Atopic Dermatitis vs Contact Dermatitis

Dermatitis” simply means inflammation of the skin and the term is used interchangeably with “eczema”, defined as an inflammatory process of the skin characterised variably by erythema, oedema, vesiculation, scaling, fissuring and lichenification, depending on severity and chronicity.

Atopic dermatitis

Atopic dermatitis is a chronic skin disorder characterized by superficial skin inflammation and intense itching. It may also be called atopic eczema or infantile eczema.

Atopic dermatitis may be associated with other atopic diseases, such as bronchial asthma and allergic rhinitis. It usually develops in infants and toddlers between ages 1 month and 1 year, commonly in those with strong family histories of atopic disease. In many cases, these children acquire other atopic disorders as they grow older.
Typically, this form of dermatitis flares and subsides repeatedly before finally resolving during adolescence. However, it can persist into adulthood.

Key signs and symptoms (Atopic dermatitis ) 

Erythematous lesions that eventually become scaly and lichenified
Excessive dry skin
Hyperpigmentation
Skin eruptions

Key test results

Serum immunoglobulin E levels are commonly elevated but this finding isn’t diagnostic.

Key treatments

Antihistamines: diphenhydramine (Benadryl), hydroxyzine (Vistaril)
Corticosteroid: hydrocortisone

Key interventions

Help the client set up an individual schedule and plan for daily skin care.
Instruct the client to bathe in plain water. (He may have to limit bathing, according to the severity of the lesions.) Tell him to bathe with a special nonfatty soap and tepid water (96° F [35.6° C]), to avoid using any soap when lesions are acutely inflamed, and to limit baths or showers to 5 to 7 minutes.
For scalp involvement, advise the client to shampoo frequently and apply corticosteroid solution to the scalp afterward.

Contact dermatitis

Contact dermatitis, also known as diaper rash, is a local skin reaction in the areas normally covered by a diaper.

CAUSES

Irritation caused by acidic urine and fecal enzymes
Moist, warm environment contained by a plastic diaper lining
• Clothing dyes or the soaps used to wash diapers
Body soaps, bubble baths, tight clothes, and wool or rough clothing

ASSESSMENT FINDINGS

Characteristic bright red, maculopapular rash in the diaper area
Irritability because the rash is painful and warm

DIAGNOSTIC TEST RESULTS

Diagnostic testing isn’t necessary. Diagnosis is based on inspection.

NURSING DIAGNOSES

Acute pain
Impaired skin integrity
Risk for infection

TREATMENT

Cleaning the affected area with mild soap and water
Leaving the affected area open to air

CONTACT DERMATITIS (DIAPER RASH)

Key signs and symptoms

Characteristic bright red, maculopapular rash in the diaper area

Key treatments

Cleaning affected area with mild soap and water
Leaving affected area open to air
Zinc oxide or vitamin A ointment

Key interventions

Keep the diaper area clean and dry.


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