Since the bacteria does not respond well to many antibiotics (Methicillin, Penicillin, Amoxicillin), infections can become serious.
Mild infections can be treated with certain antibiotics and good hygiene.
Progression of the infection into the bloodstream or bone can be potentially life-threatening.
Topical antibiotics, oral antibiotics and intravenous antibiotics are all options used to treat MRSA infections.
Note: MRSA is contagious when a person has an active infection or if somebody is a “carrier” of the bacteria.
CDC Recommendations to avoid MRSA
Wash hands with soap and warm water. Alcohol based sanitizers can be just as good.
If one has an abrasion, make sure to clean and cover the wound until it has healed.
Avoid contact with other’s wounds or bandages
Avoid sharing towels and razors
Common infections, include:
Different Strains = Level of Severity
Bacterial infection that spreads through the dermal and subcutaneous tissues.
Skin is visibly warm, red, swollen and tender
Sensitivity to pressure
Hard to culture, unless pus like substance or other drainage is available
Common infection areas, include:
Around the eyes (Periorbital Cellulitis)
Treatment options, include:
An abnormality of the nervous system. There is a problem with the communication between the brain and the body. Any part of the nerve cell (cell body, axon, or dendrites) can be damaged. The most common place for the damage to occur is in the axon. There are several types of neuropathy, including: Diabetic, Alcoholic, and Chemotherapy Induced Peripheral Neuropathy (CIPN).
The three nerve types affected are:
Sensory Nerves- controls the sense of touch, pain, temperature, numbness, etc.
Motor Nerves-control of voluntary movements
Autonomic Nerves - control involuntary functions such as breathing, digestion, blood pressure, etc.
If sensory nerves become damaged, the result could be loss of pain sensation replaced with numbness. Numbness of the extremities could cause minor wounds to become infected by bacteria, leading to Ulcers.
Diabetic patients are prone to skin disorders due to sensory neuropathy and micro-vascular disease. This is why extra caution should be taken when cleansing the skin with a light abrasive solution.
Fungi or fungus is a microscopic organism that can be found on the skin. Fungus does not always cause problems; however, problems occur when it grows out of control, in turn, creating a fungal infection.
Fungus grows in moist areas
Some people are genetically prone to fungal infections
Contagious. Can easily be transferred from one section of skin to another or from person to person.
Medications and anti-fungal ointments can be used to get rid of an infection
Fungal infections can occur on the skin and/or nails. There are several names for fungal infections depending on the infected area.
Body Ringworm (Tinea Corporis)
Athlete’s Foot (Tinea Pedis)- Most common
Jock Itch (tinea Cruris)
Scalp Ringworm (Tinea Capitis)
Tinea Corporis (Ringworm)
Tinea Capitis- Scalp Ringworm
Scalp ringworm can cause hair loss in the infected area.
Extremely hard to rid the scalp of the fungus
Note: Important to disinfect oximeters or use disposable oximeters
Sebaceous Gland Disorders
Sebaceous glands are located alongside the hair follicles. They produce oils. The most common Sebaceous gland disorders are acne and Rosacea. Some people report discomfort from sebaceous gland disorders.
Also known as an open comedo. Blackheads are formed at the surface of the skin. Oils (Sebum) and keratin cells are what clog the pore. The black coloring is due to the exposure to the air.
Whiteheads and Cystic Acne
Whiteheads are closed comedos. Whiteheads develop when oils that are clogging the pore are trapped below the skins surface.
Cystic Acne is the most severe form of acne due to its ability to cause scarring. The pressure from dead skin cells builds up causing leakage of bacteria found in the duct to inflame the dermis. If that bacteria cannot drain completely bumps and nodules appear causing cystic acne.
Early Symptoms Progression of Disease
Rosacea is a poorly understood disease affecting the face. The cause of Rosacea is unknown. There is no cure; however, symptoms can be controlled with medications.
Commonly reported symptoms, include: burning, stinging, and itching.
Other symptoms of Rosacea, include:
Redness on the cheeks, nose, chin and forehead
Small visible blood vessels
Bumps or pimples
Watery or irritated eyes
Rash and flulike symptoms caused by the herpes zoster virus that typically affect children, but can be seen in adults as well. Chickenpox is extremely contagious from two days before the rash appears until the sores have scabbed over.
Shingles is another disorder caused by the herpes zoster virus. Up to 20% of people that have had chickenpox or the varicella vaccine are at risk for getting shingles later in life.
The herpes virus lies dormant in the nerves located alongside the spinal cord. A weakened immune system or stress can cause the virus to reactivate. Many times only one nerve is effected, so the shingles rash appears on one side, in one area.
Tingling, itchy blisters and rash
Treatment includes steroids, pain medication and anti-viral medications
Vaccines for people older than 60 years to help prevent a shingles occurrence.
Shingles is not contagious to those who have had chickenpox.
Shingles is only contagious to those who have not had chickenpox.
Note: The person can NOT get shingles, but can contract chickenpox.
Shingles is only contagious before the blisters have crusted over.
Important for the infected area to be covered
Autoimmune means the body’s immune system wants to attack itself. The immune system creates antibodies to protect against outside bacteria, viruses and antigens, but these antibodies, for reasons not fully understood, can sometimes attack the body leaving it vulnerable to infections.
According to www.lupus.org , approximately 1.5 million Americans and 5 million people worldwide are believed to be living with Lupus. Lupus can be an acute or chronic inflammatory disease of bodily tissues, which effect various parts of the body, including: the skin, heart, lungs, kidneys, liver, joints, nervous system, blood, etc. The cause of Lupus is unknown. Although, there is not a cure for Lupus, medications can help alleviate or reduce the severity that the disease has on the body. Lupus is a disease known for its flare-ups.
There are different forms of Lupus. The two most commonly discussed types are:
SLE (Systemic Lupus Erythematosus)
Cutaneous Lupus Erythematosus
Drug-induced Lupus Erythematosus
SLE (Systemic Lupus Erythematosus)
SLE is the most notable form of Lupus, effecting internal organs
Can be fatal, although more recent medical advances suggest that 80-90% of people with SLE will live a normal life span
Most common reason for fatalities are due to infection or kidney failure
Cutaneous Lupus Erythematosus
Cutaneous Lupus, also referred to as Discoid Lupus, effects the skin. The most common rash resulting from cutaneous lupus is the discoid rash. The rash appears red, raised and often times scaly. The disc like lesions that develop are where the name Discoid Lupus originated.
The malar rash or butterfly rash is another example of cutaneous lupus. The malar rash develops on the cheeks, nose, and eyelids. Approximately 10% of people with Cutaneous Lupus will develop SLE (Lupus Foundation of America, 2008).
Many times the areas of the body exposed to sunlight or fluorescent lights are affected more so than areas that are covered (Lupus Foundation of America, 2008).
Psoriasis is a chronic skin condition originating in the stratum corneum and other layers of the epidermis. It is characterized by inflamed, itchy, red, scaly areas that often develop on the scalp, elbows, knees, and lower back. Psoriasis affects between 5-7 million people in the U.S. ( http://www.healthline.com , Psoriasis, 10/07)
There are different types of skin cancer. All originate in the five layers of the epidermis. Some include:
Basal Cell Carcinoma
Squamous Cell Carcinoma
Cutaneous T-Cell Lymphoma
Basal Cell Carcinoma
Most common form of skin cancer accounting for approximately 80% of all cases. Originates in the basal cells located at the bottom of the epidermis. Commonly found on the face, neck, scalp, shoulders, and back.
Melanoma is known as the deadliest form of skin cancer, due to it’s ability to metastasize. Begins in the melanocytes.
Many of these disorders present in similar ways.
Be familiar with some of the more common skin disorders if mentioned in a patients chart
Be able to recognize what some of the skin disorders look like.
Know when to use alternative methods for cleansing the skin and electrode placement.
Ensure patients are comfortable
Should you have any questions or feedback regarding this presentation please feel free to contact our program director, Jennifer Brickner-York, at [email_address] .