Skin Disorders

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• Skin Disorders
• Marlene Meador RN MSN

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Compare skin differences

• Infant skin not mature at birth
• Adolescence sebaceous glands become enlarged
  active.

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Skin Assessment

• Assess history
• Assess exposure
• Assess character
• Assess sensation

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Atopic / Contact Dermatitis

• Atopic/Eczema
• Cause unknown
• Genetic family hx
• Develop asthma or allergic rhinitis later
• Symptoms begin age 1 to 4 months

• Contact Dermatitis- skin inflammation from
  skin-to-irritiant contact
• Soaps/detergents
• Clothing dyes
• Lotions, cosmetics
• Urine ammonia

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Assessment Diagnosis

• Infants- Papulovesicular rash and scaly red
  plaques
• Extremely pruitic and dry skin
• Childhood- increases with emotional upset,
  sweating, irritating fabrics
• Other triggers- milk, eggs, wheat, soy, peanuts,
  fish

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Interventions Nursing Care

• Prevent secondary infection- control itching
• Moisturize skin
• Remove irritants
• Medication
• Parent teaching- long term

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Diagnosis / Assessment

• Infancy
• Childhood

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Impetigo

• http//www.emedicine.com/emerg/topic283.htm
• Impetigo became infected
• Hemolytic Strept infection of the skin
• Incubation period is 2-5 days after contact

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• Begins as a reddish macular rash, commonly seen
  on face/extremities
• Progresses to papular and vesicular rash that
  oozes and forms a moist, honey colored crust.
  Pruritis of skin
• Common in 2-5 year age group

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Therapeutic Management

• Apply moist soaks of Burrows solution
• Antibiotic therapy
• Patient education

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Candiditis- Thrush

• Overgrowth of Candida albicans
• Acquired through delivery

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Assessment

• Inspect mouth
• Assess for difficulty eating
• Assess diaper area

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Therapeutic Interventions

• Medication
• Nursing Care

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Dermatophytosis (Ringworm)

• Tinea Capitis
• Transmission
• Person-to-person
• Animal-to-person

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SS

• Scaly, circumscribed patches to patchy, gray
  scaling areas of alopecia.
• Pruritic
• Generally asymptomatic, but severe, deep
  inflammatory reaction may appear as boggy,
  encrusted lesions (kerions)

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• http//www.ecureme.com/quicksearch_reference.asp

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Diagnosis

• Potassium hydroxide examination
• Black Light

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Medication Therapy

• Oral- systemic
• Topical

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Patient Teaching

• transmitted by clothing, bedding, combs and
  animals
• may take 1-3 months to heal completely, even with
  treatment
• Child doesn't return to school until lesions dry

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Pediculosis Capitis (lice or cooties!)

• 
  http//www.emedicine.com/emerg/topic409.htm
• a parasitic skin disorder caused by lice
• the lice lay eggs which look like white flecks,
  attached firmly to base of the hair shaft,
  causing intense pruritus

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Diagnosis

• Direct identification of egg (nits)
• Direct identification of live insects

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Medication Therapy

• treatment shampoos RID, NIX, Kwell(or Lindane)
  shampoo is applied to wet hair to form a lather
  and rubbed in for at least amount of time
  recommended, followed by combing with a
  fine-tooth comb to remove any remaining nits.

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Patient Teaching

• Follow directions of pediculocide shampoos
• Comb hair with fine-toothed comb to remove nits
• Transmission, prevention, and eradication of
  infestation

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Scabies

• http//www.nlm.nih.gov/medlineplus/scabies.html
• Sarcoptes scabei mite.  Females are 0.3 to 0.4 mm
  long and 0.25 to 0.35 mm wide.  Males are
  slightly more than half that size.
• a parasitic skin disorder (stratum corneum- not
  living tissue) caused by a female mite.
• The mite burrows into the skin depositing eggs
  and fecal material between fingers, toes, palms,
  axillae
• pruritic grayish-brown, thread-like lesion

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• http//www.aad.org/pamphlets_spanish/sarna.html
• Scabies between thumb and index finger
• On foot

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Therapeutic Interventions

• transmitted by clothing, towels, close contact
• Diagnosis confirmed by demonstration from skin
  scrapings.
• treatment application of scabicide cream which
  is left on for a specific number of hours (4 to
  14)to kill mite
• rash and itch will continue until stratum corneum
  is replace (2-3 weeks)

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Care

• Fresh laundered linen and underclothing should be
  used.
• Contacts should be reduced until treatment is
  completed.

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Acne

• 
  http//www.pathology.iupui.edu/drhood/acne.html
• ACNE

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Assessment

• Closed lesions
• Open lesions
• Inflamed lesions

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Medication Therapy

• Topical
• Oral

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Therapeutic Management

• Goal- to prevent scaring and promote positive
  self image in the adolescent
• Individualized according to the severity of the
  condition
• 3 to 5 months required for optimal results (4 to
  6 weeks for initial improvement)

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Nursing Implications

• Provide information regarding the treatment
  regimen
• Provide support and promote positive self image
• Provide accurate information on the length of
  time required for effective treatment

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