NR 293 Skin and Skin Disorders

NR 293 Skin and Skin Disorders

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Chamberlain University

NR-293: Pharmacology for Nursing Practice

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Date

Signs, Symptoms, and Causes of Skin Disorders

Skin disorders vary in their causes, clinical presentation, and severity. Some are infectious, while others arise from immune dysfunction, genetic predisposition, or environmental triggers. Early recognition of their signs and symptoms is crucial for timely diagnosis, prevention of complications, and appropriate treatment.

Impetigo

Impetigo is a superficial bacterial infection that most commonly affects infants and young children. It is highly contagious and caused mainly by Staphylococcus aureus and, less frequently, Streptococcus pyogenes. The condition typically presents as small red sores on the face, especially around the mouth and nose, which rupture quickly and develop honey-colored crusts. Poor hygiene and crowded living conditions increase the risk of transmission.

Psoriasis

Psoriasis is a chronic autoimmune condition characterized by hyperproliferation of keratinocytes and activation of T lymphocytes. The disease is not contagious but significantly impacts quality of life. Symptoms include thickened, erythematous plaques with silvery-white scales, often located on the scalp, elbows, knees, and back. Patients frequently report itching, burning sensations, and even joint pain in psoriatic arthritis cases. Genetic factors and environmental stressors such as infection, medications, and stress can exacerbate the condition.

Herpes Simplex Virus Type 1 (HSV-1)

Herpes simplex virus type 1 is the leading cause of orolabial herpes (cold sores). It spreads primarily through direct contact with infected saliva or mucous membranes. Prodromal symptoms often include tingling, itching, or burning at the site of infection, followed by painful vesicular eruptions on or around the lips. Recurrences are triggered by stress, fever, or immunosuppression since the virus remains dormant in nerve ganglia.

Nevi (Moles)

Nevi are pigmented skin lesions composed of clusters of melanocytes. They may appear as small, flat, or raised brown spots and are generally benign. However, certain atypical nevi can progress to malignant melanoma. It is essential to monitor moles for changes in asymmetry, border irregularity, color variation, diameter, and evolution (ABCDE criteria).

Varicella (Chickenpox)

Varicella-zoster virus causes chickenpox, a highly contagious childhood disease. It manifests as an itchy, vesicular rash that progresses from macules to papules and vesicles before crusting over. Accompanying systemic symptoms include fever, malaise, and loss of appetite. Although usually self-limiting, complications can occur in immunocompromised individuals or adults.

Zoster (Shingles)

Shingles is caused by the reactivation of the varicella-zoster virus in individuals with a history of chickenpox. The infection produces a painful, unilateral rash often appearing as a band of fluid-filled blisters along nerve pathways. Commonly affected regions include the thoracic and cranial nerves. Postherpetic neuralgia, a persistent pain after rash resolution, is a frequent complication in older adults.

Pemphigus

Pemphigus is a rare but severe autoimmune disorder in which autoantibodies attack desmosomes, disrupting cell adhesion in the epidermis. This leads to blister formation, erosions, and open sores on the skin and mucous membranes, particularly in the mouth and genitals. Patients are at risk of dehydration, infection, and complications without timely treatment.

Urticaria (Chronic Hives)

Urticaria, commonly referred to as hives, results from a type I hypersensitivity reaction. Triggers include allergens, medications, insect stings, or stress. It appears as raised, erythematous, and itchy welts that can vary in size and distribution. Chronic urticaria may also involve angioedema, causing swelling of deeper tissues such as the lips, eyelids, and throat, which can be life-threatening.

Secondary Infections

Secondary infections occur when the body’s defense mechanisms are compromised after a primary illness. For example, fungal overgrowth like vaginal candidiasis may follow antibiotic therapy, or bacterial pneumonia may develop after an influenza infection. These infections complicate the primary disease and often prolong recovery time.

Candidiasis

Candidiasis is a fungal infection caused by Candida albicans. It commonly affects the mouth (oral thrush), genital areas, and skin folds. Symptoms include redness, itching, burning sensations, and the presence of thick white patches or discharge. Risk factors include immunosuppression, diabetes mellitus, and prolonged antibiotic or corticosteroid use.

Tinea Capitis

Tinea capitis is a contagious fungal infection of the scalp, caused by dermatophytes and often transmitted from infected animals or humans. Clinical features include circular patches of hair loss, scaling, itching, and black dots where hair shafts have broken. Severe cases may cause kerion formation, which involves painful, inflamed nodules that can lead to scarring.

Skin Cancers

Skin cancers range from benign lesions to life-threatening malignancies.

Type	Characteristics	Risk Factors	Notes
Seborrheic Keratosis	Benign, waxy or stuck-on appearance, usually brown or black lesions	Aging, genetics	Noncancerous but often mistaken for melanoma
Actinic Keratosis	Rough, scaly, sun-exposed patches	UV radiation, fair skin	Precancerous; may progress to squamous cell carcinoma
Squamous Cell Carcinoma	Firm, red nodules or scaly patches	Sun exposure, chronic wounds	Can metastasize if untreated
Malignant Melanoma	Asymmetrical pigmented lesions with irregular borders and color	UV exposure, family history, atypical nevi	Highly aggressive and potentially fatal

NR 293 Skin and Skin Disorders

Conclusion

Skin disorders such as impetigo, psoriasis, herpes simplex, nevi, varicella, zoster, pemphigus, urticaria, candidiasis, and tinea capitis each display unique causes, risk factors, and symptoms. Understanding their presentation aids in prompt diagnosis and treatment. Additionally, recognizing the signs of skin cancers, including seborrheic keratosis, actinic keratosis, squamous cell carcinoma, and malignant melanoma, is essential for preventing progression to severe disease. Overall, awareness and early intervention remain key to effective management of skin conditions.

References

• Bolognia, J. L., Schaffer, J. V., & Cerroni, L. (2018). Dermatology (4th ed.). Elsevier.

NR 293 Skin and Skin Disorders

• James, W. D., Elston, D. M., Treat, J. R., Rosenbach, M. A., & Neuhaus, I. M. (2020). Andrews’ diseases of the skin: Clinical dermatology (13th ed.). Elsevier.

• Habif, T. P. (2021). Clinical dermatology: A color guide to diagnosis and therapy (7th ed.). Elsevier.