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Year22.tripod.comSection of Dermatology
• ' Tinea' is derived from the Latin word meaning clothes-moth which the Romans thought wasresponsible for this condition.
• It is caused by a superficial fungus that colonizes keratin (hair, nails and the stratum corneum) • There are three genera of dennatophytes infecting the skin: Microsporum. Epidermophyton andTrichopyton • Tinea infections often result from damage • Occlusion increases the local temperature and hydration of the skin, leading toimpaired barrier function.
• This probably explains why tinea pedis is a disorder of the shod and not those who go barefoot
• The margin is most active with a tendency • Tinea corporis (body)• Tinea cruris (groin) • In tinea capitis, there is scaling and • Tinea pedis (feet)• Tinea unguium (nails)• Tinea incognito (tinea masked by steroids) • Scrapings should be taken from the skin and • Whifield's ointment (3% benzoic acid. 3% • Allylamines e.g terbinafine (Lamisil).
mouth, gemtalia, flexures and nails usually the oropharynx. gastrointestinal tract or vagina in 80% of normal individuals.
• Nystatin. This is a polyene antibiotic. It is too toxic to use parenterally hut is effective topically.
• Extremes of age. menses and pregnancy • Amphotericin. Tills is another polyene antibiotic.
• latrogenic factors, for example antibiotics, It is used in a similar manner to nystatin.
oral contraceptives, steroids
• Imidazoles. These are easy to use topically. They have a broad spectrum, being also effectiveagainst tinea and pityriasis versicolor.
Ketaconazole is effective orallv.
• Fluconazole. This is a broad spectrum triazole that • Pityriasis versicolor is an infection of the skin is effective against dermatophytes, most Candida caused by a yeast that is ordinarily a commensal species and pityriasis versicolor. It may be given • Irtraconazole. This is a broad spectrum triazolc that • It is caused by the yeasts Pitvrosporum orbiculare is effective against dermatophytes, candida species and pityriasis versicolor. It is given orally.
• The yeasts become pathogenic and produce • Amphotericin B Very toxic therefore reserved lor pseudohyphae - in this state the organism is • The yeast is an opportunist, and growth in • The condition starts as a rnacule which grows insiduously and coalesces with other increase in environmental temperature and
• The macules may be darker or lighter than • It is a disorder of the healthy, but the • Topical glucocorticostcroids account for • P. versicolor occurs usually on the front of • Imidazoles - these are all effective topically light; the affected areas fluoresce a yellow • Oral therapy - Ketaconazole. fluconazolc THIS CONDITION
• Chromoblastomycosis is a chronic, warty cutaneous and subcutaneous infection with a • Chromoblastomycosis is caused by fungi that are saprophytic in wood or soil and are found in ruralareas.
• The organism enters via a wound (e.g. a splinter) and is most common in males who work outsidebare-legged.
• Skin biopsy is helpful in diagnosis.
• Scabies is an infestation with Sarcoptes • Surgical excision is used for early lesions or • It is transmitted from one individual to • Itraconazole is effective . often combined another by prolonged physical, and usually • Terbinafine is reported as being effective.
• Amphotericin intralesionally and • The burrow is visible early but itching is delayed a • The burrow is a serpiginous. linear track, a few millimetres long with a black dot visible at one • The itching results from an allergic reaction to the • Ivermectin. This is the only oral treatment.
• Papules are found between the fingers, elbows, buttocks, axillae, around the nipples and on thegenitalia.
What You Should Know About Osteoporosis Kristen B. Schnurman, PA-S Overview Osteoporosis is a bone disease that commonly affects older adults; post-menopausal women and elderly men are most often at risk. Osteoporosis means that your bones do not have the strength they used to have. This might be from not having enough bone or not enough minerals in your bone. Your bones go through a natural proce