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A first-degree abrasion involves only epidermal injury. A second-degree abrasion involves the epidermis as well as the dermis and may bleed slightly. A third-degree abrasion involves damage to the subcutaneous layer and the skin and is often called an avulsion .
Excoriation: A punctate or linear abrasion produced by mechanical means (often scratching), usually involving only the epidermis, but commonly reaching the papillary dermis. [ 30 ] [ 33 ] Ulcer : An ulcer is a discontinuity of the skin exhibiting complete loss of the epidermis and often portions of the dermis.
The midwife (or obstetrician) supports the perineal tissue with one hand as soon as the head stretches. The other hand rests on the baby's head and regulates its speed of passage (so-called head brake). At the same time, the woman giving birth is guided to push along slowly and in a well-dosed manner.
The dermis is the layer of skin between the epidermis and subcutaneous tissue, and comprises two sections, the papillary dermis and the reticular dermis. [10] The superficial papillary dermis interdigitates with the overlying rete ridges of the epidermis, between which the two layers interact through the basement membrane zone. [ 10 ]
However, due to the stigma associated with chronic scratching, some patients will not admit to chronic rubbing or abrasion. The skin may become thickened and hyperpigmented (lichenified) as a direct result of chronic excoriation. [3] Typically this period of increased scratching is associated with stressors.
There have been many different theories regarding the causes of excoriation disorder, including biological and environmental factors. [10]A common hypothesis is that excoriation disorder is often a coping mechanism to deal with elevated levels of turmoil, boredom, anxiety, or stress within the individual, and that the individual has an impaired stress response.
Timing is important to wound healing. Critically, the timing of wound re-epithelialization can decide the outcome of the healing. [11] If the epithelization of tissue over a denuded area is slow, a scar will form over many weeks, or months; [12] [13] If the epithelization of a wounded area is fast, the healing will result in regeneration.
Venous leg ulcers due to impaired circulation or a blood flow disorder are more common in the elderly. Rare causes of skin ulcers include pyoderma gangraenosum, lesions caused by Crohn's disease or ulcerative colitis, granulomatosis with polyangiitis, morbus Behçet and infections that are usually seen in those who are immunocompromised, for ...