Contact Dermatitis

Contact dermatitis is an inflammatory response of the skin that produces skin changes after contact with a specific allergen (allergic contact dermatitis) or irritant (nonallergic contact dermatitis). It is also called a T lymphocyte-mediated dermatitis (type IV hypersensitivity).

Specific allergen that cause contact dermatitis in many people include "poisonous" plants such as poison ivy, certain foods, some metals, cleaning solutions, detergents, cosmetics, perfumes, industrial chemicals, and latex rubber.

A person who has contact dermatitis will get sign and symptom of pruritus and burning, erythema at the point of contact, edema, vesicles with drainage, as well as sign of infection.


Nursing intervention for client with diagnose of contact dermatitis will include :

• Elevation the extremity to reduce edema
• Maintaining a cool environment
• Apply cool and wet dressing and tepid bath
• Protection of the affected area from trauma
• Prevention of scratching and rubbing of the affected area
• Assisting with skin testing to determine allergen
• Encourage client to avoid contact with the allergen and harsh soaps
• Encourage client to avoid using heating pads or blankets
• Administering (as prescribed) antibiotic, antipruritic, antihistamine, and corticosteroids.

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NCLEX - CGFNS : Skin Cancer

Skin cancer is a malignant lesion of the skin which may or may not metastasize. Skin cancer can be caused by chronic friction and irritation to the skin area and exposure to ultraviolet.

Skin cancer can be diagnosed by a skin biopsy that is positive for cancer cell.

There is three types of skin cancer: basal cell, squamous cell, and malignant melanoma. Basal cell is the most common type, arises from the basal cell contained in the epidermis. Squamous cell cancer is the second most common of skin cancer that is a tumor of the epidermal keratinocytes and can infiltrate surrounding structure, metastasize to lymph nodes and bi subsequently fatal. Malignant melanoma is a cancer of the malanocytes that can metastasize to the brain, lungs, bones, liver and skin. Malignant Melanoma is ultimately fatal.

Skin cancer can be assessed by :

• Pruritus
• Local soreness
• Change in color, size, or shape of lesion
• Waxy nodule
• An Irregular, circular, bordered lesion
• Small, red, nodular lesion
• An oozing, bleeding, crusting lesion.

As a professional nurse, you can instruct client with skin cancer to :

1. Do the preventive measures
2. Monitor for lesion that do not heal
3. Avoid contact with chemical irritants
4. Wear layered clothing and use sunscreening lotions with an appropriate skin protection when outdoors
5. Avoid sun exposure between 11 AM and 3 PM
6. Assist with surgical excision of the lesion as prescribed

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