Skin Sepsis Immune 06

7/28/2019 Skin Sepsis Immune 06

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Skin Immune Disorders

Jan Bazner-Chandler

CPNP, CNS, MSN, RN


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Key Function of Skin

Protection shield from internal injury.

Immunity contains cells that ingest

bacteria and other substances. Thermoregulation heat regulation

through sweating, shivering, and

subcutaneous insulation Communication / sensation /

regeneration


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Developmental Variances

Sweat glands function by the time the child

is 3-years-old.

The visco-elastic property of the dermisbecomes completely functional at about 2

years.

The neonates dermis is thin and very

hydrated, thus is at greater risk for fluid loss

and serves as an ineffective barrier.


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Neonatal skin lesions

Vascular birth marks: hemangioma

Port wine stain

Abnormal pigmentation: Mongolian spots

Neonatal acne: small red papules and

pustules appear on face trunk.

Milia: white or yellow, 1-2mm papulesappearing on cheeks, nose, chin, and

forehead


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Diaper Dermatitis


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Diaper Dermatitis

Identify causative agent

Cleanse with mild cleaner

Apply barrier

Expose to air

Teach hazards of baby powder


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Treatment

If confined to the scalp

Wash area with mild baby shampoo

and brush with a soft brush to helpremove the scales.

Do not apply baby oil or mineral oil to

the area - this will only allow for morebuild up of the scales.


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Cradle Cap


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Baby Care


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Atopic dermatitis or Eczema

Chronic, relapsing inflammation of the

dermis and epidermis characterized by

itching, edema, papules, erythema,excoriation, serous discharge and

crusting.

Patients have a heightened reaction toa variety of allergens.


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Dermatitis


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Dermatitis


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Assessment

History of asthma, allergic rhinitis

Lesions generally occur in creases.

Management: Control the itching: OTC Benadryl

Reduce inflammation: topical

corticosteroids Hydrate the skin

Elidel Cream

Preventing infection


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Acne Vulgaris

A chronic, inflammatory process of the

pilosebaceous follicles.

Occurrence; 85% of teenager aged 15to 17 years.

More common in females than males.


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Acne

Over activity of oil glands at the base

of hair follicles

Hormone activity

Skin cell plug pores causing white

heads and blackheads.

No cure


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Acne


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Management of Acne

Topical medications

OTC preparations

Prescription - Topical retinoid preparations Prescription - Topical antibiotics

Systemic medication

Antibiotics

Hormonal therapy birth control pills

Accutane * use with extreme caution when all

else fails


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Pediculosis

Head lice infestation ranges from 1%

to 40% in children.

Most common in ages 5 to 12.

Less common in African American due

to the shape of the hair shaft.

Transmission by direct contact with

infected person, clothing, grooming

articles, bedding, or carpeting.


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Pediculosis

Head lice

Pubic lice

Body lice


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Signs and Symptoms

Symptoms: itching,

whitish colored eggs

at shaft of hair,

redness at site ofitching.


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Nits

Empty nit case Viable nit


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Interventions

Anti-lice shampoo

Removal of nits

Washing bedding, towels, anything childs headmay have come in contact with in hot soapywater.

Vacuum all floors and rugs

Do not need to fumigate the house Child can return to school after 1 day of

treatment


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Scabies

A contagious skin condition caused by

the human skin mite.

Tiny, eight-legged creature burrowswithin the skin and penetrate the

epidermis and lays eggs

Allergic reaction occurs Severe itching


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Assessment

Pruritus especially profound at night or

nap time.

Lesions may be generalized but tendto distribute on the palms, soles and

axillae

In older children: finger webs, bodycreases, beltline and genitalia


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Management

Permethrin cream is drug of choice

Massage into all skin surfaces neck

to soles of feet - leave on for 8 to 14hours.

Clothing bedding and other contactitems need to be washed in hot soapywater.

Vacuum upholstered furniture - rugs


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Scabies


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Impetigo


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Spread

Highly contagious skin infection.

Most common among children.

Spread through physical contact.

Clothes, bedding, towels and other

objects.


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Outcomes

Self-limiting

No scarring or pox marks post

infection.

Super-infection especially in the

neonate.


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Clinical Manifestations

Characteristic reddened or lilac-

colored, swollen skin that pits when

pressed with finger. Borders are indistinct.

Warm to touch.

Superficial blistering.


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Wound Management

Bowden, Dickey, Greenberg textChildren and Their Families


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Burn Wound Covering


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Neonatal sepsis

Mortality rate 50%

1 to 8 cases per 1000 live births

Meningitis occurs in 1/3


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Blood Test

C-Reactive Protein

Protein appears within 6 hours orexposure

Blood culture to identify causative agent


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AIDS

T lymphocytes are critical to fighting

infection and developing immunity.

HIV renders the immune system

useless and the child is unable to fight

infection.


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Blood Testing in Infants

Babies born to HIV-positive mothers

initially test positive for HIV antibodies.

Only 13 to 39% of these infants areactually infected.

Infants who are not infected with HIV

may remain positive until they areabout 18- months-old.


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Community Interventions

Education and prevention are the best

ways to manage AIDS.

Safe sexual practices Monogamous relationship

Avoidance of substances such as

alcohol and drugs that can cloudjudgment.


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Documents

Skin Sepsis Immune 06