24.6: Key Terms

abrasion

an area damaged by scraping

acne vulgaris

a common inflammatory skin reaction caused by bacteria, dead skin cells, or dried sebum that clogs hair follicles and prevents sebum from passing up through the pores

acute wound

a wound that occurs suddenly and progresses through expected stages of healing

angioedema

swelling of the face, lips, throat, or airways

angiogenesis

process where capillaries grow across the wound increasing blood supply and oxygen

apocrine gland

correlates with the hair follicles present in the perineum, axillae, and areolae of the breasts

arrector pili muscle

triggers hair follicles on the body to flex causing the hair to rise up

arthrofibrosis

scar tissue formed around a joint during the healing process, which limits range of motion

autolytic debridement

using occlusive dressings to enhance the body’s own defense mechanisms to liquefy or soften necrotic tissue

avulsion

a forcible tearing off of skin or another part of the body

basal cell carcinoma

the most common skin cancer that is generally found on the head or neck; it may be serious but is not usually fatal

blackhead

flesh-colored, small bump with a dark center

blanching

temporary whitening or lightening of the skin around the wound site upon applying pressure

Braden scale

pressure injury risk assessment tool used across healthcare settings to evaluate the relative risk of a patient developing skin breakdown and pressure injuries

bullae

large blisters

bullous impetigo

type of impetigo that has large, flaccid bullae on the skin that rupture and leave a thin brown crust

burn

injury to the skin caused by thermal, electrical, chemical, or electromagnetic energy

carbuncle

cluster of skin abscesses connected to one another below the surface of the skin; often form when one or more hair follicles are infected

cellulitis

localized infection and inflammation of the skin and tissues that are immediately beneath the skin

chronic wound

no healing occurs for at least three months

closed wound

does not have a break in the skin and occurs under the skin’s surface

collagen

whitish protein substance that adds flexible strength to the wound

comedone extraction

use of a comedone extractor by a healthcare professional to remove blackheads and whiteheads by incising the pore and then using gentle pressure around the pore opening with a wire loop

contusion

a region of injured tissue or skin in which blood capillaries have been ruptured

cystic acne

lesions that are usually large, red, painful, and pus-filled nodules that merge under the skin and often leave scars

debridement

removing slough or necrotic tissue and foreign material by various methods

defensin

has antimicrobial and/or cytotoxic properties and is part of the body’s first immune defense

dehiscence

partial or total rupturing of a sutured wound

dermatosis papulose nigra

small dark or skin-colored bumps on the face, neck, and upper torso; common in people with darker skin colors

dermis

the layer of skin below the epidermis connected to the epidermis by dermal papillae

desiccation

unintentional wound or tissue dehydration

diabetic neuropathy

nerve damage that causes numbing sensations

disseminated zoster

herpes zoster rash that affects three or more dermatomes

eccrine gland

located over the skin entirely, secrete sweat, and aid in thermoregulation

ecthyma (also, deep impetigo)

a skin infection that occurs deep inside the skin characterized by shallow, small ulcers that look punched out and may contain pus

eczema (also, atopic dermatitis)

rash characterized by itchy, chronic inflammation of the upper skin layers; associated with a heightened immune response

edema

swelling caused by excessive buildup of fluid in tissue spaces or a body cavity

emollients

ingredients that soothe skin dryness

enzymatic debridement

applying commercially prepared enzymes that accelerate the body’s autolytic process (cell breakdown by enzymes contained in the affected tissue)

epibole

rolled or curled-under wound edges that slow or stop the wound healing process

epidermis

the outermost layer of the skin consisting of epithelial cells

erythema

reddening of the skin

eschar

dead tissue that forms over healthy skin and then, over time, falls off or sheds

evisceration

protrusion of the viscera through the incision when the wound completely separates

excoriation

loss of the superficial layers of the skin, also known as a denuded area

filiform wart

long, small, narrow growth that appears on the lips, face, or eyelid

fistula

an abnormal passage from one internal organ or vessel to another or an internal organ or vessel to the outside of the body

flat wart

may appear in an area that is shaved or along a stretch mark

fluctuance

tense area of skin with a wavelike or boggy feeling on palpation

folliculitis

an infection of the skin follicle

friction

two surfaces rubbing against each other

genital wart (also, condyloma acuminata, venereal wart)

occurs on the vagina, vulva, cervix, and penis

granulation tissue

delicate, new reddish connective tissue and tiny blood vessels that bleed easily but provide the framework for scar tissue development

hematoma

localized collection of blood under the skin that may appear reddish blue with swelling

hemostasis

cessation of bleeding

herpes simplex

viral infection that can cause painful blisters or ulcers

herpes zoster (also, shingles)

maculopapular rash associated with shingles; most often appears on the trunk of the body along a thoracic dermatome

hydroxylation

the chemical process in which a hydroxyl group (-OH) is introduced into an organic compound

hyperpigmentation

darkened patches of skin (liver spots)

hypodermis

the subcutaneous fatty layer beneath the dermis that anchors the dermis to the underlying tissues of the body

hypopigmentation

lighter patches of skin (age spots)

hypoproteinemia

abnormally low amounts of serum protein from the diet

impetigo

highly contagious bacterial skin infection that forms pustules and yellow crusty sores

incision

a surgical cut made in skin or flesh

intentional wound

a planned wound; the result of a treatment or therapy

keloid

a thick fibrous scar caused by excessive collagen formation in response to trauma or a surgical incision

keratin

fibrous water-repellant protein gives the epidermis its strong, protective quality

keratinization

a thickening of plasma membranes of a cell

keratinocyte

cell that produces keratin

laceration

deep cut or tear in the skin or flesh

Langerhans cell

antigen-processing cell that determines the appropriate response to, for example, inflammation, or tolerance of a foreign substance

localized wound healing factors

affects wound healing directly (desiccation, maceration, trauma, pressure, excessive bleeding and edema, infection)

maceration

softening of tissues caused by prolonged wetting or soaking

malignant melanoma

the most dangerous type of skin cancer that originates in the melanocytes

mechanical debridement

applies external physical force to remove debris or necrotic tissue

melanin

dark brown to black pigment protects the keratinocytes and nerve endings from ultraviolet light damage that appears in the skin and hair

melanocyte

cell that produces melanin and keratinocyte

Merkel cell

found in the stratum basale and serves as a sensory receptor for light touch

mitotic activity

the degree in which a population of cells proliferates

Mohs procedure

layers of the skin are removed and examined for cancer cells until no signs of cancer remain

Montgomery straps

ties that attach to an adhesive backing that holds a dressing in place

mosaic wart

wart that grows in a cluster

nonbullous impetigo

type of impetigo that has pustules that rapidly break down and form thick adherent honey-colored crusts on the face and extremities

NPO

nothing by mouth

open wound

a break in the skin or mucous membranes caused either intentionally or unintentionally

palmar wart

wart on the palm of the hand

papillary layer

thin, dermal layer of the dermis composed of loose connective tissue, which contacts the epidermis

parasite

an organism that lives in or on an organism of a different species and depends on the host for nutrients

pediculosis

lice infestation

pediculosis capitis

lice infestation of the scalp

pediculosis corporis

lice infestation of the body

pediculosis pubis

lice infestation of the hairs of the anal and genital areas but can also infest the thigh, chest, and facial hair

penetration

wound caused by an object that pierces the skin and lacerates or damages adjacent tissue

perspiration

(sweat) excess water and salts that are eliminated from the body via sweat glands

phagocytosis

occurs as leukocytes and macrophages move into the interstitial space to ingest bacteria and cellular debris

photodynamic therapy

using lasers and chemicals on the skin

pimple

has a small area of red skin and can be painful or cause discomfort

pityriasis

any of various skin conditions characterized by dry scaling patches of skin

plantar wart

wart on the sole of the foot

post-inflammatory hyperpigmentation

temporary pigmentation that occurs after an injury or inflammatory skin condition, most commonly seen in people with darker skin types

pressure injury

a localized ischemic lesion of the skin and underlying tissue caused by external pressure that impairs blood and lymph flow

primary intention healing

type of healing in which the wound edges have been approximated with little to no tissue loss and show formation of nominal granulation tissue and scarring

prodromal state

period between the appearance of initial symptoms and the full development of an illness causing headache, malaise, chills, or photophobia

pruritis

itching

psoriasis

a recurring, chronic skin condition that causes one or more raised areas of red skin patches with silvery scales and a distinct border

puncture

wound made by a pointed object

pustule

similar to a pimple but contains white or yellow pus

Raynaud syndrome

a condition that causes pale or blue fingers with cold exposure

reticular layer

thick, dermal layer of the dermis that consists of dense connective tissue and collagen bundles and houses most of the sweat glands, sebaceous glands, hair follicles, hair, muscles, blood vessels, and deep sensory neurons

scabies

contagious skin infestations caused by a burrowing mite

sebaceous gland

secretes sebum, an oily substance that makes the hair and skin waterproof

seborrheic dermatitis

inflammatory skin reaction primarily on the scalp and face

secondary intention healing

healing process of extensive wounds that have significant tissue loss making approximating edges difficult or not a good option

shear

when one tissue layer slides over the other

slough

a nonviable layer of dead tissue that is stringy, moist, and yellow, tan, gray, green, or brown in color

squamous cell carcinoma

the second most common type of skin cancer that generally develops on sun-exposed areas but can grow where sun exposure is limited

stable eschar

area of eschar on the skin that is adherent, dry, and intact without fluctuance

stratum basale

(stratum germinativum) deepest layer of the epidermis that contains melanocytes and keratinocytes

stratum corneum

thickest and outermost layer of the epidermis that secretes defensins as part of the body’s first immune defense

stratum granulosum

layer above the stratum spinosum that contains a glycolipid, which slows water loss across the epidermis

stratum lucidum

layer of skin only found in thick areas like the soles of the feet and palms of hands

stratum spinosum

layer above the stratum basale; contains cytoplasmic processes (spines) that extend outward and contact neighboring cells

subcutaneous tissue

the subcutaneous fatty layer (hypodermis) beneath the dermis that separates the skin from the underlying tissue

superinfection

secondary infection that is unrelated to the original infection and results from opportunistic colonization after immunosuppression

systemic lupus erythematosus (SLE)

a chronic autoimmune inflammatory disorder involving connective tissues of the joints, skin, kidneys, mucous membranes, and blood vessel walls

systemic wound healing factors

occurs throughout the body and is not related to the wound itself (e.g., age, venous insufficiency, poor oxygenation, obesity, diabetes, medications, smoking or alcohol use)

telangiectasia

red mark on the skin caused by the widening of shallow blood vessels

tenting

the skin does not snap back when pinched; instead, it maintains a tentlike shape, which may indicate dehydration

tertiary intention healing

delayed primary intention where the wound is left open for three to five days to allow edema or infection to resolve or to let any exudate to drain

tinea (also, ringworm)

may be found on the feet, beard, body, groin, scalp, or toes

tinea barbae (also, beard ringworm)

fungal infection of the beard

tinea capitis

fungal infection of the scalp

tinea corporis

fungal skin infection of the arms, trunk, legs, and face

tinea cruris

fungal infection of the groin

tinea pedis (also, athlete’s foot)

fungal infection of the feet

tinea unguium (also, onychomycosis)

fungal infection of the toenail or fingernail

transdermal administration

placed on the skin and absorbed either locally or systemically

ulcer

open sore caused by poor blood flow

unintentional wound

a wound from an unexpected trauma

urticaria (also, hives)

rash of raised, swollen, flesh-colored or red bumps or welts on the skin

varicella (also, chickenpox)

caused by the varicella-zoster virus

venous insufficiency

failure of the veins to adequately circulate the blood, especially from the lower extremities

verruca (also, warts)

raised or flat growths caused by the viral infection human papillomavirus

vesicles

small blisters

vitiligo

chronic autoimmune disorder that causes partial or total loss of skin color in patches

whitehead

flesh-colored small bump that does not have a dark center

wound

an injury that causes a disruption of normal skin or tissue integrity

xerosis

skin dryness