DERMATITIS

Program Studi Keperawatan

Fakultas Ilmu Keperawatan
Universitas Muhammadiyah Jakarta
 Contents
 Introduction  Nursing management:
 Prevalence  Assessment
 Definition & Causes  Nursing diagnosis
 Nursing intervention
 Clasification of
Exzema/Dermatitis
 Symptoms
 Types of Medications
 Prevention
 Introduction
• Ekzema—mempunyai banyak bentuk
gambaran klinik: istilah ini tidak digunakan
lagi. Disarankan diganti dg: dermatitits
• Dermatitis: suatu reaksi peradangan kulit
yang karakteristik thd berbagai rangsangan
endogen maupun eksogen.

(Harahap, 2000)
 Prevalence
• Di Indonesia: • Di US:
• Semua bentuk ekzema: 4.66%; • 33 per 1000 (NHIS95)
termasuk: • Prevalance Rate: approx 1 in 30
• Dermatitis atopik: 0.69% or 3.30% or 8 million people in
• Ekzema numular: 0.17% USA
• Dermatitis seboroik: 2.83%
• Di AUS
• 1.1% dermatitis and eczema in
Australia 2001 (ABS 2001
(Harahap, 2000) National Health Survey,
Australia’s Health 2004,
AIHW)
• 1.0% of male; 1.2% of female
 Definition & Cause
Dermatitis is the
inflammation of the skin
caused by factors such as:
• Allergies
• Irritants
• Ultraviolet light
• Foods
• Medications
• Hereditary
 Klasifikasi Ekzema/Dermatitis
• Berdasarkan patogenik:
– Dibagi 2: endogen & eksogen;
– Ada pula yg membagi menjadi 3: endogen;
eksogen; & penyebab yg tidak diketahui
 Contoh Dermatitis Endogen & Eksogen

Contoh dermatitis Contoh dermatitis

endogen: eksogen:
• Atopik • Kontak iritan
• Seboroik • Kontak alergi
• Liken simplek kronik • Fotoalergi
• Nonspesifik • Infektif
(pompolik, numular, • Dermatofitid
xerotik, otosensitisasi)
Contoh Dermatitis yang Tidak Diketahui
Penyebabnya
Beberapa buku memasukan ke dalam
dermatitis yg tidak diketahui penyebabnya:
• Atopik
• Seboroik
• Liken simplek kronik
• Stasis
• Pompolik
• Numularis
 Symptoms associated with Dermatitis
( depending on type of dermatitis)

• Gatal merupakan gejala yang umumnya dialami

• SEBORRHEIC DERMATITIS: Skin eruptions on face,
scalp, and trunk of body. This symptoms will produce
greasy, dry scales and will appear reddish.
• CONTACT DERMATITIS: The appearance of skin
vesicles that ooze, burn, itch,sting or scale.
• ATOPIC DERMATITIS: There will appear lesions on the
face, neck, knees, elbows, trunk of body, and itching
 Medications for Dermatitis
• SEBORRHEIC DERMATITIS: Medications include but
not limited to shampoos, creams containing ketocanzole or
hydrocortisone. For severe cases use ultraviolet radiation.
• ATOPIC DERMATITIS: soap-free cleanser, creams
containing alphahydrox acid lotions. A person can also use
topical antihistamines.
• CONTACT DERMATITIS: use emollient creams, oral
steroids, topical steroids.
Contact Dermatitis
• Contact dermatitis with
Nickel.
• Reddish marking and
itching will occur.
 ATOPIC DERMATITIS
• Reddish marks appear
on face, neck ,elbows.
• This can be treated
with a soap-free
cleanser or creams.
 SEBORRHEIC DERMATITIS
• Redness and flakes
appear in the head.
• Eruptions on scalp
may appear.
• Treated with
shampoos containing
ketokonazole or
hydrocortisone
 PREVENTION
• SEBORRHEIC : Try to get adequate sleep, a good diet.
Try to avoid any allergens.
• ATOPIC: The best prevention again is to avoid any known
allergens that will trigger a reaction. The same
recommendation applies for CONTACT DERMATITIS
wear loose fitting cloths.
• PREVENTION is the best defense for any dermatitis.
 Assessment
• Rasa gatal
• Erupsi kulit (lihat
manifestasi/sign/simptom)
• Infeksi sekunder: drainage purulen; demam;
tenderness; limpedenopati regional
• Psikososial: konsern dg body image;
ketidakamampuan tidur krn gatal

(Thompson, et al, 1997)

Nursing Diagnosis Nursing Intervention
Gg integritas kulit • Cuci tangan dan higiene yg baik (utk cegah
(actual/risk) b.d. infeksi)
• Garukan • Potong kuku pendek, rapih, rata (turunkan
trauma garukan dan infeksi sekunder)
Goal/KH: • Lakukan balutan (oil, oklusive) sesuai
• Kulit intact indikasi
• Lesi garukan (-) • Skrub lesi krusta hati-hati dg sabun
• Infeksi sekunder (-) antibakteri (utk debridemen)
• Kolaboirasi pemberian kortikosteroid
• Edukasi penggunaan medikasi: kortikosteroid
Gg rasa nyaman: • Hindari iritan/alergen lingkungan
pruritus • Kompres dingin utk lesi basah; kompres oil
Gg pola tidur utk lesi kering
• Ajarkan penggunaan antipruritus
(Thompson, et al, 1997; Lewis, 2000)
Nursing Diagnosis Nursing Intervention
Gg konsep diri: body image b.d • Kaji persepsi ttg penampilan diri
• Adanya lesi yg tdk diinginkan • Diskusikan scr terbuka: tubuh, tampilan,
Goal/KH: atau takut akan penolakan org lain (utk
• Memperlihatkan harapan yg realistik ekspress feeling)
• Mempertahankan interaksi sosial yg • Jangan pelihatkan perilaku jijik saat merawat
normal lesi (cegah image lebih buruk)
• Dorong aktivitas lain (untuk mendistraksi)
Isolasi sosial b.d. • Dorong sosialisasi sesuai minat
• Menurunnya aktivitas • Ajarkan keterampilan penggunaan kosmetik
• Takut akan penolakan org lain dan pemilihan pakaian.
• <pengetahuan cara menutupi lesi
Goal/KH:
• Puas akan kehidupan sosialnya

(Thompson, et al, 1997; Lewis, 2000)

Nursing Diagnosis Nursing Intervention
Knowledge deficit: proses • Jawab pertanyaan scr lengkap
penyakit, manajemennya b.d • Ajarkan proses penyakit, rencana
• Lack of infomation management, perawatan lesi
• Misinterpretaion

Goal/KH:
• Memahami proses penyakit dan
rencana management
• Mendemonstrasikan perawatan
kulit/lesi
• Berpartisipasi dalam
menagemen penyakit

(Thompson, et al, 1997; Lewis, 2000)

 References
• Diseases of the Human Body : Carol D. Tamparo Marcia
A.Lewis. Second edition 1995.
• Harahap, M. (2000). Ilmu penyakit kulit. Jakarta: Hipokrates.
• Lewis, et al. (2000). Medical-surgical nursing: Assessment
and management of clinical problems. (5th ed). St.Louis:
Mosby.
• Smeltzer (2010). Brunner & Suddarth’s textbook of medical-
surgical nursing. (12th ed.). Lippincott: Williams & Wilkins,
• Thompson, et al (1997). Clinical nursing. StLouis: Mosby
company.