Prickly Heat, Diaper Dermatitis and Fungal Infections

Prickly Heat

heat rash, body overheating, clogged pores

Prickly Heat Treatment

-cool bath

-take of clothes, breathable clothes

-don't put anything on it

-will resolve on its own

Exclusions for Prickly Heat

-high fever

-high pulse rate

-increased respiration

-hot flushed dry skin

-hyperpyrexia

-slow or weak pulse

-lethargy

-cold, pale, clammy skin

-disorientation

Diaper Dermatitis

diaper rash, skin in contact for extended period of time with urine/feces, warm/wet/dark area -> bacteria/fungus

Diaper Dermatitis Treatment

-general hygiene

-Air, Barrier, Cleansing, Diaper (change more frequenctly), Education

-Protectants: butt paste (zinc oxide) apply liberally to clean dry skin, everywhere, seals skin to allow for healing

-antifungals and steroids: only use if patient asks you after being told by provider

Exclusions for Diaper Dermatitis

-lesions present > 7 days

-secondary infection

-another disease state

-outside diaper area

-UTI

-broken skin

-onion like skin or bulla formation

-oozing, blood, vesicles, or pus

-constitutional symptoms

-significant behavioral changes

-comorbid conditions (ex. HIV)

Tinea pedis

toes/feed (athletes foot)

OTC

Tinea corporis

body (ringworm)

OTC

Tinea cruris

jock itch

OTC

Tinea caputis

head

RX

Tinea versicolor

under skin

RX

Tinea unguim

nails

RX

Clotrimazole 1% and Miconazole 2%

-pedis and corporis: BID x 4 weeks

-cruris: BID x 2 weeks

Tolnaftate 1%

-pedis and corporis: BID x 4-6 weeks

-cruris: BID x 2-4 weeks

Terbinafine 1%

-pedis: BID x 2-4 weeks

-corporis and cruris: once daily x 1-4 weeks

Butenafine 1%

-pedis: BID x 1 week or once daily x 4 weeks

-cruris and corporis: BID x 2 weeks

Exclusions for Fungal Infections

-causative factor unclear

-unsuccessful initial treatment or worsening

-nails or scalp involved

-face, mucous membrane or genitalia involved

-secondary bacterial infection

-excessive and continuous exudation

-extensive, seriously inflamed, or debilitating

-diabetes, systemic infection, immune deficiency

-fever, malaise