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Dematological Fungal diseases (Ring worm (Nursing management and health…
Dematological Fungal diseases
Athlet`s foot
Pathophysiology
Athlete’s foot is an infection caused by a type of fungus known as a dermatophyte.
Able to infect only the top layer of dead keratin, dermatophytes affect the skin, hair shafts, and nails. Dermatophytes are classified into three genera: Trichophyton, Microsporum, and Epidermophyton.
T. rubrum is the dermatophyte most commonly associated with athlete’s foot. Although other dermatophytes can also cause the condition, they are less frequently isolated from humans.
Fungal spores from T. rubrum can live in human scales for 12 months and are therefore easily transmitted from person to person in locker rooms and public showers.
Causes
microscopic fungus that lives on dead tissue of the hair, toenails, and outer skin layers.
The most common of these fungi is trichophyton rubrum.
Clinical manifestation
itching, stinging, and burning between your toes or on soles of your feet.
blisters on your feet that itch.
cracking and peeling skin on your feet, most commonly between your toes and on your soles.
dry skin on your soles or sides of your feet.
Pharmacological treatment
Antifungal medications
topical, prescription-strength clotrimazole or miconazole
oral antifungal medications such as itraconazole (Sporanox), fluconazole (Diflucan), or prescription-strength terbinafine (Lamisil)
topical steroid medications to reduce painful inflammation
oral antibiotics if bacterial infections develop due to raw skin and blisters
Complications
Foot may be swollen
Pus drainage
Distriction of the lymphatic system
Nursing management and health education
Perform a physical exam and identify the source of problem and discuss treatment options.
Recommend proper foot hygiene and methods to minimize perspiration.
Recommend a topical anti-fungal medication.
Recommend footwear and over-the-counter products that protect the feet from re-infection.
Advice patient to keep shoes and socks dry as a preventative measure
Instruct patient to wear cotton or wool socks to help wick moisture
Teach patient to practice good foot hygiene, including daily washing of the feet with soap and water
Administer fungal foot sprays
Be sure to dry the patient’s feet thoroughly, especially between the toes, and remove
dead or thickened skin carefully before applying medicines (sprays / powders / ointments).
Teach the client to keep his feet as dry as possible, including the area between the toes.
Small pieces of cotton can be placed between the toes at night to absorb moisture.
Socks should be made of absorbent white cotton because synthetic material does not absorb perspiration.
Instruct the client to apply talcum powder or antifungal powder twice daily.
Instruct the client to alternate shoes so they can dry completely before being worn again.
Monitor for marked pain, pronounced skin changes such as spreading to other areas,
extreme redness, oozing, extreme cracking, or other persistent problems.
Diagnostic test
a doctor may order a skin test if they aren't sure a fungal infection is causing your symptoms. A skin lesion potassium hydroxide exam is the most common test for athlete's foot.
Ring worm
Dermatophytes preferentially inhabit the nonliving, cornified layers of the skin, hair, and nail, which is attractive for its warm, moist environment conducive to fungal proliferation.
Fungi may release keratinases and other enzymes to invade deeper into the stratum corneum, although typically the depth of infection is limited to the epidermis and, at times, its appendages.
They generally do not invade deeply, owing to nonspecific host defense mechanisms that can include the activation of serum inhibitory factor, complement, and polymorphonuclear leukocytes.
Following the incubation period of 1-3 weeks, dermatophytes invade peripherally in a centrifugal pattern. In response to the infection, the active border has an increased epidermal cell proliferation with resultant scaling
Causes
Human to human. Ringworm often spreads by direct,
skin-to-skin contact with an infected person.
Animal to human. You can contract
ringworm by touching an animal with ringworm. Ringworm can spread while petting
or grooming dogs or cats. It's also fairly common in cows.
Object to human. Ringworm can spread by contact
with objects or surfaces that an infected person or animal has recently touched
or rubbed against, such as clothing, towels, bedding and linens, combs, and brushes.
Soil to human. In rare cases, ringworm can be spread to humans by contact with infected soil.
Infection would most likely occur only from prolonged contact with highly infected soil
Complications
A fungal infection rarely spreads below the surface of the skin to cause serious illness. But people with weak immune systems, such as those with HIV/AIDS, may find it difficult to get rid of the infection.
Diagnostic studies
Your doctor might be able to diagnose ringworm simply by looking at it
some skin scrapings from the affected area so they can be examined under a microscope.
Clinical manifestation
Skin: darkening of the skin, fissures, peeling, red rashes, or scaly patches
hair loss or itchy scalp
Pharmacological treatment
If over-the-counter treatments don't work, you may need prescription-strength antifungal medications — such as creams or lotions that you apply to the affected skin.
If your infection is particularly severe or extensive, your doctor might prescribe antifungal pills.
Nursing management and health education
Assess the affected area
Apply antifungal lotions as prescribes
Discourage a patient from scrubbing the itching area
Keep the patient in doors avoid light
Teach the patient about personal hygiene
Give anti fungal medications as prescribed