Exam 16: Infectious, Inflammatory and Parasitic Disorders of the Skin
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| Viral Skin Disorders | Herpes Simplex (Viral).
Herpes Zoster (Shingles) (Viral).
Impetigo: (Bacterial).
Furuncle (Boil).
Fungal Infections (Dermatophytoses).
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| Herpes Simplex (Viral) | caused by the herpes virus hominis.
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| Type 1 HSV | The most common form, it causes the common cold sore. Characterized by vesicles at the corner of the mouth, lips, or on the nose.
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| Type 2 HSV | Characterized by vesicles in the genital area of both male and
female. Known as genital herpes. Transmitted primarily through sexual contact.
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| HSV: Medical Management | There is no cure for the herpes virus but treatment is aimed at relieving symptoms. Acyclovir (Zovirax) is an antiviral agent used to alter the course of the disease.
Analgesics (Tylenol) and topical anesthetics may be prescribed for pain.
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| Herpes Zoster (Shingles)(Viral): Caused by | varicella virus that causes chicken pox (Herpes varicellae).
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| Herpes Zoster (Shingles)(Viral): Characterized by | lesions along the nerve fibers of spinal ganglia. First
symptoms are pain, itching, and heightened sensitivity along the nerve pathway.
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| Herpes Zoster (Shingles)(Viral): Medical management | Acyclovir, an antiviral medication given orally and IV may reduce the pain and duration.
Lotions (Kenalog/Lidex) are used to relieve pruritus and ↓ Inflammation.
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| Impetigo: (Bacterial) Caused by | staphylococcus aureus, streptococci or a mixed bacterial infection of the skin.
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| Impetigo: (Bacterial) Leisons | Lesions start as macules that develop in pustulant vesicles. These rupture and form a crust. As the crust drops off, the skin underneath is smooth and red.
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| Impetigo:(Bacterial) Diagnostic tests | positive culture for streptococcus or Staphylococcus aureus
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| Impetigo:(Bacterial) Medical management | 1) Antibiotics such as Erythromycin, Dicloxacillin, Cephalosporin, Rocephin.
2) Topical antibiotics ( Bactroban) started early in the treatment.
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| Furuncle (Boil): | a bacterial inflammation of the skin caused by staphylococcus
infection of a hair follicle.
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| Furuncle (Boil): Clinical Manifesstations | (a) Sudden onset of red, tender, and hot skin around the hair follicle, which spreads to the surrounding skin.
(b) The center forms pus, and the core may need to be excised.
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| Furuncle (Boil): Tx | (a) Isolation procedures for wound and drainage/ secretion precautions, towels, soap and clothing if needed.
(b) Administer systemic antibiotics if a series of furuncles appear.
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| Fungal Infections (Dermatophytoses): | Tinea Capitis.
Tinea Corporis.
Tinea Cruis.
Tinea Pedis.
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| Tinea Capitis | Ringworm of the scalp. Erythematous, round lesion with pustules around the edges; causes alopecia at the site.
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| Tinea corporis | ringworm of the body. Flat lesions that are clear in the center with erythematous borders. Scaliness is found and pruritus is severe.
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| Tinea cruris | known as jock itch. Brownish-red lesions that migrate out from the groin area with pruritus and excoriation due to scratching.
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| Tinea pedis | athlete's foot. Most common of all fungal infections. Fissures and vesicles found around and below the toes.
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| Wood's light | ultraviolet light used to diagnose Tinea capitis.
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| Fungal Infections (Dermatophytoses): Medical Management | 1) Topical (Tinactin and Desenex) or oral (Fulvicin and Griseofulvin) antifungal drugs.
2) Treatment may last from 2 to 6 weeks.
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| Contact Dermatitis: | (a) Skin reaction from direct contact with agents in the environment to which a person is hypersensitive.
(b) Common causes are detergents, industrial chemicals and plants.
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| Contact Dermatitis: Clinical Manifestations | (a) Lesions appear at point of contact with the irritant.
(b) Epidermis becomes inflamed and papules form.
(c) Vesicles appear most often on the dorsal surfaces.
(d) There is burning, pain, pruritus and edema.
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| Contact Dermatitis: Diagnostic Tests | (a) Primary test is an accurate health history to identify the agent.
(b) Intradermal skin testing may be done to identify allergies.
(c) Labs: IgE levels and eosinophils are elevated.
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| Contact Dermatitis: Medical Management | corticosteroids and benadryl to treat the inflammation, edema and pruritus.
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| Contact Dermatitis: Patient Teaching | have patient wear medical alert bracelet.
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| Dermatitis venenata: | results from contact with certain plants. It is the common term for poison ivy and poison oak.
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| Urticaria: | commonly called hives. The presence of wheals caused by an allergic reaction from drugs, food, insect bites, inhalants, emotional stress or exposure to heat or cold.
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| Acne vulgaris: | an inflammatory papulopustular skin eruption that involves the
sebaceous glands. Develops when the oil glands become occluded.
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| What is the primary goal of nursing in the treatment of contact dermatitis? | Identify the offensive agent and eliminate it.
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| Psoriasis | a noninfectious disease where skin sloughing and generation of new skin cells occurs more rapidly than the normal 28 days. A chronic, hereditary disease involving the epidermis. No specific predisposing factors are known.
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| Psoriasis: Clinical Manifestation | lesions appear as raised, erythematous, silvery,
scaling plaques located on the scalp, elbows, knees, chin and trunk.
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| Psoriasis: Assessment | (a) Patient will complain of mild pruritus, but will be aware that others can see the scaling and avoid them.
(b) Besides the silver scaling, the fingernails may be pitting with a yellowish discoloration.
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| Psoriasis: Medical Management | Keratolytic agents such as tar preparations and Salicylic Acid (Calicylic) decrease the shedding of skin.
Topical steroids (Valisone) are used to decrease inflammation.
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| Pediculosis | a parasitic disorder of the skin usually associated with poor living conditions and poor hygiene.
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| Pediculosis: Medical management | topical application of a pediculicide such as (Kwell) or (RID) used on the affected area.
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| Scabies | Caused by the female itch mite penetrating and burrowing under the skin.
Once under the skin the mite lays eggs that mature and rise to the skin
Surface.
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| Scabies: Clinical Manifestation | Wavy, brown, threadlike lines on the body with severe pruritus and often secondary infection due to excoriation caused by scratching.
Normally found on the hands, arms, body folds and genitalia.
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