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Slide 1
Pediatric Skin Disorders
Slide 2
Compare skin differences Infant: skin not mature at birth
Adolescence: sebaceous glands become enlarged & active.
Slide 3
Skin Assessment Assess history Assess exposure Assess character
Assess sensation
Slide 4
Dermatitis
Slide 5
Inflammation of the skin that occurs in response to contact
with an allergen or irritant; also referred to as contact
dermatitis
Slide 6
Dermatitis Common irritants: Soap, fabric softeners, lotions,
urine and stool Common allergens poison ivy, poison oak lanolin,
latex, rubber nickel, fragrances
Slide 7
Dermatitis: signs and symptoms Erythema Edema Pruritus Vesicles
or bullae that rupture, ooze and crust
Slide 8
Dermatitis: Treatment Medications Application of a
corticosteroid topical agent: remind pt to continue use for 2-3 wks
after signs of healing Application of protective barrier ointments
Oatmeal baths, cool compresses Antihistamines given for sedative
effect
Slide 9
Eczema Chronic superficial skin disorder characterized by
intense pruritis
Slide 10
Eczema: signs and symptoms Erythematous patches with vesicles
Pruritis Exudate and crusts Drying and scaling Lichenification
(thickening of the skin)
Slide 11
Eczema, cont.
Slide 12
Goal of Treatment Hydrate the skin
Slide 13
Treatment of Eczema Emollients (creams which lubricate the
skin) Oral antihistamines (control itching) Antibiotics (treat
superinfections) Corticosteroids (anti-inflammatories)
Immunomodulators (inhibit T lymphocyte activation) AVOID
SOAPS!
Slide 14
Acne
Slide 15
Inflammatory disease of the skin involving the sebaceous glands
and hair follicles. Contributing factors include: heredity,
hormonal influences and emotional stress
Slide 16
Acne: Three main types Follicular plugs Pustular papules Cystic
nodules
Slide 17
Patient teaching 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
Slide 18
Medical treatment for acne Topical (Benzoyl peroxide, Tretinoin
(RetinA), topical preferred to systemic; however, both may be
needed Oral: Tetracycline, minocycline, erythromycin; estrogen for
female pts., Accutane
Slide 19
Acne: Nursing care Avoid picking and squeezing Use gentle skin
cleansers Avoid use of astringents containing ETOH Avoid hats or
abrasive rubbing of the skin Wash hands after handling greasy foods
Limit use of petrolatum-based hair products; hair away from face
Use oil-free makeup, protections from windy, cold weather Continue
therapy even when improved
Slide 20
Impetigo http://www.emedicine.com/emerg/topic283.htm Impetigo
became infected Hemolytic Strep infection of the skin Incubation
period is 2-5 days after contact
Slide 21
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
Slide 22
Therapeutic Management Apply moist soaks of Burrows solution
Antibiotic therapy: Keflex for 10 days Patient education
Slide 23
Therapeutic Interventions for impetigo Goal: prevent scarring
and promote + self image. Individualize treatment to gender, age,
and severity of infection Takes 4-6 wks to improve What is the
major nursing implication here?
Slide 24
Candiditis- Thrush Overgrowth of Candida albicans Acquired
through delivery
Slide 25
Thrush Characterized by white patches in the mouth, gums, or
tongue Treated with oral Nystatin suspension: swish and
swallow
Slide 26
Dermatophytosis (Ringworm) Tinea Capitis fungal infection known
as ringworm Transmission: Person-to-person Animal-to-person
Slide 27
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)
Slide 28
http://www.ecureme.com/quicksearch_reference.asp
Slide 29
Clinical manifestations Fungal infection of the stratum
corneum, nails and hair (the base of hair shaft causing hair to
break offrarely permanent) Scaly, patches Pruritis Generally
asymptomatic, but severe reactions may appear as encrusted
lesions
Slide 30
Tinea: signs and symptoms
Slide 31
Therapeutic Interventions Transmitted by clothing, bedding,
combs and animals (cats especially) May take 1-3 months to heal
completely, even with treatment Child doesnt return to school until
lesions dry
Slide 32
Diagnosis Potassium hydroxide examination Black Light
Slide 33
Medication Therapy Antifungals: Oral griseofulvin (Lamisil)
Give with fatty foods to aid in absorption Treatment is 4-6 wks Can
return to daycare when lesions are dry
Slide 34
Pediculosis Capitis (lice)
http://www.emedicine.com/emerg/topic409.htm 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
Slide 35
Diagnosis Direct identification of egg (nits) Direct
identification of live insects
Slide 36
Pediculosis
Slide 37
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.
Slide 38
Scabies http://www.nlm.nih.gov/medlineplus/scabies.html
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
Slide 39
http://www.aad.org/pamphlets_spanish/sarna.html Scabies between
thumb and index finger On foot
Slide 40
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 replaced (2-3
weeks)
Slide 41
Care: Fresh laundered linen and underclothing should be used.
Contacts should be reduced until treatment is completed.