Total body surface area (TBSA) is an assessment of injury to or disease of the skin, such as burns or psoriasis.
The human skin is the outer covering of the body and is the largest organ of the integumentary system. The skin has up to seven layers of ectodermal tissue and guards the underlying muscles, bones, ligaments and internal organs. Human skin is similar to most of the other mammals skin, and human skin is very similar to pig skin. Though nearly all human skin is covered with hair follicles, it can appear hairless. There are two general types of skin, hairy and glabrous skin (hairless). The adjective cutaneous literally means "of the skin".
Psoriasis is a long-lasting autoimmune disease characterized by patches of abnormal skin. These skin patches are typically red, dry, itchy, and scaly. On people with darker skin the patches may be purple in colour. Psoriasis varies in severity from small, localized patches to complete body coverage. Injury to the skin can trigger psoriatic skin changes at that spot, which is known as the Koebner phenomenon.
In adults, the Wallace rule of nines can be used to determine the total percentage of area burned for each major section of the body. [1]
The Wallace rule of nines is a tool used in pre-hospital and emergency medicine to estimate the total body surface area (BSA) affected by a burn. In addition to determining burn severity, the measurement of burn surface area is important for estimating patients' fluid requirements and determining hospital admission criteria.
In burn cases that involve partial body areas, or when dermatologists are evaluating the Psoriasis Area and Severity Index (PASI) score, the patient's palm can serve a reference point roughly equivalent to 1% of the body surface area.
Psoriasis Area and Severity Index (PASI) is the most widely used tool for the measurement of severity of psoriasis. PASI combines the assessment of the severity of lesions and the area affected into a single score in the range 0 to 72.
For children and infants, the Lund and Browder chart is used to assess the burned body surface area. Different percentages are used because the ratio of the combined surface area of the head and neck to the surface area of the limbs is typically larger in children than that of an adult. [2]
The Lund and Browder chart is a tool useful in the management of burns for estimating the total body surface area affected. It was created by Dr. Charles Lund, Senior Surgeon at Boston City Hospital, and Dr. Newton Browder, based on their experiences in treating over 300 burn victims injured at the Cocoanut Grove fire in Boston in 1942.
In mathematics, a ratio is a relationship between two numbers indicating how many times the first number contains the second. For example, if a bowl of fruit contains eight oranges and six lemons, then the ratio of oranges to lemons is eight to six. Similarly, the ratio of lemons to oranges is 6:8 and the ratio of oranges to the total amount of fruit is 8:14.
Typical values for common groups of humans follow. [3] (Due to rounding, values may not add to 100%.)
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The body mass index (BMI) or Quetelet index is a value derived from the mass (weight) and height of an individual. The BMI is defined as the body mass divided by the square of the body height, and is universally expressed in units of kg/m2, resulting from mass in kilograms and height in metres.
A burn is a type of injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or radiation. Most burns are due to heat from hot liquids, solids, or fire. While rates are similar for males and females the underlying causes often differ. Among women in some areas, risk is related to use of open cooking fires or unsafe cook stoves. Among men, risk is related to the work environments. Alcoholism and smoking are other risk factors. Burns can also occur as a result of self harm or violence between people.
In physiology, body water is the water content of an animal body that is contained in the tissues, the blood, the bones and elsewhere. The percentages of body water contained in various fluid compartments add up to total body water (TBW). This water makes up a significant fraction of the human body, both by weight and by volume. Ensuring the right amount of body water is part of fluid balance, an aspect of homeostasis.
Desoximetasone is a medication belonging to the family of medications known as topical corticosteroids. It is used for the relief of various skin conditions, including rashes. It helps to reduce redness, itching, and irritation. Desoximetasone is a synthetic corticosteroid, a class of primarily synthetic steroids used as anti-inflammatory and anti-pruritic agents.
Geographic tongue, also known by several other terms, is an inflammatory condition of the mucous membrane of the tongue, usually on the dorsal surface. It is a common condition, affecting approximately 2–3% of the general population. It is characterized by areas of smooth, red depapillation which migrate over time. The name comes from the map-like appearance of the tongue, with the patches resembling the islands of an archipelago. The cause is unknown, but the condition is entirely benign, and there is no curative treatment. Uncommonly, geographic tongue may cause a burning sensation on the tongue, for which various treatments have been described with little formal evidence of efficacy.
The Parkland formula, also known as Baxter formula, is a burn formula developed by Dr. Charles R. Baxter, used to estimate the amount of replacement fluid required for the first 24 hours in a burn patient so as to ensure he remains hemodynamically stable. The milliliter amount of fluid required for the first 24 hours – usually Lactated Ringer's – is four times the product of the body weight and the burn percentage. The first half of the fluid is given within 8 hours from the burn incident, and the remaining over the next 16 hours. Only area covered by second-degree burns or greater is taken into consideration, as first-degree burns do not cause hemodynamically significant fluid shift to warrant fluid replacement.
Rule of nines may refer to:
In medicine, a finger tip unit (FTU) is defined as the amount of ointment, cream or other semi-solid dosage form expressed from a tube with a 5mm diameter nozzle, applied from the distal skin-crease to the tip of the index finger of an adult. The "distal skin-crease" is the skin crease over the joint nearest the end of the finger. One FTU is enough to treat an area of skin twice the size of the flat of an adult's hand with the fingers together, i.e. a “handprint”. Two FTUs are approximately equivalent to 1g of topical steroid.
Generalized pustular psoriasis (GPP) is an extremely rare type of psoriasis that can present in a variety of forms. Unlike the most general and common forms of psoriasis, GPP usually covers the entire body and with pus-filled blisters rather than plaques. GPP can present at any age, but is rarer in young children. It can appear with or without previous psoriasis conditions or history, and can reoccur in periodic episodes.
Obesity is a medical condition in which excess body fat has accumulated to the extent that it has an adverse effect on health. Relative weight and body mass index (BMI) are nearly identical and are reasonable estimates of body fatness as measured by percentage body fat. However, BMI does not account for the wide variation in body fat distribution, and may not correspond to the same degree of fatness or associated health risk in different individuals and populations. Other measurements of fat distribution include the waist–hip ratio and body fat percentage. Normal weight obesity is a condition of having normal body weight, but high body fat percentages with the same health risks of obesity. BMI can be used to predict the risk of metabolic abnormalities like diabetes.
Pediculosis pubis is a disease caused by the pubic louse, Pthirus pubis, a parasitic insect notorious for infesting human pubic hair. The species may also live on other areas with hair, including the eyelashes, causing pediculosis ciliaris. Infestation usually leads to intense itching in the pubic area. Treatment with topic agents such as permethrin or pyrethrin with piperonyl butoxide is effective. Worldwide, pediculosis pubis affects about 2% of the population.
A burn center, burn unit or burns unit is a hospital specializing in the treatment of burns. Burn centers are often used for the treatment and recovery of patients with more severe burns.
The Baux score is a system used to predict the chance of mortality due to severe burns. The score is an index which takes into account the correlative and causal relationship between mortality and factors including advancing age, burn size, the presence of inhalational injury. Studies have shown that the Baux score is highly correlative with length of stay in hospital due to burns and final outcome.
Alexander "Alister" Burns Wallace (1906–1974) was a Scottish plastic surgeon. He was a founding member and president (1951) of the British Association of Plastic Surgeons, and the first editor of the British Journal of Plastic Surgery.
von Zumbusch (acute) generalized pustular psoriasis, is the most severe form of generalized pustular psoriasis, and can be associated with life-threatening complications.
A pediatric burn is an injury to the skin or underlying tissue in person under the age of 18, and is globally the most common type of pediatric injury. Burns can be caused my heat, cold, chemical or irritation. Most burns do not require hospital admission but a small percentage are serious and need to be transferred to specialist burn centers, where a multidisciplinary team of specially trained doctors, including surgeons and anesthesiologists can care for the child. Mortality rates at centers like this at are recorded at 3%