Question

During a physical examination, the nurse notes an area on a clients forearm that is a different color that the surrounding skin. The client reports the site was burned several years ago and, after healing, has not been able to tan. What does this finding suggest to the nurse?

1) The reticular layer of the dermis was damaged.
2) The stratum spinosum skin layer of the epidermis was damaged.
3) The stratum basale skin layer of the epidermis was damaged.
4) The papillary layer of the dermis was damaged.

Answer 1

The inability of the client's burn scar on the forearm to tan suggests damage to the stratum basale layer of the epidermis, where melanocytes are damaged or destroyed.

Step-by-step explanation:

The area on the client's forearm that is unable to tan and shows a different color than the surrounding skin suggests that the stratum basale layer of the epidermis was damaged due to the burn. The stratum basale contains melanocytes, which are responsible for producing melanin, the pigment that gives skin its color and offers protection against UV radiation. Since the area is no longer able to tan, it means that the melanocytes in that area were destroyed and are no longer able to produce melanin. This type of damage is also consistent with scarring, where normal skin structures, including melanocytes, are replaced with a collagen-rich matrix that does not have the same attributes as the undamaged skin.