Symptom Management

Skin Problems

There are a number of skin symptoms that can accompany cancer, AIDS, sickle cell disease, and other illnesses. Such skin problems include dryness, rash, itching, sores, ulcers, and swelling. It is important for you to be aware of skin problems so that they can be treated as quickly as possible in order to reduce discomfort and the risk of infection.

Common Skin Problems

Pressure Sores – blisters or breaks in the skin caused when the body's weight stops the flow of blood to a certain area, causing a breakdown in the skin.
	Most likely to affect patients who are bedridden, underweight, malnourished, or dehydrated.
	Usually occur in bony areas, such as the head, elbows, heels, hips, shoulders, and tailbone.
	Sores are made worse when the patient rubs against his/her sheets.
	Signs and symptoms:
	-	red areas on the skin that do not go away when pressure is removed
	-	cracked, blistered, scaly, or broken skin
	-	an open sore on the skin's surface or invading deeper, underlying tissue
	-	yellowish stains on clothing or sheets
	-	pain at pressure points

Ulcers – crater-like lesions on the skin.
	Usually caused by inflammation or infection of the area, or an underlying condition that may affect the skin's ability to heal.

Edema – swelling of the skin that is caused by water and salt retention.
	Can occur from certain medications; heart, liver, or kidney failure; malnutrition; and obstruction of veins or lymph nodes.
	Signs and symptoms:
	-	swelling of feet and lower legs when sitting in a chair or walking
	-	tightness in the hands when making a fist
	-	swollen or distended abdomen

Itching – the desire to rub or scratch the skin .
	Can be the result of dryness, allergies, and side effects of medications or treatments.

Rash – bumpy, red, itchy skin.
	Commonly caused by an allergy, irritation, radiation therapy, or certain infections.

Dryness – rough, flaky, red, sometimes painful skin due to a lack of water or oil in the skin layers.
	Can be caused by dehydration, cold weather, heat, and side effects of treatments (such as chemotherapy and radiation).

What You Can Do to Help

Pressure Sores

	Keep skin dry and clean
	Check skin daily for pressure sores and other skin irritations
	Try to turn a bedridden person every few hours (or as often as possible), alternating positions.
	Encourage the patient to get out of bed as much as possible.
	Never leave the patient lying or sitting in wet clothes or bedding.
	Make sure the bedding is not wrinkled or irritating the patient's skin.
	Promote a balanced nutritious diet, high in protein (fish, poultry, dairy products).
	Do not open or break blisters.
	Put dry, clean gauze on any open areas.

Ulcers

Keep skin area clean and observe for signs of infection (pain, redness, drainage that looks like pus). Follow treatment instructions from the doctor, which may include wet dressings and topical antibiotics to control infection in open ulcers.

Edema

	Keep feet elevated when lying in bed or sitting
	Take medication, and restrict fluids or salt intake, as prescribed by the doctor

Itching/Rash

	Bathing the patient with cool water may help
	Add baking soda to bath water
	Apply a cool, moist cloth to itchy areas
	Wash sheets and towels in a mild laundry soap and change daily
	Avoid harsh laundry detergents
	Apply medications prescribed by the doctor for skin irritations

Dryness

	Add mineral or baby oil to warm bath water
	Apply moisturizers
	Make sure the patient drinks 8-10 glasses of water per day
	Do not scrub the patient's skin while bathing, and gently pat the skin dry

When to Call the Doctor

	If you see pressure sores (cracked, scaly, blistered, broken skin)
	If a pressure sore is getting larger
	If a cut becomes very red, sore, or swollen
	If skin gets very rough, red, or painful
	If a rash develops or hives appear
	If pus comes out of a wound or cut
	If severe itching lasts more than a few days
	If a rash becomes worse after applying ointment or cream
	If swelling spreads up legs or arms
	If the patient's belly becomes swollen