SKIN CHANGES
The different structures that make up the skin have a limited number of pathologic responses against the multiple stimuli that may affect it. These responses are called elemental lesions. The whole collection of them, which appear on the skin of a patient are called skin rash.
The correct interpretation of the elemental lesions is essential for the diagnosis as in skin patients, the symptoms are very limited (itching, pain, swelling), and, in many cases, inexistent.
The identification and treatment of the main condition is the way to cure these skin rashes.
In Anterior items we have dealt with skin conditions (allergies, boils, parasites). We will now comment on certain problems that may occur on board, as they are quite common.
Cracks
Picture 8-17: Crack
They appear in body areas exposed to wind or salty water, or if the skin is not dried properly. Irritation and pain may occur.
If possible, try to avoid the causes that produce it, and cover the lesion with vaseline or moisturising cream and keep warm (wear gloves, for example).
Picture 8-18: Dermatitis
Skin irritation, usually due to substances which have been mishandled or misused. In other cases it is due to allergies. The most frequent irritants are detergents, washing powder, fish preservatives, solvents, petrol or derivatives.
There are several kinds of dermatitis, but in most cases they start with diffuse reddening of the affected skin. Small vesicles may appear, which break up producing scabs.
Firstly, look for the irritant agent and avoid exposure. Once other causes have been discarded, give corticoid ointment on the lesion three times a day (DRAWER 10, first aid kit A); do not prolong the treatment for more than a week, unless under medical prescription.
Picture 8-19: Impetigo
It usually affects exposed areas, such as face and hands. It starts as a liquid blister, which soon breaks up and is covered by a yellow scab. The surrounding skin is healthy.
Due to the risk of spreading, hands must be washed carefully after having treated the affected area. The treatment must be provided twice a day with an antiseptic solution (chlorhexidine, DRAWER 14, first aid kits A and B). Face rashes will be left exposed, but those in the hands or in any other covered part must be dressed with a dry gauze on a daily basis.
Picture 8-20: Heat rash
It usually occurs in tropical areas or very warm work environments, especially when humidity is very high. It affects areas where the clothes are tight or rub, or in skin folds.
It starts with small, disseminated red spots, which itch; sometimes small blisters develop in the centre of the small spots, which may break up and become infected later on.
There may be other general symptoms such as fatigue, headache or cramps. Take special care with clothing, which should be lightweight, relaxed and breathable. Have cold showers, but do not use soaps. After, dry the skin without rubbing. It is advisable to use Vaseline on areas where clothes rub.
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