Nursing Assessment for Allergic Contact Dermatitis

Nursing Assessment

Allergic contact dermatitis is an allergic contact dermatitis due to sensitization to a diverse substance causing an inflammatory reaction in the skin for those who have hypersensitivity to allergens as a result of previous exposure. (Dorland, W.A. Newman: 590. 2002)

To set the allergens causing allergic contact dermatitis required careful anamnesis, a complete medical history, physical examination and patch test.

History addressed in addition to the diagnosis as well as to find the cause. Because it is important in determining treatment and follow-up, namely to prevent recurrence. Required patience, thoroughness, understanding and good cooperation with the patient. In history should also be asked history of atopy, course of the disease, work, hobbies, contact history, and treatment was ever given by a physician and performed his own, personal objects include questions about the new clothes, old shoes, cosmetics, sunglasses, and watches as well as other conditions ie general medical history and possible psychological factors.

Physical examination found the presence of erythema, edema and papular followed by the formation of vesicles which if broken will form the moist dermatitis. The lesions usually occur in the place of contact, not demarcated and may extend into the surrounding area. Because some parts of the body very easily sensitized compared to other parts of the body, the regional predilection regional diagnosis would be very helpful in diagnosis.

Criteria for the diagnosis of allergic contact dermatitis are:
  • A history of contact with a material one, but a long, several times or one time but had previously been or frequent contact with similar material.
  • There are signs of contact dermatitis especially in places.
  • There are signs around the place of contact dermatitis and other similar places where contact but lighter and slower onset, the growth after the contact point.
  • Itching.
  • Patch test with material suspected positive results.

Diagnosis is based on a careful diagnosis and careful clinical examination. Questions about the suspected contacts based skin disorder found. For example, there are skin disorders such numularis lesions around the umbilicus form hyperpigmentation, lichenification, with papules and erosion, it is necessary to ask whether the patient wearing pants or head studs fastening plate made of metal (nickel). The data comes from history also includes employment history, hobbies, topical medications that have been used, systemic medications, cosmetics, ingredients known to cause allergies, skin disease ever experienced, as well as skin diseases in the family (eg, atopic dermatitis, psoriasis).

A physical examination is very important, because by looking at the pattern of localization and skin disorders can often be known possible causes. For example, in the armpit by deodorant, at the wrist by watches, and in both legs by shoes. Examination should be performed on the entire surface of the skin, to see the possibility of other skin disorders due to endogenous causes.

Diagnosis is based on history of exposure to an allergen or related compounds, itchy lesions, the distribution pattern suggests dermatitits contact. History should be centered around a common exposure to allergens. To identify the causative agent may be needed work like a good detective.

Nursing Diagnosis and Interventions for Dermatitis

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