Burns: Clinical

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Burns: Clinical

USMLE® Step 2 questions

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USMLE® Step 2 style questions USMLE

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A 19-year-old woman comes to the clinic because of a rash on her thighs. She has just returned home from her first semester of college for the holidays. She states that she first began to notice the rash when she first went to college and began living in her dorm room. The rash is most prominent after she has been studying on her laptop.  
The affected skin is mildly itchy and has a "lace-like" pattern.

Which of the following is the most similar to the most likely diagnosis in this patient?


Content Reviewers

The skin is the largest organ of the body, and is made of the epidermis, the dermis, and the hypodermis.

Burns result from exposure of skin cells to an overwhelming amount of energy in the form of heat, causing cellular necrosis.

The degree of injury depends on the temperature, the duration of exposure, and the baseline structural integrity of the skin; which means younger children and elderly individuals are at higher risk of injury, because their skin is relatively weaker.

Okay, burns can be classified based on the cause, or by the depth of injury which corresponds to the severity of the burn.

Burns are most commonly thermal, which can result from scalds, such as hot water, or flames, such as from house-fires.

Less commonly, burns can be electrical, like from exposure to lightning strike or high-voltage electrical current, or from exposure to chemical substances, which can be acidic or alkaline.

Based on depth, burns can be first, second, or third degree.

First degree burns are also called superficial burns, and involve the epidermis only.

A prime example would be a simple sunburn from a day on the beach, which appears red, with no blisters.

Second degree burns are further subclassified into superficial partial thickness burns, which involve the epidermis and the superficial dermis, and deep partial-thickness burns, which involve the epidermis and the deep dermis.

Superficial partial thickness burns appear red and are often blistered, whereas deep partial thickness burns appear red or white, with no blisters.

Third degree burns are full-thickness burns, extending through and destroying the entire dermis.

These appear leather-like with a charred appearance and tense feel.

Usually, third degree burns are surrounded by a rim of second degree burns.


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