1. Contact dermatitis
Contact dermatitis is a slow response hipersnsitivitas type IV reactions, inflammatory disorder that is caused by ekzematosa and skin reaction to a substance that irirtan or allergenic. There are four basic forms: allergic, irritant, phototoxic, fotoalergika. Almost any substance can cause contact dermatitis include: poison ivy, cosmetics materials, soaps detergents, and industrial materials
clinical manifestations
Itching, burning, erythema, skin lesions (vesicles), and edema followed by spending secretions, crusting formation and finally drying and flaking skin.
2. Atopic Dermatitis
Atopic dermatitis is a skin inflammation that involves excessive stimulation of T lymphocytes and mast cells. Type of chronic itching that often arise, in a state that is often called eczema. The word "atopic" refers to three groups, namely asthma, allergic disorders, allergic renitis (influenza), and atopic dermatitisIncidentGenesis of some studies suggest 75 to 80% of atopic dermatitis clients about individuals or families who have a history of allergic disorders. Atopic dermatitis is a common condition affecting interrupt 0.5 - 1% population worldwideEtiologyThe main cause of atopic dermatitis is not known. Xerosis is common even worse during periods of low humidity; wintertime northern latitudes aggravate itchingPathophysiologyCompared with normal skin, dry skin in atopic dermatitis due to any decrease in water binding capacity, high water loss in transepidermal, and a decrease in water content. On the water loss experienced drought further and cracking of the skin becomes more itchy. Rub and scratch itchy skin because of the response of some skin complaints at the clinic.
Clinical ManifestationsAtopic dermatitis begins for children. In the acute situation, which at first seemed rosy, mud and lots of crust. In infants skin lesions appear on the face and buttocks. In older children and adolescents lesions appear more often appear on the hands and feet, behind the knees, and elbows fold.Symptoms are most severe pruritus causes recurrent inflammation and formation of lesions, which are the main complaints people search bantuaan
ComplicationSkin infections by bacteria commonly found especially staphylococcus aureus, fungi, or viruses such as herpes simplex. People with this disease should avoid live attenuated virus inoculation.Diet ManagementManagement of diet in atopic dermatitis is still a controversial issue. Significant food allergy, it is not known as a cause of atopic dermatitis or what percentage of clients who have atopic dermatitis food allergies. The most common allergens that often arises is the egg, milk, soy, wheat, nuts, and fish. Known allergens should be avoided. Perawataan be done to prevent malnutrition when making any dietary restrictions.
3. Drug and Medication Reactions (Dermatitis medikamentosa) medikamentosa Dermatitis is a type I hypersensitivity disorder, is a term used for skin rashes due to internal use of drugs or certain medications. In umumya drug reactions arise suddenly, raum be accompanied by systemic symptoms or complete.Urticaria is a type I hypersensitivity allergic reaction characterized by the sudden appearance of a protruding lesion edematosus, pink with varying sizes and shapes. The affected body part including mucous membranes (mouth), larynx and gastrointestinal tract.Edema is swelling arising Angioneurotik sudden a few seconds or minutes, or slowly, that the deeper layers of the skin, so it does not seem beyond the lesion. Parts of the body are often affected are the lips, eyelids, cheeks, hands, feet, genitalia, and tongue; mucous membranes of the larynx, bronchi, and gastrointestinal tract.Food allergy is a form of type I hypersensitivity Clinical symptoms in the form of a classic allergy symptoms as the others.Serum sickness is a type III immune complex hypersensitivity.
Nursing AssessmentClients with dermatitis should be examined how the daily hygiene habits (eg, whether the client is a shower with soap and hot water?), A treatment that has been given, exposure to allergens, environmental exposure, and history of skin damage.Modification of planning for elderly clientsDermatitis is a common skin disorder in the elderly. It can be caused by hipoproteinemia, venous insufficiency, allergens, irritants, or malignant disease such as leukemia or lymphoma. Because elderly clients often take more than one drug, the dermatitis due to drug interactions can be considered. Fragility of the skin should be considered in planning treatment delivery. Most clients are elderly do not need a bath every day and should avoid hot water for bathing as well as soap. Water faucets and materials that do not make the skin dry can be used.Nursing
1. Impaired skin integrity bd dryness of the skinExpected outcomes: the client will keep the skin in order to have good hydration and decrease inflammation, characterized by• Disclose increase skin comfort• Reduced degree of exfoliation• redness Berkurangnnya• Reduced scratched by scratching• Healing the damaged skin areasIntervention:
- bath at least once a day for 15-20 minutes. Immediately apply ointments or creams that have been prescribed after a shower. Shower more often if signs and symptoms improved. Rationalizing the bath water will seep in skin saturation. Application of a moisturizing cream for 2-4 minutes after bathing to prevent water evaporation from the skin.
- Use warm water not hot. Rationalization hot water causes vasodilatation which will improve pruritus.
- Use a moisturizing soap or soap for sensitive skin. Avoid bubble bath. Rationalization moisturizing soap less alkaline content and makes no dry skin, dry soap may increase complaints.
- Apply / give ointments or creams that have been prescribed two or three times per day. Rationalization ointment or cream will hydrate the skin.
2. Risk of exposure to an allergen skin damage b.dExpected outcomes: The client will maintain the integrity of the skin, characterized by• Avoid allergensIntervention:
- Teach client to avoid or reduce exposure to known allergens. Rationalization avoid allergens will reduce the allergic response
- Read the labels of canned food to avoid food ingredients containing allergens
- Avoid pet. Rationalization if allergic to animal dander keep animals should avoid or limit the presence of animals around the area home
- Use the air conditioner (AC) at home or at work, if possible. Rationalization AC helps reduce exposure to some allergens in the environment.
3. Changes in sense of comfort b.d pruritusExpected outcomes: client showed reduced pruritus, marked by• Reduced abrasions due to scratching• Clients sleep soundly without being disturbed itch• The client expressed an increased sense of comfortIntervention:
- Describe the symptoms of itching associated with penyebanya (eg dry skin) and the principle of therapy (eg, hydration) and the cycle of itch-scratch-itch-scratch. Rationalization by knowing the physiological and psychological principles and itchy and workarounds will increase the cooperative.
- Wash all clothing before use to remove formaldehyde and other chemicals, and avoid using fabric softener manufactured. Rationalization pruritus is often caused by irritants or allergens effects of chemicals or fabric softener components.
- Use a mild detergent and rinse clothes to make sure there is no soap left. Rationalization remaining ingredients (detergents) in washing clothes can cause Irritation
