Allergies and Skin Diseases

• Integumentary System

  Made up of skin, nails, hair, glands

  Acts as a physical barrier

  Helps regulate your body temperature

  Allows to feel skin sensations

  Largest and heaviest organ
• Skin weighs _ lbs and _ mm thick

  6, 2
• Epidermis

  Top layer

  Made up of melanocytes, keratinocytes, Langerhans

  Melanin - gives the skin its color

  Has skin attachments like hair and nails

  Site of Vitamin D synthesis
• Dermis

  Also called corium or true skin

  Middle layer

  Thickest layer

  Contains sweat, oil glands, hair follicles

  Storehouse for water, blood, electrolytes
• Hypodermis


  Bottom layer

  Fatty layer that helps insulate the body

  Depot for body fats

  Also called as subcutaneous gland tissues
• Skin and Nutrition

  Epidermis - require sufficient amino acids and Vitamin A for normal keratinization and EFA for normal epidermal permeability
• Skin and Nutrition

  Vitamin C and Protein Deficiencies - alter the skin’s collagen formation
• Skin and Nutrition

  Energy and Folic Acid - increased during extensive skin inflammation
• Skin and Nutrition

  Conditions that can irritate, clog, or inflame skin can cause symptoms like redness, swelling, burning, or itching
• Skin and Nutrition

  Allergies, irritants, genetic makeup, and immune system problems can cause dermatitis, hives
• Protein Energy Malnutrition


  Deficient in protein and calories
• This is observed for children with protein energy malnutrition

  Marasmus and Kwashiorkor
• Essential Fatty Acid Deficiency


  Structural failure of skin’s cell membrane that leads to loss of fluidity and increased water loss
• Low consumption of this fat leads to eczematous skin lesions

  EFA linoleic acid
• Treatment used to treat EFA deficiency

  Linoleic acid combined with pyridoxine
• Linoleic acid is found in

  Linseed safflower

  Cottonseed

  Soybean oils

  Fish oils

  Animal tissues
• Trilinolein is found in

  Olive oils

  Rapeseed oils

  Soybean oil

  Sunflower oils
• Vitamin A Deficiency


  Decreased cell differentiation of epithelium
• Xerosis


  Dryness and roughness of skin
• Phrynoderma


  Roughness of skin due to follicular reaction
• Follicular Keratosis


  Follicles become blocked with keratin
• Pachyderma


  Also known as “Elephant Skin”
• Vitamin A Excess


  Causes dry itching skin and swelling over long bones
• Riboflavin Deficiency

  • Seborrheic Dermatitis - greasy scales around the nose and lips that extends over the cheeks and forehead
  • Angular Stomatitis (Perleche) - affects the angles of the mouth
• Niacin Deficiency


  Deeply pigmented, bilateral, infected, swollen, and ulcerated
• Pellagra


  Photosensitive dermatitis, diarrhea, dementia, death
• Pyridoxine Deficiency


  Fine, brawny scaling in forearms and lower legs
• Ascorbic Acid Deficiency


  Follicular hyperkeratosis with petechial hemorrhage
• Scurvy


  Sever Vitamin C deficiency
• Zinc Deficiency


  Dermatitis on the face, hands, feet with eczematous rash and pustular lesions
• Acrodermatitis Enteropathica 


  Inability of Zinc to Be absorbed in the gut
• Doses for Zinc supplementation in Zinc deficiency

  patients

  3 - 4 times daily
• Iron Toxicity


  Causes hemochromatosis and gives skin gray color
• Nutrition Therapy for Vitamin and Mineral Deficiencies

  Protein foods with high biological value
• Pressure Ulcers


  Pressure on the tissue is greater than the pressure in the capillaries
• Pressure Ulcer

  Also called as “bedsores”

  Common in bedridden patients
• Stages of Pressure Ulcers

  • Stage 1 - intact, nonblanchable erythema
  • Stage 2 - partial-thickness skin loss
  • Stage 3 - full-thickness loss of skin, slough or eschar, with foul smelling
  • Stage 4 - full-thickness loss of skin, and involves muscle, bone, and tendon
• Pressure Ulcers Anatomical Sites

  Sacrum - base of spine

  Coccyx - tailbone

  Trochanter - hip bones

  Gluteal - buttock

  Ischial - unrelieved pressure from sitting

  Gluteal Cleft - moisture damage
• Three risk assessment scales

  Waterlow

  Norton

  Braden
• Pressure Ulcers Management

  Prevention intervention is the best treatment

  • Excellent skincare
  • Adequate hydration/nutrition
  • Pressure dispersion cushions
  • Turning schedules
  • Support surfaces (egg crate mattress)