Medical Surgical Nursing

(Tina Sui) #1

Chapter 56


Management of Patients with Dermatologic Problems


Primary Skin Lesions



  • Macule, Patch: Flat, nonpalpable skin color change (color may be brown, white, tan,


purple, red)



  • Macule: <1 cm, circumscribed border

  • Patch: >1 cm, may have irregular border

  • Papule, Plaque: Elevated, palpable, solid mass Circumscribed border

  • Papule: <0.5 cm

  • Plaque: >0.5 cm

  • Nodule, Tumor: Elevated, palpable, solid mass. Extends deeper into the dermis than


a papule



  • Nodule: 0.5–2 cm; circumscribed

  • Tumor: >1–2 cm; tumors do not always have sharp borders

  • Vesicle, Bulla: Circumscribed, elevated, palpable mass containing serous fluid

  • Vesicle: <0.5 cm

  • Bulla: >0.5 cm

  • Pustule: Pus-filled vesicle or bulla


Bacterial Skin Infections/Impetigo



  • Caused by staphylococci, streptococci, or multiple bacteria.

  • Face, hands, neck, and extremities are most frequently involved

  • It is contagious and may spread to other parts of the patient's skin or to other members


of the family who touch the patient or use towels or combs that are soiled with the


exudate of the lesions.



  • Starts as red macules, changed to thin-walled vesicles that rupture and become


covered with a loosely adherent honey-yellow crust

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