Crusts, scabs, and eschars

2020 ◽  
pp. 393-402

Definitions and clinical images are used in this short chapter to permit differentiation between crusts, scabs, and eschars and their likely causes. These are listed as skin infections, trauma, or skin conditions such as eczema or blistering disorders. There are brief descriptions with appropriate treatment and there is cross-referencing to other chapters. Short summaries of diseases causing eschars are provided. These include bacterial infections (e.g. ecthyma, anthrax), viral infections (e.g. cowpox, orf), fungal (e.g. Tinea capitis), and protozoal (e.g. Leishmaniasis) conditions. Also included are skin diseases such as pityriasis lichenoides, toxins/allergens (from various bites and stings), and systemic disease such as autoimmune vasculitis, haematological disorders, or tumours.

Biology ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 192 ◽  
Author(s):  
Paulina Glowacka ◽  
Lidia Rudnicka ◽  
Olga Warszawik-Hendzel ◽  
Mariusz Sikora ◽  
Mohamad Goldust ◽  
...  

This review updates current knowledge regarding the risk of viral infections, including COVID-19, in patients treated with cyclosporine. We also shortly refer to bacterial infections and parasitic infestations in patients treated with cyclosporin. Cyclosporine is an immunosuppressive drug, which is widely used in medicine, including in the treatment of autoimmune skin diseases in dermatology, rheumatology, ophthalmology and nephrology, and in organ transplantation. A usual concern associated with immunosuppressive treatment is the potential risk of infections. Interestingly, several data indicate a relatively low risk of infections, especially viral infections, in patients receiving cyclosporine. It was shown that cyclosporine exerts an inhibitory effect on the replication of some viruses, or may have a potentially beneficial effect on the disease course in infections. These include hepatitis C, influenza virus, rotavirus, human immunodeficiency virus and coronavirus infections. Available data indicate that cyclosporine may have a beneficial effect on COVID-19, which is caused by the coronavirus SARS-COV2.


Author(s):  
NANDINI THUMMANAPALLY ◽  
KAVITHA LAWDYAVATH ◽  
CHARANDAS GURUVA ◽  
DEEPTHI ENUMULA ◽  
SASTRY PVK ◽  
...  

Objective: The objective of the study was to study the prevalence of various skin diseases in pediatric population. Methods: A prospective observational study was conducted at private children’s outpatient clinic in Warangal from March to August 2018 with the prior approval from the Institutional Ethical Committee BIPS/IEC/2018/P8. A total of 200 patients with various skin diseases of age group <17 years were included in the study. Results: Out of 200 pediatric skin disorders, male children 138 (69%) outnumbered female children 62 (31%). The mean age of the study population was found to be 5.85±4.11 years. About 64% of the patients are from rural area and 36% are from urban. The percentage of skin disorders is allergic infections (26%), bacterial infections (23%), viral infections (11%), fungal infections (7.5%), parasitic infections (6%), autoimmune disorders (4%), and skin adnexa (2.5%). Conclusion: Our study concludes that the prevalence of allergic and bacterial skin infections was found to be common among male children from rural area


2019 ◽  
pp. 189-211
Author(s):  
Leah Bauer ◽  
Carolyn Chooljian ◽  
Whitney Johnson

Generalized complaints such as fever, chills, malaise, and body aches are common presentations to the emergency department (ED). Some of these are due to viral infections, and some are due to systemic bacterial infections. Clues to the specific infection can be found in the geographic location of the patient or the patient’s exposure to wildlife (e.g., ticks) and animals. The patient’s history and the timing of the illness play an important part in helping to identify the possible source or cause of the infection. This chapter presents questions related to the diagnosis, clinical effects, and most appropriate treatment of a wide range of these systemic infectious disease emergencies.


2017 ◽  
Vol 9 (3) ◽  
pp. 113-118 ◽  
Author(s):  
Nabil A. Aljehawi ◽  
Omran O. Bugrein ◽  
Azza Grew ◽  
Gamal Ahmed Duweb

Abstract Cutaneous manifestations of human immunodeficiency virus (HIV) disease may result from HIV infection itself, or from opportunistic disorders secondary to the declined immunocompetence due to the disease. A total of 220 HIV positive patients, treated in the Benghazi Center of Infectious Diseases and Immunology over a period of 14 years (January 2003 to November 2016), were included in a retrospective study. The patients' age ranged from 7 to 46 years. The study was conducted by reviewing the patients' records using the management information system (MIS). Statistical analysis of the data was carried out by the t-test and Chi square test. Among the studied patients, 119 (54.1%) were males and 101 (45.9%) were females, and most of them (78.6%) were 10 – 19 years of age. The predominant mode of transmission was parenteral transmission, in 95% of patients, and positive family history was observed in 12% of patients. Among the total number of visits to dermatologists, 93% of patients had a single disease. Of the total number of skin diseases diagnosed during the visits, parasitic infestations were seen in 92 patients (21.0%), eczematous and related disorders in 78 patients (17.8%), viral infections in 71 patients (16.2%), bacterial infections in 41 patients (9.3%), and fungal infections in 35 patients (7.9%). Dermatophyte infections were the most common fungal infections recorded in 19 patients (4.3%), followed by Candida infection in 11 patients (2.5%). Warts were found in 5.9% of viral infections, followed by herpes zoster (4.1%). HIV positive patients should be examined for skin disorders, because early diagnosis and management of such problems improves the quality of life in these patients.


Author(s):  
Jeena Dixon D. ◽  
Rajesh Rajagopal

<p><strong>Background:</strong> Dermatological disorders are frequent among patients with psychiatric illness. The interaction between skin and mind is complex. Pre-existing skin diseases may be modified in psychiatric illness due to self induced changes which may delay the diagnosis and treatment of skin diseases and result in complications. There are only few published studies about skin diseases in psychiatric patients from south India. We are undertaking this study to highlight the importance of dermatology consultation in psychiatric patients.</p><p><strong>Methods:</strong> 200 patients with primary psychiatric disorders who accepted for the study were subjected to history taking and general examination. Detailed dermatological examination was carried out by visual inspection and clinical examination.</p><p><strong>Results:</strong> Out of 200 patients, 65 were diagnosed with major depressive disorder, 42 patients were with bipolar disorder, 40 with schizophrenia, 30 with obsessive compulsion disorder, 23 with anxiety disorder. 153 (76.5%) patients had dermatological findings, in which 84 (55%) had infectious disease, 35 (22.9%) had parasitic infections, 26 (17%) had fungal infections, 15 (9.8%) had bacterial infections, 8 (5.23%) had viral infections. 56 (36.6%) had non-infectious skin findings, 22 (14.4%) had acne, 15 (9.8%) had pruritis, 12 (7.84%) had eczema, 5 (3.3%) had psoriasis and 2 (1.3%) had vitiligo. 13 (8.4%) patients had psychodermatological problems, 10 (6.53%) had neurotic excoriation, 2 (1.3%) had delusion of parasitosis and 1 (0.6%) had trichotillomania.</p><p><strong>Conclusions</strong>: This study implies that there is a definite association of dermatology and psychiatry.</p>


Author(s):  
Chiara Vari ◽  
Patrizia Velotti ◽  
Alessandro Crisi ◽  
Silvana Carlesimo ◽  
Antonio G. Richetta ◽  
...  

Abstract. A broad range of literature reported higher rates of psychopathology and personality disorders among patients affected by skin conditions. Specifically, depression, anxiety, and suicidal ideations are more frequently reported by patients affected by skin diseases. This study aimed to examine psychopathology and personality in a group of patients affected by psoriasis by means of a self-report measure (Millon Clinical Multiaxial Inventory – MCMI-III) and a performance-based technique (Wartegg Drawing Completion Test [WDCT], CWS). Study results showed a higher rate of passive-aggressiveness and paranoia among psoriatic patients (MCMI-III). When assessing patients through the performance-based technique (WDCT, CWS), a higher rate of global rejection (GR) – linked by previous literature to suicidal ideation – and a lower affective quality of the drawings emerged. We discuss the clinical importance of detecting psychological issues in dermatology patients by means of a multimethod assessment that goes beyond patients’ self-evaluation of their symptoms and emotions.


2018 ◽  
Vol 24 (14) ◽  
pp. 1533-1550 ◽  
Author(s):  
Jong-Eun Kim ◽  
Ki Won Lee

Skin is a protective organ and the largest of the human body. Due to its pivotal role in aesthetic appearance, skin health has a significant impact on quality of life. Chronic inflammation of the skin often marks the beginning of various skin diseases. Immune-mediated responses serve to protect the body from external insults and require succinct control, and can lead to ongoing cellular damage and various skin conditions if left unchecked. Studies have shown that phytochemicals can alter processes involved in skin inflammation and alleviate the effects of aging, cancer, atopic dermatitis, psoriasis, and vitiligo. Direct molecular targets of some phytochemicals have been identified and their precise mechanisms of action investigated. In this review, we summarize recent findings on the effects of phytochemicals on skin inflammation and the mechanisms of action involved.


2020 ◽  
Author(s):  
Xiaoyu He ◽  
Juan Su ◽  
Guangyu Wang ◽  
Kang Zhang ◽  
Navarini Alexander ◽  
...  

BACKGROUND Pemphigus vulgaris (PV) and bullous pemphigoid (BP) are two rare but severe inflammatory dermatoses. Due to the regional lack of trained dermatologists, many patients with these two diseases are misdiagnosed and therefore incorrectly treated. An artificial intelligence diagnosis framework would be highly adaptable for the early diagnosis of these two diseases. OBJECTIVE Design and evaluate an artificial intelligence diagnosis framework for PV and BP. METHODS The work was conducted on a dermatological dataset consisting of 17,735 clinical images and 346 patient metadata of bullous dermatoses. A two-stage diagnosis framework was designed, where the first stage trained a clinical image classification model to classify bullous dermatoses from five common skin diseases and normal skin and the second stage developed a multimodal classification model of clinical images and patient metadata to further differentiate PV and BP. RESULTS The clinical image classification model and the multimodal classification model achieved an area under the receiver operating characteristic curve (AUROC) of 0.998 and 0.942, respectively. On the independent test set of 20 PV and 20 BP cases, our multimodal classification model (sensitivity: 0.85, specificity: 0.95) performed better than the average of 27 junior dermatologists (sensitivity: 0.68, specificity: 0.78) and comparable to the average of 69 senior dermatologists (sensitivity: 0.80, specificity: 0.87). CONCLUSIONS Our diagnosis framework based on clinical images and patient metadata achieved expert-level identification of PV and BP, and is potential to be an effective tool for dermatologists in remote areas in the early diagnosis of these two diseases.


Viruses ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 1
Author(s):  
Andréia Veras Gonçalves ◽  
Demócrito de B. Miranda-Filho ◽  
Líbia Cristina Rocha Vilela ◽  
Regina Coeli Ferreira Ramos ◽  
Thalia V. B. de Araújo ◽  
...  

Congenital viral infections and the occurrence of septo-optic dysplasia, which is a combination of optic nerve hypoplasia, abnormal formation of structures along the midline of the brain, and pituitary hypofunction, support the biological plausibility of endocrine dysfunction in Zika-related microcephaly. In this case series we ascertained the presence and describe endocrine dysfunction in 30 children with severe Zika-related microcephaly from the MERG Pediatric Cohort, referred for endocrinological evaluation between February and August 2019. Of the 30 children, 97% had severe microcephaly. The average age at the endocrinological consultation was 41 months and 53% were female. The most frequently observed endocrine dysfunctions comprised short stature, hypothyroidism, obesity and variants early puberty. These dysfunctions occurred alone 57% or in combination 43%. We found optic nerve hypoplasia (6/21) and corpus callosum hypoplasia (20/21). Seizure crises were reported in 86% of the children. The most common—and clinically important—endocrine dysfunctions were pubertal dysfunctions, thyroid disease, growth impairment, and obesity. These dysfunctions require careful monitoring and signal the need for endocrinological evaluation in children with Zika-related microcephaly, in order to make early diagnoses and implement appropriate treatment when necessary.


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