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CLIENT
TEACHING GUIDE
PITYRIASIS ROSEA
PROBLEM
a large, scaly patch before breaking out with the more generalized rash. It is not known to be contagious and you do not need
to isolate yourself.
CAUSE
PREVENTION/CARE
TREATMENT
Activity:
tive days will reduce itching and improve the rash. Care should be taken not to burn skin with short-term exposure to the sun.
Diet:
Medications:
itself. If the itching is severe, oral steroids may be prescribed.
You
You
Pityriasis
The
cause of pityriasis rosea is unknown.
PLAN Good
rosea is a very common condition characterized by a rash that may or may not itch. You may have noticed
Because
the cause of pityriasis rosea is unknown, there are no recommended preventive measures.
hygiene and avoidance of scratching are recommended to prevent a secondary infection.
It is not necessary for you to limit your activity. Sunlight exposure to skin for short periods of time daily for ve consecu-
No changes are required in your diet.
You may be prescribed an antihistamine medication to take by mouth and topical steroid creams to apply to the rash
Have Been Prescribed:
Need to Take:
You
Need to Notify the Office If You Have:
A.
Any new symptoms.
B.
Any reaction to your medication.
Phone:
RESOURCE
American
Academy of Dermatology 9500 W Bryn Mawr Avenue, Ste 500, Rosemont, IL 60018-5216 United States,
Phone: (888) 462-DERM (3376), www.aad.org
From FAMILY PRACTICE GUIDELINES, Sixth Edition. Copyright Springer Publishing Company, LLC. All Rights Reserved.
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CLIENT
TEACHING GUIDE
PSORIASIS
PROBLEM
elbows, knees, chest, back, arms, legs, toenails, ngernails, and fold between the buttocks may be involved.
CAUSE
PREVENTION/CARE
A.
There is no known prevention, but symptoms can be controlled.
B.
Moving to a warmer climate might be benecial. Severity increases with cold.
C.
Maintain good skin hygiene with daily baths or showers.
D.
Avoid harsh soaps.
E.
Avoid skin injury, including harsh scrubbing, which can trigger new outbreaks.
F.
Avoid skin dryness.
G.
To reduce scaling, use nonprescription, waterless cleansers, hair preparations containing coal tar (Zetar, T/Gel, Pentrax), emol-
lients (Eucerin Plus lotion or cream, Lubriderm, Moisture Plus, Moisturel), or products containing cortisone (often prescription
strength).
H.
Expose the skin to moderate amounts of sunlight as often as possible. Avoid long periods in the sun to prevent sunburn.
I.
Oatmeal baths may loosen scales. Use 1 cup of oatmeal to a tub of warm water.
J.
Stress may increase outbreaks of psoriasis. Consider counseling to assist in lifestyle changes, coping, or any psychological
problems caused by psoriasis.
Psoriasis
The
cause of psoriasis is unknown.
is a chronic, scaly, thickened skin disorder with frequent remissions and recurrences. The skin of the scalp,
TREATMENT
Activity:
Diet:
PLAN
There are no activity restrictions.
Eat a well-balanced diet. You may be instructed to try a gluten-free diet. Drink 8 to 10 glasses of water per day. Avoid alco-
hol in your diet.
Medications:
A.
Creams to rub on the skin:
1.
Ointments containing coal tar. These may stain clothing.
2.
Salicylic acid cream, anthralin cream, or vitamin D-like cream (calcipotriene).
3.
Topical cortisone creams may also be used for short periods of time.
B.
Psoralen plus ultraviolet light (PUVA; combination of a medication and exposure to UVA light).
C.
Combination of tar baths with UVB light.
D.
Antihistamines to relieve itching.
You
Have Been Prescribed:
You
Need to Take:
You
Need to Notify the Office If:
A.
You have an adverse reaction to or cannot tolerate any of the prescribed medications.
B.
Symptoms recur after treatment. Notify your healthcare provider if, during an outbreak, pustules erupt on the skin and/or are
You may be prescribed the following types of medications:
accompanied by fever, muscle aches, and fatigue.
C.
New, unexplained symptoms develop.
D.
Other:
Phone:
For
severe cases, you may be referred to a dermatologist (specialist for skin disorders).
RESOURCE
National
9166, www.psoriasis.org
From FAMILY PRACTICE GUIDELINES, Sixth Edition. Copyright Springer Publishing Company, LLC. All Rights Reserved.
Psoriasis Foundation, Suite 200, 6415 SW Canyon, Ct. Portland, OR 97221, United States, Phone: 800-723-
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CLIENT
TEACHING GUIDE
RINGWORM (TINEA)
PROBLEM
worm; it gets the name because of the round ring shape that is red on the outside and normal on the inside. It is not uncommon
to get more than one time. Other tinea fungal infections are:
A.
Tinea pedis (athlete’s foot).
B.
Tinea cruris (jock itch).
C.
Tinea capitis (ringworm on the head).
CAUSE
PREVENTION
A.
Use good hygiene, including not sharing hairbrushes and combs.
B.
Keep skin cool and dry.
C.
Wear shoes in locker rooms and around pools.
D.
Wear loose-tting clothing.
E.
Treat pets’ skin problems adequately. Ringworm is often blamed on cats, but it can come from almost any animal, including
horses, rabbits, dogs, and pigs.
F.
Infections of ngernails and toenails may require prescription medications.
TREATMENT
Ringworm
The
fungus is transmitted by direct contact. It can be transmitted from objects, shoes, locker rooms, animals, and people.
is a fungal infection of the skin which can be found on any part of the body. A worm does not cause ring-
PLAN
Activity:
Diet:
Medications:
You
You
You
A.
B.
As tolerated. Some contact sports may increase contracting tinea (football and wrestling).
There is no special diet.
Have Been Prescribed:
Need to Take:
Need to Notify the Office If:
Your symptoms get worse.
Other:
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CLIENT
TEACHING GUIDE
SCABIES
PROBLEM
ngers and in other locations, or you may have some redness and skin irritation aggravated by scratching.
CAUSE
vidual who has the condition.
PREVENTION/CARE
A.
Make sure all close contacts, sexual partners, family, and household contacts are treated.
B.
All bedding and clothing that are in contact with the infected skin should be machine-washed and machine-dried on the high-
est heat cycle.
C.
Any clothing or bedding that cannot be laundered in the way previously mentioned should be placed in a plastic bag that is
securely tied for at least a week. The mites cannot live this long away from human skin.
D.
Coats, furniture, rugs, oors, and walls do not require any special cleaning or treatment.
TREATMENT
A.
Most clients with scabies are successfully treated with only one overnight application of a cream known as scabicide.
B.
You should let your practitioner know if you are pregnant or breastfeeding.
C.
You may itch for up to a week even with successful treatment.
D.
If you still have symptoms after 2 weeks, you should see your practitioner, who will determine if you need a second treatment.
Scabies
Scabies
PLAN
is a common condition characterized by severe itching. You may have noticed small burrows between your
is caused by an infestation of the skin by a mite. You contract scabies by coming in close contact with an indi-
Yo u
can prevent reinfection of scabies by following these measures:
Activity:
Diet:
Medications:
A.
B.
C.
You
You
You
A.
B.
C.
Phone:
RESOURCE
Affected children in day care or school can return the day after treatment is completed.
There is no special diet.
The most common medications used to treat scabies include:
Permethrin (Elimite Cream), which is applied to all body areas from the neck down and washed off in 8 to 14 hours.
You may be told to use Benadryl 25 to 50mg if needed for itching.
Do not use near your eyes.
Have Been Prescribed:
Need to Take:
Need to Notify the Office If:
You have new symptoms.
You have a reaction to the medication.
Other:
American
Academy of Dermatology, 9500 W Bryn Mawr Avenue, Ste 500, Rosemont, IL 60018-5216, United States,
Phone: (888) 462-DERM (3376), www.aad.org
From FAMILY PRACTICE GUIDELINES, Sixth Edition. Copyright Springer Publishing Company, LLC. All Rights Reserved.
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CLIENT
TEACHING GUIDE
SEBORRHEIC DERMATITIS
PROBLEM
the skin. The scales anchor to the hair shafts and may itch, but they are usually painless unless complicated by infection.
CAUSE
infrequent shampoos; oily skin; other skin disorders such as rosacea, acne, or psoriasis; obesity; Parkinson disease; use of lotions
that contain alcohol; and HIV/AIDS.
PREVENTION/CARE
A.
There are no specic preventive measures.
B.
The goal of care is to minimize the severity or frequency of symptoms.
1.
To loosen scales, scrub with your ngernails while shampooing and scrub at least 5 minutes.
2.
Exsel) or zinc pyrithione (Zincon) and lubricating skin lotion.
3.
coal tar products on infants or children without specic physician prescription.
4.
scalp.
5.
6.
7.
Seborrheic
The
cause is unknown. The risk of seborrheic dermatitis increases with stress; hot and humid or cold and dry weather;
dermatitis is a skin condition characterized by greasy or dry, white, aking scales over reddish patches on
Shampoo vigorously and as often as once a day. The type of shampoo is not as important as the way you scrub your scalp.
If you suffer from minor dandruff, you may use nonprescription dandruff shampoos with selenium sulde (Selsun Blue,
For severe problems, shampoos that contain coal tar or scalp creams that contain cortisone may be prescribed. Do not use
To apply medication to the scalp, part the hair a few strands at a time and rub the ointment or lotion vigorously into the
Topical steroids may be prescribed for other affected parts of the skin.
Be sure to dry skin folds thoroughly after bathing.
Wear loose, ventilating clothing. Avoid constant cap wearing.
TREATMENT
Activity:
Diet:
Medications:
You
Have Been Prescribed:
You
Need to Take:
You
Need to Notify the Office If:
A.
You have an adverse reaction to any of the prescribed medications.
B.
You are unable to tolerate any of the medications.
C.
You have any secondary infection in affected area.
D.
Other:
Phone:
PLAN
No restrictions. Outdoor activities in the summer may help alleviate symptoms.
Eat a well-balanced diet. Drink 8 to 10 glasses of water per day. Avoid foods that seem to worsen your condition.
From FAMILY PRACTICE GUIDELINES, Sixth Edition. Copyright Springer Publishing Company, LLC. All Rights Reserved.
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CLIENT
TEACHING GUIDE
SKIN CARE ASSESSMENT
PROBLEM
that the rate of skin cancer varies by the state where you live. A state map can be accessed at www.cdc.gov/cancer/skin/statisti
cs/state.htm.
CAUSE
skin cancer. Risk factors include:
A.
Fair complexion.
B.
Advanced age with sun-damaged skin.
C.
A history of severe sunburn.
D.
A history of spending long hours outdoors.
E.
A history of x-ray procedures for skin conditions.
F.
Genetic susceptibility.
PREVENTION/CARE
A.
Protect yourself and prevent sun exposure to your skin by staying out of the harmful rays as much as possible, especially
between the hours of 11:00 a.m. and 2:30 p.m. This time frame accounts for approximately 70% of the harmful UV radiation.
B.
If you are exposed to the sun, wear a sunscreen product with an sun protection factor of 15 or greater at all times.
C.
Wear hats that screen your face and neck, as well as your ears.
D.
Clothing is available with sun-protective materials. Regular long shirts and long pants also help protect your skin.
E.
Sit in the shade to rest.
F.
Do not use a tanning booth.
Skin
cancer is the most common type of cancer. In 2006, the Centers for Disease Control and Prevention (CDC) noted
Skin
cancer is frequently caused by damage from the UV rays of the sun. Some people are at a higher risk of developing
Steps
to Take to Prevent Yourself From Having Skin Cancer
A.
Examine your skin monthly.
1.
Use a good light source and a mirror to see areas of your skin not clearly visible.
2.
Examine your entire body closely.
3.
Pay particular attention to areas frequently exposed to the sun, especially face, lips, eyes, neck, scalp, and ears.
4.
Monthly screening allows you to familiarize yourself with birthmarks and moles. Note the size, shape, and color of these
marks. Note any changes in these marks using the “ABCDE” method:
a.
Asymmetry: The shape of the mark should be noted. Any change in shape or irregularity of the mark needs to be evalu-
ated by your healthcare provider.
b.
Border: Look carefully at the border of the mark. If the border edge is ragged, notched, and not smooth, your healthcare
provider needs to evaluate it.
c.
Color: Note the color of moles. If you notice any change in color, or if you notice the mole to have several colors (brown,
black, tan, red, etc.), you need to alert your healthcare provider.
d.
Diameter: Measure the size of the mark and document it. Any change in size, especially if it is greater than 6 mm, should
be brought to the attention of your healthcare provider.
e.
Elevation: Note elevation of the lesion, change in size, and any evolving changes of the lesion. You need to alert your
healthcare provider if changes occur.
5.
You should also evaluate lesions on your skin for any type of change. If the lesions begin bleeding or hurting, or change in
texture or in any other way, your healthcare provider needs to evaluate the change.
6.
Be alerted to any skin ulcers that do not heal within 1 month. Also, any new moles or lesions need to be evaluated by your
healthcare provider for proper diagnosis of the type of lesion.
TREATMENT
Diet:
Medications:
PLAN Activity:
As tolerated, but protect yourself from sun exposure.
There is no special diet that will stop skin cancer.
There are no medications that prevent skin cancer.
From FAMILY PRACTICE GUIDELINES, Sixth Edition. Copyright Springer Publishing Company, LLC. All Rights Reserved.
(continued)
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CLIENT TEACHING GUIDE
SKIN CARE ASSESSMENT (CONTINUED)
You
Need to Notify the Office If You Have:
A.
Any of the skin changes mentioned previously that need to be evaluated by your healthcare provider.
Phone:
RESOURCE
ncer.org
American
Cancer Society, 250 Williams Street NW Atlanta, GA 30303, United States, Phone 800-227-2345, www.ca
From FAMILY PRACTICE GUIDELINES, Sixth Edition. Copyright Springer Publishing Company, LLC. All Rights Reserved.
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CLIENT
TEACHING GUIDE
TINEA VERSICOLOR
PROBLEM
chest, back, shoulders, arms, and trunk. During the summer, these spots usually appear pale and do not tan.
During the winter, the spots may appear pinker or darker than the normal skin color.
CAUSE
moist conditions. It is common to have recurring episodes.
PREVENTION/TREATMENT
A.
Air-dry skin as much as possible.
B.
Apply medication as directed.
C.
Patches on skin (color changes) may take several weeks to resolve.
D.
Monthly treatments may help prevent recurrences.
Activity:
Diet:
There is no special diet.
Medications:
A.
Apply Selsun Blue shampoo or other medication as directed.
B.
Most medications may be washed off from skin 30 minutes after application.
C.
Selsun Blue shampoo may be used daily on the affected skin for 2 weeks.
D.
Keep shampoo out of the eyes and genital area.
E.
Leave it on skin for about 20 minutes and then rinse it off.
yeast infection of the skin, tinea versicolor, may cause color changes of the skin, commonly on the
Tinea
versicolor is caused by an increased production of yeast on the skin, which is influenced by warm,
PLAN
There are no activity restrictions with tinea versicolor.
You
Have Been Prescribed:
You
Need to Take:
You
Need to Notify the Office If You:
A.
Do not see improvement, despite proper treatment.
B.
Develop new symptoms.
C.
Other:
Phone:
RESOURCE
American
Academy of Dermatology, 9500 W Bryn Mawr Avenue, Ste 500, Rosemont, IL 60018-5216, United States,
Phone: (888) 462-DERM (3376), www.aad.org
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CLIENT
TEACHING GUIDE
WARTS
PROBLEM
CAUSE
PREVENTION/TREATMENT
A.
Wash hands well.
B.
Avoid scratching or picking warts. Warts bleed easily.
C.
Some warts go away spontaneously after time without any treatment.
D.
Medications may be prescribed.
To
Enhance Destruction:
A.
Soak the wart in warm water 10 to 15 minutes a day.
B.
After soaking, use an emery board to le the wart down.
C.
Apply over-the-counter medication as prescribed (Compound W) to the site.
D.
Duct tape may be applied over the wart. Perform these steps every night until resolved.
E.
Warts may reappear at the same spot or in other areas.
F.
Cryotherapy “freezing” is another treatment option. Discuss this with your healthcare provider.
Activity:
Diet:
There are no special diets for warts.
wart is a raised, rough growth projecting from the skin which can be contagious.
Warts
are caused by a viral infection that stimulates the cells of the skin to multiply rapidly, resulting in an outward growth.
PLAN
There are no activity restrictions for warts.
Medications:
You
Have Been Prescribed:
You
Need to Take:
You
Need to Notify the Office If:
A.
You develop an infection at the site of the wart.
B.
Other:
Phone:
RESOURCE
American
Academy of Dermatology, 9500 W Bryn Mawr Avenue, Ste 500, Rosemont, IL 60018-5216, United States,
Phone: (888) 462-DERM (3376), www.aad.org
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CLIENT
TEACHING GUIDE
WOUND CARE: LOWER EXTREMITY ULCERS
PROBLEM
CAUSE
PREVENTION/CARE
A.
Keep the area clean and free of foreign debris.
B.
Dressing changes: _______________________
C.
You may be prescribed antibiotics; if so, take all antibiotics until they are completely gone.
TREATMENT
Activity:
Diet:
Eat a well-balanced diet. Increase protein intake.
Medications:
You
Have Been Prescribed:
You
Need to Take:
You
Need to Notify the Office If You Have:
A.
A reaction or cannot tolerate any of the prescribed medications.
B.
A fever and a general ill feeling.
C.
Any new or unexplained symptoms related to the ulcer:
1.
Increase in size.
2.
New odor.
3.
Increased drainage.
4.
Change in color of the drainage.
5.
Increased pain at the site.
D.
Any questions or concerns.
ulcer on the body that lies on the lower extremities.
Edema,
trauma, ischemia, and venous insufciency.
PLAN
Do not apply direct pressure to the site of the ulcer. You may be prescribed to elevate your lower extremities.
Phone:
From FAMILY PRACTICE GUIDELINES, Sixth Edition. Copyright Springer Publishing Company, LLC. All Rights Reserved.
Соседние файлы в папке Библиотека им академика М.И. Перельмана