PHRD5975 Self-Care - Contact Dermatitis

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Author:
daynuhmay
ID:
264948
Filename:
PHRD5975 Self-Care - Contact Dermatitis
Updated:
2014-03-04 02:05:08
Tags:
Contact Dermatitis
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Description:
Contact Dermatitis
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  1. ICD vs ACD
    • ICD: inflammatory rxn of the skin caused by exposure to an irritant
    • ACD: immunologic rxn of the skin caused by exposure to an antigen
  2. primary treatment advice for ICD
    avoidance of further irritant exposure
  3. why should -caine anesthetics be avoided for tx of ICD?
    it can cause ACD
  4. why is hydrocortisone OINTMENT recommended for use in tx of ICD?
    creates barrier to protect skin & keep moisture in
  5. MOA of emollients in tx of ICD
    • helps restore moisture to stratum corneum
    • serves as protectant from further exposure to effects of a wet working enviroment
  6. how long does a cell-mediated/Ag-sensitized T cell immune rxn take?
    24 hrs - 21 days
  7. in previously sensitized patients, how long does it take for ACD sx to appear?
    2-48 hours
  8. plants know to have cross-sensitivity w/ urushiol (4)
    • 1) cashew nut shell
    • 2) mango peel
    • 3) Japanese lacquer tree lacquer
    • 4) gingko fruit
  9. presentation of ICD vs ACD
    • ICD: dry, cracked, inflamed skin
    • ACD: papules, small vesicles, & sometimes large bullae over inflamed, swollen skin
  10. visual presentation suggesting poison ivy/oak exposure
    • streaks of vesicles that correspond with points of urushiol contact from the damaged plant
    • specks of black oxidized urushiol on skin/clothing
  11. how long does dermatitis take to resolve naturally?
    10-21 days
  12. exclusions to self-tx of ACD
    • <2yo
    • >20% of BSA
    • swelling of extremities
    • signs of infection
    • failure to self-tx after 7 days
  13. primary non-pharm action for relief of ACD-induced itching
    take cold/tepid showers
  14. for up to ____(time), washing may remove unreacted oleoresin
    30min
  15. why is alcohol NOT recommended for removal of Ag?
    can dissolve & transport surface oleoresin to clean skin surfaces
  16. FDA-approved barrier product used to protect against exposure to oleoresin
    IvyBlock Lotion
  17. how to use IvyBlock
    • apply topically at least 15min before exposure to Toxicodendron
    • reapply q4h or prn
  18. youngest age to use IvyBlock
    <6yo
  19. pharm tx for ACD-induced itching (2)
    • 1) oral antihistamines
    • 2) topical corticosteroid cream
  20. name 3 oral antihistamines used in the tx of ACD-induced itching
    • cetirizine
    • diphenhydramine
    • chlorpheniramine
  21. MOA of hydrocortisone cream in the tx of ACD-induced itching
    treats immune-mediated inflammation that causes itching
  22. MOA of astringents in the treatment of ACD (3)
    • 1) cool/dry skin through evaporation
    • 2) cause vasoconstriction & reduce blood flow in inflamed tissue
    • 3) cleanse skin of exudates, crust, & debris
  23. why should ointments NOT be applied in ACD cases?
    • removal from skin is more difficult
    • may trap bacteria beneath
  24. most effection form of topical agent for tx of mild-mod ACD (that doesn't involve edema & extensive areas of the skin)
    hydrocortisone cream
  25. MOA of colloidal oatmeal in the tx of ACD-induced inflammation
    • emollient
    • soothes area
    • decreases itching
  26. margin presentation: ICD vs ACD
    • ICD: no clear margins
    • ACD: clear margins based on contact of offending substances

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