The document discusses various types of skin infections, their causes, symptoms, and treatment. It covers bacterial infections like impetigo, folliculitis, furuncles, carbuncles, and cellulitis. Impetigo appears as oozing sores that can be treated with antibiotics or antiseptic ointment. Folliculitis causes red bumps around hair follicles. Furuncles are boils that can be drained with warm compresses. Carbuncles are clusters of connected boils. Cellulitis presents as swollen red skin that requires antibiotics. Nursing care focuses on pain management, preventing secondary infections, and patient education.

1. SKIN DISORDERS
BY –
SHUBHRIMA KHAN

2. INTRODUCTION
• Skin is the largest organ of your body. It is a soft outer covering of an animal, in particular
a vertebrate.
• The skin functions in thermoregulation, protection, metabolic functions and sensation.
• Skin is composed of three primary layers:
1. The epidermis, which serves as a barrier to infection
2. The dermis, which serves as a location for the appendages of skin
3. The hypodermis (subcutaneous adipose layer)
• Its function is to protect from infection. Sometimes the skin itself becomes infected.
• Skin infections are caused by a wide variety of germs, and symptoms can vary from mild
to serious. Mild infections may be treatable with over-the-counter medications and home
remedies, whereas other infections may require medical attention

4. TYPES OF SKIN INFECTIONS
• Bacterial skin infections
• Viral skin infections
• Fungal skin infections
• Parasitic skin infections

5. BACTERIAL SKIN INFECTIONS
• Gram positive staphylococcus aureus and beta hemolytic streptococci cause
bacterial infections.
• Primary infection occur if break present in skin present.
• Secondary infection occurs if it followed after already damaged skin or as sign of
systematic infection.
• Predisposing Factors: Moisture, Obesity, Skin disease, Systematic corticosteroids,
Antibiotics, Chronic diseases like diabetes mellitus increase the incidence of
infection.

6. IMPETIGO
• Impetigo is superficial skin infection caused by staphylococci, streptococci or
multiple bacteria,
• It involves exposed areas of body, face, hands, neck and extremities. It is often
called school sores because it most often affects children. It is quite contagious.
• Primary impetigo occurs due to poor hygiene and malnutrition. Secondary
impetigo occurs due to pediculosis capitis (Head lice scabies, herpes simplex,
insect bite or eczema).
CLINICAL MANIFESTATIONS
• Impetigo presents with pustules and round, oozing patches which grow larger day
by day
• There may be clear blisters or golden yellow crusts.

8. CONT..
TREATMENT
• Soak moist or crusted areas: Soak a clean cloth in a mixture of half a cup of white
vinegar in a liter of tepid water. Apply the compress to moist areas for about ten
minutes several times a day. Gently wipe off the crusts.
• Antiseptic or antibiotic ointment: apply it two or three times a day to the affected
areas and surrounding skin.
• Oral antibiotics: Oral antibiotics are recommended if infection is extensive,
proving slow to respond to topical antibiotics, or if impetigo is recurrent. The
preferred antibiotic is penicillin antibiotic. The complete course should be taken,
usually at least 7 days.

9. FOLLICULITIS
• Folliculitis means an inflammation or infection of the hair follicles of the skin. It is a
problem that is not usually serious.
• Tiny pus-filled spots (pustules) develop at the hair where friction, moisture, rubbing
or oil is more.
• Common sites for folliculitis are the beard, arms, legs, armpits.

10. CONT..
CLINICAL MANIFESTATIONS
Superficial folliculitis, which affects the upper part of the hair follicle, may cause:
• Clusters of small red or pus-filled bumps that develop around hair follicles
• Red and inflamed skin
• Itchiness or tenderness
Deep folliculitis starts deeper in the skin surrounding the hair follicle and affects the
entire hair follicle. Signs and symptoms include:
• A large swollen bump or mass
• Pus-filled blisters that break open and crust over
• Pain

11. CONT..
TREATMENT
• Mild folliculitis usually heals on its own in about 2 weeks.
• Warm compresses made with white vinegar solution ease itching & helps healing.
• Medicated shampoo can be used to treat folliculitis on the scalp or beard.
• Antibiotics applied to the skin (mupirocin) or taken by mouth (dicloxacillin).
• Gently wash the infected skin twice a day with antibacterial soap.
• Avoid shaving irritated skin. If must shave, use an electric razor rather than a blade
and apply a soothing aftershave lotion when finished. Also, shave in the direction of
hair growth rather than against it.
• Don't share towels or washcloths

12. FURUNCLE
• Furuncle is another word for "boil." A boil is
a bacterial infection of a hair follicle.
• The infected hair follicle can be on any part
of body. Furuncles mostly occur on body
areas prone to excessive perspiration,
friction and irritation such as back of neck,
thigh, axillae, and perineum or on buttocks.

13. CONT..
CLINICAL MANIFESTATIONS
• Deep, firm, red, raised bump on skin which is 1 – 5 cm in diameter,
• Pain which gets worse as it fills with pus and dead tissue.
• White or yellow centers (pustules)
• Spreading to other skin areas or joining with other boils
• Weeping, oozing, or crusting
• Fatigue
• Fever and general ill-feeling
• Itching before the boil develops
• Skin redness around the boil

14. CONT..
TREATMENT
• Put warm, moist compresses on the boil several times a day to speed draining and
healing.
• Cleanse surrounding skin with antibacterial soap, followed by application of
antibacterial ointment.
• Surgical incision and drainage may be performed.
• Systemic antibiotic therapy is instituted for carbuncles or spreading furuncles.
Analgesia and antipyretics are ordered as necessary.
• Cover mattress and pillows with plastic and wipe daily with a disinfectant.
• Wash all linens, towels, and clothing after each use.
• Strict hand washing is maintained to prevent cross-contamination.

15. CARBUNCLES
• A carbuncle is a red, swollen, and painful cluster of boils that are connected to
each other under the skin. A carbuncle occurs when a group of hair follicles next
to each other become infected. It is like a multiple boil. Furuncles may progress to
carbuncles.
• Carbuncles found on back of neck, upper arm, buttocks and lateral thighs.

16. CONT..
CLINICAL MANIFESTATIONS
• The boils that collect to form carbuncles usually start as red, painful bumps.
• The carbuncle fills with pus and develops white or yellow tips that weep, ooze, or
crust.
• Untreated carbuncles rupture, discharging a creamy white or pink fluid.
• Superficial carbuncles which have multiple openings on the skin's surface are less
likely to leave a deep scar.
• Deep carbuncles are more likely to cause significant scarring.
• Other carbuncle symptoms include chills, fever, fatigue, and a feeling of general
sickness.
• Swelling may occur in nearby tissue and lymph nodes, especially lymph nodes in the
neck, armpit, or groin.

18. CELLULITIS
• Cellulitis is an inflammation of the skin and subcutaneous tissue resulting from a
generalized bacterial infection.
• Cellulitis appears as a swollen, red area of skin that feels hot and tender.
CAUSES AND RISK FACTORS
• Staphylococcus and streptococcus bacteria
• Cracks or peeling skin between the toes
• Weakened immune system
• Injury or trauma with a break in the skin (skin wounds)
• Insect bites, animal bites.
• Ulcers from certain diseases, including diabetes and vascular disease.
• Use of corticosteroid medications or medications that suppress the immune system
• Intravenous drug use
• Obesity
• Wound from a recent surgery

19. CONT..
CLINICAL MANIFESTATIONS
• Pain or tenderness in the affected area
• Skin redness or inflammation (Swelling)
• Warm skin in the area of redness
• Fever with chills
• Malaise
• Headache
• Swollen lymph nodes
• Tight, glossy, stretched appearance of the skin
• Hair loss at the site of infection
• Joint stiffness caused by swelling of the tissue over the joint

20. CONT..
TREATMENT
• Topical/systemic antibiotics are prescribed according to culture and sensitivity test
results.
• Debridement of nonviable tissue is necessary if there is an open wound.
• Systemic antibiotics are indicated if fever and lymphadenopathy are present.
• Warm, moist compresses may be ordered.
• Immobilization and raise the infected area higher than heart to reduce swelling
• Wash wound daily with soap and water
• Moisturizing and lubricating skin regularly helps prevent cracking and peeling.
• Wear appropriate footwear and gloves.
• Regularly check feet for signs of injury.
• In severe cases: Hospitalization required

21. DIAGNOSIS OFALL BACTERIAL INFECTIONS
Lesion drainage and blood culture tested to identify causative organism. Drug
sensitivity also checked.
In case of repeated bacterial infections. Culture is taken from external nares to
determine carriers of bacteria (MRSA).

22. NURSING MANAGEMENT
Nursing Diagnosis:
1. Acute Pain may be related to presence of localized inflammation and open
lesions, possibly evidenced by verbal reports, distraction behaviors, and
restlessness.
2. Risk for [secondary] Infection: risk factors may include broken/traumatized
tissue, altered immune response, and untreated infection/ treatment failure.
3. Risk for ineffective sexuality pattern: risk factors may include lack of
knowledge, and/or fear of transmitting the disease.

23. CONT..
Nursing interventions
• Monitor location, duration and intensity of pain. Monitor for adverse effects of
pain medications.
• Assess patient's level of discomfort and medicate as prescribed.
• Encourage distraction techniques such as music therapy.
• Teach relaxation techniques, such as deep breathing, progressive muscle
relaxation, and imagery, to help control pain.
• Apply antibacterial ointments (after acute stage) as prescribed, to soften and
separate adherent crusts and prevent secondary infection.
• Administer antibacterial medication in dosage prescribed (usually high dose).
• Apply wet compresses and calamine lotion for soothing effect.

24. CONT..
• Teach patient to use proper hand-washing technique, to avoid secondary infection.
Advice the patient to observe signs of systematic infection i.e. fever, malaise,
headache, increased redness, formation & drainage of pustules.
• Maintain strict isolation.
• Wear gown & gloves if contact has to be established with patient.
• Keep patient’s room cool and avoid heavy clothes and bedding.

25. VIRAL SKIN INFECTIONS