| Journals Watch
2001 This section features a constantly updated list of recently published articles relevant to nurse prescribing. Abstracts of the papers are included and incorporate an expert's opinion about the article. Users are encouraged to submit their views about published papers through the feedback section. Please note: In this section of the website we aim to cover articles on areas where nurses do prescribe. However, not all the treatments or appliances mentioned are prescribable by nurses. For that reason, nurses should check the up-to-date versions of the Nurse Prescribing Formulary and Drug tariff if they are in any doubt. Skin care Clark S and Hoare C. Making the most of emollients. The Pharmaceutical Journal 2001; 266:227-229 Summary: Although emollients are often prescribed for conditions such as atopic eczema, contact dermatitis and psoriasis, they are often used incorrectly. The prescription or use of small amounts may add to the perception that they are ineffective. The article describes the function of the epidermal barrier, how dry skin results from abnormal function and how the barrier can be healed using emollients. It then looks at the practical use of emollients and suggests that using a combination of lotions, creams and ointments is most effective. Lighter creams may be preferred during the day. Other suggestions include avoiding contact with shampoo on affected areas, avoiding sweating, carrying emollient in a small container to encourage its frequent use, and avoiding biological powders and fabric softeners with laundry. Individuals may have to try different emollient products to find the most suitable one for them: compromise may be necessary as the greasier products are generally more effective but less acceptable to patients. Some emollients contain potential allergens. It is important to discuss the choice of emollient and its correct use with the patient: the recommendations for complete emollient therapy, emollient bath oil and emollient soap substitute are described. The correct use of emollients may reduce the quantity of topical steroid preparations needed. backWebsite: www.pharmj.com Hicks R. Infected eczema. Practice Nurse 2001; February 23; 34-38 Summary: Even mild eczema is likely to harbour Staphylococcus aureus, which can make the condition worse and reduce the effects of steroid treatment. Here, the author discusses how to identify and resolve this problem. Although eczema can be colonized by this bacteria without obvious signs, the classical clinical signs are redness, excoriation, weeping and crusting. Swabs should also be taken if the eczema does not respond to treatment. The toxins from Staphylococcus aureus act as superantigens (low levels produce considerable immune reactions) and hamper the efficacy of steroids. Infection must therefore be diagnosed and treated with a combination of steroid and antibiotic, as well as emollients. A steroid used alone to treat overtly infected eczema is likely to increase colonization. A combination cream or ointment such as fusidic acid plus betamethasone cream can be used in mild to moderate cases and in more severe cases an oral antibiotic is used as well as topical steroid. back
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