Skin Disorders Marlene Meador RN MSN

Compare skin differences Infant: skin not mature at birth Adolescence: sebaceous glands become enlarged & active.

Skin Assessment Assess history Assess exposure Assess character Assess sensation

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

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

Interventions & Nursing Care Prevent secondary infection- control itching Moisturize skin Remove irritants Medication Parent teaching- long term

Diagnosis / Assessment Infancy Childhood

Impetigo Impetigo became infected Hemolytic Strept infection of the skin Incubation period is 2-5 days after contact

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

Therapeutic Management Apply moist soaks of Burrow’s solution Apply moist soaks of Burrow’s solution Antibiotic therapy Patient education

Candiditis- Thrush Overgrowth of Candida albicans Acquired through delivery

Assessment Inspect mouth Assess for difficulty eating Assess diaper area

Therapeutic Interventions Medication Nursing Care

Dermatophytosis (Ringworm) Tinea Capitis Transmission: – Person-to-person – Animal-to-person

S&S: 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)

Diagnosis Potassium hydroxide examination Black Light

Medication Therapy Oral- systemic Topical

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

Pediculosis Capitis (lice or cooties!) 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

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

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.

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

Scabies Scabies 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

Scabies between thumb and index finger On foot

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)

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

Acne ACNE

Assessment Closed lesions Open lesions Inflamed lesions

Medication Therapy: Topical Oral

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)

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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