|
| Fig. 64.8 Lightning strike skin burn. Note the whorled fernlike pattern characteristic of this type of burn injury. |
Lightning strike patients often have very characteristic skin findings. In addition to entry and exit burn wounds, the skin of these patients can often exhibit a swirled or fernlike erythema of the involved area (Fig. 64-8). If there is any doubt of the etiology, the biopsy findings in the skin are pathognomonic. It is important to diagnose this injury, because significant covert injury to the underlying fascia and muscles can occur. The degree of damage must be assessed and the patient treated for arrhythmias, shock, fluid and electrolyte imbalances, peripheral and central neural damage, and covert tissue damage to optimize recovery.
