Skin Disorders. Impetigo. Vesicles or pustule surrounded by edema and redness. Impetigo. 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
Vesicles or pustule surrounded by edema and redness
Impetigo became infected
group a hemolytic strep infection of skin.
Incubation period is 2-5 days after contact
Easily spread merely by touching another part of skin after scratching infected area.
Apply warm, moist soaks to soften lesions, remove crusts
Apply Bactroban TID to cleaned lesions
Cephalexin (keflex) for 10 days
Teach good handwashing and hygiene to prevent spread, keep fingernails short
Be alert for signs of acute glomerulonephritis,
If the impetigo was caused by beta-hemolytic streptococci
What is the major nursing implication here?
Fungal or yeast infection also known as Thrush
Caused by a group of fungi called dermatophytes
fungal infection of the stratum corneum, nails and hair(the base of hair shaft causing hair to break off-rarely permanent.
Scaly, circumscribed patches to patchy, gray scaling areas of alopecia.
Generally asymptomatic, but severe, deep inflammatory reaction may appear as boggy, encrusted lesions (kerions)
Tinea pedis or athletes foot
Give with fatty foods to aid in absorption
Treatment is for 6- 8 weeks
Can return to day care when lesions are dry
Avoid sun exposure
Nizoral, Diflucan, Lamisil – used only in older children because of risk of hepatoxicity
transmitted by clothing, bedding, combs and animals (cats)
may take 1-3 months to heal completely, even with treatment
Child doesn't return to school until lesions dry.
See Home Care for Child with Tinea infection on
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
Close examination of scalp reveals (nits) firmly attached to hair shafts.
Easily transmitted by clothing towels, combs, close contact, unrelated to hygiene.
pediculicide, permethrin (NIX) crème rinse
Applied to washed and towel dried hair. Massage into the hair and scalp one section at a time.
**Wet hair dilutes the product and may contribute to treatment failure.
Leave in place for 10 minutes and rinse
Comb hair with a fine-tooth comb to remove any remaining nits.
Repeat in 1-2 weeks
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
of the human body to survive. Away from the body, they die within 48 hours.
Scabies between thumb
and index finger
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)
Fresh laundered linen and underclothing should be used.
Contacts should be reduced until treatment is completed.
Inflammation of the skin that occurs in response to contact with an allergen or irritant
Soap, fabric softeners, lotions, urine and stool
Poison ivy, Poison oak
Vesicles or bullae that rupture, ooze and crust
Application of a corticosteroid topical agent – remind to continue use for 2-3 weeks after signs of healing
Application of protective barrier ointments
Oatmeal baths, Cool compresses
Antihistamines given for sedative effect
Chronic superficial skin disorder characterized by intense pruritis
Erythematous patches with vesicles
Exudate and crusts
Drying and scaling
Lichenification (thickening of the skin)
Hydrate the Skin
Reduce the amount of allergen exposure
Inflammatory disease of the skin involving the sebaceous glands and hair follicles.
Comedomal- noninflammatory follicular plug
Cystic- nodules and cysts
Papulopustular- papules and pustules
Do not pick! this increases the bacterial count on the surface of the skin and opens lesions to infection which worsens scarring.
Remind patients that the treatment will not show improvement until about 4-6 weeks but they must consistently follow the regime set up by the physician.
Topical: Benzoyl Peroxide, Tretinoin (RetinA), tetracycline and erythromycin. Topical agents are preferred treatment to systemic antibiotics, however increases in antibiotic resistant bacteria may require use of systemic antibiotics.
Oral: Tetracycline, minocycline, erythromycin and clindamycin- used for severe inflammatory acne or resistant to topical medications. Estrogen may also work for female patients. Isotretinoin (Accutane)- side effects include cataracts, dry skin, pruritius, conjunctivitis, nosebleeds and depression. Also a teratogen!