Download Skin Infections and Infestations

Skin Infections and Infestations
Impetigo (Staphylococcus)
• Honey- crusted
lesion
• Spreads
peripherally by
direct contact
• Pruritus common
Treatment:
Compresses of Burrow’s Solution to remove crusted exudate
Topical antibacterial ointment
Oral or IV antibiotics for severe cases
Cellulitis (Strep, Staph, H. influenzae)
• Firm, swollen, red area of skin
and subQ tissue
• Possible systemic symptoms
like fever, malaise
Treatment:
Oral or IV antibiotics
Rest and immobilize affected area
Apply warm, moist compresses
Viral Infections
Verruca (Warts)
• Elevated, rough, gray-brown
firm papules
• Can occur anywhere on the
skin
• Can be single or in groups
Treatment: Surgical removal,
electrocautery, cryotherapy, laser
Plantar: Caustic solution applied
to wart, soak affected area for 20
mins, repeat treatment until wart
falls off. Decrease pressure to
area for 2-3 days.
Chicken Pox (Varicella)
• Red, raised papules. Highly
pruritic and spreads
peripherally and by direct
contact.
• Same virus as shingles
Treatment:
Acetaminophen (to reduce fever). Children
with chickenpox should NEVER be given
aspirin.
Topical lotion (to relieve itchiness)
Antiviral drugs (for severe cases)
Bedrest
Increased fluid intake (to prevent
dehydration)
Cool baths with baking soda (to relieve
itching)
Molluscum Contagiosum
• Asymptomatic flesh-colored
papules on stalks
• Very contagious
Treatment:
Resolves spontaneously in 18 months
Can remove pox in complicated cases.
Fungal Infections
Tinea capitis
• Scaly, circumscribed lesion
with alopecia on the scalp
Treatment:
Selenium sulfide
shampoo.
Topical antifungal meds
(clotrimazole).
Oral griseofulvin.
Treat infected pets, if
necessary.
Tinea corporis (Ringworm)
• Round erythematous scaling
patch
• Spreads peripherally and
clears centrally
Treatment:
Oral griseofluvin
Topical antifungals
Apply wet compresses or
take sitz bath
Wear light-colored socks,
well ventilated shoes.
Treat infected pets
Candidiasis
• Found in moist areas of the
skin
• White exudate, peeling
inflamed areas that bleed
easily
• Pruritic
Treatment:
Topical antifungal ointment
(nystatin)
Client Teaching
• Use appropriate hand hygiene
• Avoid sharing clothing, hats, combs, brushes,
and/or towels
• Keep child from touching the affected area
• Do not squeeze vesicles
• Administer medications as prescribed
Arthropod Bites and Stings
Bees, wasps, hornets, fire ants, yellow
jackets
• Local reaction: small red itchy
wheal that is warm to touch
• Systemic reaction: mild to
severe- generalized edema,
pain, nausea and vomiting,
confusion, respiratory
problems, and shock
Treatment:
Remove the stinger
Clean with soap and water
Apply cool compresses
Topical and oral antihistamines
Epinephrine and steroids for
severe cases
Ticks
• Attaches to the skin with head
embedded
• Firm, discrete, pruritic nodule
at the site
• Possible urticaria or persistent
localized edema
Treatment:
Remove by pulling straight up with
steady, even pressure with tweezers to
remove the tick
Remove any remaining parts using a
sterile needle
Cleanse site with soap and disinfectant.
Watch for Lyme Disease
Client Teaching
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Prevent secondary infections
Wear medical alert bracelet for severe reactions
Inspect skin after possible exposure
Prevent bites:
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Avoid areas of tall grass
Use insect repellent
Avoid contact with insects
Avoid wood piles
Inspect and treat pets, carpets, and furniture
Avoid flowery prints and bright clothing
Avoid perfumes and colognes
Skin Infestations
Scabies
Itchy, esp at night
Rash, esp between fingers
Thin, pencil mark lines on the skin
Infants: Widespread on the body,
pimples on the trunk, blisters on the
palms of the hands and soles of the feet
Young Children: Most common on the
head, neck, shoulders, palms and soles
Older Children: Most common on
hands, wrists, genitals, and abdomen.
Treatments:
5% permetherin cream over the entire body as a one-time
treatment, may need to repeat in one week
Treat entire family
Wash underwear, towels, clothing, and sleepwear in HOT water
Vacuum carpets and furniture
Apply calamine lotion or cool compresses until itching subsides
Pediculosis capitis (Lice)
• Intense itching
• Small, red bumps on the scalp
• Nits (white specks) on the hair
shaft
Treatment:
Shampoos containing 1%
permethrin as prescribed
Remove nits with a nit comb, repeat
in 7 days after shampoo treatment
Wash clothing, bedding, in hot
water with detergent
Client Teaching
• Teach about medications
• Avoid home remedies, as it may worsen infection
• Teach about the correct laundering of potentially
infected clothing, bedding
• Teach parents to bag items that cannot be laundered
into tightly sealed bags for 14 days
• Boil combs, brushes, and hair accessories in licekilling products for 1 hour
• Do not share personal items!
• Watch for secondary infections.
Acne
Lesions are either open
(blackheads) or closed
(whiteheads). Both are most
often found on the face, neck,
back, and chest.
P. acnes may lead to
inflammation manifesting as
papules, pustules, nodules, or
cysts.
Nursing Care of Acne
• Discuss the self-limiting process with child and
family
• Discuss the importance of adherence with the
prescribed plan
• Teach child to gently wash the face and affected
areas, avoid scrubbing and abrasive cleaners
• Teach medication side effects
• Provide support and encouragement to the child
and family (body image changes)
Eczema
• Infants: generalized
distribution of lesions on
cheeks, scalp, trunk, hands,
and feet, as well as extensor
surfaces of extremities.
Lesions are papules that may
ooze, weep, crust, and scale.
• Children: Lesions in the
flexural areas, wrists, ankles,
and feet with symmetric
involvement. Lesions are
clustered, erythematous or
flesh colored, dry, and have
lichenification.
Nursing Care of Eczema
• Keep skin hydrated with tepid baths and apply
emollients immediately after.
• Avoid excessive heat and sweating
• Avoid irritants (bubble baths, soaps, perfumes)
• Dress in cotton clothing (breathable)
• Provide support for child and family
• Watch for secondary infections
• Keep nails short and trimmed
Medications for Eczema
• Antihistamines to relieve itching
• Topical steroids for reduce or control flare-ups
• Emollient Creams to keep skin moist and
prevent flare-ups
• Antibiotics or antifungals to treat secondary
infections.