Skin Lesions Other than Pressure Ulcers of the Patients in a Rehabilitation Unit

Shim, Jae Ho; Lee, Jong Min; Park, Jeong Mee; Park, Roh Wook; Lee, Young Hee

Abstract

OBJECTIVE
The purpose of this study is to investigate the incidence and types of skin lesions occurring in the patients with a spinal cord injury(SCI), traumatic brain injury(TBI), cerebrovascular accident(CVA), and an amputation. METHOD: Five hundred and eighty-nine charts from 1991 to 1997 were retrospectively reviewed. During the hospitalization, the skin lesions were examined by the dermatologists upon consultations. The patients were divided by their diagnosis of the SCI, TBI, CVA, and amputation. The incidence of the skin lesions were analysed.
RESULTS
The number of patients was as follows; SCI 228, TBI 181, CVA 143, and amputation 37. The skin lesions occurred in 72 cases(12.9%) of which 30 cases(13.2%) occured in SCI, 21 cases(11.6%) in TBI, 15 cases(9.8%) in CVA and 7 cases(18.9%) in amputation. These include dermatophytosis 23 cases(23.9%), seborrheic dermatitis 21 cases(21.8%), pilosebaceous disorder 17 cases(17.7%) such as folliculitis, acne, and acneiform eruption, eczema 11 cases(11.4%), drug eruption 9 cases(9.4%), candidiasis 6 cases(6.3%), and others 9 cases(9.4%) such as steatocytoma multiplex, epidermal cyst, intertrigo, alopecia areata, and etc. The incidence of ANS related skin lesion such as seborrheic dermatitis and pilosebaceous disorder in SCI was significantly higher than in TBI and stoke, which the defect is in the brain(p<0.05). However, the incidence in other lesions such as dermatophytosis, eczema, and candidiasis was not significantly different between these two groups(p>0.05). The number of cases of ANS related skin lesions was 21(52.5%) and 3(42.9%) in SCI patients whose level of injury was from C1 to T6(in 40) and at or below T7(in 7) respectively. In contrast, the number of cases of other skin lesions such as dermatophytosis, eczema, and candidiasis was 15(37.5%) of C1 to T6 level and 4(57.1%) of at or below T7 level in the same SCI patients groups.
CONCLUSION
This study illustrates that the incidence of skin lesion in rehabilitation unit is 72 cases of 589 patients(12.9%). The incidence of ANS related skin lesion is higher in the patients with spinal cord injury than brain lesion. And the level of injury is higher in SCI, the more skin lesions occur.