Skin diseases due to mechanical and thermal causes

Pressure blister (epidermolysis bullosa traumatica, traumatic bulla)
A blister on the non-inflamed underlying skin at the site of pressure

Clinical image
After manual hand activity, new shoes, long walking, orthopedic defects, blister solit.x multiple, firm covering, sometimes hemorrhagic contents, surrounding normal color

Therapy
Wipe over with disinfectant, puncture, tape over.

Callus (tyloma, casus)
Focal hyperkeratosis induced by mechanical stress, a defensive reaction

Clinical image
Most commonly hands, feet, indistinctly circumscribed stiff slightly raised papule, surface mostly rough, peeling, sometimes painful cracks, sometimes professionally (fingers of violinists)

Differential diagnosis
Clavus, keratoma palmare, jantare

Therapy
Softening ointments with salicylic acid or urea, removing the mech.action

Corn (clavus)
Painful focal hyperkeratosis over articular or bony prominences, especially in orthopaedic defects (e.g. hallux valgus)

Pathogenesis
Prolonged concentrated pressure against a firm base - the corner taper pin sometimes extends to the painful periosteum.

Clinical image
Circular, yellowish lesion, raised, sharply demarcated, sometimes with an indentation in the middle, very painful when walking!

Diferencial diagnosis
Pressure blister, veruka

Diagnosis
Histology - parakeratosis, hyperkeratosis at margins; mostly typical appearance

Therapy
Sometimes difficult, change of shoes, keratolytic ointment

Decubitus
Pressure-related ischaemic necrosis - first erythema with maceration - then areas of dry necrosis and ulceration - extends to adipose tissue and muscle

Therapy
Methods of moist wound healing, collaboration with surgeon, systematic nursing care

Tattoo
Traumatic x decorative - there may be infectious complications, especially pyodermia

Irritation (intertrigo)

 * Mechanical friction of skin against skin + chemical influences (sweat) at the site of skin folds
 * Sharply demarcated red, swollen areas, sore, burning
 * Mostly obese persons - often secondary bacterial and yeast infection

Frostbite (congelatio)
Prone people with blood circulation disorders, acral areas affected - hands, feet, earlobes, tip of nose,...


 * 1) degree - whitening and then redness of the skin - severe soreness
 * 2) degree - hemorrhagic blisters
 * 3) degree - necrosis

Therapy
Surgery

Related articles

 * Injury by low temperature

Chilblains (perniones)
Skin changes caused by cold - especially skin of the hands - impaired blood circulation, acrocyanosis, increased sweating contribute to the appearance; more common in women

Clinical image

 * elevated maculopapules - light red in warmth, reddish blue in cold
 * itching, burning to pain - especially in warmth and with temperature changes
 * at summer without problems, recurring as autumn approaches

Therapy
Vasodilators (pentoxifylline), staying warm

Prognosis
A chronic illness with winter relapses

Related articles

 * Injury by low temperature

Burns (combustio)
A burn injury is damage to the skin from heat (scalding, contact with a heat source or fire), chemicals, electricity or radiation. In children, it is most often heat damage to the skin. In more serious cases, burn disease develops, threatening the patient's life initially with burn shock and later with sepsis.

Degrees of burns

 * 1) degree - erythema
 * 2) degree - subepidermal blisters
 * 3) degree - superficial necrosis

Therapy
Immediately cool down, corticoid ointment in small degree, in bigger degree system corticoids for a short time, otherwise surgery

Similar to cauterisation (cauterisatio) - worse with lye - collapsing necrosis

Related articles

 * Burn injury

Erythema ab igne
Radiant heat (ab igne = from fire) - electric blankets, sitting by the fireplace; reticular erythema, turning into brown hyperpigmentation - thermal melanosis.

The finding is one of the precancers!!!

Related articles

 * Burn injury

Acute radiodermatitis
A skin disease resulting from exposure to ionizing radiation. In the acute form, redness, swelling, and in more severe cases, blisters appear.

Degrees of radiation exposure
3-12 days after exposure (at least 7Gy)


 * 1) degree - dry skin with hair loss
 * 2) degree - redness blistering
 * 3) degree - radiation ulcer - very painful, slow to heal

Therapy
Emolients + local corticosteroids

Chronic radiodermatitis
The chronic form is characterized by atrophy of the skin, its easy wounding with poorly healing ulcers.

Clinical image
Poikilodermia'' - a circumscribed area of atrophic skin with prominent vascular pattern, sclerotization of connective tissue at high doses, skin easily damaged - poorly healing ulcers

Terapie
Emolients + on the ulcer epithelizing ointments with vitamins or hydrocolloids; must be monitored for the possibility of carcinoma

Related articles

 * Deterministic effect of ionizing radiation