disorders of skin integrity + function part 3

allergic/hypersensitivity conditions

- erythema multiforme minor

- stevens johnson syndrome

- toxic epidermal necrolysis (TEN)

- atopic dermatitis

- nummular eczema

- uticaria (hives)

- lichenification

Erythema Multiforme Minor description

less extreme than stevens-johnson syndrome and TEN

Erythema Multiforme Minor treatment

self limiting

Erythema Multiforme Minor at risk

those taking drugs like sulfonamides, anticonvulsants, and NSAIDS

Erythema Multiforme Minor transmission

irritant exposure

Stevens-Johnson syndrome description

< 10% body surface

Stevens-Johnson syndrome treatment

- compresses

- antipruritic drugs

- topical anesthetic

Stevens-Johnson syndrome at risk

- children and younger adults

- can develop at any age

Stevens-Johnson syndrome transmission

irritant exposure

Toxic Epidermal Necrolysis (TEN) description

- >30% epidermal

detachment death/breakdown

- Skin falling off, needs

fluid report.

(if losing on skin probably losing on lungs)

Toxic Epidermal Necrolysis (TEN) treatment

- compresses

- antipruritic drugs

- topical anesthetic

Toxic Epidermal Necrolysis (TEN) at risk

- those with HIV infection

- certain genetic variations (HLA-B genes)

- a history of allergic reactions to specific medications

- those who take certain drugs like anticonvulsants, sulfonamides, and some HIV medications

Toxic Epidermal Necrolysis (TEN) transmission

irritant exposure

Atopic dermatitis description

- Erythema

- edema

- vesicle

- large bullae

Atopic dermatitis treatment

removal of irritant

Atopic dermatitis at risk

severe skin dryness

Atopic dermatitis transmission

irritant exposure

Nummular (discoid) eczema description

- Lesions are coin shaped

- papulovesicular patches

Nummular (discoid) eczema treatment

- reduce stress

- frequent bathing

- increase humidity

- Topical ointments

Nummular (discoid) eczema at risk

cold winter months

Nummular (discoid) eczema transmission

unknown

Urticaria (hives) description

- Pale, raised,itchy

papules or plaques

(superficial dermis).

- Looks wheal like.

Urticaria (hives) treatment

Antihistamins

Urticaria (hives) at risk

- females

- adults

Urticaria (hives) transmission

Irritant exposure:

foods/drinks/medications

Lichenification (chronic)

- thickening and hardening of the skin

- giving it a leathery appearance

- typically caused by chronic rubbing or scratching

Integumentary changes in the elderly

diminution

in subcutaneous

Integumentary changes in the elderly

thinning of

epidermal and dermal layers

Integumentary changes in the elderly

decreased

- melanocytes

- langerhans cells

- merkel cells

Integumentary changes in the elderly

decrease and thickening of

blood cells

Integumentary changes in the elderly

- keratoses (usually benign)

- actinic keratoses

- lentinges

- vascular lesions

- cherry angioma

- spider angioma

lentigines: macule

- age spots (freckle like)

- not sun exposure cause

vascular legions

- telangiectasia (vascular)

Pediatric skin conditions requiring interventions (all airborne but scarlet)

- roseola infantum

- rubella (german measles 3 days)

- rubeola (7 days measles)

- varicella

- scarlet fever

Roseola infantum

- no long term effects

- HHV-6 sixth disease

Rubella (German measles 3 days)

- gestational transmission can cause congenital rubella syndrome

- blindness/mental retardation

Rubeola (7-day measles)

- Koplik spots (buccal mucosa)

- Photosensitivitiy

varicella

chicken pox

scarlet fever

- not viral (staph/strep)

- skin lesions look like sand paper

Acanthosis nigricans

- characterize by pigmented hyperkeratosis that occur in skin flexures (axillary, perineal areas, back of neck)

- symmetric

- verrucous

- papillary lesions

Acanthosis nigricans associated w

- paraneoplastic syndrome

- clinical manifestations of metabolic syndrome

- often has to do w diabetes or blood sugars or thyroid issues

Know the warning signs of malignant melanoma ABCDE

- A: asymmetry

- B: border

- C: color (changes)

- D: diameter (changing)

- E: evaluation/elevation (growing)

Pressure injuries

- decubitus ulcers or bed sores

- ischemic lesions of the skin and underlying structures caused by unrelieved pressure

- not enough blood flow to lesion

Pressure injuries 4 factors contribute

- Pressure

- Shear force: moving pt. Bed to bed makes the skin move in an

opposite direction of the material

- Friction

- Moisture (bed bath, incontinence)

pressure injury prevention

- Turn patient every two hours

- Keep skin dry

- Check for incontinence

- Nutrition and hydration

- Helps with circulation

- Check for anemia

- Mobility

- Circulatory status

- no presence of shear and friction forces

- Meticulous skincare

- Food crumbs, IV tubing and other debris (checking for these)

pressure injury stage 1

non-blanchable erythema of intact skin

pressure injury stage 2

partial skin loss, the dermis has been broken into

pressure injury stage 3

- full thickness skin loss

- subcutaneous exposed

- rolled edge appearance

pressure injury stage 4

- full thickness skin and tissue loss

- exposed bone and or muscle

- can happen as result of not turning patient

pressure injury unstageable

- skin hasn't broken but it is bad

- based covered by slough and eschar

- base can not be determined