Is the distinction between superficial pressure ulcers and moisture lesions justifiable? A clinical-pathologic study.

Objective: Pressure ulcers are classified into 4 distinct stages, which allows comparisons between institutions and even countries. Recently, attempts have been made to single out so-called moisture lesions from the early stages of pressure ulcer lesions as a distinct entity.

Methods: To investigate the justification for this development, 14 histopathologic samples from patients with both incontinence and pressure ulcer lesions were studied in an attempt to delineate differences in the pathophysiology and histopathology.

Results: Two distinct histopathologic pictures emerged: an ischemic pattern and a pattern of irritation. The latter appeared to be associated with lesions that clinically fit the description of moisture lesions, but this association was not absolute.

Conclusions: There is no justification for singling out moisture lesions from pressure ulcer lesions. The distinction may even be dangerous when proper preventive measures for the development of pressure ulcers are not taken because of the existence of a possible moisture lesion.