Integumentary Disorders: In a Nutshell (Pediatric Nursing)

00:00 So in a nutshell, fungal infections occur due to any type of Candida. It can involve the skin, the mouth, the throat, the vagina, the penis, the diaper region, or can be systemic. There is an increased risk after taking antibiotics because remember you're disrupting the normal flora.

00:19 Signs and symptoms are itching and redness, and you're going to treat Candidal infection with antifungal medications. It rarely becomes invasive, but if it becomes disseminated these patients usually do not do well. So, in a nutshell, impetigo is a bacterial infection involving the superficial skin. We have bullous and non-bullous forms. The patient will have honey-crusted lesions and Staph and Strep are the most common causes. Patients can prevent this by washing their hands and we treat it with antibiotics. So, in a nutshell, cellulitis is a bacterial infection of the inner layers of the skin. It results from a break in the skin and this may not be visible. The common causes are Strep and Staph bacteria, and they're going to enter the deeper layers and begin to spread. This affects the dermis and the subcutaneous fat and it is usually painful. The legs and the face are common sites. In children, we commonly see periorbital cellulitis which is around the eye and we treat with oral antibiotics and close follow-up. These children are not septic and they do not have a fever. More severe cases are orbital cellulitis and these children need inpatient management. We treat with IV antibiotics and close inpatient observation. These children usually require IV antibiotics. If an abscess is present, it requires incision and drainage. We're going to treat the cellulitis with antibiotics but remember this can take a few days to become effective. Complications are rare but they include necrotizing fasciitis, sepsis, and death. So, in a nutshell, fungal infections are due to dermatophytes. They're classified according to their site of infection. Examples; ringworm, athlete's foot, or Jock itch. Signs, symptoms and management depend on the site involved and classically we'll see a ring-shaped, red, scaly patch that's well-demarcated and has a central clearing. These are very common infections. We're going to treat them with antifungal medications and remember sometimes we can treat topically and sometimes orally depending on the site. And always remember, these oral antifungals are hepatotoxic so you need to monitor liver function tests. So, in a nutshell; eczema, dermatitis, inflammation of the skin.

02:39 This is where the skin becomes dry, red and itchy. It can occur anywhere on the body and it can be a small patch or it can cover the whole body. The cause is unclear. We know it's common in children, but it can occur at any age. Remember, atopic dermatitis is also known as eczema and this is a chronic condition. It's going to flare periodically and you can control these exacerbations with moisturizing treatment and steroids. This condition is sometimes accompanied by asthma and hay fever, but remember they just co-exist, one does not cause the other.

03:12 And the treatment goal is to relieve itching and prevent flares. So, in a nutshell, this is Pediculosis capitis, also known as head lice and these are wingless insects that feed on human blood. Humans are the only known host and fortunately they don't transmit disease. Some patients are asymptomatic, but if your patient has symptoms it's usually going to be itching and bites. You can detect live lice bugs and nits on their hair during a thorough exam and it requires the mechanical removal with a nit comb and chemical treatments and remember you also need to treat all household contacts. So, in a nutshell, scabies is an itchy skin condition caused by a burrowing mite called Sarcoptes scabiei. It causes very intense itching where the mite burrows. Itching is usually worse at night and this is a very contagious condition.

04:06 Symptoms begin after about 6 weeks with your first exposure and symptoms can begin after a few days with the second exposure. Treatment is available. We give permethrin and you want to treat all household contacts and family members at the same time. Remember, even if treatment is effective the itching can persist for a few weeks after treatment as the body responds to these dead mites.