STUDY - Technical - New Dacian's Medicine
Pustular
rash (Classical / Allopathic Medicine)
A
pustular rash is made up of crops of pustules - vesicles
and bullae that fill with a purulent exudate. These
lesions vary greatly in size and shape and can be
generalized or localized to the hair follicles or sweat
glands. (See Identifying a pustule.) Pustules can result
from skin or systemic disorders, the use of certain drugs,
or exposure to skin irritants. For example, people who
have been swimming in salt water commonly develop a
papulopustular rash under the bathing suit or elsewhere on
the body from irritation by sea organisms. Although many
pustular lesions are sterile, a pustular rash usually
indicates infection. Any vesicular eruption, or even acute
contact dermatitis, can become pustular if a secondary
infection occurs.
HISTORY:
Ask the patient to describe the appearance, location, and onset of the first pustular lesion. Ask him if another type of skin lesion preceded the pustule and how the lesions spread.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Ask the patient if he has applied a topical medication to his rash. If so, ask him to name the medication. When did he last apply it?
Ask the patient if there's a family history of skin disorders.
Ask the patient to describe the appearance, location, and onset of the first pustular lesion. Ask him if another type of skin lesion preceded the pustule and how the lesions spread.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Ask the patient if he has applied a topical medication to his rash. If so, ask him to name the medication. When did he last apply it?
Ask the patient if there's a family history of skin disorders.
PHYSICAL
ASSESSMENT:
Examine the entire skin surface, noting whether it's dry, oily, moist, or greasy.
Record the exact location and distribution of the skin lesions and their color, shape, and size. Note if the rash is linear or follows a dermatome.
Examine the entire skin surface, noting whether it's dry, oily, moist, or greasy.
Record the exact location and distribution of the skin lesions and their color, shape, and size. Note if the rash is linear or follows a dermatome.
Identifying
a pustule
A pustule is a raised, circumscribed lesion that's usually less than 1 cm in diameter and contains purulent material, which makes it a yellow-white color.
A pustule is a raised, circumscribed lesion that's usually less than 1 cm in diameter and contains purulent material, which makes it a yellow-white color.
Recognizing
impetigo
In impetigo, when vesicles break, crusts form from the exudate. This infection is especially contagious among young children.
In impetigo, when vesicles break, crusts form from the exudate. This infection is especially contagious among young children.
SPECIAL
CONSIDERATIONS:
Observe wound and skin isolation procedures until the infection is ruled out by a Gram stain or culture and sensitivity test of the pustule's contents.
Observe wound and skin isolation procedures until the infection is ruled out by a Gram stain or culture and sensitivity test of the pustule's contents.
PEDIATRIC
POINTERS:
Among the various disorders that produce a pustular rash in children are varicella, erythema toxicum neonatorum, candidiasis, impetigo, infantile acropustulosis, and acrodermatitis enteropathica. (See Recognizing impetigo.)
Among the various disorders that produce a pustular rash in children are varicella, erythema toxicum neonatorum, candidiasis, impetigo, infantile acropustulosis, and acrodermatitis enteropathica. (See Recognizing impetigo.)
PATIENT
COUNSELING:
Instruct the patient to keep his toiletry articles and linens separate from those of other family members.
Instruct the patient to keep his toiletry articles and linens separate from those of other family members.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common symptoms,
Edition V, McGraw - Hill, 2002.