DERMATITIS
PRESENTED BY-
OM VERMA
RELIANCE INSTITUTE OF NURSING

INTRODUCTION :
Dermatitis is an inflammation of the skin and
which are commonly swollen, reddened and
irritatingly itchy. Although not an alarming
condition, this type of skin diseases can makeyou
very uncomfortable, unease and self-conscious.
Dermatitis is an itchy inflammation of the skin. It
is notcontagious ordangerous, but it can be
uncomfortable. There are many types of dermatitis,
including allergic dermatitis, eczema, and
seborrheic dermatitis (which causes dandruff). A
rash is an abnormal condition and reaction of the
skin.

DEFINITION :
ACCORDING TO BRUNNER AND SUDDHART -
Dermatitis is inflammation of the upper layers of theskin,
causing itching, blisters, redness, swelling, and often
oozing, scabbing, and scaling.
ACCORDING TO LEWIS – Dermatitis isan
inflammation of the skin and which arecommonly
swollen, reddened and irritatingly itchy.

A medical condition in which the
skin becomes red, swollen, and
sore, sometimes with small
blisters, resulting from direct
irritation of theskin byan external
agentoran allergic reaction to it.
According to Lippincott….

INCIDENCE : Itaffects males and
females and accounts for 10 to 20 percent of
all visits to dermatologists (doctors who
specialize in the careand treatmentof skin
diseases). Although atopic dermatitis may
occur at any age, it most often begins in
infancy and childhood. Women tends to
develop the disease at an earlierage (20 to 40
years of age ) compared to men ( 60 to 70
years of age ), and women areaffected more
frequently.

Stages of dermatitis -
Acutedermatitis -
Acute dermatitis is characterised by
erythema, vesiculation and oozing, often
with oedema.

Subacute dermatitis
Subacute dermatitis is similar to
acute dermatitis, but with scaling
and crusting

CHRONIC DERMATITIS - Chronic
dermatitis is characterised by thickened
dry patches, often lichenified
chronicrubbing (increased
markings). Lichenification
from
skin
is often
predominantly follicular in pigmented
skin.

Generalized exfoliative
Pompholix Herpitiform
Seborrheic
Stasis Perioral
Atopic Nummular
Localized stretch
Classification
Contact

1.CONTACT DERMATITIS
Contact dermatitis is skin inflammation
caused by direct contact with a particular
substance. The rash is very itchy, is
confined to a specific area, and often has
clearlydefined boundaries.

IRRITANT
TYPES OF
CONTACT
DERMATITIS
ALLERGIC

IRRITANT CONTACT DERMATITIS : -
Irritant contact dermatitis, which
accounts for 80% of all cases of contact
dermatitis, occurs when a chemical
substance causes direct damage to the
skin; symptoms are more painful than
itchy. Typical irritating substances are
acids, alkalis (such as drain cleaners),
solvents (such as acetone in nail polish
remover), strong soaps, and plants (such
as poinsettias and peppers).

ALLERGIC CONTACT DERMATITIS
Allergic contact dermatitis is a reaction
by the body's immune
substance contacting
system to a
the skin.
Sometimes a person can be sensitized by
only one exposure,
sensitization occurs
and other
only after
times
many
exposures to a substance. After a person
is sensitized, the next exposure causes
itching and dermatitis within 4 to 24
hours.

ATOPIC DERMATITIS
Atopic dermatitis is chronic, itchy inflammation of the
upper layers of theskin that oftendevelops in peoplewho
have hay fever or asthma and in people who have family
members with theseconditions.
Infants may develop red, oozing, crusted rashes on the
face, scalp, diaper area, hands, arms, feet, or legs. Infants
may developred, oozing, crusted rashes on the face, scalp,
diaperarea, hands, arms, feet, or legs.
Treatment
The scalp can be treated with a shampoo
containing pyrithione zinc, selenium
sulfide , an Antifungal drug, salicylicacid
and sulfur, or tar.

NUMMULAR DERMATITIS
Nummular dermatitis is a persistent, usually itchy,
rash and inflammation characterized by coin-
shaped spots, often with tiny blisters, scabs, and
scales.
Most people benefit from skin moisturizers. Other
treatments include antibiotics taken by mouth,
corticosteroid creams and injections, and
phototherapy.
Most people benefit from skin
moisturizers. Other treatments
Include antibiotics taken by mouth,
corticosteroid creams
and injections, and phototherapy.

2.SEBORRHOEIC DERMATITIS
Seborrhoeic dermatitis (also known as
"seborrheic eczema") is an inf lammatoryskin
disorder affecting the scalp, face, and trunk.
seborrheic dermatitis presents with scaly,
flaky, itchy, red skin. The condition's
symptoms appeargradually and usually the
first signs of seborrheic dermatitis are the
flakes of skin called dandruff.
TREATMENT : Dermatologist
recommend topical treatments such as
shampoos, cleansers orcreams/lotions that
contain antifungal
, antiinf lammatory, sebosuppresive
or keratolytic ingredients.

STASIS DERMATITIS
Stasis dermatitis is inflammation on the lower
legs from pooling of blood and fluid.
have varicose (dilated, twisted) veins and swelling
(edema). It usually occurs on the ankles but may
spread upward to the knees.
have varicose (dilated, twisted) veins and swelling
(edema). It usually occurs on the ankles but may
spread upward to the knees.
Treatment
Long-termtreatment is aimed at keepingblood
from poolingin the veins around the ankles.
When sitting, the person should elevate the legs
above the level of the heart.
Antibiotics are used onlywhen the skin is
alreadyinfected

PERIORAL DERMATITIS
Perioral dermatitis is a red,
bumpy rash around the mouth
and on the chin that resembles
acne orrosacea
Perioral dermatitis is
distinguished from acne by the
lack of blackheads and
whiteheads
Treatment is with tetracyclines
or other antibiotics taken by
mouth.

3. GENERALIZED EXFOLIATIVE DERMATITIS
Generalized exfoliativedermatitis (erythroderma) is severe
inflammation that causes the entire skin surface to
become red, cracked, and covered with scales.
Treatment - Peoplewith severe
exfoliative dermatitis often
need to be hospitalized and
given antibiotics (for infection),
intravenous fluids (to replace
the fluids lost through theskin)
, and nutritional supplements.
Corticosteroids (such as
prednisone) given by mouth or
intravenously.

POMPHOLYX
Pompholyx/ dyshidrosis, is a
chronic dermatitis
characterized by itchy blisters
on the palms and sides of the
fingers and sometimes on the
soles of the feet.
The blisters are often scaly, red,
and oozing.. Wetcompresses
with potassium permanganate
oraluminum acetate (Burow's
solution) may help the blisters
resolve. Strong topical
corticosteroid

Dermatitis herpitiform :
Dermatitis herpitiform is a particular
typeof dermatitis thatappears as a result
of a gastrointestinal condition, known
as celiacdisease .

4. LOCALIZED SCRATCH DERMATITIS
Localized scratch dermatitis (lichen simplex chronicus,
neurodermatitis) is chronic, itchy inflammation of the top
layerof the skin.
Localized scratch dermatitis can occur anywhere on the
body, including the anus (pruritus ani ) and the vagina
(pruritus vulvae ), but is most common on the head, arms,
and legs. In theearly stages, the skin
looks normal, but it itches. Laterdryness
scaling, and dark patches developas a
resultof the scratching and rubbing.
Applying surgical tape saturated with a
corticosteroid (applied in the morning
and replaced in the evening) helps
relieve itching and inflammation and

GENETIC ALLERGENS DISEASE
NUTRITIONAL
SEASONAL
CHANGES
INFECTION
SICKNESS
STRESS HORMONAL
SWINGS
CAUSES:

PATHOPHYISIOLOGY :
There is a vasoconstriction of superficial blood vessels and the
skin blanches readily
Cold and low humilidity are poorly tolerated because of drifting
effects
Heat and high humidity are poorly tolerated because
vasodilatation increases the inflammatory reaction thus
aggravating the dermatitis and causing increased the itching and
discomfort
Lesion become localized to the flexor surface of the neck , to the
eyelids , behind the ears , in the anticubital and poplital areas and
at the wrist
The erythema is now dusty in colour and excoriations may
become secondary secondiarily infected

By the late twenties or early thirties the lesions usually
disappear , but they may recur at a late date as chronic
hand or foot eczema
Person with atopic dermatitis is highly suseptable to viral
infections, especially herpes, and to bacterial infections,
such as those caused by staphyloccus or hemolytic
streptococcus
There is also an increased incidence of fungal infection
such as tinae.
By the late twenties or early thristies the lesions usually
dissapper ,

RISK
FACTOR
GENETIC
AGE
MEDICAL
CONDITION
ENVORONM
ENT

CLINICAL MANIFESTATION :
Red rash. This is the usual reaction. The rash
appears immediately in irritant contact dermatitis;
in allergic contact dermatitis, the rash sometimes
does not appear until 24–72 hours after exposure to
theallergen.
Blisters or wheals. Blisters, wheals (welts),
and urticaria (hives) often form in a pattern where
skin was directly exposed to the allergen or irritant.
Itchy, burning skin. Irritant contact dermatitis
tends to be more painful than itchy, while allergic
contact dermatitis often itches.

Symptomsof dermatitis
The symptoms of dermatitis range from mild to
severeand will look differentdepending on what part
of the body is affected. Not all peoplewith dermatitis
experienceall symptoms.
In general, the symptoms of dermatitis may include:
rashes
blisters
dry, cracked skin
itchy skin
painful skin, with stinging or burning
redness
swelling

MANAGEMENT :
MEDICAL MANAGEMENT
•Bathing Reduce how often you bath or shower, using
lukewarm water. Showers are better. Replace standard
soap with a substitute such as a mild detergent soap-free
cleanser : your chemist or dermatologist can advise you.
• Clothing Wear soft smooth cool clothes; wool is best
avoided.
•Irritants Protect your skin from dust, water, solvents,
detergents, injury. Avoid exposure to environmental or food
allergens. Common foods that cause allergic reactions are
dairy, soy, citrus, peanuts, wheat (sometimes all gluten
containing grains), fish, eggs, corn, and tomatoes.
•Emollients Apply an emollient liberally and often,
particularly after bathing, and when itchy. Ask your doctor
or dermatologist to recommend some to try; avoid perfumed
products when possible.

• Topical steroids Apply a topical steroid cream or
ointment to the itchy patches fora 5 to 15 day course.
•Pimecrolimus cream Pimecrolimus is a new anti-
inflammatory cream shown to be very effective for atopic
dermatitis, with fewersideeffects than topical steroids.
•Antibiotics Your doctor will recommend antibiotics such
as flucloxacillin or erythromycin if infection is
complicating or causing the dermatitis. The infection is
most often with Staphylococcus aureus or Streptococcus
pyogenes .
•Antihistamines Antihistamine tablets may help reduce
the irritation, and are particularly useful at night.
• Other treatments Systemic steroids , azathioprine
, phototherapy , and other complicated treatments may
also be used forseverecases.

Medical care
Corticosteroids - A corticosteroid
medication similar to hydrocortisone may be
prescribed to combat inflammation in a
localized area.T
his medication may be
applied to your skin as a creamor ointment.
I f the reaction covers a relatively large
portion of the skin or is severe,a corticosteroid
in pill or injection form may be prescribed.
Antihistamines - Prescription
antihistamines may be given if nonprescription
strengths are inadequate .

Cleansing Properly
UseThe Right Products
Protecting The Skin
Environment
Watch Your Diet
Drink Water
Prescriptiondrugs
Reducing provoking factors
NURSING MANAGEMENT :

NURSING
CARE
PLAN

PREVENTION :
Dermatitis relies on
an irritantor an allergen to initiatethe
reaction, itis importantfor thepatientto
identify the responsible agent and avoid it.
Inan industrialsetting theemployerhas a
duty of care to the individual worker to
provide the correct level of safety equipment
to mitigate the exposure to harmful irritants.
This can take the form of protective clothing,
gloves or barrier cream depending on the
working environment.

THYROID DISEASE
INTESTINE CANCER
VASCULITIS
ANAPHYLECTIC
C O M P L I C A T I O N

HEALTH
EDUCATION

Conclusions–
Atopic dermatitis can be treated by
following a few basic rules regarding skin hydration,
use of a moisturizer, and topical steroid applications
to reduce inflammation. The distinction between the
various types of contact dermatitis is based on a
number of factors. these findings have been
acknowledged not to distinguish [9], and even positive
patch testing does not rule out the existence of an
irritant form of dermatitis as well as an
immunological one. It is important to remember,
therefore, that the distinction between the types of
contact dermatitis is often blurred, with, for example,
certain immunological mechanisms also being
involved in a caseof irritantcontactdermatitis.

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