NCM 109: Integumentary

• Integumentary System

  • Protective barrier against infectious organisms, external agents and mechanical trauma
• Bacterial Infection

  • Mainly caused by Staphylococcus Aureus
• Impetigo

  • Highly contagious superficial skin infection
• 2 major disease form of Impetigo

  • Non bullous Impetigo
  • Bullous Impetigo
• Bullous Impetigo

  • Blister that is common in newborns and infants
• Non bullous Impetigo

  • Dishpere that is common in young children
• Non bullous Impetigo

  • Staphylococcus aureus or Streptococci is the main causative agents
• Incidence of Impetigo

  • Direct skin Contact - mode transmission
• S / Sx of Non bullous Impetigo

  • Macules - Small flat lesions
  • Papules - Small raised lesion
  • Vesicles - Small blisters
  • Pustules
  • Honey colored or Dark brown crust
• S / Sx of bullous Impetigo

  • Superficial vesicle
  • Bullae - large blisters that may rupture and may have the appearance of honey colored crust
  • Honey Colored crust - at least 2 cm in diameter
• Treatment of Impetigo

  • Topical antibiotic therapy
  • Oral antibiotics
• Cellulitis

  • Acute spreading inflammation of the skin
• Topical Antibiotic therapy

  • reduce complications and spread of infection and relief
• Nursing Management of impetigo

  • History - any exposure to someone with similar lesions
• Cellulitis

  • that is characterized by painful and swollen erythema
• Etiology of cellulitis

  • Facial cellulitis more common in children below 3 years old
• Etiology of cellulitis

  • S. pyogenes and S. aureus - are the most common organism
• 4 Cardinal Signs of cellulitis

  • Erythema - Abnormal redness of skin
  • Swelling
  • Skin warm to touch
  • Pain
• Systemic symptoms of cellulitis

  • Fever
  • Chills
  • Malaise
• Treatment for cellulitis

  • Systemic Antibiotics administration
  • Appropriate oral antibiotics
  • Hospitalization
  • Intravenous antibiotics
• Candidiasis (oral thrush)

  • Fungal infection caused by a yeast
• Candidiasis (oral thrush)

  • Most common during infancy in the oral cavity or diaper area
• Etiology of Candidiasis

  • Candida diaper dermatitis - most common as to the oral thrush
  • Candida ablicans (causative organism)
  • Infections are common both as oral candidiasis (thrush) or candida diaper dermatitis
• Clinical manifestation of Candidiasis

  • Oral Cavity - white plaques with erythematous
• Clinical manifestation of Candidiasis

  • Diaper area - erythematous plaque papules and pustules itchiness (atopic dermatitis)
• Diagnosis of candidiasis

  • Microscopic potassium hydrochloric test (KOH) - oral percutaneous measure to help diagnosis of candidiasis
• Diagnosis of candidiasis

  • Gram stains
  • Yeast culture
• Treatment for Oral (thrush)

  • Oral nystatin suspension (specific for candida)
  • gentian violet (2nd line treatment)
• Treatment for Diaper dermatitis

  • Topical ointment (nystatin cream, miconazole cream, fluconazole)
• Tinea capitis (Ring worm)

  • Fungal infection of the scalp, common under 12 years
• Etiology of Tinea Capitis

  • Dermatophytes - mold like fungal
• Etiology of Tinea Capitis

  • Microsporum, Trichopyton, Epidermophyton are the most common infection
• Clinical Manifestation of Tinea Capitis

  • Swollen red patches
  • Patches of hair loss (alopecia)
  • Flaking scalp (Dandruff)
• Treatment of Tinea Capitis

  • Antifungal medications (6 weeks)
• Treatment of Tinea Capitis

  • Selenium sulfide shampoo - help prevent the spread of tinea capitis
• Treatment of Tinea Capitis

  • Antifungal cream
  • Corticosteroids
• Tinea corporis

  • Can occur in most areas in the body; ring shaped lesions that most affect organisms
• Incidence and Etiology

  • Trichophyton rubra, Trichophyton tonsurans, Microsporium
  • Dermatophytes - occur form contact with infected humans and animals
• Treatment of tinea corporis

  • Topical agents (Ketoconazole)
• Tinea pedis (athlete's foot)

  • Fungal infection that affects the sole of the feet/ interdigital spaces