PURPOSE: This study was done to develop an evidence-based nursing clinical practice guideline for Moisture associated skin damage (MASD) prevention and management for patients in Korea. METHODS: The guideline adaptation process was used and conducted according to the guideline adaptation manual developed by the Korean Hospital Nurses Association. It consists of three main phases and 9 modules including a total of 24 steps. RESULTS: The adapted MASD clinical practice guideline consisted of 4 sections, 8 domains and 28 recommendations. The number of recommendations in each section was: 7 on MASD assessment, 14 on MASD prevention and management, 4 on education, and 3 on organizational policy. Of the recommendations, 3.6% were marked as A grade, 28.6% as B grade, and 67.8% as C grade. CONCLUSION: This MASD clinical practice guideline is the first to be developed in Korea. The developed guideline will contribute to standardized and consistent MASD prevention and management. The guideline can be recommended for dissemination and utilization by nurses nationwide to improve the quality of MASD prevention and management. Regular revision is recommended.
Dermatitis, Irritant ; Education ; Evidence-Based Nursing ; Evidence-Based Practice ; Humans ; Intertrigo ; Korea ; Organizational Policy ; Skin Care ; Skin

BACKGROUND: Intertrigo is a form of contact dermatitis of skin folds of the body, for which a large variety of topical medications may be recommended. Application of a suitable barrier preparation is the cornerstone for the prevention and treatment for the intertrigo. OBJECTIVE: There is a notable absence of controlled trials to support and guide the use of barrier preparations for intertrigo. METHODS: We evaluated the effect of powders and moisturizers with non-invasive measuring methods on irritated skin reactions induced by sodium lauryl sulphate in the sintertriginous skin of 21 healthy volunteers. After skin irritation for 24 hours with patch test of 1% sodium lauryl sulphate on both axilla, we applied a powder and a moisturizer respectively. Evaluation was done at 2 weeks by transepidermal water loss, electrical capacitance. RESULTS: TEWL values of the moisturizer treated side were significantly lower than that of the powder treated side. Water holding capacity values of the moisturizer treated side were significantly higher than that of the powder treated side. CONCLUSION: These results suggest that topical application of a moisturizer might improve the disruption of permeability barrier function of intertrigo. We suggest this experimental model for further barrier preparation efficacy testing of intertrigo.
Axilla ; Dermatitis, Contact ; Intertrigo ; Models, Theoretical ; Patch Tests ; Permeability ; Powders ; Skin ; Sodium

Zinc deficiency in breast-fed infants is an important disorder. Unlike acrodermatitis enteropathica, it is transient and stops when nursing ends. We report on a case of a breast-fed, full-term male infant who presented with erythematous fine scaly patches and plaques involving the flexural area and trunk at 4 month of age. Clinical impressions of intertrigo, fungal infection or inverse psoriasis were considered. These lesions did not respond to treatment with topical antifungal agents and corticosteroids. The results of laboratory investigations revealed a lowered zinc level in the infant's serum (48.4microg/dl: normal 70~121microg/dl) and in the mother's milk (16microg/dl: normal 48~75microg/dl) and a normal level of zinc in the mother's serum. After the patient's mother was given zinc supplements, the skin lesions were dramatically improved and his serum zinc level became normal. Early recognition of the disorder and introduction of zinc supplementation rapidly reversed the transient zinc deficiency.
Acrodermatitis ; Adrenal Cortex Hormones ; Antifungal Agents ; Humans ; Infant ; Intertrigo ; Male ; Milk ; Mothers ; Psoriasis ; Skin ; Zinc

BACKGROUND: Gefitinib (ZD 1839, Iressa) is a new anticancer agent; more specifically, it is a selective epidermal growth factor receptor tyrosine kinase inhibitor that is, widely used for various solid cancers, including lung cancer. Cutaneous adverse reactions induced by gefitinib have recently been reported; however, not much on this topic has been reported in the Korean literature. METHOD: We studied cutaneous adverse reactions of gefitinib in 23 patients who suffered with non-small cell lung cancer at Chonnam National University Hwasun Hospital from October 2004 to September 2005. RESULT: The patients ranged from 23-72 years old, and there were 17 patients with adenocarcinoma, 5 with squamous cell carcinoma and 1 with bronchioloalveolar carcinoma. The most common adverse reaction was acneiform eruptions in 15 patients (65.2%). This reaction appeared within 2 months after medication, and it didn't correlate with the therapeutic response and tumor type. Pruritus was the second most common reaction (39.1%), which was mild and generalized, especially around eyelid area. Xerosis (26.1%), exfoliation on palm and sole (21.7%), and paronychia (21.7%) followed. Hair breakage and intertrigo were rare adverse reactions. CONCLUSION: Various cutaneous adverse reactions were observed in patients with non-small cell lung carcinoma after gefitinib treatment. The skin complications could be alleviated with dermatologic consultations and treatments, skin complications could be alleviated.
Acneiform Eruptions ; Adenocarcinoma ; Adenocarcinoma, Bronchiolo-Alveolar ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Eyelids ; Hair ; Humans ; Intertrigo ; Jeollanam-do ; Lung Neoplasms* ; Lung* ; Paronychia ; Protein-Tyrosine Kinases ; Pruritus ; Receptor, Epidermal Growth Factor ; Referral and Consultation ; Skin

BACKGROUND: ZD1839 (Iressa(R)Gefitinib) is an orally active, selective epidermal growth factor (EGF) receptor tyrosine kinase inhibitor that blocks signal production pathways in cell proliferation. It is currently used in the treatment of advanced stage non-small cell lung cancer. Cutaneous side effects commonly associated with ZD 1839 treatment include acneiform eruption, dry skin and hair growth abnormalities. Cutaneous eruptions result from direct interference with functions of EGF receptor signaling in the skin. OBJECTIVE: The purpose of our study was to investigate the clinical features of cutaneous side effects of ZD 1839 in Korean with literature review. We also analysed the relationship between skin rash severity, onset and objective tumor response. METHOD: We retrospectively reviewed medical records and the histologic materials of 23 Korean patients who had been treated with ZD 1839 at Ajou University Hospital from March 2002 to September 2003 . RESULTS: The results are summarized as follows. 1. The most common cutaneous side effect was acneiform skin rash (56%) which is a well known complication of ZD 1839. 2. Acneiform eruptions were easily controlled by oral antibiotics, such as minocycline and topical retinoid ointment. 3. The second common side effect was dry scaly skin (43%). 4. We also found acute paronychia, finger tip desquamation, alopecia and intertrigo. 5. The severity of the skin rash correlated well with the treatment response of ZD 1839. 6. When the skin rash appeared within 1 week after taking ZD 1839, the skin rash was severe, and the tumor responded well to the ZD 1839. CONCLUSION: The results of this study suggest that acneiform eruption and dry skin are the most common cutaneous side effects of ZD 1839. The association between rash severity and onset of tumor response suggests that the rash may serve as a marker of response to ZD1839 therapy and may be used to guide treatment to obtain optimal response. However, further prospective studies on the potentially important association between rash severity or onset and outcome of treatment with ZD 1839 are needed.
Acneiform Eruptions ; Alopecia ; Anti-Bacterial Agents ; Carcinoma, Non-Small-Cell Lung ; Cell Proliferation ; Epidermal Growth Factor ; Exanthema ; Fingers ; Hair ; Humans ; Intertrigo ; Medical Records ; Minocycline ; Paronychia ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Retrospective Studies ; Skin

BACKGROUND: There have been few clinical and mycological studies of superficial cutaneous candidiasis in Korea. OBJECTIVE: The purpose of the study was to investigate the recent clinical and mycological features of superficial cutaneous candidiasis and correlation between underlying diseases and candidiasis. METHODS: Among 233 patients, 233 strains of Candida(C.) species were isolated and identified by Sabouraud's dextrose agar culture, germ tube test and sugar assimilation test using API 20C kit. RESULTS AND CONCLUSION: 1. The incidence of superficial cutaneous candidiasis was 4.0% out of a total of 5,809 out-patients. 2. The ratio of male to female patients was 1.1:1. 3. Among the age groups, the incidence rate was high in the first decade and above sixth decade. 4. Candidal intertrigo was the most common type of infection(56.7%). 5. Among 233 Candida species C. albicans(90.6%), C. parapsilosis(4.7%), C. guilliermondii(2.1%), C. tropicalis(1.7%), C. glabrata(0.9%) were identified. 6. Neurological disease was the most common underlying disease(56.4%).
Agar ; Candida* ; Candidiasis ; Candidiasis, Cutaneous* ; Female ; Glucose ; Humans ; Incidence ; Intertrigo ; Korea ; Male ; Outpatients

BACKGROUND: Because of recently increasing reports of azole-resistant Candida species, it is necessary to perform antifungal susceptibility test. E test(AB Biodisk, Sweden) is a rapid, easy-to- perform in-vitro antifungal susceptibility test. OBJECTIVE: The purpose of the study was to investigate the minimal inhibitory concentration(MIC) of azole antifungal agents against Candida sp. isolated from skin lesion using E test. METHODS: Twenty-seven clinical isolates of Candida sp.(including 24 C. albicans, 2 C. parapsilosis, and 1 C. guilliermondii) were tested. MIC endpoints of E test for itraconazole(ICZ) and fluconazole (FCZ) susceptibility were read after 24 hours for each isolates on Casitone agar. RESULTS: MIC of azole antifungal agents against Candida sp. : MIC of ICZ was 0.008-1.0microgram/mL on C. albicans, 0.023-0.125microgram/mL on C. parapsilosis, and 0.064microgram/mL on C. guilliermondii. MIC of FCZ was 0.5-4.0microgram/mL on C. albicans, 1.5-2.0microgram/mL on C. parapsilosis, and 0.5microgram/mL on C. guilliermondii. According to NCCLS(National Committee for Clinical Laboratory Standards) guidelines, two strains of C. albicans isolated from patients with Candidal intertrigo showed ICZ-resistant. CONCLUSION: We found that E test represented a simple and valuable method for susceptibility test for Candida sp.
Agar ; Antifungal Agents ; Candida* ; Danazol* ; Fluconazole ; Humans ; Intertrigo ; Skin

Malassezia intertrigo is a very rare clinical entity in which the clinical lesions occur in intertroginous areas as erythematous scaling macules and direct microscopic examinatons of scales reveal only large numbers of yeast forms of Malassezia organism. A 59-year-old man, developed brown, finely scaling macular lesions on the inguinal areas. Direct microscopy and culture of the scalings taken from the lesional areas of the patient revealed only oval forms of Malassezia organism.
Humans ; Intertrigo* ; Malassezia* ; Microscopy ; Middle Aged ; Weights and Measures ; Yeasts

Candidiasis is an acute or chronic infection caused most commonly by Candida albicans and occasionally by other species of the genus Candida. The superficial cutaneous candidiasis is varied; oral Candidiasis, perieche, candidal vulvovaginitis, candidal balanitis, candidal intertrigo, erosio interdigitalis blastomycetica, perianal candidiasis, candidal paronychia, candidal onychia, chronic mucocutaneous candidiasis, congenital cutaneous candidiasis, and candidid. Diagnosis can be made by typical appearance of the clinical lesions and the presence of satellite vesicopustules. This can be confirmed by KOH examination and culture of skin scrapings. Treatment is the correction of predisposing factors, topical therapy of imidazoles and/or systemic administration of itraconazole or fluconazole.
Balanitis ; Candida ; Candida albicans ; Candidiasis ; Candidiasis, Chronic Mucocutaneous ; Candidiasis, Cutaneous* ; Candidiasis, Oral ; Causality ; Diagnosis ; Fluconazole ; Imidazoles ; Intertrigo ; Itraconazole ; Male ; Paronychia ; Skin ; Vulvovaginitis

Chronic dermatological problems associated with lower limb amputation sites include local maceration, intertrigo, blistering and ulceration, contact dermatitis, tissue atrophy, verrucous hyperplasia, lichenification, callosities, epidermoid cyst formation, and malignant neoplasia. A 60 year-old male was presented with a verrucous oozing eruption of the amputation stump of the left leg. He had been involved in a railroad logging accident 30 years before, resulting in the loss of the left lower limb. He were a below-knee prosthesis (patellar-tendon hearing). We diagnosed him as verrucous hyperplasia by clinical and histological findings and then referred him to the division of rehabilitation for a refitting of his prosthesis, after which his eruption cleared two months later.
Amputation ; Amputation Stumps ; Amputees* ; Atrophy ; Blister ; Callosities ; Dermatitis, Contact ; Epidermal Cyst ; Humans ; Hyperplasia* ; Intertrigo ; Leg ; Lower Extremity ; Male ; Middle Aged ; Prostheses and Implants ; Railroads ; Rehabilitation ; Ulcer