3- contact dermatitis

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contact dermatitis

Tutorial Q&A

Q5: Peter is 12 years old has taken triamcinolone 0.1% cream for long periods of time for contact dermatitis and has been applying the cream thickly to large areas of his body. His mother reports to his doctor that Peter’s face has become rounder and puffy, and that Peter has noticed weakness in his arms. What condition do you think Peter may have?

D. Unknown condition

C. Hyperthyroidism

B. Cushing's syndrome

A. Rosacea

Q4: Sally has irritant contact dermatitis. Which of the following statements shows that Sally needs more education about her condition:

D. “I will avoid scratching my skin”

C. “I will choose fragrance free soaps”

B. “I will wear the same pair of gloves all day during my working day to protect my skin and I will remove the gloves after I finish work”

A. “I will wash my skin immediately after exposure to possible irritants”

Q3: In the research article by Alluhayyan et al (2020) On Occupational – related contact dermatitis (see VLE for article) what part of the body was most reported by participants regarding skin changes?

D. Nasal bridge

C. Cheeks

B. Wrists or forearms

A. Hands

Q2: Tom asks the nurse how long he will be wearing the patch tests on his back for. Which is the correct response from the nurse?

D. “The patches are usually removed after one month”

C. “The patches are usually removed after seven days”

B. “The patches are normally removed after 48 hours”

A. “The patches are normally removed after 4 hours”

Q1: Tom will be having a patch test this week. Which of the following statements indicate that Tom needs more education about the patch test procedure?

D. “I will be able to continue with strenuous activity and sports during the patch test”

C. “I will wear dark colored clothing instead of light colored clothing”

B. “I will avoid swimming during the days of the patch testing”

A. “I will avoid exposing my back to sunlight during the patch testing”

Nursing management

explain how to apply the ointment

Seek medical advice if not improving

Avoid touching the skin with the tip of ointment

Apply thin firm of ointment and rub it gently

Wash and dry hand and affected area

education about

Prevent recurrent of the problem

change them and strict to hand hygiene

cool water and use fragrance free soaps , and then dry the skin and then apply moisturizer

Wear protective equipment

strict to the treatment

lubricate the skin

avoid the allergen or irritant

Protect the integrity of the skin

dry the skin after washing

moisturizing by creams and water.

how to minimize the severity of symptoms

moisturize the skin, avoid rubbing and avoid exposure to allergen or irritant.

Medical management

• Diphenhydramine tab. 25mg, PO

an antihistamine used to relive allergy symptoms such as itching, rash and runny nose.

• Triamcinolone acetonide 0.1% ointment

a medium to strong potency corticosteroids used to reduce redness , swelling and itching .

Assessment and Diagnostic findings

history

use of skin care products

any identifiable relationship to work environment

date of onset

patch test

A positive skin test means that the client is allergen to the substance. A negative skin test means he probably aren’t allergic to the allergen.

involves application of antigens on the skin 48h, and then to assess the final reading in 96h because of possibility of delayed reactions.

Thin-layer Rapid Use Epicutaneous test

Clinical manifestations

caused by the inflammation and the inflammatory mediators

skin thickening, hardening, and scaling

skin lesions (vesicles and papules)

erythema(redness) and edema

burning

itching

types

photo allergic

allergenic contact + light exposure

Photo-toxic

irritant + sunlight + chemical

Irritant

contact with substances the chemically or physically damages the skin

Allergic

contact of skin and allergenic substances

What is it?

caused by

contact with an exogenous substance that elicits an allergic response

a type IV delayed hypersensitivity reaction