A burn victim shows erythema and blistering with blanching on pressure and intact sensation to pinprick. Which depth of burn is most consistent with these findings?

Explanation

## Superficial Partial-Thickness Burns (Superficial 2nd Degree) ### Clinical Features Identification The stem describes: 1. **Erythema and blistering** — indicates dermal involvement 2. **Blanching on pressure** — viable capillaries in dermis respond to pressure 3. **Intact sensation to pinprick** — nerve endings preserved These are **pathognomonic for superficial partial-thickness burns**. ### Clinical Presentation Comparison Table | Feature | Superficial (1st) | Superficial Partial (2nd) | Deep Partial (2nd) | Full-Thickness (3rd) | | --- | --- | --- | --- | --- | | **Appearance** | Erythema only | Erythema + blisters | Mottled red/pale, blisters | Charred, leathery, white | | **Blanching** | Blanches | **Blanches** | Does not blanch | Does not blanch | | **Sensation** | Painful | **Intact to pinprick** | Diminished | Absent | | **Depth** | Stratum corneum | Epidermis + superficial dermis | Epidermis + deep dermis | All layers | | **Healing** | 3–7 days | 2–3 weeks | 3–6 weeks | Requires grafting | | **Scarring** | None | Minimal | Hypertrophic | Permanent | **Key Point:** Blanching indicates viable capillaries in the dermis — a critical sign of partial-thickness rather than full-thickness burn. Intact sensation confirms nerve preservation. **High-Yield:** The **blanch test** is the single most useful bedside discriminator: - Blanches → Partial-thickness (2nd degree) - Does not blanch → Full-thickness (3rd degree) or deeper **Mnemonic:** **BLISTER = Blanching + Intact Sensation = Superficial Partial (2nd degree)** **Clinical Pearl:** Superficial partial-thickness burns are the most common type (85% of all burns). They are painful, moist, and weep fluid — all signs of viable dermis. Healing occurs by re-epithelialization from wound edges and appendages within 2–3 weeks.