207 Nursing Assessment, Management and Treatment of Autoimmune Diseases
When working with patients who are dealing with alopecia areata nurses have a responsibility to work with patients and families as they attempt to navigate the
mental health issues that often accompa- ny the disease. They should be prepared to discuss these issues and intervene ef- fectively.
CASE STUDY: MR. NATHAN LACY
Nathan has recently been diagnosed with alopecia areata. He has a few patches of alopecia over his scalp and is distressed over his hair loss. There is no hair loss of eyebrows or other facial hair. At 28 years of age, Nathan says, “I never thought I’d be going bald at my age!” The nurse practitioner, who is Nathan’s primary healthcare provider, assures him that there are treatment options for alopecia areata.
Question 1 : What treatment options are available to Nathan? Commentary on question 1 : There are several treatment options for Nathan. Treatment varies according to age and the amount of hair loss. Nathan is over 10 years of age and has only a few patches of alopecia. Corticosteroids may be injected directly into the bald areas every 4 to 8 weeks. Topical medications that are available are minoxidil (Rogaine) and/or anthralin. Minoxidil is applied to the bald spots once or twice a day. Anthralin is applied to bald spots and left on the skin for a prescribed amount of time, after which it is washed off. Patients should anticipate skin irritation when using anthralin. Treatment is most effective when these drugs are used together. Nathan also needs to receive emotional support. He has already told his nurse practi- tioner that he is distressed about his hair loss. Research shows that people who have alopecia areata are at risk for a variety of mental health issues including anxiety disorders, mood disor- ders, and personality disorders. A mental health assessment is very important as is ongoing observation and professional mental health consultation as needed. Celiac disease
on blood tests, and 0.7% based on the results of biopsies. The prevalence was higher in females than males and was sig- nificantly higher in children compared to adults (Celiac Disease Foundation, 2018). EVIDENCE-BASED PRACTICE Research shows that celiac disease typically becomes evident between the ages of 6 and 18 months after glu- ten-containing foods are introduced into the diet (Meadows-Oliver, 2019). Therefore, parents should be taught to carefully observe their children for symptoms of the disease during this period of time.
Celiac disease, also referred to as ce- liac sprue or gluten-sensitivity enteropa- thy, is an immune reaction to eating glu- ten, which is a protein found in wheat, barley, and rye (Mayo Clinic, 2020a). An estimated one in 100 people throughout the world are affected by celiac disease. Two and one-half million Americans are undiagnosed and at risk for long-term health-related complications (Celiac Dis- ease Foundation, 2018; Celiac Disease Foundation, 2021). A recent meta-analysis and review of studies from throughout the world showed that the world-wide prevalence of celiac disease is an estimated 1.4% based
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