Integumentary

Past 20% of the body surface, a burn stops being a skin wound and becomes a whole-body illness — leak, shock, and an airway that can close overnight.

Sustained pressure closes capillaries and tissue dies from the inside out — a staged, largely preventable injury the nurse owns.

Four phases with real timelines, and every factor that impairs healing attacks one of them. The scar never exceeds 80% of the original strength, the wound is weakest around postoperative day 5 to 8, and that timing is the whole reason dehiscence happens when it does.

The same doorway, three destinations. A break in the skin lets bacteria into the dermis, and what follows is either a treatable cellulitis, a fascial infection that is destroying tissue faster than the skin shows it, or a superantigen-driven shock. The middle one is the one that gets missed.

The most common cancers of all — basal and squamous cell carcinomas that are usually cured by removing them, and melanoma, rarer but responsible for most skin-cancer deaths. Ultraviolet damage drives all three, so recognition (the ABCDEs, a sore that won’t heal) and sun protection are the nursing core.

Three chronic, non-contagious inflammatory skin diseases — psoriasis (T cells drive skin cells to multiply too fast), atopic dermatitis (a leaky skin barrier and an itch–scratch cycle) and contact dermatitis (irritant or allergic) — with topical corticosteroids as the shared tool and their limits as the nursing core.

Reactivated varicella-zoster virus travels down one sensory nerve and erupts as a painful, one-sided, dermatomal band of blisters. Start antivirals early (ideally within 72 hours), match precautions to the host and extent, treat any face or eye involvement as urgent, and watch for postherpetic neuralgia — pain that outlasts the rash. Two doses of Shingrix help prevent shingles and its complications.

A rare, life-threatening, mostly drug-triggered reaction in which cytotoxic T cells kill the epidermis and mucous membranes — painful dusky rash, blisters, sheets of peeling skin and mouth, eye and genital erosions. Stop the culprit drug at once, give burn-unit/ICU-level supportive care, protect the eyes, and never re-challenge.