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Skin disorders are very frequent during palliative care.

Skin is the most exposed organ of our body. Skin disorders may become major problems for patients during the terminal phase. Specific attention to skin should be paid by caregivers (particularly physicians who often spontaneously delegate this pathology to nurses), in order to avoid major pain (physical and psychological pain), a consequence of skin lesions.

Skin is a natural barrier avoiding the transmission of microbes inside the organism: clean skin and regular body care avoiding maceration are simple ways to avoid many of the general infections observed at the end of life. On the contrary, local irritation may represent the basis of any local and potentially generalised superinfection.

Skin is also the area of thermal exchange between the constant internal temperature (around 37°C) and external thermal variations. Good skin circulation enables the correction of such divergent temperature. Major skin lesions may modify these exchange possibilities (particularly near pressure points).

Skin is a very sensitive organ with several nerve terminations. Skin lesions are often very painful. These nerve terminations are most important for maintaining skin trophicity, thus explaining trophicity modifications observed during herpes or diabetes lesions.

Skin has an excellent power of regeneration (wounding and repairing), requiring a regular well furnished blood supply. Irrigation disorders (for instance through lengthy pressure in more or less conscious patients) will rapidly lead to trophic skin lesions and bedsores.

The following pages deal with:

Skin tumours,

Paraneoplastic skin syndromes, (same text and illustrations as the last page of the General History chapter )

Pruritus,

Sweating,

Treatment of skin lesions,

Bedsores.