Chemotherapy: uses and safety considerations

Topical chemotherapy is used for treating specific skin diseases. Dermatology nurses must understand topical chemotherapy use to minimize exposure for staff and patients.

Radiation therapy in the management of skin cancers

Radiation therapy plays a major role in the management of skin cancers. This article presents an overview of nonmelanoma skin cancer. A brief explanation of the mechanisms of action of radiation is provided. Side effects and related nursing management are discussed.

Actinic keratosis and premalignant skin damage

Because of the prevalence of actinic keratosis and its significance if untreated, dermatology nurses must understand the clinical characteristics, etiologies, and risks of malignant transformation of these lesions.

Xeroderma pigmentosum: a nursing perspective

Xeroderma pigmentosum is a rare disorder manifested by high rates of skin cancer due to abnormal repair of ultraviolet-induced DNA damage. This article describes clinical presentation, treatment, and nursing management for this severe and chronic disorder.

Mohs' surgery: nursing responsibilities, efficiency, and accountability

The increasing incidence and surgical treatment of skin cancer has also increased the nurse's role in this treatment. Nurses have certain pre-, intra-, and postoperative responsibilities to Mohs' surgery patients in providing the best possible care and treatment.

Healing by second intention: its use in Mohs' micrographic surgery

Healing by second intention is wound "healing by nature." This article discusses clinical advantages and patient benefits in allowing some wounds to heal by second intention as opposed to surgical repair, and the experiences and techniques employed by a dermatology department in Florida.

Fungating and ulcerating malignant lesions: a review of the literature

This paper presents a review of the literature concerning the care of cancer patients who develop fungating and/or ulcerating lesions. The nature, sites of presentation, prognosis, different therapeutic modalities, incidence among cancer patients and characteristics of the patients affected are discussed. In order to assess the current state of knowledge about wound management and to determine its applicability to malignant lesions, a review of the general wound healing literature was undertaken and is presented here in part. The review demonstrates that there is little published research which deals specifically with this condition. The reports which are available give little indication of the knowledge base and rationale on which nursing management is founded. The authors conclude that an informed and considered choice regarding the use of conventional and non-conventional topical agents and dressings is as pertinent to the nursing management of malignant lesions as it is to other wound types. They also suggest that awareness of and sensitivity to the psychological problems that such patients often present is as important as controlling the physical symptoms associated with this condition.

Complex wound management: a case study

Mr. G.'s situation was challenging, because it did not readily conform to the management techniques currently available and required consideration of psychosocial and other physical factors. To meet individual patient needs, nurses must be creative in finding solutions to unusual problems. By focusing on the short-term goals for wound management and the goals for family-centered home care as a guide to interventions, adaptations were made to fit this patient's needs.

Perceived well-being in malignant melanoma survivors

This study examined well-being in survivors of malignant melanoma. A conceptual framework was developed based on a review of the literature that identified locus of control, social support, and self-esteem as having a significant effect on perceived well-being. Data from 31 subjects were analyzed revealing that internal locus of control and self-esteem had a direct positive effect on well-being. This study provided new information for understanding the variables that influence cancer survivors' perceptions of well-being.

Cutaneous malignant melanoma: nursing's role in prevention and early detection

The incidence of cutaneous malignant melanoma (CMM) is increasing at an alarming rate. Risk factors that may contribute to the increase include ultraviolet (UV) radiation, lack of skin pigmentation, and genetic, hormonal, and immunologic factors. Although the exact nature of the relationship between melanoma and UV radiation is unclear, evidence suggests a correlation between sun exposure and CMM incidence. Caucasians with fair skin who sunburn and freckle easily and individuals with numerous nevi or moles and/or atypical nevi or moles are also at increased risk of CMM. Melanoma almost always is curable by surgery if it is detected early. Nursing can make a major contribution to reducing the morbidity and mortality of CMM both through educating the public in prevention and early detection measures and by screening individuals for suspicious lesions.

Neurofibromatosis: relinquishing the masks; a quest for quality of life

Neurofibromatosis (NF) or von Recklinghausen's disease is mankind's most common neurologic genetic disorder, occurring in one of every 3000 live births. While many individuals with NF suffer disfiguring, disabling, or life-threatening complications, NF is extremely variable in its symptoms, intensity, and progression. For many of its victims, NF is a pseudonym for uncertainty and physical and psychosocial havoc. John Merrick, 'The Elephant Man', endured one of the most severe cases of NF ever recorded. Merrick's rejection by post-Dickensian England forced him to become a sideshow circus attraction just to survive. The essence of nursing intervention with NF patients and their families engaged in the quest for quality of life is to restore them to optimal physical and psychosocial functioning, and, ideally, to help them utilize the experience for growth. Many individuals respond to the frustration of NF and society's reactions to the disorder by the wearing of psychological masks. Likewise, nurses may wear emotional masks as a defence against their own discomfort and fears concerning the disorders. Comprehensive nursing management of NF is realized only as nurses and patients relinquish their respective masks. This article examines the nurse's role in genetic disorders with special considerations presented by NF. Adaptation to NF involves coping with NF and its accompanying sequelae and coping with life as it is affected by NF. The concepts of 'chromosomal coping', 'genetophobia', 'genetic guilt, and 'genetic overload syndrome' are presented and analyzed utilizing the theoretical nursing frameworks of Imogene King and Sister Callista Roy.