An interesting post on the topic of skin hygiene. Basic rules of skin hygiene. Nails and hair

The cells of our body live in a liquid environment. Through blood, lymph and tissue fluid, they receive nutrients and oxygen, and release decay products in them. A whole organism is in a gaseous environment, it is surrounded by air. The skin is the organ that separates the internal environment from the external, reliably protecting its constancy.

Chapter 1. Methodical recommendations for conducting lessons on the topic: "Structure, function and hygiene of the skin"

The material on this topic reveals the great importance of the skin as an integumentary organ that plays the role of an external barrier in the metabolism of the body with the environment.

Considering the content of the concept of "skin", the teacher should touch upon the properties of the skin as the largest organ of our body, the main functions of which are related to its structure. Hygienic concepts such as "hygiene of the skin, clothes and shoes" and "hardening of the body" are of particular importance.

The study of the topic can be carried out in 4-5 lessons. The first lesson reveals the meaning of the skin, its structure and function. On the second, it is recommended to study one of the most important functions of the skin - maintaining a constant body temperature. On the third - the assimilation of material on the hygiene of the skin and its derivatives (hair and nails), the hygiene of clothes and shoes. The fourth lesson can be devoted to studying the material on hardening the body. In lesson 5, it is advisable to consider skin diseases and measures for their prevention.

In the course of studying the material of the topic, along with educational tasks, the tasks of the development and education of students are solved. This is facilitated by the study of issues in a logical sequence, the establishment of interdisciplinary connections in order to obtain a single picture of the world.

From the means of visualization, when studying the topic, micropreparations of the structure of the skin, wall tables, educational films, atlases are used. To demonstrate experiments and observations, a magnifying glass, a microscope, an electric iron with a heat regulator and a signal lamp, jars of water of different temperatures are used.

The study of this topic is important for the development of concepts of metabolism, homeostasis, neuro-humoral regulation, as well as for the acquisition of the most important hygienic knowledge, skills and abilities. It is necessary to organize and conduct observations of students on their own skin in order to identify its characteristic properties.

The topic continues to concretize the concepts of the relationship between the structure of organs and the functions they perform.

I. Development of cognitive interest.

1. In the Russian folk tale "The Frog Princess" Vasilisa the Wise sheds her frog skin in order to take on a human form. While she bakes bread, weaves a carpet overnight, striking those present at the feast, the frog's skin lies in a secluded place, while maintaining full vitality. An end to these disguises is put by her husband - he burns the skin in the oven. This forces Vasilisa to cope with the kingdom of the dead to Koshchey the Immortal. Explaining this situation from the point of view of medicine, we can say that Vasilisa in the form of a frog receives a thermal burn that is incompatible with life. But in a fairy tale, everything ends well. Ivan rescues his spouse from Koshcheev's captivity, that is, he carries out her resuscitation. And the release of Vasilisa from the embrace of death ends successfully. Unfortunately, in real life, the fight against damage to large areas of human skin often ends with the death of the body.

2. The skin is an external integumentary organ, it is the most ancient organ of protection of our body. If the integrity of the skin is violated, pathogens enter the body. Burns that affect about a third of the body surface are deadly. They are accompanied by painful shock and poisoning of the body with decay products of damaged tissues. Now, if, like Vasilisa, in a critical situation it was possible to put on new skin, then many problems of burn therapy would be solved. Meanwhile, such a situation is no longer a fantasy.

3. In the middle of the XVII century. in the rich Italian cities, they liked to arrange magnificent festivities. The nobles strove to surpass each other in sophistication and splendor. In 1646, a festive procession took place in Milan, led by the "golden boy" - the personification of the "golden age". The child's body was covered in gold paint. The holiday was a success. The boy was forgotten after the procession. He spent the whole night in a cold castle and was very cold. The golden paint that covered his body caused a sharp expansion of the skin vessels, as a result he lost a lot of heat, his body temperature dropped sharply, the boy fell ill and soon died.

For a long time they could not explain the reason for the death of the child. It was speculated that the gold dye interfered with the perspiration and respiration of the skin. Only much later, in the 19th century, an experiment carried out on two men who were varnished showed that the reason was also a violation of the body's heat regulation.

4. The first attempts to preserve living pieces of human skin outside the body were made back in the 19th century. From volunteer donors, they were kept in a nutrient fluid consisting of salts, blood plasma and glucose. In such an environment, the skin pieces remained viable for some time and took root after being transplanted to their original place. But this method was not suitable for closing large wound surfaces.

The advances in modern biology make it possible to cultivate (grow) outside the body various types of cells in living organisms. But the problem is that it is difficult to find exactly those cells from which the skin is formed. This integumentary organ consists of several layers of cells. Figuratively, the skin can be compared to a house, the basements of which form the deepest part of the skin - the dermis. There, among the interlacing of various communications (blood vessels and nerve endings), cells - fibroblasts - live. They secrete a collage protein that forms collagen fibers similar to marine ropes. In terms of its structure, this structure resembles reinforced concrete. In it, a rigid metal frame (collagen fibers) is filled with cement (proteins and polysaccharides that connect the fibers). All together they form connective tissue - a solid foundation on which the cell walls of the upper layers of the skin - the epidermis - are erected. Only in it old cells lie at the top, and new ones are formed at the bottom at the border of the dermis and epidermis. Here are the stitched keratin stem cells that are constantly dividing. They are gradually pushed back to the skin surface. Having lost contact with the dermis, these cells lose the ability to divide and instead begin to produce keratin - the main protein in hair, feathers, horns and hooves.

The cells of the epidermis gradually change their shape, becoming flatter. Then they turn into keratinized dead scales. Once on the surface, they separate from the body, giving way to other cells.

From what has been said, it is clear that for growing skin outside the human body, special cells are needed - fibroblasts and keratinocytes.

For cultivation, only 1 cm of the donor's skin is taken, all keratinocytes are isolated from it. After a few days of cultivation (growing outside the body), these cells will occupy an area of ​​about 1 m 2. Then you can pack the grown keratinocytes into plastic tubes, freeze in liquid nitrogen and create a skin cell bank. Perhaps soon it will be possible to freeze not only cells, but also pieces of skin grown outside the body (in vitro, as scientists say). Such frozen epithelium is not difficult to deliver by plane to any part of the country in a few hours. You can also go the other way - to create small laboratories at emergency medical institutes, large clinics and burn centers, constantly engaged in the cultivation of skin material for transplants. Unfortunately, there will always be a need for it. According to the World Health Organization, burns rank 3rd among all types of injuries. So, a new era in trauma treatment begins - the era of tissue engineering. Perhaps, the time is not far off when, just in case, samples of human skin cells taken from him at birth will be stored in special banks.

II. Conversation about the structure and functions of the skin.

First, students recall material about integumentary tissues, the meaning and properties of the skin, answering the following questions: What tissues is the skin formed by? What part of the body is the skin? What is the meaning of the skin? What are the functions of the skin?

After that, they move on to studying the relationship between the functions of the skin and its structure. The reasoning can be as follows: "In the process of evolution in animals and humans, integumentary tissues were formed - leather. It directly borders on the changing environment, therefore its functions are varied. "

Problematic questions arise: what role does the skin play in the implementation of the body's connection with the environment and what is the dependence of its structure on function?

To answer these questions, it is necessary to get acquainted with the various functions of the skin: protective, thermoregulatory, excretory, receptor and partially respiratory.

Then the question should be answered: with what structural formations are these or those functions tied! To do this, students must study the microstructure of the skin, its blood supply, get an idea of ​​the receptors located in it, their role in realizing the unity of the body with the environment.

Test task on the topic "Skin"

Next to the questions (indicated in capital letters from A to G) are the answer options (from 1 to 12). The student marks the selected answer with a cross or a tick in the corresponding column of the answer card.

Leather Answer Card

Skin hygiene is the foundation of personal hygiene. The importance of skin hygiene is very important: thanks to it, the skin can be achieved so that your skin remains beautiful, youthful and healthy.

In the case of inadequate or insufficient nutrition, unsatisfactory working and living conditions, many dermatoses may occur.

To avoid any skin diseases, it is recommended to observe the rules of skin hygiene and, if possible, eliminate harmful domestic and occupational factors.

Hygiene of the human skin

To maintain good skin condition, it is necessary that the gastrointestinal tract functions normally and nutrition is complete. With a lack of vitamins A, B, D, C, PP, the appearance or exacerbation of certain skin diseases, including psoriasis and eczema, is possible.

To cleanse the skin of sweat, dirt, sebum, microorganisms and scales, you must regularly follow the rules of skin hygiene. It is recommended to take baths, the duration of which should be no more than 15 minutes, at least once a week. It is advisable to shower daily without using soap, while the water should be at room temperature.

Regardless of what your skin type is, you need to moisturize and nourish it. When choosing cosmetics, it is necessary to take into account their composition and effect on a specific skin type.

Nourishing creams contain numerous additives that have a beneficial effect on the vital functions of cells. These additives include vitamins, extracts, beeswax, lanolin, plant juices, and stone seed oil. Fats and oils that are included in the composition of cosmetic preparations, as a rule, are well absorbed, they reduce the return of water by the skin, which prevents it from drying out. In addition, they prevent microbes from entering the skin, and also have a protective effect on the skin from irritating environmental factors.

Maintaining the moisture balance in skin cells is essential for skin hygiene. To do this, you must regularly use moisturizing lotions and creams. A moisturizer is universal, therefore its use is suitable for oily skin, and dry, especially fading, because it not only moisturizes the skin, but also adds vitamins, fats, biologically active components and other useful substances to its layers.

Face and neck skin hygiene includes washing with warm water. In the case of thin and dry skin that is sensitive to sunlight and atmospheric influences, it is advisable not to use soap, but to use soft water - boiled, tap or rain, adding ¼ teaspoon of baking soda to 1 liter of water.

For proper skin hygiene, it is useful to take a contrast shower, which helps to relieve fatigue, has a beneficial effect on the skin, and also helps to improve its blood supply due to the fact that the blood vessels periodically narrow and expand. It is recommended to start showering with warm water, gradually increasing its temperature. Then you need to quickly pour cold water over it. Repeat the procedure 2-3 times and finish with cold or cool water. Hypothermia should be avoided and scalding ice water should not be used.

Of no small importance is the protection of the skin from injuries, which act as a gateway for pyogenic infection. For this purpose, if necessary, you need to use overalls, protective paste and special detergents.

Observing the rules of skin hygiene, it is necessary to take into account that the sun's rays in case of moderate exposure, fresh air, and the adoption of water procedures, including sea bathing, have a beneficial effect on the skin. With the help of these measures, the skin's resistance to external stimuli is increased. In addition, it is useful to engage in physical education or sports.

The skin not only serves as a protective shell for the human body, but also actively interacts with the external environment. In particular, it primarily takes a blow from a variety of irritants - chemical, physical and infectious, many of which are capable of causing numerous pathological processes both on the skin itself and inside the body. Also, often, the epithelial cover is the first indicator, signaling that something is wrong with our health. Therefore, keeping the skin clean is one of the main points in the complex of hygiene procedures.

Function of the skin

Throughout a person's life, the epithelial cover performs many functions aimed at maintaining the health and vital activity of the body:

  1. Protective.
  2. Thermoregulation.
  3. Secretory.
  4. Resorptive.
  5. Respiratory.
  6. Participation in the general metabolic process.
  7. Acting as a sense organ.

Protective function

The skin protects the body from the diverse negative influences of the external environment, which can cause both mechanical and viral harm to the internal organs.

Thermoregulation function

The skin reacts to a large extent to temperature changes: in the cold, its vessels narrow, and heat transfer decreases, while in heat they expand, sweating and active radiation of excessive heat by the body begins.

Secretory and resorption functions

With the secretory function, excess fluid is released in combination with the work of the sebaceous and sweat glands, and with the resorption function, on the contrary, the absorption of the missing amount of water to maintain the natural balance of the body occurs.

Respiratory function

Although a person receives the overwhelming amount of O 2 through the respiratory tract, the skin also participates in the oxygen saturation system - with its help, gas exchange processes are activated.

Skin as a sensory organ

The skin reacts to touch, pain, heat and cold, and through nerve endings it transmits information to the brain. And already on the basis of the results of its processing, a person models the system of his behavior in a given situation.

In order for all of the above functions to be carried out in a stable mode, in order to avoid disruptions in the body, careful skin care is required. Skin hygiene, or rather, its rules, has some characteristics for different ages, as well as some common points.

General rules

As a result of pollution and damage, not only the skin can earn multiple diseases, but the entire body as a whole. In this regard, both children and adults are advised to follow some general rules of skin hygiene:

Daily washing and showering;

Use of mild or ph-neutral hygiene products (baby soaps, gels, wet wipes, foams);

Regular change of underwear and items of clothing that have direct contact with the skin;

If peeling occurs, it is necessary to lubricate the skin with a moisturizer or special ointment;

Mechanical removal of abscesses, acne, overgrown crust at the sites of wounds and scratches is unacceptable;

Regular consumption of plant and dairy foods, vitamins;

Avoid sources that cause allergic skin rashes (food, drinks, animal dander, clothing made from unnatural materials);

In case of skin contact with unknown plants, chemical reagents, rinse the contact area as soon as possible;

Avoid frostbite and chapping of the skin;

Wash your hands regularly with soap and water;

Wipe dry after water procedures;

If possible, use removable shoes indoors, avoid sweating or hypothermia of the feet;

Daily walks in the fresh air lasting at least 20-30 minutes;

Moderate sunbathing or quartzing.

As you can see, standard skin hygiene is a fairly simple set of rules that should not be forgotten by either child or adult. However, the skin of these two age categories still has some differences, and, therefore, its own care nuances.

Differences between adult and child skin

The skin of a child up to 7-8 years old is more prone to allergic reactions, it is too thin and delicate, unlike an adult. It contains more fat cells and more blood. Some functions of children's skin are not yet fully debugged, however, after 9 years, some stability in the work of sweat and sebaceous glands begins to appear.

The older a person gets, the sooner the skin begins to fade. Over the years, it is less elastic, not so abundantly filled with blood, the work of the glands slows down or stops altogether. The upper epithelium dries up, due to which wrinkles begin to erupt, age spots appear.

In this regard, the hygiene of the child's skin has some features, which must be paid attention to at an early age.

Hygiene rules for the child

It is necessary to take care of the skin of children from the very first weeks of his life. It is hardly worth explaining that at these stages he does not yet have sufficient immunity, and all the functions of the body are just beginning to develop.

Hygiene of the skin of a newborn should be done very carefully and delicately. It is carried out in accordance with some of the following conditions:

Bathing every night;

The use of certified cosmetics for newborns, which do not contain substances that irritate the skin and mucous membranes;

The composition of cosmetics should be absent: phenoxyethanol, sodium hydroxide, ethylene oxide, lauryl sulfates, various preservatives;

When bathing, it is possible to use natural plant extracts or a small amount of herbal oils;

For severe contamination, the use of children's lotions is permissible;

Using milk to protect from the sun when walking outdoors;

Elimination of dry skin with baby cream or oil;

Regular change of diapers, soiled diapers and clothes;

The use of soft sponges, napkins, cotton swabs and tampons, if possible, do not leave lint;

Careful monitoring of the baby's body reactions to environmental factors (the occurrence of itching, allergic reactions, redness, diaper rash).

Skin hygiene for a grown-up child should become a habitual item in the daily routine. It is necessary to explain to the kid what non-observance of elementary rules can lead to. The sooner your child begins to understand the usefulness of these habits, the easier it will be for parents in the future - there will be no need to constantly monitor, for example, whether the child has washed his hands.

Features of skin hygiene of an adult

Personal hygiene of the skin of an adult also has some features that cannot be ignored:

The bath can be taken 1-2 times a week with daily rinsing under the shower;

If possible, during the shower, try not to use soap, especially antibacterial - the composition of the current products is such that they are able to eliminate not only harmful microorganisms, but also useful ones;

Both men and women equally, regardless of skin type, should use moisturizing and nourishing creams, lotions;

It is best to wash your face with water at room temperature;

Remember that a contrast shower is extremely useful - it keeps the skin tone, elasticity and firmness;

Deep cleansing of the face with the use of cosmetics is recommended once a week, for problem skin - twice;

Shaving will be easier if you rinse your face with hot water before the procedure;

Dull shaving machines are not only ineffective, but can also injure the skin, pulling out hairs;

Do not neglect swimming in a river, lake or sea, but make sure that the water is at a comfortable temperature, and swimming is not prohibited;

All creams, masks and other caring and leave-in products are applied only to clean skin without makeup.

Hygiene of the scalp

Special attention should be paid to such an issue as skin and hair hygiene. Almost all people (with rare exceptions) have hair on their heads of varying degrees of density. So that the scalp does not suffer, and the hair has a healthy appearance, it is necessary to take care of them no less than the cover on the rest of the body:

Brush your hair regularly and correctly;

Use curlers, curling irons, hair dryers in a gentle mode;

Apply special shampoos, masks, balms, oils;

It is best to wash your hair once a week;

Eliminate dandruff at its first manifestations;

If possible, avoid perming and dyeing with ammonia products.

Unfortunately, in everyday life we ​​do not always pay enough attention to such an aspect as human skin hygiene. It is often forgotten that the main purpose of these rules is not beauty and preservation of youth, but to improve the quality of life and longevity.

Hygiene of the human skin is a system of measures that ensure the maintenance of the skin in a clean, safe and well-groomed condition.

Skin hygiene is, first of all, a way to protect health from the effects of external environmental factors. Many diseases enter our body through the skin, and it is in our power to prevent most of them. The skin performs a protective function in the body, but in order for it to cope with its important task, it needs the help of its owner.

It is important to take a shower every day for anti-pollution. Washing with gel or soap should be done 1-2 times a week, but no more. It is undesirable to use detergents on the entire surface of the body every day. Human skin has a water-lipid coating, the pH of which is normally acidic. and fungi are afraid of an acidic environment, and it is difficult for them to harm the human body. With frequent use of detergents, the pH is disturbed and shifted to the alkaline side. This creates favorable conditions for the development of pathogenic microbes. However, skin hygiene in areas where sweat can stagnate and create conditions for the development of bacteria should be done every day with soap. These include: the perineum, legs, armpits, breasts, and under the breasts (in women).

In order to strengthen the immune system and improve the health of the body, daily dousing or rubbing with cold water can be performed. But people with increased excitability with cold water should be careful, as it excites the nervous system. In this case, it is better to consult a doctor before hardening.

The contrast shower procedure has a good firming and invigorating effect. It takes place in several stages. First you need to get under a warm shower and gradually increase the temperature of the water until it becomes noticeably hot, but not scalding. Stand this way for about a minute, then suddenly switch the water and make it cool. After several procedures and the body's habituation, the water can be made very cold. It is enough to stand under cold water for 30-60 seconds, then open hot water again. Repeat all steps one or two more times. stimulates metabolic processes in the body, maintains and improves skin tone, removes toxins from the body. In addition, it has a positive effect on the functioning of blood vessels and strengthens the cardiovascular system.

Skin hygiene includes skin care. If the skin is dry or, conversely, oily, it requires additional care. Depending on, it is important to choose the right hygiene products. If the skin is dry, it is better to use regular baby soap for washing, it will help restore the water-fat balance and normalize the skin condition. If it is not possible to solve the problem only with soap, you can use moisturizers, which are widely represented on the modern cosmetic market. For oily skin, use regular toilet soap, or After washing, you can use a body scrub to exfoliate the top layer of the epithelium and remove sebum.

Every conscious adult person independently monitors the condition of his skin and the whole body. But no less important is the hygiene of the skin of the child, who himself is not able to perform this procedure with high quality. It is very important for parents to monitor the hygiene of their children in order to avoid unpleasant consequences in the form of various infections and diseases.

Hygiene of the skin, as well as of the nose, hair and nails, is essential for well-being, good health and good mood. Cleanliness is the key to health!

A child's skin protects the body much worse from fluctuations in ambient air temperature, exposure to sunlight, various injuries and mechanical damage, as well as from the effects of various bacteria than the skin of an adult. Therefore, it is very important for the normal condition of the skin and the functioning of the body to observe hygiene of the skin of children, daily care for it and prevent possible damage to it.

Residues of sweat, sebum, dead cells of the epidermis, bacteria, dust accumulate on the surface of the skin. All these layers pollute the skin, clog the openings of the sebaceous and sweat ducts. Sebum and organic sweat residues decompose and create an unpleasant odor. On contaminated skin, favorable conditions are created for the development of pathogenic bacteria, which results in various skin diseases, eczema, etc.

Bacteria, as well as the eggs of worms on the surface of the skin, can easily get into, especially from the skin of the hands, into the mouth and cause serious illnesses (dysentery, scarlet fever, typhoid fever, worm infections, etc.). Especially a lot of pathogenic bacteria accumulate in the folds of the skin. That is why it is so important to take care of the cleanliness of the skin, both its exposed parts and covered with underwear. Change bed linen weekly.

It is necessary to teach children how to wash properly. During the morning wash, you first need to wash your hands, washing not only your hands, but also your forearms. Then wash your face, neck, ears. It is necessary to wash with soap, since water alone cannot completely remove dirt from the skin. Soap dissolves fatty acids that accumulate on the surface of the skin as a result of the activity of the sebaceous and sweat glands. The soap also softens the epidermis and makes it easier to remove dead tissue from the epidermis. You need to wash yourself with water of normal room temperature. Before going to bed, you need to wash your face and wash your feet with lukewarm water and soap. Hands should always be washed before eating, after work, in particular after returning home from school, and after using the toilet.

At least once a week, children should bathe in the bathtub or wash their entire body in a hot shower. Only hot water with soap and a washcloth or a sponge can completely cleanse the skin from dirt, dust, particles of exfoliated epidermis, sebum deposits and decay products released with sweat, as well as cleanse the excretory ducts of the skin glands.

On clean skin, germs die much faster than on dirty. Washing the body with hot water and soap improves blood circulation in the skin. At the same time, the work of the heart and respiratory organs increases, the metabolism increases. But using hot water to wash your body more than twice a week is not advisable, as this leads to excessive defatting of the skin and leads to dryness.

To wash your hair, it is best to use the so-called "soft" water (rain or river), which is low in lime and magnesium salts. Soap is easier to wash in soft water and it is easier to remove dirt from the skin and hair. It is better for boys to cut their head hair short. Then they accumulate less dust and are easier to wash. Long hair in boys and braids in girls should be combed regularly with a fine comb.

Fingernails and toenails should be cut short and washed thoroughly to prevent dirt from collecting underneath. It is necessary to fight the bad habit of children to bite their nails, because this is often the cause of infection with worms and infectious diseases.

Protect the skin from frostbite and burns. The skin is frostbitten more often on the nose, ears, fingers and toes. With frostbite of the first degree, the skin turns pale, there is severe pain. With frostbite of the second degree, the skin swells, dark red spots form and sensitivity is lost; with frostbite of the third degree, the necrosis of the frostbite area begins. In severe frosts, children should wear hats with headphones, and warm gloves on their hands. In very severe frosts, it is recommended to lubricate the exposed parts of the face with a thin layer of Vaseline before leaving the room. It is good to drink warm tea, milk or coffee.

If you find signs of frostbite, you should immediately consult a doctor. But first, it is necessary to restore blood circulation in the frostbitten areas of the body - move the child to a warm room, remove the frozen things, very carefully grind and massage the frostbitten areas, wrap it with a soft warm cloth or fur and let the body gradually warm up. Drink warm tea and call a doctor.

In case of frostbite of the second and third degree, rubbing should not be done, you must immediately consult a doctor. For any degree of frostbite, hot food and tea are useful. It should be remembered that frostbite most often occurs with relatively little frost, but with strong winds. In frosty, windy weather, you need to be very careful, take timely precautions against frostbite of children.

Burns. You can burn yourself with a flame, boiling water, hot metal, sun rays, alkali, acid, and the like. A first-degree burn is accompanied by redness, slight swelling of the skin and pain. With second-degree burns, bubbles form, with third-degree burns, the deeper layers of the skin are damaged, with fourth-degree burns, the affected area is charred.

You can not process the damaged surface of the child's skin with improvised folk remedies, try to clean the wound yourself, apply bandages. Do not pierce blisters or peel off clothing adhering to wounds. It is necessary to remove the fabric from the damaged area, carefully cut the adhered fabric around.

For burns of 1 and 2 degrees, pour cool water on the affected area for 5-10 minutes, and wrap the child himself at the same time so as not to bring the body to hypothermia. Spray Panthenol or Olazol (one of them should always be at home) and apply a bandage of several layers of gauze or bandage. Give your child as much water as possible to drink. The sterile dressing is changed once a day. If it sticks, pre-moisten it with furacilin solution or pale pink potassium permanganate. If after a few days the skin around the blister turns red and pus forms inside, you should see a doctor.

In case of a 3rd and 4th degree burn, apply a clean, damp cloth, call an ambulance, and give as much water as possible to drink. An ambulance should also be called for a 1-2 degree burn, if the lesion has affected a large area of ​​the body, there are open wounds, groin, head, nose, mouth, and respiratory organs are affected.