Contact dermatitis & diaper rash

Question 1

Contact Dermatitis

Answer 1

• Inflammation, redness,itaching, burning, stinging and vesicle or pustule formation
• ICD and ACD

Question 2

ICD ( irritant)

Answer 2

• Due to exposure to irritant
• Appear after first exposure or multiple exposures to the same agents
• Inflammed skin, swollen and turns red
• If rash occurs, itching and stinging and burning may occur

Question 3

ACD

Answer 3

• Poison ivy/Oak/ Sumac ( toxicodendron genus)
• Latex allergy
• Inflammatory dermal response to exposure to an allergen that activates T-cells
• Type 4 delayed hypersensitivity reaction the symptoms may not appear for 2-48 hours after 2nd exposure.
• Urushiol-Induced ACD caused by Toxicodendron plants

Question 4

ACD Clinical Presentation

Answer 4

• ACD can occur anywhere toxin is present with the antigen.
• Papules, small vesicles over inflamed swollen skin.

Question 5

Treatment of ICD & ACD

Answer 5

• Non Pharm : Tepid, soapless showers, preventative & protective measure.
• Pharm. Therapy :
  
  • Avoid topical LA ( -caine ) & Atihistamines, and antibiotics ( increase risk of sensitization)
  • Only take oral Anti-histamines
  • Hydrocortisone (NTE 7 days)
  • Astrigents ( promote drying reduce inflammation and improve healing)
  • Burrow’s solution ( aluminum Acetate ) + whitch hazel
  • Calamine can leave stains on clothes
  • If due to poison Ivy, tell patients to wash clothes throroughly

Question 6

Diaper Dermatitis

Answer 6

Occurs in the perinuem, buttocks, lower ab and lower thighs

Bright red-Maroon rash that can be shiny/wet- looking

Causes :

• Occlusion
• Moisture
• Changed in pH
• Mechanical Chafing/Friction
• Medications/foods that affect motility or flora of GI or hinder urination autonomic control

Can lead to Secondary infections

Prevent Recurrences is the best treatment

Question 7

Treatments for Diaper Rash

Answer 7

• Reduce Occlusion, irritation and trauma
• Decrease contact time, protect skin, encourage healing
• Increase diaper changes (6 times/ day)
• Clean area with non-irritating wipes or lukewarm water
• Use diapers that wick water/moisture away from the surface.

Question 8

Pharm. Treatment for Diaper Dermatiris

Answer 8

use Skin Protectants

• Zinc Oxide ( can be difficult to remove)
• Calamine ( Zinc and ferrous Oxides ) - absorptive, antiseptic and antipuritic properties.
• Petrolaum/Mineral Oil
• Lanolin - bacteriostatic fatty substance found in wool
• Dimethicone - Repeals water and counteracts inflammation
• Topical cornstarch ( inhalation warning)

DO not use : Topical antibiotics, antifunal, Hydrocortisone

Question 9

Prickly Heat

Answer 9

• Fine, pinpoint and red raised rash that occurs on any part of the body that has sweat glands
• Results from cloffed or blocked glands.
• No prodrome
• Skin is unable to breath

Question 10

Prickly Heat Pharm. Treatment

Answer 10

• Emollients, skin protectants, antipruritics
• Relieve burning/irritation
• Water washable, cream based products
• Coll. Oatmeal ( Aveeno)
• Powders ( abosorb moisture)
• Use hydrocortisone on adults if less than 10 % of the body is involved –> it only relieves itching