1 / 71

Dermatologic Problems/ Integumentary System

Dermatologic Problems/ Integumentary System. Physical Examination. Obtain history WHATS UP Inspection Palpation Gloves are worn during examination . Physical Examination. Observe for: Color Temperature Moisture Dryness. Physical Examination. Skin texture (rough-smooth) Lesions

mavis
Download Presentation

Dermatologic Problems/ Integumentary System

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Dermatologic Problems/ Integumentary System

  2. Physical Examination • Obtain history • WHATS UP • Inspection • Palpation • Gloves are worn during examination

  3. Physical Examination • Observe for: • Color • Temperature • Moisture • Dryness

  4. Physical Examination • Skin texture (rough-smooth) • Lesions • Vascularity • Mobility • Texture of hair and nails • Skin turgor

  5. Physical Examination • Color • Varies from person to person • Ivory-deep brown • Pigmentations r/t • Sun exposure • Fevers • Sunburn, inflammation- • Pink or • Reddish hue • Pallor • Decreased skin tones

  6. Physical Examination • Color • Vascularity • Observed in • Conjunctivae • Mucous membranes • Bluish hue • Cyanosis = cellular hypoxia • Jaundice • Yellow pigment • sclera • mucous membrane

  7. Physical Examination • Color • Dark skinned persons • Have reddish base and undertones • Buccal mucosa, tongue, lips,nails normally appear pink • Cyanosis-skin assumes grayish cast • Age related changes

  8. Physical Examination • Types of dressings • Wet-dry dressings • Moisture-retentive dressings • Already impregnated with moisture • Occlusive dressings • Cover wound

  9. Physical Examination • Topical medications • Lotions, suspensions • Clear solutions, liniment, • Powders, creams, • Gels, pastes, • Ointments, sprays, • Corticosteroids etc.

  10. Abrasion – skin is rubbed or scraped off Lacerations – torn, ragged, irregular edges made by blunt objects Avulsions – the tearing away of tissue from a body part Incisions – cuts made by sharp cutting instruments Punctures – caused by objects that penetrate tissue while leaving a small surface opening  Amputations – traumatic is the nonsurgical removal of a limb from the body Wounds

  11. Wound Healing • 1st intention • 2nd intention • 3rd intention

  12. Diagnostic Tests/Treatments • Cultures • Skin biopsy • Wood’s light examination • Skin testing (allergies) • Open wet dressing/other dressings • Therapeutic baths • Topical meds

  13. Herpes Zoster {Shingles} • Acute inflammatory and infectious disorder • Painful vesicular eruption • Bright red edematous plaques along the nerve from one or more posterior ganglia

  14. Herpes Zoster {Shingles} cont’d • Eruption follows the course of the nerve • Almost always unilateral

  15. Herpes Zoster {Shingles} cont’d • Cause • Varicella-zoster virus (like chicken-pox) • Incubation period 7-21 days • Vesicles appear in 3-4 days • Occur posteriorly • Progress anteriorly & peripherally • Along dermatome • Duration 10 days to 5 weeks

  16. Herpes Zoster {Shingles} cont’d • Occurs most frequently in • Elderly • Immunosuppressed • Malignancy or injury to spinal or cranial nerve

  17. Herpes Zoster {Shingles} cont’d • Complications • Facial and acoustic nerve involvement • Hearing loss • Tinnitus • Facial paralysis • Vertigo • painful

  18. Herpes Zoster {Shingles} cont’d • Complications • Full thickness skin necrosis and scarring • Systematic infection from scratching, causing virus to enter blood stream

  19. Herpes Zoster {Shingles} cont’d • Medical treatment • Control outbreak • Reduce pain and discomfort • Prevent complications • Acyclovir (Zovirax) IV, PO, topically • Corticosteroids • Antihistamines • Antibiotics

  20. Herpes Zoster {Shingles} cont’d • Nursing Care • Cool compresses two-three times per day • Help cleanse and dry lesions • Measures to decrease itching • Medication

  21. Parasitic Skin Infections (PSI) • Higher risk situations? • Poor hygiene • Living in close quarters

  22. Pediculosis- Lice (PSI) • Infestation by human lice • Pediculosis capitis-head • Pediculosis corporis-body • Pediculosis pubis- pubic or crab

  23. Pediculosis (PSI) • Parasite • Approximately 2-4 mm • Female lays eggs-hundreds-nits • Deposit on hair shaft base

  24. Pediculosis (PSI) • Symptoms • Pruritus • Excoriation • Vectors of other diseases • Typhus • Recurrent fever

  25. Pediculosis Capitis (PSI) • More common in women • Sides and back of scalp • Assess for • Visible white flecks (nits) • Matting and crusting of scalp • Foul odor

  26. Pediculosis Capitis (PSI) • Treatment • Pediculicides • Hand pick or comb nits out • Launder bed linens & vacuum • Seal items in plastic bags for 14 days • Repeat above in 10-14 days

  27. Pediculosis Corporis (PSI) • Lice live and lay eggs in clothing • Itching • Assess for • Excoriation on • Trunks • Abdomen • Extremities

  28. Pediculosis Pubis (PSI) • Intense pruritis • Vulvar region • Peri-rectal • More compact • Crab-like appearance

  29. Pediculosis Pubis (PSI) • Contracted from • Infested bed linens • Sexual intercourse • May also infest • Axilla • Eyelashes • Chest

  30. Pediculosis (PSI) • Treatment • Chemical killing • Clean linens with hot water and soap • Dry-clean • Fine-tooth comb • Treat social contacts

  31. Scabies (PSI) • Contagious skin disease • Mite infestation • Transmitted by • Close-prolonged contact with • Infested companion • Infested bedding

  32. Scabies (PSI) • Characterized by • Epidermal curved or linear ridges • Follicular papules • Pruritus Palms • More intense and unbearable at night • White visible epidermal ridges by • Mite burrowing into outer layers of skin

  33. Scabies (PSI) • Hypersensitivity reaction • Excoriated erythematous papules • Pustules, crusted lesions • Elbows • Axillary folds • Lower abdomen • Buttocks, thighs • Between fingers • Genitalia

  34. Scabies (PSI) • Treatment • Topical sulfur preparations • One-two applications daily • Launder personal items • No disinfectant

  35. Ringworm - an infection caused by a fungus Jock itch – form of ringworm on groin area Athlete’s foot – fungal infection of foot (feet) Fungus live and spread on the top layer of the skin and on the hair grow best in warm, moist areas, contagious via skin-to-skin contact with a person or animal that has it or when you share things like towels, clothing, or sports gear. You can also get ringworm by touching an infected dog or cat, although this form of ringworm is not common. Ringworm (PSI)

  36. Psoriasis • Lifelong disorder • Exacerbations • Remissions • Cannot be cured

  37. Psoriasis • Pathophysiology • Scaling disorder • Underlying dermal inflammation • Abnormality in proliferation of epidermal cells in outer skin layers • Normal – 28 days to shed cells • Psoriasis Cells shed every 4-5 days

  38. Psoriasis • Cause-unknown • Genetic predisposition • Environmental factors • May appear after skin trauma • Sunburn • Surgery

  39. Psoriasis • Improves in warmer climates • Aggravated by • Infections • Streptococcal throat infection • Candida infections • Hormonal changes • Psychological stress

  40. Psoriasis • Assessment • History • Family history • Age at onset • Disease progression • Pattern of recurrences • Gradual or sudden

  41. Psoriasis Vulgaris {Ordinary/Common} • Most common • Thick erythematous papules or plaques • Surrounded by silvery white scales

  42. Psoriasis Vulgaris {Ordinary/Common} • Common sites • Scalp • Elbows • Trunk • Knees • Sacrum • Extensor surfaces of limbs

  43. Skin Cancers • Overexposure to sunlight • Common skin cancers • Squamous cell carcinoma • Basal cell carcinoma • Melanoma

  44. Actinic Keratosis • Pre-malignant lesions • Cells of epidermis • Chronically sun-damaged skin • Can lead to squamous cell carcinoma

  45. Squamous Cell Carcinoma • Malignant neoplasms of epidermis • Invade locally • Potentially metastic • Ear • Lip • External genitalia • Cause • Repeated irritation or injury

  46. Basal Cell Carcinoma • Basal cell layer of epidermis • Lesions go unnoticed • Metastasis rare • Underlying tissue destruction progresses to underlying vital structure

  47. Melanomas • Pigmented malignant lesions • Originate in melanin-producing cells of epidermis

  48. Melanomas • Risk factors • Genetic predisposition • Excessive exposure to UV light • Precursor lesions resembling unusual moles • Highly metastatic • Survival depends on early diagnosis and treatment

  49. Skin Cancers • Incidence/Prevalence • Light skinned persons • Outside work • Higher altitudes • Chemical carcinogens

More Related