Shingles, bruises, herpes, and bumps are all skin conditions that can affect people of all ages. However, they are much more common among the elderly population, i.e., people aged 60 years and above, and they often lead to serious medical implications. Motswaledi (2018) acknowledges that shingles are caused by the Varicella-zoster virus, which causes chickenpox. Considering that about 90% of the people in the United States have suffered from chickenpox in their lifetime, shingles is widespread among the US elderly affecting about 33% of the entire population (CDC, 2018).
If not treated, shingles and herpes can lead to impairment of vision and stroke caused by granulomatous arteritis. Among immunosuppressed patients, chronic encephalitis is a common phenomenon that occurs within months after the first attack of the virus (Motswaledi, 2018). When it comes to bruises, they are often caused by an impact on the skin. However, Dyer and Miller (2018) suggest that unprovoked cases often cause bruises among the elderly. The authors suggest that bruises and bumps cause weakness in the skin, which leads to delayed wound healing in cases of laceration, especially on the lower extremities. This delayed wound healing often results in chronic wounds that aggravate infections such as cellulitis.
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From the above discussion, it is clear that skin wounds, more so shingles, are shared among the elderly and often result in significant medical complications, which in rare cases, are irreversible. The following is a case of a patient who presented with a skin complication. The assessment, diagnosis, treatment, and management will be discussed in this section. The patient is a 58-year-old woman who noticed that she developed a rash on the left side of her chest. She described the rash as first appearing as a small strip of tiny bumps that felt like extreme goosebumps at first. The rash then persisted and began itching. It was at this stage that the strip became painful herpetic vessels with the formation of pruritus.
After a short history and assessment, the patient was diagnosed with shingles. The assessment involved locating the rash and having the patient describe how it began. Furthermore, the patient noted that she had been previously diagnosed with chickenpox at a very young age. The patient was prescribed with acyclovir to alleviate the nerve pain. Acetaminophen was added to her prescription as it helped relieve her overall pain. The patient was then advised not to touch the rash and always to keep it covered until the rash crusts dried off. Additionally, for prevention control, the patient was advised to steer away from pregnant women, premature infants, and people who are immunocompromised. Before discharge, the patient was then advised to consider vaccination as an alternative.
From the above management, the patient received an adequate standard of care and treatment. Conceicao (2018) acknowledges the shingles treatment as to include antivirals such as acyclovir and analgesics that are non-steroidal anti-inflammatory in nature. Acyclovir and acetaminophen both meet the suggested management, thus affirming adequate care to the patient. However, despite many of the signs pointing to shingles, it is crucial to have another form of assessment. Carrying out a lab test for the Varicella-zoster virus would have affirmed the presence of the condition. Also, the pruritus was indirectly managed since Conceicao (2018) proposes the use of antihistamines. They include chlorpheniramine that was not prescribed to the patient, despite her reporting the presence of a severe itch in the region of the rash. Incorporating these points in the next management of shingles will be essential in the provision of adequate standards of care to the patients.
References
Centres for Disease Control and Prevention (CDC). (2018, March 14). Shingles . Retrieved from https://www.cdc.gov/dotw/shingles/index.html .
Conceicao, V. (2018). Prevention and management of shingles and associated complications. Journal of Community Nursing , 32 (6).
Dyer, J. M., & Miller, R. A. (2018). Chronic skin fragility of aging: current concepts in the pathogenesis, recognition, and management of dermatoporosis. The Journal of Clinical and Aesthetic Dermatology , 11 (1), 13.
Motswaledi, M. H. (2018). Herpes zoster (Shingles). South African Family Practice , 60 (4), 28- 30.
