Nt1310 Unit 1.3

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Unit 1
Skin Disorders
Skin Disorders

Skin lesions

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Objectives
At the end of the session students will be able to:
Explain the disease process and nursing care of following conditions seen in children:

Ringworm infections
Candidiasis
Candidiasis
Pediculosis
Scabies
Herpes Simplex

Ringworm infections
Ringworm infections
Ringworm infections
Ringworm infections
Tinea or ringworm infection is a fungal infection caused by dermatophytes (class of fungus)
These dermatophytes live in the superficial layer of the skin, nail and hair
Causes: poor nutrition, hygiene, tropical climate,
Causes: poor nutrition, hygiene, tropical climate, debilitating disease, contact with infected persons or formites

Clinical
types of Tinea
Clinical types of Tinea
Clinical types of Tinea
Clinical types of Tinea
Tinea Captis
Ringworm of the scalp
Children up to puberty are more susceptible and boys more often than girls
There may be painful swelling, patchy hair loss, broken hair,
There may be painful swelling, patchy hair loss, broken hair, inflammation and swelling
Tinea cruris: thighs and buttocks
Tinea pedis: feet

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Tinea
Tinea corporis
Children age 2 to 10 years
The lesions are found on non-hairy parts of the body, commonly on the face, neck and arms
The lesions are flat, erythematous, found or oval, scaling patches that that spread peripherally and have a clearing centre, creating the ring appearance
Children may complain of pruritis

Candidiasis
Candidiasis
Candidiasis
Candidiasis
Is an infection caused by yeast like fungus Candida albicans and other species of candida
Candid albicans is a normal bacterial flora of the skin and mucous membrane. Overgrowth
Overgrowth occurs when there is breakdown or an overgrowth in intact epithelial barriers and invasion into the epidermis occurs, secondary to moisture and warmth and breaks in the barriers Predisposing factors
Predisposing factors
Predisposing factors
Predisposing factors
Prolonged use of antibiotics
Corticosteroid therapy
Found in conjunction with diaper rash

Oral candidiasis
Oral candidiasis
Common in neonates and infants
Curdy white easily removable membrane on an erythmatous background involving buccal mucosa and tongue palate

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Investigations
Investigations
Investigations
Investigations
Potassium hydroxide mount
Fungal culture

Treatment
The affected area should be kept dry
Clothing and towel should be changed and washed frequently Local application of antifungal agents: Clotrimazole,

Micanazole, Ketaconozalo, Flucanazole
Antihistamines for pruritis
Duration of treatment may from 4 to 12 weeks

Treatment
Based on the location of the candidiasis
Oral candidiasis: Nystatin oral suspension
0.5% GV solution painted in oral cavity 1 to 2 times a day
For diaper dermatitis: Nystatin cream should be applied liberally to to the affected area

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Nursing care
Nursing care
Nursing care
Nursing care
Prevented by cleanliness especially regarding feeding equipments
Also keep the mucous membranes of the mouth moist in case of high fever or dehydration
Babies on antibiotics are highly prone to thrush
Give the prescribed medication according to the doctor’s order
Special care to prevent cross infection
Special care to prevent cross infection

Head lice (pediculosis)
Head lice (pediculosis)
Head lice (pediculosis)
Head lice (pediculosis)
A parasitic infection caused by Pediculosis humanus capitis
Common in school-age children who share clothing and combs
And who have close physical contacts
Causes
Unhygienic conditions and can get easily transmitted among
Unhygienic conditions and can get easily transmitted among children and their family members

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Cont.

Nurses should wash their hands thoroughly after giving care to a baby with thrush and also before attending to another baby
Complications
Infection of GI tract and cause septicaemia.
If there are buttock lesions it should be treated with local applications applications
Exposed the buttock area to air
Teach the mother importance of hygiene.

Medical treatment and Nursing care

Scabies

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Assess for lice eggs and intense itching
Use medication shampoo on the hair
Carefully follow the manufactures directions in using the shampoo
Advice the parents to wash the child’s hair and remove the nits with a fine-toothed comb
Advice the parents to wash bed linens, and other personal belongings belongings thoroughly to prevent re-infection
Teach the parents importance of keeping the hair clean

A parasitic infection which is a common contagious infection of the children and adults
Causative organism: itch mite or sarcoptes scabies
Causative factors: Crowded living, poor personal hygiene
Clinical manifestations
Severe itching with generalized papular eruptions in hands,
Severe itching with generalized papular eruptions in hands, wrist, elbows, buttocks
Itching more common during night time
Secondary bacterial infection is common

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Herpes Simplex
Herpes Simplex
Herpes Simplex
Herpes Simplex
Usually known as cold sores or fever blisters
Causative organism: form of type I herpes virus
Signs and symptom: clusters of painful, grouped vesicles found on the lips or skin surrounding the mouth. In 2-3 days vesicle crust and then dry vesicle crust and then dry

Management
Keeping the vesicles dry helps them fade sooner
Keeping the vesicles lubricated reduces pain
Tropical acyclovir reduces pain and increase healing
Psychological support as children may feel self conscious about
Psychological support as children may feel self conscious about the lesions

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Investigations: Skin scraping, skin biopsy

Treatment
Isolation
Wash the whole body with soap and dry
Application of 20-25% benzyl benzoate emulsion on the whole body below the neck and leave for 8-12 hours body below the neck and leave for 8-12 hours
Boil and sun dry all the clothes
Antihistamines to relieve itching
Treatment of secondary bacterial infection