Chapter 39: Integumentary System

Wound healing phases—hemostasis, inflammation, proliferation, and remodeling—form the foundation for understanding both acute and chronic skin conditions. The chapter then systematically addresses infectious skin disorders, including fungal infections like candidiasis, viral conditions such as herpes zoster and herpes simplex, and bacterial infections including methicillin-resistant staphylococcus aureus and cellulitis. Inflammatory and immune-mediated conditions receive detailed attention, covering contact dermatitis from plant oils, psoriasis with its characteristic plaque formation, and Stevens-Johnson syndrome as a severe medication-induced reaction. Malignant skin lesions are examined through the lens of basal cell carcinoma, squamous cell carcinoma, and melanoma, emphasizing risk stratification, histological features, and preventive education. The chapter dedicates substantial content to burn injuries, classifying burns by depth and extent using standardized assessment tools like the rule of nines, and explaining the pathophysiological cascade of fluid shifts, systemic inflammation, and shock. Burn management is structured across three phases: the resuscitation phase addressing fluid replacement and airway protection, the acute phase encompassing escharotomy and surgical grafting with autografts and synthetic alternatives, and the rehabilitative phase focusing on functional recovery and scar management. Additional coverage includes pressure injury classification and evidence-based treatment strategies, cold-related injuries such as frostbite with staged progression and rewarming protocols, and arthropod-related envenomations with appropriate antidotal and supportive interventions. Throughout, the chapter emphasizes nursing assessment, infection prevention, pain management, and psychosocial support essential for comprehensive integumentary care.