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Community Health Nursing Skin disease or skin problemGroup member: 9/14/2011 3 shahid aziz & shah khalid Group member Syed Jamal shah Zia-Ur-Rehman Shahar ali Shah khalid zia Ullah Shahid aziz Teacher…. Baroz KhanTeaching plan: 9/14/2011 4 shahid aziz & shah khalid Teaching planSlide 5: 9/14/2011 5 shahid aziz & shah khalid Skin disease or skin problemSkin disease or skin problem: 9/14/2011 6 shahid aziz & shah khalid Skin disease or skin problem Skin or integument is the largest organ exposed to the internal environment. It provide the 1 st line of defense of the body. Problem of the skin are often present in difficult management challenges. Dermatology is the study of skin and its problem. The normal structure of skin are shown in diagramNatural Defenses of the Skin: 9/14/2011 7 shahid aziz & shah khalid Natural Defenses of the Skin The natural defense mechanism of the skin are composed of following… Keratin Skin sloughing Sebum: low pH, high lipid Sweat: low pH, high salt, and Lysozyme, which digests peptidoglycanSkin problem: 9/14/2011 8 shahid aziz & shah khalid Skin problem The most common skin disease are…Skin problem: 9/14/2011 9 shahid aziz & shah khalid Skin problem Viral infection.. Herpes Simplex. Herpes zoster. Verruca vulgaris Warts MeaslesHerpes simplex: 9/14/2011 10 shahid aziz & shah khalid Herpes simplex Causative organism …. HSV.(DNA containing core surrounded by phospholipids) Clinical manifestation .. Painful local reactions, grouped vesicles, fever and malaise. Management … Symptomatic medication (anti-viral agent such as acyclovir zovinax, and its topical use.)Herpes zooster: 9/14/2011 11 shahid aziz & shah khalid Herpes zooster Causative organism… Varicella zooster Clinical manifestation …. Linear patches of group vesicles, uni-lateral or on trunk, malaise, fever, itching, and pain. Enlargement of lymph node may occur with rashes. Medical management .. Symptomatic, anti-viral such as acyclovir, Val acyclovir, moist compress, Analgesic for pain.Warts: 9/14/2011 12 shahid aziz & shah khalid Warts It develops from hypertrophy of epidermal cell as a result of viral infection .Causative organism are human papiloma virus . CLINICAL MANIFESTATION … Planter warts on foots, skin marking,cone shaped with black dot thrombose vessels. MANAGEMENT .. Electrodessication, Cryosurgery…Skin problem: 9/14/2011 13 shahid aziz & shah khalid Skin problem Parasitic infection.. Lice manifestation. Scabies.Lice manifestation: 9/14/2011 14 shahid aziz & shah khalid Lice manifestation It is mostly present in children and people who live in overcrowded dwelling with inadequate hygienic condition. The clinical signs are…. Pruerites, itching, trauma due to scratching. .Lice manifestation: 9/14/2011 15 shahid aziz & shah khalid Lice manifestation Community health teaching. Contact screening with bed partner, the infected person should soak comb, brushes and hair utensils in hot water, and also shampoo for 15 min.Clothing and bedding should be laundered in hot water and dry in light. lindane, permithrine may be usedBacterial infections: 9/14/2011 16 shahid aziz & shah khalid Bacterial infectionsImpetigo: 9/14/2011 17 shahid aziz & shah khalid Impetigo Causative organism. Staphylococci Clinical sign. thick lesion, honey colored crust, pruritic mostly on face. Community teaching maintain cleanliness, promote hygienic need, Management.. promote cleanliness and apply topical anti-biotic like penicillin.Furuncles and carbuncles: 9/14/2011 18 shahid aziz & shah khalid Furuncles and carbuncles Deep folliculites that originate superficial or deep nodules around hair follicles. An infection that involve several sorrounding hair follicles is termed as carbuncles. Causative organism are staplococci. In clinical sign there will be tender area around hair follicles. pus formation are mostly occure on face, back of the neck, breast buttucks and thigh. Carbuncles are present in nape of neck and back. Other sign are malaise, adenopathy, and feverFuruncles and carbuncles: 9/14/2011 19 shahid aziz & shah khalid Furuncles and carbuncles Community teaching are focus on spread of the infection. teach the patient to keep the hand away from the discharge to prevent infection. In management warm compress, systemic anti-biotic after C/S study. Antimicrobial cream and care of involved skin.Fungal infection: 9/14/2011 20 shahid aziz & shah khalid Fungal infection Candidase, ringworm (Tenia capites and tenea carporis) and athletic foot (tenia pedis) Candidase are mostly caused by yeast like fungus (candida albicans )Candidase: 9/14/2011 21 shahid aziz & shah khalid Candidase Clinical sign of skin mouth and vagina are vaganites (painfull vaginal wall, pain on urination and intercoarse On skin papular erythematouse rash and lesion around effected area. In community teaching advise to wear loose cloth and use topical midication like powder to dry the skin.skin hygene, avoidence of lubricants. it may be diagnose feom c/s and culture reports.Dermatophytose(tenia…..): 9/14/2011 22 shahid aziz & shah khalid Dermatophytose(tenia…..) Tenia corporis… (ringworm) The effected area should be kept dry and clean. Over bathing should be avoided. loose underclothing should worn. it usually occur on non-hairy part. Cream like clotrimizole can be used.Allergic Reaction: 9/14/2011 23 shahid aziz & shah khalid Allergic Reaction Contact Dermatitis.. It occur mostly from external agent (cosmetic, clothing, jewellery, detergent, and perfumes.) Clinical sign are red, hive like papules, pruiritic, occasional vesicles mostly on expose area. Management…Washed the infected area after every 45 mints. Topical corticosteroid. Anti-histamine and nursing teaching.Allergic Reaction: 9/14/2011 24 shahid aziz & shah khalid Allergic Reaction Other allergic reaction are…. Urticaria, drugs reaction, skin reaction, skin reation due to infectious disease, ( chicken pox, small pox, and measles)Acne vulgaris: 9/14/2011 25 shahid aziz & shah khalid Acne vulgaris It is an inflammatory disorder of sebaceous gland. some of the causes are endocrine effects, diet, hereditary and infections. it occur mostly in teenagers.Acne vulgaris: 9/14/2011 26 shahid aziz & shah khalid Acne vulgaris Clinical signs…mostly on face and neck The inflammatory lesion include papules, cyst etc. Management… it may be topical,(benzoil per-oxide, vit A, erthromycin) Systemetic (systemic anti-biotic) surgery (derm abrasion to remove scar)Other skin disorder: 9/14/2011 27 shahid aziz & shah khalid Other skin disorder Pressure ulcer burns tumour of the skin PuritiesHealth promotion for skin disease: 9/14/2011 28 shahid aziz & shah khalid Health promotion for skin disease Envoiromental hazards Sun exposure.. medication The community nurse should teach that the chemical in some drugs like anti cancer (methotexate) anti-microbial (tetracyline) and many other absorb light and release energy that harm cells and tissue. Nurse have role about photosensitizing effect of medicine and to aware people about it.Health promotion for skin disease: 9/14/2011 29 shahid aziz & shah khalid Health promotion for skin disease Irritant and allergen The nurse should counsil his patient to avoid known irritant.. (ammonia, detergents) Radiation.. the nurse should help the patient about the intielligent dicision. Rest and sleep … the community nurse should teach that rest and sleep promote health. Rest reduce the threshold of itching and potential skin damage from resultant scraching. Exercise ..Exercise increase the blood circulation and also dilate the blood vessles. caution must be used to avoid the person from over exposure to heat, cold, and sunlight during outdoor exercise.Health promotion for skin disease: 9/14/2011 30 shahid aziz & shah khalid Health promotion for skin disease 6) hygiene .. the nurse should know that the oily skin person may clean the skin with dry agent, while dry skin may be benefits from super-fatted soap to increase moisture. Older person should avoid to use harsh soap b/c they may result in dryness of skin. 7) nutrition … the nurse should teach about the balance diet which help in promoting of healthy skin. The basic element are … vit A, vit B, vit C vit K, protein, and unsaturated fatty acid. 8) self-treatment.. the nurse need to increase the patint awareness about the danger of self diagnose and self treatment.Scabies: 9/14/2011 31 shahid aziz & shah khalid Scabies Scabies is an infestation of skin cause by female itchmite (sarcoptea scabiei). It is present in people having substandard hygiene but also common in clean indivisaul. The mite burrow into the skin and remain there. Incubation period 4-6 weeks. Clinical sign…. The classic symptom of the scabies take 4 weeks from the time of contact. Some of the symptoms are intense itching, present of burrow (through magnifying glass), thread like lesion (finger, wrist, elbow, foot), severe itching at night, rashes.Scabies: 9/14/2011 32 shahid aziz & shah khalid Scabies Community teaching for scabies patient The patient should aware to wore clean cloth and sleep in freshly bed linen. All the cloths and bed linen should wash in hot water and dry on hot dryer cycle. After treatment the patient should apply ointment like corticosteroid b/c the scabicide may irritate the skin. The patient must understand medication instruction. Oral anti-histamine may help to reduce the itching process. All family member and closed contact should be treated simultaneously to eliminate mites..Slide 33: 9/14/2011 33 shahid aziz & shah khalid THANK YOUPrepared by: 9/14/2011 34 shahid aziz & shah khalid Prepared by Shahid Aziz and Shah KhalidReference: 9/14/2011 35 shahid aziz & shah khalid Reference Medical and surgical nursing written by BT Basavanthappa Published by. Jaypee brother medical publisher new Dehli India. You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.