “Rule of nines” If the whole anterior right arm is burned … 4.5% If 1/3 of the abdomen is burned … 3%

15. Estimating % of the body burned “Rule of nines” If 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 …

16. Estimating % of the body burned “Rule of nines” If 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%

17. Estimating % of the body burned “Rule of nines” • You do: • Half of upper back • All of right arm • All of head

18. Estimating % of the body burned “Rule of nines” • You do: • Half of upper back • 4.5% • All of right arm • 9% • All of head • 9%

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

20. 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

21. Common Types of Skin Cancer There 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 sun exposure increases the risk of each of these cancers

22. Basal Cell Carcinoma • Most common form of skin cancer • Affects ~2.8 million people in the US each year • Slow-growing and rarely fatal

23. 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

24. 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.

25. Closure • 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? Homework:Study for Quiz!