Principles of Skin Care A Guide for Nurses

Principles of Skin Care is a practical, evidence based guide to the principles of skin management and skin health. Broader than a dermatology book, this text focuses on the generic components of helping patients with skin conditions, exploring the underlying evidence base, and provides practitioners with the skills and information needed to become competent in caring for the skin, preventing skin break-down, managing patients with common skin conditions and helping patients cope with the psychological impact of skin problems. Divided into two sections, the first takes a look at the fundamental principles of skin management, addressing some of the core nursing issues that are relevant across the board of dermatological care. The second section covers the dermatological conditions most commonly see in practice, such as Psoriasis, Eczema, and Acne. It also explores the principles of illness management, describing disease processes and enabling health care practitioners to work effectively with patients to choose the best treatment available for their condition. Explores the essential principles of skin care and their application to clinical management Written by renowned experts in the field Full colour illustrations throughout Evidence-based with extensive referencing

Rebecca Penzer is a Community Dermatology Nurse Specialist for Norfolk Community Health and Care. She is co-editor of Dermatological Nursing (the journal of the British Dermatological Nursing Group, BDNG) and is a trustee of the Psoriasis Association. She is a founder of the International Skin Care Nursing Group and current secretary. Rebecca has been a recipient of the Stone Award by the BDNG for services to dermatological nursing. Professor Steven J. Ersser is Chair in Nursing Development and Skin Care Research at Bournemouth University and Director of the Centre for Wellbeing Quality of Life. He is a Founder Inaugural Chair of the International Skin-care Nursing Group. He is widely published and is Research Consultant to the Dermatology Nursing Journal (USA) and was co-founder of the Journal of Clinical Nursing and a Visiting Professor of Nursing at the University of Southampton. He has worked in the Oxford and Southampton Departments of Dermatology. Steven has also been a recipient of the Stone Award by the BDNG.

Acknowledgements	p. ix
Introduction	p. 1
What is skin?	p. 1
Skin health	p. 2
What is in this book	p. 7
Conclusion	p. 8
References	p. 8
Fundamental principles of managing the skin	p. 9
Biology of the skin	p. 11
Introduction	p. 11
Skin structure	p. 11
Functions of the skin	p. 20
Skin and ageing	p. 24
Conclusion	p. 28
References	p. 28
Assessment and planning care	p. 29
Introduction	p. 29
Assessment	p. 30
Planning care	p. 42
Intervention	p. 44
Evaluation	p. 45
Conclusion	p. 46
References	p. 46
Protecting the skin and preventing breakdown	p. 49
Introduction	p. 49
The concept of skin vulnerability	p. 49
What causes skin breakdown?	p. 50
Preventative practices	p. 55
Nursing intervention to support behavioural change (prevention) in relation to sun exposure	p. 60
Nutrition to support skin integrity	p. 61
Preventing skin damage by scratching	p. 63
Conclusion	p. 64
References	p. 64
Emollients	p. 71
Introduction	p. 71
Definition	p. 71
Constituents of emollients	p. 72
Potential side effects	p. 73
Emollient formulations	p. 75
How emollients work?	p. 80
Considerations that will effect how patients use emollients	p. 82
Conclusion	p. 83
References	p. 83
Psychological and social aspects of skin care	p. 85
Introduction	p. 85
Social impacts	p. 85
Psychological impact	p. 88
Nursing interventions	p. 92
Conclusion	p. 100
References	p. 100
Helping patients make the most of their treatment	p. 103
Introduction	p. 103
Self-management and patient support	p. 103
The challenge of promoting treatment adherence	p. 109
Prescribing skin-related products and opportunities for medicines education	p. 112
Conclusion	p. 115
References	p. 115
Principles of illness management	p. 119
Psoriasis	p. 121
Introduction	p. 121
History of psoriasis	p. 121
Who gets psoriasis?	p. 122
Biology of psoriasis	p. 122
Comorbidities associated with psoriasis	p. 123
Clinical variants of psoriasis	p. 124
Physical symptoms that accompany psoriasis	p. 128
Trigger factors in psoriasis	p. 130
Treatments for psoriasis	p. 131
Measuring quality of life	p. 145
Conclusion	p. 145
References	p. 147
Eczema	p. 151
Introduction	p. 151
What is eczema?	p. 151
Atopic eczema	p. 154
What is eczema commonly mistaken for?	p. 157
Eczema severity assessment	p. 158
Caring for children with eczema	p. 159
Other forms of eczema in adulthood	p. 160
Contact dermatitis	p. 161
Treatment options for eczema	p. 163
Conclusion	p. 173
References	p. 173
Acne	p. 179
Introduction	p. 179
What is acne?	p. 179
Who gets acne and distribution	p. 184
Treatments	p. 185
Psychological impact	p. 192
Conclusion	p. 193
References	p. 193
Skin cancer and its prevention	p. 195
Introduction	p. 195
Skin cancer epidemiology: the scale of the problem	p. 195
Pre-malignant skin lesions	p. 196
Non-melanoma skin lesions	p. 198
Introduction to melanoma	p. 202
Surgery	p. 207
Causation, risk prevention and early detection	p. 208
Nursing intervention and promoting self-examination	p. 209
Conclusion	p. 213
References	p. 214
Infective skin conditions and infestations	p. 221
Introduction	p. 221
Bacterial skin infections	p. 222
Viral infections	p. 226
Fungal infections	p. 233
Infestations	p. 240
Conclusion	p. 242
References	p. 243
Less common skin conditions	p. 247
Introduction	p. 247
Blistering conditions	p. 247
Connective tissue disorders	p. 251
Drug reactions	p. 252
Lichen planus	p. 255
Pityriasis rosea	p. 257
Primary cutaneous T-cell lymphomas	p. 258
Rosacea	p. 260
Urticaria	p. 262
Vitiligo	p. 265
Conclusion	p. 266
References	p. 266
Appendices	p. 269
The psoriasis area severity index (PASI)	p. 269
The SCORAD index	p. 271
Examples of emollients with excipients	p. 272
Index	p. 273
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Principles of Skin Care A Guide for Nurses and Health Care Practitioners

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