Which of the following burn depths is characterized by erythema, blistering, and severe pain, with intact dermal appendages and expected healing within 2–3 weeks without scarring?

Explanation

## Classification of Burn Depth **Key Point:** Second-degree (partial-thickness) burns destroy the epidermis and part of the dermis while preserving dermal appendages (hair follicles, sweat glands), allowing re-epithelialization and healing without grafting if infection is prevented. ### Burn Depth Classification | Degree | Depth | Clinical Features | Pain | Healing | Scarring | | --- | --- | --- | --- | --- | --- | | **First** | Epidermis only | Erythema, no blistering, dry | Severe | 3–7 days | None | | **Second** | Epidermis + part of dermis | Erythema, blistering, moist | Severe | 2–3 weeks | None (if no infection) | | **Third** | Full dermis | Charred, leathery, white/brown | None (nerve destruction) | Requires grafting | Yes | | **Fourth** | Subcutaneous + muscle/bone | Carbonized, eschar | None | Requires grafting | Yes | **High-Yield:** Second-degree burns are the **most painful** because sensory nerve endings remain intact. The presence of blistering is pathognomonic for second-degree injury — the blister fluid represents serum from damaged capillaries in the dermis. ### Mechanism of Healing Second-degree burns heal via: 1. Epithelialization from surviving dermal appendages (hair follicles, sweat glands, sebaceous glands) 2. Contraction and re-epithelialization from wound margins 3. No skin grafting needed if infection is prevented **Clinical Pearl:** The distinction between superficial and deep second-degree burns: - **Superficial (2a):** Blisters, blanching erythema, moist, heals in 1–2 weeks - **Deep (2b):** Non-blanching erythema, slower healing (3+ weeks), may require grafting if deep **Warning:** Do not confuse second-degree with third-degree. Third-degree burns are painless (nerve destruction), leathery, and do NOT blanch — they require grafting.