ππ©Ί Anatomy and Physiology of the Integumentary System
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
β Introduction / Definition
The Integumentary System is the bodyβs first line of defense, comprising the skin, hair, nails, sebaceous glands, and sweat glands. It plays a critical role in protecting internal organs, regulating body temperature, and providing sensory information.
β βThe integumentary system is the protective covering of the body, essential for defense, thermoregulation, excretion, and sensory perception.β
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
The skin is the largest organ of the body and forms a protective barrier against environmental hazards. It is composed of three primary layers: Epidermis, Dermis, and Hypodermis (Subcutaneous Tissue).
β βThe skinβs layered structure ensures protection, thermoregulation, sensation, and synthesis of essential substances like Vitamin D.β
| Sub-layers of Epidermis (From Deep to Superficial) |
| 1. Stratum Basale (Germinativum) β Active cell division and melanin production. |
| 2. Stratum Spinosum β Provides strength and flexibility. |
| 3. Stratum Granulosum β Initiates keratinization. |
| 4. Stratum Lucidum β Present only in thick skin (palms and soles). |
| 5. Stratum Corneum β Outermost layer; composed of dead keratinized cells for protection. |
| Layer | Primary Functions |
| Epidermis | Protection against pathogens, UV rays; barrier function. |
| Dermis | Sensation, thermoregulation, housing skin appendages. |
| Hypodermis | Insulation, shock absorption, energy storage. |
Q1. Which layer of the skin contains blood vessels and nerve endings?
π
°οΈ Epidermis
β
π
±οΈ Dermis
π
²οΈ Hypodermis
π
³οΈ Stratum Corneum
Q2. Which layer of the epidermis is responsible for active cell division?
π
°οΈ Stratum Corneum
β
π
±οΈ Stratum Basale
π
²οΈ Stratum Lucidum
π
³οΈ Stratum Spinosum
Q3. The hypodermis primarily consists of which tissue?
π
°οΈ Dense Connective Tissue
π
±οΈ Stratified Epithelium
β
π
²οΈ Adipose Tissue
π
³οΈ Muscle Tissue
Q4. Which layer of skin is responsible for Vitamin D synthesis?
π
°οΈ Dermis
β
π
±οΈ Epidermis
π
²οΈ Hypodermis
π
³οΈ Subcutaneous Layer
Q5. Which sublayer is present only in the thick skin of palms and soles?
π
°οΈ Stratum Spinosum
π
±οΈ Stratum Basale
β
π
²οΈ Stratum Lucidum
π
³οΈ Stratum Granulosum
ππ©Ί Functions of the Skin
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
β I. Introduction / Definition
The skin is the largest and most versatile organ of the human body, forming the bodyβs outer protective covering. It performs multiple vital functions necessary for survival, including protection, sensation, thermoregulation, and synthesis of essential nutrients.
β βThe skin is a multifunctional organ that provides protection, regulates body temperature, enables sensory perception, and participates in metabolic functions such as Vitamin D synthesis.β
π II. Primary Functions of the Skin
| Function | Description |
| π‘ Protection | Acts as a physical barrier against pathogens, UV radiation, chemicals, and mechanical injuries. |
| π‘ Thermoregulation | Maintains body temperature through sweating, vasodilation (heat loss), and vasoconstriction (heat conservation). |
| π‘ Sensory Perception | Contains nerve endings that detect touch, pressure, temperature, and pain. |
| π§ Excretion | Excretes waste products like urea, salts, and water through sweat glands. |
| π Vitamin D Synthesis | Converts 7-dehydrocholesterol to Vitamin D under UV light exposure, essential for calcium metabolism. |
| π Barrier to Water Loss | Prevents dehydration by controlling transepidermal water loss. |
| π¦ Immune Defense | Langerhans cells in the epidermis participate in immune surveillance and response. |
| β¨ Aesthetic & Social Functions | Skin appearance plays a role in personal identity and social interaction. |
π III. Specialized Glandular Functions
| Gland | Function |
| Sebaceous Glands | Produce sebum to lubricate skin and hair, preventing dryness. |
| Sweat Glands (Eccrine) | Help in thermoregulation and excrete waste. |
| Apocrine Glands | Located in axilla and groin; responsible for body odor after puberty. |
π VI. Nurseβs Role
π Golden One-Liners for Quick Revision:
β Top 5 MCQs for Practice
Q1. Which function of the skin is responsible for maintaining body temperature?
π
°οΈ Protection
π
±οΈ Excretion
β
π
²οΈ Thermoregulation
π
³οΈ Sensation
Q2. Which cells in the skin are responsible for immune defense?
π
°οΈ Melanocytes
β
π
±οΈ Langerhans Cells
π
²οΈ Keratinocytes
π
³οΈ Merkel Cells
Q3. What is the primary function of sebaceous glands?
π
°οΈ Excrete sweat
β
π
±οΈ Produce sebum to lubricate skin and hair
π
²οΈ Synthesize Vitamin D
π
³οΈ Filter blood
Q4. Which vitamin is synthesized by the skin under UV light?
π
°οΈ Vitamin A
π
±οΈ Vitamin C
β
π
²οΈ Vitamin D
π
³οΈ Vitamin K
Q5. Excessive water loss through damaged skin is primarily due to the loss of which function?
π
°οΈ Immune defense
β
π
±οΈ Barrier to Water Loss
π
²οΈ Sensory perception
π
³οΈ Vitamin synthesis
Hair is a filamentous structure composed mainly of the protein keratin, originating from the hair follicles located in the dermis layer of the skin. Hair plays roles in protection, temperature regulation, and enhancing sensory perception.
β βHair is a keratinized structure arising from follicles in the dermis, serving protective, sensory, and thermoregulatory functions.β
| Part of Hair | Description |
| Hair Shaft | Visible part of hair above the skin surface; composed of dead keratinized cells. |
| Hair Root | Embedded in the skin within the follicle. |
| Hair Follicle | Surrounds the root; contains the living cells that produce hair. |
| Hair Bulb | Enlarged base of the follicle where cells actively divide (matrix). |
| Dermal Papilla | Provides nutrients and oxygen to growing hair via capillaries. |
| Layer | Function |
| Medulla | Central core; contains soft keratin. |
| Cortex | Provides strength and color (contains melanin). |
| Cuticle | Outer protective layer; made of overlapping cells. |
| Function | Description |
| Protection | Protects the scalp from UV radiation and injury; eyelashes and eyebrows protect the eyes. |
| Temperature Regulation | Helps retain heat; piloerection (goosebumps) reduces heat loss. |
| Sensory Perception | Hair follicles contain nerve endings that detect touch and movement. |
| Aesthetic and Social Role | Hair contributes to appearance and self-esteem. |
| Type | Description |
| Lanugo Hair | Fine, soft hair covering the fetus. |
| Vellus Hair | Soft, light-colored hair covering most of the body. |
| Terminal Hair | Thick, coarse, pigmented hair (e.g., scalp, eyebrows, pubic area). |
| Phase | Duration | Description |
| Anagen (Growth Phase) | 2β6 years | Active hair growth; longest phase. |
| Catagen (Transition Phase) | 2β3 weeks | Hair follicle shrinks; growth stops. |
| Telogen (Resting Phase) | 2β3 months | Hair falls out; new hair begins to grow. |
| Condition | Description |
| Alopecia | Hair loss due to genetics, hormonal imbalance, or disease. |
| Hirsutism | Excessive hair growth in females due to hormonal imbalance. |
| Trichotillomania | Psychological disorder involving compulsive hair pulling. |
| Dandruff (Seborrheic Dermatitis) | Flaking of the scalp due to fungal infection or dry skin. |
| Folliculitis | Inflammation or infection of hair follicles. |
Q1. Which part of the hair contains actively dividing cells for hair growth?
π
°οΈ Hair Shaft
π
±οΈ Hair Cuticle
β
π
²οΈ Hair Bulb
π
³οΈ Dermal Papilla
Q2. Which phase of the hair growth cycle is known as the resting phase?
π
°οΈ Anagen
π
±οΈ Catagen
β
π
²οΈ Telogen
π
³οΈ Exogen
Q3. Which hormone imbalance often leads to excessive hair growth in females?
π
°οΈ Estrogen
π
±οΈ Progesterone
β
π
²οΈ Androgen
π
³οΈ Insulin
Q4. What is the outermost protective layer of the hair shaft called?
π
°οΈ Cortex
π
±οΈ Medulla
β
π
²οΈ Cuticle
π
³οΈ Follicle
Q5. What is the clinical term for compulsive hair pulling?
π
°οΈ Hirsutism
π
±οΈ Alopecia
β
π
²οΈ Trichotillomania
π
³οΈ Dandruff
ππ©Ί Nail
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
β I. Introduction / Definition
Nails are hard, keratinized structures located at the distal end of fingers and toes. They protect the tips of digits, enhance fine motor skills, and reflect the bodyβs overall health status.
β βNails are protective keratinized plates that cover the dorsal surface of the fingers and toes, assisting in defense, sensation, and manipulation of objects.β
π II. Anatomy and Structure of the Nail
| Part of Nail | Description |
| Nail Plate | Visible hard part of the nail composed of keratin. |
| Nail Bed | Skin beneath the nail plate, rich in blood vessels, gives the nail its pink color. |
| Nail Matrix | Located under the proximal nail fold; responsible for nail growth. |
| Lunula | Crescent-shaped whitish area at the base of the nail plate (visible part of the matrix). |
| Cuticle (Eponychium) | Thin layer of skin that protects the nail matrix from infection. |
| Hyponychium | Area under the free edge of the nail; acts as a barrier to pathogens. |
π III. Functions of the Nail
| Function | Description |
| Protection | Protects the distal phalanx and fingertip from trauma. |
| Sensory Enhancement | Enhances touch sensation and precision during tasks. |
| Aesthetic Role | Contributes to physical appearance and personal grooming. |
| Health Indicator | Changes in nail appearance can indicate systemic diseases. |
π IV. Nail Growth and Physiology
π V. Clinical Significance
| Condition | Description |
| Clubbing | Bulbous enlargement of fingertips; associated with chronic hypoxia (e.g., lung diseases). |
| Koilonychia (Spoon Nails) | Concave-shaped nails seen in iron deficiency anemia. |
| Onychomycosis | Fungal infection of the nails. |
| Paronychia | Infection of the nail fold. |
| Beauβs Lines | Transverse depressions in nails; associated with severe illness or malnutrition. |
| Leukonychia | White spots or lines on nails due to trauma or zinc deficiency. |
π VI. Diagnostic Evaluation
| Test | Purpose |
| Physical Examination | Identifies changes in nail color, shape, and texture. |
| Fungal Culture | Diagnoses fungal nail infections. |
| Biopsy of Nail Bed | Evaluates suspicious nail lesions (e.g., melanoma). |
| Blood Tests | Check for nutritional deficiencies or systemic diseases affecting nail health. |
π VII. Nurseβs Role
π Golden One-Liners for Quick Revision:
β Top 5 MCQs for Practice
Q1. Which part of the nail is responsible for its growth?
π
°οΈ Nail Bed
π
±οΈ Hyponychium
β
π
²οΈ Nail Matrix
π
³οΈ Cuticle
Q2. What is the clinical term for fungal infection of the nails?
π
°οΈ Paronychia
π
±οΈ Onycholysis
β
π
²οΈ Onychomycosis
π
³οΈ Leukonychia
Q3. Which nail change is typically seen in iron deficiency anemia?
π
°οΈ Clubbing
β
π
±οΈ Koilonychia
π
²οΈ Beauβs Lines
π
³οΈ Pitting
Q4. What does the presence of Beauβs lines on the nails suggest?
π
°οΈ Fungal Infection
π
±οΈ Trauma
β
π
²οΈ Severe Illness or Malnutrition
π
³οΈ Vitamin D Deficiency
Q5. Which of the following is a sign of chronic hypoxia?
π
°οΈ Koilonychia
π
±οΈ Onychomycosis
β
π
²οΈ Clubbing
π
³οΈ Leukonychia
ππ©Ί Sweat Glands and Sebaceous Gland
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
β I. Introduction / Definition
Sweat Glands are exocrine glands responsible for the secretion of sweat, aiding in thermoregulation and waste excretion.
Sebaceous Glands are exocrine glands that secrete sebum, an oily substance that lubricates and waterproofs the skin and hair.
π II. Types of Sweat Glands
π’ 1. Eccrine Glands
| Feature | Details |
| Location | Widely distributed across the body, especially on the palms, soles, and forehead. |
| Secretion | Watery, odorless sweat composed mainly of water, salts, and urea. |
| Duct Opening | Directly onto the surface of the skin. |
| Function | Primary role in thermoregulation and excretion of waste. |
| Activation | Active from birth; controlled by the sympathetic nervous system. |
π’ 2. Apocrine Glands
| Feature | Details |
| Location | Found in axillary (underarms), areolar (breast), perianal, and genital areas. |
| Secretion | Thick, milky, protein-rich sweat that becomes odorous after bacterial action. |
| Duct Opening | Into hair follicles. |
| Function | Plays a role in pheromone release and emotional sweating. |
| Activation | Becomes active after puberty under hormonal influence. |
π III. Sebaceous Glands
| Feature | Details |
| Location | Found all over the body except the palms and soles; abundant on scalp, face, and upper back. |
| Secretion | Sebum (oily substance containing lipids and cellular debris). |
| Duct Opening | Opens into hair follicles. |
| Function | Lubricates and waterproofs skin and hair; has mild antibacterial properties. |
| Activation | Stimulated by androgens; active during puberty. |
π IV. Functions of These Glands
| Gland | Primary Functions |
| Eccrine Gland | Thermoregulation and waste excretion. |
| Apocrine Gland | Emotional sweating, pheromone release, and social signaling. |
| Sebaceous Gland | Lubrication of skin and hair; prevents drying and has protective antibacterial action. |
π V. Clinical Significance
| Condition | Associated Gland |
| Hyperhidrosis | Eccrine glands (excessive sweating). |
| Anhidrosis | Eccrine glands (lack of sweating). |
| Bromhidrosis | Apocrine glands (foul body odor). |
| Acne Vulgaris | Sebaceous glands (blocked and infected follicles). |
| Sebaceous Cysts | Blocked sebaceous glands forming cysts. |
π VI. Nurseβs Role
π Golden One-Liners for Quick Revision:
β Top 5 MCQs for Practice
Q1. Which sweat glands are widely distributed and responsible for thermoregulation?
π
°οΈ Apocrine Glands
β
π
±οΈ Eccrine Glands
π
²οΈ Sebaceous Glands
π
³οΈ Mammary Glands
Q2. Which glands are responsible for body odor after puberty?
π
°οΈ Eccrine Glands
β
π
±οΈ Apocrine Glands
π
²οΈ Sebaceous Glands
π
³οΈ Lacrimal Glands
Q3. Sebum is secreted by which gland?
π
°οΈ Sweat Gland
β
π
±οΈ Sebaceous Gland
π
²οΈ Endocrine Gland
π
³οΈ Salivary Gland
Q4. Which condition is associated with overactivity of sebaceous glands?
π
°οΈ Hyperhidrosis
π
±οΈ Bromhidrosis
β
π
²οΈ Acne Vulgaris
π
³οΈ Seborrhea
Q5. Which sweat glands become active at puberty?
π
°οΈ Eccrine Glands
β
π
±οΈ Apocrine Glands
π
²οΈ Sebaceous Glands
π
³οΈ Endocrine Glands
ππ©Ί Diagnostic Tests of the Integumentary System
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
β I. Introduction / Definition
Diagnostic tests of the integumentary system help in the identification of skin diseases, infections, malignancies, allergies, and systemic disorders reflected through skin changes.
β βIntegumentary diagnostic tests are performed to assess skin integrity, diagnose infections, detect allergies, and identify malignant lesions.β
π II. Common Diagnostic Tests
| Test Name | Purpose / Indication |
| Skin Biopsy | Diagnoses skin cancers, chronic skin conditions like psoriasis, eczema, lupus. |
| Patch Test | Detects allergic contact dermatitis by applying allergens to the skin. |
| Skin Prick Test | Diagnoses immediate hypersensitivity reactions (e.g., food, pollen allergies). |
| Woodβs Lamp Examination | Detects fungal infections, pigmentary disorders like vitiligo under UV light. |
| Tzanck Smear | Used for diagnosing Herpes Simplex and Varicella-Zoster infections. |
| KOH Preparation | Identifies fungal infections (e.g., dermatophytosis) by examining skin scrapings. |
| Gram Stain / Culture & Sensitivity | Diagnoses bacterial skin infections and determines effective antibiotics. |
| Dermoscopy (Trichoscopy) | Examines moles, skin lesions, and scalp conditions in detail using a dermoscope. |
| Nail and Hair Analysis | Detects deficiencies, fungal infections, and systemic diseases. |
π III. Advanced Diagnostic Imaging
| Test Name | Purpose |
| CT Scan / MRI | Evaluates deep skin tumors or metastasis. |
| PET Scan | Identifies metastasis of skin cancers like melanoma. |
| Thermal Imaging | Assesses circulation and inflammation in the skin. |
π IV. Special Investigations
| Test Name | Purpose |
| Slit Skin Smear | Diagnostic test for Leprosy. |
| Sweat Chloride Test | Diagnoses Cystic Fibrosis (affecting sweat glands). |
| Skin Surface Biopsy | Evaluates skin parasites like scabies or demodex mites. |
π V. Nurseβs Role in Diagnostic Testing
π Golden One-Liners for Quick Revision:
β Top 5 MCQs for Practice
Q1. Which test is commonly used to diagnose fungal skin infections?
π
°οΈ Tzanck Smear
π
±οΈ Gram Stain
β
π
²οΈ KOH Preparation
π
³οΈ Patch Test
Q2. Which diagnostic tool uses ultraviolet light to detect skin conditions?
π
°οΈ Dermoscopy
β
π
±οΈ Woodβs Lamp
π
²οΈ MRI
π
³οΈ PET Scan
Q3. What is the confirmatory test for contact dermatitis?
π
°οΈ Tzanck Smear
π
±οΈ Skin Prick Test
β
π
²οΈ Patch Test
π
³οΈ Slit Skin Smear
Q4. Which test is used to detect Herpes Simplex Virus on the skin?
π
°οΈ KOH Test
β
π
±οΈ Tzanck Smear
π
²οΈ Patch Test
π
³οΈ Gram Stain
Q5. Which test is performed to diagnose leprosy?
π
°οΈ Gram Stain
π
±οΈ Tzanck Smear
β
π
²οΈ Slit Skin Smear
π
³οΈ Woodβs Lamp Examination
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
β βPrimary lesions represent the initial changes in skin pathology, while secondary lesions result from progression, healing, or manipulation of primary lesions.β
| Lesion Type | Characteristics | Examples |
| Macule | Flat, non-palpable, β€1 cm | Freckles, Measles. |
| Patch | Flat, non-palpable, >1 cm | Vitiligo, CafΓ©-au-lait spots. |
| Papule | Raised, solid, β€1 cm | Warts, Moles. |
| Plaque | Elevated, flat-topped, >1 cm | Psoriasis. |
| Nodule | Firm, deeper in dermis, >1 cm | Lipoma. |
| Tumor | Large mass, benign/malignant | Skin Cancer. |
| Vesicle | Fluid-filled, β€1 cm | Chickenpox, Herpes Simplex. |
| Bulla | Fluid-filled, >1 cm | Burns, Blisters. |
| Pustule | Pus-filled lesion | Acne, Impetigo. |
| Wheal | Transient, raised, edematous | Urticaria (Hives). |
| Cyst | Encapsulated fluid/semi-solid | Sebaceous Cyst. |
| Lesion Type | Characteristics | Examples |
| Scale | Flakes of dead epidermis | Psoriasis, Dandruff. |
| Crust | Dried exudate (serum, blood, pus) | Impetigo, Scab. |
| Fissure | Linear crack in the skin | Athleteβs Foot. |
| Erosion | Loss of superficial epidermis | After blister rupture. |
| Ulcer | Deep loss of skin tissue | Pressure Ulcer, Diabetic Ulcer. |
| Scar (Cicatrix) | Permanent fibrotic skin change | Healed wound scar. |
| Excoriation | Linear scratches from trauma | Eczema due to scratching. |
| Lichenification | Thickened skin from chronic scratching | Chronic Eczema. |
| Disorder | Associated Lesions |
| Chickenpox | Vesicles (Primary), Crusts (Secondary). |
| Psoriasis | Plaques and Scales. |
| Acne Vulgaris | Papules, Pustules, and Scars. |
| Eczema | Vesicles (Primary), Excoriation & Lichenification (Secondary). |
| Pressure Ulcers | Ulcers and Scars. |
Q1. Which of the following is a primary skin lesion?
π
°οΈ Scar
β
π
±οΈ Papule
π
²οΈ Scale
π
³οΈ Excoriation
Q2. What type of lesion is seen in chickenpox before rupture?
π
°οΈ Papule
π
±οΈ Pustule
β
π
²οΈ Vesicle
π
³οΈ Wheal
Q3. Which lesion is characterized by a deep loss of skin tissue?
π
°οΈ Erosion
π
±οΈ Excoriation
β
π
²οΈ Ulcer
π
³οΈ Scale
Q4. What is the clinical term for thickened skin due to chronic scratching?
π
°οΈ Erosion
π
±οΈ Scar
β
π
²οΈ Lichenification
π
³οΈ Wheal
Q5. Which of the following is an example of a secondary skin lesion?
π
°οΈ Macule
π
±οΈ Nodule
β
π
²οΈ Crust
π
³οΈ Tumor
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
Pruritus is the medical term for itching, a common uncomfortable sensation that provokes the desire to scratch. It may be a symptom of localized skin conditions or a sign of systemic diseases.
β βPruritus is an unpleasant skin sensation leading to a reflex desire to scratch.β
| Type | Description | Examples |
| Localized Pruritus | Limited to a specific area | Insect bites, Eczema. |
| Generalized Pruritus | Affects the entire body | Chronic kidney failure, Liver disease. |
| Pruritus with Skin Lesions | Accompanied by visible skin changes | Scabies, Psoriasis. |
| Pruritus without Skin Lesions | No visible lesions initially | Systemic diseases (e.g., Jaundice, Renal failure). |
| Category | Examples |
| Dermatological | Eczema, Psoriasis, Scabies, Fungal infections. |
| Systemic | Chronic renal failure, Liver disease (Cholestasis), Diabetes mellitus, Thyroid disorders. |
| Psychogenic | Anxiety, Stress, Depression. |
| Allergic | Food allergies, Drug reactions, Contact dermatitis. |
| Parasitic | Scabies, Lice infestation. |
| Test | Purpose |
| Complete Blood Count (CBC) | Rule out anemia or infection. |
| Liver and Renal Function Tests | Detect systemic causes (Jaundice, Uremia). |
| Thyroid Function Tests | Rule out hypothyroidism or hyperthyroidism. |
| Skin Scrapings and KOH Test | Diagnose fungal and parasitic infections. |
| Allergy Testing (Patch/Prick Test) | Identify allergens causing pruritus. |
Q1. Which mediator is primarily responsible for the itching sensation?
π
°οΈ Serotonin
π
±οΈ Dopamine
β
π
²οΈ Histamine
π
³οΈ Epinephrine
Q2. Which systemic condition is commonly associated with generalized pruritus?
π
°οΈ Migraine
π
±οΈ Hypertension
β
π
²οΈ Chronic Kidney Disease
π
³οΈ Myopia
Q3. Which topical agent provides soothing relief in pruritus?
π
°οΈ Betamethasone
π
±οΈ Mupirocin
β
π
²οΈ Calamine Lotion
π
³οΈ Ketoconazole
Q4. Which nerve fibers are mainly responsible for transmitting the itch sensation?
π
°οΈ A-delta fibers
π
±οΈ B fibers
β
π
²οΈ C-fibers
π
³οΈ Alpha fibers
Q5. What is the term for thickened, leathery skin resulting from chronic scratching?
π
°οΈ Erosion
π
±οΈ Excoriation
β
π
²οΈ Lichenification
π
³οΈ Crust
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
Dermatitis is a general term for inflammation of the skin, resulting in redness, swelling, itching, and often blistering or oozing lesions. It may be caused by external irritants, allergens, or underlying systemic conditions.
β βDermatitis is a non-contagious inflammatory condition of the skin characterized by redness, itching, and skin lesions.β
| Type | Description | Examples |
| Contact Dermatitis | Inflammation caused by direct contact with irritants or allergens. | Detergents, Nickel allergy. |
| Atopic Dermatitis | Chronic, hereditary eczema often associated with allergies. | Common in children. |
| Seborrheic Dermatitis | Inflammation in sebaceous gland-rich areas. | Dandruff, Cradle cap. |
| Nummular Dermatitis | Coin-shaped itchy lesions. | Common in elderly. |
| Stasis Dermatitis | Occurs in lower legs due to poor venous circulation. | Seen in varicose veins. |
| Factors | Examples |
| Allergic Triggers | Pollen, Dust mites, Certain foods. |
| Irritants | Soaps, Detergents, Chemicals. |
| Environmental | Heat, Humidity, Dry air. |
| Systemic Conditions | Diabetes, Venous insufficiency. |
| Genetic Predisposition | Family history of eczema or allergies. |
| Test | Purpose |
| Physical Examination | Identifies characteristic skin changes. |
| Patch Test | Diagnoses allergic contact dermatitis. |
| Skin Biopsy | Confirms diagnosis in doubtful cases. |
| Blood Tests (IgE Levels) | Elevated in atopic dermatitis. |
Q1. Which of the following is a common feature of dermatitis?
π
°οΈ Numbness
π
±οΈ Hyperpigmentation
β
π
²οΈ Itching
π
³οΈ Bruising
Q2. Which test is used to diagnose allergic contact dermatitis?
π
°οΈ Tzanck Smear
π
±οΈ KOH Test
β
π
²οΈ Patch Test
π
³οΈ Slit Skin Smear
Q3. What is the primary nursing intervention for a patient with atopic dermatitis?
π
°οΈ Encourage frequent bathing.
β
π
±οΈ Educate about trigger avoidance and moisturizing.
π
²οΈ Use alcohol-based cleansers.
π
³οΈ Apply dry dressings.
Q4. Which of the following medications is used to relieve itching in dermatitis?
π
°οΈ Antibiotics
π
±οΈ Beta-blockers
β
π
²οΈ Antihistamines
π
³οΈ Diuretics
Q5. Which type of dermatitis is commonly seen in areas with excessive sebum production?
π
°οΈ Atopic Dermatitis
π
±οΈ Contact Dermatitis
β
π
²οΈ Seborrheic Dermatitis
π
³οΈ Stasis Dermatitis
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
Impetigo is a highly contagious bacterial skin infection, primarily affecting children but can also occur in adults. It is characterized by vesicular or pustular lesions that rupture to form honey-colored crusts.
β βImpetigo is a superficial bacterial infection of the skin characterized by pustules, blisters, and yellowish crusts, often seen in children.β
| Type | Description |
| Non-Bullous Impetigo | Most common; starts as red sores that rupture and form honey-colored crusts. |
| Bullous Impetigo | Caused by toxin-producing strains of Staphylococcus aureus; involves larger fluid-filled blisters (bullae). |
| Ecthyma | Severe form; deeper ulcerative lesions penetrating the dermis. |
| Causative Agents | Common Examples |
| Bacteria | Staphylococcus aureus (most common), Streptococcus pyogenes. |
| Risk Factors | Poor hygiene, hot and humid climate, skin injuries (cuts, insect bites), pre-existing skin conditions (eczema), immunocompromised state. |
| Test | Purpose |
| Clinical Examination | Based on characteristic skin lesions. |
| Bacterial Culture and Sensitivity | Confirms the causative organism and appropriate antibiotic treatment. |
| Gram Stain | Detects gram-positive cocci. |
Q1. Which bacteria is most commonly responsible for impetigo?
π
°οΈ Pseudomonas aeruginosa
π
±οΈ Escherichia coli
β
π
²οΈ Staphylococcus aureus
π
³οΈ Clostridium difficile
Q2. What is the characteristic appearance of impetigo lesions?
π
°οΈ Black crusts
β
π
±οΈ Honey-colored crusts
π
²οΈ Purple rashes
π
³οΈ White scaly patches
Q3. Which topical antibiotic is commonly used to treat localized impetigo?
π
°οΈ Clindamycin
π
±οΈ Erythromycin
β
π
²οΈ Mupirocin
π
³οΈ Doxycycline
Q4. Which type of impetigo involves large fluid-filled blisters?
π
°οΈ Non-Bullous Impetigo
β
π
±οΈ Bullous Impetigo
π
²οΈ Ecthyma
π
³οΈ Cellulitis
Q5. What is the most important nursing intervention to prevent the spread of impetigo?
π
°οΈ Encourage frequent bathing with soap.
π
±οΈ Cover lesions with plastic wrap.
β
π
²οΈ Educate about hand hygiene and avoid sharing personal items.
π
³οΈ Use only warm water to clean lesions.
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
Acne Vulgaris is a common chronic inflammatory disorder of the pilosebaceous unit (hair follicle and sebaceous gland) characterized by comedones (blackheads and whiteheads), papules, pustules, nodules, and cysts.
β βAcne Vulgaris is a multifactorial skin condition primarily affecting adolescents and young adults, resulting from excess sebum production, follicular blockage, and bacterial infection.β
| Type | Description |
| Comedonal Acne | Presence of open (blackheads) and closed (whiteheads) comedones. |
| Inflammatory Acne | Papules, pustules, and erythema due to inflammation. |
| Nodulocystic Acne | Severe acne with deep, painful nodules and cysts. |
| Acne Conglobata | Severe, chronic, disfiguring acne with abscesses and scarring. |
| Factor | Examples |
| Hormonal | Increased androgens during puberty, PCOS. |
| Excess Sebum Production | Hyperactive sebaceous glands. |
| Follicular Hyperkeratinization | Blockage of hair follicles by dead skin cells. |
| Bacterial Infection | Propionibacterium acnes (now known as Cutibacterium acnes). |
| Lifestyle Factors | High-glycemic diets, stress, poor skin hygiene, use of comedogenic cosmetics. |
| Medications | Steroids, lithium, isoniazid. |
| Test | Purpose |
| Clinical Examination | Diagnosis based on typical lesions and distribution. |
| Hormonal Assessment | Evaluate for PCOS or hormonal imbalance in females. |
| Culture (if resistant) | Rule out resistant bacterial infections. |
Q1. Which bacteria is commonly associated with acne vulgaris?
π
°οΈ Staphylococcus aureus
β
π
±οΈ Cutibacterium acnes (formerly Propionibacterium acnes)
π
²οΈ Streptococcus pyogenes
π
³οΈ Pseudomonas aeruginosa
Q2. Which drug is considered first-line for comedonal acne?
π
°οΈ Oral Antibiotics
π
±οΈ Benzoyl Peroxide
β
π
²οΈ Topical Retinoids
π
³οΈ Isotretinoin
Q3. Which of the following is a side effect of oral isotretinoin therapy?
π
°οΈ Weight Gain
β
π
±οΈ Teratogenicity
π
²οΈ Hyperpigmentation
π
³οΈ Hypotension
Q4. Which hormone is primarily responsible for increased sebum production in adolescence?
π
°οΈ Estrogen
π
±οΈ Progesterone
β
π
²οΈ Androgens
π
³οΈ Insulin
Q5. Which topical agent has both antibacterial and comedolytic effects?
π
°οΈ Clindamycin
π
±οΈ Adapalene
β
π
²οΈ Benzoyl Peroxide
π
³οΈ Hydrocortisone
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
Herpes Zoster, also known as Shingles, is an acute, localized, and painful viral skin infection caused by the reactivation of the Varicella-Zoster Virus (VZV), the same virus responsible for chickenpox.
β βHerpes Zoster is a reactivation of latent varicella-zoster virus in the dorsal root ganglia, leading to painful vesicular skin eruptions along a specific dermatome.β
| Type | Description |
| Typical Herpes Zoster | Localized along a single dermatome, often on the trunk. |
| Herpes Zoster Ophthalmicus | Involves the ophthalmic branch of the trigeminal nerve; affects the eye and forehead. |
| Herpes Zoster Oticus (Ramsay Hunt Syndrome) | Affects the facial nerve and ear; associated with facial paralysis. |
| Disseminated Herpes Zoster | Widespread lesions; seen in immunocompromised patients. |
| Cause | Examples |
| Virus Reactivation | Latent Varicella-Zoster Virus in dorsal root ganglia. |
| Risk Factors | Aging (above 50 years), Immunosuppression (HIV, cancer, chemotherapy), Stress, Organ transplant recipients. |
| Test | Purpose |
| Clinical Examination | Based on characteristic painful, dermatomal rash. |
| Tzanck Smear | Shows multinucleated giant cells (non-specific). |
| PCR Test | Confirms Varicella-Zoster Virus DNA. |
| Viral Culture | Rarely used; slow. |
Q1. Which virus causes Herpes Zoster?
π
°οΈ Herpes Simplex Virus
π
±οΈ Epstein-Barr Virus
β
π
²οΈ Varicella-Zoster Virus
π
³οΈ Human Papillomavirus
Q2. What is the most common complication of Herpes Zoster?
π
°οΈ Paralysis
π
±οΈ Blindness
β
π
²οΈ Postherpetic Neuralgia
π
³οΈ Pneumonia
Q3. Which medication is most effective if started early in Herpes Zoster?
π
°οΈ Amoxicillin
β
π
±οΈ Acyclovir
π
²οΈ Rifampicin
π
³οΈ Hydrocortisone
Q4. In Herpes Zoster, the rash is typically:
π
°οΈ Bilateral
β
π
±οΈ Unilateral along a dermatome
π
²οΈ Generalized
π
³οΈ Found on palms and soles
Q5. Which vaccine is used for the prevention of shingles?
π
°οΈ BCG Vaccine
π
±οΈ MMR Vaccine
β
π
²οΈ Shingrix Vaccine
π
³οΈ DPT Vaccine
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
Scabies is a highly contagious parasitic skin infestation caused by the mite Sarcoptes scabiei var hominis. It results in intense itching and characteristic skin rashes, especially in warm and moist areas of the body.
β βScabies is a skin infestation caused by the mite Sarcoptes scabiei, characterized by intense pruritus and papular eruptions due to hypersensitivity to mite eggs and feces.β
| Type | Description |
| Typical Scabies | Classic presentation with itching and burrows. |
| Crusted Scabies (Norwegian Scabies) | Severe form seen in immunocompromised patients; characterized by thick crusts and high mite load. |
| Nodular Scabies | Persistent nodules, often seen in genital areas. |
| Test | Purpose |
| Clinical Diagnosis | Based on itching, burrows, and rash distribution. |
| Ink Test | Ink is applied to suspected burrows, and wiped off; burrows retain ink. |
| Skin Scraping Test | Scraping of lesions examined under microscope for mites, eggs, or feces. |
π Golden One-Liners for Quick Revision:
Q1. What is the first-line drug used for treating scabies?
π
°οΈ Benzyl Benzoate
β
π
±οΈ Permethrin 5% Cream
π
²οΈ Ivermectin
π
³οΈ Sulfur Ointment
Q2. Which of the following is the causative organism of scabies?
π
°οΈ Pediculus humanus
π
±οΈ Cimex lectularius
β
π
²οΈ Sarcoptes scabiei
π
³οΈ Tunga penetrans
Q3. What is the most common symptom of scabies?
π
°οΈ Blisters
β
π
±οΈ Intense Itching, Especially at Night
π
²οΈ High Fever
π
³οΈ Severe Pain
Q4. Which type of scabies is commonly seen in immunocompromised patients?
π
°οΈ Typical Scabies
π
±οΈ Nodular Scabies
β
π
²οΈ Crusted (Norwegian) Scabies
π
³οΈ Infantile Scabies
Q5. Which test is commonly used to diagnose scabies by visualizing mites?
π
°οΈ Patch Test
π
±οΈ Mantoux Test
β
π
²οΈ Skin Scraping Test
π
³οΈ Tzanck Smear
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
Psoriasis is a chronic, non-contagious, autoimmune skin disorder characterized by rapid proliferation of keratinocytes, leading to the formation of thick, scaly, erythematous plaques. It commonly affects the scalp, elbows, knees, and lower back.
β βPsoriasis is an autoimmune skin condition causing hyperproliferation of epidermal cells, resulting in red, scaly patches.β
| Type | Description |
| Plaque Psoriasis (Psoriasis Vulgaris) | Most common; raised, red patches with silvery-white scales. |
| Guttate Psoriasis | Small, drop-like lesions; often triggered by streptococcal throat infection. |
| Inverse Psoriasis | Occurs in skin folds (groin, armpits); smooth, shiny, red lesions. |
| Pustular Psoriasis | White pustules surrounded by red skin; may be localized or generalized. |
| Erythrodermic Psoriasis | Severe, life-threatening form with widespread redness and scaling of the skin. |
| Psoriatic Arthritis | Psoriasis associated with joint inflammation and pain. |
| Factor | Examples |
| Genetic | Family history (HLA-Cw6 gene). |
| Autoimmune | Abnormal T-cell mediated immune response. |
| Environmental Triggers | Stress, infections (Streptococcal throat infection), skin injuries (Koebner phenomenon). |
| Medications | Beta-blockers, Lithium, Antimalarials. |
| Lifestyle Factors | Smoking, alcohol use, obesity. |
| Test | Purpose |
| Clinical Examination | Based on typical skin lesions and distribution. |
| Skin Biopsy | Confirms hyperproliferation of keratinocytes. |
| Blood Tests | Elevated inflammatory markers (ESR, CRP). |
| X-Ray / MRI | In psoriatic arthritis, assess joint involvement. |
π Golden One-Liners for Quick Revision:
Q1. Which type of psoriasis is most common?
π
°οΈ Guttate Psoriasis
π
±οΈ Pustular Psoriasis
β
π
²οΈ Plaque Psoriasis (Psoriasis Vulgaris)
π
³οΈ Inverse Psoriasis
Q2. What is the hallmark sign observed when psoriatic scales are removed?
π
°οΈ Koebner Phenomenon
π
±οΈ Nikolskyβs Sign
β
π
²οΈ Auspitz Sign
π
³οΈ Darierβs Sign
Q3. Which immune cells play a key role in the pathogenesis of psoriasis?
π
°οΈ B-Lymphocytes
β
π
±οΈ T-Lymphocytes
π
²οΈ Mast Cells
π
³οΈ Neutrophils
Q4. Which of the following drugs is commonly used in systemic therapy for psoriasis?
π
°οΈ Metformin
π
±οΈ Ceftriaxone
β
π
²οΈ Methotrexate
π
³οΈ Amlodipine
Q5. What is the name of the phenomenon where psoriasis develops at sites of skin injury?
π
°οΈ Auspitz Sign
β
π
±οΈ Koebner Phenomenon
π
²οΈ Darierβs Sign
π
³οΈ Nikolskyβs Sign
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
Pemphigus Vulgaris is a rare, chronic, potentially life-threatening autoimmune blistering disorder affecting the skin and mucous membranes. It is characterized by the formation of flaccid bullae (blisters) and erosions due to loss of cell-to-cell adhesion within the epidermis (acantholysis).
β βPemphigus Vulgaris is an autoimmune disorder characterized by intraepidermal blister formation caused by autoantibodies against desmogleins (desmosomal proteins).β
| Cause | Description |
| Autoimmune Reaction | Autoantibodies against desmoglein-1 and desmoglein-3 proteins disrupt keratinocyte adhesion. |
| Genetic Factors | HLA-DR4, HLA-DR14 associations. |
| Environmental Triggers | UV radiation, drugs (e.g., penicillamine, ACE inhibitors), stress. |
| Age Group | Commonly affects middle-aged and elderly individuals. |
| Test | Purpose |
| Clinical Examination | Presence of bullae and erosions; positive Nikolskyβs sign. |
| Tzanck Smear | Shows acantholytic cells (detached keratinocytes). |
| Skin Biopsy with Immunofluorescence | Gold standard; shows IgG deposits in the intercellular spaces (chicken wire appearance). |
| ELISA Test | Detects anti-desmoglein antibodies. |
π Golden One-Liners for Quick Revision:
Q1. What type of hypersensitivity reaction is Pemphigus Vulgaris?
π
°οΈ Type I
π
±οΈ Type II (Cytotoxic)
β
π
²οΈ Type II (Autoimmune)
π
³οΈ Type IV
Q2. Which protein is targeted by autoantibodies in Pemphigus Vulgaris?
π
°οΈ Collagen
π
±οΈ Elastin
β
π
²οΈ Desmoglein
π
³οΈ Fibrillin
Q3. What is the gold standard diagnostic test for Pemphigus Vulgaris?
π
°οΈ Tzanck Smear
π
±οΈ Blood Culture
β
π
²οΈ Direct Immunofluorescence of Skin Biopsy
π
³οΈ Mantoux Test
Q4. Which drug is the first-line treatment for Pemphigus Vulgaris?
π
°οΈ Methotrexate
β
π
±οΈ Prednisolone
π
²οΈ Hydroxychloroquine
π
³οΈ Azathioprine
Q5. Nikolskyβs sign is:
π
°οΈ Negative in Pemphigus Vulgaris
β
π
±οΈ Positive in Pemphigus Vulgaris
π
²οΈ Seen only in infants
π
³οΈ A diagnostic test for fungal infections
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
β βSJS and TEN are severe hypersensitivity reactions involving widespread skin and mucous membrane damage, usually triggered by medications or infections.β
| Feature | SJS | TEN |
| BSA Involved | <10% | >30% |
| Severity | Moderate | Severe, Life-threatening |
| Mortality Rate | 5β10% | 30β50% |
| Cause | Examples |
| Drugs (Most Common) | Sulfonamides, Antiepileptics (Phenytoin, Carbamazepine), NSAIDs, Allopurinol, Antibiotics. |
| Infections | Mycoplasma pneumoniae, Herpes Simplex Virus. |
| Others | Vaccines, Malignancies, Idiopathic. |
| Test | Purpose |
| Clinical Diagnosis | Based on characteristic skin and mucosal involvement. |
| Skin Biopsy | Confirms epidermal necrosis and subepidermal detachment. |
| SCORTEN Score | Predicts severity and mortality risk. |
| Laboratory Tests | CBC, electrolytes, renal and liver function to assess complications. |
π Golden One-Liners for Quick Revision:
Q1. What is the most common cause of Stevens-Johnson Syndrome?
π
°οΈ Infections
β
π
±οΈ Drug Reactions
π
²οΈ Sun Exposure
π
³οΈ Genetic Disorders
Q2. Which clinical sign is positive in both SJS and TEN?
π
°οΈ Koebner Sign
π
±οΈ Auspitz Sign
β
π
²οΈ Nikolskyβs Sign
π
³οΈ Darierβs Sign
Q3. What is the recommended site of care for patients with TEN?
π
°οΈ Home Care
π
±οΈ General Ward
β
π
²οΈ ICU or Burn Unit
π
³οΈ Dermatology Outpatient
Q4. Which drug class is most commonly implicated in causing SJS/TEN?
π
°οΈ Beta-blockers
β
π
±οΈ Sulfonamides
π
²οΈ Antacids
π
³οΈ Diuretics
Q5. What is the mortality rate associated with Toxic Epidermal Necrolysis (TEN)?
π
°οΈ 5β10%
π
±οΈ 10β20%
π
²οΈ 20β30%
β
π
³οΈ 30β50%
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
Skin tumors are abnormal growths of skin cells that can be benign (non-cancerous) or malignant (cancerous). They may arise from various layers and components of the skin, including the epidermis, dermis, and adnexal structures.
β βSkin tumors are abnormal proliferations of skin cells, classified into benign and malignant types, depending on their potential for invasion and metastasis.β
| Type | Examples |
| Benign Tumors | Nevus (mole), Seborrheic Keratosis, Lipoma, Dermatofibroma, Hemangioma. |
| Premalignant Tumors | Actinic Keratosis, Bowenβs Disease. |
| Malignant Tumors | Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), Malignant Melanoma. |
| Type | Key Features |
| Basal Cell Carcinoma (BCC) | Most common, slow-growing, rarely metastasizes; pearly nodules with central ulceration. |
| Squamous Cell Carcinoma (SCC) | Second most common; scaly, ulcerated lesions; can metastasize. |
| Malignant Melanoma | Highly aggressive; arises from melanocytes; responsible for most skin cancer deaths. |
| Factor | Examples |
| UV Radiation | Prolonged sun exposure, tanning beds. |
| Genetic Predisposition | Family history, fair skin. |
| Chemical Exposure | Arsenic, industrial chemicals. |
| Immunosuppression | Organ transplant recipients, HIV/AIDS. |
| Chronic Wounds | Marjolinβs ulcer (SCC in chronic ulcers). |
| Type of Tumor | Characteristic Features |
| BCC | Pearly, translucent nodules; central ulcer (rodent ulcer); usually on face. |
| SCC | Scaly plaques, ulcers with raised edges; commonly on sun-exposed areas. |
| Melanoma | Pigmented lesions; follows ABCDE rule: |
| Test | Purpose |
| Clinical Examination | Visual inspection using ABCDE criteria for melanomas. |
| Dermatoscopy | Magnification for detailed examination of pigmented lesions. |
| Skin Biopsy | Gold standard; confirms diagnosis. |
| Imaging (CT, MRI, PET) | To assess metastasis in malignant tumors. |
π Golden One-Liners for Quick Revision:
Q1. What is the most common type of malignant skin tumor?
π
°οΈ Squamous Cell Carcinoma
π
±οΈ Malignant Melanoma
β
π
²οΈ Basal Cell Carcinoma
π
³οΈ Kaposi Sarcoma
Q2. Which feature is suggestive of malignant melanoma based on the ABCDE rule?
π
°οΈ Symmetrical shape
π
±οΈ Uniform color
β
π
²οΈ Diameter >6 mm
π
³οΈ Smooth border
Q3. What is the gold standard diagnostic method for skin tumors?
π
°οΈ Dermatoscopy
π
±οΈ Fine Needle Aspiration
β
π
²οΈ Skin Biopsy
π
³οΈ CT Scan
Q4. Which of the following is a premalignant skin lesion?
π
°οΈ Lipoma
π
±οΈ Hemangioma
β
π
²οΈ Actinic Keratosis
π
³οΈ Seborrheic Keratosis
Q5. Which of the following therapies is most suitable for metastatic melanoma?
π
°οΈ Topical Steroids
π
±οΈ Cryotherapy
β
π
²οΈ Immunotherapy (Checkpoint Inhibitors)
π
³οΈ Radiotherapy Only
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
Systemic Lupus Erythematosus (SLE) is a chronic, complex, autoimmune inflammatory disease that can affect multiple organ systems, including the skin, joints, kidneys, heart, lungs, and nervous system. It is characterized by the production of autoantibodies against the bodyβs own tissues, leading to widespread inflammation and tissue damage.
β βSLE is a multisystem autoimmune disorder marked by the production of autoantibodies, causing inflammation and damage to multiple organs.β
| Factor | Examples |
| Genetic | HLA-DR2, HLA-DR3 associations. |
| Hormonal | More common in females; estrogen influence. |
| Environmental | UV light exposure, viral infections. |
| Drugs (Drug-Induced SLE) | Hydralazine, Procainamide, Isoniazid. |
| Immunological | Abnormal B-cell and T-cell activity. |
| System Affected | Common Symptoms |
| General | Fatigue, fever, weight loss. |
| Skin | Classic butterfly rash over cheeks and nose, photosensitivity, discoid rash. |
| Musculoskeletal | Joint pain (polyarthritis), muscle weakness. |
| Renal | Lupus nephritis (proteinuria, hematuria). |
| Cardiovascular | Pericarditis, myocarditis. |
| Respiratory | Pleuritis, pulmonary hypertension. |
| Neurological | Seizures, psychosis, depression. |
| Hematological | Anemia, thrombocytopenia, leukopenia. |
π Important Diagnostic Features (Mnemonic – SOAP BRAIN MD):
| Test | Purpose |
| ANA Test | Screening test; positive in most SLE cases. |
| Anti-dsDNA and Anti-Smith Antibodies | Highly specific for SLE diagnosis. |
| ESR, CRP | Elevated in active disease. |
| Urinalysis | Detects proteinuria and hematuria (renal involvement). |
| CBC | Anemia, leukopenia, thrombocytopenia. |
| Chest X-ray, ECG | Assess cardiopulmonary involvement. |
π Golden One-Liners for Quick Revision:
Q1. Which antibody is highly specific for diagnosing SLE?
π
°οΈ ANA
π
±οΈ Anti-CCP
β
π
²οΈ Anti-dsDNA
π
³οΈ Rheumatoid Factor
Q2. The classic butterfly rash in SLE is also known as:
π
°οΈ Discoid Rash
π
±οΈ Morbilliform Rash
β
π
²οΈ Malar Rash
π
³οΈ Vesicular Rash
Q3. Which drug is commonly used to manage skin lesions in SLE?
π
°οΈ Methotrexate
π
±οΈ Cyclophosphamide
β
π
²οΈ Hydroxychloroquine
π
³οΈ Belimumab
Q4. What is the most serious complication of SLE affecting the kidneys?
π
°οΈ Glomerulonephritis
β
π
±οΈ Lupus Nephritis
π
²οΈ Pyelonephritis
π
³οΈ Nephrolithiasis
Q5. Which of the following symptoms is NOT typically associated with SLE?
π
°οΈ Photosensitivity
β
π
±οΈ Hyperthyroidism
π
²οΈ Polyarthritis
π
³οΈ Oral Ulcers
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
Cellulitis is an acute, rapidly spreading bacterial infection of the skin and subcutaneous tissues, typically affecting the lower limbs but can occur anywhere on the body. It is characterized by redness, swelling, warmth, and pain at the affected site.
β βCellulitis is a bacterial infection involving the skin and underlying connective tissues, often caused by Streptococcus and Staphylococcus species.β
| Risk Factors | Examples | ||
| Skin Injuries | Cuts, wounds, insect bites. | ||
| Chronic Diseases | Diabetes mellitus, peripheral vascular disease. | ||
| Immunosuppression | HIV, chemotherapy, steroid therapy. | ||
| Skin Conditions | Eczema, fungal infections, ulcers. | ||
| Lymphedema | Impaired lymphatic drainage. | ||
| Test | Purpose |
| Clinical Examination | Redness, warmth, swelling, and tenderness. |
| Blood Tests (CBC) | Elevated WBC count indicates infection. |
| Blood Culture | If systemic infection is suspected. |
| Wound Culture | Identifies causative organisms. |
| Ultrasound | To detect abscess formation. |
π Golden One-Liners for Quick Revision:
Q1. What is the most common causative organism of cellulitis?
π
°οΈ Pseudomonas aeruginosa
β
π
±οΈ Streptococcus pyogenes
π
²οΈ Escherichia coli
π
³οΈ Candida albicans
Q2. Which of the following is NOT a typical symptom of cellulitis?
π
°οΈ Redness
π
±οΈ Swelling
β
π
²οΈ Cold, pale skin
π
³οΈ Warmth
Q3. Which test is most important to identify systemic involvement in cellulitis?
π
°οΈ Urinalysis
π
±οΈ ECG
β
π
²οΈ Blood Culture
π
³οΈ Skin Biopsy
Q4. Which nursing intervention helps reduce edema in cellulitis?
π
°οΈ Applying ice packs continuously
β
π
±οΈ Elevating the affected limb
π
²οΈ Massaging the affected area
π
³οΈ Keeping the limb dependent
Q5. Which antibiotic is preferred for cellulitis caused by MRSA?
π
°οΈ Amoxicillin
π
±οΈ Ceftriaxone
β
π
²οΈ Vancomycin
π
³οΈ Azithromycin
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
Alopecia refers to hair loss from the scalp or any part of the body. It may be temporary or permanent and can result from various causes including genetic, autoimmune, hormonal, nutritional, and psychological factors.
β βAlopecia is the partial or complete absence of hair from areas where it normally grows, caused by disturbances in hair growth or damage to hair follicles.β
| Type | Description |
| Alopecia Areata | Autoimmune disorder causing patchy hair loss. |
| Androgenetic Alopecia | Common baldness; hereditary (male and female pattern baldness). |
| Telogen Effluvium | Temporary hair shedding due to stress, illness, or hormonal changes. |
| Anagen Effluvium | Sudden hair loss during growth phase, often due to chemotherapy. |
| Cicatricial (Scarring) Alopecia | Permanent hair loss due to follicle destruction (e.g., lichen planopilaris). |
| Traction Alopecia | Hair loss due to pulling or tight hairstyles. |
| Cause | Examples |
| Genetic | Androgenetic alopecia. |
| Autoimmune | Alopecia areata. |
| Hormonal Imbalance | Thyroid disorders, PCOS, menopause. |
| Nutritional Deficiencies | Iron, Zinc, Biotin, Protein deficiency. |
| Medications | Chemotherapy drugs, anticoagulants, beta-blockers. |
| Stress | Emotional or physical stress. |
| Infections | Fungal infections like tinea capitis. |
| Test | Purpose |
| Clinical Examination | Inspection of scalp and hair loss pattern. |
| Hair Pull Test | To assess active hair shedding. |
| Scalp Biopsy | Differentiates scarring and non-scarring alopecia. |
| Blood Tests | Assess thyroid function, iron levels, and autoimmune markers. |
| Dermatoscopy | Visualizes hair follicles and scalp condition. |
π Golden One-Liners for Quick Revision:
Q1. Which of the following drugs is commonly used to treat androgenetic alopecia?
π
°οΈ Methotrexate
π
±οΈ Prednisolone
β
π
²οΈ Minoxidil
π
³οΈ Hydrocortisone
Q2. Which of the following is a cause of telogen effluvium?
π
°οΈ Autoimmune Disease
π
±οΈ Fungal Infection
β
π
²οΈ Emotional or Physical Stress
π
³οΈ Androgen Hormone
Q3. What is the most specific diagnostic test for alopecia?
π
°οΈ Hair Pull Test
π
±οΈ Scalp Biopsy
β
π
²οΈ Dermatoscopy
π
³οΈ Urinalysis
Q4. Which of the following is an autoimmune cause of alopecia?
π
°οΈ Androgenetic Alopecia
β
π
±οΈ Alopecia Areata
π
²οΈ Traction Alopecia
π
³οΈ Telogen Effluvium
Q5. Finasteride is primarily used in:
π
°οΈ Female Pattern Hair Loss
β
π
±οΈ Male Pattern Hair Loss
π
²οΈ Alopecia Areata
π
³οΈ Chemotherapy-Induced Alopecia
ππ©Ί Burns
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
β I. Introduction / Definition
A burn is an injury to the skin or underlying tissues caused by heat, chemicals, electricity, radiation, or friction. Burns can cause tissue destruction, fluid imbalance, and systemic complications depending on the severity.
β βBurns are traumatic injuries resulting from exposure to thermal, chemical, electrical, or radiation sources, affecting skin integrity and body homeostasis.β
ππ©Ί Classification of Burn Injury
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
β I. Introduction / Definition
Burn injuries are classified based on depth, cause, extent of body surface area involved, and severity. Classification helps determine management strategies and predict patient outcomes.
β βBurn injuries are categorized to assess the depth of tissue damage, extent of area involved, and to guide appropriate treatment and prognosis.β
π II. Classification Based on Depth of Burn (Degree of Burn)
| Degree | Involved Layers | Clinical Features |
| First-Degree (Superficial) | Epidermis Only | Redness, pain, dry skin, no blisters (e.g., sunburn). Heals in 3β5 days without scarring. |
| Second-Degree (Partial Thickness) | Epidermis + part of Dermis | Painful, red, swollen skin with blisters, moist appearance. Heals in 10β21 days, may leave pigment changes. |
| Third-Degree (Full Thickness) | Epidermis + Dermis + Subcutaneous Tissue | Skin appears dry, leathery, charred, or white. Painless due to nerve destruction. Requires grafting. |
| Fourth-Degree | All layers including muscles, bones, and tendons | Black, charred skin; involves deep tissues. Life-threatening; often requires surgical interventions and amputation. |
π III. Classification Based on Cause of Burn
| Type | Source |
| Thermal Burns | Flames, hot liquids (scalds), steam, hot objects. |
| Chemical Burns | Strong acids (e.g., sulfuric acid), alkalis (e.g., sodium hydroxide). |
| Electrical Burns | Low-voltage or high-voltage electrical injuries; entry and exit wounds common. |
| Radiation Burns | Exposure to UV rays (sunburn), X-rays, or radiation therapy. |
| Friction Burns | Abrasions from rough surfaces or road traffic accidents. |
π IV. Classification Based on Extent (Severity)
| Severity | Criteria |
| Minor Burns | Less than 10% TBSA in adults, less than 5% in children. |
| Moderate Burns | 10β20% TBSA in adults, 5β10% in children. |
| Major Burns | More than 20% TBSA in adults, more than 10% in children, or any full-thickness burn over critical areas (face, hands, feet, genitalia, perineum). |
π Golden One-Liners for Quick Revision:
β Top 5 MCQs for Practice on Classification of Burn
Β·
Β·
Β·
Β·
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
The extent of body surface area (BSA) burned is a critical assessment to determine the severity of burn injury, guide fluid resuscitation, and plan treatment. It is expressed as a percentage of the total body surface area affected.
β βEstimation of burned body surface area helps assess burn severity, guide fluid replacement, and predict prognosis.β
This is a quick and simple method to estimate burn area percentages.
| Body Part | Percentage of BSA |
| Head and Neck | 9% |
| Each Upper Limb | 9% |
| Each Lower Limb | 18% |
| Anterior Trunk | 18% |
| Posterior Trunk | 18% |
| Perineum (Genital Area) | 1% |
β Total = 100%
| Extent of Burns | Severity |
| Less than 10% BSA | Minor Burns |
| 10β20% BSA | Moderate Burns |
| More than 20% BSA | Major Burns (Requires critical care) |
π Note: Any burn involving the face, hands, feet, perineum, or airway is considered critical regardless of percentage.
π Golden One-Liners for Quick Revision:
Q1. According to the Rule of Nines, what percentage of BSA is assigned to each leg?
π
°οΈ 9%
β
π
±οΈ 18%
π
²οΈ 12%
π
³οΈ 15%
Q2. Which method is most accurate for assessing burn area in children?
π
°οΈ Rule of Nines
β
π
±οΈ Lund and Browder Chart
π
²οΈ Parkland Formula
π
³οΈ Palm Method
Q3. In the Rule of Nines, the anterior trunk accounts for what percentage of BSA?
π
°οΈ 9%
β
π
±οΈ 18%
π
²οΈ 12%
π
³οΈ 24%
Q4. Which body part is assigned 1% of BSA in burn calculations?
π
°οΈ Head
π
±οΈ Each Arm
π
²οΈ Chest
β
π
³οΈ Perineum
Q5. Which of the following is used to estimate small scattered burns?
π
°οΈ Rule of Nines
π
±οΈ Lund and Browder Chart
β
π
²οΈ Palm Method
π
³οΈ Wallaceβs Rule
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
Burn injuries trigger a complex series of physiological responses involving multiple body systems. The severity of the response depends on the extent and depth of burns. Early recognition of these responses is essential for timely management.
β βThe bodyβs response to burn injury involves systemic inflammatory, metabolic, and immune reactions aimed at restoring homeostasis and healing.β
| Phase | Duration | Key Features |
| Emergent Phase (Resuscitative Phase) | First 24β48 hours | Hypovolemic shock, fluid loss, electrolyte imbalance, airway compromise. |
| Acute Phase | 48β72 hours to wound closure | Fluid resuscitation, infection control, wound healing, hypermetabolic state. |
| Rehabilitation Phase | After wound closure | Scar management, physical rehabilitation, psychological support. |
| Hormone | Effect |
| ADH (Antidiuretic Hormone) | Promotes water retention. |
| Aldosterone | Increases sodium and water retention. |
| Catecholamines (Epinephrine, Norepinephrine) | Increase heart rate and vasoconstriction. |
π Golden One-Liners for Quick Revision:
Q1. Which phase of burn injury is associated with hypovolemic shock?
π
°οΈ Acute Phase
β
π
±οΈ Emergent Phase
π
²οΈ Rehabilitation Phase
π
³οΈ Hyperdynamic Phase
Q2. What is the primary cause of decreased urine output after a major burn?
π
°οΈ Increased metabolism
β
π
±οΈ Reduced renal perfusion
π
²οΈ Electrolyte imbalance
π
³οΈ Increased protein intake
Q3. Which hormone promotes sodium and water retention following a burn injury?
π
°οΈ Insulin
π
±οΈ Thyroxine
β
π
²οΈ Aldosterone
π
³οΈ Cortisol
Q4. What is a life-threatening complication associated with inhalation burns?
π
°οΈ Anemia
β
π
±οΈ Acute Respiratory Distress Syndrome (ARDS)
π
²οΈ Diarrhea
π
³οΈ Edema
Q5. Which metabolic state is commonly seen after major burns?
π
°οΈ Hypometabolic
β
π
±οΈ Hypermetabolic
π
²οΈ Normometabolic
π
³οΈ None of the above
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
Fluid replacement in burn victims is a critical life-saving intervention aimed at correcting hypovolemia, electrolyte imbalance, and preventing shock during the acute phase of burn injury.
β βThe goal of fluid replacement in burn patients is to maintain tissue perfusion, prevent hypovolemic shock, and support organ function.β
π Important Notes:
| Phase | Duration | Focus |
| Resuscitation Phase | First 24 hours | Rapid fluid replacement based on formulas. |
| Maintenance Phase | 24β48 hours | Adjust fluids based on clinical response and ongoing losses. |
π Golden One-Liners for Quick Revision:
Q1. What is the Parkland formula for calculating fluid replacement?
π
°οΈ 2 mL Γ Weight (kg) Γ % TBSA
β
π
±οΈ 4 mL Γ Weight (kg) Γ % TBSA
π
²οΈ 3 mL Γ Weight (kg) Γ % TBSA
π
³οΈ 5 mL Γ Weight (kg) Γ % TBSA
Q2. Which intravenous fluid is preferred for initial burn resuscitation?
π
°οΈ Normal Saline
β
π
±οΈ Ringerβs Lactate
π
²οΈ Dextrose 5%
π
³οΈ Half Normal Saline
Q3. How much of the calculated fluid volume should be given in the first 8 hours after a burn?
π
°οΈ 25%
β
π
±οΈ 50%
π
²οΈ 75%
π
³οΈ 100%
Q4. What is the target urine output for adequate fluid resuscitation in an adult burn patient?
π
°οΈ 0.25 mL/kg/hr
β
π
±οΈ 0.5 β 1 mL/kg/hr
π
²οΈ 1.5 β 2 mL/kg/hr
π
³οΈ 2.5 mL/kg/hr
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
A skin graft is a surgical procedure that involves transplanting skin from one area of the body (donor site) to another area (recipient site) where the skin is missing or damaged due to burns, trauma, infections, chronic wounds, or after surgical removal of tumors.
β βSkin grafting is a reconstructive surgery technique used to cover large wounds, promote healing, and restore skin integrity.β
| Type | Description |
| Autograft | Skin taken from the patientβs own body (most common and ideal). |
| Allograft (Homograft) | Skin taken from another human donor (temporary). |
| Xenograft (Heterograft) | Skin taken from animals (commonly pigs; temporary cover). |
| Synthetic Grafts | Artificial skin substitutes made of collagen and polymers. |
| Type | Description |
| Split-Thickness Skin Graft (STSG) | Includes epidermis and part of dermis; used for large wounds; heals faster. |
| Full-Thickness Skin Graft (FTSG) | Includes both epidermis and full dermis; used for cosmetic areas; better functional and cosmetic outcome. |
| Phase | Description |
| Plasmatic Imbibition | First 24-48 hours; graft absorbs nutrients from the wound bed. |
| Inosculation | 48-72 hours; new capillaries begin to connect with the graft. |
| Revascularization | Blood vessels fully grow into the graft for permanent integration. |
π Golden One-Liners for Quick Revision:
Q1. Which type of skin graft uses the patientβs own skin?
π
°οΈ Allograft
π
±οΈ Xenograft
β
π
²οΈ Autograft
π
³οΈ Synthetic Graft
Q2. What is the first phase of graft healing?
π
°οΈ Revascularization
π
±οΈ Inosculation
β
π
²οΈ Plasmatic Imbibition
π
³οΈ Maturation
Q3. Which graft includes both epidermis and full dermis layers?
π
°οΈ Split-Thickness Graft
β
π
±οΈ Full-Thickness Graft
π
²οΈ Synthetic Graft
π
³οΈ Xenograft
Q4. Which nutrient is most essential for wound healing after skin grafting?
π
°οΈ Calcium
β
π
±οΈ Protein
π
²οΈ Iron
π
³οΈ Phosphorus
Q5. Which of the following is a contraindication for skin grafting?
π
°οΈ Well-vascularized wound bed
π
±οΈ Controlled diabetes
β
π
²οΈ Active infection at recipient site
π
³οΈ Adequate nutrition
ππ©Ί Wound Debridement
π Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Community Health Nursing Exams
β I. Introduction / Definition
Wound debridement is the medical procedure of removing dead (necrotic), infected, or non-viable tissue from a wound to promote healing and prevent infection.
β βDebridement is the removal of devitalized tissue from a wound bed to facilitate the growth of healthy tissue and accelerate wound healing.β
π II. Objectives of Debridement
π III. Types / Methods of Wound Debridement
| Type | Description | Indications |
| Surgical (Sharp) Debridement | Removal of dead tissue using scalpels, scissors. | Large necrotic tissue, infected wounds. |
| Mechanical Debridement | Use of wet-to-dry dressings or irrigation to remove tissue. | Moderate necrosis, pressure ulcers. |
| Autolytic Debridement | Bodyβs natural enzymes break down necrotic tissue under moist dressings. | Painless method for small wounds. |
| Enzymatic Debridement | Application of chemical agents (e.g., collagenase) to dissolve dead tissue. | Non-surgical option for chronic wounds. |
| Biological Debridement (Maggot Therapy) | Sterile maggots consume necrotic tissue. | Chronic non-healing wounds, resistant infections. |
π Note: Surgical debridement is the fastest but most invasive method. Autolytic and enzymatic methods are slower but less painful.
π IV. Indications for Debridement
π V. Contraindications for Debridement
π VI. Nurseβs Role in Wound Debridement
π Golden One-Liners for Quick Revision:
β Top 5 MCQs for Practice
Q1. Which method of debridement is the fastest in removing necrotic tissue?
π
°οΈ Autolytic
π
±οΈ Enzymatic
β
π
²οΈ Surgical (Sharp)
π
³οΈ Biological
Q2. Which debridement method involves the use of chemical agents like collagenase?
π
°οΈ Mechanical
π
±οΈ Autolytic
β
π
²οΈ Enzymatic
π
³οΈ Surgical
Q3. Which of the following is a contraindication for wound debridement?
π
°οΈ Diabetic Foot Ulcer
π
±οΈ Pressure Ulcer with Slough
β
π
²οΈ Dry, Stable Eschar on Heel
π
³οΈ Infected Wound
Q4. What is the role of sterile maggots in wound care?
π
°οΈ Provide nutrients to the wound.
β
π
±οΈ Consume necrotic tissue and promote healing.
π
²οΈ Increase blood supply to the area.
π
³οΈ Close the wound surgically.
Q5. Which phase of wound healing is facilitated by proper debridement?
π
°οΈ Inflammatory Phase
β
π
±οΈ Proliferative Phase
π
²οΈ Hemostasis Phase
π
³οΈ Maturation Phase