Skin condition assessment

TABLE 39.1 Description of Grades Used in Skin Condition Assessment... 

Sodium dodecyl sulfate has been used to induce a dry, scaly skin condition in human subjects by daily treatment with a 4% aqueous solution on one leg over a period of 2 weeks. Measurements were made of stratum comeum hydration, scaliness, and lipid composition which were used to assess in vivo surfactant perturbations on desquamation [381]. 

The skin condition reflects the skin irritation elicited by a surfactant when applied. Skin surface appraisal is hence a means for assessing product mildness. 

The amounts of ointments and creams people apply are highly individualized. So are the techniques of application. Some patients vigorously rub semisolid formulations into the skin, while others just spread films until they are more or less uniform over the desired area. While pharmacokinetic assessments of a system s delivery attributes is ordinarily done using normal skin (in vitro) or on healthy volunteers (in vivo), the site of its clinical deployment is usually anything but normal. Rather, it is determined by the skin condition to be treated. Clearly, the manufacturer is without control over how a disease is expressed in a particular patient. For many diseases, disease manifestation can be anywhere on the body. Moreover, from individual to individual it varies in intensity and vastness. Thus, more area may be involved in one case than in another, and the barrier function of the skin may be more or less intact in any instance. This creates a set of imponderables with respect to delivery, efficacy, and safety. 

If you look in the medical literature, you will often see the term placebo defined as a non-specific treatment. What does it mean to say that a treatment is not specific It could mean that the treatment is effective for many different disorders, rather than for only one particular condition. In this sense, placebos are indeed non-specific. Besides depression, placebos have been shown to affect anxiety, pain, ulcers, irritable bowel syndrome, Parkinson s disease, angina, autoimmune diseases, Alzheimer s disease, rheumatoid arthritis, asthma, gastric function, sexual dysfunction and skin conditions. We know this from the thousands of studies in which placebos have been used as control conditions, against which the effects of medication have been evaluated, and from studies that were specifically designed to assess the placebo effect. 

Patients with chronic skin conditions should be evaluated periodically to assess disease control, the efficacy of current therapy, and the presence of possible adverse effects. 

Assess for improvement of skin conditions, relief of pruritus, and healing of lesions... 

Perkins, M.A., Osterhues, M.A., Farage, M.A., and Robinson, M.K. A noninvasive method to assess skin irritation and compromised skin conditions using simple tape adsorption of molecular markers of inflammation. Skin Res. Technol. 2001 7 227-233. 

Assess onset, type, location, and duration of pain, fever or inflammation. Inspect affected joints for immobility, deformities, and skin condition. 

In a survey of patients about the sources of advice they use for skin conditions, pharmacists ranked second, just behind physicians. Interestingly, the advice sought seemed to depend on the nature of the condition, in that patients sought more pharmacist advice on conditions such as dermatitis, psoriasis, skin cancer, and acne. To properly assess a patient, pharmacists and other primary care providers must not only understand clinical presentations of common skin disorders, but they must also be able to quickly identify patients that may need referral for further evaluation by a physician. 

Bio-inspired sensor, Condition assessment Flexible strain gauge Sensing skin Sensor network Shape reconstruction Soft elastomeric capacitor Structural health monitoring... 

For the physical assessment, the nurse generally appraises the patient s physical condition and limitations. If the patient has arthritis (any type), the nurse examines the affected joints in the extremities for appearance of the skin over the joint, evidence of joint deformity, and mobility of the affected joint. Fhtients with osteoporosis are assessed for pain particularly in the upper and lower back or hip. Vital signs and weight are taken to provide a baseline for comparison during therapy. If the patient has gout, the nurse examines the affected joints and notes the appearance of the skin over the joints and any joint enlargement. 

Assessing the patient s general condition and including observations such as skin color (pale, cyanotic, flushed), orientation, level of consciousness, and the patient s general status (such as appears acutely ill or appears somewhat ill). All observations must be recorded to provide a means of evaluating the response to drag therapy. 

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