Final_Info_Test_2.pdf

Epidermis-5 layers o Passive circulation from dermis o Cell types in epidermis ▪ Keratinocytes (90%) • Essential for the skin’s protective barrier function ▪ Melanocytes (5%) • Protection against UV sunlight ▪ Langerhans’ • Essential for skin immunity ▪ Merkel cells • Touch receptors • Dermis o Highly vascular o Collagen ▪ Critical in wound healing ▪ Responsible for skin’s mechanical strength o Elastic fibers and reticular fibers • Subcutaneous Tissue o Connective tissue and fat cellsSecondary skin lesions o Change with time o Occur because of secondary factors (scratching, infection, etc.) o Fissure ▪ Linear crack or break from epidermis to dermis, dry or moist ▪ Ex. Athletes foot, cracks at corner of the mouth o Scale ▪ Excess, dead epidermal cells produced by abnormal keratinization and shedding ▪ Ex. Flaking skin after drug reaction or sunburn o Scar ▪ Abnormal formation of connective tissue that replaces normal skin ▪ Ex. Surgical incision, healed wound o Ulcer ▪ Loss of epidermis, extending into dermis, crater-like irregular shape ▪ Ex. Pressure ulcer, chancre o Atrophy ▪ Depression in skin resulting from thinDiagnostic tools • Inspection and history • Dermatoscopy • Biopsy • Potassium hydroxide (KOH) • Tzanck test • Stains and cultures • Curretage • Mineral oil slides • Wood’s lamp • Patch testing Study Description and Purpose Nursing Responsibility Biopsy Punch Special punch biopsy instrument of appropriate size used. Instrument rotated to appropriate level to include dermis and some fat. Suturing may or may not be done. Provides full-thickness skin for diagnostic purposes Before: Verify that consent form is signed (if needed). During: Assist with site preparation, anesthesia, procedure, and hemostasis. Properly identify specimen. After: Apply dressing, give postprocedure instructions to patient.