Faye Lyons DNP RN FNP-C - Dermatology for the Advanced Practice Nurse

Dermatology

for the

Advanced Practice Nurse

Faye Lyons, DNP, RN, FNP-C, is a doctor of nursing practiceprepared family nurse practitioner who has been practicing in family medicine, internal medicine, dermatology, and aesthetic dermatology since 1999. Prior to becoming an NP, Dr. Lyons was a member of the armed services (U.S. Air Force), and an RN in medical, cardiac, and surgical intensive care units and dialysis units. Her experience in dermatology includes working in two large dermatology practices during her NP career and serving rural areas with dermatological services while working in internal medicine. Her responsibilities included skin examinations, biopsies, surgical excisions, and cosmetic procedures that included Botox, cosmetic fillers, and laser therapies. Dr. Lyons is credentialed in dermatology nursing by the Dermatology Nursing Association. Her publications include an award-winning poster presentation on dermatology decision trees at the 2012 Virginia Nurse Practioner Association meeting, dermatological chapters in an upcoming geriatric textbook titled Healthy Aging: Principles and Clinical Practice for Clinicians and in Solving a Skin Rash in Primary Care: Use of a Diagnostic Decision Tree in the journal Advance for NPs and PAs.

Lisa Ousley, DNP, RN, FNP-C, is a doctor of nursing practiceprepared family nurse practitioner who has been a primary care provider since 1999. Within primary care, Dr. Ousley has assessed, treated, and referred thousands of skin conditions. Dr. Ousley has been taking photos of skin conditions for many years and has a collection of over 1,000 photos, many of which are used in this book. Dr. Ousley is the director of Eastern Tennessee State University (ETSU) Student/University Health Services. This clinical opportunity supports health promotion and clinical management of acute and episodic illness for a culturally diverse university population. Dr. Ousleys past primary care experiences include Hillsville and Galax Family Care, outpatient hospital-based clinics in Virginia, and she has worked as a hospitalist service provider at Twin County Regional Hospital and in a clinic targeting the public-housing population in Johnson City, Tennessee. Since 2009, Dr. Ousley has been an online graduate instructor at the University of Phoenix, teaching graduate nursing theory.

Dermatology

for the

Advanced Practice Nurse

Faye Lyons, DNP, RN, FNP-C

Lisa Ousley, DNP, RN, FNP-C

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ISBN: 978-0-8261-3643-5

e-book ISBN: 978-0-8261-3644-2

Digital image bank ISBN: 978-0-8261-2825-6

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14 15 16 17 / 5 4 3 2 1

The author and the publisher of this Work have made every effort to use sources believed to be reliable to provide information that is accurate and compatible with the standards generally accepted at the time of publication. Because medical science is continually advancing, our knowledge base continues to expand. Therefore, as new information becomes available, changes in procedures become necessary. We recommend that the reader always consult current research and specific institutional policies before performing any clinical procedure. The author and publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers use of, or reliance on, the information contained in this book. The publisher has no responsibility for the persistence or accuracy of URLs for external or third-party Internet websites referred to in this publication and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.

Library of Congress Cataloging-in-Publication Data

Lyons, Faye, author.

Dermatology for the advanced practice nurse / authors, Faye Lyons, Lisa Ousley.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-0-8261-3643-5ISBN 978-0-8261-3644-2 (e-Book)

I. Ousley, Lisa Ellen, author. II. Title.

[DNLM: 1. Skin Diseasesnursing. 2. Nursing Diagnosismethods. 3. Primary Nursingmethods. 4. Skin Carenursing. WY 154.5]

RL125

616.50231dc23

2014008527

Printed in the United States of America by Bang Printing.

Contents

Preface

In primary care, common things occur regularly. This definitely applies to skin conditions. However, each patient and his or her skin is unique. Common dermatological problems seen frequently in primary care practice can be difficult to identify. Becoming educated about the descriptors provides an important foundation for building clinical skills in assessment, differential diagnosis, and preferred management of common skin conditions. Fifteen years ago, when we attended college to become nurse practitioners, there was no formal training in dermatology. Our introduction to dermatology was a 2-hour lecture that covered common rashes and skin cancers. Needless to say, 2 hours is not enough time to cover dermatology.

Dermatology is a complex and challenging field of study. Learning more about the skin reveals that it is one of the most amazing organs in the body. The skin tells us when there are abnormalities or health issues inside the body, it shows us the nutritional status of an individual, and it can also be an indicator of emotional concerns. Knowledge of the most common dermatological presentations elevates the providers skills and abilities to offer appropriate care to patients.

This book features dermatology diagnostics, treatments, and management strategies. Dermatologic diagnostics include skin assessment, specimen collection, and the use of mechanical devices. Evidence-based topical, systemic, and surgical treatment options for skin conditions are provided. Additionally, wide-ranging management strategies are included.

To facilitate the practitioners ability to more quickly identify which of the 60 conditions a patient has, the section covering these conditions is organized using a standard format that includes overview, epidemiology, etiology, clinical presentation, histology, differential diagnosis, treatment and management, special considerations and appropriate referrals, patient education, patient follow-up, and clinical pearls. Of utmost importance and to help the clinician in identifying each condition, photos are provided to highlight important visual identifiers for each condition. This collection of photos was taken by Dr. Ousley and her colleagues and captures actual patient presentations observed by them during primary care patient visits.