Skin Infectious Diesease Gops

8/12/2019 Skin Infectious Diesease Gops

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Largest organ. Skin is made up of two layers that cover a third

fatty layer. The outer layer is called the epidermis. The second layer (located under the epidermis)

is called the dermis.


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Epidermis The outer layer of the skin No blood supply Composed of stratified squamous epithelium Divided into layers: Stratum germinativum, pigment-

containing layer, stratum corneum


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Dermis True skin Contains blood vessels, nerves, oil glands, sweat glands,

and hair folliclesSubcutaneous layer

Connects the skin to the muscles Composed of adipose and loose connective tissue


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Appendages of the skin Sudoriferous glands sweat glands Ceruminous glands secrete cerumen (earwax)

Located in the external ear canal Sebaceous glands oil glands

Secrete sebum

Hair Composed of modified dead epidermal tissue, mainly

keratin Nails

Composed mainly of keratin


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Inspection and palpation (continued) Assess for rashes, scars, lesions, or ecchymoses Assess temperature and texture Inspect nails for normal development, color, shape,

and thickness Inspect hair for thickness, dryness, or dullness Inspect mucous membranes for pallor or cyanosis Assess the ceruminous and sebaceous gland for

overactivity or underactivity


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Ecchymoses is a subcutaneous purpura (extravasation of blood) larger than 1 centimeter or a hematoma , commonly, but erroneously, called a bruise


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Assessment of dark skin Degree of lightness or darkness is genetically

determined Melanocytes account for skin color Lips and mucous membranes are easier to assess as

the skin is thinner Rashes may be difficult to see and will require

palpation


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Primary skin lesionsMaculePapulePatchPlaqueWheal

NoduleTumorVesicle

Bulla

PustuleCystTelangiectasiaScale

LichenificationKeloid

Scar Excoriation Fissure Erosion Ulcer Crust Atrophy


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Macule: A circumscribed, flat area, recognizable by colorvariation from surroundingskin, 1 cm

Patch: A large macule, >1 cm

Papule: A circumscribed elevation, 1 cm

Plaque: A large superficial papule, >1 cm

Nodule: A circumscribed solid elevation, 1 cm

Vesicle (small blister): A clear, fluid-filled elevation, 1 cm

Bullae (large blister): A fluid-filled elevation, >1 cm

Pustule: A circumscribed elevation of skin filled with pus


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Chief complaint assessment toolP = Provocative and Palliative factorsQ = Quality and QuantityR = RegionS = Severity of the signs and symptomsT = Time the patient has had the disorder


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The skin always has some amount of bacteria,

fungus and viruses living on it.

Occur when there are breaks in the skin and

the organisms have uncontrolled growth


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Bacterial Fungal

Viral Parasitic


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Common pathogens Staphylococcus aureus Haemophilus influenzae

Risk factors Transmission of the infection


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Clinical manifestations Erythema

Pain Tenderness Vesicle formation Enlarged lymph nodes

redness of the skin or mucous membranes, caused by hyperemia of superficialcapillaries


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Assessment parameters Diagnostic tests Medical management Nursing interventions


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Skin infection that affects mostly infants andchildren

Rash normally appears on face , but can spreadto other parts of body


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2 types of bacteria Staph Strep

Adults-Usually a complication of injury to skinor other skin disorder

Children- cuts, scrapes, insect bites Other people


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Starts as a red sore that quickly ruptures Oozes for a few days

Forms a yellowish-brown crust (looks likehoney or brown sugar)


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Highly contagious! Scratching or touching sores can spread it to

other parts of body Can be spread to other people, too


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I Impetigo Contagiosa Itchy sores No fever, normally Swollen lymph nodes in infected area

II Bullous Impetigo Painless fluid filled blisters, which break and scab

with a yellow crust Red and itchy skin around sores


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III Ecthyma- More serious, penetrates to dermis

Painful fluid- or pus-filled sores that turn into deepulcers, usually on the legs and feet

A hard, thick, gray-yellow crust covering the sores Swollen lymph glands in the affected area

Scars that remain after the ulcers heal


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Risk Factors Direct contact with an adult or child who has

impetigo or with contaminated towels, beddingor clothing

Crowded conditions Warm, humid weather impetigo infections

are more common in summer

Participation in sports that involve skin-to-skincontact, such as football or wrestling Having chronic dermatitis


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Minor infections can clear in 2-3 weekswithout medication

Can lead to complications Sometimes treated by oral antibiotics or an

antibiotic ointment Normally arent contagious after 24 hours of

antibiotic treatment


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Infection of the skin, hair or nails caused by agroup of keratinophilic fungi, calleddermatophytes

Microsporum Hair, skin Epidermophyton Skin, nail Trichophyton Hair, skin, nail


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Contact and trauma Moisture

Crowded living conditions Cellular immunodeficiency (chronic inf.) Re-infection is possible (but, larger inoculum

is needed, the course is shorter )


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Skin: Circular, dry, erythematous, scaly, itchylesions

Hair: Typical lesions,kerion, scarring,alopecia

Nail: Thickened, deformed, friable,discolored nails, subungual debrisaccumulation


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Close human contact Sharing clothes, combs, brushes, towels,

bedsheets... (Indirect) Animal-to-human contact (Zoophilic)


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I. ClinicalAppearanceII. Lab

A. Direct microscopic examination(10-25% KOH)Ectothrix/endothrix/favic hairIII CultureMycobiotic agarSabouraud dextrose agar


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TopicalMiconazole, clotrimazole,econazole, terbinafine...

OralGriseofulvinKetaconazoleItraconazoleTerbinafine


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HEAD

LOUSE

BODYLOUSE


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Head Louse One sees its eggs, which are minute, white oval

bodies, so-called "nits," deposited on the scalp hairs.

There is periodic itching and stinging sensations inthe scalp. One examination, one commonly sees scratch marks

on the back of the neck as well as nits on some of thescalp hairs


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Treatment consists in washing the scalp withanti pediculosis shampoo. A comb with fineteeth may then be used to carry the nits


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BODY LOUSE It causes itching of the trunk. The itching is worse during the day, that is, when the

infected clothing is in contact with the body. One sees parallel rows of long and short linear

scratch marks on the areas which are easily accessibleto the finger nails.


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Ringworm is a disease which is produced bynumerous varieties of vegetable parasites called"fungi."

Many of the hair stumps in the involved areas have

delicate whitish sheaths about them, and the patcheshave the appearance of having been strewn withashes, the grayish appearance being due to finescaling in the areas.


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In the beginning the lesions are usually solid discs, but within a few days after their appearance they clearin the center, thus forming a circle. This characteristic

is responsible for the common name of the disorder. Since the infected child may pass the condition on to

others, he should be isolated until treated.


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It is most often contracted from walking barefoot onfloors infected with the causative organism

It begins under the toes as an itching, splitting, and

maceration of the skin. Later, blisters usually appearon the soles and sides of the feet

Maceration is defined as the softening and

breaking down of skin resulting from prolonged exposure to moisture


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Acne vulgaris, commonly referred to as pimples and blackheads, is usually most marked during the teens,the period at which all the glands of the body aredeveloping and are overactive.

The disorder is manifested by large or small pimplesand blackheads , seen chiefly on the face, forehead,neck, back, chest, and outer surfaces of the arms .


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Factors Individual's general vitality tends to aggravate the acne Constipation, faulty diet, anemia

Insufficient sleep, or improper hygiene. In young women it is frequently aggravated by the

menstrual period All cases of acne should be properly treated to avoid

subsequent scarring and to afford the afflictedindividual a minimum of embarrassment.


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Management All persons with acne should avoid an excess of

sweets, fried foods, highly seasoned articles of diet,

and indigestible foods. Fresh aid, sunshine, sufficient rest and sleep, and

exercise in moderation are important. The bowelsshould be regulated by diet alone.


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It is characterized by from one to a dozen or morewell-elevated, horny thickenings . Although theselesions are usually responsible for no discomfort, theyoften become inflamed when they are so located thatthey are frequently injured

The organism usually gains entrance into the skin

through such an abrasion. One should not pick at warts. Picking them will not

cure them, and it will spread them


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Psoriasis is a chronic skin disorder characterized bythe presence of red, scaling lesions most markedly inthe scalp, elbows, and knees.

Characteristically, each lesion is covered with silvery

white or mother-of-pearl colored scale. When the bottom-most scale is removed, a bleeding point isleft. This characteristic is not found in other scalingdisorders.


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The cause of psoriasis is not known. Often it isaggravated by the eating of foods that come fromanimals, notably meat, eggs, and cheese.

Not considered a hereditary disorder, nor a contagiousof infectious one. It can be cleared up by the use ofinternal medicines and local preparations, butimprovement is usually only temporary.


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It is a form of sensitization dermatitis

Foods of all kinds, carbohydrates and fats as well as proteins, may be important causative factors.

Eczema in infants and children occurs as a redness,scaling, swelling, and crusting in large, ill-defined areas.

Lotions, ointments, and other local measures should besuggested by the physician. Soap and water should not beallowed to touch the involved areas.


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Skin Infectious Diesease Gops