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With increased personal hygiene level and better nutritional status, the infections of the skin have come down drastically. The increased prevalence of diabetes, cancer and other diseases affecting the immune system have led to continued presence of skin infections. We will learn about a few common skin infections in brief

Bacterial Infections

Bacterial infections are most commonly caused by staphylococci or streptococci. The common clinical presentations are in the form of impetigo, folliculitis, furunculosis, abscess and echthyma.

Impetigo

Usually seen on exposed areas and is contagious. Predisposing factors – poor health and hygiene, malnutrition, atopic dermatitis and other skin infections. Clinical findings: starts as a reddish, flat lesion, then develops into fluid filled lesion (vesicles/ vesiculo pustule ) then breaks and leaves a crusting. Regional lymph node enlargement may be present.

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Echthyma

Deep bacterial infection that has an ulceration beneath the crusts. Ecthyma may be accompanied by fever and malaise.

Folliculitis

Folliculitis is infection of hair follicle and surrounding area. Commonly involved sites are hair bearing region that is subject to friction and maceration. Clinically presents as redness, warm painful, Pustules- that may rupture and leave behind a raw area

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Abscess

Abscess are walled–off collections of pus often larger than furuncles.
Treatment of bacterial infections: Oral and topical antibiotics, as per requirement (Based on culture and sensitivity of the organism demonstrated in the pus collection) Rarely, in recurrent cases long term therapy may be required. Proper hygienic measures are to be instituted.

Viral Infection

Warts

It is a very common growth on the skin caused by human papilloma virus. Warts are dry, rough and grows up to 2cm diameter.They usually grow on hands and feet but can also appear on the body. They can appear on the body. Treatment options are local applications, electric cautery or lasers.

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Molluscum Contagiosum

These are smooth surfaced pearly white small swellings caused by pox virus. These can appear in groups or wide spread on different parts of the body. It affects both children and adults and spread by person to person contact. Treatment options are local creams or surgical removal.

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Herpes simplex infection

Herpes simplex infections are caused by 2 viruses HSV1 & HSV2. The lesions are very painful, HSV1 affects face and nongenital areas, HSv2 affects genital areas. Treatment options are anti-viral tablets, pain killers and cold compress.

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varicellazoster(Shingles)

This very painful and debilitating disease is caused by same virus which causes chicken pox. People who have suffered from chicken pox before would still have the virus in the nerve Cuti Care. This virus become active when the persons immunity goes down. Fluid filled multiple lesions come-up along the nerve Cuti Care causing intense pain. These are spread by contact. The lesion always spread along the nerve in a linear fashion and usually affect the chest and thigh. Treatment is by anti-viral tablets, painkillers and antibiotics if needed.

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Fungal Infections

Fungal Infections are predominantly opportunistic in nature. It affects the skin folds where there is lot of sweat and warmth and in between the toes(athletes foot). It also affects people who take long term steroids, diabetics, pregnant ladies and immune compromised people.

Candidiasis

Usually affects the mouth and genital areas. In the mouth it causes white patches. Females with genital candidiasis will have white discharge and males will have white patches on their genitals. Treatment is anti-fungal agents and treatment of the underlying cause which led to Fungal infection.

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Dermatophyte infection

Based on the area affected, the types of dermatophytic infection are classified as: Tinea Capitis : Fungal infections of the scalp. Common in children. Clinically present as pustules around hair follicles, patchy hair loss, with broken hairs, scaling, sometimes associated with painful boggy swelling, oozing and crusting, which heals with scarring. commonly seen after tonsurance. The lesion spreads peripherally with central clearing.


Tinea barbae:Infection of beard region [Clinically seen as itchy, scaly, reddish lesion with a definite border]
Tinea corporis : Fungal infection involving the skin of the body.
Tinea cruris:Infection of groin and buttock region.
Tinea manium / tinea pedis: Infection of hands and feet respectively.
Onychomycosis: Fungal infection of nail.
Diagnosis :On examination and lab investigations which includes scraping for fungus.
Treatment: Includes topical or oral antifungal based on severity.

Seborrhoeic Dermatitis/ Dandruff

Clinically presents as diffuse, white or greasy scaling on the scalp usually associated with itching and sometimes associated with redness or inflammation.

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Contributing factors: Stress, genetic factors and cold weather. Other sites of involvement: face, eyes, intertrigenous areas (inframammary, groins and umbilical region), chest and back
Treatment:Topical shampoos, lotions and if severe oral antifungal.

Scabies

Scabies is an intensely itchy, contagious condition of the skin caused by a microscopic mite, Sarcoptes scabiei. Itching is due to an allergic reaction to the mites, and is associated with a rash of red, raised spots. The itch is worse at night, and may often affect more than one family member. Mite burrows into the skin in the webs of fingers, wrists, around elbows and armpits, the areolae of the breasts in females and on genitals of males, along the belt line, and on the lower buttocks. The face usually does not become involved in adults. Spreads by skin-to-skin contact , clothing, bedding, or towels. It takes approximately 4-6 weeks to develop symptoms after exposure.
Treatment:Oral and topical anti scabietic medications.

Pediculosis:

These are commonly called as lice. There are two types of lice – head lice & body lice. Head lice common in children and in crowded environment. Body lice is common in unhygienic adults. .

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Clinical presentation:

Irritation and itching, constant scratching may lead to skin darkening (Hyper pigmentation) and thickening (lichenification). Nits (eggs) are visible on hair shafts.
Treatment:Topical application of medicated lotions and rinsing after a period of contact (around 10 min). If severe, oral tablets are required. Hygienic measures are to be followed.