Skin Diseases and Problems in Children PDF

SKIN DISEASES AND PROBLEMS IN CHILDREN Lecturer Merve ORAL PRESENTATION PLAN Skin Layers of the Skin Features of the skin in a newborn Characteristics of the Skin in Adolescence Dermatological Lesions Bacterial Infections Vi...

SKIN DISEASES AND PROBLEMS IN CHILDREN Lecturer Merve ORAL PRESENTATION PLAN Skin Layers of the Skin Features of the skin in a newborn Characteristics of the Skin in Adolescence Dermatological Lesions Bacterial Infections Viral Infections Fungal Infections Infestations Pressure Ulcers Burnt SKIN The skin is the largest organ of the body and has a thin structure. While it is about 1 mm at birth, it increases in size about 2 times as it matures.  FUNCTIONS OF THE SKIN Protection: Trauma, chemical, physical and mechanical radiation Permeability: Removing sweat, reabsorbing some substances Heat regulation: Regulating blood vessels Sensation: Pain, heat, cold, lipid tissues under the skin (protection from external traumas) Synthesis of vitamin D Pigmentation Aesthetic appearance LAYERS OF THE SKIN  LAYERS OF THE SKIN Epidermis: It is the top layer of the skin. There are four layers of the epidermis: the top layer is the stratum corneum, the middle layers are the stratum lucidum and the stratum granulosum, respectively; Its lower layer is the stratum germinativum. in the epidermis; melanocytes, Langerhans cells and Merkel cells. LAYERS OF THE SKIN  LAYERS OF THE SKIN Dermis: Nerves, muscle, connective tissue, hair follicles, sweat glands, sebaceous glands, lymphatic ducts and vessels. Cells in the dermis; fibroblasts, mast cells and macrophages.  LAYERS OF THE SKIN Subcutaneous tissue:It is adipose tissue and separates the skin from the underlying tissues. Skin activities are controlled by the nervous system and endocrine glands. FEATURES OF THE SKIN IN A NEWBORN The skin is very thin. The epidermis is loosely attached to the dermis. Eccrine sweat glands function and produce sweat in heat and emotional situations. Apocrine sweat glands are small and non-functional. At birth, melanin is scarce, so the skin color is light. FEATURES OF THE SKIN IN ADOLESCENTS The skin is thick. The epidermis and dermis are tightly connected, its resistance to infection and irritation increases. Sweat glands function fully, after puberty, boys produce more sweat than girls. Apocrine sweat glands mature at puberty. Melanin is at the adult level,it gives the skin color.  DERMATOLOGICAL LESIONS Papules:They are hard skin protrusions that disappear without a trace smaller than 1 cm. Nodule:They are protrusions with a diameter of 1-2 cm that settle in the subcutaneous tissue and make elastic bumps on the skin. Vesicle:They are round, protrusions in the epidermis, containing serous fluid, smaller than 1 cm (eg: chickenpox). Bulla:They are vesicles larger than 1cm. Fistula: It is similar to a vesicle, but with purulent fluid inside. Macula: Non-palpable rashes less than 1 cm that are raised from the skin (eg measles)  DERMATOLOGICAL LESIONS Cyst: It is palpable, located deep in the skin and surrounded by a thick wall that surrounds the liquid or semi-solid substance inside. Fissure:They are smooth slits from the epidermis to the dermis. Erosion:It is the loss of part or all of the epidermis. It is the previous form of the ulcer. Ulcer:The epidermis and dermis are affected, there is tissue loss.  BACTERIAL INFECTIONS IMPETIGO They are superficial infections that are common in children and are highly contagious. The most common areas are: Face, around the mouth, hands, neck and extremities.  BACTERIAL INFECTIONS IMPETIGO The microorganisms that lead to infection are usually streptococci and staphylococci. Clinical Signs and Symptoms Impetigo lesions begin as vesicles or fistula. There may be itching or regional lymphadenopathy. If the secondary infection does not develop, it heals in 10-14 days without scarring.  BACTERIAL INFECTIONS IMPETIGO In local treatment, the crusts are removed and topical antibiotics are applied the importance of taking oral and topical medications for the recommended period of time is emphasized. It is said that the child's belongings should not be shared with anyone. Attention should be paid to the personal hygiene of the child.  BACTERIAL INFECTIONS FOLLICULITIS It is an inflammation of the hair follicle. It can occur in any part of the body that contains hair. It is seen as a painful swelling surrounding the hair and sometimes as a pus-filled vesicle that settles in the middle of it.  BACTERIAL INFECTIONS FOLLICULITIS The causative agent is usually Staphylococcus aureus. There may be itching. Individually, the lesions can deepen. In order to prevent the development of infection, the family and the child are informed. The area should be kept clean and loose cotton clothing should be preferred.  BACTERIAL INFECTIONS CELLULITE It is an infection of the dermis and subcutaneous adipose tissue. Temperature increase in the affected area, tenderness, erythema and plaques with unclear boundaries are characteristic features.  BACTERIAL INFECTIONS CELLULITE The most common causative agents are Staphylococcus aureus, Streptococcus pneumoniae. IV antibiotic therapy is started. Warm compresses can be applied to the affected area 4 times a day. The aim of care is to diagnose the signs of serious infection early, to prevent the development of complications, to support the child and his family, and to inform them about home care.  VIRAL INFECTIONS WARTS (VERRUCA) Wart; The causative agent is human papilloma virus. Although it is mostly seen in the hands and feet, it can occur in the whole body.  VIRAL INFECTIONS WARTS (VERRUCA) The main treatment methods are keratolytic agents that dissolve the upper layer of the skin, cold therapy (cryotherapy), acidic solutions that kill the wart microbe, and can be used in surgical methods in some cases.  VIRAL INFECTIONS MOLLUSCUM CONTAGIOSUM It is a viral inflammation of the skin caused by the smallpox virus. There is direct contact or passage from the surface contaminated with the virus. The lesions usually disappear spontaneously in 6-9 months. Local antiviral drugs can be administered. VIRAL INFECTIONS  FUNGAL INFECTIONS Tinea Capitis They are fungal infections that are seen in the first place. It is common in children. It is passed from person to person or from animal to human. It causes epidemics in schools and kindergartens. Alopecia appears in the affected area. There may be itching.  FUNGAL INFECTIONS Tinea Corporis It is a fungal infection that occurs on the body. It usually passes as a result of contact with infected animals. The disease begins with round, pale red plaques on the balding skin.  FUNGAL INFECTIONS Tinea Pedis They are fungal infections that occur in the feet. It is on the plantar surface between the fingers or on the foot. Lesions can be in the form of macerations, fissures between the fingers, vesicles and plaques. The area is itchy.  INFESTATIONS PEDICULATOSIS (LICE) It is an infestation caused by Pediculosis capitis (head lice), Pediculosis corporis (body lice) and Pediculosis pubis (pubic lice), which feed on human blood. It is usually seen in children aged 3-12 years.  INFESTATIONS PEDICULATOSIS (LICE) The classic symptom is intense itching. Infections can be seen as a result of deterioration of skin integrity. The eggs are silver-white, yellow or dark in color and 1 mm in size, round.  INFESTATIONS PEDICULATOSIS (LICE) Special shampoos and creams are applied in the treatment. Oral antihistamines or topical corticosteroids may be used for itching. After the treatment, if the hair is washed with 3-5% acetic acid (diluted vinegar) and combed with a dense-toothed comb, the empty eggs can be separated from the scalp.  INFESTATIONS SCABIES It is a highly contagious infestation caused by the Sarcoptes scabei parasite. It is transmitted by skin-to-skin contact and is common in domestic transmission. The female parasite lays her eggs under the upper layer of the epidermis. The incubation period of the egg is 2-4 days. About 1 month after the settlement, irritation and intense itching begin on the skin. Itching increases especially at night.  PRESSURE ULCERS Symptoms That May Develop Pressure Ulcers and Possible Causes Fields Possible causes Occipital area in the head region Lack of ability to lift the head Sacrum and buttocks Being bedridden or wheelchair-bound Legs and feet Casts, leg or foot splints Back and neck Scoliosis splint Knees and elbows Rubbing on bed linen  PRESSURE ULCERS NURSING INITIATIVES The purpose of nursing care of children at risk of developing pressure ulcers; It is the prevention, early detection and treatment of the development of pressure ulcers. In the content of nursing care; protection of the child from infections, providing appropriate wound care, eliminating conditions that may cause discomfort such as pain and itching, education and support of the child and his family.  PRESSURE ULCERS NURSING INITIATIVES Evaluation of the Skin It is important for the nurse to properly identify any problems in the structure of the skin using the inspection and palpation method. Features such as color, shape or spread of the wound are recorded on the nursing observation form. The depth of tissue damage, signs of healing, and signs of infection (increase in erythema, edema, purulent exudate, pain, and temperature) should be evaluated in pressure ulcers. The skin is gently palpated for detailed examination of the findings obtained by inspection. Features such as heat, humidity, structure, elasticity, edema are evaluated.  PRESSURE ULCERS NURSING INITIATIVES Creation of Nursing Diagnoses Deterioration of Skin Integrity due to environmental agents and immunological deficits Risk of Deterioration in Skin Integrity due to mechanical trauma, body secretions and infection Risk of Infection due to the presence of an infected organism Acute Pain due to skin lesion and itching Disturbance in Body Image related to perception of appearance  BURNS Determination of Surface Area An accurate calculation of the burn surface area reveals the severity of the burn injury and the amount of fluid replacement therapy to be given. With the Lund and Browder card, the total body surface area burned in different age groups can be calculated. BURNS  BURNS Determining the Depth of the Burn First Degree Burn (Superficial Burns):The damage is only in the epidermis, which is the upper layer of the skin. It is characterized by pain and erythema. No scarring occurs. Mild sunburns and superficial burns can be given as examples.  BURNS Determining the Depth of the Burn Second Degree Burns (Partial thicknessBurns):It affects the entire epidermis, part of the dermis. The appearance of these sores is red, wet and in the form of bullae. When the nerve endings in the dermis are affected by the burn, there is severe pain.  BURNS Determining the Depth of the Burn Third Degree Burn (Full-thickness Burns):It affects the epidermis, dermis and subcutaneous tissue. Nerve endings, sweat glands and hair follicles are destroyed. Wounds do not heal on their own, surgical excision and grafting are performed.  BURNS Determining the severity of the burn in a child Determining the severity of the burn Mild Burns 2nd Degree Body Surface Burn