Inflammatory
Eczema (atopic dermatitis): dry, itchy, erythematous patches. Treatment: moisturizers, topical steroids, antihistamines. Psoriasis: red plaques with silvery scales, extensor surfaces. Treatment: topical steroids, vitamin D analogs, phototherapy, biologics. Contact dermatitis: erythema, vesicles at contact site. Treatment: remove irritant, topical steroids. Seborrheic dermatitis: greasy scales on scalp, face.
Infectious
Bacterial: impetigo (honey-colored crusts, children), cellulitis (erythema, warmth, edema), folliculitis. Viral: herpes simplex (grouped vesicles), herpes zoster (dermatomal vesicles), warts. Fungal: tinea corporis (ringworm, annular with central clearing), tinea pedis (athlete foot), candidiasis (intertrigo, red macerated). Parasitic: scabies (burrows, intense itching, worse at night), pediculosis (lice).
Other Conditions
Urticaria (hives): wheals, allergic reaction. Erythema multiforme: target lesions, drug reaction or infection. Stevens-Johnson syndrome (SJS): mucosal involvement, skin sloughing — emergency. Pemphigus: flaccid blisters, Nikolsky positive. Vitiligo: depigmented patches. Rosacea: facial erythema, papules, telangiectasia. Acne: comedones, papules, pustules.
Nursing Care
Assess lesions: location, distribution, pattern, evolution. Avoid irritants. Apply topical medications as ordered. Educate on skin care, trigger avoidance. Monitor for secondary infection. For SJS: stop offending drug, fluid resuscitation, wound care, ophthalmology consult. Report severe or rapidly progressing rashes immediately.
Important Notes
- Stevens-Johnson syndrome (SJS) is a dermatologic emergency — mucosal involvement, skin sloughing, Nikolsky sign — stop drug immediately.
- Scabies causes intense itching that is worse at night — look for burrows in finger webs, wrists, axillae.
Clinical Tips
- Herpes zoster follows a dermatomal distribution — initiate antivirals within 72 hours of rash onset for best efficacy.
- Impetigo is contagious — honey-colored crusts in children — treat with topical or oral antibiotics.
Summary
Common skin conditions include inflammatory (eczema, psoriasis), infectious (impetigo, tinea, scabies), and severe reactions (SJS) requiring prompt recognition and treatment.
