A male client with psoriasis visits the dermatology clinic. When inspecting the affected areas, the nurse expects to see which type of secondary lesion?
A. Scale
B. Crust
C. Ulcer
D. Scar
Correct Answer: A. Scale
A scale is the characteristic secondary lesion occurring in psoriasis. Although crusts, ulcers, and scars also are secondary lesions in skin disorders, they don’t accompany psoriasis. Psoriasis is a chronic proliferative and inflammatory condition of the skin. It is characterized by erythematous plaques covered with silvery scales particularly over the extensor surfaces, scalp, and lumbosacral region.
Option B: Impetigo is a common infection of the superficial layers of the epidermis that is highly contagious and most commonly caused by gram-positive bacteria. It most commonly presents as erythematous plaques with a yellow crust and may be itchy or painful. The lesions are highly contagious and spread easily.
Option C: Decubitus ulcers are skin or soft tissue injuries that form due to prolonged pressure exerted over specific areas of the body. They should receive prompt treatment; otherwise, complications associated with these injuries can be fatal. The cornerstone of treatment is to reduce the pressure exerted at the site of the lesion.
Option D: Hypertrophic scarring represents an undesirable variant in the wound healing process. In hypertrophic scars, excess connective tissue is deposited in the area of the original tissue wound. Hypertrophic scarring presents as an area of increased induration and often dyspigmentation over the site of a wound, especially in areas of increased wound tension.
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