Answer 2 for NUR 606 Week 5 Discussion 1 Question-Based Discussion—Team A (Skin Disorders)

Thank you for your informative post on terms and examples regarding skin lesions. As future APRNs, we will come across many patients who live in environments with weather changes, mold, and dust or may smoke and have emotional stress, all of which can worsen atopic dermatitis. Considering these lesions, it’s important to identify skin conditions to treat them adequately. According to Osmosis (2020), an example of atopic dermatitis is Lichenification, and it falls into a Type 4 hypersensitivity reaction. As you pointed out, Lichenification has objective signs that include thick, dry, rough, and leatherlike skin surfaces. Some subjective symptoms of Lichenification, include eosinophilia (a high level of white blood cells), increased serum IgE, sensitivity in the infected area, and pruritis (VanMeter & Hubert, 2018). This type of reaction starts with an allergen in the environment. The allergen can travel through porous skin, and it gets picked up by an immune cell, which starts sensitization (Osmosis, 2020). This process ultimately leads to degranulation or release of pro-inflammatory molecules like histamine, leukotrienes, and proteases (Osmosis, 2020). The inflammation response can make the skin barrier leaky, allowing more of the allergen in while letting water escape, leaving the skin dry and scaly (Osmosis, 2020). Over a prolonged period, the skin can become lichenified, meaning it turns to leather, hence the term Lichenification. As a future APRN, one important fact is understanding that atopic dermatitis has a significant genetic factor associated with it. A study by Engler et al. (2019 identified that a positive parental history is the strongest risk factor for atopic dermatitis. When the disease presents in one parent, the likelihood of incidence in their child is doubled or tripled should both patients suffer from atopic dermatitis (Engler et al., 2019).