Integumentary Communicable Diseases

CHARACTERISTICS OF LESIONS
Macule – flat lesion or flush with skin surface ex. Freckle
Papule – Elevated lesion ex. Pimple
Vesicles – Tear drop lesion that are fluid filled
Crust/scab- dried vesicles, take years to fade
Pustular – fluid filled pus lesion, deeper scars
MEASLES/Rubeola
Morbilli/Red Measles
7 days Measles
Causative Agent: Measles Virus (RNA- containing paramyxovirus
Mode of Transmission: Airborne-Droplet
Incubation Period: 8 – 20 days Average: 10 days
MEASLES
Signs and Symptoms:
Pre-eruptive stage – highly communicable
Fever
Stimson’s Line – transverse line of the inflammation along the margin of the eyelid –
excessive lacrimation
Catarrhal symptoms- rhinitis, conjuctivitis, bronchitis
Koplik’s spots – small whitish pinpoint dots with a reddish areola on an erythematous
background with vesicles on the mouth cheek area
fever blisters/stomatitis
Eruptive Stage
maculo papular rashes starting from head to feet (hot to touch, dry and slightly elevated)
Fever 40 to 41 C at the height of rashes
Desquamation Stage/Convalescent
rashes dry, peel off (brownish color)
MEASLES
Complications:
Bronchopneumonia
Tuberculosis
Otitis Media – inflamed eardrum
Encephalitis
Conjunctivitis
Diarrhea
MEASLES
Diagnostic Exam: NO specific
Treatment: Symptomatic and Supportive
Isolation
Antibiotics – with complication
Supportive
- steam inhalation
- Vitamin A supplement
MEASLES
Nursing Care:
Medical Asepsis
Eye, ear, and oral care
Isolation
Skin care
Treat Fever
DIET
small frequent feedings
increase fluid intake
Prevention:
Avoid MOT
Immunization
IMCI CLASSIFICATION
Severe Complicated Measles
Child has clouding of the cornea, or deep or extensive mouth ulcers
Hospitalization
Measles with Eye or Mouth Complications
Child has pus draining from the eyes or mouth ulcers which are not deep or extensive
Home Care + Antibiotics
Measles
Child has measles now or within the last three months and with none complications
Home Care

IMCI TREATMENT FOR MEASLES

Eye Infections – Tetracycline ointment, bring the child after 2 days
Mouth ulcers – Gentian violet, 2x/day for 5 days
Sore throat, Cough – Tamarind, Calamansi, ginger or codeine derivatives, continue
breastfeeding.
GERMAN MEASLES/Rubella
3 Days Measles
Causative Agent: RNA-containing toga virus
Mode of Transmission: Droplet
Incubation Period: 10 – 21 days
Signs and Symptoms:
maculo-papular rashes (first) face, trunk, limbs (1st Day Only)
headache,
Low-grade fever before rashes (X Rubeola)
sorethroat
mild catarrhal symptoms (x Rubeola)
enlarged post-cervical, post auricular, sub-occipital glands (swelling below the ear, nape
of neck)
GERMAN MEASLES
Treatment:
Symptomatic and Supportive
For exposed pregnant woman- serum immune globulin
Nursing Care: Symptomatic
Prevention:
Avoid mode of transmission
Immunization
CHICKEN POX/VARICELLA
Causative Agent: Varicella Zoster Virus
Mode of Transmission: Droplet/airborne
Direct contact with secretions from vesicles
Signs and Symptoms:
Itchy vesiculo-pustular lesions first appearing on the chest and trunk spreading to
extremities (centrifugal)- Fluid filled with pus
Body malaise, Low grade fever
Incubation: 10-21 days
SMALL POX
Causative Agent – Variola Virus
Mode of Transmission – Direct, droplet
Signs & Symptoms
Centripetal itchy vesiculo-pustular lesions
High Grade Fever
Incubation Period – 8 to 17 days

CHICKEN POX/SMALL POX

Diagnostic Exam: NO specific
Treatment: Symptomatic
Nursing Care: antipyretic
Isolation
Handwashing
Skin care – calamine lotion (Chicken Pox) and Na Bicarbonate (Small Pox), cut
fingernails
Diet-Liquid, soft bland diet
Prevention:
1. Avoid MOT
2. immunization
HERPES ZOSTER/SHINGLES
Causative Agent: Herpes Zoster virus dormant VZV
Mode of Transmission: DropleT Direct contact with secretions fro vesicles
Incubation – throughout illness
Signs and Symptoms:
painful vesiculo-postular lesions on limited portion of the body (commonly: trunk,
shoulder) clusters.
Low-grade fever
HERPES ZOSTER
Treatment:
 Symptomatic
Anti-pyretic/analgesic
Nursing Care: Symptomatic and supportive
Prevention:
1. Avoid MOT
SCABIES
Causative Agent: Itch mite, Sarcoptes Scabiei --> hominis
--> canis
Mode of Transmission: Direct contact with infected individuals
Signs and Symptoms:
itchy papulo-vesicular eruptions on warm folds and areas of friction of the body (elevated
lesions)
Diagnostic Exam: culture of wound secretions
SCABIES
Treatment: Crotamiton, Kwell lotion
Nursing Care:
contact isolation
launder and iron soiled clothe
all members of the family should be treated at the same time
Prevention:
Avoid MOT; personal hygiene; cleanliness