Chapter 22: Caring for the Child With an Integumentary Condition

The chapter systematically examines primary and secondary skin lesions, including macules, papules, vesicles, and pustules, and explains the three overlapping phases of wound healing: inflammation, proliferation, and remodeling. Common bacterial infections such as acne vulgaris, impetigo contagiosa, methicillin-resistant Staphylococcus aureus, and cellulitis are discussed with attention to their distinctive presentations and treatment approaches, including the strict teratogenic precautions required for isotretinoin therapy. Viral infections including molluscum contagiosum and human papillomavirus infections, along with fungal dermatophytosis affecting the scalp, body, and feet, are covered with diagnostic methods such as Wood's lamp examination. The chapter details management of parasitic infestations including pediculosis capitis and scabies, emphasizing the importance of family-wide treatment and environmental decontamination. Hypersensitive skin reactions encompassing atopic dermatitis, contact dermatitis, and seborrheic dermatitis are explored as chronic conditions requiring ongoing management. Vector-borne diseases transmitted through insect and animal bites, including Lyme disease with its characteristic erythema migrans rash, Rocky Mountain spotted fever, and cat scratch disease, are presented as conditions requiring prompt recognition. The chapter extensively covers burn injuries classified by type, depth, and total body surface area, with emphasis on the Lund and Browder Chart for pediatric assessment, fluid resuscitation protocols, infection prevention, and mandatory assessment for signs of abuse. Environmental injuries including hypothermia and frostbite are discussed with appropriate emergency interventions. Throughout, the chapter addresses the psychological impact of visible skin conditions on children's self-esteem and development, emphasizing the nurse's role in providing emotional support and fostering social integration.