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Hi my name is burn boss slit and I among of the infectious disease doctors at the University of California San Francisco, and today I'm going to be discussing with you some characteristics of primary and secondary skin lesions within the necrotizing fasciitis module by the end of this session you should be able to describe the components of the integumentarysystem you should also be able to define several of the primary skin lesions including a MAUL patch plaque papulevesicle bull pustule and Weill, and finally you should be able to define several of these secondary skin lesions that I will discuss including scale crust like benefice action erosion ulcer and fissure our skin is the largest organ of our bodies informs integumentary system which is composed of multiple layers of tissue and associated glands plus appendages that provide defense against the outside environment the skin can generally redivided into three broad layers the epidermis dermis and the hypodermisbriefly the epidermis is the outermost avascular layer of skin that contains mostly keratinocytes which are keratin filled epithelial cells but also contains pigment producing melanocytes immunologic Langerhans cells neuroendocrine Merkel cells the dermis lies below the epidermis and contains many structures including connective tissue vessels hair follicles sweat and sebaceous glands and nerve endings called mechanoreceptors that enable sensation below the dermis hypodermis contains the main vascular and lymphatic supply as well as adipose tissue so when the skin is affected by disease one or all of these layers maybe involved diseases affecting the skin can manifesting a number of ways some skin lesions are a result of localized damage to the skin while other lesions represent cutaneous manifestations of a systemic disease or process a primary skin lesions one that originates from previously normal skin and is directly associated with a disease process primary lesions are rarely specific to a single disease entity however correctly naming the primary lesions whenever possible is the first step towards identification of the disease or process that×39’s causing the lesion this is why you should always strive to describe skin lesions with detailed dermatological terminology which we'll introduce here primary lesions include the macular patch papulenodule plaque vesicle bulk and pustules let's define each of those terms now macular is simply a change in the color of the skin it is totally flat and if you were to close your eyes and run your fingers over the surface of a purelymacular lesion you could not detect itimmaculee than one centimeter at its widest dimension may be referred to as patch a pa pule is a solid raised lesion that has distinct borders and is less than one centimeter in diameter papulesmay have a variety of shapes in profile they may be domed flat-topped or Allocated, and they may be associated with secondary features such as crusts or scales which we will describe...
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