User-agent: Google Allow: A Simple Guide to Medical Conditions: itch

Search This Blog

Showing posts with label itch. Show all posts
Showing posts with label itch. Show all posts

Saturday, October 25, 2008

A Simple Guide to Cutaneous Larva migrans

A Simple Guide to Cutaneous Larva migrans
----------------------------------------------

What is Cutaneous Larva migrans?
------------------------------------

Cutaneous Larva migrans is a common skin condition which appears as a red snake-like itchy rash caused by penetration and subsequent migration of larvae of various worm parasites.

The condition is benign and self-limited.

It is most commonly found in tropical countries.

Who is at risk from Cutaneous Larva migrans?
---------------------------------------

1.People of all ages are affected but it is more common in children

2.It is more common in hot tropical climates

3.Certain occupations that involve contact with warm, moist, sandy soil:
Farmer
Gardener

4.Certain hobbies that involve contact with warm, moist, sandy soil:
Tropical climate travellers
Barefoot beach goers
Children building sandcastles

What are the causes of Cutaneous Larva migrans?
--------------------------------------------------

The larvae usually hatch from eggs laid in animal faeces and then penetrate through the intact skin of the children or adults.

After shedding their covering, they begin migrating in the epidermis.

Because they are unable to penetrate through the dermis, the disease remains limited to the skin of humans.

THE MOST COMMON PARASITES ARE:
DOG HOOKWORMS:
Ancylostoma braziliense
Ancylostoma caninum
Uncinaria stenocephala

Rarer causes are:
Ancylostoma tubaeforme (cat hookworm)
Necator americanus (human hookworm)
Ancylostoma duodenale

What are Signs and symptoms of Cutaneous Larva migrans?
----------------------------------------------------------

Symptoms:

1.prickling sensation at the site within 30 minutes of larva penetration of the skin

2.Intense itchiness

3.Red linear lesions that moves

4.walking barefoot on the beach in a tropical location

Signs:

1.Itchy, red, raised papules or vesicles

2.snakelike, slightly elevated, red tunnels that are 2-3mm wide and 3-4 cm long from the penetration site

3.Vesicles with clear fluid

4.Tract movement of 1-2 cm/day

5.peripheral eosinophilia (Loeffler syndrome),

6.migratory lung infiltrates,

7.Lesions are typically present on the distal lower extremities,
the dorsa of the feet and the interdigital spaces of the toes,
anogenital region,
the buttocks,
the hands, and
the knees.

How is the diagnosis of Cutaneous Larva migrans made?
--------------------------------------------------------

Diagnosis is mostly based on the
1.classic clinical appearance of the eruption.

2.peripheral eosinophilia on a Complete Blood Count

3.increased IgE levels on total serum immunoglobulin determinations.

4. skin biopsy taken just before leading edge of a tract may show
a larva (periodic acid-Schiff positive) in a
suprabasalar burrow,
basal layer tracts,
spongiosis
intraepidermal vesicles,
necrotic keratinocytes,
an epidermal and upper dermal chronic inflammatory infiltrate with many eosinophils.

What are the complications of Cutaneous Larva migrans?
-----------------------------------------------

1. secondary bacterial infection, usually with Streptococcus pyogenes, may lead to cellulitis.

2. Allergic reactions may occur.

What is the treatment of Cutaneous Larva migrans?
---------------------------------------------------------

The condition is usually self-limiting.
The intense itchiness and risk for infection may require treatment.

Invasive treatment:
---------------------
1.liquid nitrogen cryotherapy for progressive end of larval burrow.

2.electrocautery

Medication:
----------------

1.Thiabendazole
Thiabendazole is the best medication
Topical application is used for early, localized lesions.
The oral route is preferred for widespread lesions or unsuccessful topical treatment.

2.Mebendazole (Vermox)
Broad-spectrum anthelmintic that inhibits microtubule assembly and irreversibly blocks glucose uptake, thereby depleting the parasites' glycogen stores.

Other effective treatments include
3.albendazole,
4.ivermectin.

In most cases there is decreased itchiness within 24-48 hours and lesions resolve in 1 week.

5.Antibiotics are given if there are secondary bacterial superinfections.

6.Antihistamines are given for severe itchiness

What is the prognosis of Cutaneous Larva migrans ?
----------------------------------------------------

The prognosis is excellent.

This is a self-limiting disease.

Humans are accidental hosts and the larva usually dies within 4-8 weeks.

The lesions usually will disappear within 8 weeks to 1 year depending on complications.

What are the Preventive measures taken for Cutaneous Larva migrans ?
-----------------------------------------------------------------------------

Travellers to tropical regions and pet owners should be made aware of this condition.

Prevention is by avoiding direct skin contact with possible faecally contaminated soil.

Thursday, October 23, 2008

A Simple Guide to Prickly Heat

A Simple Guide to Prickly Heat
----------------------------------------------


What is Prickly Heat?
------------------------------------


Prickly Heat(also known as miliaria) is a common non contagious disease which appears as acute itchy red rash on the body due to retained sweat.


Who is at risk from Prickly Heat?
---------------------------------------


People of all ages are affected but it is more common in children and infants due to their underdeveloped sweat glands.

It is more common in hot and humid conditions.


What are the types of Prickly Heat?
----------------------------------------------


I.Miliaria crystallina-
minute superficial vesicular lesions that normally do not cause any symptoms

2.Miliaria rubra -
deeper layer inflammatory lesions causing the typical appearance of redness (hence rubra) and larger blister-like lesions.

There is intense itching with a lack of sweating to affected areas.

This is the most common form of prickly heat.

3.Miliaria profunda-
the most severe form of miliaria due to the rapid spread and severe burning sensations.

The obstruction is deep in the structure of the sweat gland resulting in the sweat to leak between the superficial and deep layers of the skin.

The rash occurs within hours of an activity provoking sweating and disappear within hours when the stimulus for the sweating is removed.

The risk of heat exhaustion is higher.


What are the causes of Prickly Heat?
--------------------------------------------------


The cause is the result of the keratin or dead skin cells or bacteria such as Staphylococcus epidermidis of the skin blocking the sweat ducts.

The occluded sweat ducts ruptures when sweating occur and the sweat form an intraepidermal vesicle which leads to irritation(prickly sensation) and itchiness.

Secondary infection may occurs from invasion of staphalococcus.


What are Signs and symptoms of Prickly Heat?
---------------------------------------------

Symptoms:

1.Occurs in humid hot weather

2.Small red papulovesicular rashes

3.Occurs on the face, neck, under the breasts, trunk, under the scrotum, skin folds, behind knee and antecubital fossa.

4.Usually very itchy

5.Rash usually presents with prickly sensation


How is the diagnosis of Prickly Heat made?
--------------------------------------------------------

1.Symptoms and signs of small rashes occuring in hot humid condition with itchiness and prickly sensation

2.Skin scraping for microscopic examination.


What are the complications of Prickly Heat?
-----------------------------------------------

1.Fungal infection

2.bacterial infection


What is the treatment of Prickly Heat?
--------------------------------------------------


A. Cool Environment
--------------------------
1. air-conditioned environment

2. avoid heat and sweat-inducing activities

3. avoid occlusive clothing,

4. take frequent cool showers.

B. Medicines:
-----------------
1. topical antibacterials may reduce the symptoms in miliaria rubra

2. anti-itch preparations such as calamine or menthol preparations

3. topical steroid creams,

4. Avoid oil based preparations because they increase blockage to the sweat glands.

5. Oral Antibiotics may be given if there is secondary infection.

6. Oral antihistamines may be given if itch is troublesome.

7. VItamin C or A in high dosages have not been found to be effective


What is the prognosis of Prickly Heat ?
------------------------------------------


Generally good to excellent but may recur.

Environmental factors like humidty and heat should be avoided.


What are the Preventive measures taken for Prickly Heat ?
--------------------------------------------------------


1.Good skin hygiene

2.Healthy lifestyle with balanced diet and adequate sleep.

3.Wear light clothing

4.Reduce sweating (use air conditioner)

5.Frequent showers should help

6.Avoid heat and humidity.



Sunday, December 16, 2007

A Simple Guide to Balanitis

A Simple Guide to Balanitis
----------------------------------


What is Balanitis?
----------------------


Balanitis is an infection of the glans and prepuce of the penis.

What are the causes of Balanitis?
---------------------------------------


It can occur because of:

1. Sexually transmitted bacterial diseases such as gonorrhea, chlamydia, candidiasis.

2. Viral diseases like genital herpes

3. Parasitic infection such as trichomoniasis

4. drug allergy and eruptions

5. Contact dermatitis,psoriasis,lichen planus,seborrheic dermatitis

6. collagen disease (Reiter's syndrome)

7. phimosis

What are the symptoms of Balanitis?
--------------------------------


1. Itchiness of the glans and prepuce with scratch marks

2. Pain and burning sensation on passing urine

3. Subpreputial(below prepuce) discharge 2-3 days after intercourse in venereal disease

4. Oedema of prepuce

5. Ulceration of the glans

6. Blisters or rashes in genital herpes

7. enlarged inguinal lymph nodes

How do you diagnose Balanitis?
--------------------------------------


Physical examination.

Blood tests for venereal disease and glucose

Urine for sugar and leucocytes


What is the treatment of Balanitis?
-----------------------------------------


1. Antibiotic

2. Hygience

3. Treat underlying cause. (eg Diabetes)

4. circumcision

What is the prognosis of Balanitis?
------------------------------------------

Prognosis is good.

Sometimes the disease may recur due to underlying causes.

Circumcision will cure any balanitis due to phimosis

A Simple Guide to Anal fissure

A Simple Guide to Anal fissure
-------------------------------------


What is Anal fissure?
--------------------------


Anal fissure is a superficial linear tear at the edge of the anus.

What are the causes of Anal fissure?
-------------------------------------------


Anal fissure occur after a tear in the posterior midline of the anus caused by the passage of hard large stools and constipation.

The tear is covered by a sentinel skin tag at the lower end(sentinel pile).

The tear may occur at any age but are more common in young children and pregnant women.

Sometime the tear may occur at the anterior midline of the anus.

What are the symptoms and signs of Anal Fissure?
------------------------------------------------------------


Symptoms:

1.Pain during and after passing motions

2.Serous discharge from tear

3.Itch (pruritis ani)

4.blood streak on stools

Signs:

1.sentinel skin tag covering a posterior midline tear of the anus

2.spasm of the anal sphincter

3.perianal infection

What are the investigations required in Anal fissure?
---------------------------------------------------------------


1.Digital examination of the anus

2.Proctoscopy to exclude piles

3.Sigmoidoscopy may be required in adults.

What is the treatment of Anal fissure?
----------------------------------------------


1.Stool softener

2.low residue diet

3.Avoid constipation -take more fruits and water

4.Give painkiller if necessary

5.Apply anti-itch cream

6.Use antibiotic cream if there is evidence of perianal infection

Saturday, December 8, 2007

A Simple Guide to Beestings

A Simple Guide to Beestings
----------------------------------


What are beestings?
--------------------------


Beestings include stings by different bees, wasps and hornets.
The most common sting is by the common honeybee.
Usually the bee stings the patient skin, leaving its stinger behind and dies.

What are the symptoms of Beestings?
-------------------------------------------


1. stinger left on the skin

2. pain and mild discomfort may last a few hours

3. swelling of the skin at the sting site in sensitive patients reacting to the venom of the sting

4. itch at the site may lasts for a week

The main component of bee venom responsible for pain is the toxin melittin.
Histamine and amines in the beesting contribute to the pain and itching.
Most beesting are acidic in nature.

What is the treatment of Beestings?
------------------------------------------


1.Remove the barbed stinger.

2.Apply cold compress to reduce pain and swelling.

3.Use baking soda solution to conteract the acid.

4.Give paracetamol and antihistmines
for pain and itch

For more severe reactions such as allergy and anaphylactic shock to the beestings, emergency treatment may be required:

1.Give adrenaline injection subcutaneously slowly over a minute peroid
followed by

2.antihistamine like diphenhydramine intravenously

3.Treat shock

4.Corticosteroids
may be needed to counter allergy

Multiple beestings may cause severe reaction with shock and hemaglobinuria.
This may require hospitalisation.

Multiple beestings have been known to cause the kidneys and vital organs to shut down and should be treated urgently.

Wednesday, November 7, 2007

A Simple Guide to Hepatitis A

A Simple Guide to Hepatitis A
-----------------------------------

What is Hepatitis A?
-------------------------

Hepatitis A is a acute inflammatory infection of the liver which is caused by the hepatitis A virus(HAV).

How is Hepatitis A virus spread?
--------------------------------------

The virus is excreted in faeces and transmitted through contaminated food and water. Eating shellfish, cockle shells, prawns or crabs taken from sewage-contaminated water is a common means of contracting hepatitis A.
It can also be acquired by close contact with individuals infected with the virus.
HAV causes the liver to become enlarged, inflamed and tender resulting in all the symptoms of hepatitis.
There is no chronic (long-term) infection.

What are the Symptoms of Hepatitis A?
----------------------------------------------

A person is infectious for 2-3 weeks before he or she experiences symptoms:
1.fever and joint pains

2.jaundice

3.fatigue

4.loss of appetite

5.nausea and vomiting

6.abdominal pain

7.pale coloured stools and dark urine

8.itchy skin due to irritation by the bilirubin.

During the first week of the illness he feels very sick and weak.
As the condition improves, the patient generally feels better after the first week but may requires to rest at home for 6 weeks to avoid damage to the liver.

How is the diagnosis of Hepatitis A made?
-------------------------------------------------

A blood test is the best way to diagnose hepatitis A.
His hepatitis antigens are raised at the early stage but as his condition improves the antibodies become positive.

His liver function tests are also done to assess the damage to the liver.
Usually the serum bilirubin is high, liver enzymes or tramsaminase, alkaline phosphatase are raised in the acute stage of illness.
As the condition improves, these tests gradually returned to normal.

What is the Treatment of Hepatitis A?
---------------------------------------------

There are no medicines for treatment of Hepatitis A except for symptomatic treatment of symptoms.
1.Rest in bed

2.multivitamins especially vitamin B to improve the function of the liver

3.Lots of fluids

4.carbohydrate diet

5.Anti-itch creams and lotions to stop itch

Recovery is usual with very rare cases going on to cirrhosis of the liver.

What is the Prevention of Hepatitis A?
---------------------------------------------

Hepatitis A vaccination is the best protection.
It is usually given in 2 doses within 1 year.

Immune globulin can be given for short-term protection.
It is given before and within 2 weeks after coming in contact with hepatitis A virus.

The vaccine is recommended for travellers travelling to developing countries and people with chronic liver disease.

Always practice good food hygiene
.
Avoid food like seafood which may be contaminated by unhygienic water.

Always wash your hands with soap and water after using the toilet, before preparing and eating food.

Recovery is usual within 6 weeks.

What is the difference between Hepatitis A and Hepatitis B?
----------------------------------------------------------------------

Hepatitis A is spread through eating food contaminated with the HAV virus.
Examples include partially cooked shellfish (oysters, clams) or in situations where there is poor hygiene (food/drink/utensils contaminated with an infected person's faeces).
Most people suffer an acute episode and upon recovery have immunity to Hepatitis A.

Hepatitis B is spread by contact with blood or body/fluids of an infected person (including a carrier) or from a carrier mother to her newborn during childbirth.
Hepatitis B infection can lead to hepatitis carrier stage or chronic hepatitis which can results in liver cirrhosis or cancer.

Subscribe Now: Feed Icon

Clicktale

Click and bookmark these Social Networking Bookmarks

Social Bookmarking bookmark at folkd

Labels

Is the medical Guide simple enough?

Ads by Adbrite