NUR 6111 WEEK 1
Dermatologic Disorders
Complete Notes & Study Guide
William Paterson University
Verified Content
Ace your Advanced Practice Nursing I –
Dermatologic Disorders with this Week 1
study resource from William Paterson
University. This detailed guide covers all
major conditions, diagnostic criteria, and management
approaches for advanced nursing exams.
,●Atopic Dermatitis
○ Pruritic maculopapular with few vesicular rash
○ Medical history: Asthma and hay fever
○ Common in Asians and African Americans
○ Dry skin, flexural surface, lichenification, and scaling
○ Diagnosis
■ The simplified criteria include itchy skin, with at least 3 of the following
● History of asthma or allergic rhinitis
● History of Flexural Involvement
● History of generalized dry skin
● The onset of rash before 2 years of age
● And visible flexural dermatitis
○ Management
■ Alleviate pruritus, decrease dryness and inflammation, and prevent
infection
■ Pharmacologic
● Pruritus
○ Benadryl 25 – 50 mg PO q 4-6 hours max: 300 mg/24 hrs
○ Atarax 25 mg TID/QID
● Inflammation
○ Topical steroids—hydrocortisone (Buttaro and Hollier)
■ Fluticasone propionate (Cutivate; cream 0.05%)
■ Short–term (2-4 weeks) – avoid atrophy
■ DC when inflammation subsides, emollient should
be continued
■ Potency depends on location and clinical
presentation
○ Nonsteroidal calcineurin inhibitor
■ moderate-severe concern of topical steroid s/e, use
short-term and intermittent
■ Tacrolimus 0.03%, 0.1% and Elidel 1%
■ Maintenance 2/weekly x 12 months
○ Systemic corticosteroids
■ Intermittent (1-2x/year) IM can help during flare
■ More commonly used is oral
■ A typical ER “dose-pak” course (4-6 days) is
insufficient, and often requires 2-3 weeks
■ Taper 60mg/40mg/20mg over 15-21 days
■ Non-Pharmacologic
● Tepid bath/soak for an acute flare-up
● Limit bathing- do not use hot water – prevent drying skin
● Super-fatted soaps
● Follow bath or soaks with emollient–hydrated petroleum (Cetaphil,
Eucerin, Aquaphor, CeraVe)
, ■ Follow up in 2 weeks and 6 to 8 weeks
■ If severe flare-up, increase potency x2 weeks
■ Moisturize!
■ Avoid/treat secondary infection.
○ Indications for Referral
■ Uncertain diagnosis
■ Attempts at management have not controlled the symptoms
■ Patient has atopic dermatitis on the face that has not responded to
treatment
■ Patient has frequent flare-ups or severe atopic dermatitis
■ Patient requires systemic therapies for flare-ups or maintenance
■ Condition is causing significant psychosocial disturbances (e.g., sleep
disruption, school or work attendance problems)
■ Contact allergic dermatitis is suspected (especially on the face, eyelids, or
hands)
○
●Contact Dermatitis
○ Pruritic erythematous papular rash with multiple vesicles in a linear distribution
pattern
Dermatologic Disorders
Complete Notes & Study Guide
William Paterson University
Verified Content
Ace your Advanced Practice Nursing I –
Dermatologic Disorders with this Week 1
study resource from William Paterson
University. This detailed guide covers all
major conditions, diagnostic criteria, and management
approaches for advanced nursing exams.
,●Atopic Dermatitis
○ Pruritic maculopapular with few vesicular rash
○ Medical history: Asthma and hay fever
○ Common in Asians and African Americans
○ Dry skin, flexural surface, lichenification, and scaling
○ Diagnosis
■ The simplified criteria include itchy skin, with at least 3 of the following
● History of asthma or allergic rhinitis
● History of Flexural Involvement
● History of generalized dry skin
● The onset of rash before 2 years of age
● And visible flexural dermatitis
○ Management
■ Alleviate pruritus, decrease dryness and inflammation, and prevent
infection
■ Pharmacologic
● Pruritus
○ Benadryl 25 – 50 mg PO q 4-6 hours max: 300 mg/24 hrs
○ Atarax 25 mg TID/QID
● Inflammation
○ Topical steroids—hydrocortisone (Buttaro and Hollier)
■ Fluticasone propionate (Cutivate; cream 0.05%)
■ Short–term (2-4 weeks) – avoid atrophy
■ DC when inflammation subsides, emollient should
be continued
■ Potency depends on location and clinical
presentation
○ Nonsteroidal calcineurin inhibitor
■ moderate-severe concern of topical steroid s/e, use
short-term and intermittent
■ Tacrolimus 0.03%, 0.1% and Elidel 1%
■ Maintenance 2/weekly x 12 months
○ Systemic corticosteroids
■ Intermittent (1-2x/year) IM can help during flare
■ More commonly used is oral
■ A typical ER “dose-pak” course (4-6 days) is
insufficient, and often requires 2-3 weeks
■ Taper 60mg/40mg/20mg over 15-21 days
■ Non-Pharmacologic
● Tepid bath/soak for an acute flare-up
● Limit bathing- do not use hot water – prevent drying skin
● Super-fatted soaps
● Follow bath or soaks with emollient–hydrated petroleum (Cetaphil,
Eucerin, Aquaphor, CeraVe)
, ■ Follow up in 2 weeks and 6 to 8 weeks
■ If severe flare-up, increase potency x2 weeks
■ Moisturize!
■ Avoid/treat secondary infection.
○ Indications for Referral
■ Uncertain diagnosis
■ Attempts at management have not controlled the symptoms
■ Patient has atopic dermatitis on the face that has not responded to
treatment
■ Patient has frequent flare-ups or severe atopic dermatitis
■ Patient requires systemic therapies for flare-ups or maintenance
■ Condition is causing significant psychosocial disturbances (e.g., sleep
disruption, school or work attendance problems)
■ Contact allergic dermatitis is suspected (especially on the face, eyelids, or
hands)
○
●Contact Dermatitis
○ Pruritic erythematous papular rash with multiple vesicles in a linear distribution
pattern
