At-risk patient – diabetic foot ulcers: Individuals with diabetes have a higher risk of ulceration, typically on the lower extremities. Other factors contributing to the risk of ulceration include peripheral neuropathy, peripheral arterial disease, infection, and pressure. Chronic venous insufficiency: A disease process principally caused by venous hypertension and valve dysfunction that can lead to venous reflux, pooling, dilated or tortuous veins, and thrombosis and can be a precursor to venous leg ulcers. Dyschromia: An increase or decrease in dark skin’s pigmentation as a response to trauma or inflammation. Occurs when the melanocytes respond in an exaggerated way. Fitzpatrick Skin Phototype (FSP): Consists of 3 score groups. "Low" meaning least amount of pigment, "medium," and "high" meaning the most amount of pigment. Established in 1960, it classified skin tone on a scale from I-VI by color and reaction to the sun. Hypertrophic scarring: Scarring that results from an abnormal response to an injury or trauma where the collagen synthesis exceeds collagen lysis. These scars are thick, wide, and often raised.
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Hypopigmentation: Represented by localized or widespread loss of melanin in the skin. May occur due to the loss of functional melanocytes and may lead to white/pink discoloration of the involved tissue, often described as depigmented macules and patches with feathered edges. Ischemia: Insufficient vascular supply, possibly resulting in tissue damage if no intervention occurs. It can be caused by either acute obstruction (critical limb ischemia) or constriction (possibly chronic vascular complication of disease states such as diabetes mellitus). Keloid scar: Enlarged, thick, raised scars often larger than the surrounding area. These scars occur when the tissue response to healing is greater than necessary for normal tissue repair. Post-inflammatory hyperpigmentation: Dyschromia related to inflammation, where there is an increase in melanin production or uneven distribution. Pressure injury, stage 1: Pressure injuries characterized by intact tissue with localized, non-blanchable erythema, which may manifest differently in individuals with darkly pigmented skin. Visual change in the wound may be preceded by blanchable erythema or changes in sensation, temperature, or firmness of the tissue area.
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