Chapter 30: Atopic Dermatitis (In Children)

Question 1

Atopic Dermatitis

Answer 1

chronic skin condition with three phases (acute, subacute, and chronic) with no known etiology

• found in children with allergies
• found in children with a family history of allergies, asthma, and rhinitis

Question 2

How Does Atopic Dermatitis Present?

Answer 2

• Infant: rash presents on head, face, and lateral arms and legs
• Older Child: rash presents in the folds of the arms and legs; occasionally on the eyelids and neck

Question 3

Signs and Symptoms

Answer 3

• red, raised rash that is pruritic and painful
• red papules that may have serous exudate (clear fluid) during the acute phase
• rash is dry and easily cracks and excoriates in the subacute phase
• if disease progresses and rash becomes chronic, the skin thickens, lichenification may be present, and the papules become fibrotic (thickening and scarring of tissue)

Question 4

Diagnosis

Answer 4

• complete family history
• visual assessment
• blood tests reveals an increase in circulating IgE antibodies

Question 5

Prevention

Answer 5

• priority: stopping a secondary infection
• good skin care and close monitoring
• maintain skin hydration

Question 6

Nursing Care

Answer 6

• close and frequent monitoring and assessment of the rash
• use non-soap cleansers to decrease drying (Johnson and Johnson Gentle Cleansing Was, Cetaphil, Neutrogena Extra Gentle Cleanser etc.)
• warm, not hot, bathing water will decrease irritation
• encourage adolescent to keep water a bit cooler, avoid excessive scrubbing with exfoliating scrubs and cloths, and pat dry
• moisturizing immediately after bath with emollients

Question 7

Education/ Discharge

Answer 7

• reinforce gentle cleansing
• use of tepid to slightly warm water for bathing
• appropriate emollients
• practice itch-scratch avoidance
• keep fingernails trimmed short with no sharp edges
• s/s of secondary infection: fever above 101.5 degrees F or evidence of red, painful, pus-filled lesions