GANGGUAN-GANGGUAN

INTEGUMEN PADA BAYI DAN ANAK

Siti Yuyun Rahayu Fitri, S.Kp., M.Si

BACTERIAL INFECTION

IMPETIGO
IMPETIGO

IS HIGHLY CONTAGIOUS SUPERFICIAL BACTERIAL SKIN INFECTION AND IS CHARACTERIZED BY LOCALIZED INFLAMATION AND INFECTION IN EPIDERMIS INCIDENCE : MOST PREVALENT AMONG INFANTS AND CHILDREN, WITH A PEAK AMONG INCIDENCE AMONG CHILDREN 2 TO 6 YEARS AGE, POOR SANITATION, CROWDED LIVING CONDITIONS PLACE

Two major disease form : - Impetigo cantagiousa (crusted lession) - Bullous impetigo

ETIOLOGY
IN

MOST CASES, MINOR TRAUMA TO THE SKIN SUCH AS A SCRATCH OR INSECT BITE IS NECESSARY TO DISRUPT THE SKIN BARIER AND ALLOW INTRODUCTION BACTERIA, WHICH ARE MOST COMMONLY SPREAD BY DIRECT CONTACT WITH AN INFECTED INDIVIDUAL S. AUREUS

NURSIG MANAGEMENT
FOCUSES ON RESOLUTION OF THE INFECTION, COMFORT MEASURES AND EDUCATION FOR CAREGIVER TO PREVENTING THE SPREAD OF INFECTION AND PREVENTION OF COMPLICATION HANDWASHING, WEARING GLOVE DURING CARE GENTLE SOAKING AND REMOVAL OF CRUSTS WITH WARM SOAPY WATER , CHILDS NAIL CUT SHORT,DISTRACTION TECHNIQUES

 General

measures During the infectious stage, i.e. while the impetigo is oozing or crusted: Cover the affected areas. Avoid close contact with others. Affected children must stay away from school until crusts have dried out. Use separate towels and flannels. Change and launder clothes and linen daily.

CELLULITIS
BACTERIAL INFECTION INVOLVING THE DERMIS AND SUB-CUTANEOUS TISSUE IT IS CHARACTERIZED BY PAINFUL AREA OF ERYTHEMA AND SWELLING THAT MAY SPREAD THROUGH THE SURROUNDING TISSUE NOT CONTAGIOUS INCIDENCE : OCCUR IN CHILDREN OF ANY AGE ONSET OF SYMPTOM S TYPICALLY OCCURS 1 TO 2 DAYS FOLLOWING MINOR TRAUMA THAT DISRUPTS THE NORMAL PROTECTIVE FUNCTION OF THE SKIN

MOST COMMON AREA : THE EXTRIMITIES, FACE, PERIORBITAL, BUCCAL AREA MOST COMMON INFECTIVE ORGANISMS : STREPTOCOCCUS PYOGENES AND STAPHYLOCOCCUS AUREUS. H.INFLUENZAE : FACIAL CELLULITIS IN CHILDREN FROM 3 MONTHS 3-5 YEARS

CLINICAL MANIFESTATION
ACUTE INFLAMATORY ; ERYTHEMA, SWELLING, WARMTH, PAIN. THE BORDER OF THE AFFECTED AREA ARE DIFFUSE AND WILL EXTEND AS THE INFECTION PROGRESS LYMPHAGITIS SYSTEMIC SYMPTOMS : FEVER, CHILLS, MALAISE

NURSING MANAGEMENT
ERADICATION OF INFECTION (PENICILLIN, CEPHALOSPORIN) PROMOTION OF CHILD COMFORT (IMMOBILIZATION WARM COMPRESS FOR INCREASING CIRCULATION AREA. COLD COMPRESS FOR RELIEVING DISCOMFORT PAIN RELIEVE AND REDUCE FEVER PREVENTION COMPLICATION

FUNGAL INFECTION

CANDIDIASIS
MONILIASIS IS FUNGAL INFECTION CAUSE BY CANDIDA SPECIES MOST COMMON CAUSATIVE ORGANISM : CANDIDA ALBICANS , A COMENSAL FUNGUS OF THE MOUTH AND GIT EXIST IN 2 FORMS : A YEAST OR SPORE (RELATIVELY HARMLESS) AND HYPHAL FORM (BRANCHING OUTGROWTHS INVADE THE TISSUE INFECTION) INCIDENCE : DIFFICULT TO DETERMINE

IN INFANTS AND YOUNG CHILDREN, CANDIDIASIS IS MOST OFTEN MANIFESTED AS OROPHARYNGEAL CANDIDIASIS, OR THRUSH AND AS CANDIDAL DIAPER DERMATITIS THRUSH : DEVELOPMENT OF CREAMY WHITE PLAQUES ON THE BUCCAL MUCOSA AND LATERAL BORDER OF THE TONGUE CANDIDAL DIAPER DERMATITIS : ACUTE ONSET OF ERYTHEMATOUS PAPULES BEGINNING IN THE PERINEAL AREA -PERINEUM

NURSING MANAGEMENT
RESOLUTION OF THE INFECTION PROMOTION OF THE CHILDS COMFORT CONTINUATION OF BREASTFEEDING NURSING HISTORY : AB USE IN CHILD AND MOTHER, YEAST INFECTION OF MOTHER

TINEA INFECTION
TINEA INFECTIONS ARE CAUSED BY DERMATOPHYTE ( A GROUP OF CLOSELY RELATED FUNGI THAT INVADE THE OUTER KERATIN LAYER OF THE SKIN AND ITS APPENDAGES) THE FIVE MOST COMMONLY KNOWN TINEA INFECTIONS ARE DISTINCT CLINICAL ENTITIES, DEFINED BY THE ANATOMIC SITE OF THE INFECTIONAND THE FUNGUS INVOLVED

TINEA CAPITIS ( HEAD RINGWORM) TINEA CORPORIS (BODY RINGWORM) TINEA PEDIS (ATHLETES RINGWORM) TINEA CRURIS (JOCK ITCH) TINEA UNGUIM (NAIL FUNGUS)

SYMPTOMS
Itchy, red, raised, scaly patches that may blister and ooze. The patches tend to have sharply-defined edges. Red patches are often redder around the outside with normal skin tone in the center. This may look like a ring. If ringworm affects your hair, you will have bald patches. If ringworm affects your nails, they will become discolored, thick, and even crumble.

PREVENTION
Keep your skin and feet clean and dry. Shampoo regularly, especially after haircuts. Do not share clothing, towels, hairbrushes, combs, headgear, or other personal care items. Such items should be thoroughly cleaned and dried after use. Wear sandals or shoes at gyms, lockers, and pools. Avoid touching pets with bald spots.

TREATMENT

ANTIFUNGAL AGENT MYOLOGIC CURE (NO FUNGAL SPECIES PRESENT) CLINICAL CURE : RESOLUTION OF ALL CLINICAL SIGN AND SYMPTOMS OF SUPERFICIAL FUNGAL INFECTION KEEP THE SKIN CLEAN AND DRY. APPLY OVER-THE-COUNTER ANTIFUNGAL OR DRYING POWDERS, LOTIONS, OR CREAMS THAT CONTAIN MICONAZOLE, CLOTRIMAZOLE, OR SIMILAR INGREDIENTS. DON'T WEAR CLOTHING THAT RUBS AGAINST AND IRRITATES THE AREA. WASH SHEETS AND NIGHTCLOTHES EVERY DAY WHILE YOU ARE INFECTED.

TINEA CAPITIS

TINEA CORPORIS

TINEA PEDIS

TINEA CRURIS

INFESTATIONS

PEDICULOSIS
REFERS TO INFESTATION OF AN AFFECTED INDIVIDUAL BY LICE HEAD LICE ARE ECTOPARASITES (LIVE ON THE SURFACE OF THE BODY), REQUIRE SEVERSL MEALS OF HUMAN BODY EACH DAY, NOT VECTOR OF HUMAN DISEASE INCIDENCE : 6 12 MILLION PEOPLE IN USA (CDC, 2004), MOST COMMON AMONG HEALTHY CHILDREN 3 10 YEARS OF AGE. GIRLS ARE AT INCREASED RISK, ALL SOCIOECONOMIC, CAUCASIAN, SCHOOL AGE FEMALES.

THE CLASSROOM IS CONSIDERED THE PRIMARY SOURCE OF INFESTATION TRANSMITTED PRIMARILY THROUGH HEAD TO HEAD CONTACT IMPLICATED BY HATS,COMBS, BEDDING AND PERSONAL ITEMS LICE CAN CRAWL QUICKLY ON DRY HAIR MANIFESTATION : ITCHING, SCRATCHING, PRURITUS, LYMPHADENOPATY, MALAISE

TREATMENT
PEDICULOCIDES ALONG WITH REMOVAL NIT CASES PROPHYLACTIC TREATMENT OF UNINFESTED CONTACTS IS UNNECESSARY NOT RECOMMENDED USE OF PEDICULOCIDES ON CHILDREN LESS THAN 2 YEARS OF AGE, SO TREATMENT FOR THESE CHILDREN SHOULD CONSIST OF MANUAL REMOVAL OF NITS AND LICE.

NURSING MANAGEMENT
HANDWASHING BEFOR AND AFTER CONTACT WITH CHILD DO NOT BE USED A CONDITIONER RESOLUTION OF INFECTION COMFORT MASURES EDUCATION FOR THE CAREGIVER

SCABIES

INFLAMATORY DISORDER

SEBORRHEIC DERMATITIS
-

IN INFANT : CRADLE CAP FIRST 3 MONTHS OF LIFE ADOLESCENCE --- FOLOWING PUBERTY INCREASED ACTIVITY G.SEBACEA --- NORMAL OCCURANCE IN INFANT AND ADOLESCENCE

DIAPER DERMATITIS
DIAPER RASH AN ACUTE INFLAMATORY PROCESS OCCURING IN THE DIAPER AREA CONSEQUENCE OF PRIMARY IRITANT CONTACT DERMATITIS INCIDENCE : 9 12 MONTHS AGE EXACT ETIOLOGY IS UNKNOWN, MULTIPLE FACTORS ARE INVOLVED IN ITS DEVELOPMENT, SUCH AS CHEMICAL IRRITANT OF STOOL AND DIAPER

TRATMENT
PREVENTION IS THE BEST APPROACH IN THE MANAGEMENT OF DIAPER DERMATITIS ESSENTIAL PRINCIPLES : KEEPING THE SKIN DRY, PROTECTED AND FREE INFECTION. BARRIER CREAM : PETROLATUM AND ZINC PRODUCTS LOW DOSE STEROID CREAM SUCH AS 1 % HYDROCORTISON

NURSING MANAGEMENT
HISTORY : DIAER USE, USE ANY CARE PRODUCTS CHANGE DIAPERS AS SOON AS DIAPER SOILED PLASTIC PANTS SHOULD BE AVOIDED DIAPER REA MAY BE EXPOSED TO AIR

DIFFERENT

DIFFERENT OF CANDIDIASIS AND DIAPER DERMATITIS

SEBORRHEIC DERMATITIS

CONTACT DERMATITIS

ACNE

BITES AND STING

ANIMAL BITES

INSECT BITES AND STING

SUNBURN

ADDITIONAL INTEGUMENTARY DISORDER

FOLICULITIS

FURUNCLES AND CARBUNCLES

FROSTBITE