Eczema
Treatment
Currently, there is no curative treatment of eczema. Therefore, traditional interventions are limited to reducing inflammation and to alleviate the discomfort caused by eczema. Identification of allergens or irritants that cause them to avoid outbursts of eczema, which will relieve the symptoms.
Medications
Corticosteroids
Apply creams or ointments or corticosteroid to the affected areas, will reduce itching and inflammation. Sometimes oral corticosteroids are prescribed in severe cases, but only for a short period of time due to adverse effects such as bone demineralization.
Antihistamines
Antihistaminecele can sometimes be used to reduce itching. They are especially effective in children because it helps them sleep, preventing scratching during eruptive crises occurring at night.
Immunomodulators
Tacrolimus and pimecrolimus are two immunomodulating drugs recently. Their effect is to weaken the immune system (inflammation, for example) and can replace corticosteroids as appropriate, since they have fewer side effects.
Antibiotics are necessary in case of bacterial infections (particularly in impetigo).
Ultraviolet radiation therapy
Eczema Treatment Or fotochimioterapia Phototherapy (exposure to ultraviolet rays associated with taking a drug that sensitizes the skin before exposure to UVA) may be prescribed. It uses devices that emit UVA and UVB radiation. These methods, however, presents an increased risk of cancer or premature skin aging. Moreover, simple exposure to sunlight has beneficial effects in some patients.
Tuesday, February 1, 2011
Eczema Diagnosis
Eczema
Diagnosis
Contact eczema is identified by the fact that the reaction occurs between 12 and 48 hours after the suspect and use a product reproduces the contact area (bracelet, belt, watch, earrings, jewelry, etc.).
But this is not always topographic data (eg, nail polish that triggers a flare of eczema of the eyelids, because the patient often goes hand gestures to face daily).
Allergic eczema is diagnosed based on history and a thorough investigation. Diagnosis is confirmed using skin tests. For this, a number of allergens are used to cover the main substances that cause eczema. Different patches are applied to the skin of the patient (especially the rear), each containing an allergen solution. Patches are maintained 48 hours and results are read after this time. If the skin condition is normal, the test is negative (there is an allergic reaction). If skin is inflamed, the test is positive, the patient is allergic to the product tested. In addition, a positive test is measured according to the intensity of the reaction.
Diagnosis
Contact eczema is identified by the fact that the reaction occurs between 12 and 48 hours after the suspect and use a product reproduces the contact area (bracelet, belt, watch, earrings, jewelry, etc.).
But this is not always topographic data (eg, nail polish that triggers a flare of eczema of the eyelids, because the patient often goes hand gestures to face daily).
Allergic eczema is diagnosed based on history and a thorough investigation. Diagnosis is confirmed using skin tests. For this, a number of allergens are used to cover the main substances that cause eczema. Different patches are applied to the skin of the patient (especially the rear), each containing an allergen solution. Patches are maintained 48 hours and results are read after this time. If the skin condition is normal, the test is negative (there is an allergic reaction). If skin is inflamed, the test is positive, the patient is allergic to the product tested. In addition, a positive test is measured according to the intensity of the reaction.
Eczema Causes and Risk Factors
Eczema
Causes and Risk Factors
Despite research in the field, eczema causes remain largely unknown. What is known is the fact that both genetic factors and environmental ones are involved. Cases are distinguished internal and external causes (contact). The latter are common, representing over 50% of illnesses, but meeting and eczema related to household activities.
Eczema may be due to physical or chemical attacks multiple agents: animal substances, vegetable, various chemicals. This type of reaction is present in 70% of contact eczema. This phenomenon can be acute - in contact with skin, some aggressive chemicals trigger fast reactions with burning strictly localized area of skin contact (industrial solvents, detergents, etc..) Or chronic - is minimal trauma, but repeated; dry skin and painful cracks.
Atopic eczema, the most common type of eczema in children, often have a genetic component. But some patients find that environmental factors trigger outbursts of eczema. Triggers are numerous, the most common being detergents, soap, dust, animal dander (skin, hair, fur), mold, pollen and even sudden temperature variations. Contact Eczema is caused by an object that comes into direct contact with the skin: water, detergents, soap, saliva, acids, solvents, fiberglass, leaves of plants, etc.. Allergic contact eczema is a reaction that involves the immune system, triggered by a foreign substance (allergen): some herbs, resins, metals (especially nickel), adhesives, latex, rubber, perfumes, cosmetics, topical medications (applied directly skin). Seborrheic Eczema is caused by an immune system reaction to a fungus called Malassezia, present in areas rich in sebaceous glands of the skin (scalp, eyebrows, chest and back in men). The exact cause of the reactions of the organism is not known.
Risk factors
- Family history of allergy (allergic asthma, allergic rhinitis, food allergy, urticaria) - Life in a dry climate or urban areas
Factors that can aggravate eczema are many and very variable from one individual to another: - Irritation caused by contact with skin (wool or synthetic fibers, soaps and detergents, perfumes, cosmetics, sand, smoke, etc.). - Food allergens, or those from plants, animals, air - Emotional factors - anxiety, conflict and stress. - Skin infections, especially those with fungi - athlete's foot
Causes and Risk Factors
Despite research in the field, eczema causes remain largely unknown. What is known is the fact that both genetic factors and environmental ones are involved. Cases are distinguished internal and external causes (contact). The latter are common, representing over 50% of illnesses, but meeting and eczema related to household activities.
Eczema may be due to physical or chemical attacks multiple agents: animal substances, vegetable, various chemicals. This type of reaction is present in 70% of contact eczema. This phenomenon can be acute - in contact with skin, some aggressive chemicals trigger fast reactions with burning strictly localized area of skin contact (industrial solvents, detergents, etc..) Or chronic - is minimal trauma, but repeated; dry skin and painful cracks.
Atopic eczema, the most common type of eczema in children, often have a genetic component. But some patients find that environmental factors trigger outbursts of eczema. Triggers are numerous, the most common being detergents, soap, dust, animal dander (skin, hair, fur), mold, pollen and even sudden temperature variations. Contact Eczema is caused by an object that comes into direct contact with the skin: water, detergents, soap, saliva, acids, solvents, fiberglass, leaves of plants, etc.. Allergic contact eczema is a reaction that involves the immune system, triggered by a foreign substance (allergen): some herbs, resins, metals (especially nickel), adhesives, latex, rubber, perfumes, cosmetics, topical medications (applied directly skin). Seborrheic Eczema is caused by an immune system reaction to a fungus called Malassezia, present in areas rich in sebaceous glands of the skin (scalp, eyebrows, chest and back in men). The exact cause of the reactions of the organism is not known.
Risk factors
- Family history of allergy (allergic asthma, allergic rhinitis, food allergy, urticaria) - Life in a dry climate or urban areas
Factors that can aggravate eczema are many and very variable from one individual to another: - Irritation caused by contact with skin (wool or synthetic fibers, soaps and detergents, perfumes, cosmetics, sand, smoke, etc.). - Food allergens, or those from plants, animals, air - Emotional factors - anxiety, conflict and stress. - Skin infections, especially those with fungi - athlete's foot
Eczema Signs and symptoms
Eczema
Signs and symptoms
- Itchy red plates, crusts and scales, the precise location (depending on the type of eczema in question) - Pruritus (itching) - The appearance of small vesicles - While, the skin may thicken and dry, observing the loss of pigmentation and changes pilozitatii
In infants, atopic eczema affects especially the cheeks, scalp, shoulders, torso and thumb (for children who suck their thumb). The child over two years, are affected fold of the elbow, wrist, knees and ankles. The teenager, the lesions are located in some flexion creases of the limbs, but also around the eyes and the base. Later, in adults, the lesions are situated mainly in the neck, and upper and lower limbs.
The rash develops into four successive stages:
- The first stage is acute or erythematous skin with an intense red color, slightly distorted by the appearance of small blisters that give it a grainy appearance. This stage is very itchy (intense itching train). - Vesicles gradually gathers. - Breaking the third train vesicle stage (exudative), characterized by receiving a clear liquid. - The fourth stage is characterized by the appearance of scabs, which fall after the skin stays red, the scarring and healing evolution.
After chronic, eczema is presented in various forms, which can be classified into three main categories:
- Dried forms, characterized by the presence of red tiles, imprecise definitions, forming red plaques with scaling - Forms with lichenification - areas characterized by the presence of thickened skin, violet-purple, where the apparent emphasis on the appearance of wrinkles and cadrilaj) - Eczema dishidrotica - characterized by the appearance of blisters on the front side of the fingers, sometimes causing cracks on the palms and plants (feet)
Signs and symptoms
- Itchy red plates, crusts and scales, the precise location (depending on the type of eczema in question) - Pruritus (itching) - The appearance of small vesicles - While, the skin may thicken and dry, observing the loss of pigmentation and changes pilozitatii
In infants, atopic eczema affects especially the cheeks, scalp, shoulders, torso and thumb (for children who suck their thumb). The child over two years, are affected fold of the elbow, wrist, knees and ankles. The teenager, the lesions are located in some flexion creases of the limbs, but also around the eyes and the base. Later, in adults, the lesions are situated mainly in the neck, and upper and lower limbs.
The rash develops into four successive stages:
- The first stage is acute or erythematous skin with an intense red color, slightly distorted by the appearance of small blisters that give it a grainy appearance. This stage is very itchy (intense itching train). - Vesicles gradually gathers. - Breaking the third train vesicle stage (exudative), characterized by receiving a clear liquid. - The fourth stage is characterized by the appearance of scabs, which fall after the skin stays red, the scarring and healing evolution.
After chronic, eczema is presented in various forms, which can be classified into three main categories:
- Dried forms, characterized by the presence of red tiles, imprecise definitions, forming red plaques with scaling - Forms with lichenification - areas characterized by the presence of thickened skin, violet-purple, where the apparent emphasis on the appearance of wrinkles and cadrilaj) - Eczema dishidrotica - characterized by the appearance of blisters on the front side of the fingers, sometimes causing cracks on the palms and plants (feet)
Dermatophytic - Tinea Treatment
Dermatophytic - Tinea
Treatment
Use two major classes of antifungals: azolii and alilaminele. Azolii inhibit an enzyme that converts lanosterol to ergosterol, an important element of the fungal wall, leading to permeability and loss of reproductive capacity of the fungus. Alilaminele inhibit an enzyme that transforms squalene to ergosterol, leading to accumulation of toxic levels of squalene in fungi and death.
Therapy in tinea capitis. Choice of treatment is determined by the species of fungus, the degree of inflammation and immunological and nutritional status of the patient. Topical administration of griseofulvin is the first effective oral therapy for tinea capitis. Single topical treatment is not recommended and is inefficient. Antifungal as ketoconazole, itraconazole, terbinafine and fluconazole are effective options. The most used are terbinafine and itraconazole. Shampoo with selenium sulfide can reduce the risk of infection during the early expansion of the therapy reduces the number of spores.
Therapy in tinea barbae. Since this form of the disease in all affected hairs therapeutic procedure is similar to that of tinea capitis. It is recommended to shave the hair or hair removal hot compresses to remove crusts and waste. Topical antifungal formulas (shampoo, lotion, cream) can be applied but requires oral therapy. The prognosis is usually good. Inflammatory lesions spontaneously go into remission within a few months, however, let untreated scar alopecia. Noninflamatorii lesions tend to be chronic and not resolve spontaneously.
Therapy in tinea corporis and cruris. Topical therapy is recommended for a localized infection as dermatophytic rarely invade living tissue. This should be applied to at least 2 cm lesions with its edges once or twice a zit for 2 weeks. The use of topical azoles: econazole, ketoconazole, itraconazole, Clotrimazole, miconazole, oxiconazole, sulconazole. Sertaconazole is the newest agent of the group. Capacity is being used as a fungicide and anti-inflammatory agent with broad spectrum. Alilaminele: naftifina terbinafine in stratum corneum are neficiente because lipophilic nature. Also Adinda penetrates in the hair follicle. Ciclopirox olamine is a topical fungicide. It causes instability in the membrane by accumulating fungus and interfere with membrane transport of amino acids.
Medium potency topical corticosteroids may be added to topical fungal system. They should be used only in the first days of treatment. Regimes lead to prolonged atrophy, striae and skin teleangiectazii. For extensive tinea corporis, the immunocompromised, and resistance associated with topical antifungals or unguium tinea capitis, systemic therapy is recommended. The prognosis is excellent for localized tinea corporis, with a 70-100% cure rate after treatment. The infection may recur if treatment does not result in complete eradication of the organism. Reinfection can occur in reservoirs such as infected nails and hair follicles.
Therapy in tinea pedis. Tinea pedis can be treated with oral or topical antifungal agents or a combination of both. Use topical agents for 1-6 weeks. Patients with moccasin tinea treatment must apply on both sides of the foot. Ise appellant due to patient discontinuation of needles after symptoms disappear. Tinea pedis is recalcitrant and use keratinolitice and urea topical antifungal help to answer.
Dermatophytic - Tinea Treatment Hyperkeratotic tinea pedis as her chic inflammatory / vesicular require oral therapy, and patients with diabetes, onychomycosis, peripheral vascular disease, conditions imunocompromitere. Complications that can result from foot infection include cellulitis, limfangita, pyoderma, osteomyelitis. They are seen especially in patients with chronic edema, immunosuppression and diabetes.
Treatment
Use two major classes of antifungals: azolii and alilaminele. Azolii inhibit an enzyme that converts lanosterol to ergosterol, an important element of the fungal wall, leading to permeability and loss of reproductive capacity of the fungus. Alilaminele inhibit an enzyme that transforms squalene to ergosterol, leading to accumulation of toxic levels of squalene in fungi and death.
Therapy in tinea capitis. Choice of treatment is determined by the species of fungus, the degree of inflammation and immunological and nutritional status of the patient. Topical administration of griseofulvin is the first effective oral therapy for tinea capitis. Single topical treatment is not recommended and is inefficient. Antifungal as ketoconazole, itraconazole, terbinafine and fluconazole are effective options. The most used are terbinafine and itraconazole. Shampoo with selenium sulfide can reduce the risk of infection during the early expansion of the therapy reduces the number of spores.
Therapy in tinea barbae. Since this form of the disease in all affected hairs therapeutic procedure is similar to that of tinea capitis. It is recommended to shave the hair or hair removal hot compresses to remove crusts and waste. Topical antifungal formulas (shampoo, lotion, cream) can be applied but requires oral therapy. The prognosis is usually good. Inflammatory lesions spontaneously go into remission within a few months, however, let untreated scar alopecia. Noninflamatorii lesions tend to be chronic and not resolve spontaneously.
Therapy in tinea corporis and cruris. Topical therapy is recommended for a localized infection as dermatophytic rarely invade living tissue. This should be applied to at least 2 cm lesions with its edges once or twice a zit for 2 weeks. The use of topical azoles: econazole, ketoconazole, itraconazole, Clotrimazole, miconazole, oxiconazole, sulconazole. Sertaconazole is the newest agent of the group. Capacity is being used as a fungicide and anti-inflammatory agent with broad spectrum. Alilaminele: naftifina terbinafine in stratum corneum are neficiente because lipophilic nature. Also Adinda penetrates in the hair follicle. Ciclopirox olamine is a topical fungicide. It causes instability in the membrane by accumulating fungus and interfere with membrane transport of amino acids.
Medium potency topical corticosteroids may be added to topical fungal system. They should be used only in the first days of treatment. Regimes lead to prolonged atrophy, striae and skin teleangiectazii. For extensive tinea corporis, the immunocompromised, and resistance associated with topical antifungals or unguium tinea capitis, systemic therapy is recommended. The prognosis is excellent for localized tinea corporis, with a 70-100% cure rate after treatment. The infection may recur if treatment does not result in complete eradication of the organism. Reinfection can occur in reservoirs such as infected nails and hair follicles.
Therapy in tinea pedis. Tinea pedis can be treated with oral or topical antifungal agents or a combination of both. Use topical agents for 1-6 weeks. Patients with moccasin tinea treatment must apply on both sides of the foot. Ise appellant due to patient discontinuation of needles after symptoms disappear. Tinea pedis is recalcitrant and use keratinolitice and urea topical antifungal help to answer.
Dermatophytic - Tinea Treatment Hyperkeratotic tinea pedis as her chic inflammatory / vesicular require oral therapy, and patients with diabetes, onychomycosis, peripheral vascular disease, conditions imunocompromitere. Complications that can result from foot infection include cellulitis, limfangita, pyoderma, osteomyelitis. They are seen especially in patients with chronic edema, immunosuppression and diabetes.
Dermatophytic - Tinea Symptoms and Diagnosis
Dermatophytic - Tinea
Symptoms and Diagnosis
Clinical tinea is classified according to body area affected: Tinea capitis-scalp- Tinea corporis, trunk and extremities, Tinea pedis, tinea manuum and-palms, plants and interdigital Tinea cruris-groin- Beard area, tinea barbae, and neck Holding face-to-face Unghuium-nail-holding.
Tinea capitis. Occurs mostly in children and occasionally in other age groups. It is seen in children under 10. Infection begins through a small erythematous papule on the scalp, eyelids or eyebrows. In a few days becomes pale and scaly, the hair is discolored, dull and brittle. It breaks several mm from the scalp. Spreading lesion forming numerous papules form a circle. Round lesions may coalesce with other infected areas. Pruritus is usually minimal but can be intense. Alopecia is common in infected areas. Inflammation may be mild or severe. Red swollen areas characterized severe infection, with formation of pustules or kerion kerion called cels. In patients with severe infection may develop cervical lymphadenopathy.
Tinea barbae. The hair on the face appears at puberty so tinea barbae may only occur in teenagers and adult men. Infection begins on the chin or neck, but affected people can cover the entire area shaving. Occasionally may cause warty indurated plates or nodules. Can be asymptomatic, pruritus is characteristic easy. Spontaneous resolution may occur, especially in inflammatory tinea barbae. Sicoza wolf-like, you can profoundly shape appears. It is named so because it is similar to lupus vulgaris.
Tinea corporis. Infected patients may be asymptomatic. Symptomatic infection is characteristic of them round a plate appearance, itching, burning the local. HIV positive or immunocompromised patients may develop severe pain or itching. Tinea corporis may result from contact with infected people, animals or objects. History includes the veterinary profession, worked on farms, tester, contact with animals, working environment, contact sports: swimming.
Tinea corporis can occur intro variety of forms: Typically begins through a plate-scaly lesions, erythematous, which grows rapidly -After central lesion resolution may take the form of ring-cancellation -As a result of inflammation can develop scales, blisters, papules, vesicles, especially at the edges Rar may-called tinea corporis pruritic purpuric macules Zoophilia-infections caused by dermatophytes or geofili can produce more intense inflammatory reaction HIV-positive or immunocompromised individuals presents an atypical picture including deep abscesses or disseminated infection of the skin.
Majocchi granuloma perifoliculari manifest as localized granulomatous nodule typical two-thirds of the women's lower leg. Tinea corporis is manifested gladiatorum water head, neck sib rates, distribution attributed to melee combat. Tinea nested is recognized clinically by scaly plaques arranged in concentric rings distinct.
Tinea cruris. Adults are most affected. Patients accused itching and redness in the groin. Medical history shows boxers wearing elastic synthetic underwear wearing other people, participation in sports, tropical climate, diabetes or obesity. It manifests as erythema symmetrically groin. Wanness large erythematous spots with central peaks centered and dedicated to extending the thighs and pubic area. Scales are well demarcated in the periphery. In acute infection may be exudative erythema. Chronic infections are dried or cancellation arciforme papules, scaling barely perceptible to the edge. Central areas are erythematous papules and hyperpigmented and contain scales. Penis and observe are avoided, however the infection can spread to the perineum and thighs. Approximately half of patients with tinea cruris and tinea pedis shows.
Dermatophytic - Tinea Symptoms and Diagnosis Tinea pedis. Tinea pedis prevalence increases with age. Most cases occur after puberty. Patients describe ulcers and fissures itchy, scaly, painful fingers. More rarely describe ulcerative blistering lesions. Some patients, especially elderly ones, may assign dry skin scales.
Patients with tinea pedis shows four clinical presentations: Interdigital: -Is the most characteristic form of tinea pedis with erythema, maceration, fissuring and scaling, most often in digital spaces 4 and 5, is accompanied by itching -Dorsal surface of the foot is normal -Is associated with bacterial infection.
Chronic hyperkeratotic: -Is characterized by scaling erythema with chronic plantar hyperkeratosis few and diffuse, may be asymptomatic or itchy Is also called tinea pedis, moccasin, moccasins aviind a similar distribution -Both feet are affected -Dorsal surface of the foot is normal.
Inflammatory / vesicular: Characterized by bubbles or blisters, painful, itchy anterior plantar surface -Lesions may contain clear or purulent fluid Remain break-after scaling and erythema -That you hold can be complicated by cellulitis, and lymphadenopathy limfangita -May be associated with both eruptive dermatofitida called the reactive surfaces on the palm and fingers.
Ulcerative: -Ulcerative form is expanding rapidly through injuries veziculopustuloase, ulcers and erosions -Accompanied by bacterial infection -Malaise, cellulite, limfangita, fever may accompany this form -Is described in diabetic and immunocompromised.
Diagnosis
Dermatophytic - Tinea Symptoms and Diagnosis Laboratory studies: Direct-microscopy by treatment with potassium hydroxide specimens of nails, skin and hair follicles -Can be viewed hyphae, around hair spores can be observed Fungal cultures may be effectual, to identify species Wood-lamp examination showed yellow-green fluorescent M. canis and M. audouinii, T. schoenleinii produces dark green fluorescence.
The differential diagnosis is made with the following conditions: candida, cellulite, eczema, contact, erysipelas, impetigo, psoriasis, vulvo, alopecia areata, eritrasma, intertrigo, seborrheic dermatitis.
Symptoms and Diagnosis
Clinical tinea is classified according to body area affected: Tinea capitis-scalp- Tinea corporis, trunk and extremities, Tinea pedis, tinea manuum and-palms, plants and interdigital Tinea cruris-groin- Beard area, tinea barbae, and neck Holding face-to-face Unghuium-nail-holding.
Tinea capitis. Occurs mostly in children and occasionally in other age groups. It is seen in children under 10. Infection begins through a small erythematous papule on the scalp, eyelids or eyebrows. In a few days becomes pale and scaly, the hair is discolored, dull and brittle. It breaks several mm from the scalp. Spreading lesion forming numerous papules form a circle. Round lesions may coalesce with other infected areas. Pruritus is usually minimal but can be intense. Alopecia is common in infected areas. Inflammation may be mild or severe. Red swollen areas characterized severe infection, with formation of pustules or kerion kerion called cels. In patients with severe infection may develop cervical lymphadenopathy.
Tinea barbae. The hair on the face appears at puberty so tinea barbae may only occur in teenagers and adult men. Infection begins on the chin or neck, but affected people can cover the entire area shaving. Occasionally may cause warty indurated plates or nodules. Can be asymptomatic, pruritus is characteristic easy. Spontaneous resolution may occur, especially in inflammatory tinea barbae. Sicoza wolf-like, you can profoundly shape appears. It is named so because it is similar to lupus vulgaris.
Tinea corporis. Infected patients may be asymptomatic. Symptomatic infection is characteristic of them round a plate appearance, itching, burning the local. HIV positive or immunocompromised patients may develop severe pain or itching. Tinea corporis may result from contact with infected people, animals or objects. History includes the veterinary profession, worked on farms, tester, contact with animals, working environment, contact sports: swimming.
Tinea corporis can occur intro variety of forms: Typically begins through a plate-scaly lesions, erythematous, which grows rapidly -After central lesion resolution may take the form of ring-cancellation -As a result of inflammation can develop scales, blisters, papules, vesicles, especially at the edges Rar may-called tinea corporis pruritic purpuric macules Zoophilia-infections caused by dermatophytes or geofili can produce more intense inflammatory reaction HIV-positive or immunocompromised individuals presents an atypical picture including deep abscesses or disseminated infection of the skin.
Majocchi granuloma perifoliculari manifest as localized granulomatous nodule typical two-thirds of the women's lower leg. Tinea corporis is manifested gladiatorum water head, neck sib rates, distribution attributed to melee combat. Tinea nested is recognized clinically by scaly plaques arranged in concentric rings distinct.
Tinea cruris. Adults are most affected. Patients accused itching and redness in the groin. Medical history shows boxers wearing elastic synthetic underwear wearing other people, participation in sports, tropical climate, diabetes or obesity. It manifests as erythema symmetrically groin. Wanness large erythematous spots with central peaks centered and dedicated to extending the thighs and pubic area. Scales are well demarcated in the periphery. In acute infection may be exudative erythema. Chronic infections are dried or cancellation arciforme papules, scaling barely perceptible to the edge. Central areas are erythematous papules and hyperpigmented and contain scales. Penis and observe are avoided, however the infection can spread to the perineum and thighs. Approximately half of patients with tinea cruris and tinea pedis shows.
Dermatophytic - Tinea Symptoms and Diagnosis Tinea pedis. Tinea pedis prevalence increases with age. Most cases occur after puberty. Patients describe ulcers and fissures itchy, scaly, painful fingers. More rarely describe ulcerative blistering lesions. Some patients, especially elderly ones, may assign dry skin scales.
Patients with tinea pedis shows four clinical presentations: Interdigital: -Is the most characteristic form of tinea pedis with erythema, maceration, fissuring and scaling, most often in digital spaces 4 and 5, is accompanied by itching -Dorsal surface of the foot is normal -Is associated with bacterial infection.
Chronic hyperkeratotic: -Is characterized by scaling erythema with chronic plantar hyperkeratosis few and diffuse, may be asymptomatic or itchy Is also called tinea pedis, moccasin, moccasins aviind a similar distribution -Both feet are affected -Dorsal surface of the foot is normal.
Inflammatory / vesicular: Characterized by bubbles or blisters, painful, itchy anterior plantar surface -Lesions may contain clear or purulent fluid Remain break-after scaling and erythema -That you hold can be complicated by cellulitis, and lymphadenopathy limfangita -May be associated with both eruptive dermatofitida called the reactive surfaces on the palm and fingers.
Ulcerative: -Ulcerative form is expanding rapidly through injuries veziculopustuloase, ulcers and erosions -Accompanied by bacterial infection -Malaise, cellulite, limfangita, fever may accompany this form -Is described in diabetic and immunocompromised.
Diagnosis
Dermatophytic - Tinea Symptoms and Diagnosis Laboratory studies: Direct-microscopy by treatment with potassium hydroxide specimens of nails, skin and hair follicles -Can be viewed hyphae, around hair spores can be observed Fungal cultures may be effectual, to identify species Wood-lamp examination showed yellow-green fluorescent M. canis and M. audouinii, T. schoenleinii produces dark green fluorescence.
The differential diagnosis is made with the following conditions: candida, cellulite, eczema, contact, erysipelas, impetigo, psoriasis, vulvo, alopecia areata, eritrasma, intertrigo, seborrheic dermatitis.
Seborrheic dermatitis Treatment
Seborrheic dermatitis
Treatment
Skin care plays an essential role in controlling seborrheic dermatitis. Frequent washing with soap is recommended, since removing the fat from the affected regions. Exposure to ultraviolet rays from the sun is also beneficial, although to avoid sunburn. Pharmaceutical preparations for the treatment of seborrheic dermatitis include antifungal agents (selenium sulfide, pyrithione zinc, azole derivatives, topical terbinafine), which reduce fungal colonization and P. ovale anti-inflammatory agents (topical steroids). In severe cases, keratolytic agents (salicylic acid or tar containing products) can be used to remove dense crust, in combination with application of topical steroids. Other solutions to remove crusts consist of some oils (olive, etc..) Overnight to dissolve the crusts, followed by using a shampoo that contains tar. In cases refractory to treatment, the solution consists in the administration of agents that suppress the activity of sebaceous glands (isotretinoin).
Scalp Treatment Many cases of seborrheic dermatitis can be treated effectively with daily or once every two days of anti-dandruff shampoo containing selenium sulfide 2.5% or 1 to 2% zinc pyrithione. You can also use a shampoo containing ketoconazole. Shampoo should be applied to the scalp and leave on for 5 -10 minutes before washing. After the disease is controlled, frequency of use of medical shampoos may be reduced to two times per week, or in case of necessity. Terbinafine 1% solution is also effective in the treatment of seborrheic dermatitis affecting the scalp. If the scalp is covered with thick scales, they can be removed by applying a hot oil scalp and wash after a few hours with a shampoo that contains tar. An alternative is to apply during the night of a product containing keratolytic tar, scalp and then cover with plastic wrap, followed by shampooing in the morning. In case of inflammation, treatment consists of applying fluocinolone acetonide on the whole scalp, previously soaked, covered overnight with plastic wrap, then shampoo the morning. Treatment may be repeated every evening until the disappearance of inflammation, and then performed 3 times a week, or in case of necessity. Solutions, lotions or ointments with corticosteroids can be used two times daily for 1-3 weeks instead of the application of fluocinolone acetonide. Treatment can be discontinued with the disappearance of pruritus and erythema. Next, use anti-dandruff shampoos. Patients should be advised to uilizeze moderately strong topical steroids, as excess can lead to skin atrophy and telangiectasia.
Face Treatment Affected portions of the face can be washed frequently with shampoos effective against seborrheic dermatitis. Ketoconazole 2% cream may be applied 1 to 2 times daily on affected areas. Often, 1% hydrocortisone cream can be added to stop the redness and itching.
Skin care body Seborrheic dermatitis affecting the trunk can be treated by frequent washing with soaps or shampoos containing zinc-containing tar. In addition, ketoconazole 2% cream and / or creams, lotions or corticosteroid solutions applied 1-2 times a day is proving to be effective. Benzoyl peroxide is also effective in controlling seborrheic dermatitis of the trunk. These agents may excessively dry skin, so that patients can apply a moisturizer after the treatment.
Treatment in severe cases
Seborrheic dermatitis Treatment Patients with severe seborrheic dermatitis does not respond to conventional topical treatments may be candidates for isotretinoin therapy. Isotretinoin may result in a 90% reduction in size of sebaceous glands, which corresponds to a reduction in sebum production. Isotretinoin also possesses anti-inflammatory properties. Treatment with daily doses of isotretinoin may result in severe seborrheic dermatitis improved after four weeks. Then, establish a maintenance treatment with lower doses over many years. Treatment with isotretinoin is indicated for a small number of patients because of adverse effects on their shows. Isotretinoin is a teratogenic agent (may cause fetal malformations), and among its side effects include: hyperlipidemia, neutropenia (low white blood cells), anemia and hepatitis, Cheilitis, xerosis, conjunctivitis and urethritis. Long-term use was associated with diffuse idiopathic skeletal development hiperostozei (HSID).
Treatment
Skin care plays an essential role in controlling seborrheic dermatitis. Frequent washing with soap is recommended, since removing the fat from the affected regions. Exposure to ultraviolet rays from the sun is also beneficial, although to avoid sunburn. Pharmaceutical preparations for the treatment of seborrheic dermatitis include antifungal agents (selenium sulfide, pyrithione zinc, azole derivatives, topical terbinafine), which reduce fungal colonization and P. ovale anti-inflammatory agents (topical steroids). In severe cases, keratolytic agents (salicylic acid or tar containing products) can be used to remove dense crust, in combination with application of topical steroids. Other solutions to remove crusts consist of some oils (olive, etc..) Overnight to dissolve the crusts, followed by using a shampoo that contains tar. In cases refractory to treatment, the solution consists in the administration of agents that suppress the activity of sebaceous glands (isotretinoin).
Scalp Treatment Many cases of seborrheic dermatitis can be treated effectively with daily or once every two days of anti-dandruff shampoo containing selenium sulfide 2.5% or 1 to 2% zinc pyrithione. You can also use a shampoo containing ketoconazole. Shampoo should be applied to the scalp and leave on for 5 -10 minutes before washing. After the disease is controlled, frequency of use of medical shampoos may be reduced to two times per week, or in case of necessity. Terbinafine 1% solution is also effective in the treatment of seborrheic dermatitis affecting the scalp. If the scalp is covered with thick scales, they can be removed by applying a hot oil scalp and wash after a few hours with a shampoo that contains tar. An alternative is to apply during the night of a product containing keratolytic tar, scalp and then cover with plastic wrap, followed by shampooing in the morning. In case of inflammation, treatment consists of applying fluocinolone acetonide on the whole scalp, previously soaked, covered overnight with plastic wrap, then shampoo the morning. Treatment may be repeated every evening until the disappearance of inflammation, and then performed 3 times a week, or in case of necessity. Solutions, lotions or ointments with corticosteroids can be used two times daily for 1-3 weeks instead of the application of fluocinolone acetonide. Treatment can be discontinued with the disappearance of pruritus and erythema. Next, use anti-dandruff shampoos. Patients should be advised to uilizeze moderately strong topical steroids, as excess can lead to skin atrophy and telangiectasia.
Face Treatment Affected portions of the face can be washed frequently with shampoos effective against seborrheic dermatitis. Ketoconazole 2% cream may be applied 1 to 2 times daily on affected areas. Often, 1% hydrocortisone cream can be added to stop the redness and itching.
Skin care body Seborrheic dermatitis affecting the trunk can be treated by frequent washing with soaps or shampoos containing zinc-containing tar. In addition, ketoconazole 2% cream and / or creams, lotions or corticosteroid solutions applied 1-2 times a day is proving to be effective. Benzoyl peroxide is also effective in controlling seborrheic dermatitis of the trunk. These agents may excessively dry skin, so that patients can apply a moisturizer after the treatment.
Treatment in severe cases
Seborrheic dermatitis Treatment Patients with severe seborrheic dermatitis does not respond to conventional topical treatments may be candidates for isotretinoin therapy. Isotretinoin may result in a 90% reduction in size of sebaceous glands, which corresponds to a reduction in sebum production. Isotretinoin also possesses anti-inflammatory properties. Treatment with daily doses of isotretinoin may result in severe seborrheic dermatitis improved after four weeks. Then, establish a maintenance treatment with lower doses over many years. Treatment with isotretinoin is indicated for a small number of patients because of adverse effects on their shows. Isotretinoin is a teratogenic agent (may cause fetal malformations), and among its side effects include: hyperlipidemia, neutropenia (low white blood cells), anemia and hepatitis, Cheilitis, xerosis, conjunctivitis and urethritis. Long-term use was associated with diffuse idiopathic skeletal development hiperostozei (HSID).
Seborrheic dermatitis Causes
Seborrheic dermatitis
Causes
The etiology of seborrheic dermatitis remains unknown, although many factors (genetic, hormonal, environmental, etc.) are involved.
Pityrosporum ovale (a species of fungus) has been implicated in this disease. Seborrheic dermatitis is believed to be the result of an inflammatory response against this fungus, but this has not been demonstrated.
P. ovale is present at all, but the causes of seborrheic dermatitis in some people just are not known. The level of colonization of affected skin with this body is lower than that of healthy skin. However, the fact that seborrheic dermatitis responds to antifungal drugs suggests that the fungus is involved in this skin condition.
Genetic and environmental factors, and comorbid diseases increase the risk of developing seborrheic dermatitis.
Seborrheic dermatitis
Causes
Although seborrheic dermatitis affects only 3% of the general population, the incidence in people with HIV is 85%. People with central nervous system disorders (Parkinson's disease, cranial nerve paralysis, etc..) seem to be prone to seborrheic dermatitis or are refractory to treatment.
Causes
The etiology of seborrheic dermatitis remains unknown, although many factors (genetic, hormonal, environmental, etc.) are involved.
Pityrosporum ovale (a species of fungus) has been implicated in this disease. Seborrheic dermatitis is believed to be the result of an inflammatory response against this fungus, but this has not been demonstrated.
P. ovale is present at all, but the causes of seborrheic dermatitis in some people just are not known. The level of colonization of affected skin with this body is lower than that of healthy skin. However, the fact that seborrheic dermatitis responds to antifungal drugs suggests that the fungus is involved in this skin condition.
Genetic and environmental factors, and comorbid diseases increase the risk of developing seborrheic dermatitis.
Seborrheic dermatitis
Causes
Although seborrheic dermatitis affects only 3% of the general population, the incidence in people with HIV is 85%. People with central nervous system disorders (Parkinson's disease, cranial nerve paralysis, etc..) seem to be prone to seborrheic dermatitis or are refractory to treatment.
Seborrheic dermatitis Signs and symptoms
Seborrheic dermatitis
Signs and symptoms
Seborrheic dermatitis occurs in 3-5% of the population and is in the form of red plates, covered by greasy scales, more or less itchy.
This dermatitis is limited to the face and torso areas where sebaceous glands are numerous and very active. Distribution is symmetrical, and the affected regions are covered with hair - scalp, eyebrows, chin, and forehead, nasolabial grooves and ear canal. On the trunk, especially in the right scales appear sternum and skin folds - underarms, submammary, umbilical and anogenital.
Seborrheic dermatitis that occurs in the neonatal period, disappears in the first 6 to 12 months of life, is indicating that a maternal response to hormonal stimulation.
One of the features of seborrheic dermatitis is dandruff, characterized by scaly scalp, sometimes accompanied by pruritus (itching). Many patients believe that the appearance of these fine scales, white is due to dryness and use less shampoo, which favors the accumulation of scales. Inflammation that will worsen the symptoms.
More severe seborrheic dermatitis is characterized by the presence of greasy scales on erythematous background of boards. Patients accused itching and burning sensations in the face affected by seborrheic dermatitis. Untreated, scales can thicken and become yellow and fatty. Sometimes, there is a bacterial overgrowth.
Seborrheic dermatitis Signs and symptoms
Signs and symptoms
Seborrheic dermatitis occurs in 3-5% of the population and is in the form of red plates, covered by greasy scales, more or less itchy.
This dermatitis is limited to the face and torso areas where sebaceous glands are numerous and very active. Distribution is symmetrical, and the affected regions are covered with hair - scalp, eyebrows, chin, and forehead, nasolabial grooves and ear canal. On the trunk, especially in the right scales appear sternum and skin folds - underarms, submammary, umbilical and anogenital.
Seborrheic dermatitis that occurs in the neonatal period, disappears in the first 6 to 12 months of life, is indicating that a maternal response to hormonal stimulation.
One of the features of seborrheic dermatitis is dandruff, characterized by scaly scalp, sometimes accompanied by pruritus (itching). Many patients believe that the appearance of these fine scales, white is due to dryness and use less shampoo, which favors the accumulation of scales. Inflammation that will worsen the symptoms.
More severe seborrheic dermatitis is characterized by the presence of greasy scales on erythematous background of boards. Patients accused itching and burning sensations in the face affected by seborrheic dermatitis. Untreated, scales can thicken and become yellow and fatty. Sometimes, there is a bacterial overgrowth.
Seborrheic dermatitis Signs and symptoms
Monday, January 31, 2011
Dupuytren's contracture Treatment
Dupuytren's contracture
Treatment
In the early stages of disease when metacarpophalangeal joint contracture is below 15 degrees and there is sickness interphalangeal contracture can be treated medically.
Medical therapy. Multiple therapies have been tried: creams with vitamin E, allopurinol, colchicine, physical therapy and ultrasound, some without success. Topical retinoids have proved effective, topical corticosteroids, calcium channel blockers, tamoxifen. Therapies are still under study: Acetate Intralesional injections of triamcinolone in Colagenazo-enzyme-fasciomiotomia intralesional collagenase-injected -Ilomastat promising agent that inhibits fibroblast matrix formation 5-fluorouracil decreases collagen formation by inhibiting fibroblast differentiation and miofibroblastelor -Radiation Immunomodulator imiquimod, which decreases TNF-alpha and fibroblast growth by lowering IL2 infiba Botulinum toxin-inflammatory pathway inhibits the activation of IL2 intralesional.
Surgical therapy. Surgery is indicated when the contraction is over 20 metacarpofalangiana joint degrees and over 30 degrees at the interphalangeal. Surgical methods include: Involves excision-fasciectomia-palmar fascia -Fasciomiotomia-limited incisions, diseased tissue is removed but not incised. Complications of surgery include infection, damage to arteries, nerves, carpal tunnel syndrome, hematoma formation, wound necrosis, scar contraction. Regional pain syndrome known as reflex dystrophy simpatico occurs in 10% of patients who have surgery.
Prognosis. Dupuytren's contracture Treatment Spontaneous resolution without treatment does not appear. Progression is unpredictable and not all cases anatomic deformation progresses. Patients with early onset disease tend to present the picture more aggressive, often requiring surgery. The rate of recurrence is related to disease severity, multiple lesions and coexistent diabetes. Postoperative recurrence rate is 60%.
Treatment
In the early stages of disease when metacarpophalangeal joint contracture is below 15 degrees and there is sickness interphalangeal contracture can be treated medically.
Medical therapy. Multiple therapies have been tried: creams with vitamin E, allopurinol, colchicine, physical therapy and ultrasound, some without success. Topical retinoids have proved effective, topical corticosteroids, calcium channel blockers, tamoxifen. Therapies are still under study: Acetate Intralesional injections of triamcinolone in Colagenazo-enzyme-fasciomiotomia intralesional collagenase-injected -Ilomastat promising agent that inhibits fibroblast matrix formation 5-fluorouracil decreases collagen formation by inhibiting fibroblast differentiation and miofibroblastelor -Radiation Immunomodulator imiquimod, which decreases TNF-alpha and fibroblast growth by lowering IL2 infiba Botulinum toxin-inflammatory pathway inhibits the activation of IL2 intralesional.
Surgical therapy. Surgery is indicated when the contraction is over 20 metacarpofalangiana joint degrees and over 30 degrees at the interphalangeal. Surgical methods include: Involves excision-fasciectomia-palmar fascia -Fasciomiotomia-limited incisions, diseased tissue is removed but not incised. Complications of surgery include infection, damage to arteries, nerves, carpal tunnel syndrome, hematoma formation, wound necrosis, scar contraction. Regional pain syndrome known as reflex dystrophy simpatico occurs in 10% of patients who have surgery.
Prognosis. Dupuytren's contracture Treatment Spontaneous resolution without treatment does not appear. Progression is unpredictable and not all cases anatomic deformation progresses. Patients with early onset disease tend to present the picture more aggressive, often requiring surgery. The rate of recurrence is related to disease severity, multiple lesions and coexistent diabetes. Postoperative recurrence rate is 60%.
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