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How to manage a client with a foreign body in the ear

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  3. Foreign bodies in the ear are relatively common in emergency medicine. However, attempts at removal made outside the healthcare setting by untrained persons can result in complications of varying degrees. We conducted a 3-year retrospective review of 123 cases of aural foreign bodies at our hospital
  4. Purpose. This document provides clinical guidance for all staff involved in the care and management of a child presenting to an Emergency Department (ED) in Queensland with a suspected or confirmed foreign body in the ear. This guideline has been developed by senior ED clinicians and Paediatricians across Queensland, with input from ENT.

A foreign body in the ear can also damage the eardrum, which may or may not affect hearing. Because you can't see the eardrum from the outside, an exam of the ear is recommended. In the majority of cases, the situation of having something in your ear will not be life-threatening Management of foreign body in ear 1. Learning outcomes At the end of the online lecture, student should be able to: 1.Describe the sign and symptoms children with foreign body in the ear. 2. Identify the type of foreign body correctly. 3. Prepare the equipment correctly. 4. Differentiate the warning sign of complication . 5 Most ear and nose foreign bodies can be removed by a skilled physician in the office with minimal risk of complications. Common removal methods include use of forceps, water irrigation, and suction..

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  1. Localized external otitis caused by bacterial infection of a hair follicle Hearing impaired if the lesion blocks the canal, most commonly cerumen (wax) Treatment with local and systemic antibiotics, heat application, earwick to relieve pain, and possible incision and drainag
  2. Ear Problems In agony!! Tiniest foreign body in ear Follow Posted 4 years ago, 2 users are following..
  3. - ENT specialist doctor in Gurgaon can manage and diagnose disorders and diseases related to the ear, nose, throat, head, and neck. They can treat ordinary conditions that you frequently encounter like blocked ears, a stuffy nose, or a sore throat

If client is able to lie for 15 minutes, have client lay with affected ear up. Instill body temperature- warm water (37 degrees Celsius) into ear canal. Have client lie for 15 minutes with water in the ear, and then irrigate ear per procedure. 3.5.3 Procedure Explain procedure to client and gain verbal consent to proceed with irrigation Management focuses on reducing inflammation, edema, and pain. Nursing priorities include comfort measures, such as applying heat to the ear for 20 minutes three times a day. This can be accomplished by using towels warmed with water and then wrapped in a plastic bag or by using a heating pad placed on a low setting Assess for signs and symptoms of ear infection. Ask about frequency of ear hygiene. Observe the canal for earwax or foreign body. Ask about exposure to loud noises

Registrants must have a risk management plan in place to manage any complications that may arise or, if necessary, refer the client to a physician. In certain instances (e.g., impression material in the middle ear, dislodged tympanostomy tube, Vasovagal response), this could require immediate medical intervention. Registrants must counsel the client and significant others about negative consequences that might occur as a result of the ear impression process For mild infection, ear drops with vinegar and corticosteroids can help clear the infection. Your doctor may prescribe antibiotic ear drops for a more serious infection. Taking ibuprofen and acetaminophen can help manage the pain until the ear infection starts to get better. Keep the ear dry until the infection clears up Instillation of diluted alcohol Insects are killed before removal unless they can be coaxed out by a flashlight or a humming noise. Mineral oil or diluted alcohol is instilled into the ear to suffocate the insect. which then is removed by using forceps To increase client compliance, show them how to clean and treat the ears, provide detailed written instructions, and schedule follow-up calls, all of which can be done by skilled veterinary nurses. To increase patient compliance, provide pain control and ensure that ear cleaning and treatment are gently performed The other, an effort to remove a foreign body from the external ear, wasn't successful, although the doctor tried several times using different tools. How should we bill for these? A: When a procedure isn't completed, bill the CPT code for that service with the -52 modifier (reduced services)

object which will not swell Occasionally animal foreign body such as fleas, ants or flies may enter the external ear canal causing distressing tinnitus The creature is is killed by instilation of either alcohol or spirit and then may be syringed or suctioned out. LR/EO Instrument used in the removal of aural foreign bodies 12. Dhillon RS, East CA View ENT FOREIGN BODIES.ppt from A EN MISC at Zambian Open University. PRESENTATION ON FOREIGN BODIES OF THE EAR, NOSE AND THROAT MSN 442 J. KAPOBE 05/05/20 INTRODUCTION Foreign bodies of the ear Ear flushing The main purpose of a thorough ear flush is the removal of excessive cerumen, foreign body material, microorganism and their toxins, and inflammatory mediators. The goal should be to obtain a clean ear canal so that topical ear medication is able to directly interact with the epithelium

Gently pull the earflap straight up and hold it with one hand. Apply a small amount of medication into the vertical part of the ear canal while continuing to keep the earflap elevated. Hold this position long enough for the medication to run down to the turn between the vertical and horizontal canal Stand 4 feet away from the client to ensure that the client can hear at this distance. Whisper a statement and ask the client to repeat it. Whisper a statement with the examiners back facing the client. Whisper a statement while the client blocks both ears At a sink, stand over the sink, cup the hands, and put the face into the running water. Hold a glass of water to the eye and tip the head back. Do this multiple times. If one is near a shower, get in and put the eye under the running water. If one is working outside, a garden hose running at a very modest flow will work

The nurse is admitting a client in the emergency room with a foreign body in the ear identified as an insect. Which of the following interventions is a priority for the nurse to perform? Instill an antibiotic ointment into the affected ear Irrigate the affected ear Ear Surgery. Precautions: for 1 week: cough with mouth open, no shampooing, limite physical activity (3 weeks if active), airplane flights, may return to work after 3-7 days, keep ear dry 4-6 weeks after surgery, use cotton ball/vaseline if needed. Labyrinthitis Ear check - advice/education £10 Instrumentation wax removal £10 Irrigation £40 1 ear £60 2 ears Microsuction £40 1 ear £60 2 ears Removal of foreign body £10 Free follow up checks on discretion. With over 30 years nursing experience and 22 years caring for ears, clients can expect a professional, honest, tailor made appointment Client has cerumen in the ear. Chapter 64: Assessment and Management of Patients With Hearing and Balance Disorders - Page 1939 The client reports that the hearing aid is not helping, such that the sounds are not loud enough. This statement is consistent with inadequate amplification. Cerumen in the ears is a possible cause

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Management of foreign bodies in the ear: a retrospective

Often ear noises become audible when a foreign substance enters or during a middle ear infection. A number of illnesses stress can trigger subjective tinnitus.Sudden deafness or hearing loss is generally accepted as a cause of tinnitus. In summary: subjective tinnitus at a glance. Foreign substances in the auditory canal (e.g. a build up of ear. Definition. Ear irrigation is the process of flushing the external ear canal with sterile water or sterile saline. It is used to treat patients who complain of foreign body or cerumen (ear wax) impaction. Purposes. The purpose of ear irrigation is to remove earwax that is obstructing the ear canal or to remove a foreign object lodged in the ear canal A foreign body in the ear. Change in air pressure (from flying or diving) Arthritis in the jaw. A hole in the eardrum. Temporomandibular joint syndrome (TMJ) Sinus infections. Tooth infections. Treating ear pain depends on the cause. Infections may require prescription antibiotics. A foreign object needs to be removed by a doctor

Foreign body in the ear - Emergency management in children

Postprocedure Management . A normal tympanum usually heals in 21 to 35 days. Therefore, if the ear is kept free of infection after myringotomy, the tympanic membrane should heal within 5 weeks. Non-ototoxic antibiotic and steroids may be infused inside the middle ear and external ear canal after the ear flushing, if necessary Management may include: - Anti-reflux management. - Speech-language therapy assessment. Otolaryngology referral indicated if: 1. Hypopharyngeal foreign body suspected (oesophageal lesions and foreign bodies normally referred to General Surgery/ Gastroenterology - Category 1. 2. Dysphagia with hoarseness - Category 2

Foreign Body in Ear: How to Remove, Symptoms, Treatment

Dementia and Pain Management: A Personal Story. My father was screaming in the nursing home. The staff had tried changing any number of his medications, but nothing stopped his agitation until the physician ordered Vicodin, a strong painkiller. I called the physician and asked him to assess what might be causing my father's pain Other possible disease-causing agents include yeasts such as Malassezia, fungi such as Aspergillus, and ear mites which increase the likelihood of bacterial infection. Alternate causes include trauma to the body, such as from a car accident, the presence of tumors or polyps in the ear, and the presence of foreign objects in the ear Otitis externa is a common condition that is frequently seen in specialty dermatology clinics and small animal general practices. 1,2 It is defined as inflammation of the ear canal with or without involvement of the pinna. 1-3 Otitis is often considered a final diagnosis, but it is merely a clinical sign. The many factors that can contribute to otitis need to be addressed so that initial.

Earwax is produced by glands in the ear canal, which leads from the outer ear to the eardrum. Earwax helps protect the ear by trapping dust and other foreign particles that could damage the ear. Normally, earwax moves toward the opening of the ear and falls out or is washed away, but some people's ears produce too much wax Foreign body. The most common foreign body associated with otitis externa is the grass awn, foxtails, dirt, sand or toys however can be found on occasion. Acute inflammation, scratching at the ear and head shaking are usually noted. In chronic cases, suppurative inflammation is seen and even otitis media as a result of migration can occur

Management of foreign body in ear - SlideShar

If the infection is caused by a foreign body, such as a foxtail or tumor in the ear canal, treatment with medication alone will not resolve the problem. The dog must also be examined to be sure that the eardrum is intact. Middle ear or inner ear infections can result if the ear drum is ruptured Over-treatment such as over-use of an ear cleaner can lead to an excess of moisture within the ear canal and could cause mechanical trauma. Under-treatment, however, is the biggest reason for failure in managing cases of otitis. Drugs may not have been administered for long enough and in many cases we may just be under- dosing Side effects of treatment that interfere with the body's normal defense against infection. The body's defense against infection includes: Organs that are part of the immune system: Skin and mucous membranes: The skin is the largest organ in the body and our first line of defense against infection. Any break in the skin is a potential site of. Microsoft Azure Government has developed an 11-step process to facilitate access control with the security principles within CMMC, NIST SP 800-53 R4 and NIST SP 800-171 standards. Note this process is a starting point, as CMMC requires alignment of people, processes, policy and technology so refer to organizational requirements and respective. Manage app info from your devices. How shopping recommendations work on Google Search. Videos to help with the Search basics. Search educational resources. Google Search Forum. Share suggestions, ask questions, and connect with other users and top contributors in the Google Search community forum

Find out the best time to catch your supervisor's ear, such as 7:30 a.m. or Wednesday afternoons. Place matters too -- you may wish to time the receipt of your request with when your supervisors or clients have just arrived at work, or returned from lunch, and are in their offices checking email Section 41517.5: Medical Therapy Program. (a) CCS applicants with at least one of the following conditions shall be medically eligible for participation in the CCS Medical Therapy Program: (1) Cerebral palsy as specified in Section 41517.3 (a) (2). (2) Neuromuscular conditions that produce muscle weakness and atrophy, such as poliomyelitis. NCLEX 19 practice questions: Ear. Otosclerosis is a common cause of conductive hearing loss. Which such a partial hearing loss: The nurse has notes that the physician has a diagnosis of presbycusis on the client's chart. The nurse plans care knowing the condition is: A conductive hearing loss that occurs with aging Potential Causes: In many dogs, the ear appears to be an Achilles' heel that can show inflammation or discomfort before any other part of the skin. For example, allergies to foods or airborne allergens in the environment commonly cause skin problems on various parts of the body, especially the external ear canal. Often External Ear Canal Anatomy. The external ear canal is a funnel-shaped cartilaginous tube which extends from the external auditory meatus to the tympanic membrane. It comprises a vertical canal and a horizontal canal. The terminal portion of the horizontal canal is formed by a bony projection of the petrous temporal bone

Foreign Bodies in the Ear, Nose, and Throat - American

Use a free project management tool like ClickUp to stay on top of it all. Using a good project management tool will help you to: Allocate projects and tasks with detailed descriptions and files. Set clear deadlines, number of hours allocated, task dependencies. Check the status of your projects - in list or Kanban-style views I offer all of my clients a comprehensive list of diagnostic and treatment protocols. Here's an example of the procedures that could be included in the protocol for a possible foreign body obstruction: OTITIS Physical examination Ear cytology Culture and sensitivity Remove ear hair Ear flushing Antibiotic injection or prescription Ear.

Nursing Management of Patients with Ear and Hearing

Tinnitus can occur in one ear (left or right) or both. The noises originate in the head and ear canal rather than outside the body. There are about 200 health disorders that could cause tinnitus sounds. One of the most frequent reasons for ear ringing is hearing loss. The damage could be caused by age related factors, noise factors or both connect with clients or co-workers in different time zones. People who like to quit at 5 p.m. aren't the people who work well remotely, says Michelle LaBrosse, CEO of Cheetah Learning, a. Most piercing disasters occur after clients go home. Improper aftercare can lead to major complications, says Kristina Kelley, piercing manager at Stingray Body Art in Boston

The use of an endoscope during equine dental examinations, cleaning, floating, extractions or other procedures improves visualization and accuracy and allows for documentation of findings. Robust construction protects telescope from damage. Completely soakable. Light and irrigation connectors are rotatable Exporting. Exports are any resources, intermediate goods, or final goods or services that a buyer in one country purchases from a seller in another country. The International Trade Administration provides tools, assistance, and expert knowledge to help your company grow in the global marketplace. Depending on the good or service, you may need a.

Details Report for: 29-2092.00 - Hearing Aid Specialists. Select and fit hearing aids for customers. Administer and interpret tests of hearing. Assess hearing instrument efficacy. Take ear impressions and prepare, design, and modify ear molds Read This Before Taking Your Dog To The Emergency Vet. Dr Tamara Hebbler. April 16, 2021. Health emergencies are frightening - for you and your dog. You hand over your pet and your credit card and wait patiently for updates. Emotions build and that can lead to bad decision-making. And I've heard some horror stories general partner, managing member, or equivalent. The Final Rule also states that the ownership interests of foreign persons acting in concert or controlled by a single foreign state are aggregated.8 c. Covered Licensing Requirements The Final Rule did not change the definition of critical technologies.9 A mandatory licensing requirement i Central Auckland Auckland Hearing - Maree O'Sullivan 66 Michaels Ave, Ellerslie Adults (15 years and over) Fee: $60 - ACC clients (with ACC number): $20 Call: 09 525 0522 Text/SMS: 027 808 3522 Email: info@aucklandhearing.co.nz Book an appointment Boutique Ear Care Ear Nurse: Jing Feng Mt Hobson Specialist Centre - 155 Remuera Road, Remuera, Auckland 105

Evidence of foreign body in the ear canal Perforation of the tympanic membrane Pregnancy Breastfeeding Management of excluded clients If patient meets exclusion criteria, refer to medical practitioner Record the reason for exclusion and any action taken on PharmOutcomes. Management of patients requiring referra FOREIGN BODY. Foreign bodies in the nose and ear are common in children. A foreign body in the nose, unless impacted, may be inhaled and cause airway compromise. The best way of removal from the nose is to encourage the patient to blow it out themselves, although this can be very difficult in children Care Of The Clients With Eye And Ear Disorder (Exam Mode) By Rnpedia. A client arrives at the emergency room with a foreign body in the left ear that has been determined to be an insect. Which intervention would the nurse anticipate to be prescribed initially? Project Management Planning Trivia Quiz Project Management Planning Trivia Quiz

nal or middle ear Conductive hear-ing loss Insert and inspect ear canal and tympanic membrane. Dillon (2003); Jarvis (2004) Whisper test Able to hear (>50%) combina-tion of whispered numbers, letters, or words at 1 to 2 feet or less Conductive, sensorineural, or mixed hearing loss In a quiet environment, stand arm's length behind seated resident It is appropriate therefore to approach the diagnosis of ear disease just as you would for any other skin disease. Obtaining the signalment is the first step that must be taken when a dog is presented w/clinical signs of ear disease. Age, breed and sex can help point you in the right directions Tinnitus, a roaring in your ears, can be the result of loud noises, medicines or a variety of other causes. Meniere's disease may be the result of fluid problems in your inner ear; its symptoms include tinnitus and dizziness. Ear barotrauma is an injury to your ear because of changes in barometric (air) or water pressure A client arrives at the hospital emergency department and tells the nurse that there is something in his eye. The nurse looks into the client's eye and notes that the foreign body is visible and is not embedded. Which nursing action is appropriate? 1. Irrigate the eye with normal saline. 2. Tell the client that the object will work its way out. 3 Otitis externa is a common condition that is frequently seen in specialty dermatology clinics and small animal general practices. 1,2 It is defined as inflammation of the ear canal with or without involvement of the pinna. 1-3 Otitis is often considered a final diagnosis, but it is merely a clinical sign. The many factors that can contribute to otitis need to be addressed so that initial.

Ears. They're the bane of veterinarians and clients alike, not to mention the dogs and cats who must contend with itchy or painful ear conditions caused by environmental and food allergies, bacteria and yeast overgrowth, mites, foreign bodies, trauma, tumors, or polyps. Ear problems can spring from many different sources Management of acute, chronic and complicated ear infections. Ear infections in dogs and cats occur most commonly secondary to a foreign body (e.g. grass seed) or allergy and less likely to a polyp or tumor. Chronic and complicated ear infections can extend to the middle and inner ears Unit XIV. Renal and Urinary Disorders of the Adult Client, 838. 62 Renal System, 840. 63 Renal Medications, 875. UNIT XV. Eye and Ear Disorders of the Adult Client, 885. 64 The Eye and the Ear, 887. 65 Ophthalmic and Otic Medications, 908. UNIT XVI. Neurological Disorders of the Adult Client, 919. 66 Neurological System, 921. 67 Neurological. Ok guys, so hearing loss is when the hearing acuity is decreased. This can be caused by alterations in the external, middle, or inner ear. So sound is transmitted by air conduction and bone conduction - basically how the person receives sound. Usually air conduction of sound is more sensitive than bone conduction Otologic examinations evaluate for the presence of impacted cerumen or other foreign objects in the ear canal, which may require removal for relief of vertiginous symptoms. Signs of middle ear disease (e.g., fluid behind the eardrum, perforation, extensive scarring, hearing loss) should be further evaluated.

A foreign body ( FB) is any object originating outside the body of an organism. In machinery, it can mean any unwanted intruding object. Most references to foreign bodies involve propulsion through natural orifices into hollow organs. Foreign bodies can be inert or irritating. If they irritate they will cause inflammation and scarring foreign body in the external ear canal, otitis externa, keratosis obturans (build-up of keratin in the external ear canal). Keratosis obturans is more commonly seen in younger clients and is rare (especially in Western countries), but people may present with bilateral accumulation of large plugs of desquamate An aural hematoma is a collection of blood within the cartilage of the ear and the skin. It usually arises as a self-inflicted injury from your pet's scratching and head shaking. The underlying causes include all conditions that result in otitis externa (infection of the external ear canal).. Hematoma formation has also been associated with increased capillary fragility (e.g., as seen with. Why Is Time Management Important? Time management isn't a hard concept, but it is hard to practice well. Psychologists define it [1] as the ability to plan and control how [one] spends the hours in a day to effectively accomplish their goals.. People who manage their time well are planners.They look at their goals, and they decide how much time to devote to each in a given hour, day.

management:- removing wax blockage removing foreign body treating ear infection by medication ear irrigation aural toileting hearing aids surgical managemnt:- tympanoplasty stapedectomy myringotomy 43. hearing aids:- hearing aid is an electroacoustic device fits in or behind the ear & is design to improve hearing ability of wearer's Interdigital 'cysts' are a common, recurrent and painful problem in many dogs. Treating the secondary infections will often result in only a short to medium term resolution. Recurrence is very likely unless the primary cause is detected & treated. The paw (s) may be inflamed only, or inflamed and infected with any combination of microbes. Pending culture, instruct clients to wash paws daily with a combination of 2% chlorhexidine/2% miconazole shampoo. Pending culture, apply a polymyxin B and bacitracin ointment several times a day. If there is a concurrent Malassezia overgrowth, administer ketoconazole 5 mg/kg once daily or, in small dogs, itraconazole 5 mg/kg once daily The peak age of incidence is 6-15 months and decreases with age. It is less common at school age. More than 75% of episodes occur in children under 10 years of age. Otitis media occurs more in the winter than summer months, as it is usually associated with a cold. It occurs very slightly more frequently in boys than in girls A records management company may have to deal with selling both services and hardware and software products. A medical transcription and billing service would include topics such as Services Provided, Rates, Transcription, References, Qualifications, Billing Options, and so on

Rolesville Veterinary Hospital - Rolesville, NC Veterinarians

In agony!! Tiniest foreign body in ear Ear Problems

colonise the ear and then we have a severe otitis setting in. This vicious cycle of ear disease is illustrated on the next page. Treatment will therefore depend very much on what is causing the initial problem: Ear Mites - need specific treatment with anti-parasite therapy. Foreign Bodies - need to be removed Ear lobes usually take about two to three months to heal, and cartilage takes about three to 10 months. Once it stops hurting, swelling, and secreting fluid, and any redness disappears, it's. Linear Foreign Bodies in Dogs and Cats. Lipomas in Dogs and Cats. Sleeping and Resting Respiratory Rates in Managing Heart Failure in Dogs and Cats. Splenic Masses in Dogs (Splenectomy) Total Ear Canal Ablation and Ventral Bulla Osteotomy (TECA) for End-Stage Ears in Dogs and Cats Treating Ear Infections in a Dog or Cat. When you bring your pet in to see us, we will use an otoscope, with light and magnification, to examine the canals and tympanic membrane. By doing this, we will be able to make sure there is no foreign body present, such as plant material, and we will be able to check the health of the tympanic membrane Dogs with ear infections may violently shake their head or scratch their ears causing an aural hematoma. . In some cases, there may be a piece of foreign material lodged in the ear canal such as a tick, piece of grass, etc. It is also possible that a foreign body initiated the shaking but was later dislodged

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Overview. [Kirkland's] lawyers are super talented and super hard-working with expertise across numerous areas - Chambers USA, 2020. Our International Trade and National Security Practice provides strategic and legal advice to companies, investment funds and financial institutions operating or investing across international borders Dermatology for Skin Cancer Skin cancer is one of the easiest cancers to identify and find. This is due to the fact that skin cancer typically starts where i Body piercing is widely considered a simple procedure, with potential complications being under-recognised by both providers and their clients [6,13,14]. Commercial body piercing (not including regular ear piercing) is typically done at tattoo studios and non-commercial piercing 'backyard jobs' are not uncommon [6,14] In fact, HPV is estimated to cause 70 percent of the cancers that arise in these areas. Symptoms of cancers in this region include pain, intermittent bleeding out of the mouth, ear pain, a foreign body sensation in the throat, and if the cancer spreads to the neck lymph nodes, a new lump that persists in the neck

GPO and OMB Release President Biden's FY2022 Budget 05/28/21 The U.S. Government Publishing Office (GPO) and the Office of Management and Budget (OMB) have released President Biden's Fiscal Year 2022 Budget. GPO works with OMB to produce and distribute the President's Budget, an annual tradition since the Budget and Accounting Act was established in 1921 Alternate causes include trauma to the body, such as from a car accident, the presence of tumors or polyps in the ear, and the presence of foreign objects in the ear. As you can see there are occasional reasons why an ear infection wouldn't be caused by bacteria An allergy is when the body mounts an immune attack against one of these substances that it considers a foreign invader. The skin and ears get inflamed, and then the yeast and bacteria that are on the skin normally take advantage of this inflamed skin and overgrow to cause an infection. Topical medications can be effective if the client is.

Care of Patients with Ear and Hearing Problems Nurse Ke

Dog Ear Infection Lupus Mo Feb 05, 2021 · Allergy involves an exaggerated response of the immune system, often to common substances such as foods, furry animal dander, or pollen.; The immune system is a complex system that normally defends the body against foreign invaders, such as bacteria and viruses, while also surveying for abnormal. Veterinarians Dr. Sherburne and Dr. Brown perform advanced orthopedic procedures and spine surgery at The Animal Clinic of Billings and Animal Surgery Clinic in Billings Montana. Doctors Brown and Sherburne have more than 65 years combined veterinary practice experience and have successfully managed thousands of complex orthopedic injuries swelling, redness and increasing pain in the affected area. pus forming in or around the wound. feeling generally unwell. a high temperature (fever) of 38C or above. swollen glands under your chin or in your neck, armpits or groin. An infected wound can usually be successfully treated with a short course of antibiotics

Visual and auditory Management Practice Tests Nurses

We cover the best desktop, web and mobile apps, guides and how-to tips for Windows, Mac, Linux, Android and iOS The symptoms are typical for any dog ear infection, including odor, consistent scratching, sensitivity, discharge from the ear, swelling, and frequent shaking of the head. Pseudomonas. : This is a group of about 200 types of bacteria, which actually cause ear infections. Proteus Mirabilis. : This type of infection is a bacterial infection. The inciting factor that results in the malfunction of the immune system is usually not known. One theory is that the skin is somehow altered, making it appear foreign to the immune system. Since one of the immune system's normal functions is to remove foreign substances from the body, the immune system attacks the altered skin