Skin Conditions/Skin Care

Skin is considered the body's largest organ, and any damage can often lead to scarring. Although the pathology and physiology of what leads to scarring are not entirely understood, some details are concrete, including the series of processes that occur after the skin is damaged. These processes will be discussed in detail below, as well as the different types of scars. The appearance of these scars, as a result of these processes, may also present differently on various skin tones and types.

By Hannah Fell, Digital Managing Editor

The occurrence of conjoined twins isn’t common. Research about the development varies, but some sources suggest that the birth of conjoined twins can happen 1 in every 75,000 births, while others suggest every 50,000 to 200,000 births, and out of the latter number, 60% are stillbirths. Conjoined twins result from an embryo that doesn’t divide completely after day 13 of fertilization.

Laura Swoboda, DNP, APNP, FNP-C, FNP-BC, CWOCN-AP

Medical misdiagnosis is common and can be caused by errors in clinical reasoning that arise from knowledge deficits, cognitive biases, and dual-process thinking.¹ Dual process thinking is a generally accepted conceptualization of clinical reasoning that includes an initial intuitive assessment followed by a slower logical analysis. Misdiagnosis can arise during both of these evaluative processes.

by Ivy Razmus, RN, PhD, CWOCN

As a nurse who works with vulnerable populations, I have seen how foot health affects homeless patients in the hospital setting. I often witnessed that foot health was rarely addressed in their care plan. Although distressing, this issue has not received much attention, in my opinion.

Holly M. Hovan MSN, APRN, GERO-BC, CWOCN-AP

Moisture-associated skin damage (MASD) is sometimes accompanied by serous exudate, a denuded appearance of skin, or a secondary cutaneous infection. As the most common form of MASD, incontinence-associated dermatitis (IAD) is characterized by erythema and edema of the skin’s surface. IAD is a top-down injury, often presenting with inflammation, erosion, or denudation in the setting of fecal or urinary incontinence.

Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP

Peristomal pyoderma gangrenosum (PPG) is a somewhat uncommon and challenging condition to diagnose and treat, as no evidence-based guidelines or standard treatments exist. PPG can occur after the surgical placement of an ostomy, impacting approximately 0.5 to 1.5 people per million annually, and accounts for 15% of pyoderma gangrenosum cases. Effective management of PPG requires local and often systemic immunosuppression and topical wound care, which is compatible with being applied beneath an ostomy pouch.

By Cathy L. Harmon, DNP, MSN, FNP-BC, CWON, CFCN

According to the definition from the International Skin Tear Advisory Panel (ISTAP), “a skin tear is a traumatic wound caused by mechanical forces, including removal of adhesives. Severity may vary by depth (not extending through the subcutaneous layer).”

Elizabeth Day Dechant, BSN, RN, CWOCN, CFCN

Diaper rash, more officially known as incontinence-associated dermatitis (IAD), affects hospitalized and incontinent patients of all ages. In my years as a WOC Nurse in a pediatric hospital, IAD has been by far the most frequently treated condition. However, outside of a health care setting, IAD is the most common skin problem in infants and young children who are not yet toilet trained. Diaper rash has plagued babies and new parents for centuries, yet its treatment remains highly debated. For the purpose of this article, I am focusing on the prevention and treatment of diaper rashes in infants and young children, although the principles of topical treatment discussed here apply to all patients.

By Jeffrey M. Levine, MD, AGSF, CWSP

The malodor that emanates from some wounds has been recognized throughout human history, as starkly demonstrated in the ancient Greek play named after the principal character, Philoctetes. Written by Sophocles in the fifth century BCE, Philoctetes (pronounced fil-ok-tee’-teez) was a warrior of outstanding marksmanship who set out to win the hand of Helen of Troy, considered the most beautiful woman in the world. On the journey, his foot was bitten by a snake. The bite caused a chronic, painful wound that emitted such a foul odor that his fellow soldiers abandoned him on the deserted island of Lemnos.

By Cheryl Carver, LPN, WCC, CWCA, DAPWCA, FACCWS

May is Mental Health Awareness Month and with the staggering statistics of one in four adults living with mental illness, I immediately was motivated to write a personal blog. I previously shared my son’s experience here in 2020, in “Wound Management Challenges in Prison Populations,” and discussed the importance of establishing a quality of wound care. I started thinking about the high number of incarcerated people with mental health issues, and it prompted me to conduct a bit more research. Given my son's dual diagnosis of schizophrenia and post-traumatic stress disorder (PTSD), I recall having a conversation with him during this time about debridement methods because advanced wound care would become extremely complicated. I immediately started educating him on possible dressings and debridement methods that could be used on his wound. This gave him an idea of what to expect and allowed him to decline certain treatments if he so preferred.