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Is Eczema Symmetrical
Diagnostic examination of the Child's skin
As a student pediatrician, you need to know these basic procedures for proper examination and diagnosis of related diseases. Mothers and as well parents in general are not limited to this knowledge as it is very educative for them to apply some or all of these procedures even at home. It is not everything you will need the doctor to do for you, isn't it?
The doctor palpates the skin for texture, noting moisture and temperature, any marks or scars that are suggestive of healed injuries are noted, and inquiries are made about their origin. Normally, the skin of young children is smooth, soft and slightly fries to the touch, not oily or clammy. Any variations from these findings are noted, because they may indicate common problems of childhood such as cradle cap (scaliness on the scalp), eczema (scaliness and desquamation on the scalp, cheeks, knees, and elbows), diaper rash (redness and dryness in the genital area), or excessive dryness (xeroderma) all over the body from too frequent bathing, exposure to the weather, or vitamin-A deficiency. Excessively moist, clammy skin may indicate serious health problems, particularly heart disease.
Assessment of the temperature. A doctor evaluates the skin temperature by symmetrical feeling each part of the body and comparing the upper areas with the lower ones. Any distinct difference in temperature is noted, although not a common anomaly. One of the key signs for coarctation of the aorta is warm upper extremities and cool lower ones. A doctor also observes the skin temperature of the dressed child. Young children produce heat rapidly and they quickly become overheated if dressed too warmly. Many parents do not realize this and fail to change the amount of clothing to accommodate climatic variations.
Assessment of the texture of the skinA doctor palpates the skin in symmetric spots of the body and in the extremities particularly on the palms and soles and notes their moisture and temperature. Normally the skin of young children is smooth, soft and slightly dry to the touch, not oily or clammy.
Assessment of skin elasticityIt is best determined by grasping the skin on the external surface of the palms or flexor surface of an elbow between a thumb and index finger, pulling it taut, and quickly releasing it. Elastic tissue immediately assumes its normal positions without residual marks or creases. In children with poor skin elasticity and turgor, the skin remains suspended or tented for a few seconds before slowly falling back.
Assessment of skin turgorIt is determined by tension of the soft tissues of the shoulder or the femur with fingers. Normally the doctor must feel flexibility or elasticity of the tissues. The skin turgor and its elasticity are the best estimates of an adequate hydration and nutrition.
While evaluating turgor, the nurse also inspects for signs of edema, normally evident as swelling or puffiness. Periorbital edema is a sign of several systemic disorders, such as kidney diseases, but may normally be seen in children who have been crying or sleeping or who have allergies. Edema should be evaluated for change according to position, its specific location and response to pressure. For example, in pitting edema, pressing a finger into the edematous area will cause a temporary indentation.
Get this right and help the child stay healthy.
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Pityriasis Alba Treatment Tips
Pityriasis alba is a common skin disorder similar to very mild eczema, causing round or oval, colorless, finely-scaled patches of skin. It is characterized by ill or well-defined, chronic patches of mild erythema, hypopigmentation and furfuraceous scaling. Size of patch is about that of a rupee; lesion is solitary or there may be 2-3 patches. Pityriasis Alba mainly affects the forehead, cheeks and chin of children, to a less extent, that of adults. It can occur at any time of the year, but is more common in cold winter and dry hot summer. Pityriasis alba depend on the body symmetric minimally scaly hypopigmented discrete and confluent macules.
Pityriasis alba appears as superficial, pale pink to light brown macules with irregular, poorly circumscribed margins.
During the winter season when the skin becomes dry, the rash becomes flakier. This disease is more visible during summer months when the surrounding skin gets tanner. Pityriasis Alba is a harmless, non-scarring and usually non-infectious affection, which responds slowly to treatment. The treatment consists of a nourishing diet, mild sunbathing, tonics, particularly vitamins, and the application of mild antiseptics like ammoniated mercury ointment, Bradex-vioform (P), bacitracin ointment etc. Application of a hydrocortisone or moisturizer helps the body to get rid of the patches faster. Treatment involves daily lubrication with a good moisturizer (such as Aquaphor), especially whenever the skin gets wet. Integument must be properly lubricated. Children should not play in the hot sun and cold winds.
Pityriasis Alba Treatment Tips
1. Use non-soap cleansers or moisturizing soaps.
2. Avoid sun exposure and wear sunscreen.
3. Apply over-the-counter hydrocortisone cream sparingly for 3–7 days.
4. Certain lotions and moisturizers cream may help to improve the dry appearance.
5. The hydrocortisone cream may also help to make the patches go away more quickly.
6. Apply moisturizers such as petroleum jelly or fragrance-free ointments and creams.
7. The use of Pragmatar ointment, Lac-Hydrin, 2% Zetar in Cordran cream gives the effective results.
8. Pimecrolimus cream has also been reported to be effective.
About the Author
Juliet Cohen writes articles for women health blog and skin treatment. She also writes articles for hair styles.
