Dermatoses

• Dermatosis is a general term used to describe any skin defect and lesion. Dermatosis is a broad term that denotes any disease of the skin.
• While dermatitis denotes a condition involving skin inflammation.

Infectious dermatoses

• Infectious dermatoses are caused by bacteria, viruses, fungi, parasites, and other infections. Infectious dermatoses include skin conditions such as impetigo, folliculitis, cellulitis, warts, herpes simplex, candidiasis, scabies, etc.

Non infectious dermatoses (non infectious dermatoses)

• Non infectious dermatoses are those that are not caused by an infection but are caused by another cause. is.
• For example, conditions such as psoriasis, seborrheic dermatitis, hyperpigmentation, vitiligo, alopecia areata are included.

Define acne vulgaris

• Ecne vulgaris is the most common skin disorder. It affects the hair follicles. Which we know as acne or pimple.
• Acne vulgaris is mainly found on the face, neck and upper trunk.
• Acne vulgaris is more common in adolescents and young adults, i.e. between the ages of 12 and 35.
• Acne vulgaris is associated with hormonal changes, diet patterns, and stress.

What is the cause of acne vulgaris

• Caused by excessive sebum production
• Hair follicles become plugged with dead skin cells or oil.
• Caused by abnormal keratinization of the epithelium.
• Anaerobic bacteria Causes
• Family history

Explain pathophysiology of acne vulgaris

During puberty, the sebaceous glands are stimulated by androgen hormones.
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The size of the sebaceous glands increases. Sebaceous glands produce natural oils and sebum.
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In the condition of acne vulgaris, the sebaceous glands are stimulated by many factors.
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This leads to increased sebum production. This sebum flow comes out on the skin surface.
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This causes the yellow sebaceous ducts to become plugged, resulting in comedones.

Write sign & symptoms seen in acne vulgaris (right sign and symptoms seen in acne vulgaris)

• Whiteheads (closed plugged pores), blackheads (open plugged pores), papules, pustules, nodules and cysts are seen on the face, neck, shoulders and trunk.
• In severe cases, cyst formation is seen and pigmentation is seen.
• Scar formation is seen.

How to diagnose acne vulgaris

• History collection
• Physical examination
• Culture test (if pus is present)

Write medical management of acne vulgaris

Topical medicine

• Salicyclic acid and benzoyl peroxide are used as topical medicines. In which benzoyl peroxide is used more.
• Benzoyl peroxide quickly reduces inflammation and reduces sebum production.
• Topical antibiotics are also often used. Which decreases the level of superficial fatty acids and reduces comedones, papules and pustules.
• Tretinoin (vitamin A acid) is also used. Which clears keratin plugs from the pilosebaceous ducts. Systemic medicine
• Antibiotics and synthetic vitamin – A compounds are used as systemic medicine.
• Estrogen therapy is also used in female patients. Estrogen progesterone preparations reduce sebum production and reduce the oiliness of the skin. This therapy is not used in men because breast enlargement is seen with the use of this therapy in men. Intra lesional injection
• In intra lesional injection, a corticosteroid drug is injected into the lesion. This procedure is used to treat C acne. Diet therapy:
• Diet plays an important role in acne vulgaris.
• Avoid foods that trigger acne. Such as chocolate, cola, fried food, milk products and high glucose food Hygiene therapy
• Wash the affected area twice a day with a cleansing soap.
• Use oil-free cosmetics and personal products.

Write surgical management of acne vulgaris

Comdone extraction

• In comedone extraction, comedones are removed with the help of a comedone extractor. In which the opening of the comedone extractor is placed over the comedone and pressure is applied to it so that the plug comes out.

Crayosurgery

• Cryosurgery is used for both nodular and cystic forms of acne.

Inscion & drainage

Define acne rosacea

• Rosacea is a chronic inflammatory skin condition that affects the central face. One sees small red papules and pustules on the face in rosacea. There is also an itching and burning sensation on the face. The face is seen flushing and blushing. Along with this, telangiectasia is also seen, meaning spider-like blood vessels are seen on the cheeks.
• Ek rosacea is most commonly seen in middle-aged women and people with fair skin. That is, it is more common between the ages of 30 and 50.
• There is no specific treatment for acne rosacea, but antibiotics, azelaic acid, are used

Define acne conglobata

• One Conglobata is a rare but severe form of nodulocystic acne. The primary cause of conglobata is unknown. However, trigger factors include anabolic steroids, testosterone, leukemia, and cancer.
• It is characterized by comedones, cysts, nodules, and burrowing abscesses on the face, shoulders, back, chest, and thighs. Comedones occur in groups of two to three. It can cause an offensive-smelling discharge and the formation of irregular scars.
• Anti-acne medicines are used in the treatment of acne, such as tretinoin. Systemic steroids and antibiotics are also used.

Fungal infection of skin

• Fungal infections are also known as ‘mycosis’.
• Fungus is more common in warm and moist areas. Therefore, fungal infections are more common in moist areas such as the feet, armpits, and areas where the skin folds.
• Fungal infections are spread by direct or indirect contact with an infected person.
• Infections are mainly seen in people using systemic corticosteroids and antibiotics, people using birth control pills, people with immunosuppression, people with systemic diseases, and people living in warm climates.
• Tinea and candidiasis are more common fungal infections.

What is Tinea

Tinea is also known as ‘dermatophytosis’. Tinea is the most common fungal infection. Tinea is also known as ‘ring worm infection’ because it causes red ring-shaped patches.

Explain type of tinea

Tinea is classified into the following types depending on the part of the body involved:

• Tinea pedis
• Tinea corporis
• Tinea capitis
• Tinea cruris
• Tinea unguium
• Tinea barbae
• Tinea faciei
• Tinea manuum

Tinea pedis (Tinea pedis)

Tinea pedis is also known as ‘ringworm of the feet’ or ‘athlete’s foot’ .
Tinea pedis affects the area between the sole of the foot and the toes.

Explain sign & symptoms seen in tinea pedis

• Scaly, peeling and cracked skin is seen between the toes.
• Itching is seen in that area.
• Stinging and burning sensations are seen.
• The skin appears inflamed and discolored.
• In severe cases, painful fissures are seen and foul odor is observed from them.

Write medical management of tinea pedis

• Soak the feet in Boro solution, vinegar solution, potassium permanganate solution, or saline solution to remove crusts, scales, and debris and reduce inflammation.
• Apply a topical antifungal agent to the infected area. Such as clotrimazole, miconazole

Write nursing management of tenia pedis (Write nursing management of tinea pedis)

• Assess vital signs.
• Check the area between the toes and toes.
• Topical on the affected area Apply medicine.
• Advise the patient to avoid wearing rubber and plastic shoes.
• Wear cotton socks.
• Keep the toe area dry.
• Clean the toe area thoroughly with soap.
• Administer the medicine prescribed by the doctor.
• Maintain records and reports.

Tinea corporis (Tinea corporis)

Tinea corporis is also known as ‘Ringworm of the body’. Tinea corporis is an infestation of the body. It mainly affects the face, neck, trunk and extremities. Tinea corporis can occur at any age but is more common in children.

Sign & symptoms seen in tenia corporis (signs and symptoms seen in tinea corporis)

• Initially small red macules are seen.
• Later large ring-shaped papules, pustules or vesicles are seen.
• In which a red colored rice border is seen.
• These lesions are seen in the form of clusters.
• Itching and erythema are seen in the affected area.

Write management of tenia corporis

• Apply a topical antifungal cream to the affected area. For example clotrimazole
• In severe cases, provide oral antifungal medicine. For example griseofulvin, terbinafine
• Apply cold compresses.

Write nursing management of tinea corporis

• Assess vital signs.
• Note the color, type, and size of the lesion.
• Apply topical medicine to the infected area.
• Advise the patient to keep the affected area dry.
• Avoid wearing tight-fitting clothing.
• Wear cotton clothes.
• Maintain proper hygiene.
• Administer medicine prescribed by the doctor.
• Maintain records and reports.

Tinea capitis (Tinea capitis)

• Tinea capitis is also known as ‘ringworm of the scalp’. Tinea capitis is a highly contagious fungal infection that affects the hair shaft. Tinea capitis is most common in children between the ages of two and ten.

Explain sign & symptoms seen in tinea capitis (Explain signs and symptoms seen in tinea capitis)

• Red oval shaped erythematous patches are seen on the scalp.
• Small papules and pustules are seen on the scalp.
• Itching is seen in that place.
• Hair becomes brittle due to which temporary hair loss is seen.

Write medical management of tinea capitis

• Use an antifungal drug to treat fungal infections.
• Apply a topical antifungal ointment to the infected area.
• Wash your hair with shampoo two to three times a week.
• Use Nizoral or selenium sulfamide as a shampoo.

Write nursing management of tinea capitis

• Take vital signs.
• Note the characteristics of the lesion.
• Provide isolation to the patient.
• Restrict visitors.
• Maintain proper hygiene.
• Wash hands twice a week.
• Advise the patient and his family members that each family member should use a separate towel, comb, and brush.
• Apply the medicine prescribed by the doctor.
• Maintaining records and reports.

Tinea cruris (Tinea cruris)

• Tinea cruris is also known as ‘ringworm of the groin’ or ‘jock itch’.
• Tinea cruris is a ringworm infestation of the groin area, which can affect the inner and outer areas of the buttocks.
• Tinea cruris is more common in obese people and in people who wear tight underwear. is.

Explain sign & symptoms seen in tinea cruris (Explain signs and symptoms seen in tinea cruris)

• Small red scaling patches and circular elevated plaques are seen in the groin area.
• Severe itching is seen in the affected area.
• Clusters of pustules are seen around the border. Write management of tinea cruris
• Apply topical antifungal cream to the affected area.
• Give oral antifungal medicine in severe cases.
• Advise the patient to avoid wearing tight underwear.
• Keep the groin area dry and clean.

Tinea unguium

• Tinea unguium is also known as ‘Onychomycosis’.
• Tinea unguium is an infestation of the fingernail or toenail. However, the toenail is more commonly affected.

Explain sign & symptoms seen in tinea unguium (Explain signs and symptoms seen in tinea unguium)

• The nail is seen as thick, fragile and deformed.
• The nail is seen as yellow in color and luster is seen.
• Debris collects under the nail plate, which causes it to separate from the nail plate.
• If the infection persists for a long time, The nail is completely destroyed.

Write management of tinea unguium

• Use antifungal medicine to treat fungal infections.
• Apply a topical antifungal cream to the infected area.
• In chronic conditions, nail avulsion is performed, meaning the nail is removed.

Tinea barbae

• Tinea barbae is a rare fungal infection. In which the skin, hair and hair follicles in the beard and moustache area are affected and red ring-shaped skin rashes are seen there.

Tinea faciei (Tinea faciei)

• Tinea facies is a facial ringworm infestation. It affects the superfacial skin on the face. In which scaly plaques are seen on the cheeks, nose, chin, and forehead.

Tinea manuum

• Tinea manum is an infection of the superficial skin of the hand. In which round and oval shaped rashes are seen in the hands.

What is candidiasis (वोट इस कंडियासीस)

• Candidiasis is also known as ‘yeast infection’.
• Candidiasis is a fungal infection caused by Candida It is caused by Candida albicans.
• Candida albicans is a yeast type fungus. Hence it is also called yeast infection.
• Candida albicans is mainly found in our body in small amounts in the mouth, throat, vagina and GI tract. But when it finds a favorable environment, it multiplies and creates a condition of candidiasis.

Write types of candidiasis

Candidiasis is classified into the following types based on the location of the infection:

i) Vaginal candidiasis

• Vaginal candidiasis is caused by an overgrowth of yeast in the vagina.
• Vaginal candidiasis causes swelling and redness in the vagina and vulva.
• Burning and itching are also seen in that area.
• A thick, white, cottage cheese-like vaginal discharge is seen.
• Pain is seen during urination and intercourse.
• Antifungal suppositories, tablets, or creams are used as treatment.

ii) Oral candidiasis (oral candidiasis)

• Oral candidiasis is also known as ‘oral thrush’.
• In oral candidiasis, Candida yeast spreads in the mouth and throat.
• Oral thrush is mainly seen in newborns and older adults.
• Oral thrush causes white or yellow colored sores on the lips, mouth, tongue, throat and esophagus.
• Oral thrush is treated with antifungal medicines clotrimazole, fluconazole.
• Rinse with chlorhexidine mouthwash.

iii) Cutaneous candidiasis

• Cutaneous candidiasis is an infection of the skin.
• Cutaneous candidiasis is mainly found in warm and moist areas. Such as underarms, under the breast, groin area, between the fingers and toes.
• In which small raised red colored pin point satellite lesions are seen on the skin.
• Antifungal cream is used as treatment.

iv) Candida granuloma (Candida granuloma)

• Candida granuloma is a chronic infection that affects different parts of the body such as the face, mouth, skin, scalp and nails
• In which white cheesy plaques are seen in the mouth and pin point satellite lesions and papules are seen on the skin.

v) Invasive candidiasis (Invasive Candidiasis)

• Invasive Candidiasis as ‘Systemic Candidiasis’ Also known as.
• In invasive candidiasis, Candida A reaches the blood, heart, brain, eyes, and bones through treatment or instrumentation. And due to this, serious life-threatening conditions are seen.

How to diagnose candidiasis

• History Collection
• Physical Examination
• Culture
• Skin scraping
• Wood lamp examination

Write medical management of candidiasis

• Antifungal medicine is used to treat fungal infections.
• Apply a topical antifungal cream to the affected area.
• Antifungal suppositories are used in vaginal candidiasis.

Write nursing management of candidiasis (Write Nursing Management of Candidiasis)

• Assess the patient’s vital signs.
• Note which part of the body is affected.
• Apply topical medicine to the affected area.
• Advise the patient not to share personal items.
• Everyone should Use separate towels and washcloths.
• Avoid wearing rubber and plastic shoes.
• Avoid wearing tight and fitting clothes.
• Wear cotton clothes.
• Maintain proper hygiene and keep the skin dry.
• Administer the medicine prescribed by the doctor.
• Maintaining records and reports

Parasite infestation of skin

• Skin infections caused by parasites (lice, mites) are known as parasitic infestations.
• In parasitic infestations, insects or worms live in burrows on the skin, multiply there and obtain nourishment from there. is.
• Parasite infestations are spread through direct and indirect contact with an infected person.
• Parasitic skin infestations include pediculosis and scabies.

What is pediculosis

• Pediculosis is a lice infestation.
• This parasite lives outside the animal or human body and gets nourishment from the blood from there, hence lice are also known as ‘ectoparasites’.
• Anticoagulants are present in the saliva of lice, hence when the lice pierces the skin to take blood from the host, the host’s blood does not clot.
• Lice infestation is seen in people of any age. But it is more common in school-going children.
• There are three main types of pediculosis:
• pediculosis capitis
• pediculosis corporis
• pediculosis pubis

Pediculosis capitis (pediculosis capitis)

• Pediculosis capitis is a scalp infestation caused by head lice. Which in our language is called head lice.
• These lice are found behind the ears and in the nape of the neck.
• We can see the eggs (nits) laid by the lice with the naked eye. Which appear silvery and glistening oval-shaped and stick to the hair.

Explain sign & symptoms seen in pediculosis capitis (Explain signs and symptoms seen in pediculosis capitis)

• There is a feeling of something moving in the hair.
• There is itching in the scalp, which causes scratching.
• There is erythema in that area.

Write management of pediculosis capitis

• Wash the hair with a shampoo or shampoo containing permethrin or linden.
• Wash the hair and remove the nits and lice with a fine-toothed comb.
• After using the comb, soak it in hot water for 10 minutes.
• Wash towels, clothes and other items used by the infected person in hot water.

Pediculosis corporis (Pediculosis Corporis)

• Pediculosis Corporis is also known as ‘vagbond disease’.
• Pediculosis corporis is a body infestation caused by body lice.
• Pediculosis corporis is found in people with poor hygiene and in people who do not bathe for a long time.

Explain sign & symptoms seen in pediculosis corporis (Explain signs and symptoms seen in pediculosis corporis)

• Erythematous macules are seen on the trunk, neck, soles and buttocks.
• Then wheals and papules are seen in that place.
• Itching and scratching are seen in that place.

Write management of pediculosis corporis

• Apply permethrin or lindane lotion to the affected area.
• Wash towels, clothes, and other items used by the patient with hot water.

Pediculosis pubis

• Pediculosis Pubis is an infestation of the pubic area caused by pubic lice.
• Pubic lice are also known as ‘crabs’.
• The pubic lice lay their eggs on the pubic hair and obtain nourishment from there.

Explain sign & symptoms seen in pediculosis pubis

• Intense itching is seen in the groin area and the itching increases at night.
• Scratch marks and crusting are seen in that place.
• The area appears gray or bluish in color.

Write management of pediculosis pubis

• Apply permethrin lotion to the affected area.
• Wash the comb and clothes used by the patient with warm water.

What is scabies

Scabies is also known as ‘sarcoptic mange’ . Scabies is a highly contagious parasitic skin infestation. Which is caused by the ‘Sarcoptes scabiei mite’ . Scabies is mainly found in the space between the fingers and toes, under the fingernails, in the folds of the legs and genital area, around the nipples, in the armpits, wrists, elbows and knees.

Explain pathophysiology of scabies

When an infected person comes into contact with a scabies mite, the scabies mite is found on the skin. Scabies mites live.
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The adult female lays eggs in the burrow.
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The larvae hatch from the eggs in three to four days and become adult mites in one to two weeks.
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After four to six weeks, the patient shows symptoms of scabies.

Explain sign & symptoms seen in scabies

• Severe itching is seen in the area where the mite burrows and itching increases at night.
• Pimple-like rashes are seen on the skin.
• Tiny blisters and bumps are seen on the skin that look like wavy tunnels.
• Vesicles, crusts and excoriations are seen as secondary lesions.

How to diagnose scabies

• History Collection
• Physical Examination
• Skin Scraping

Write management of scabies

• Ask the patient to bathe with warm soapy water.
• Then apply scabicidal lotion to the area except the face and scalp, i.e. below the neck.
• Use lindane or permethrin as a scabicidal lotion.
• Keep this lotion on for 12 to 24 hours and then bathe.
• Do this procedure for a week.

Write nursing management of scabies

• Assess the patient’s condition.
• Advise the patient to apply scabicidal lotion from the neck down.
• Do not apply the lotion repeatedly because That it causes irritation.
• Advise the patient to maintain proper hygiene.
• Ask the patient to use clean towels and clean clothes.
• Wash the towels and clothes used by the patient with hot water.
• Administer the medicine prescribed by the doctor.
• Maintain records and reports to do.

What is phempigus vulgaris

• The word pemphigus is derived from the Greek word ‘pemphix’ which means ‘blister’.
• Pemphigus vulgaris is an autoimmune disease in which the immune system mistakenly attacks epidermal cells and mucous membranes, resulting in painful blisters.
• In which a reaction is seen between desmoglein (antigen) and antibody (IgG) present in epidermal cells.
• A type 2 hypersensitivity type reaction is seen in pemphigus vulgaris.
• In pemphigus vulgaris, it is mainly seen in the mouth, nose, eyes, back, chest, umbilicus and genital area.

Explain sign & symptoms seen in pemphigus vulgaris (Explain signs and symptoms seen in pemphigus vulgaris)

• First painful blisters and sores are seen in the mouth and scalp.
• Then the blisters spread to other parts of the body.
• Erosion and ulceration are seen in the area where the blisters are.
• Using at that place, Crusting and peeling are seen.
• Musty discharge is seen from the blisters.
• Nikolsky’s sign is positive (pressure on the blister spreads to the surrounding skin)
• The skin heals slowly.
• Bacterial superinfection is seen and often a condition like septicemia arises.

How to diagnose pemphigus vulgaris

• History Collection
• Physical Examination
• Skin Biopsy (Punch Biopsy)
• Immunofluorescence
• Tzanck smear

Write management of pemphigus vulgaris

• Corticosteroid: Administer systemic corticosteroid. Initially give high dose and provide antacid medicine along with it. Apply topical corticosteroid on affected area.
• Immunosuppressive agent: Immunosuppressive agent is used to suppress immunity. Hence intravenous immunoglobulin is given. Methotrexate, cyclophosphamide are used as immunosuppressive agents.
• Plasmapheresis: Plasmapheresis is used to reduce serum antibody levels.
• In case of severe mouth ulcers, IV fluids should be provided.

Write nursing management of pemphigus vulgaris

• Assess vital signs.
• Assess the patient’s condition.
• Provide a comfortable position for the patient.
• Provide oral care to the patient.
• Apply lip balm to the lips. So that the lips remain moist and prevent them from drying out.
• Provide warm moist compression.
• Apply a wet dressing to the affected area.
• Observe the signs and symptoms of infection.
• Provide psychological support to the patient.
• Reassure the patient and his family members.
• Apply topical medicine prescribed by the doctor.
• Administer the medicine prescribed by the doctor.
• Maintain records and reports.

What is stevens johnson syndrome

• • Stevens-Johnson syndrome is also known as ‘erythema multiforme major’.

• • Stevens-Johnson syndrome is a rare and serious skin reaction disorder. In which reactions are seen on the skin due to taking certain medicines.

• • In which painful blisters and lesions are mainly seen on the skin and mucous membranes.

• • In Stevens-Johnson syndrome, reactions are seen due to the following medicines.
    Antigout medicines, anticonvulsant medicines, antipsychotic medicines, antibacterial medicines (especially sulfonamides) pain relieving medicines, non-steroidal anti-inflammatory drugs

• • It is more common in HIV-positive people and people with pneumonia, as well as in immunosuppressed patients.

Explain sign & symptoms seen in stevens johnson syndrome

• Initially, flu-like symptoms are seen such as high temperature, headache, cough, throat pain, joint pain
• Pen-filled blisters are seen in the skin, mouth, eyes, nose and genital area. After a few days, shedding is seen in the blistered area.
• Swelling is seen in the mouth, lips, tongue and face.
• Pain is seen in the eyes. Pain in the eye is also seen when looking at bright light.

How to diagnose stevens johnson syndrome

• History collection
• Physical examination
• Skin Biopsy

Write management of stevens johnson syndrome

• Administer IV immunoglobulin.
• Provide systemic corticosteroids.
• Antibiotics to control infection Provide.
• Provide analgesic medicine to relieve pain.
• Provide IV fluids to maintain fluid and electrolyte balance.
• Provide eye care and wound care.
• Clean the skin and remove dead tissue. Cover the wound with a non-adhesive dressing.

Write nursing management of stevens johnson syndrome

• Assess vital signs.
• Maintain an intake output chart.
• The patient Provide a comfortable position.
• Change position every two hours.
• Provide IV fluids to the patient.
• Provide eye care and wound care to the patient.
• Note whether signs of infection are present.
• Administer the medicine prescribed by the doctor. To do.
• Maintain records and reports.

Write complications of Stevens johnson syndrome (Write complications of Stevens-Johnson syndrome)

• Dehydration
• Sepsis
• Pneumonia
• Multiple Organ Failure

What is psoriasis

• Psoriasis is an autoimmune condition. In which skin cells grow and multiply rapidly, due to which overproduction of keratin is seen and white silvery plaques are seen in the skin.
• Psoriasis can be seen at any age but is more common between the ages of 15 and 35.
• The exact cause of psoriasis is unknown, but psoriasis is seen due to family history and certain trigger factors.
• The factors that trigger psoriasis are as follows:
• Emotional Stress
• Anxiety
• Trauma
• Infection
• Seasonal and Hormonal Changes
• Cold and Dry Weather
• Sunburn

Explain pathophysiology of psoriasis

Etiological factors cause T-cell hyperactivation.
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This leads to epidermal infiltration and keratinocyte proliferation. That is, normally skin cells are replaced in 10 to 30 days, but in such conditions, they are replaced in three to four days.
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This results in a large amount of production of various cytokines.
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Also, an inflammatory response is observed. Superficial blood vessels become dilated and vascular engorgement occurs.
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Epidermal hyperplasia results in insufficient lipid release, leading to flaking and scaling of the skin.

Write types of psoriasis

Plaque psoriasis:

• Plaque Psoriasis is also known as ‘vulgar psoriasis’. Plaque psoriasis is the most common form in which raised inflamed lesions are seen on the skin. These are called plaques. They are covered with silvery white scales. These lesions appear symmetrical. Which is mainly found in the scalp, trunk, limbs, elbows and knees.

Erythrodermic psoriasis (Erythrodermic Psoriasis):

• Erythrodermic psoriasis is a rarer but more severe form. In which red scaly skin is seen in the body as well as severe itching, burning and peeling.

Guttate psoriasis

• In guttate psoriasis, small pinkish-red colored spots are seen on the torso and limbs. Guttate psoriasis is mainly seen in children and young adults.

Inverse psoriasis

• Inverse psoriasis is characterized by smooth, scaly red patches. These are mainly seen in areas where there are folds. Such as under the breast, armpit and groin area

Pustular psoriasis

• Pustular psoriasis is a rare form in which pustular or pus-filled blisters are seen and their surrounding red skin is seen. Pustular psoriasis is mainly found on the hands and feet.

Nail psoriasis

• Nail psoriasis affects fingernails and toenails. In which the nail appears white, yellow or brown in color and there appears to be a drop of blood or oil under the nail plate. The skin inside the nail thickens and the nail separates from the nail plate.

How to diagnose psoriasis

• History Collection
• Physical Examination
• Biopsy
• Immunofluorescence
• Ultrasound

Write management of psoriasis

Topical corticosteroid :

• Topical corticosteroids are used in the treatment of mild to moderate psoriasis. Corticosteroids reduce inflammation and reduce inflammation.

Vitamin D analogues :

• Vitamin D analogue creams are applied in combination with steroid creams that reduce skin cell production. For example calcitriol, calcipotriol

Calcineurin inhibitor :

• Calcineurin inhibitors reduce the activity of the immune system and reduce inflammation. For example, tacrolimus ointment

Coal tar :

• Coal tar is used when other topical treatments are not effective. Callus reduces scaling, itching, and inflammation.

Retinoid cream :

• Retinoid cream is a synthetic form of vitamin A. Which is applied with steroids.

Immunosuppression drug :

• To suppress immunity, immunosuppressants such as methotrexate, cyclophosphamide are used

Phototherapy :

• In phototherapy, the skin is exposed to UV light, which decreases the growth rate of epidermal cells.

Systemic corticosteroid :

• In severe cases, systemic corticosteroids are used.

Write nursing management of psoriasis

• Assess vital signs.
• Assess skin integrity.
• Provide a comfortable position for the patient.
• Explain skin care to the patient.
• Advise the patient to bathe with warm water instead of hot water.
• Advise the patient to avoid rubbing and friction on the affected area.
• Clean the affected area and apply topical medicine.
• Provide psychological support to the patient.
• Providing reassurance to the patient and his family members.
• Administering the medicine prescribed by the doctor.
• Maintaining records and reports.

Define skin cancer

• Skin cancer is the most common cancer. The growth of abnormal cells found in skin tissue is known as skin cancer.

Write cause & risk factor of Skin cancer

• People with light skin and fair skin
• People exposed to UV light and X-rays
• People with a family history
• People with a weak immune system
• Old age

Explain types of skin cancer

There are mainly three types of skin cancer:

1) Basal cell carcinoma
2) Squamous cell carcinoma
3) Malignant melanoma

1) Basal cell carcinoma

• Basal cell carcinoma is the most It is common skin cancer. In which carcinoma is found in the basal cells in the lower part of the epidermis.
• Basal cell carcinoma does not usually spread to other areas.
• In which round growths of flash color are seen in the skin, as well as pear-like bumps and pinkish color patches are seen.
• Basal cell carcinoma is commonly seen more in people with fair skin.
• Basal cell carcinoma mainly occurs on the head, neck, arms, Chest, abdomen and legs are affected.

2) Squamous cell carcinoma

• Squamous cell carcinoma is the second most common skin cancer. In which carcinoma is found in the squamous cells of the outside layer of the skin.
• In which red bumps and scaly patches are seen. Sores that heal but then reappear in the same place.
• These lesions are mainly found on the ears, face, neck, arms, chest, and back.
• Squamous cell carcinoma is more common in people with light skin color.

3) Malignant melanoma:

• Malignant melanoma is the most serious type of skin cancer because it spreads to the surrounding area.
• In which malignancy is seen in the melanocyte cells that produce melanin.
• Malignant melanoma frequently develops on the skin and dark spots are seen on the skin.

Apart from this, there are some types of cancer:

Kaposi sarcoma

• Kaposi sarcoma is a type of skin cancer in which malignancy is seen in the endothelial cells in the lymph and blood vessels. In which lesions of various colors are found in the skin, lymph, oral cavity, GI tract and respiratory tract.

Markel cell carcinoma

• Markel cell carcinoma is a rare form of skin cancer. In which overgrowth is seen in the Merkel cells. Merkel cells are a special type of cell found in the epidermis.

Sebaceous carcinoma

• Sebaceous carcinoma is a rare type of skin cancer in which carcinoma is found in the oil glands in the skin. It mainly affects the eyelids and causes lumps and thickening of the skin.

Dermatofibrosarcoma protuberans

• Dermatofibrosarcoma protuberans is a rare soft tissue tumor that affects the dermis and subcutaneous tissue and often involves muscles and fascia. In which firm plaques are seen on the skin.

Explain sign & symptoms seen in skin cancer (Explain signs and symptoms seen in skin cancer)

• Skin cancer mainly has ABCDE symptoms.
• Asymmetry: Lesions are seen in irregular shape and lesions or moles are not similar to each other.
• Border: Blurry or irregularly shaped edges are seen.
• Colour: Spot Or moles are found in different colors such as white, pink, black, blue and red
• Diameter: Diameter is found to be larger than a pencil. (6 mm)
• Evolving: Changes are seen in shape, size, color, and consistency.

Write management of skin cancer

Management depends on the stage of the cancer. Biopsy is also effective for small and limited cancerous cells.

Chemotherapy:

• Chemotherapy involves the administration of oral, topical, and intravenous medications that kill cancerous cells.

Radiation therapy :

• Radiation therapy uses strong beam energy to kill cancerous cells.

Immunotherapy :

• Immunotherapy uses certain medicines that stimulate the immune system so that it kills cancerous cells. Does.

Photodynamic therapy:

• Photodynamic therapy uses light and photosensitizing chemicals to kill cancerous cells.

Crayotherapy :

• Cryotherapy uses liquid nitrogen to freeze and kill cancerous cells.

Mohs surgery :

• In Mohs surgery, one layer after another is removed and the cancerous cells are removed last. The layer is removed.

Excisional surgery:

• In excisional surgery, the tumor and surrounding healthy skin are removed through an incision.

Currete & electrodessication (curette and electrodessication) :

• In electrodessication, cancerous cells are destroyed by electric current.

Burns & its management

Introduction of burns

• Burn injuries occur due to direct contact with thermal, chemical, electrical and radiation.
• Injuries to the skin and tissues caused by contact with hot liquids, hot objects, streams, fire, sun, electricity and chemicals are known as ‘burn injuries’.
• Burn injuries occur due to the transfer of heat energy to the body. This heat is transferred through conduction and radiation.
• Human skin can tolerate temperatures up to 42-44 c. But when exposed to temperatures higher than this temperature, tissue destruction occurs.
• Burn injuries are a major global public health problem and have a physical, psychological, and financial impact on people.
• Most burns occur accidentally.
• Burn injuries occur in people of all ages and all socioeconomic groups.

Write causes of burns

Thermal burns:

• Thermal burns are the most common type of burn. Thermal burns are caused by contact with fire, flame, hot liquids, hot objects, and steam. The severity of thermal burns depends on the temperature of the object and the duration of exposure. For example, residential fire, automobile accident.

Chemical burns:

• Chemical burns are caused by contact with household or industrial chemicals such as strong acids, alkalis, and organic compounds. Examples include sulfuric acid, phosphoric acid, sodium and calcium hypochlorite. The severity of chemical burns depends on the concentration of the chemical, the volume and the duration of exposure.

Electrical burns:

• Electrical burns are caused by electrical energy or electrical shock. The severity of electrical burns depends on the intensity of the current and the duration of exposure. For example, electrical burns are caused by contact with faulty electrical wiring. Electrical burns are difficult to diagnose. Because it does not show any symptoms on the skin but internal damage is seen.

Radiation burns:

• Radiation burns occur due to contact with a radioactive source. Such as UV light, X-rays, gamma rays. For example, a nuclear bomb explosion. The severity of radiation burns depends on the strength, duration, distance, and surface area of ​​the radiation.

Inhalation burns:

• Inhalation burns are caused by exposure to asphyxiants, smoke. For example, carbon monoxide poisoning.

Types & classification of burns

According to burn depth & severity of penetrate the skin surface (According to burn depth and severity of penetrated skin surface)

• Burns are classified into first degree burns, second degree burns, third degree burns, and fourth degree burns based on their depth.
• The depth of the burn depends on the temperature of the burning object and the duration of exposure to it.

First degree burns / superficial partial thickness

• In first-degree burns, the superficial layer of the skin, the epidermis, is affected and there is minimal tissue injury.
• In this, the burned area appears pink to reddish in color and there is erythema, dryness, and pain in that area. The area appears to be overly sensitive (hyperesthesia).
• Blister formation is not seen.
• First degree burns heal within a week and do not form scars.
• First degree burns can be treated at home.
• Sunburn is an example of first degree burns.

Second degree burns / deep partial thickness

• Second-degree burns are also known as ‘dermal burns’.
• In second-degree burns, the epidermis and dermis layers are affected and the epidermis layer is destroyed.
• In addition, hair follicles and sweat glands are also affected.
• It causes redness, pain, swelling and blister formation in the burned area.
• Second degree burns heal within 2-3 weeks and scar formation is seen.

Third degree burns / full thickness

• In third degree burns, the epidermis, dermis and subcutaneous layer are affected. The epidermis and dermis layers are destroyed. In addition, bones, muscles, tendons, and organs are often affected.
• The burned area appears waxy white and charred, meaning it appears blackened by burning. The area appears firm, leathery, and dry.
• Pain and sensation are absent due to destruction and damage to the nerve endings. In addition, conditions such as hematuria and shock are seen.
• Third-degree burns cause deep scars, which is why cosmetic or reconstructive surgery and skin grafts are used.
• Third-degree burns heal slowly. Forth-degree burns
• Fourth-degree burns extend to the fascia. Also, bone, muscle, tendon and organ damage is seen in it.
• In which the affected area looks like dry char and that area is painless and eschar is also seen. (Dead tissue is seen on the skin due to burns. And it is seen to be shaded off)
• This type of burns is seen due to deep flame and electrical burns.
• If the extremities are affected in the fourth degree, then amputation is required.

According to burn severity

Burns are classified into minor burns, moderate burns, and severe burns based on the severity of the burn and how much body surface area is affected.

Minor burns:

• Minor burns are defined as burns that affect less than 10% of the total body surface area in children and less than 15% of the total body surface area in adults.
• Patients with minor burns can be treated on an opd basis.
• Minor burns include all first degree and second degree.

Moderate burns:

• Moderate burns involve 20 to 30% of the total body surface area. About 25% of the area is affected. In adults, 15 to 25% of the total body surface area is affected, while in children, 10 to 20% of the total body surface area is affected.

Severe burns:

In severe burns, more than 20 to 25 percent of the total body surface area is affected. In adults, more than 25% of the total body surface area is affected, while in children, more than 20% of the area is affected.

• Severe burns include inhalation and electrical burns.
• Third-degree burns and fourth-degree burns are included in severe burns.

How does calculate percentage of burns
Or
Extent of body surface area injured

Different methods are used to calculate how much of the total body surface area is affected in burns. Such as Rule of Nine, Lund and Browder Method, Palm Method

Rule of nine

• The Rule of Nine is a quick method for calculating the percentage of burns in adults.
• The Rule of Nine was given by Alexander Wallace, hence the Rule of Nine is also known as ‘Wallace’s Nine’.
• In the Rule of Nine, different areas are divided into percentages as follows Distributed as follows:
  Head = 9%
  Right arm = 9%
  Left arm = 9%
  Right leg = 18%
  Left leg = 18%
  Chest = 18%
  Back = 18%
  Genital area = 1%
• As shown above, the percentage of the total body surface area affected can be found.
• This method is not used in infants and children because the body area of ​​children is smaller than that of adults.

Lund & Browder method

• The Lund and Browder method is the most accurate and precise method for estimating total body surface area in children and adults.
• Because in this method, percentages are given according to the size of different body areas of children and adults. For example, in children, the head is larger while the size of the extremities is smaller. Therefore, the head is given a higher percentage in children, while the head is given a lower percentage in adults.
• The percentage is calculated as shown in the table below.

Palmar method

• The palmar method is more useful and effective when the burn injury is small, irregular or patchy.
• In this method, the palm of the patient’s hand is considered 0.5% of the total body surface area and the palm and fingers are considered 1%.
• Thus, burn injuries at different places in the body are calculated using the palmar method.
• This The method is used in both children and adults.

Jackson burn model

• The Jackson burn model helps to understand the pathophysiology of burn wounds.
• In this model, damaged tissue is divided into 3 zones:
  zone coagulation, zone stasis, and zone hyperemia

Zone coagulation :

• The zone of coagulation is the most central area of ​​the burn in which the tissue is severely damaged and is reversible, meaning it cannot be recovered.

Zone stasis :

• The area around the zone of coagulation is known as the zone of stasis There is less damaged tissue and vascular transudate, inflammatory reaction, and impaired tissue perfusion are seen in that area. If a good environment is provided, the tissue recovers, otherwise necrosis is observed.

Zone hyperaemia:

• Zone hyperaemia is the outermost layer of the burn, where there is an increase in blood flow due to vasodilation, due to which the tissue recovers faster and the chances of necrosis are reduced.

Explain pathophysiology of burns

• Burn injuries occur due to the transfer of heat resources, or energy, to the body.
• The severity of burn injuries depends on the temperature of the heating agent and the duration of exposure.
• If less than 25% of the total body surface area is affected, a primary local response is observed, but if more than 25% of the total body surface area is affected, local and systemic responses are observed. First 24 to 48 hours following burn injury Burn Injury | Coagulation necrosis is seen in soft tissue.
  |
  Vasoactive substances and inflammatory mediators are released. (such as cytokines, histamine, oxidase, catecholamine)
  |
  This increases vascular integrity and capillary permeability and vasodilation is observed.
  |
  This causes fluid to shift from the intracellular space to the interstitial space.(Most of the fluid shifts within 12 hours and this process continues for 30 hours)
  |
  Due to fluid shift, peripheral edema develops and tissue colloidal osmotic pressure increases and fluid electrolyte imbalance is observed.
  |
  On the other hand, intravascular volume decreases, resulting in a decrease in blood volume and a decrease in cardiac output.
  |
  Thus, this stage is called Also known as the hypovolemic stage. After 48 to 72 hours of burn

After 48 to 72 hours of burn
|
Vascular integrity and capillary permeability return to normal.
|
Fluid returns from the interstitial space to the intravascular space, resulting in a reduction in peripheral edema.
|
Intravascular volume increases (often leading to fluid overload). (This fluid is then excreted in the urine. This stage is also known as the diuretic stage.)
|
This also increases blood volume and Cardiac output also increases.
|
This results in increased blood flow to all organs and tissues.

Explain local & systemic effect of burns (Explain local and systemic effect of burns)

Local effect of burns (Local effect of burns) :

If less than 25 percent of the total body surface area is affected in a burn injury, local effect is seen.

Tissue damage:
When exposed to high temperatures, the tissue and cells present there are damaged and necrosis is seen. is.

Edema:
Fluid shifts from the intravascular space to the interstitial space, causing edema.

Inflammation:
Our body responds to burn injury by releasing inflammatory mediators and causing inflammation. Redness, erythema, swelling and blister formation are seen in the affected area.

Infection:
Due to tissue destruction and broken skin integrity, microorganisms grow and enter the body. This leads to infection.

Systemic effects of burns:

• If more than 25% of the total body surface area is affected in a burn injury, local and systemic responses are seen.
• This systemic effect is seen due to the release of vasoactive substances and inflammatory mediators. Such as histamine, cytokines, oxidase, catecholamine

Cardio vascular alteration:

• A decrease in cardiac output is observed.
• This causes hypotension and tachycardia.
• RBCs are destroyed.
• Hematocrit levels increase and plasma levels decrease.
• Abnormalities are observed in coagulation.
• Cardiac dysrhythmia is seen in electrical burns.

Pulmonary alteration:

• Pulmonary alteration is seen due to inhalation burns.
• Bronchoconstriction is seen.
• Secretion is increased and congestion is seen.
• Airway obstruction is seen.
• Stider and hoarseness sounds are seen.
• Pulmonary edema is seen.
• Hypoxia is seen.

Renal alteration (Renal Alteration):

• Renal function is altered due to decreased renal blood flow.
• Glomerulo filtration rate is decreased.
• Blood is seen in urine.

GI alteration (GI alteration) :

• Intestinal paralytic movement is decreased and there is also a decrease in bowel sounds.
• Increases metabolism.
• Blood in the GI tract causes vomiting and blood in the stool.
• Stress and ulceration are seen.

Immunologic alteration:

Skin barrier damage Due to this, microorganisms grow there and enter the body and infection occurs in the tissue.

Thermoregulatory alteration:

Due to skin loss, the function of regulating body temperature is altered, resulting in the condition of hypothermia.

Fluid & Electrolyte alteration:

Conditions such as hyponatremia and hyperkalemia are seen.

Immediate care of burns patients

• • Move the victim away from the scene.

• • Burn cloth worn by the patient and remove jewelry.

• • Assess the patient for airway, breathing, and circulation.

• • If breathing is not present, clear the airway and provide CPR.

• • Flush the burn area with running water and cover the wound.

• • Transfer the patient to the nearest hospital.

• • Provide oxygen to the patient if necessary. Provide therapy.

• • Secure the patient’s IV line.

• • Administer intravenous fluids.

Write first aid care of burns injury

• Move the victim away from the scene and check that the patient does not come into contact with the burning material.
• Remove burn clothes and ornaments worn by the victim. If the cloth is stuck to the body area, do not remove it.
• Then check the victim for airway, breathing, and circulation.
• If breathing is not present, clear the airway and provide CPR.
• If the patient is breathing, apply running water to the affected area.
• If the fingers are stuck together due to the burn, gently separate them. To do.
• Then loosely cover the wound with a clean cloth. So that it can be prevented from contamination and air can be prevented from coming into contact with the surface.
• Avoid friction and pressure on the burned area.
• Do not apply any kind of ointment or cream on that area.