Giddens Handouts

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7/31/2012 1 Obesity: Skin Problems and Care Obesity: Skin Problems and Care Produced by the Alabama Department of Public Health Video Communications and Distance Learning Division Produced by the Alabama Department of Public Health Video Communications and Distance Learning Division Satellite Conference and Live Webcast Wednesday, May 23, 2012 2:00 – 4:00 p.m. Central Time Satellite Conference and Live Webcast Wednesday, May 23, 2012 2:00 – 4:00 p.m. Central Time Faculty Faculty Jacqueline Giddens, RN, MSN, WOCN, CWCCN Clinical Nurse Consultant Alabama Department of Public Health Jacqueline Giddens, RN, MSN, WOCN, CWCCN Clinical Nurse Consultant Alabama Department of Public Health Bariatrics Bariatrics Bariatrics /bar·i·at·rics/ (-e-ă triks) a field of medicine encompassing the study of overweight and its causes, prevention, and treatment Bariatrics /bar·i·at·rics/ (-e-ă triks) a field of medicine encompassing the study of overweight and its causes, prevention, and treatment Skin is an ORGAN Skin is an ORGAN Did you know the skin is an organ? Largest organ Heaviest organ Did you know the skin is an organ? Largest organ Heaviest organ 15% of body weight 15% of body weight Skin Is an ORGAN Skin Is an ORGAN In a 150 pound person, the skin weighs about 12 pounds and can cover 18 square feet These numbers increase with the In a 150 pound person, the skin weighs about 12 pounds and can cover 18 square feet These numbers increase with the obese patient obese patient Skin Changes Skin Changes Acanthosis Nigricans Dark patches Skin tags Acanthosis Nigricans Dark patches Skin tags Stretch marks Stasis dermatitis Varicose veins Stretch marks Stasis dermatitis Varicose veins

Transcript of Giddens Handouts

Page 1: Giddens Handouts

7/31/2012

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Obesity: Skin Problems and Care

Obesity: Skin Problems and Care

Produced by the Alabama Department of Public HealthVideo Communications and Distance Learning DivisionProduced by the Alabama Department of Public HealthVideo Communications and Distance Learning Division

Satellite Conference and Live WebcastWednesday, May 23, 2012

2:00 – 4:00 p.m. Central Time

Satellite Conference and Live WebcastWednesday, May 23, 2012

2:00 – 4:00 p.m. Central Time

FacultyFaculty

Jacqueline Giddens, RN, MSN, WOCN, CWCCNClinical Nurse Consultant

Alabama Department of Public Health

Jacqueline Giddens, RN, MSN, WOCN, CWCCNClinical Nurse Consultant

Alabama Department of Public Health

BariatricsBariatrics• Bariatrics /bar·i·at·rics/ (-e-ă triks) a

field of medicine encompassing the

study of overweight and its causes,

prevention, and treatment

• Bariatrics /bar·i·at·rics/ (-e-ă triks) a

field of medicine encompassing the

study of overweight and its causes,

prevention, and treatment

Skin is an ORGANSkin is an ORGAN• Did you know the skin is an organ?

– Largest organ

– Heaviest organ

• Did you know the skin is an organ?

– Largest organ

– Heaviest organ

• 15% of body weight• 15% of body weight

Skin Is an ORGANSkin Is an ORGAN– In a 150 pound person, the skin

weighs about 12 pounds and can

cover 18 square feet

– These numbers increase with the

– In a 150 pound person, the skin

weighs about 12 pounds and can

cover 18 square feet

– These numbers increase with the

obese patientobese patient

Skin ChangesSkin Changes

• Acanthosis Nigricans

– Dark patches

• Skin tags

• Acanthosis Nigricans

– Dark patches

• Skin tags

• Stretch marks

• Stasis dermatitis

• Varicose veins

• Stretch marks

• Stasis dermatitis

• Varicose veins

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Acanthosis Nigricans Acanthosis Nigricans • Presentation

– Velvety, light-brown-to-black

markings that occur in areas

including the neck, armpits, groin,

• Presentation

– Velvety, light-brown-to-black

markings that occur in areas

including the neck, armpits, groin, g , p , g ,

and under the breasts

• Treatment

– Weight loss

– Insulin control

g , p , g ,

and under the breasts

• Treatment

– Weight loss

– Insulin control

Acanthosis NigricansAcanthosis Nigricans

Acanthosis NigricansAcanthosis Nigricans Skin TagsSkin Tags

• Presentation

– Growths that stick out and may be

connected to the skin with a

narrow stock

• Presentation

– Growths that stick out and may be

connected to the skin with a

narrow stocknarrow stock

• The extra weight causes friction

between the affected areas of

skin

narrow stock

• The extra weight causes friction

between the affected areas of

skin

Skin TagsSkin Tags

• Treatment

– Laser or surgical removal

• Treatment

– Laser or surgical removal

Stretch Marks Stretch Marks

• Presentation

– Indented streaks that appear in the

skin called striate, pink, reddish, or

purplish

• Presentation

– Indented streaks that appear in the

skin called striate, pink, reddish, or

purplishpurplish

• Treatment

– Laser therapy

– Creams

purplish

• Treatment

– Laser therapy

– Creams

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Skin TagsSkin Tags Stretch MarksStretch Marks

Stasis DermatitisStasis Dermatitis• Presentation

– Darkening or redness of skin at the

ankles or legs

– Itching

• Presentation

– Darkening or redness of skin at the

ankles or legs

– ItchingItching

– Leg pains

– Skin lesion

– Skin appears thin, tissue-like

Itching

– Leg pains

– Skin lesion

– Skin appears thin, tissue-like

Stasis DermatitisStasis Dermatitis– Skin irritation of the legs

– Thickening of skin at the ankles or

legs

– Open sores ulcers

– Skin irritation of the legs

– Thickening of skin at the ankles or

legs

– Open sores ulcersOpen sores, ulcersOpen sores, ulcers

Stasis DermatitisStasis Dermatitis• Treatment

– Disease management

• Compression for Venous Stasis

Di

• Treatment

– Disease management

• Compression for Venous Stasis

DiDisease

• Prevention of trauma to areas

Disease

• Prevention of trauma to areas

Stasis DermatitisStasis Dermatitis– Open wounds

• Topical antibiotics

• Anti-fungals

– Open wounds

• Topical antibiotics

• Anti-fungals

• Antimicrobial dressings• Antimicrobial dressings

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Stasis DermatitisStasis Dermatitis Stasis DermatitisStasis Dermatitis

Varicose Veins Varicose Veins

• Presentation

– Swollen, enlarged veins that are

raised above the skin's surface

• Presentation

– Swollen, enlarged veins that are

raised above the skin's surface

• Usually on the inside of the legs

and backs of the calves

• Usually on the inside of the legs

and backs of the calves

Varicose Veins Varicose Veins

• Treatment

– Compression stockings

– Laser

• Treatment

– Compression stockings

– Laser

– Surgery– Surgery

Varicose VeinsVaricose Veins Varicose VeinsVaricose Veins

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Skin InfectionsSkin Infections• Candidiasis Albicans

• Cellulitis

• Folliculitis

• Candidiasis Albicans

• Cellulitis

• Folliculitis

• Erythrasma

• Tinea Cruris

• Erythrasma

• Tinea Cruris

CandiasisCandiasis• Presentation

– Itchy, red, or purple patch on the

skin with lesions

F l t

• Presentation

– Itchy, red, or purple patch on the

skin with lesions

F l t– Fungal, yeast– Fungal, yeast

CandiasisCandiasis• Treatment

– Topical antifungal

• Over the counter or prescription

• Treatment

– Topical antifungal

• Over the counter or prescription

– Oral antifungals

– IV antifungals

– Oral antifungals

– IV antifungals

CandiasisCandiasis

CandiasisCandiasis CellulitisCellulitis• Presentation

– Cased by bacteria

– Pain, tenderness, redness, warmth,

weepy

• Presentation

– Cased by bacteria

– Pain, tenderness, redness, warmth,

weepyweepy

– Chills, shaking, muscle aches and

sweating

weepy

– Chills, shaking, muscle aches and

sweating

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CellulitisCellulitis

• Treatment

– Good hygiene

– Oral or IV antibiotics

• Treatment

– Good hygiene

– Oral or IV antibiotics

– Wound care, if indicated– Wound care, if indicated

CellulitisCellulitis

CellulitisCellulitis FolliculitisFolliculitis• Presentation

– Small to medium sized whiteheads

around one or more of the hair

follicles

• Presentation

– Small to medium sized whiteheads

around one or more of the hair

folliclesfollicles

– Redness around hair follicles

– Usually in patches

follicles

– Redness around hair follicles

– Usually in patches

FolliculitisFolliculitis• Treatment

– Good hygiene

– Oral or IV antibiotics

• Treatment

– Good hygiene

– Oral or IV antibiotics

– Topical antibiotics to support the

oral or IV antibiotics

– Topical antibiotics to support the

oral or IV antibiotics

FolliculitisFolliculitis

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FolliculitisFolliculitis ErythrasmaErythrasma• Presentation

– Raised, reddish brown, scaly,

patches

– Itches

• Presentation

– Raised, reddish brown, scaly,

patches

– Itches– Itches

– Caused by bacterial infection

– Appears between skin folds, groin,

armpits, and knees

– Spreads if untreated

– Itches

– Caused by bacterial infection

– Appears between skin folds, groin,

armpits, and knees

– Spreads if untreated

ErythrasmaErythrasma• Treatment

– Keep area dry

– Wash with antibacterial soap and

i ll

• Treatment

– Keep area dry

– Wash with antibacterial soap and

i llrinse well

– Topical antifungals, antibiotics,

moisture barriers

rinse well

– Topical antifungals, antibiotics,

moisture barriers

ErythrasmaErythrasma– Oral or IV antibiotics

• Erythromycin or Azithromycin

– Photo-therapy with specialized

li ht

– Oral or IV antibiotics

• Erythromycin or Azithromycin

– Photo-therapy with specialized

li htlightslights

ErythrasmaErythrasma ErythrasmaErythrasma

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ErythrasmaErythrasma Tinea CrurisTinea Cruris• Presentation

– “Jock Itch”

– Red, patchy rash

• Presentation

– “Jock Itch”

– Red, patchy rash

– Found in groin areas

– Fungal skin infection

– Found in groin areas

– Fungal skin infection

Tinea CrurisTinea Cruris

• Treatment

– Topical antifungal

– Oral antifungal if needed

• Treatment

– Topical antifungal

– Oral antifungal if needed

– Keep skin clean and dry– Keep skin clean and dry

Tinea Cruris (Jock Itch)Tinea Cruris (Jock Itch)

Skin Care Basics:Obese Patient

Skin Care Basics:Obese Patient

• Good personal hygiene

• Prevention of friction

• Control moisture and perspiration

• Good personal hygiene

• Prevention of friction

• Control moisture and perspiration• Control moisture and perspiration

• Daily skin checks for breakdown or

changes

• Prompt treatment of any open areas

or rashes

• Control moisture and perspiration

• Daily skin checks for breakdown or

changes

• Prompt treatment of any open areas

or rashes

LymphedemaLymphedema

• Presentation

– Fatigue

– Heavy, swollen limb

• Presentation

– Fatigue

– Heavy, swollen limb

– Localized fluid accumulation

– Skin discoloration

– Deformity

• Elephantiasis

– Localized fluid accumulation

– Skin discoloration

– Deformity

• Elephantiasis

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LymphedemaLymphedema

• Treatment

– Chronic (no cure)

– Weight loss

• Treatment

– Chronic (no cure)

– Weight loss

– Specialized

• Exercise

• Compression

• Massage

– Specialized

• Exercise

• Compression

• Massage

Lymphedema and DermatitisLymphedema and Dermatitis

LymphedemaLymphedema LymphedemaLymphedema

ResourcesResources• http://www.amylhwilliams.com/

• http://www.obesityaction.org/

• http://skinipedia.org/skin-and-

b it /i d ht l

• http://www.amylhwilliams.com/

• http://www.obesityaction.org/

• http://skinipedia.org/skin-and-

b it /i d ht lobesity/index.html

• http://www.skinsight.com/adult/stasi

sDermatitis.htm

• http://www.dermnet.com/

obesity/index.html

• http://www.skinsight.com/adult/stasi

sDermatitis.htm

• http://www.dermnet.com/