ACNE VULGARIS , ALLERGIES, ECZEMA, PEMPHIGUS.pdf

Acne definition, causes, signs and symptoms, types, diagnosis, medical management, nursing management, Allergies definition, types, causes, signs and symptoms, management, nursing management, Eczema definition, causes, clinical manifestation, management, prevention, nursing management, Pemphigus definition, types, causes, signs and symptoms, diagnosis, medical management, prevention, nursing management.

1. ACNE, ALLERGIES, ECZEMA, PEMPHIGUS
PREPARED BY DOLISHA WARBI

2. ACNE:
Acne, also known as acne vulgaris, is a common skin condition characterized by the occurrence of pimples, blackheads,
whiteheads, cysts, and nodules on the skin. It typically affects areas with a high density of oil glands, such as the face,
chest, back, and shoulders. Acne can vary in severity from mild to severe and can have a significant impact on a
person's self-esteem and quality of life.

3. CAUSES:
1)Excess sebum production.
2)Clogged hair follicles.
3)Bacterial infection.
4)Hormonal changes
5)Genetic factors.
6)Dietary factors.
SIGNS AND SYMPTOMS:
§Blackheads (open comedones).
§Whiteheads (closed comedones)
§Papules: Small, red, inflamed bumps on the skin.
§Pustules.
§Nodules.
§Cysts.
What are the 7 types of acne?
There are several types of acne, but the most
common types include:
•Whiteheads
•Blackheads
•Papules
•Pustules
•Nodules
•Cysts
•Acne conglobata
Acne conglobata

4. Black head White head
Papules
Pustules
Nodules
Cysts

5. DIAGNOSIS:
ØPhysical examination.
ØMedical history.
ØSymptomatic finding.
ØSkin cultures.
MEDICAL MANAGEMENT:
1.Topical medications: Such as retinoids, benzoyl peroxide, and topical antibiotics to target acne lesions and prevent
new ones from forming.
2.Oral medications: Including oral antibiotics, hormonal therapy (such as birth control pills), and isotretinoin (a
potent retinoid) for severe or resistant acne.
3.Procedures: Such as chemical peels, microdermabrasion, laser therapy, and extraction of comedones to improve skin
texture and reduce the appearance of acne scars.
4.Intralesional corticosteroid injections: For large, inflamed acne lesions such as cysts or nodules.
5.Combination therapy: A combination of different medications or treatments tailored to the individual's specific
needs and acne severity.

6. NURSING MANAGEMENT:
§Providing information to patients about the causes of acne, proper skincare practices, and the importance of
adherence to treatment regimens.
§Monitoring the patient's skin condition, treatment response, and any adverse effects of medications.
§Offering emotional support and encouragement, as acne can significantly impact a person's self-esteem and
psychological well-being.
§Working closely with other members of the healthcare team, including dermatologists and pharmacists, to optimize
patient care and treatment outcomes.
§Scheduling regular follow-up appointments to assess progress, adjust treatment as needed, and address any concerns
or questions the patient may have.

7. ALLERGIES:
Allergies are abnormal immune responses to substances that are typically harmless to most people. These substances,
called allergens, can trigger an immune system reaction in individuals who are sensitive to them. Allergic reactions can
range from mild to severe and can affect various systems in the body.
TYPES of Skin Allergiers:
qSkin Allergies:
•Atopic Dermatitis (Eczema)
•Contact Dermatitis

8. .
Atopic Dermatitis (Eczema): Characterized by dry, itchy, and inflamed skin.
qUrticaria (Hives):
Raised, itchy welts on the skin that can vary in size and shape, caused by allergic reactions to foods, medications,
insect stings, infections, or physical stimuli like heat or pressure.
q Angioedema:
Similar to hives but involves swelling in deeper layers of the skin, often affecting areas like the eyes, lips, throat, and
genitals, and can be triggered by allergic reactions or other factors like medications, infections, or genetic
predisposition.
qAllergic Skin Reactions to Medications.
qPhotosensitivity Reactions.
qAllergic Reactions to Insect Bites or Stings.

9. CAUSES:
qGenetics.
qEnvironmental Factors.
qImmune System Dysfunction.
qEarly Childhood Exposures.
qDietary Factors - Peanuts, tree nuts, shellfish, eggs, milk, soy, and wheat, can trigger allergic reactions.
qMedications.
qInsect Stings – e.g. bees, wasps,
qLatex.
qOccupational Exposures.

10. SIGNS AND SYMPTOMS:
qSkin reactions (itching, hives, eczema).
qRespiratory symptoms (sneezing, coughing, wheezing, shortness of breath).
qNasal congestion and runny nose.
qWatery, itchy eyes.
qGastrointestinal symptoms (nausea, vomiting, diarrhea).
qAnaphylaxis (a severe, life-threatening allergic reaction characterized by swelling of the throat, difficulty breathing, rapid
heartbeat, and loss of consciousness).
MANAGEMENT:
vAllergy Testing:
vMedications:
vAntihistamines
vDecongestants.
vCorticosteroids,
vEpinephrine.
vAllergy Shots (Immunotherapy)
•Topical Treatments: Hydrocortisone cream, Ointments like calamine lotion. Cold compresses.
vCalamine Lotion:
vTopical Corticosteroids: Budesonide, hydrocortisone, prednisolone.etc.

11. NURSING MANAGEMENT:
üMonitor the patient skin condition
üEducate the patient to avoid irritant
üAssist the patient during treatment
üProvide supportive care to the patient
üProvide comfortable environment to the patient
üAdministered prescribed to the patient

12. ECZEMA:
DEFINITION:
•Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition characterized by red, itchy, and
inflamed patches of skin. It often presents with a relapsing-remitting pattern, meaning symptoms may come and go
over time.
CAUSES:
1.Genetic predisposition
2.Immune system dysfunction
3.Environmental factors such as allergens, irritants, and climate
4.Stress
5.Microbial factors (bacteria, viruses)

13. CLINICAL MANIFESTATIONS:
qRedness and inflammation of the skin
qIntense itching
qDry, scaly, or cracked skin
qThickened, leathery skin (lichenification) due to repeated scratching
qOozing or crusting in severe cases
qDiscoloration of the affected skin areas
qPossible secondary infections due to scratching and compromised skin barrier

14. MANAGEMENT:
1.Moisturizing: Regularly moisturize the skin to maintain hydration and strengthen the skin barrier.
2.Avoiding triggers: Identify and avoid triggers such as certain soaps, detergents, fabrics, and environmental allergens.
3.Topical corticosteroids or immunomodulators: These medications can reduce inflammation and itching during flare-
ups.
4.Antihistamines: Oral antihistamines may help relieve itching, especially at night.
5.Wet dressings or bandages: These can help soothe and protect irritated skin.
6.Avoiding scratching: Encourage patients to avoid scratching to prevent further skin damage and infections.
PREVENTION:
1.Moisturize regularly to keep the skin hydrated.
2.Identify and avoid triggers.
3.Use mild, fragrance-free skincare products.
4.Maintain a comfortable indoor environment with moderate temperatures and humidity.
5.Manage stress through relaxation techniques or counseling if necessary.

15. .NURSING MANAGEMENT:
ØTeaching proper skincare techniques, such as gentle cleansing and moisturizing.
ØProviding guidance on identifying and avoiding triggers.
ØDemonstrating how to apply topical medications correctly.
ØEncouraging compliance with treatment plans.
ØMonitoring for signs of infection and providing appropriate wound care if needed.
ØOffering emotional support and coping strategies for dealing with the impact of eczema on daily life.

16. PEMPHIGUS:
The word Pemphigus is derived from Greek word “pemphix” meaning blister or bubble. • Until the early twentieth
century, all blistering diseases were grouped under this name.
DEFINITION:
•PEMPHIGUS is a group of rare autoimmune diseases characterized by the formation of blisters and erosions on the
skin and mucous membranes.
•There are several types of pemphigus, with the two main ones being pemphigus vulgaris (PV) and pemphigus
foliaceus (PF).

17. PEMPHIGUS TYPES:
1.Pemphigus Vulgaris (PV):
•PV is the most common and severe form of pemphigus.
•It typically affects middle-aged or older adults, but it can occur at any age.
•PV is characterized by the formation of deep, painful blisters on the skin and mucous membranes, including the mouth, throat,
and genitals.
•Blisters can be widespread and may rupture easily, leading to erosions and raw areas.
•PV can be life-threatening if not properly treated, as complications such as infection and fluid loss can occur.
2.Pemphigus Foliaceus (PF):
•PF is characterized by superficial blistering limited to the upper layers of the skin.
•It often presents with scaly or crusted lesions rather than fluid-filled blisters.
•PF typically affects the face, scalp, chest, and back.
•Unlike PV, mucous membranes are usually spared in PF.
•PF tends to be less severe than PV, although it can still cause significant discomfort and complications if left untreated.
3.Paraneoplastic Pemphigus:
•Paraneoplastic pemphigus is a rare and severe variant of pemphigus associated with underlying malignancies, most commonly
lymphoproliferative disorders such as lymphoma.
•It is characterized by widespread blistering and erosions on the skin and mucous membranes.
4.Pemphigus Erythematosus:
•Pemphigus erythematosus is considered a variant of pemphigus foliaceus with overlapping features of lupus erythematosus.
•It typically presents with scaly, erythematous plaques on the face, scalp, and upper trunk.
5.IgA Pemphigus:
•IgA pemphigus is a rare subtype of pemphigus characterized by the presence of IgA antibodies rather than IgG antibodies,
which are typically seen in other forms of pemphigus.
•It encompasses various clinical presentations, including sub-corneal pustular dermatosis-like lesions, pemphigus
herpetiformis-like lesions, and intraepidermal neutrophilic IgA dermatosis-like lesions.

18. CAUSES:
Autoimmune disease involving immunoglobulin G.
Genetic factors .
May be associated with Penicillin's and Captopril and with Myasthenia Gravis.
SIGNS AND SYMPTOMS:
§Oral lesions - Painful, bleed easily, and heal slowly.
§The skin bullae enlarge, rupture, and leave large, painful eroded areas that
are accompanied by crusting and oozing.
§Offensive odour emanates from the bullae and the exuding serum.
§Erosions and raw areas where blisters have burst
§Itching and burning sensation
§Difficulty eating or swallowing if the blisters occur in the mouth or throat
§Scaly or crusted skin lesions in pemphigus foliaceus

19. DIAGNOSIS:
oClinical evaluation.
oSkin biopsy,
oLaboratory tests.
MEDICAL MANAGEMENT:
oCombination of systemic corticosteroids & Immunosuppressive drugs (such as azathioprine, mycophenolate mofetil,
or rituximab),
oSupportive care to manage symptoms and prevent complications.
oIn severe cases, intravenous immunoglobulin (IVIG) therapy or plasmapheresis may be used.

20. PREVENTION:

21. NURSING MANAGEMENT:
Nursing care for patients with pemphigus involves:
1.Providing education about the disease, its management, and the importance of adherence to treatment.
2.Monitoring for signs of infection, since the compromised skin barrier can increase the risk of secondary infections.
3.Assisting with wound care and providing comfort measures to alleviate pain and discomfort.
4.Collaborating with other members of the healthcare team to ensure comprehensive care and support for the patient.
5.Monitoring the patient's response to treatment and reporting any changes or concerns to the healthcare provider.
6.Providing emotional support and counseling to help the patient cope with the physical and emotional challenges of
living with pemphigus.

22. THANKS YOU