Skin Disorders: Dermatitis/Eczema Psoriasis Fungal Infection Herpes Infection Windfield International College Of Nursing and Allied Sciences (NURS 2062)

Skin Disorders:Skin Disorders:Dermatitis/EczemaDermatitis/Eczema

PsoriasisPsoriasisFungal InfectionFungal InfectionHerpes InfectionHerpes Infection

Windfield International CollegeWindfield International CollegeOf Nursing and Allied SciencesOf Nursing and Allied Sciences

(NURS 2062)

Lecturer: Ms. Bernie

ObjectiveObjectiveAt the end of this lessons, students will be able to;At the end of this lessons, students will be able to;

1. Define and differentiate the types of skin 1. Define and differentiate the types of skin disordersdisorders

2. Identify the causes of each type of skin 2. Identify the causes of each type of skin disordersdisorders

3. State and explain the medical and nursing 3. State and explain the medical and nursing management for specific skin disordersmanagement for specific skin disorders

4. Discuss common skin tests and procedures 4. Discuss common skin tests and procedures used in diagnosing skin disordersused in diagnosing skin disorders

EczemaEczema

Eczema is an itchy inflammation of the skin. Eczema is an itchy inflammation of the skin.

It is associated with the following;It is associated with the following;

1. Redness on affected areas of skin1. Redness on affected areas of skin

2. Dry skin, often thickened in the areas that have 2. Dry skin, often thickened in the areas that have been scratchedbeen scratched

3. Lumps or blisters in affected areas3. Lumps or blisters in affected areas

4. Signs of superficial infection such as weeping or 4. Signs of superficial infection such as weeping or crusty depositscrusty deposits

Causes of EczemaCauses of Eczema

Exact cause is unknown, contributing factors Exact cause is unknown, contributing factors are the following;are the following;

1. Hereditary – passed down through the 1. Hereditary – passed down through the familyfamily

2. Irritants - like tobacco smoke, chemicals 2. Irritants - like tobacco smoke, chemicals or or solventssolvents

3. Allergens - like dust mites, moulds, plant 3. Allergens - like dust mites, moulds, plant pollens, petspollens, pets

Causes of Eczema con’t…Causes of Eczema con’t…4. Changes in temperature or humidity4. Changes in temperature or humidity

5. Chemical irritants - pesticides, paint, alcohol, 5. Chemical irritants - pesticides, paint, alcohol, astringents, perfumes, harsh soaps, detergents, astringents, perfumes, harsh soaps, detergents, and household cleaners and household cleaners

6. Physical irritants - such as clothes made of 6. Physical irritants - such as clothes made of rough or scratchy fabrics, like wool Allergies (to rough or scratchy fabrics, like wool Allergies (to dust, pollen, mold) dust, pollen, mold)

7. Intense emotion or stress Infections of any kind7. Intense emotion or stress Infections of any kind

EczemaEczema

How is eczema diagnosedHow is eczema diagnosed Thorough physical examination of the skin Thorough physical examination of the skin

as well as the patient’s account of the as well as the patient’s account of the history of the conditionhistory of the condition

Changes in environment or contact with Changes in environment or contact with certain materialscertain materials

A biopsy of the skin may be taken A biopsy of the skin may be taken

Allergy tests, a skin “patch test,” may be Allergy tests, a skin “patch test,” may be carried outcarried out

What is the treatment for eczema?What is the treatment for eczema?

1. Keeping the skin well hydrated through 1. Keeping the skin well hydrated through the application of creams, avoiding the application of creams, avoiding over bathing is an important step in over bathing is an important step in treatmenttreatment

2. Lifestyle modifications to avoid triggers 2. Lifestyle modifications to avoid triggers for the conditionfor the condition

What is the treatment for eczema? ..con’tWhat is the treatment for eczema? ..con’t

3. If itching is severe, oral antihistamines 3. If itching is severe, oral antihistamines may be prescribed.may be prescribed.

To control itching, the sedative type To control itching, the sedative type antihistamine drugsantihistamine drugs

4. Corticosteroid creams are sometimes 4. Corticosteroid creams are sometimes prescribed to decrease the inflammatory prescribed to decrease the inflammatory reaction in the skinreaction in the skin

PsoriasisPsoriasis

Psoriasis is a common, chronic disease of rapid Psoriasis is a common, chronic disease of rapid epidermal cell production (6 to 9 times the epidermal cell production (6 to 9 times the normal rate) without cellular maturation of the normal rate) without cellular maturation of the skinskin

Etiology:Etiology:

Exact cause is unknown, contributing factors;Exact cause is unknown, contributing factors;

1. Hereditary1. Hereditary

2. Climate - Cold, dry weather commonly starts 2. Climate - Cold, dry weather commonly starts a psoriasis flare-upa psoriasis flare-up

Etiology: PsoriasisEtiology: Psoriasis

3. Stress, unexpressed anger, and 3. Stress, unexpressed anger, and emotional disorders such as depression emotional disorders such as depression and anxietyand anxiety

4. Mild injuries to the skin such as abrasions 4. Mild injuries to the skin such as abrasions can trigger a psoriasis flare can trigger a psoriasis flare

Clinical manifestations.. PsoriasisClinical manifestations.. Psoriasis

It is characterized by raised, inflamed, red It is characterized by raised, inflamed, red lesions covered with a silvery-white lesions covered with a silvery-white buildup of dead skin cells (scales) buildup of dead skin cells (scales)

psoriasispsoriasis, toe nails , toe nails

Treatment for PsoriasisTreatment for Psoriasis

1. Topical treatments – agents applied to the 1. Topical treatments – agents applied to the skin, the first line of defense in treating skin, the first line of defense in treating psoriasis. psoriasis.

2. Systemics - are prescription medications 2. Systemics - are prescription medications that affect the entire body, for patients with that affect the entire body, for patients with moderate to severe psoriasis. moderate to severe psoriasis.

UrticariaUrticaria

Urticaria is an itchy rash or skin eruption, Urticaria is an itchy rash or skin eruption, which may occur anywhere on the which may occur anywhere on the body body

It is usually temporary, disappearing within It is usually temporary, disappearing within 24 to 48 hours. The rash has red 24 to 48 hours. The rash has red

weals weals (hard, raised patches of skin) (hard, raised patches of skin) and is and is usually itchy usually itchy

Etiology: UrticariaEtiology: UrticariaContributing factors;Contributing factors;

1. Digestive Disorders1. Digestive Disorders It may result from digestive disorders like It may result from digestive disorders like

mechanical irritation in the digestive tractmechanical irritation in the digestive tract

2. Drugs2. Drugs It may be caused by drugs like aspirin, It may be caused by drugs like aspirin,

penicillin, quininepenicillin, quinine

Etiology: Urticaria… con’tEtiology: Urticaria… con’t

3. Certain food3. Certain foode.g. strawberries, tomatoes, cucumber, e.g. strawberries, tomatoes, cucumber, mushrooms, oatmeal, wheat, nuts, fish, eggs, mushrooms, oatmeal, wheat, nuts, fish, eggs, chocolate, cheese, butter, and sausages. chocolate, cheese, butter, and sausages.

4. Bug bites4. Bug bitese.g. bedbugs, wasps, bees, mosquitoes, fliese.g. bedbugs, wasps, bees, mosquitoes, flies

5. Emotional excitement5. Emotional excitementIt may also result from emotional excitement It may also result from emotional excitement

UrticariaUrticaria

Blotchy rash typical of Blotchy rash typical of urticariaurticaria

General Treatment: UrticariaGeneral Treatment: Urticaria1.1. Identification and then elimination of the Identification and then elimination of the

contributing factorscontributing factors

2. Improved environment, corrected food 2. Improved environment, corrected food habitshabits

Fungal InfectionFungal InfectionFungi, tiny members of a subdivision of the Fungi, tiny members of a subdivision of the

plant kingdom that feed on organic matter plant kingdom that feed on organic matter are responsible for various common skin are responsible for various common skin infectioninfection

Types of fugal infectionTypes of fugal infection Tinea pedis (atheletes foot)Tinea pedis (atheletes foot) Tinea corporis (ringworm of the body)Tinea corporis (ringworm of the body) Tinea capitis (ringworm of the scalp)Tinea capitis (ringworm of the scalp) Tinea cruris (ringworm of the groin)Tinea cruris (ringworm of the groin)

Etiology of fungal infectionEtiology of fungal infection

1. Fungi – microscopic organisms that can 1. Fungi – microscopic organisms that can live on the dead tissues of the hair, nails, live on the dead tissues of the hair, nails, and outer skin layers. and outer skin layers.

Fungal infections include mold-like fungi Fungal infections include mold-like fungi (dermatophytes, which cause tinea (dermatophytes, which cause tinea infections), and yeast-like fungi (such as infections), and yeast-like fungi (such as candida). candida).

Symptoms for fungal infectionSymptoms for fungal infection

Itching (may be intense) Itching (may be intense) Skin lesion or rash Skin lesion or rash Skin redness or inflammation Skin redness or inflammation Enlarging patch Enlarging patch Macule or papule Macule or papule May have satellite lesions (smaller lesions next to May have satellite lesions (smaller lesions next to

bigger ones) bigger ones) Located on the skin folds, genitals, trunk, buttocks, Located on the skin folds, genitals, trunk, buttocks,

under the breasts, or on other skin areas under the breasts, or on other skin areas Infection of hair follicles ("folliculitis") may have a Infection of hair follicles ("folliculitis") may have a

pimple-like appearance pimple-like appearance

Fungal infectionFungal infection

Prevention of Fungal Toenail Prevention of Fungal Toenail InfectionInfection

1. Keep the nails dry and clean1. Keep the nails dry and clean

2. Change socks often, even several times a day if 2. Change socks often, even several times a day if necessarynecessary

3. Use an antifungal foot spray or powder3. Use an antifungal foot spray or powder

4. Avoid cutting or tearing the skin around the 4. Avoid cutting or tearing the skin around the toenails since this may be an entry point for toenails since this may be an entry point for infectioninfection

nail nail fungal infectionfungal infection

Fungal infectionFungal infection of the mouth of the mouth

TreatmentTreatment for fungal infection for fungal infection1.1. General hygiene is vital to the treatmentGeneral hygiene is vital to the treatment

2. Keeping the skin dry and exposed to air is 2. Keeping the skin dry and exposed to air is helpfulhelpful

3. Topical antifungal medications may be 3. Topical antifungal medications may be used used to treat infection of the skinto treat infection of the skin

4. Systemic antifungal medications may be 4. Systemic antifungal medications may be necessary for folliculitis or nail infection.necessary for folliculitis or nail infection.

Herpes infectionHerpes infection

Herpes zosterHerpes zoster - a common viral infection - a common viral infection of of the nerves, characterized by a the nerves, characterized by a painful painful skin rash of small blisters skin rash of small blisters anywhere anywhere on the bodyon the body

also known as shingles, is the reactivation of also known as shingles, is the reactivation of varicella zoster virus, leading to a crop of varicella zoster virus, leading to a crop of painful blisters over the area of a painful blisters over the area of a dermatomedermatome

Treatment: Acyclovir ( cream/ tablet)Treatment: Acyclovir ( cream/ tablet)

Herpes simplexHerpes simplex

Herpes simplexHerpes simplex

The Herpes simplex virus infection (common The Herpes simplex virus infection (common names: herpes, cold sores) is a common, names: herpes, cold sores) is a common, contagious, incurable, and in some cases contagious, incurable, and in some cases sexually transmitted disease caused by a sexually transmitted disease caused by a double-stranded DNA virus double-stranded DNA virus

The infection can also affect the brain, in The infection can also affect the brain, in which case the consequent disease is which case the consequent disease is called herpes simplex encephalitiscalled herpes simplex encephalitis

TransmissionTransmission

1. Herpes is contracted through direct skin contact with an infected 1. Herpes is contracted through direct skin contact with an infected person.person.

2. The virus travels through tiny breaks in the skin or mucous 2. The virus travels through tiny breaks in the skin or mucous

membranes in the mouth (HSV-1) and genital areas (HSV-2),membranes in the mouth (HSV-1) and genital areas (HSV-2),

3. Mucous membranes - even microscopic abrasions are sufficient to 3. Mucous membranes - even microscopic abrasions are sufficient to expose the nerve endings into which the virus can penetrate itselfexpose the nerve endings into which the virus can penetrate itself

This is why most herpes transmission happens in mucous This is why most herpes transmission happens in mucous membranes, or in areas of the body where mucous membranes and membranes, or in areas of the body where mucous membranes and normal skin merge (e.g., the corners of the mouth).normal skin merge (e.g., the corners of the mouth).

InfectionInfection of the of the herpesherpes

Nursing management for skin Nursing management for skin disordersdisorders

Goal : Maintain skin integrityGoal : Maintain skin integrity

1. Remove moisture from skin by blotting 1. Remove moisture from skin by blotting gently and avoiding frictiongently and avoiding friction

2. Guard carefully against risks of thermal 2. Guard carefully against risks of thermal injuries from excessively hot wet injuries from excessively hot wet

dressingsdressings 3. Advise patients to use sunscreen agents 3. Advise patients to use sunscreen agents


Goal: Relief of discomfortGoal: Relief of discomfort 1. Examine the area of involvement;1. Examine the area of involvement;

A. Attempt to discover the cause of discomfort – help A. Attempt to discover the cause of discomfort – help to identify comfort measuresto identify comfort measures

B. Record observation in detail, using descriptive B. Record observation in detail, using descriptive terminologyterminology


Goal: Relief of discomfortGoal: Relief of discomfort2. Control environmental and physical 2. Control environmental and physical

factors;factors;a. Maintain a cool environment – a. Maintain a cool environment –

coolness deters itchingcoolness deters itchingb. Use mild soap for sensitive skin b. Use mild soap for sensitive skin

(dove, cataphyl)(dove, cataphyl)c. Remove excess clothing and c. Remove excess clothing and

beddingbeddingd. Wash bedlinens and clothings d. Wash bedlinens and clothings

with with mild mild fragragrant – free soapfragragrant – free soap


Goal: Relief of discomfortGoal: Relief of discomfort

3. Use skincare measures to maintain 3. Use skincare measures to maintain skin integrity and promote skin integrity and promote comfortcomfort

a. provide tepid cooling baths or a. provide tepid cooling baths or cool dressings for cool dressings for

itchingitching

b. Apply skin lotion or cream b. Apply skin lotion or cream immediately after bathingimmediately after bathing

c. keep nails trimmedc. keep nails trimmed


Goal: Achievement of restful sleepGoal: Achievement of restful sleep

1. Prevent and treat dry skin1. Prevent and treat dry skin

a. Advise patient to keep bedroom well ventilated a. Advise patient to keep bedroom well ventilated – – comfortable environment promotes relaxationcomfortable environment promotes relaxation

b. Keep skin moisturizedb. Keep skin moisturized

c. Bathe/shower only as necessaryc. Bathe/shower only as necessary

2. Advise patients that may be helpful in promoting sleep2. Advise patients that may be helpful in promoting sleep

a. Keep regular schedule for sleepinga. Keep regular schedule for sleeping

b. Avoid caffeinated drinks in the eveningb. Avoid caffeinated drinks in the evening

c. Use antihistamine at bedtime if prescribedc. Use antihistamine at bedtime if prescribed

•

ReferenceReference

Medical Surgical Nursing, Vol 1, 10Medical Surgical Nursing, Vol 1, 10 thth edition by edition by Suzanne C. Smeltzer and Brenda G. BareSuzanne C. Smeltzer and Brenda G. Bare

Medical Surgical Nursing, 5Medical Surgical Nursing, 5thth edition by Donna edition by Donna D. Ignatavicius , M.S., RN, CD. Ignatavicius , M.S., RN, C

M. Linda Workman, PHD, RN, FAANM. Linda Workman, PHD, RN, FAAN

Medical Surgical Nursing, 3Medical Surgical Nursing, 3rdrd Edition by Priscilla Edition by Priscilla Lemone and Karen BurkeLemone and Karen Burke

Documents

Skin Disorders: Dermatitis/Eczema Psoriasis Fungal Infection Herpes Infection Windfield International College Of Nursing and Allied Sciences (NURS 2062)