Dermatitis slide

OM VERMA
ASSISTANT PROFESSOR
RELIANCE INSTITUTE OF NURSING

1. DERMATITIS
PRESENTED BY-
OM VERMA
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
seborrheicdermatitis (which causes dandruff). A
rash is an abnormal condition and reaction of the
skin.

5. 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.

6. 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.
According to Lippincott….

7. INCIDENCE: 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.

8. Stagesofdermatitis-
Acutedermatitis-
Acutedermatitisischaracterisedby
erythema,vesiculationandoozing,often
withoedema.

9. Subacutedermatitis
Subacutedermatitis is similar to
acute dermatitis, but with scaling
and crusting

10. CHRONICDERMATITIS-Chronic
dermatitisischaracterisedbythickened
drypatches,oftenlichenifiedfrom
chronicrubbing (increasedskin
markings).Lichenificationisoften
predominantlyfollicularinpigmented
skin.

11. Generalized exfoliative
Pompholix Herpitiform
Seborrheic
Stasis Perioral
Contact
Atopic Nummular
Localizedstretch
Classification

12. 1.CONTACTDERMATITIS
Contactdermatitisisskininflammation
causedbydirectcontactwithaparticular
substance.Therashisveryitchy,is
confinedtoaspecificarea,andoftenhas
clearlydefinedboundaries.

13. IRRITANT
ALLERGIC
TYPES OF
CONTACT
DERMATITIS

14. IRRITANTCONTACTDERMATITIS:-
Irritantcontactdermatitis,which
accountsfor80%ofallcasesofcontact
dermatitis,occurswhenachemical
substancecausesdirectdamagetothe
skin;symptomsaremorepainfulthan
itchy.Typicalirritatingsubstancesare
acids,alkalis(suchasdraincleaners),
solvents(suchasacetoneinnailpolish
remover),strongsoaps,andplants(such
aspoinsettiasandpeppers).

15. ALLERGIC CONTACT DERMATITIS
Allergiccontactdermatitisisareaction
bythebody'simmunesystemtoa
substancecontactingtheskin.
Sometimesapersoncanbesensitizedby
onlyoneexposure,andothertimes
sensitizationoccursonlyaftermany
exposurestoasubstance.Afteraperson
issensitized,thenextexposurecauses
itchinganddermatitiswithin4to24
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 pyrithionezinc,selenium
sulfide, an Antifungal drug, salicylic acid
and sulfur, or tar.

17. NUMMULAR DERMATITIS
Nummulardermatitisisapersistent,usuallyitchy,
rashandinflammationcharacterizedbycoin-
shapedspots,oftenwithtinyblisters,scabs,and
scales.
Mostpeoplebenefitfromskinmoisturizers.Other
treatmentsincludeantibioticstakenbymouth,
corticosteroidcreamsandinjections,and
phototherapy.
Mostpeoplebenefitfromskin
moisturizers.Othertreatments
Includeantibioticstakenbymouth,
corticosteroidcreams
andinjections,andphototherapy.

18. 2.SEBORRHOEIC DERMATITIS
Seborrhoeicdermatitis(also known as
"seborrheiceczema") is an inflammatoryskin
disorder affecting the scalp, face, andtrunk.
seborrheicdermatitis presents with scaly,
flaky, itchy, red skin. The condition's
symptoms appear gradually and usually the
first signs of seborrheicdermatitis are the
flakes of skin called dandruff.
TREATMENT : Dermatologist
recommendtopical treatments such as
shampoos, cleansers or creams/lotions that
containantifungal
,antiinflammatory,sebosuppresive
orkeratolyticingredients.

19. 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

20. PERIORALDERMATITIS
Perioraldermatitisisared,
bumpyrasharoundthemouth
andonthechinthatresembles
acneorrosacea
Perioraldermatitis is
distinguishedfromacnebythe
lackofblackheadsand
whiteheads
Treatmentiswithtetracyclines
orotherantibioticstakenby
mouth.

21. 3. GENERALIZED EXFOLIATIVE DERMATITIS
Generalized exfoliativedermatitis (erythroderma) is severe
inflammation that causes the entire skin surface to
become red, cracked, and covered with scales.
Treatment -People with severe
exfoliativedermatitis 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.

22. 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

23. Dermatitis herpitiform:
Dermatitis herpitiformis a particular
type of dermatitis that appears as a result
of a gastrointestinal condition, known
asceliac disease .

24. 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 (pruritusani) and the vagina
(pruritusvulvae ), 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.

25. GENETIC ALLERGENS DISEASE
NUTRITIONAL
SEASONAL
CHANGES
INFECTION
SICKNESS
STRESS
HORMONAL
SWINGS
CAUSES :

26. PATHOPHYISIOLOGY :
There is a vasoconstriction of superficial blood vessels and the
skin blanches readily
Cold and low humilidityare 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 anticubitaland poplitalareas and
at the wrist
The erythemais now dusty in colourand excoriations may
become secondary secondiarilyinfected

27. 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 suseptableto viral
infections, especially herpes, and to bacterial infections,
such as those caused by staphyloccusor hemolytic
streptococcus
There is also an increased incidence of fungal infection
such as tinae.
By the late twenties or early thristiesthe lesions usually
dissapper,

31. RISK
FACTOR
GENETIC
AGE
MEDICAL
CONDITION
ENVORONM
ENT

32. CLINICAL MANIFESTATION :
Redrash.Thisistheusualreaction.Therash
appearsimmediatelyinirritantcontactdermatitis;
inallergiccontactdermatitis,therashsometimes
doesnotappearuntil24–72hoursafterexposureto
theallergen.
Blistersorwheals.Blisters,wheals(welts),
andurticaria(hives)oftenforminapatternwhere
skinwasdirectlyexposedtotheallergenorirritant.
Itchy,burningskin.Irritantcontactdermatitis
tendstobemorepainfulthanitchy,whileallergic
contactdermatitisoftenitches.

34. 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

36. •BathingReduce how often you bath or shower, using
lukewarm water. Showers are better. Replace standard
soap with a substitute such as a mild detergentsoap-free
cleanser : your chemist or dermatologist can advise you.
•ClothingWear soft smooth cool clothes; wool is best
avoided.
•IrritantsProtect 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.
•EmollientsApply anemollient liberally and often,
particularly after bathing, and when itchy. Ask your doctor
or dermatologist to recommend some to try; avoid perfumed
products when possible.
MANAGEMENT :
MEDICAL MANAGEMENT

37. •TopicalsteroidsApplyatopicalsteroidcreamor
ointmenttotheitchypatchesfora5to15daycourse.
•PimecrolimuscreamPimecrolimusisanewanti-
inflammatorycreamshowntobeveryeffectiveforatopic
dermatitis,withfewersideeffectsthantopicalsteroids.
•AntibioticsYourdoctorwillrecommendantibioticssuch
asflucloxacillinorerythromycinifinfectionis
complicatingorcausingthedermatitis.Theinfectionis
mostoftenwithStaphylococcusaureusorStreptococcus
pyogenes.
•AntihistaminesAntihistaminetabletsmayhelpreduce
theirritation,andareparticularlyusefulatnight.
•OthertreatmentsSystemicsteroids,azathioprine
,phototherapy,andothercomplicatedtreatmentsmay
alsobeusedforseverecases.

38. Medical care
Corticosteroids -Acorticosteroid
medication similar tohydrocortisonemay 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 .

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

40. NURSING
CARE
PLAN

41. 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 orbarriercreamdepending on the
working environment.

42. THYROID DISEASE
INTESTINE CANCER
VASCULITIS
ANAPHYLECTIC
COMPLICATION

43. HEALTH
EDUCATION

44. Conclusions–
Atopicdermatitiscanbetreatedby
followingafewbasicrulesregardingskinhydration,
useofamoisturizer,andtopicalsteroidapplications
toreduceinflammation.Thedistinctionbetweenthe
varioustypesofcontactdermatitisisbasedona
numberoffactors.thesefindingshavebeen
acknowledgednottodistinguish
[9]
,andevenpositive
patchtestingdoesnotruleouttheexistenceofan
irritantformofdermatitisaswellasan
immunologicalone.Itisimportanttoremember,
therefore,thatthedistinctionbetweenthetypesof
contactdermatitisisoftenblurred,with,forexample,
certainimmunologicalmechanismsalsobeing
involvedinacaseofirritantcontactdermatitis.

45. THANK YOU