Radiotherapy is one of the mainline treatments for cancer, but less commonly understood are some of the side-effects, which include skin problems that range from being mild (dull erythema and tightening of the skin) to severe (moist desquamation with open wounds and oedema). This article highlights an ongoing study that aims to assess the implementation of a best practice skin guideline for the management of both dry and moist desquamation in patients with evidence of radiotherapy-induced skin reactions.
Audrey Scott, Macmillan Head and Neck Clinical Nurse Specialist, Mount Vernon Cancer Centre, Hertfordshire
Over 60% of individuals receive radiotherapy as part of their cancer treatment, either with curative or palliative intent. Radiotherapy is usually provided as an outpatient service, which means that community nurses need to understand the most common radiotherapy-induced side-effect, an acute skin reaction, which can range from mild erythema to confluent moist desquamation. All patients receiving external beam radiotherapy are at potential risk of developing this reaction. This article presents information on the assessment and management of what can be a debilitating side-effect.
Ellen Trueman, Senior Sister, Radiotherapy Review Clinic, St James’s Institute of Oncology, Leeds Teaching Hospitals NHS Trust; Nursing Times 2011 Winner — Cancer Nurse Leader Award
In patients with venous and lymphovenous disease, skin changes to the lower limb(s) occur gradually, and become more serious over time if left untreated. The CHRonic Oedema Signs and Symptoms (CHROSS) Checker is a tool kit consisting of an assessment chart and key cards that have been developed to help clinicians easily identify the skin changes that occur as a result of underlying venous and lymphovenous disease, when carrying out holistic patient assessment. It also provides clear guidance on which compression products can be used to manage the disease type and severity of skin change. For clinicians unfamiliar with some or all of the signs and symptoms listed on the CHROSS Checker chart, the key cards contain further information in the form of a photograph, definition and cause of each sign and symptom listed. This article will describe the theory behind the development of the CHROSS Checker tools and explain how to use them in clinical practice.
Janice Bianchi, Independent Medical Education Specialist and Honorary Lecturer, Glasgow University
With government reforms increasingly bringing care into patients’ homes, community nurses will inevitably encounter more and more people who have a stoma. Stomas essentially involve the maintenance of a permanently open breach of the skin, therefore, the site requires expert skin care as it is vulnerable to stripping and break down. This article looks at the use of silicone-based adhesive removers, which improve quality of life and can also reduce healthcare costs as they prevent the escalation of peristomal skin dysfunction. These products also help to prevent costly ongoing treatment for the effects of stripping on sensitive peristomal skin.
Jackie Stephen-Haynes, Professor and Consultant Nurse in Tissue Viability, Birmingham City University and Worcestershire Health and Care NHS Trust
The roles of health care professionals are rapidly evolving. Over recent years, the nursing profession has taken on new challenges and extended roles in respect of patient care. Many nurses in senior roles work autonomously and at a higher level of practice, engaging in flexible cross boundary partnership working. In order to undertake such roles effectively, guidance is required to maintain standards. This article presents an overview of the development and implementation of a new dermatology pocket guide in Scotland.
Janice Bianchi, Medical Education Specialist/Honorary Lecturer Glasgow University MSc, BSc, RGN, RMN, Pg Cert TLHE,
Barbara Page, RGN, DipN BN, ENB 25, Dermatology Liaison Nurse, NHS Fife
Sheila Robertson, RGN, Dermatology Liaison Nurse, NHS Fife.
Article accepted for publication: June 2012
Psoriasis is a common, recurring inflammatory condition that affects the skin, scalp and joints. It can have a profound effect on an individual’s self-image, self-esteem, and sense of well-being and can negatively affect all aspects of life.
This paper will outline the physiological and psychological impact of psoriasis on the individual and discuss its subsequent impact on adherence to treatment. It will also examine the benefits of self-management of long-term conditions, such as psoriasis and look at the role nurses can play in helping to support self-management.
Susan Maguire, RN, BA (Hons), Professional Officer, British Dermatological Nursing Group, 88 Kingsway, London WC2B 6AA
Article accepted for publication: February 2012
People who are incontinent of urine and/or faeces are at greater risk of developing localised redness, irritation, skin peeling and fungal infections around the perineum, sacrum, groin, ischial tuberosities and hips. In addition, the risk of skin breakdown and pressure ulcers in association with moisture can be increased. This article will explore best recommended practice in the management of skin damage caused by incontinence.
Maureen Benbow MSc BA RGN HERC Senior Lecturer, University of Chester.
Article accepted for publication: January 2012
Fiona Wondergem describes a dermatology prescribing case study utilising a patient centred approach.
Fiona Wondergem MSc, BSc (Hons), PG Dip HV, PG Dip HPE, RGN, RSCN, Independent & Supplementary Prescriber V300 is a Senior Lecturer, University of Huddersfield, West Yorkshire
Article accepted for publication: December 2011
Dr Jay Herbert gives an overview of some of the most common forms of dry skin problems and their treatment.
Sarah Purcell & Dr. David Paige give a brief overview on the management of dry skin conditions in infants & young children.
