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In a major injury, if epithelial cell migration and tissue contraction cannot cover the wound, suturing the edges of the injured skin together, or even replacement of lost skin with skin grafts, may be required to restore the skin. As epithelial cells continue to migrate around the scab, the dermis is repaired by the activity of stem cells.
A wound is any disruption of or damage to living tissue, such as skin, mucous membranes, or organs. [1] [2] Wounds can either be the sudden result of direct trauma (mechanical, thermal, chemical), or can develop slowly over time due to underlying disease processes such as diabetes mellitus, venous/arterial insufficiency, or immunologic disease. [3]
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.
Hyperpigmentation is excess coloration, or darkening of the skin, [8] while hypopigmentation is a diminished or pallid coloring to the skin. Pigmentation changes in PVA, apparent in the epidermal (outermost) skin layer, may be attributed to incontinence (leaking out) of melanin from melanocytes into the dermal skin layer below. [5]
Fissure is a lesion in the skin that is usually narrow but deep. [29] [33] Induration is dermal thickening causing the cutaneous surface to feel thicker and firmer. [29] Atrophy refers to a loss of skin, and can be epidermal, dermal, or subcutaneous. [30] With epidermal atrophy, the skin appears thin, translucent, and wrinkled. [29]
Shearing is a separation of the skin from underlying tissues. When a patient is partially sitting up in bed, skin may stick to the sheet, making the skin susceptible to shearing in case underlying tissues move downward with the body toward the foot of the bed. This may also be possible on a patient who slides down while sitting in a chair.
A dermatofibroma, or benign fibrous histiocytomas, is a benign nodule in the skin, typically on the legs, elbows or chest of an adult. [3] It is usually painless. [3] It usually ranges from 0.2cm to 2cm in size but larger examples have been reported. [3] It typically results from mild trauma such as an insect bite. [3]
In cases of short duration, there may be small blisters, while in long-term cases the skin may become thickened. [1] The area of skin involved can vary from small to covering the entire body. [1] [2] Dermatitis is also called eczema but the same term is often used for the most common type of skin inflammation, atopic dermatitis. [7]