Nursing 104

N104: Essentials of Nursing Care – Health Safety Study Guide • Regeneration or proliferation: This is where the epidermal cells begin to reproduce to fill in the wound and recreate the thickness of the healthy skin. Typically, this process occurs from day four through day 21. • Maturation: This is the final stage of wound healing and begins at approximately three weeks after the initial injury, and may continue as long as two years. During this period, the wound develops strength. Types of Skin Lesions A traumatic or pathological mark on the skin that is different from surrounding skin is called a skin lesion. There are two types of skin lesions: • Primary skin lesions are those that develop as a result of some stimuli that may be caused by internal or external conditions. Examples of primary lesions include: o Macule: The lesion appears as a circular, small, and flat spot that is one mm to one cm in diameter and with the color not the same as that of nearby skin. Flat moles, measles, petechiae, and freckles are examples of macules. o Patch: This is a macule that is more than one cm in diameter and irregular in shape. o Vesicle: This is a raised lesion that is less than 0.5 cm across. Lesions are round or oval in shape with thin mass filled with serous blood or clear fluid. Herpes simplex, burn blisters, and early chicken pox are examples of vesicles. o Bulla: This is another example of a vesicle that is more than five mm across. Bullae are caused by chemical burns, exposure to sunlight, insect bites, or viral infection. o Pustule: This is a raised vesicle or bulla lesion filledwith pus. Infection is the primary cause. Acne vulgaris, impetigo, and boils are examples. o Papule: This is a solid elevated skin lesion less than one cm across. Papules are rough in texture and are usually pink, red, or brown. This lesion is associated with psoriasis, skin cancer, actinic keratosis, and syphilis. Warts, acne, pimples, and elevated moles are examples. o Nodule: This is a solid, elevated lesion that has edges and area 0.5-2 cm. A nodule is described as "palpable" where hard mass is felt from the tissue surrounding it. The size of the nodule is more than two cm in diameter. Malignant melanoma and hemangioma are examples. o Wheal: This is a red, swollen, and itchy lesion with localized edema. The wheal is usually caused by an allergic reaction, insect bites, or reaction from drugs. Hives, urticarial, and mosquito bites are examples. o Telanglectasia: These are dilated small blood vessels in the surface of the skin. It is often a manifestation of other diseases, such scleroderma or rosacea. o Plaque: This is a patch of closely grouped papules more than one cm across. Lesions are rough in texture and are brown, red, or pink in color. The size is larger than one cm. Rubeola and psoriasis are examples. o Cyst: This is an elevated and encapsulated skin lesion typically filled with fluid. The size is one cm or larger. Epidermoids, sebaceous cysts, and chalazion of the eyelid are examples. • Secondary skin lesions result from trauma, infections, or other conditions that change the original lesions. Examples of these include fissures, fistulas, scars, scales, crusts, ulcers, erosions, lichenification, abscess, burrow, petechiae, and papilloma.

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