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Case Study
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Improving quality of life in a young lamellar ichthyosis client David Davolt, Sr, CHT, Enrique C. Almaguer, MD, PA, Nix Southwest Wound Care Center, San Antonio, TX Background: Lamellar ichthyosis is an autosomal recessive skin disorder that is apparent at birth and is present throughout the lifespan. It appears as scaling skin that can be fine or ÒplateÓ like, resembling a fish. Although the disorder is not life threatening, it is quite disfiguring and can cause substantial psychological stress to the affected Problem: Patients with lamellar ichthyosis have accelerated epidermal turnover with proliferative kyperkeratosis (flaking), in contrast to retention hyperkeratosis (buildup). In the neonatal period, the newborn is at risk for secondary sepsis and hypernatremic dehydration. As the child ages, the hyperkeratosis can interfere with normal sweat gland function, which can predispose to heat intolerance and potential heat shock The disorder has no cure, only limited treatment. The study client had previously tried an alpha-hydroxy acid1, an oil in water emulsion2, and a pertrolatum based ointment3, without adequate physical or cosmetic relief The case study client is a young, active teenager whose activity level was cut short due to her disease process. She had suffered heat exhaustion in the past, aggravated by the occlusive topical products that she was using Objective: Develop a new plan of skin care that offered breathable products that provide relief from dry skin, itching, disruption in body image and change in activity level Results: The case study client reported that she was able to participate in activities that were previously off-limits due to her condition. Her skin also progressed from dry, tight and flaky to nearly normal in appearance, texture and hydration after only eight weeks Conclusion: Endermic nutrition with products containing Olivamine4 may help dermatologic conditions such as ichthyosis and other serious skin circumstances where there are no known cures or adequate treatments Product Notation:.1. Lac-Hydrin¨ 12%, Bristol-Myers Squibb Company, Princeton, NJ.2. Eucerin¨, Beiersdorf, Inc., Wilton, CT.3. Aquaphor¨ Ointment, Beiersdorf, Inc., Wilton, CT.4. REMEDYª Advanced Skin Care Products, Medline Industries, Inc., Mundelein, IL Conologue T, Meffert J. Lamellar ichthyosis. Available at: http://www.emedicine.com/derm/topic190.htm. Accessed February 25, 2004. Foundation for Ichthyosis & Related Skin Types (FIRST). Available at: http://www.scalyskin.org. Accessed: October, 2005 Hill MJ. Dermatology nursing essentials: a core curriculum. Anthony J. Jannetti, Inc., Pittman, NJ: Publication Management, 2003 Fleck CA, McCord D. The dawn of advanced skin care. ECPN. September/October 2004;32Ð39 Fore J. The epidermal skin barrier: Implications for the wound care practitioner, Part 1. Adv Skin Wound Care. October 2004 Fore J. The epidermal skin barrier: implications for the wound care practitioner, Part 2. Adv Skin Wound Care. November 2004 McCord D. Using Remedy Nutrashield to Prevent Excessive Transepidermal Water Loss (e-TEWL), Independent studies performed by Dow Corning, 2004 . |
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