33305 Lecture 5 dermatological problems and management

Learning Outcome 1

Describe common dermatological lesion terminology and differentiate key features used in skin assessment

Descriptive terms:

• Asymmetrical — one side only

• Symmetrical — both sides equally

• Localised — confined area

• Generalised/diffuse — widespread

• Discrete — separate lesions

• Confluent — lesions merge together

• Grouped — clustered lesions

• Solitary — single lesion

• Zosteriform — follows dermatome (shingles)

Difference between primary and secondary skin lesions?

• Primary skin lesions → the initial/original skin change caused directly by a disease or condition

  • e.g. macule, papule, vesicle

• Secondary skin lesions → develop from primary lesions due to scratching, infection, healing, or progression

  • e.g. scale, ulcer, crust, lichenification

Learning Outcome 1

Describe common dermatological lesion terminology and differentiate key features used in skin assessment

Primary skin lesions ?

Flat vs raised lesions?

• Macule → flat <1 cm

• Patch → flat >1 cm

• Papule → raised solid <1 cm

• Plaque → raised flat >1 cm

Learning Outcome 1

Describe common dermatological lesion terminology and differentiate key features used in skin assessment

Primary skin lesions ?

Fluid filled lesions?

• Vesicle → fluid-filled <1 cm

• Bulla → fluid-filled >1 cm

• Pustule → pus-filled

• Cyst → encapsulated fluid/semi-solid lesion

Learning Outcome 1

Describe common dermatological lesion terminology and differentiate key features used in skin assessment

Primary skin lesions ?

Other primary lesions?

• Wheal → temporary itchy swelling

• Nodule → firm deep lesion

• Telangiectasia → dilated superficial vessels

Learning Outcome 1

Describe common dermatological lesion terminology and differentiate key features used in skin assessment

Secondary skin lesions?

• Scale → flaky skin

• Lichenification → thick leathery skin from scratching

• Keloid → raised scar beyond wound edges

• Excoriation → scratch injury

• Ulcer → loss of epidermis + dermis

• Atrophy → thinning skin

• Fissure → linear crack

• Erosion → moist superficial skin loss

Learning Outcome 2

Identify common skin infections and conditions and outline relevant nursing management principles

Common skin condition - Eczema?

• Dry itchy inflamed skin

Nursing management

• Moisturisers/emollients

• Steroid creams

• Avoid triggers

Learning Outcome 2

Identify common skin infections and conditions and outline relevant nursing management principles

Common skin condition - Psoriasis

• Red scaly plaques

• Autoimmune/inflammatory

Nursing management

• Moisturisers

• Steroids

• UV therapy

• Emotional support

Learning Outcome 2

Identify common skin infections and conditions and outline relevant nursing management principles

Common skin condition - Rosacea?

• Facial redness/flushing

• Telangiectasia common

Management

• Gentle skincare

• Avoid triggers

Learning Outcome 2

Identify common skin infections and conditions and outline relevant nursing management principles

Common skin condition - Acne?

• Pustules/papules from excess sebum

Management

• Hygiene

• Topical/systemic treatment

Skin Infections?

Bacterial

• Impetigo

Viral

• Herpes zoster (shingles)

• Chickenpox

• Herpes simplex

Fungal

• Tinea pedis

• Tinea corporis

• Tinea capitis

Parasitic

• Scabies

• Lice

Learning Outcome 3

Explain principles of advanced wound care and skin integrity management

Goals of care?

• Prevent further damage (e.g. protect fragile skin)

• Prevent infection (e.g. aseptic wound care)

• Reduce inflammation (e.g. topical corticosteroids)

• Relieve symptoms (e.g. pain/itch management)

Learning Outcome 3

Explain principles of advanced wound care and skin integrity management

Nursing care?

• Wound dressings (e.g. protective foam dressing)

• Hygiene (e.g. gentle skin cleansing)

• Pressure care (e.g. regular repositioning)

• Moisture management (e.g. barrier cream for incontinence)

• Infection control (e.g. hand hygiene)

• Pain/itch relief (e.g. analgesia, antihistamines)

Learning Outcome 3

Explain principles of advanced wound care and skin integrity management

Preventing skin breakdown?

• Repositioning (e.g. turn every 2 hrs)

• Nutrition (e.g. high-protein diet)

• Skin inspection (e.g. check bony prominences)

• Hydration (e.g. adequate fluid intake)

• Pressure-relieving devices (e.g. air mattress)

Learning Outcome 4

Discuss safe use and patient education for topical and systemic treatments

Topical treatments?

= medications or products applied directly to the skin.

• Corticosteroids (e.g. hydrocortisone) → reduce inflammation/itching

• Antifungals (e.g. clotrimazole) → treat fungal infections

• Antibiotics (e.g. mupirocin) → treat/prevent bacterial infection

• Emollients (e.g. sorbolene) → moisturise and protect skin barrie

Learning Outcome 4

Discuss safe use and patient education for topical and systemic treatments

Systemic treatments?

• Oral antibiotics (e.g. flucloxacillin) → treat widespread infection

• Antihistamines (e.g. cetirizine) → reduce itching/allergic response

• Immunosuppressants (e.g. methotrexate) → suppress severe inflammatory disease

Learning Outcome 4

Discuss safe use and patient education for topical and systemic treatments

Patient education?

• Correct cream application (e.g. thin layer in direction of hair growth) → improves effectiveness/reduces irritation

• Medication adherence (e.g. complete antibiotic course) → prevents recurrence/resistance

• Avoid irritants (e.g. harsh soaps/fragrances) → reduces skin irritation

• Hand hygiene (e.g. before/after wound care) → prevents infection

• Sun protection (e.g. SPF 50+) → prevents skin damage/photosensitivity

Learning Outcome 4

Discuss safe use and patient education for topical and systemic treatments

Allergy testing?

• Wheal (raised swelling) → histamine response

• Flare (surrounding redness) → vasodilation/inflammation

Learning Outcome 5

Analyse risk factors, clinical features, and management of common skin malignancies

Melanoma and risk factors?

Serious skin cancer from melanocytes.

Risk Factors

• UV exposure

• Fair skin

• Sunburn history

• Family history

Learning Outcome 5

Analyse risk factors, clinical features, and management of common skin malignancies

ABCDE melanoma signs?

A — Asymmetry

Uneven shape

B — Border

Irregular edges

C — Colour

Multiple colours

D — Diameter

Greater than 6 mm

E — Evolving

Changing lesion

Learning Outcome 5

Analyse risk factors, clinical features, and management of common skin malignancies

Prevention of melanoma?

• Sunscreen

• Protective clothing

• Avoid UV exposure

• Skin checks

Learning Outcome 6

Apply nursing priorities to dermatological presentations to support health and wellbeing

Nursing priorities?

• Maintain skin integrity (e.g. protective dressings/repositioning) → prevent breakdown

• Prevent infection (e.g. aseptic technique/hand hygiene) → reduce infection risk

• Relieve pain & itching (e.g. analgesia, antihistamines) → improve comfort

• Promote hygiene (e.g. gentle cleansing) → support healing

• Patient education (e.g. medication and skin care teaching) → improve self-management

• Psychosocial support (e.g. emotional support/body image care) → support mental wellbeing