Pediatric

Skin Disorders
Prepared by Dr. Darin Mathkor
 General Objectives Specific Objectives

• Be able to identify different skin • will be able to:

disorders in children and discuss • Define the common skin disorders.
nursing care management. • Differentiate between each disorder.
• Apply nursing care plan and
management for each skin
disorders.

Objectives
skin disorders due to:

Bacterial infections •
Viral infections •
Fungal infections •
Parasitic infections/infestations •
Chemicals •
Bacterial infections

Staphylococci Streptococci
High risk children for developing bacterial infection

Congenital or acquired immune disorders (such as [AIDS])

Debilitated condition
• Receiving immunosuppressive therapy, and those with a
• Generalized malignancy (such as, leukemia or lymphoma)

([‫ﺑﻛﺗﯾرﯾﺔ اﻻﺿطراﺑﺎت اﻟﻣﻧﺎﻋﯾﺔ اﻟﺧﻠﻘﯾﺔ أو اﻟﻣﻛﺗﺳﺑﺔ )ﻣﺛل ]اﻹﯾدز‬

‫ﺣﺎﻟﺔ اﻟوھن‬
‫ واﻟذﯾن ﯾﻌﺎﻧون ﻣن‬، ‫• ﺗﻠﻘﻲ اﻟﻌﻼج اﻟﻣﺛﺑط ﻟﻠﻣﻧﺎﻋﺔ‬
(‫• ورم ﺧﺑﯾث ﻣﻌﻣم )ﻣﺛل اﻟﻠوﻛﯾﻣﯾﺎ أو ﺳرطﺎن اﻟﻐدد اﻟﻠﯾﻣﻔﺎوﯾﺔ‬
 BACTERIAL infections
• Impetigo contagiosa
• Staphylococci
‫• ﻣ ظ ﺎھ ر‬
• Manifestation
‫ ﯾظﮭر ﺑﺷﻛل ﺷﺎﺋﻊ ﻋﻠﻰ اﻟوﺟﮫ‬، ‫• ﯾﺑدأ ﻛطﻔﺢ ﺟﻠدي ﺑﻘﻌﻲ ﻣﺣﻣر‬
‫ اﻷطراف‬/ • Begins as a reddish macular rash, commonly seen
on face/extremities
‫• ﯾﺗطور إﻟﻰ طﻔﺢ ﺟﻠدي ﺣطﺎطﻲ وﺣوﯾﺻﻠﻲ ﯾﻧﺿﺢ وﯾﺷﻛل‬
.‫ﻗﺷرة رطﺑﺔ ﺑﻠون اﻟﻌﺳل‬ • Progresses to papular and vesicular rash that
oozes and forms a moist, honey colored crust.
‫ﺣﻛﺔ اﻟﺟﻠد‬ •
• Pruritis of skin
‫ﺷﺎﺋﻊ ﻋﻧد اﻷطﻔﺎل اﻟﺻﻐﺎر وﻣرﺣﻠﺔ ﻣﺎ ﻗﺑل اﻟﻣدرﺳﺔ‬ • • Common in toddlers and preschoolers
‫ﺑدون أﻋراض ظﺎھرة‬ • • Asymptomatic
‫إدارة‬ • • Management
‫أو ﻣرھم ﻣﺿﺎد‬mupirocin ‫ﻣرھم ﻣوﺿﻌﻲ ﻣﺑﯾد ﻟﻠﺟراﺛﯾم‬ • • topical bactericidal ointment mupirocin or triple antibiotic
‫ﺣﯾوي ﺛﻼﺛﻲ ﻋن طرﯾق اﻟﻔم‬ ointment Oral
.(‫اﻟﻣﺿﺎدات اﻟﺣﯾوﯾﺔ ﺑﺎﻟﺣﻘن )اﻟﺑﻧﺳﻠﯾن‬ • • parenteral antibiotics (penicillin)
(‫ﻓﺎﻧﻛوﻣﺎﯾﺳﯾن )ﻣرﺳﺎ‬ • • Vancomycin (MRSA)
‫ أﯾﺎم‬5 ‫ ﯾوﺿﻊ ﻣرﺗﯾن ﯾوﻣﯾﺎ ً ﻟﻣدة‬، ٪Retapamulin 1 ‫ﻣرھم‬ • • Retapamulin 1% ointment, applied twice daily for 5 days
 BACTERIAL infections
• Folliculitis (pimple), furuncle (boil), carbuncle (multiple boils)
• Staphylococcus aureus
• methicillin-resistant S. aureus (MRSA)
• Manifestation
• Infection of hair follicle
• Systemic effects: Malaise, if severe
‫اﻟﻣظﺎھر‬ •
‫إﺻﺎﺑﺔ ﺑﺻﯾﻼت اﻟﺷﻌر‬ • • Management
‫ إذا ﻛﺎﻧت ﺷدﯾدة‬، ‫ اﻟﺗوﻋك‬:‫اﻟﺗﺄﺛﯾرات اﻟﺟﮭﺎزﯾﺔ‬ • • Skin cleanliness
• Local warm, moist compresses
‫إدارة‬ •
• Topical antibiotic agents
‫ﻧظﺎﻓﺔ اﻟﺟﻠد‬ •
‫ﻛﻣﺎدات ﻣﺣﻠﯾﺔ داﻓﺋﺔ ورطﺑﺔ‬ •
• Systemic antibiotics in severe cases
‫ﻋواﻣل اﻟﻣﺿﺎدات اﻟﺣﯾوﯾﺔ اﻟﻣوﺿﻌﯾﺔ‬ • • Incision and drainage of severe lesions
‫اﻟﻣﺿﺎدات اﻟﺣﯾوﯾﺔ اﻟﺟﮭﺎزﯾﺔ ﻓﻲ اﻟﺣﺎﻻت اﻟﺷدﯾدة‬ •
‫ﺷق وﺗﺻرﯾف اﻵﻓﺎت اﻟﺷدﯾدة‬ •
 BACTERIAL infections
• Cellulitis
• Streptococci
‫• اﻟﻣظﺎھر اﻟﺳرﯾرﯾﺔ‬ • Staphylococci
‫• اﻟﺗﮭﺎب اﻟﺟﻠد واﻷﻧﺳﺟﺔ ﺗﺣت اﻟﺟﻠد ﻣﻊ اﺣﻣرار ﺷدﯾد وﺗورم وﺗﺳﻠل‬ • Haemophilus influenzae
‫ﻗوي‬
• Manifestation
‫اﻟﺗﮭﺎب اﻷوﻋﯾﺔ اﻟﻠﻣﻔﯾﺔ "اﻟﺧطوط" اﻟﺗﻲ ﺗظﮭر ﺑﺷﻛل ﻣﺗﻛرر‬ •
• Inflammation of skin and subcutaneous tissues with intense
‫إﺻﺎﺑﺔ اﻟﻐدد اﻟﻠﯾﻣﻔﺎوﯾﺔ اﻹﻗﻠﯾﻣﯾﺔ ﺷﺎﺋﻌﺔ‬ • redness, swelling, and firm infiltration
‫ﻗد ﯾﺗطور إﻟﻰ ﺗﻛوﯾن اﻟﺧراج‬ • • Lymphangitis “streaking” frequently seen
‫ ﺗوﻋك‬، ‫ ﺣﻣﻰ‬:‫اﻟﺗﺄﺛﯾرات اﻟﺟﮭﺎزﯾﺔ‬ • • Involvement of regional lymph nodes common
• May progress to abscess formation
‫إدارة‬ • • Systemic effects: Fever, malaise
‫اﻟﻣﺿﺎدات اﻟﺣﯾوﯾﺔ ﻋن طرﯾق اﻟﻔم أو ﺑﺎﻟﺣﻘن‬ •
‫اﻟراﺣﺔ وﺗﺛﺑﯾت اﻟﻣﻧطﻘﺔ اﻟﻣﺻﺎﺑﺔ واﻟطﻔل‬ • • Management
• Oral or parenteral antibiotics
• Rest and immobilization of both affected area and child
 Bacterial infections
• Staphylococcal scalded skin syndrome
• Staphylococcus. aureus
• Manifestation
• Macular erythema with “sandpaper” texture of
‫ﻣظ ﮭر‬
involved skin
‫اﻟﺣﻣﺎﻣﻲ اﻟﺑﻘﻌﯾﺔ ذات ﻣﻠﻣس "ورق اﻟﺻﻧﻔرة" ﻟﻠﺟﻠد اﻟﻣﺻﺎب‬ • Epidermis becomes wrinkled (in 2 days or less), and
‫ﺗﺗﺟﻌد اﻟﺑﺷرة )ﻓﻲ ﯾوﻣﯾن أو أﻗل( وﺗظﮭر ﻓﻘﺎﻋﺎت ﻛﺑﯾرة‬ large bullae appear
‫اﻟﻘوﺑﺎء اﻟﻔﻘﺎﻋﯾﺔ اﻟﻣوﺿﻌﯾﺔ ﻋﻧد اﻷطﻔﺎل اﻷﻛﺑر ﺳﻧًﺎ‬ • Localized bullous impetigo in older child
‫ • إدارة‬Management
‫اﻟﻣﺿﺎدات اﻟﺣﯾوﯾﺔ اﻟﺟﮭﺎزﯾﺔ‬ • Systemic antibiotics
‫ﺗﻧظﯾف ﻟطﯾف ﺑﻣﺣﻠول ﻣﻠﺣﻲ أو ﻣﺣﻠول ﺑورو أو ﻛﻣﺎدات ﻧﺗرات اﻟﻔﺿﺔ‬ • Gentle cleansing with saline, Burrow solution, or
٪0.25 ‫ﺑﻧﺳﺑﺔ‬ 0.25% silver nitrate compresses
 Prevent the spread of infection and to prevent
complications.
Nursing care management
.‫• ﻣﻧﻊ اﻧﺗﺷﺎر اﻟﻌدوى وﻣﻧﻊ ﺣدوث ﻣﺿﺎﻋﻔﺎت‬ Caution the child against touching the involved area.
‫ ﻏﺳل اﻟﯾدﯾن إﻟزاﻣﻲ ﻗﺑل‬.‫• ﺣذر اﻟطﻔل ﻣن ﻟﻣس اﻟﻣﻧطﻘﺔ اﻟﻣﺻﺎﺑﺔ‬
.‫وﺑﻌد ﻣﻼﻣﺳﺔ اﻟطﻔل اﻟﻣﺻﺎب‬
Hand washing is mandatory before and after contact
.‫ﺿﺎ ﻋﻠﻰ ﻏﺳل اﻟﯾدﯾن ﻟﻛل ﻣن اﻟطﻔل واﻷﺳرة‬
ً ‫• رﻛز أﯾ‬
with an affected child.
‫• ﯾﺟب ﺗزوﯾد اﻟطﻔل ﺑﻣﻧﺎﺷف وﻣﻧﺎﺷف ﻣﻧﻔﺻﻠﺔ ﻋن ﺗﻠك اﻟﺧﺎﺻﺔ‬
‫ ﯾﺟب ﺗﻐﯾﯾر ﺑﯾﺟﺎﻣﺔ اﻟطﻔل وﻣﻼﺑﺳﮫ اﻟداﺧﻠﯾﺔ‬.‫ﺑﺄﻓراد اﻷﺳرة اﻵﺧرﯾن‬ Also emphasize hand washing to both the child and the
.‫وﻏﯾرھﺎ ﯾوﻣﯾًﺎ وﻏﺳﻠﮭﺎ ﺑﺎﻟﻣﺎء اﻟﺳﺎﺧن‬ family.
‫• ﯾﺟب اﻟﺗﺧﻠص ﻣن ﻣﺎﻛﯾﻧﺎت اﻟﺣﻼﻗﺔ اﻟﻣﺳﺗﺧدﻣﺔ ﻓﻲ اﻟﺣﻼﻗﺔ ﺑﻌد ﻛل‬
.‫اﺳﺗﺧدام وﻋدم ﻣﺷﺎرﻛﺗﮭﺎ‬ The child should be provided with washcloths and
‫• ﯾوﺻﻲ ﺑﻌض اﻟﻣﺗﺧﺻﺻﯾن ﻓﻲ اﻷﻣراض اﻟﻣﻌدﯾﺔ ﺑﺎﻻﺳﺗﺣﻣﺎم ﻓﻲ‬ towels separate from those of other family members.
.‫ﺣﻣﺎم اﻟﻛﻠور ﻣرة أو ﻣرﺗﯾن أﺳﺑوﻋﯾًﺎ‬
The child's pajamas, underwear, and other clothes
should be changed daily and washed in hot water.
Razors used for shaving should be discarded after each
use and not shared.
Some infectious disease specialists recommend bathing
in a chlorine bath once or twice weekly.
 Daily bathing or showering with an antibacterial soap.
‫• اﻻﺳﺗﺣﻣﺎم اﻟﯾوﻣﻲ أو اﻻﺳﺗﺣﻣﺎم ﺑﺻﺎﺑون ﻣﺿﺎد‬
.‫ﻟﻠﺑﻛﺗﯾرﯾﺎ‬
Cont.
.‫• ﻻ ﺗﻌﺻر اﻵﻓﺎت اﻟﺟرﯾﺑﯾﺔ‬
Do not squeeze follicular lesions.
‫• اﻟﺗﮭﺎب اﻟﻧﺳﯾﺞ اﻟﺧﻠوي اﻟﻣﺣدود ﻟﻸطراف ﯾﺗم‬
‫إدارﺗﮫ ﻓﻲ اﻟﻣﻧزل ﺑﺎﻟﻣﺿﺎدات اﻟﺣﯾوﯾﺔ ﻋن طرﯾق‬
.‫اﻟﻔم واﻟﻛﻣﺎدات اﻟداﻓﺋﺔ‬
‫• ﻋﺎدة ً ﻣﺎ ﯾﺗم إدﺧﺎل اﻟﺗﮭﺎب اﻟﻧﺳﯾﺞ اﻟﺧﻠوي اﻷﻛﺛر‬
‫ ﺧﺎﺻﺔ ﺣول اﻟﻣﻔﺻل اﻟﻣﺻﺎب ﺑﺎﻟﺗﮭﺎب‬، ‫اﻧﺗﺷﺎًرا‬ Limited cellulitis of an extremity managed at home with oral
antibiotics and warm compresses.
‫ أو ﻣﻊ آﻓﺎت أﻛﺑر ﻣن‬، ‫اﻟﻌﻘد اﻟﻠﻣﻔﯾﺔ أو ﻋﻠﻰ اﻟوﺟﮫ‬
‫ إﻟﻰ اﻟﻣﺳﺗﺷﻔﻰ ﻣن أﺟل‬، (‫ ﺑوﺻﺔ‬2) ‫ ﺳم‬5
.‫ واﻟﺗﺻرﯾف‬، ‫ واﻟﺷق‬، ‫اﻟﻣﺿﺎدات اﻟﺣﯾوﯾﺔ ﺑﺎﻟﺣﻘن‬
‫• اﻟﻣﻣرﺿﺎت ﻣﺳؤوﻟون ﻋن ﺗﻌﻠﯾم اﻷﺳرة ﻛﯾﻔﯾﺔ‬ More extensive cellulitis, especially around a joint with
lymphadenitis or on the face, or with lesions larger than 5 cm (2
.‫إدارة اﻟدواء واﺳﺗﺧدام اﻟﻛﻣﺎدات‬ inches), are usually admitted to the hospital for parenteral
antibiotics, incision, and drainage.

Nurses are responsible for teaching the family to administer the

medication and to apply compresses.
 Viral Infections
Viruses are intracellular parasites that produce their effect by
using the intracellular substances of the host cells.

viruses are unable to provide for their own metabolic needs or

to reproduce themselves.

.‫اﻟﻔﯾروﺳﺎت ھﻲ طﻔﯾﻠﯾﺎت داﺧل اﻟﺧﻼﯾﺎ ﺗﻧﺗﺞ ﺗﺄﺛﯾرھﺎ ﺑﺎﺳﺗﺧدام اﻟﻣواد داﺧل اﻟﺧﻼﯾﺎ ﻓﻲ اﻟﺧﻼﯾﺎ اﻟﻣﺿﯾﻔﺔ‬

.‫اﻟﻔﯾروﺳﺎت ﻏﯾر ﻗﺎدرة ﻋﻠﻰ ﺗوﻓﯾر اﺣﺗﯾﺎﺟﺎﺗﮭﺎ اﻷﯾﺿﯾﺔ أو إﻋﺎدة إﻧﺗﺎج ﻧﻔﺳﮭﺎ‬
 Viral infections
• Verruca (warts)
• Human papillomavirus (various types)
• Well-circumscribed, gray or brown, elevated, firm
(‫• اﻟﺛﺂﻟﯾل )اﻟﺛﺂﻟﯾل‬ papules with a roughened, finely papillomatous
texture
(‫ﻓﯾروس اﻟورم اﻟﺣﻠﯾﻣﻲ اﻟﺑﺷري )أﻧواع ﻣﺧﺗﻠﻔﺔ‬ •
• Usually appear on exposed areas, such as fingers,
، ‫ ﻣرﺗﻔﻌﺔ‬، ‫ رﻣﺎدﯾﺔ أو ﺑﻧﯾﺔ‬، ‫• ﺣطﺎطﺎت ﻣﻘﯾدة ﺟﯾدًا‬ hands, face, and soles
‫ﺻﻠﺑﺔ ذات ﻣﻠﻣس ﺣﻠﯾﻣﻲ ﺧﺷن‬
• May be single or multiple
‫ ﻣﺛل اﻷﺻﺎﺑﻊ‬، ‫• ﺗظﮭر ﻋﺎدة ﻋﻠﻰ اﻟﻣﻧﺎطق اﻟﻣﻛﺷوﻓﺔ‬
‫واﻟﯾدﯾن واﻟوﺟﮫ وﺑﺎطن اﻟﻘدم‬ • Asymptomatic
‫ﻗد ﺗﻛون ﻣﻔردة أو ﻣﺗﻌددة‬ • • Management
‫• ﺑدون أﻋراض ظﺎھرة‬ • Local destructive therapy, individualized according
to location, type, and number—surgical removal,
‫• إدارة‬ electrocautery, curettage, cryotherapy (liquid
‫ ﻓردي ﺣﺳب اﻟﻣوﻗﻊ واﻟﻧوع‬، ‫• اﻟﻌﻼج اﻟﻣدﻣر اﻟﻣوﺿﻌﻲ‬ nitrogen)
، ‫ اﻟﻛﺣت‬، ‫ اﻟﻛﻲ اﻟﻛﮭرﺑﺎﺋﻲ‬، ‫ اﻹزاﻟﺔ اﻟﺟراﺣﯾﺔ‬- ‫واﻟﻌدد‬
(‫اﻟﻌﻼج ﺑﺎﻟﺗﺑرﯾد )اﻟﻧﯾﺗروﺟﯾن اﻟﺳﺎﺋل‬
 Viral infections
• Cold sore, fever blister:
• Herpes simplex virus (HSV) type 1
• Genital herpes: HSV type 2
1 ‫ﻣن اﻟﻧوع‬HSV) ) ‫ﻓﯾروس اﻟﮭرﺑس اﻟﺑﺳﯾط‬ • Grouped burning and itching vesicles on
2 ‫ﻣن اﻟﻧوع‬HSV :‫اﻟﮭرﺑس اﻟﺗﻧﺎﺳﻠﻲ‬
inflammatory base
• Usually on or near mucocutaneous
‫ﺣوﯾﺻﻼت ﺣرﻗﺔ وﺣﻛﺔ ﻣﺗﺟﻣﻌﺔ ﻋﻠﻰ ﻗﺎﻋدة اﻟﺗﮭﺎﺑﯾﺔ‬ junctions (lips, nose, genitalia, buttocks)
‫ﻋﺎدة ﻋﻧد اﻟﺗﻘﺎطﻌﺎت اﻟﺟﻠدﯾﺔ اﻟﻣﺧﺎطﯾﺔ أو ﺑﺎﻟﻘرب ﻣﻧﮭﺎ‬ • Vesicles dry, forming a crust, followed by
(‫)اﻟﺷﻔﺎه واﻷﻧف واﻷﻋﺿﺎء اﻟﺗﻧﺎﺳﻠﯾﺔ واﻷرداف‬ exfoliation
‫ﺗﺟف اﻟﺣوﯾﺻﻼت وﺗﺷﻛل ﻗﺷرة ﯾﺗﺑﻌﮭﺎ ﺗﻘﺷﯾر‬ • Spontaneous healing in 8 to 10 days
‫ أﯾﺎم‬10 ‫ إﻟﻰ‬8 ‫اﻟﺷﻔﺎء اﻟﺗﻠﻘﺎﺋﻲ ﻓﻲ ﻏﺿون‬ • May be accompanied by regional
‫ﻗد ﯾﻛون ﻣﺻﺣوﺑًﺎ ﺑﺗﺿﺧم اﻟﻌﻘد اﻟﻠﻣﻔﯾﺔ اﻟﻣوﺿﻌﻲ‬ lymphadenopathy

‫إدارة‬ • Management
‫ﻣﺿﺎد ﻟﻠﻔﯾروﺳﺎت ﻋن طرﯾق اﻟﻔم‬ • Oral antiviral
 Fungal infections
• Ringworm are infections caused by a group of closely
related filamentous fungi that invade primarily the stratum
corneum, hair, and nails.

• Superficial infections by organisms that live on, not in, the

skin.

‫اﻟﺳﻌﻔﺔ ھﻲ ﻋدوى ﺗﺳﺑﺑﮭﺎ ﻣﺟﻣوﻋﺔ ﻣن اﻟﻔطرﯾﺎت اﻟﺧﯾطﯾﺔ وﺛﯾﻘﺔ‬

‫اﻟﺻﻠﺔ واﻟﺗﻲ ﺗﻐزو ﻓﻲ اﻟﻣﻘﺎم اﻷول اﻟطﺑﻘﺔ اﻟﻘرﻧﯾﺔ واﻟﺷﻌر‬
.‫واﻷظﺎﻓر‬

‫ﻋدوى ﺳطﺣﯾﺔ ﺑواﺳطﺔ ﻛﺎﺋﻧﺎت ﺣﯾﺔ ﺗﻌﯾش ﻋﻠﻰ اﻟﺟﻠد وﻟﯾس‬

‫ﺑداﺧﻠﮫ‬
 Fungal infections
(Ringworm)
• Tinea capitis
• Trichophyton tonsurans, Microsporum
audouinii, Microsporum canis
• Manifestation
• Lesions in scalp but may extend to hairline
or neck
• circumscribed patches or patchy, scaling
areas of alopecia
‫• ﻣظﺎھر‬ • asymptomatic, but severe, deep
‫• آﻓﺎت ﻓﻲ ﻓروة اﻟرأس وﻟﻛﻧﮭﺎ ﻗد ﺗﻣﺗد إﻟﻰ ﺧط اﻟﺷﻌر أو اﻟرﻗﺑﺔ‬ inflammatory reaction may occur that
‫• ﺑﻘﻊ ﻣﻘﯾدة أو ﻣﻧﺎطق ﻣﺗﻘﺷرة ﻣن اﻟﺻﻠﻊ‬ manifests as boggy, encrusted lesions
(kerions)
، ‫• ﻗد ﯾﺣدث ﺗﻔﺎﻋل اﻟﺗﮭﺎﺑﻲ ﻋﻣﯾق ﻏﯾر ﻣﺻﺣوب ﺑﺄﻋراض‬
(‫ ﯾﺗﺟﻠﻰ ﻓﻲ ﺷﻛل آﻓﺎت ﻣﺳﺗﻧﻘﻌﺔ وﻣﻐطﺎة )ﺗﻘرﻧﺎت‬، ‫وﻟﻛﻧﮫ ﺷدﯾد‬ • Pruritic
‫• ﺣ ﺎﻛﺔ‬
 Fungal infections
(Ringworm)
• Tinea corporis:
• Trichophyton rubrum, Trichophyton
mentagrophytes, M. canis,
Epidermophyton organisms

• Manifestation
‫• ﻣظﺎھر‬ • Round or oval, erythematous scaling
patch that spreads peripherally and
‫• رﻗﻌﺔ ﻣﺗﻘﺷرة ﺣﻣﺎﻣﯾﺔ داﺋرﯾﺔ أو ﺑﯾﺿﺎوﯾﺔ ﺗﻧﺗﺷر ﺑﺷﻛل‬
‫ﻣﺣﯾطﻲ وﺗﻧﺗﮭﻲ ﻣرﻛزﯾًﺎ ؛ ﻗد ﺗﺷﻣل اﻷظﺎﻓر‬ clears centrally; may involve nails
 Fungal infections
(Ringworm)

• Tinea cruris (“jock itch”)

• Epidermophyton floccosum, T.
rubrum, T. mentagrophyte
• Manifestation
• Skin response similar to that in tinea
corporis
‫ﻣظ ﮭر‬
• Localized to medial proximal aspect
‫اﺳﺗﺟﺎﺑﺔ اﻟﺟﻠد ﻣﻣﺎﺛﻠﺔ ﻟﺗﻠك اﻟﻣوﺟودة ﻓﻲ ﺳﻌﻔﺔ اﻟﺟﺳم‬
of thigh and crural fold; may involve
‫ﻣﺗرﺟﻣﺔ إﻟﻰ اﻟﺟﺎﻧب اﻟﻘرﯾب اﻹﻧﺳﻲ ﻣن اﻟﻔﺧذ‬
‫واﻟطﯾﺑﺔ ؛ ﻗد ﯾﺷﻣل ﻛﯾس اﻟﺻﻔن ﻋﻧد اﻟذﻛور‬ scrotum in males
‫ﺣﺎﻛﺔ‬ • Pruritic
 Treatmen and nursing care
• Local treatment with strong antifungal ointment
‫اﻟﻌﻼج اﻟﻣوﺿﻌﻲ ﺑﻣرھم ﻗوي ﻣﺿﺎد ﻟﻠﻔطرﯾﺎت‬ • Oral griseofulvin, oral ketoconazole for difficult cases
‫ ﻛﯾﺗوﻛوﻧﺎزول ﻋن طرﯾق‬، ‫اﻟﺟرﯾزوﻓوﻟﻔﯾن ﻋن طرﯾق اﻟﻔم‬ • Griseofulvin and possibly oral corticosteroids for 2 weeks to achieve
‫اﻟﻔم ﻟﻠﺣﺎﻻت اﻟﺻﻌﺑﺔ‬ therapeutic effect
‫اﻟﺟرﯾزوﻓوﻟﻔﯾن ورﺑﻣﺎ اﻟﻛورﺗﯾﻛوﺳﺗﯾروﯾدات ﻋن طرﯾق‬ • Should emphasize good health and hygiene.
‫اﻟﻔم ﻟﻣدة أﺳﺑوﻋﯾن ﻟﺗﺣﻘﯾق اﻟﺗﺄﺛﯾر اﻟﻌﻼﺟﻲ‬
• Affected children
.‫ﯾﺟب اﻟﺗﺄﻛﯾد ﻋﻠﻰ اﻟﺻﺣﺔ اﻟﺟﯾدة واﻟﻧظﺎﻓﺔ‬
• should not exchange personal items with other children
‫اﻷطﻔﺎل اﻟﻣﺗﺿررﯾن‬ such as grooming items, headgear, scarves that have been
‫ﯾﺟب ﻋدم ﺗﺑﺎدل اﻷﻏراض اﻟﺷﺧﺻﯾﺔ ﻣﻊ اﻷطﻔﺎل‬ in proximity to the infected area
‫ واﻷوﺷﺣﺔ‬، ‫ وأﻏطﯾﺔ اﻟرأس‬، ‫اﻵﺧرﯾن ﻣﺛل أدوات اﻟﻌﻧﺎﯾﺔ‬ • provided with their own towels and directed to wear a
‫اﻟﺗﻲ ﻛﺎﻧت ﻋﻠﻰ ﻣﻘرﺑﺔ ﻣن اﻟﻣﻧطﻘﺔ اﻟﻣﺻﺎﺑﺔ‬ protective cap at night to avoid transmitting the fungus to
‫ﻣزودة ﺑﻣﻧﺎﺷف ﺧﺎﺻﺔ ﺑﮭم وﻣوﺟﮭﺔ ﻻرﺗداء ﻏطﺎء واﻗﻲ‬ bedding
‫ﻟﯾﻼً ﻟﺗﺟﻧب اﻧﺗﻘﺎل اﻟﻔطرﯾﺎت إﻟﻰ اﻟﻔراش‬
• Should emphasize to family members the importance of maintaining
‫ﯾﺟب اﻟﺗﺄﻛﯾد ﻷﻓراد اﻷﺳرة ﻋﻠﻰ أھﻣﯾﺔ اﻟﺣﻔﺎظ ﻋﻠﻰ ﺟدول‬ the prescribed dosage schedule and of taking the medication with
‫اﻟﺟرﻋﺎت اﻟﻣوﺻوف وﺗﻧﺎول اﻟدواء ﻣﻊ اﻷطﻌﻣﺔ اﻟﻐﻧﯾﺔ‬ high-fat foods for best absorption.
.‫ﺑﺎﻟدھون ﻟﻠﺣﺻول ﻋﻠﻰ أﻓﺿل اﻣﺗﺻﺎص‬
 Parasitic infections
• Pediculosis Capitis (head lice)
• An infestation of the scalp by
Pediculus humanus capitis
• Common parasite in school-age
children.
(‫• ﻗﻣل اﻟرأس )ﻗﻣل اﻟرأس‬
• Manifestation
Pediculus ‫• ﻏزو ﻓروة اﻟرأس ﺑواﺳطﺔ‬
humanus capitis • Itching
.‫طﻔﯾﻠﻲ ﺷﺎﺋﻊ ﻋﻧد اﻷطﻔﺎل ﻓﻲ ﺳن اﻟﻣدرﺳﺔ‬ • • Common sites of involvement are
‫ﻣ ظ ﺎھ ر‬ • the occipital area, behind the ears,
‫ﻣﺛﯾر ﻟﻠﺣﻛﺔ‬ •
and at the nape of the neck.
• Management
‫• اﻷﻣﺎﻛن اﻟﺷﺎﺋﻌﺔ ﻟﻺﺻﺎﺑﺔ ھﻲ اﻟﻣﻧطﻘﺔ اﻟﻘذاﻟﯾﺔ وﺧﻠف‬
.‫اﻷذﻧﯾن وﻣؤﺧر اﻟﻌﻧق‬ • application of pediculicides and
‫إدارة‬ • manual removal of nit cases.
‫• اﺳﺗﺧدام ﻣﺑﯾدات اﻟﻘﻣل واﻹزاﻟﺔ اﻟﯾدوﯾﺔ ﻟﺣﺎﻻت‬
.‫اﻟﺻﺋﺑﺎن‬
 Nursing Management
• Nurses should emphasize that anyone
can get pediculosis
• Lice can be transmitted from one person
‫• ﯾﺟب ﻋﻠﻰ اﻟﻣﻣرﺿﺎت اﻟﺗﺄﻛﯾد ﻋﻠﻰ أن أي‬ to another on personal items.
‫ﺷﺧص ﯾﻣﻛن أن ﯾﺻﺎب ﺑﺎﻟﻘﻣل‬
‫• ﯾﻣﻛن أن ﯾﻧﺗﻘل اﻟﻘﻣل ﻣن ﺷﺧص إﻟﻰ آﺧر ﻓﻲ‬
• Children are cautioned against sharing
.‫اﻷﻏراض اﻟﺷﺧﺻﯾﺔ‬
combs, hair ornaments, hats, caps,
scarves, coats, and other items used on
‫ وزﺧﺎرف‬، ‫• ﯾ ُﺣذر اﻷطﻔﺎل ﻣن ﻣﺷﺎرﻛﺔ اﻷﻣﺷﺎط‬
، ‫ واﻷوﺷﺣﺔ‬، ‫ واﻟﻘﺑﻌﺎت‬، ‫ واﻟﻘﺑﻌﺎت‬، ‫اﻟﺷﻌر‬
or near the hair.
‫ واﻷﺷﯾﺎء اﻷﺧرى اﻟﻣﺳﺗﺧدﻣﺔ ﻋﻠﻰ‬، ‫واﻟﻣﻌﺎطف‬ • Lice are not carried or transmitted by
.‫اﻟﺷﻌر أو ﺑﺎﻟﻘرب ﻣﻧﮫ‬ pets.
‫• ﻻ ﯾﻧﺗﻘل اﻟﻘﻣل أو ﯾﻧﺗﻘل ﻋن طرﯾق اﻟﺣﯾواﻧﺎت‬
.‫اﻷﻟﯾﻔﺔ‬
• Nurses or parents should carefully
inspect children who scratch their heads
‫• ﯾﺟب ﻋﻠﻰ اﻟﻣﻣرﺿﺎت أو اﻵﺑﺎء ﻓﺣص اﻷطﻔﺎل‬ more than usual for bite marks, redness,
‫اﻟذﯾن ﯾﺧدﺷون رؤوﺳﮭم أﻛﺛر ﻣن اﻟﻣﻌﺗﺎد ﺑﺣﺛ ًﺎ‬ and nits.
.‫ﻋن ﻋﻼﻣﺎت اﻟﻌض واﻻﺣﻣرار واﻟﺻﺋﺑﺎن‬
 Diaper Dermatitis

• Common in infants and one of several acute inflammatory skin disorders

caused either directly or indirectly by wearing diapers.
• The peak age of occurrence is 9 to 12 months old.
• The incidence is greater in bottle-fed infants than in breastfed infants.

‫ﺷﺎﺋﻊ ﻋﻧد اﻟرﺿﻊ وواﺣد ﻣن اﻟﻌدﯾد ﻣن اﻻﺿطراﺑﺎت اﻟﺟﻠدﯾﺔ اﻻﻟﺗﮭﺎﺑﯾﺔ اﻟﺣﺎدة اﻟﺗﻲ ﺗﻧﺗﺞ ﺑﺷﻛل ﻣﺑﺎﺷر أو‬
.‫ﻏﯾر ﻣﺑﺎﺷر ﻋن طرﯾق ارﺗداء اﻟﺣﻔﺎﺿﺎت‬
.‫ ﺷﮭًرا‬12 ‫ إﻟﻰ‬9 ‫ﯾﺑﻠﻎ ﻋﻣر اﻟذروة ﻣن‬
‫ﯾﻛون اﻟﺣدوث أﻛﺑر ﻋﻧد اﻟرﺿﻊ اﻟذﯾن ﯾرﺿﻌون ﻣن اﻟزﺟﺎﺟﺔ ﻣﻘﺎرﻧﺔ ﺑﺎﻟرﺿﻊ اﻟذﯾن ﯾرﺿﻌون ﻣن‬
‫اﻟﺛدي‬
 • Causes
• Prolonged and repetitive contact with an irritant (such s
‫• اﻷﺳﺑﺎب‬
urine, feces, soaps, detergents, ointments, friction).
‫• اﻻﺗﺻﺎل اﻟﻣطول واﻟﻣﺗﻛرر ﻣﻊ ﻣﺎدة ﻣﮭﯾﺟﺔ )ﻣﺛل اﻟﺑول‬ • Diaper wetness
.(‫واﻟﺑراز واﻟﺻﺎﺑون واﻟﻣﻧظﻔﺎت واﻟﻣراھم واﻻﺣﺗﻛﺎك‬
• Chemical irritation from
‫ﺑﻠل اﻟﺣﻔﺎﺿﺎت‬ •
• Urine, feces, especially diarrheal stools
‫ﺗﮭﯾﺞ ﻛﯾﻣﯾﺎﺋﻲ ﻣن‬ • • Detergents or soaps from inadequately rinsed cloth
‫اﻟﺑول واﻟﺑراز وﺧﺎﺻﺔ اﻟﺑراز اﻹﺳﮭﺎل‬ • diapers or the chemicals in disposable wipes.
‫• اﻟﻣﻧظﻔﺎت أو اﻟﺻﺎﺑون ﻣن ﺣﻔﺎﺿﺎت اﻟﻘﻣﺎش اﻟﻣﻐﺳوﻟﺔ‬ • Candida albicans infection -It is seen in up to 90% of
‫ف أو اﻟﻣواد اﻟﻛﯾﻣﯾﺎﺋﯾﺔ اﻟﻣوﺟودة ﻓﻲ‬
ٍ ‫ﺑﺷﻛل ﻏﯾر ﻛﺎ‬ infants with chronic diaper dermatitis
.‫اﻟﻣﻧﺎدﯾل اﻟﻣﺑﻠﻠﺔ اﻟﺗﻲ ﺗﺳﺗﺧدم ﻟﻣرة واﺣدة‬ • Ammonia ---- association between the strong odor on
‫ ﺗظﮭر ﻓﻲ ﻣﺎ ﯾﺻل إﻟﻰ‬- ‫• ﻋدوى اﻟﻣﺑﯾﺿﺎت اﻟﺑﯾض‬ diapers and dermatitis.
‫ ﻣن اﻷطﻔﺎل اﻟﻣﺻﺎﺑﯾن ﺑﺎﻟﺗﮭﺎب اﻟﺟﻠد اﻟﺣﻔﺎﺿﻲ‬٪90
‫اﻟﻣزﻣن‬ • The lesions represent a variety of types and configurations.
‫ اﻻرﺗﺑﺎط ﺑﯾن اﻟراﺋﺣﺔ اﻟﻘوﯾﺔ ﻋﻠﻰ‬---- ‫• اﻷﻣوﻧﯾﺎ‬ • Manifested primarily on convex surfaces or in folds.
.‫اﻟﺣﻔﺎﺿﺎت واﻟﺗﮭﺎب اﻟﺟﻠد‬
.‫ﺗﻣﺛل اﻵﻓﺎت ﻣﺟﻣوﻋﺔ ﻣﺗﻧوﻋﺔ ﻣن اﻷﺷﻛﺎل واﻟﺗﻛوﯾﻧﺎت‬ •
‫• ﺗﺗﺟﻠﻰ ﺑﺷﻛل أﺳﺎﺳﻲ ﻋﻠﻰ اﻷﺳطﺢ اﻟﻣﺣدﺑﺔ أو ﻓﻲ‬
.‫اﻟطﯾﺎت‬
 Nursing interventions are aimed at altering the three factors
that produce dermatitis: wetness, pH, and fecal irritants.
Nursing Care
Changing the diaper as soon as it becomes wet.
Management
‫• ﺗﮭدف اﻟﺗدﺧﻼت اﻟﺗﻣرﯾﺿﯾﺔ إﻟﻰ ﺗﻐﯾﯾر اﻟﻌواﻣل‬
‫ اﻟﺑﻠل ودرﺟﺔ‬:‫اﻟﺛﻼﺛﺔ اﻟﺗﻲ ﺗؤدي إﻟﻰ اﻟﺗﮭﺎب اﻟﺟﻠد‬
.‫اﻟﺣﻣوﺿﺔ واﻟﻣﮭﯾﺟﺎت اﻟﺑرازﯾﺔ‬ Removing the diaper to expose healthy skin to air facilitates
.‫• ﺗﻐﯾﯾر اﻟﺣﻔﺎض ﺑﻣﺟرد أن ﯾﺑﺗل‬ drying.
‫• إزاﻟﺔ اﻟﺣﻔﺎض ﻟﺗﻌرﯾض اﻟﺟﻠد اﻟﺳﻠﯾم ﻟﻠﮭواء ﯾﺳﮭل‬
.‫اﻟﺗﺟﻔﯾف‬ Diaper construction has a significant impact on the
‫• ﺑﻧﺎء اﻟﺣﻔﺎﺿﺎت ﻟﮫ ﺗﺄﺛﯾر ﻛﺑﯾر ﻋﻠﻰ ﺣدوث وﺷدة‬ incidence and severity of diaper dermatitis.
.‫اﻟﺗﮭﺎب اﻟﺟﻠد اﻟﺣﻔﺎظﻲ‬
‫• اﻟﺣﻔﺎﺿﺎت اﻟورﻗﯾﺔ ﻓﺎﺋﻘﺔ اﻻﻣﺗﺻﺎص ﺗﻘﻠل ﻣن‬ Superabsorbent disposable paper diapers reduce diaper
‫ ﻧﺷﺎ اﻟذرة ﻓﻌﺎﻟﺔ ﻓﻲ ﺗﻘﻠﯾل‬.‫اﻟﺗﮭﺎب اﻟﺟﻠد اﻟﺣﻔﺎﺿﻲ‬ dermatitis.
.‫اﻻﺣﺗﻛﺎك‬
Cornstarch is effective in reducing friction.
 Guidelines for controlling diaper rash
• Keep skin dry
• Use superabsorbent disposable diapers to reduce skin wetness.
• Change diapers as soon as soiled especially with stool.
• Expose healthy or only slightly irritated skin to air, not heat, to dry completely.
• Apply ointment, such as zinc oxide or petrolatum, to protect skin, especially if skin is very red or has
moist, open areas.

‫• ﺣﺎﻓظ ﻋﻠﻰ ﺟﻔﺎف اﻟﺟﻠد‬

.‫• اﺳﺗﺧدم ﺣﻔﺎﺿﺎت ﻓﺎﺋﻘﺔ اﻻﻣﺗﺻﺎص ﻟﺗﻘﻠﯾل ﺑﻠل اﻟﺟﻠد‬
.‫• ﺗﻐﯾﯾر اﻟﺣﻔﺎﺿﺎت ﺑﻣﺟرد اﺗﺳﺎﺧﮭﺎ ﺧﺎﺻﺔ ﻣﻊ اﻟﺑراز‬
.‫• ﺗﻌرﯾض اﻟﺑﺷرة اﻟﺳﻠﯾﻣﺔ أو اﻟﻣﺗﮭﯾﺟﺔ ﻗﻠﯾًﻼ ﻟﻠﮭواء وﻟﯾس اﻟﺣرارة ﺣﺗﻰ ﺗﺟف ﺗﻣﺎًﻣﺎ‬
.‫ ﺧﺎﺻﺔً إذا ﻛﺎن اﻟﺟﻠد ﺷدﯾد اﻻﺣﻣرار أو ﺑﮫ ﻣﻧﺎطق رطﺑﺔ وﻣﻔﺗوﺣﺔ‬، ‫ ﻟﺣﻣﺎﯾﺔ اﻟﺟﻠد‬، ‫ ﻣﺛل أﻛﺳﯾد اﻟزﻧك أو اﻟﻔﺎزﻟﯾن‬، ‫• ﺿﻊ ﻣرھًﻣﺎ‬
 Cont‘
• Avoid removing skin barrier cream with each diaper change; remove waste material and reapply
skin barrier cream.
• Use mineral oil; to completely remove ointment, especially zinc oxide.
• Avoid over washing the skin, especially with perfumed soaps or commercial wipes.
• May use a moisturizer or non-soap cleanser, such as cold cream or Cetaphil, to wipe urine from
skin.
• Gently wipe stool from skin using a soft cloth and warm water. Use disposable diaper wipes that
are detergent- and alcohol-free

.‫ﺗﺟﻧب إزاﻟﺔ ﻛرﯾم ﺣﺎﺟز اﻟﺟﻠد ﻣﻊ ﻛل ﺗﻐﯾﯾر ﻟﻠﺣﻔﺎﺿﺎت ؛ إزاﻟﺔ اﻟﻧﻔﺎﯾﺎت وإﻋﺎدة ﺗطﺑﯾق ﻛرﯾم ﺣﺎﺟز اﻟﺑﺷرة‬
.‫اﺳﺗﺧدام اﻟزﯾوت اﻟﻣﻌدﻧﯾﺔ ﻹزاﻟﺔ اﻟﻣرھم ﻧﮭﺎﺋﯾﺎ ً وﺧﺎﺻﺔ أﻛﺳﯾد اﻟزﻧك‬
.‫ ﺧﺎﺻﺔً ﺑﺎﻟﺻﺎﺑون اﻟﻣﻌطر أو اﻟﻣﻧﺎدﯾل اﻟﻣﺑﻠﻠﺔ اﻟﺗﺟﺎرﯾﺔ‬، ‫ﺗﺟﻧب اﻹﻓراط ﻓﻲ ﻏﺳل اﻟﺟﻠد‬
.‫ ﻟﻣﺳﺢ اﻟﺑول ﻣن اﻟﺟﻠد‬، ‫ ﻣﺛل اﻟﻛرﯾم اﻟﺑﺎرد أو ﺳﯾﺗﺎﻓﯾل‬، ‫ﯾﻣﻛن اﺳﺗﺧدام ﻣرطب أو ﻣﻧظف ﻏﯾر ﺻﺎﺑون‬
‫ اﺳﺗﺧدم ﻣﻧﺎدﯾل ﺣﻔﺎﺿﺎت ﯾﻣﻛن اﻟﺗﺧﻠص ﻣﻧﮭﺎ وﺧﺎﻟﯾﺔ ﻣن اﻟﻣﻧظﻔﺎت واﻟﻛﺣول‬.‫اﻣﺳﺢ اﻟﺑراز ﻣن اﻟﺟﻠد ﺑرﻓق ﺑﺎﺳﺗﺧدام ﻗطﻌﺔ ﻗﻣﺎش ﻧﺎﻋﻣﺔ وﻣﺎء داﻓﺊ‬
 Atopic Dermatitis (AD)
(Eczema)
• A type of pruritic eczema that usually begins during infancy and
is associated with an allergic contact dermatitis with a
hereditary tendency (atopy)
• AD’s manifestation based on child's age and the distribution of
lesions

‫• ﻧوع ﻣن اﻹﻛزﯾﻣﺎ اﻟﺣﺎﻛﺔ ﯾﺑدأ ﻋﺎدة ً ﻓﻲ أﺛﻧﺎء اﻟطﻔوﻟﺔ وﯾﺗراﻓق ﻣﻊ اﻟﺗﮭﺎب اﻟﺟﻠد‬
(‫اﻟﺗﻣﺎﺳﻲ اﻟﺗﺣﺳﺳﻲ ﻣﻊ ﻣﯾل وراﺛﻲ )اﻟﺗﺄﺗب‬
‫• ظﮭور ﻣرض اﻟزھﺎﯾﻣر ﺑﻧﺎًء ﻋﻠﻰ ﻋﻣر اﻟطﻔل وﺗوزﯾﻊ اﻵﻓﺎت‬
 Child’s Age Distribution of Lesions Appearance of Lesions
Infantile (infantile eczema) begins at 2 to 6 months of age, generally Generalized, especially cheeks, Erythema, vesicles papules, weeping oozing,
undergoes spontaneous remission by 3 scalp, trunk, and extensor surfaces crusting scaling, often symmetric
years of age of extremities
Childhood occurs at 2 to 3 years of age; 90% of Flexural areas (antecubital and Symmetric involvement, Clusters of small
children have manifestations by 5 years popliteal fossae, neck), wrists, erythematous or minimally scaling patches,
of age ankles, and feet Dry and may be hyperpigmented,
Lichenification (thickened skin with
accentuation of creases, Keratosis pilaris
(follicular hyperkeratosis) common
Preadolescent and Begins at about 12 years of age; may Face, sides of neck, hands, feet, same as childhood manifestations, Dry, thick
adolescent continue into the early adult years or face, and antecubital and popliteal lesions (lichenified plaques) common
indefinitely fossae (to a lesser extent) Confluent papules

clinical Manifestations of AD
 Therapeutic Management
• The major goals of management are to hydrate the skin, relieve pruritus, prevent and
minimize flare-ups or inflammation, and prevent and control secondary infection.
• Management strategies for reducing pruritus include:
• Avoiding exposure to skin irritants or allergens (e.g. soaps, detergents, fabric
softeners, perfumes, and powders)
• Avoiding overheating (proper dress for climatic conditions is essential)
• Administrating medications such as antihistamines, topical immunomodulators,
topical steroids, and (sometimes) mild sedatives, as indicated.
• Enhancing skin hydration and preventing dry skin

.‫• ﺗﺗﻣﺛل اﻷھداف اﻟرﺋﯾﺳﯾﺔ ﻟﻺدارة ﻓﻲ ﺗرطﯾب اﻟﺟﻠد وﺗﺧﻔﯾف اﻟﺣﻛﺔ وﻣﻧﻊ وﺗﻘﻠﯾل اﻟﻧوﺑﺎت أو اﻻﻟﺗﮭﺎﺑﺎت وﻣﻧﻊ اﻟﻌدوى اﻟﺛﺎﻧوﯾﺔ واﻟﺳﯾطرة ﻋﻠﯾﮭﺎ‬
:‫• ﺗﺷﻣل اﺳﺗراﺗﯾﺟﯾﺎت اﻹدارة ﻟﺗﻘﻠﯾل اﻟﺣﻛﺔ ﻣﺎ ﯾﻠﻲ‬
(‫ﺗﺟﻧب اﻟﺗﻌرض ﻟﻣﮭﯾﺟﺎت اﻟﺟﻠد أو ﻣﺳﺑﺑﺎت اﻟﺣﺳﺎﺳﯾﺔ )ﻣﺛل اﻟﺻﺎﺑون واﻟﻣﻧظﻔﺎت وﻣﻧﻌﻣﺎت اﻷﻗﻣﺷﺔ واﻟﻌطور واﻟﻣﺳﺎﺣﯾق‬ •
(‫• ﺗﺟﻧب ارﺗﻔﺎع درﺟﺔ اﻟﺣرارة )ارﺗداء اﻟﻣﻼﺑس اﻟﻣﻧﺎﺳﺑﺔ ﻟﻠظروف اﻟﻣﻧﺎﺧﯾﺔ أﻣر ﺿروري‬
.‫ ﻛﻣﺎ ھو ﻣﺣدد‬، ‫ و )أﺣﯾﺎﻧًﺎ( اﻟﻣﮭدﺋﺎت اﻟﺧﻔﯾﻔﺔ‬، ‫ واﻟﻣﻧﺷطﺎت اﻟﻣوﺿﻌﯾﺔ‬، ‫ وﻣﻌدﻻت اﻟﻣﻧﺎﻋﺔ اﻟﻣوﺿﻌﯾﺔ‬، ‫• إدارة اﻷدوﯾﺔ ﻣﺛل ﻣﺿﺎدات اﻟﮭﯾﺳﺗﺎﻣﯾن‬
‫• ﯾﻌزز ﺗرطﯾب اﻟﺑﺷرة وﯾﻣﻧﻊ ﺟﻔﺎﻓﮭﺎ‬
 Nursing Care Management
• Assessment of the child with AD includes:
:‫• ﯾﺷﻣل ﺗﻘﯾﯾم اﻟطﻔل اﻟﻣﺻﺎب ﺑﻣرض اﻟزھﺎﯾﻣر‬ • A family history for evidence of atopy
‫• ﺗﺎرﯾﺦ ﻋﺎﺋﻠﻲ ﻟﻠﺣﺻول ﻋﻠﻰ دﻟﯾل ﻋﻠﻰ اﻟﺗﺄﺗب‬ • A history of previous involvement
‫• ﺗﺎرﯾﺦ ﻣن اﻟﺗدﺧل اﻟﺳﺎﺑق‬ • Any environmental or dietary factors associated with the present and
previous exacerbations.
.‫أي ﻋواﻣل ﺑﯾﺋﯾﺔ أو ﻏذاﺋﯾﺔ ﻣرﺗﺑطﺔ ﺑﺎﻟﺗﻔﺎﻗم اﻟﺣﺎﻟﻲ واﻟﺳﺎﺑق‬ •
• Examined the skin lesions for type, distribution, and evidence of secondary
‫• ﻓﺣﺻت اﻵﻓﺎت اﻟﺟﻠدﯾﺔ ﻟﻣﻌرﻓﺔ ﻧوﻋﮭﺎ وﺗوزﯾﻌﮭﺎ وإﺛﺑﺎت وﺟود‬ infection.
.‫ﻋدوى ﺛﺎﻧوﯾﺔ‬
‫ ﺧﺎﺻﺔ ﻓﯾﻣﺎ‬، ‫ • • أﺟرى ﻣﻘﺎﺑﻠﺔ ﻣﻊ اﻟواﻟدﯾن ﺑﺧﺻوص ﺳﻠوك اﻟطﻔل‬Interviewed the parents regarding the child's behavior, especially in relation
.‫ﯾﺗﻌﻠق ﺑﺎﻟﺧدش واﻟﺗﮭﯾﺞ وأﻧﻣﺎط اﻟﻧوم‬ to scratching, irritability, and sleeping patterns.
‫اﺳﺗﻛﺷﺎف ﻣﺷﺎﻋر اﻷﺳرة وطرق اﻟﺗﻌﺎﯾش ﻣﻌﮭﺎ‬ • • Exploration of the family's feelings and methods of coping
.‫اﻟﺳﯾطرة ﻋﻠﻰ اﻟﺣﻛﺔ اﻟﺷدﯾدة‬ • • Controlling the intense pruritus.
‫ﻟﻣﻧﻊ أو ﺗﻘﻠﯾل اﻟﺧدش‬ • • To prevent or minimize the scratching
.‫ﯾﺗم ﻗص أظﺎﻓر اﻟﯾدﯾن واﻟﻘدﻣﯾن واﻟﺣﻔﺎظ ﻋﻠﯾﮭﺎ ﻧظﯾﻔﺔ‬ • • Fingernails and toenails are cut short, kept clean.
• Gloves or cotton stockings can be placed over the hands and
‫• ﯾﻣﻛن وﺿﻊ اﻟﻘﻔﺎزات أو اﻟﺟوارب اﻟﻘطﻧﯾﺔ ﻋﻠﻰ اﻟﯾدﯾن وﺗﺛﺑﯾﺗﮭﺎ‬
.‫ﻋﻠﻰ أﻛﻣﺎم اﻟﻘﻣﺻﺎن‬ pinned to shirtsleeves.
• One-piece outfits with long sleeves and long pants also decrease
‫• ﻛﻣﺎ أن اﻟﻣﻼﺑس اﻟﻣﻛوﻧﺔ ﻣن ﻗطﻌﺔ واﺣدة ﺑﺄﻛﻣﺎم طوﯾﻠﺔ‬
.‫ﺿﺎ ﻣن اﻻﺗﺻﺎل اﻟﻣﺑﺎﺷر ﺑﺎﻟﺟﻠد‬
ً ‫وﺳراوﯾل طوﯾﻠﺔ ﺗﻘﻠل أﯾ‬ direct contact with the skin.
 Cont.
• Proper dress for climatic conditions
• Pruritus is often precipitated by exposure to the irritant effects of certain components of common
products, such as soaps, detergents, fabric softeners, perfumes, and powders.
• Avoid the exposure to latex products, such as gloves and balloons
• Apply wet soaks and compresses and administer medications for pruritus or infection as directed.
• Educate the family about the preparation and use of soaks, special baths, and topical medications
• Emphasize that one thick application of topical medication is not equivalent to several thin
applications and that excessive use of an agent (steroids) can be hazardous.

‫• اﻟﻠﺑﺎس اﻟﻣﻧﺎﺳب ﻟﻠظروف اﻟﻣﻧﺎﺧﯾﺔ‬

.‫ ﻣﺛل اﻟﺻﺎﺑون واﻟﻣﻧظﻔﺎت وﻣﻧﻌﻣﺎت اﻷﻗﻣﺷﺔ واﻟﻌطور واﻟﻣﺳﺎﺣﯾق‬، ‫• ﻏﺎﻟﺑًﺎ ﻣﺎ ﺗﺗﺳﺑب اﻟﺣﻛﺔ ﻓﻲ اﻟﺗﻌرض ﻟﻠﺗﺄﺛﯾرات اﻟﻣﮭﯾﺟﺔ ﻟﺑﻌض ﻣﻛوﻧﺎت اﻟﻣﻧﺗﺟﺎت اﻟﺷﺎﺋﻌﺔ‬
‫ ﻣﺛل اﻟﻘﻔﺎزات واﻟﺑﺎﻟوﻧﺎت‬، ‫• ﺗﺟﻧب اﻟﺗﻌرض ﻟﻣﻧﺗﺟﺎت اﻟﻼﺗﻛس‬
.‫• ﺿﻊ اﻟﻣﻧﻘﻊ واﻟﻛﻣﺎدات اﻟﻣﺑﻠﻠﺔ وأدوﯾﺔ ﻋﻼج اﻟﺣﻛﺔ أو اﻟﻌدوى ﺣﺳب اﻟﺗوﺟﯾﮭﺎت‬
‫• ﺗوﻋﯾﺔ اﻷﺳرة ﺣول ﻛﯾﻔﯾﺔ ﺗﺣﺿﯾر واﺳﺗﺧدام اﻟﻧﻘﻊ واﻟﺣﻣﺎﻣﺎت اﻟﺧﺎﺻﺔ واﻷدوﯾﺔ اﻟﻣوﺿﻌﯾﺔ‬
.‫• أﻛد ﻋﻠﻰ أن اﻻﺳﺗﺧدام اﻟﻛﺛﯾف ﻟﻸدوﯾﺔ اﻟﻣوﺿﻌﯾﺔ ﻻ ﯾﻌﺎدل ﻋدة ﺗطﺑﯾﻘﺎت رﻓﯾﻌﺔ وأن اﻻﺳﺗﺧدام اﻟﻣﻔرط ﻟﻌﺎﻣل )اﻟﻣﻧﺷطﺎت( ﯾﻣﻛن أن ﯾﻛون ﺧطﯾًرا‬
 Cont.
• Parents are assured that the lesions will not produce scarring and that the disease is not contagious..
• Parents need help to understand the reason for the diet modification and the guidelines for avoiding
hyperallergenic foods.
• Hypoallergenic diets take time before visible effects are apparent, parents need reassurance that
results may not be seen immediately.
• During acute phases, the family need time to discuss negative feelings and to be reassured that these
feelings are normal.
• Stress tends to aggravate the severity of the condition.

.. ‫• ﯾﺗﺄﻛد اﻵﺑﺎء ﻣن أن اﻵﻓﺎت ﻟن ﺗﺳﺑب ﻧدﺑﺎت وأن اﻟﻣرض ﻟﯾس ﻣﻌدﯾًﺎ‬

.‫• ﯾﺣﺗﺎج اﻵﺑﺎء إﻟﻰ اﻟﻣﺳﺎﻋدة ﻓﻲ ﻓﮭم ﺳﺑب ﺗﻌدﯾل اﻟﻧظﺎم اﻟﻐذاﺋﻲ واﻟﻣﺑﺎدئ اﻟﺗوﺟﯾﮭﯾﺔ ﻟﺗﺟﻧب اﻷطﻌﻣﺔ ﺷدﯾدة اﻟﺣﺳﺎﺳﯾﺔ‬
.‫ وﯾﺣﺗﺎج اﻵﺑﺎء إﻟﻰ اﻟطﻣﺄﻧﯾﻧﺔ ﺑﺄن اﻟﻧﺗﺎﺋﺞ ﻗد ﻻ ﺗظﮭر ﻋﻠﻰ اﻟﻔور‬، ‫ﺗﺳﺗﻐرق اﻷﻧظﻣﺔ اﻟﻐذاﺋﯾﺔ اﻟﺗﻲ ﻻ ﺗﺳﺑب اﻟﺣﺳﺎﺳﯾﺔ وﻗﺗ ًﺎ ﻗﺑل ظﮭور اﻟﺗﺄﺛﯾرات اﻟﻣرﺋﯾﺔ‬ •
.‫ ﺗﺣﺗﺎج اﻷﺳرة إﻟﻰ وﻗت ﻟﻣﻧﺎﻗﺷﺔ اﻟﻣﺷﺎﻋر اﻟﺳﻠﺑﯾﺔ واﻟﺗﺄﻛد ﻣن أن ھذه اﻟﻣﺷﺎﻋر طﺑﯾﻌﯾﺔ‬، ‫• ﺧﻼل اﻟﻣراﺣل اﻟﺣﺎدة‬
‫ﯾﻣﯾل اﻹﺟﮭﺎد إﻟﻰ ﺗﻔﺎﻗم ﺷدة اﻟﺣﺎﻟﺔ‬ •
References

1. Wong’s Essentials of Pediatric

Nursing, 10th Edition, Elsevier
Publication, Page No: 373-389, 656-
662.