Dermatitis ppt

Dermatitis ppt

1. DERMATITIS PRESENTED BY MR. ROMAN BAJRANG RELIANCE INSTITUTE OF NURSING

2. INTRODUCTION Dermatitis is an inflammation of the skin and which are commonly swollen, reddened and irritatingly itchy. Although not an alarming condition, this type of skin diseases can make you very uncomfortable, unease and self-conscious . Dermatitis is an itchy inflammation of the skin. It is not contagious or dangerous, but it can be uncomfortable. There are many types of dermatitis, including allergic dermatitis, eczema, and seborrheic dermatitis (which causes dandruff ). A rash is an abnormal condition and reaction of the skin.

3. Dermatitis, also known as is eczema,inflammation of the skin. It is characterized by itchy, erythematous , vesicular, weeping and crusting patches. The term eczema is also commonly used to describe atopic dermatitis, also known as atopic eczema. The cause of dermatitis in unclear. One possibility is a dysfunctional interplay between the immune system and skin. Dermatitis is the inflammation of the skin characterised by erythema and pain is called dermatitis. DEFINITION

4. DEFINITION : - ACCORDING TO BRUNNER AND SUDDHART - Dermatitis is inflammation of the upper layers of the skin, causing itching, blisters, redness, swelling, and often oozing, scabbing, and scaling . ACCORDING TO LEWIS – Dermatitis is an inflammation of the skin and which are commonly swollen, reddened and irritatingly itchy . ACCORDING TO LIPPINCOTT - A medical condition in which the skin becomes red, swollen, and sore, sometimes with small blisters, resulting from direct irritation of the skin by an external agent or an allergic reaction to it.

5. It affects males and females and accounts for 10 to 20 percent of all visits to dermatologists (doctors who specialize in the care and treatment of skin diseases). Although atopic dermatitis may occur at any age, it most often begins in infancy and childhood. Women tends to develop the disease at an earlier age (20 to 40 years of age ) compared to men ( 60 to 70 years of age ), and women are affected more frequently. INCIDENCE

6. Sta g es of DERMA T ITIS - Acute dermatitis - Acute dermatitis is characterised by erythema , vesiculation and oozing, often with oedema.

7. Acute dermatitis

8. CH R O N IC D E R M A T I TI S - C h r on i c dermatitis is characterised by thickened dry patches, often lichenified f r o m chronicrubbing (increased Skin markings). Lichenification is often p r edomin a nt l y f oll i cula r i n p ig m en t ed skin.

9. CH R O N IC D E R M A T I TI S

10. Generalized exfoliative Seborrheic Stasis Perioral Atopic N um m u l ar Localized stretch H erp i t i f orm Pompholix Classification C on t act

11. 1.CONTACT DERMATITIS Contact dermatitis is skin inflammation caused by direct contact with a particular substance. The rash is very itchy, is confined to a specific area, and often has clearly defined boundaries.

12. CONTACT DERMATITIS

13. I R R I T A N T TYPES OF CONTACT D E RM A TITIS ALLERGIC

14. IRRITANT C ON T A C T D E R M A TI T IS : - Irritant contact d e r m a t iti s , w hich accounts for 80% of all cases of contact dermatitis , occurs when a chemical substance causes direct damage to the skin ; symptoms are more painful than itchy. Typical irritating substances are acids, alkalis (such as drain cleaners), solvents (such as acetone in nail polish remover), strong soaps, and plants (such as poinsettias and peppers).

15. ALLERGIC C O N T A C T DERMATITIS A lle r gic c ont a c t d e r ma t iti s i s a r eacti o n by the body's s y s t e m t o a immune substance contacting t he s k i n . Sometimes a person can be sensitized by Only one exposure, and other tim e s sensitiz a ti o n o c curs only after ma n y exposures to a substance. After a person is sensitized, the next exposure causes itching and dermatitis within 4 to 24 hours.

16. ATOPIC DERMATITIS Atopic dermatitis is chronic, itchy inflammation of the upper layers of the skin that often develops in people who have hay fever or asthma and in people who have family members with these conditions. Infants may develop red, oozing, crusted rashes on the face, scalp, diaper area, hands, arms, feet, or legs. Infants may develop red, oozing, crusted rashes on the face, scalp, diaper area, hands, arms, feet, or legs . Treatment The scalp can be treated with a shampoo containing pyrithione zinc, selenium sulfide , an Antifungal drug, salicylic acid and sulfur, or tar.

17. ATOPIC DERMATITIS

18. NUMMULAR DERMATITIS Nummular dermatitis is a persistent, usually itchy, rash and inflammation characterized by coin- shaped spots, often with tiny blisters, scabs, and scales . Most people benefit from skin moisturizers. Other treatments include antibiotics taken by mouth, corticosteroid creams and injections, and phototherapy . Most people benefit from skin moisturizers. Other treatments Include antibiotics taken by mouth, corticosteroid creams and injections, and phototherapy.

19. NUMMULAR DERMATITIS

20. 2.SEBORRHOEIC DERMATITIS Seborrhoeic dermatitis (also known as "seborrheic eczema") is an inflammatory skin disorder affecting the scalp, face, and trunk. seborrheic dermatitis presents with scaly, flaky, itchy, red skin. The condition's symptoms appear gradually and usually the first signs of seborrheic dermatitis are the flakes of skin called dandruff. TREATMENT : Dermatologist recommend topical treatments such as shampoos , cleansers or creams/lotions that contain antifungal , an t i i n f la mm a t o r y , s e b o s upp r e s i v e or keratolytic ingredients .

21. SEBORRHOEIC DERMATITIS

22. STASIS DERMATITIS Stasis dermatitis is inflammation on the lower legs from pooling of blood and fluid. have varicose (dilated, twisted) veins and swelling (edema). It usually occurs on the ankles but may spread upward to the knees . have varicose (dilated, twisted) veins and swelling (edema). It usually occurs on the ankles but may spread upward to the knees . Treatment : Long-term treatment is aimed at keeping blood from pooling in the veins around the ankles. When sitting, the person should elevate the legs above the level of the heart. Antibiotics are used only when the skin is already infected

23. STASIS DERMATITIS

24. PERIORAL DERMATITIS Perioral dermatitis is a red, bumpy rash around the mouth and on the chin that resembles acne or rosacea Perioral dermatitis is distinguished from acne by the lack of blackheads and whiteheads Treatment is with tetracyclines or other antibiotics taken by mouth.

25. PERIORAL DERMATITIS

26. 3. GENERALIZED EXFOLIATIVE DERMATITIS Generalized exfoliative dermatitis (erythroderma) is severe inflammation that causes the entire skin surface to become red, cracked, and covered with scales . Treatment – People with severe exfoliative dermatitis often need to be hospitalized and given antibiotics (for infection), intravenous fluids (to replace the fluids lost through the skin) , and nutritional supplements. Corticosteroids (such as prednisone) given by mouth or intravenously.

27. GENERALIZED EXFOLIATIVE DERMATITIS

28. POMPHOLYX Pompholyx/ dyshidrosis, is a chronic dermatitis characterized by itchy blisters on the palms and sides of the fingers and sometimes on the soles of the feet. The blisters are often scaly, red, and oozing.. Wet compresses with potassium permanganate or aluminum acetate ( Burow's solution ) may help the blisters resolve. Strong topical corticosteroid

29. POMPHOLYX

30. Dermatitis herpitiform : Dermatitis herpitiform is a particular type of dermatitis that appears as a result of a gastrointestinal condition, known as celiac disease .

31. DERMATITIS HERPITIFORM

32. 4. LOCALIZED SCRATCH DERMATITIS Localized scratch dermatitis (lichen simplex chronicus, neurodermatitis) is chronic, itchy inflammation of the top layer of the skin. Localized scratch dermatitis can occur anywhere on the body, including the anus (pruritus ani ) and the vagina (pruritus vulvae ), but is most common on the head, arms, and legs. In the early stages, the skin looks normal, but it itches. Later dryness scaling, and dark patches develop as a result of the scratching and rubbing. Applying surgical tape saturated with a corticosteroid (applied in the morning and replaced in the evening) helps relieve itching and inflammation and protects the skin from scratching.

33. LOCALIZED SCRATCH DERMATITIS

34. GE N ETIC ALLERGENS DISEASE NUTRITIONAL SEASONAL CHANGES INFECTION SICKNESS S TRESS HO R M O N AL SWINGS C A USE S :

35. There is a vasoconstriction of superficial blood vessels and the skin blanches readily Cold and low humilidity are poorly tolerated because of drifting effects Heat and high humidity are poorly tolerated because vasodilatation increases the inflammatory reaction thus aggravating the dermatitis and causing increased the itching and discomfort Lesion become localized to the flexor surface of the neck , to the eyelids , behind the ears , in the anticubital and poplital areas and at the wrist The erythema is now dusty in colour and excoriations may become secondary secondiarily infected PATHOPHYISIOLOGY :

36. by the late twenties or early thirties the lesions usually disappear , but they may recur at a late date as chronic hand or foot eczema Person with atopic dermatitis is highly suseptable to viral infections, especially herpes, and to bacterial infections, such as those caused by staphyloccus or hemolytic streptococcus There is also an increased incidence of fungal infection such as tinae. By the late twenties or early thristies the lesions usually dissapper ,

37. various exogenous and endogeneous agent(dyes perfumes) initiate inflammatory response of the skin skin eruption present that are specific to causative agent erythema , vesicles, scales and pruritis occur PATHOPHYISIOLOGY : Cause stretching In response to irritation and edema serous discharge and crusti Long term irritation also causes thickened lethargy and darker skin

38. RISK F A C T OR GE N E T IC A GE MEDICAL C O ND I T I ON ENVORONM ENT

39. CLINICAL MANIFESTATION : Red rash. This is the usual reaction. The rash appears immediately in irritant contact dermatitis; in allergic contact dermatitis, the rash sometimes does not appear until 24–72 hours after exposure to the allergen . Blisters or wheals. Blisters, wheals (welts), and urticaria (hives) often form in a pattern where skin was directly exposed to the allergen or irritant. Itchy, burning skin. Irritant contact dermatitis tends to be more painful than itchy, while allergic contact dermatitis often itches.

40. ALLERGIC CONTECT DEREMATITIS Erythema swelling and pruritic vesicles in area of allergen CONTECT DERMATITIS Acute Phase- pt have erythema itching burning exposed to agent. Sabacute phase- crusting, drying, fissuring, burning, exposed to agent Chronic phase- after repeted reaction pt. Scratch the skin CLINICAL MANIFESTATION :

41. Symptoms of dermatitis The symptoms of dermatitis range from mild to severe and will look different depending on what part of the body is affected. Not all people with dermatitis experience all symptoms . In general, the symptoms of dermatitis may include: rashes blisters dry, cracked skin itchy skin painful skin, with stinging or burning redness swelling

42. MA NA GEM E N T : MEDICAL MANAGEMENT Bathing Reduce how often you bath or shower, using lukewarm water. Showers are better. Replace standard soap with a substitute such as a mild detergent soap-free cleanser : your chemist or dermatologist can advise you. Clothing Wear soft smooth cool clothes; wool is best avoided. Irritants Protect your skin from dust, water, solvents, detergents, injury. Avoid exposure to environmental or food allergens. Common foods that cause allergic reactions are dairy, soy, citrus, peanuts, wheat (sometimes all gluten containing grains), fish, eggs, corn, and tomatoes. Emollients Apply an emollient liberally and often, particularly after bathing, and when itchy. Ask your doctor or dermatologist to recommend some to try; avoid perfumed products when possible.

43. T o p ica l s t e r o i ds A pp l y a t o p ica l s t e r o i d c r eam or ointment to the itchy patches for a 5 to 15 day course. Pimecrolimus cream Pimecrolimus is a new anti- inflammatory cream shown to be very effective for atopic dermatitis, with fewer side effects than topical steroids. Antibiotics Your doctor will recommend antibiotics such as flucloxacillin or erythromycin if infection is complicating or causing the dermatitis. The infection is most often with Staphylococcus aureus or Streptococcus pyogenes . Antihistamines Antihistamine tablets may help reduce the irritation, and are particularly useful at night. Other treatments Systemic steroids , azathioprine , phototherapy , and other complicated treatments may also be used for severe cases.

44. Medical care Corticosteroids -A corticosteroid medication similar to hydrocortisone may be prescribed to combat inflammation in a localized area. This medication may be applied to your skin as a cream or ointment. If the reaction covers a relatively large portion of the skin or is severe, a corticosteroid in pill or injection form may be prescribed . Antihistamines-Prescription antihistamines may be given if nonprescription strengths are inadequate .

45. Cleansing Properly Use The Right Products Protecting The Skin Environment Watch Your Diet Drink Water Prescription drugs Reducing provoking factors NURSING MANAGEMENT :

46. N U R S ING CARE PLAN

47. PREVENTION : Dermatitis relies on an irritant or an allergen to initiate the reaction, it is important for the patient to identify the responsible agent and avoid it. In an industrial setting the employer has a duty of care to the individual worker to provide the correct level of safety equipment to mitigate the exposure to harmful irritants. This can take the form of protective clothing, gloves or barrier cream depending on the working environment.

48. THYROID DISEASE IN T E S T I N E CANCER VASCULITIS ANAPHYLECTIC COMPLICATION

49. HEALTH EDUCATION

50. Conclusions – Atopic dermatitis can be treated by following a few basic rules regarding skin hydration, use of a moisturizer, and topical steroid applications to reduce inflammation. The distinction between the various types of contact dermatitis is based on a number of factors. these findings have been acknowledged not to distinguish [9] , and even positive patch testing does not rule out the existence of an irritant form of dermatitis as well as an immunological one. It is important to remember, therefore, that the distinction between the types of contact dermatitis is often blurred, with, for example, certain immunological mechanisms also being involved in a case of irritant contact dermatitis.