Skin infections and infestations can be caused by bacteria, fungi, viruses, or infestations. Common bacterial infections include impetigo, cellulitis, and folliculitis. Fungal infections such as ringworm and candidiasis are also frequent. Viral warts and molluscum contagiosum occur commonly. Infestations like scabies and head lice can spread rapidly among close contacts. Effective treatment depends on the specific causative organism and may involve topical or oral antibiotics, antifungals, antivirals, or pesticides.
Skin infections and infestations are commonly seen in primary care. They include bacterial infections like impetigo and cellulitis, fungal infections such as ringworm and candidiasis, viral infections including herpes and warts, and infestations like scabies and head lice. Treatment depends on the specific infection, but may involve topical or oral antibiotics, antifungals, antivirals, or insecticide creams and solutions. Accurate diagnosis is important for effective management of skin infections and infestations.
This document summarizes a webinar on the changing face of canine pyoderma (bacterial skin infections in dogs) and strategies for control. It discusses why dogs are prone to pyoderma due to defective natural defenses. It also covers classification of pyoderma, clinical signs, diagnosis, treatment including antibiotics and alternatives, and problems with antibiotic resistance. The webinar aims to educate veterinarians on pyoderma identification, treatment, and prevention of further resistance issues.
LEPROSY
CELLULITIS
IMPETIGO
LEPROSY REVISION NOTES FOR NEET PG AIIMS PREPARATION
WITH HIGH YIELD TOPICS BASED ON LECTURE NOTES AND PREVIOUS YEAR QUESTIONS
\\
This document provides an overview of various skin diseases and disorders, including:
- Psoriasis, characterized by chronic pink or red lesions with silvery scaling. Genetic and autoimmune factors may play a role. Symptoms include thick flaky scaling and pruritus.
- Acne vulgaris, an inflammatory disease of hair follicles causing comedos, papules and pustules. Hormonal changes and stress can precipitate outbreaks. Treatment focuses on reducing bacterial infection and inflammation.
- Rosacea, a chronic inflammatory condition causing erythema and pustule formation on the face. Symptoms include flushing of the cheeks, forehead and chin. Treatment includes topical cre
- Atypical mycobacteria include nontuberculous mycobacteria found in the environment that can cause disease in humans under certain conditions.
- Mycobacterium leprae causes leprosy (Hansen's disease), with a spectrum of clinical manifestations depending on immune response from tuberculoid to lepromatous leprosy.
- Diagnosis involves skin smears and biopsy showing acid-fast bacilli. Treatment is multidrug therapy including dapsone, rifampin, and clofazimine.
The skin is not only the largest organ of the body, but it also forms a living biological barrier with several functions.
Pyodermas are any pyogenic skin disease (has pus). Skin infections can be caused by bacteria (often Staphylococcal or Streptococcal) either invading normal skin, or affecting a compromised skin barrier
Some bacterial skin infections resolve without serious morbidity. However, skin infections can be severe and result in sepsis or death, particularly in vulnerable patient groups.
1. Antifungal agents target components of fungal cell walls and membranes that are different from mammalian cells, such as ergosterol in fungal cell membranes.
2. Major classes of antifungals include azoles which inhibit ergosterol synthesis, polyenes which bind to ergosterol, and echinocandins which inhibit cell wall synthesis.
3. Liposomal formulations of amphotericin B have advantages of lower toxicity compared to conventional amphotericin B due to targeted delivery to fungal cells and less interaction with human membranes.
This document summarizes various soft tissue infections that can occur in children, including cellulitis, abscesses, furuncles, carbuncles, impetigo, and erysipelas. For each infection, the summary discusses signs and symptoms, causes, diagnosis and treatment options. The treatments discussed include antibiotics, incision and drainage, wound cleaning and dressing. Preventative measures like good hygiene are also emphasized.
Skin infections and infestations are commonly seen in primary care. They include bacterial infections like impetigo and cellulitis, fungal infections such as ringworm and candidiasis, viral infections including herpes and warts, and infestations like scabies and head lice. Treatment depends on the specific infection, but may involve topical or oral antibiotics, antifungals, antivirals, or insecticide creams and solutions. Accurate diagnosis is important for effective management of skin infections and infestations.
This document summarizes a webinar on the changing face of canine pyoderma (bacterial skin infections in dogs) and strategies for control. It discusses why dogs are prone to pyoderma due to defective natural defenses. It also covers classification of pyoderma, clinical signs, diagnosis, treatment including antibiotics and alternatives, and problems with antibiotic resistance. The webinar aims to educate veterinarians on pyoderma identification, treatment, and prevention of further resistance issues.
LEPROSY
CELLULITIS
IMPETIGO
LEPROSY REVISION NOTES FOR NEET PG AIIMS PREPARATION
WITH HIGH YIELD TOPICS BASED ON LECTURE NOTES AND PREVIOUS YEAR QUESTIONS
\\
This document provides an overview of various skin diseases and disorders, including:
- Psoriasis, characterized by chronic pink or red lesions with silvery scaling. Genetic and autoimmune factors may play a role. Symptoms include thick flaky scaling and pruritus.
- Acne vulgaris, an inflammatory disease of hair follicles causing comedos, papules and pustules. Hormonal changes and stress can precipitate outbreaks. Treatment focuses on reducing bacterial infection and inflammation.
- Rosacea, a chronic inflammatory condition causing erythema and pustule formation on the face. Symptoms include flushing of the cheeks, forehead and chin. Treatment includes topical cre
- Atypical mycobacteria include nontuberculous mycobacteria found in the environment that can cause disease in humans under certain conditions.
- Mycobacterium leprae causes leprosy (Hansen's disease), with a spectrum of clinical manifestations depending on immune response from tuberculoid to lepromatous leprosy.
- Diagnosis involves skin smears and biopsy showing acid-fast bacilli. Treatment is multidrug therapy including dapsone, rifampin, and clofazimine.
The skin is not only the largest organ of the body, but it also forms a living biological barrier with several functions.
Pyodermas are any pyogenic skin disease (has pus). Skin infections can be caused by bacteria (often Staphylococcal or Streptococcal) either invading normal skin, or affecting a compromised skin barrier
Some bacterial skin infections resolve without serious morbidity. However, skin infections can be severe and result in sepsis or death, particularly in vulnerable patient groups.
1. Antifungal agents target components of fungal cell walls and membranes that are different from mammalian cells, such as ergosterol in fungal cell membranes.
2. Major classes of antifungals include azoles which inhibit ergosterol synthesis, polyenes which bind to ergosterol, and echinocandins which inhibit cell wall synthesis.
3. Liposomal formulations of amphotericin B have advantages of lower toxicity compared to conventional amphotericin B due to targeted delivery to fungal cells and less interaction with human membranes.
This document summarizes various soft tissue infections that can occur in children, including cellulitis, abscesses, furuncles, carbuncles, impetigo, and erysipelas. For each infection, the summary discusses signs and symptoms, causes, diagnosis and treatment options. The treatments discussed include antibiotics, incision and drainage, wound cleaning and dressing. Preventative measures like good hygiene are also emphasized.
This document summarizes common skin problems seen by Dr. Sanjeeva Hulangamuwa. It discusses several conditions including eczema, psoriasis, infections (bacterial, viral, fungal, parasitic), drug eruptions, nutritional deficiencies, vasculitis, skin cancers, blistering diseases, diabetes manifestations, and more. Treatment options are provided for each condition.
Cataract Surgery and LASIK Update 2013 - Dr. Jeff Martin of North Shore Eye C...Jeff Martin, MD, FACS
This document provides case studies and information about cataract surgery, LASIK, and corneal conditions from Dr. Jeffrey Martin of North Shore Eye Care. It includes summaries of two case studies, one involving a post-PRK patient with reduced vision and discomfort, and another involving a post-LASIK patient with pain, redness and photophobia. It also discusses techniques for cataract surgery and LASIK, medications used, and conditions like bacterial keratitis, herpes keratitis, and various forms of peripheral corneal thinning.
This document summarizes several common bacterial and fungal skin infections. It describes the etiology, signs and symptoms, and management of conditions like impetigo, folliculitis, furuncles, carbuncles, hidradenitis suppurativa, acne, cellulitis, erysipelas, lymphadenitis, and gas gangrene. It also covers fungal infections caused by dermatophytes, including tinea capitis, corporis, unguium, and cruris. Effective treatment involves identifying the causative organism and using appropriate topical or systemic antifungal/antibacterial medications along with wound cleaning and drainage when necessary.
This document summarizes several common bacterial skin infections and disorders:
- Impetigo is caused by streptococci or Staphylococcus aureus and presents as vesicles and pustules that rupture and crust. It is treated with topical antibiotics or cleansing.
- Boils (furuncles) are infections of hair follicles by staphylococci that appear as reddened, painful nodules. Warm compresses and antibiotics may be used.
- Carbuncles involve clusters of hair follicles and form deep abscesses, treated with drainage and antibiotics.
- Folliculitis is hair follicle inflammation from bacteria, causing papules or pustules around follicles.
- Herpetic eye disease is caused by herpes simplex virus and is a major cause of corneal blindness worldwide. It can cause epithelial keratitis, disciform keratitis, necrotizing stromal keratitis, neurotrophic ulceration, and iridocyclitis.
- Treatment involves topical antivirals like acyclovir along with topical steroids. Oral antivirals may be used for severe or recurrent cases. Recurrences can be reduced by 50% with long-term oral acyclovir prophylaxis.
- Complications include secondary infection, glaucoma, cataracts, and iris atrophy. Recurrence after keratoplasty is also
This document provides an overview of acne in a 60 minute session. It defines acne as a cutaneous disorder involving papules, pustules or nodules on the face, neck or upper body. Acne is caused by obstruction of hair follicles due to excessive sebum and skin cell production, exacerbated by the bacteria P. acne. It most commonly affects adolescents and young adults. Treatment involves topical retinoids, antibiotics and benzoyl peroxide to target the pathogenic factors as well as oral antibiotics for more severe cases. The diagnosis is clinical and differential diagnoses include rosacea and folliculitis.
1. Oral candidiasis is the most common fungal infection of the oral cavity, caused by Candida albicans. It presents as pseudomembranous, erythematous, or chronic hyperplastic lesions.
2. Histoplasmosis, caused by the dimorphic fungus Histoplasma capsulatum, can cause oral ulcers but is usually asymptomatic. It is endemic in certain regions of India.
3. Mucormycosis is a rare infection caused by fungi in the order Mucorales. It mainly affects immunocompromised individuals and can cause rhino-orbital or pulmonary forms. Rhino-orbital mucormycosis commonly involves the
This document discusses common fungal skin infections, including different types of ringworm (dermatophytosis) that infect various body areas like the scalp (tinea capitis), beard (tinea barbae), feet (tinea pedis), body (tinea corporis), and groin (tinea cruris). It also covers candidal infections like oral thrush and vulvovaginal candidiasis. Finally, it discusses onychomycosis (fungal nail infection) and its treatment with oral antifungals like fluconazole or griseofulvin over many weeks.
This document discusses different types of conjunctivitis including viral, bacterial, and allergic conjunctivitis. It defines conjunctivitis as inflammation of the conjunctiva, which causes the eye to appear red with or without discharge. The document categorizes conjunctivitis as either infectious or non-infectious and discusses the classification, causes, symptoms, signs, and treatment for various types including bacterial (staphylococcal, gonococcal, etc.), viral (adenoviral), and allergic conjunctivitis.
Hand Infections by Dr Rogers Ntambi.
This power point presentation is about infections of the hand, relevant anatomy, epidemiology, investigations and treatment options.
The deep palmar infections, webspace, space of parona and other hand infections have been included.
Some atypical hand infections have also been included
Plastic surgery and Orthopedics surgery approaches have also been shown.
This document discusses lymphangitis and lymphadenitis. Lymphangitis is defined as inflammation of the lymphatic channels that occurs as a result of infection at a site distal to the channel. Common causes include streptococcal bacteria. Symptoms include red streaks on the skin extending from the infection site toward lymph nodes. Treatment involves antibiotics. Lymphadenitis is inflammation of lymph nodes, which can be caused by various bacteria, viruses, fungi or other pathogens. Evaluation may involve imaging and biopsy to determine the cause and guide treatment.
Exfoliative dermatitis is a condition where more than 90% of the skin surface becomes inflamed and scaly. It can be caused by underlying skin diseases like psoriasis or eczema, drug reactions, or systemic illnesses. Clinically, it presents as generalized redness and scaling of the skin with potential complications involving other organs. Making an accurate diagnosis requires considering the patient's medical history and risk factors, examining skin changes and biopsy findings, and ruling out potential etiologies through laboratory tests and imaging.
This document provides information about a dermatology module including the learning outcomes, common skin conditions and their treatments, diagnostic procedures, nursing care plans, ethical and medico-legal considerations, and health education principles. The module aims to help students identify skin lesions, design nursing care plans, describe health education, and discuss ethical and legal issues related to caring for patients with skin disorders. It covers 10 common conditions like folliculitis, furuncles, impetigo, herpes, warts, tinea, scabies, pediculosis, dermatitis, and basal cell carcinoma.
This document discusses disease transmission and infection control. It covers the following key points:
1. Microorganisms like bacteria, viruses, fungi and protozoa can cause illness in humans. The chain of infection requires a microorganism, a mode of transmission to a susceptible host, and a portal of entry.
2. Common modes of disease transmission include airborne via aerosols or droplets, direct contact, fecal-oral, and blood or body fluids. Standard precautions like hand hygiene and barriers are used to prevent transmission.
3. Proper sterilization, disinfection and barriers are critical for infection control. Sterilization kills all microbes using steam, dry heat or chemicals
Odontogenic infections arise from dental sources and can range from mild to severe. They typically progress through edematous, cellulitis, and abscess stages as bacteria spread. Management principles include determining the infection severity, evaluating the patient's defenses, and choosing appropriate antibiotics. For complex infections, deep facial spaces may become inflamed. Osteomyelitis is bone infection that can become chronic. Prevention relies on regular dental care and treating infections early.
Bacterial skin infections like impetigo, folliculitis, furuncles, and carbuncles are commonly caused by Staphylococcus aureus and Streptococcus pyogenes bacteria. Impetigo typically presents as non-bullous or bullous lesions that rupture, forming crusts. Folliculitis is a superficial infection of hair follicles. Furuncles (boils) are deeper hair follicle infections that become pustular and necrotic. Carbuncles involve groups of contiguous follicles and surrounding tissues. Treatment involves antibiotics, good hygiene, and addressing predisposing skin or medical conditions.
Conjunctivitis is an inflammation or swelling of the conjunctiva. The conjunctiva is the thin transparent layer of tissue that lines the inner surface of the eyelid and covers the white part of the eye. Often called "pink eye".
Sexually transmitted infections (STIs) are caused by different microbes transmitted sexually. Over 20 microbes can cause STIs. STIs are a major public health problem worldwide, especially in developing countries with limited diagnostic and treatment facilities. Common STIs include those causing urethral discharge, vaginal discharge, genital ulcers, and lower abdominal pain. STIs are usually managed through etiologic or syndromic approaches depending on availability of diagnostic testing. Treatment involves antibiotics targeting likely causative agents. Partner treatment and health education are important for control of STIs.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
This document summarizes common skin problems seen by Dr. Sanjeeva Hulangamuwa. It discusses several conditions including eczema, psoriasis, infections (bacterial, viral, fungal, parasitic), drug eruptions, nutritional deficiencies, vasculitis, skin cancers, blistering diseases, diabetes manifestations, and more. Treatment options are provided for each condition.
Cataract Surgery and LASIK Update 2013 - Dr. Jeff Martin of North Shore Eye C...Jeff Martin, MD, FACS
This document provides case studies and information about cataract surgery, LASIK, and corneal conditions from Dr. Jeffrey Martin of North Shore Eye Care. It includes summaries of two case studies, one involving a post-PRK patient with reduced vision and discomfort, and another involving a post-LASIK patient with pain, redness and photophobia. It also discusses techniques for cataract surgery and LASIK, medications used, and conditions like bacterial keratitis, herpes keratitis, and various forms of peripheral corneal thinning.
This document summarizes several common bacterial and fungal skin infections. It describes the etiology, signs and symptoms, and management of conditions like impetigo, folliculitis, furuncles, carbuncles, hidradenitis suppurativa, acne, cellulitis, erysipelas, lymphadenitis, and gas gangrene. It also covers fungal infections caused by dermatophytes, including tinea capitis, corporis, unguium, and cruris. Effective treatment involves identifying the causative organism and using appropriate topical or systemic antifungal/antibacterial medications along with wound cleaning and drainage when necessary.
This document summarizes several common bacterial skin infections and disorders:
- Impetigo is caused by streptococci or Staphylococcus aureus and presents as vesicles and pustules that rupture and crust. It is treated with topical antibiotics or cleansing.
- Boils (furuncles) are infections of hair follicles by staphylococci that appear as reddened, painful nodules. Warm compresses and antibiotics may be used.
- Carbuncles involve clusters of hair follicles and form deep abscesses, treated with drainage and antibiotics.
- Folliculitis is hair follicle inflammation from bacteria, causing papules or pustules around follicles.
- Herpetic eye disease is caused by herpes simplex virus and is a major cause of corneal blindness worldwide. It can cause epithelial keratitis, disciform keratitis, necrotizing stromal keratitis, neurotrophic ulceration, and iridocyclitis.
- Treatment involves topical antivirals like acyclovir along with topical steroids. Oral antivirals may be used for severe or recurrent cases. Recurrences can be reduced by 50% with long-term oral acyclovir prophylaxis.
- Complications include secondary infection, glaucoma, cataracts, and iris atrophy. Recurrence after keratoplasty is also
This document provides an overview of acne in a 60 minute session. It defines acne as a cutaneous disorder involving papules, pustules or nodules on the face, neck or upper body. Acne is caused by obstruction of hair follicles due to excessive sebum and skin cell production, exacerbated by the bacteria P. acne. It most commonly affects adolescents and young adults. Treatment involves topical retinoids, antibiotics and benzoyl peroxide to target the pathogenic factors as well as oral antibiotics for more severe cases. The diagnosis is clinical and differential diagnoses include rosacea and folliculitis.
1. Oral candidiasis is the most common fungal infection of the oral cavity, caused by Candida albicans. It presents as pseudomembranous, erythematous, or chronic hyperplastic lesions.
2. Histoplasmosis, caused by the dimorphic fungus Histoplasma capsulatum, can cause oral ulcers but is usually asymptomatic. It is endemic in certain regions of India.
3. Mucormycosis is a rare infection caused by fungi in the order Mucorales. It mainly affects immunocompromised individuals and can cause rhino-orbital or pulmonary forms. Rhino-orbital mucormycosis commonly involves the
This document discusses common fungal skin infections, including different types of ringworm (dermatophytosis) that infect various body areas like the scalp (tinea capitis), beard (tinea barbae), feet (tinea pedis), body (tinea corporis), and groin (tinea cruris). It also covers candidal infections like oral thrush and vulvovaginal candidiasis. Finally, it discusses onychomycosis (fungal nail infection) and its treatment with oral antifungals like fluconazole or griseofulvin over many weeks.
This document discusses different types of conjunctivitis including viral, bacterial, and allergic conjunctivitis. It defines conjunctivitis as inflammation of the conjunctiva, which causes the eye to appear red with or without discharge. The document categorizes conjunctivitis as either infectious or non-infectious and discusses the classification, causes, symptoms, signs, and treatment for various types including bacterial (staphylococcal, gonococcal, etc.), viral (adenoviral), and allergic conjunctivitis.
Hand Infections by Dr Rogers Ntambi.
This power point presentation is about infections of the hand, relevant anatomy, epidemiology, investigations and treatment options.
The deep palmar infections, webspace, space of parona and other hand infections have been included.
Some atypical hand infections have also been included
Plastic surgery and Orthopedics surgery approaches have also been shown.
This document discusses lymphangitis and lymphadenitis. Lymphangitis is defined as inflammation of the lymphatic channels that occurs as a result of infection at a site distal to the channel. Common causes include streptococcal bacteria. Symptoms include red streaks on the skin extending from the infection site toward lymph nodes. Treatment involves antibiotics. Lymphadenitis is inflammation of lymph nodes, which can be caused by various bacteria, viruses, fungi or other pathogens. Evaluation may involve imaging and biopsy to determine the cause and guide treatment.
Exfoliative dermatitis is a condition where more than 90% of the skin surface becomes inflamed and scaly. It can be caused by underlying skin diseases like psoriasis or eczema, drug reactions, or systemic illnesses. Clinically, it presents as generalized redness and scaling of the skin with potential complications involving other organs. Making an accurate diagnosis requires considering the patient's medical history and risk factors, examining skin changes and biopsy findings, and ruling out potential etiologies through laboratory tests and imaging.
This document provides information about a dermatology module including the learning outcomes, common skin conditions and their treatments, diagnostic procedures, nursing care plans, ethical and medico-legal considerations, and health education principles. The module aims to help students identify skin lesions, design nursing care plans, describe health education, and discuss ethical and legal issues related to caring for patients with skin disorders. It covers 10 common conditions like folliculitis, furuncles, impetigo, herpes, warts, tinea, scabies, pediculosis, dermatitis, and basal cell carcinoma.
This document discusses disease transmission and infection control. It covers the following key points:
1. Microorganisms like bacteria, viruses, fungi and protozoa can cause illness in humans. The chain of infection requires a microorganism, a mode of transmission to a susceptible host, and a portal of entry.
2. Common modes of disease transmission include airborne via aerosols or droplets, direct contact, fecal-oral, and blood or body fluids. Standard precautions like hand hygiene and barriers are used to prevent transmission.
3. Proper sterilization, disinfection and barriers are critical for infection control. Sterilization kills all microbes using steam, dry heat or chemicals
Odontogenic infections arise from dental sources and can range from mild to severe. They typically progress through edematous, cellulitis, and abscess stages as bacteria spread. Management principles include determining the infection severity, evaluating the patient's defenses, and choosing appropriate antibiotics. For complex infections, deep facial spaces may become inflamed. Osteomyelitis is bone infection that can become chronic. Prevention relies on regular dental care and treating infections early.
Bacterial skin infections like impetigo, folliculitis, furuncles, and carbuncles are commonly caused by Staphylococcus aureus and Streptococcus pyogenes bacteria. Impetigo typically presents as non-bullous or bullous lesions that rupture, forming crusts. Folliculitis is a superficial infection of hair follicles. Furuncles (boils) are deeper hair follicle infections that become pustular and necrotic. Carbuncles involve groups of contiguous follicles and surrounding tissues. Treatment involves antibiotics, good hygiene, and addressing predisposing skin or medical conditions.
Conjunctivitis is an inflammation or swelling of the conjunctiva. The conjunctiva is the thin transparent layer of tissue that lines the inner surface of the eyelid and covers the white part of the eye. Often called "pink eye".
Sexually transmitted infections (STIs) are caused by different microbes transmitted sexually. Over 20 microbes can cause STIs. STIs are a major public health problem worldwide, especially in developing countries with limited diagnostic and treatment facilities. Common STIs include those causing urethral discharge, vaginal discharge, genital ulcers, and lower abdominal pain. STIs are usually managed through etiologic or syndromic approaches depending on availability of diagnostic testing. Treatment involves antibiotics targeting likely causative agents. Partner treatment and health education are important for control of STIs.
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The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
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- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
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- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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8. What did the review look at?
• Do topical antibiotics work
• Are they as good as oral antibiotics
• Which oral antibiotics work and which don’t
• Do we need different treatments for localised
and extensive disease
• Do disinfectant treatments work
What do you think will be the answers?
9. Cochrane results (1)
• 68 RCTs (n 5708) oral treatments and topical
treatments, including placebo,
• Topical antibiotics better than topical placebo
• Topical mupirocin and fusidic acid as effective
as oral antibiotics for localised disease There
• Topical mupirocin superior to oral
erythromycin
10. Cochrane results (2)
• Oral penicillin not effective for impetigo, but
others are e.g. erythromycin and cloxacillin
• Not clear if oral antibiotics are superior to
topical antibiotics for extensive impetigo
• Lack of evidence to suggest that using
disinfectant solutions improves impetig
• When 2 studies with 292 participants were
pooled, topical antibiotics were significantly
better than disinfecting treatments
11. Cellulitis
• Bacterial infection of the
skin and deeper tissues
• Commonest on the legs
• May be localised
symptoms
• Commonly systemic
symptoms, fever and
malaise
13. Cellulitis: predisposing factors
• Previous episode(s) of
cellulitis
• Venous disease,leg ulcers
• Current or prior injury (e.g.
trauma, surgical wounds)
• Diabetes
• Alcoholism
• Obesity
• Pregnancy
• Tinea pedis in the toes of the
affected limb
• Fissured eczema soles
14. Cellulitis:organisms and treatment
• Two thirds due to strep
pyogenes
• Staph aureus
• Rarities (dog bites etc)
• Oral or IV antibiotics
• Usually penicillin or
erythromycin
• TREAT UNDERLYING
PREDISPOSING FACTOR
16. Cellulitis: Cochrane review
• 25 CTs, no two trials investigated the same
antibiotics, and there was no standard
treatment regime used as a comparison
• The best treatment for cellulitis could not be
decided on the evidence
• No single treatment was clearly superior
17. Cellulitis: Cochrane review
• Surprisingly, oral antibiotics appeared to be
more effective than IV for moderate to severe
celullitis
• IM antibiotics as effective as IV
• More studies needed
18. Recurrent cellulitis
Patients with recurrent cellulitis should:
• Avoid trauma
• Keep skin clean and nails well tended
• Avoid blood tests from the affected limb
• Treat fungal infections of hands and feet early
• Keep swollen limbs elevated during rest periods to
aid lymphatic circulation
• Chronic lymphoedema: compression garments.
• Long term low dose antibiotic treatment with
penicillin or erythromycin.
19. Recurrent cellulitis (PATCH study)
• Systematic review
• Antibiotic prophylaxis reduces recurrent
cellulitis
• Not clear what dose, what length of time or
which antibiotic
• PATCH studies used 12 months penicillin V 250
twice daily
• http://www.nottingham.ac.uk/research/group
s/cebd/projects/patch.aspx
23. Tinea corporis
• Asymmetrical
• Ringed/annular
• Central sparing
• Scaly
• Pruritic
• Ideally take scraping for
mycology
• Topical imidazole and
steroid eg Daktacort
24. Dermatophytes: tinea capitis
• Not usually from
animals these days
• Typically trichophytum
tonsurans
• Children
• Scaly patches, itchy
• Hair loss
• Spreads between
families
25. Tinea capitis
• Hair for mycology (NOT just
skin) and family
• Confirm diagnosis
mycologically
• Treat with terbinafine
wherever possible: 12
weeks
• DTB article reviews choices
• No licence for children but
accepted practice
26. Dermatophytes: tinea unguum
• Very common
• Typically elderly
• May act as a reservoir
for recurrent infections
• Nail dystrophy
• Asymmetrical
• Confirm with mycology
27. Tinea unguum
• DTB review of
treatment
• Topical therapy
relatively ineffective
• Amorolfine nail paint
• Oral therapy:
terbinafine 12 week
course
• Relatively safe
• Recurrence common
28. Candidal skin infections
• Common cause of
nappy rash
• Candidal vulvitis
• Pruritic
• Satellite lesions
• Responds to imidazole
creams
29. Pityriasis versicolor
• Common in young
adults
• Widespread scaly
erythematous
macules
• Slow progression
• Often presents with
hypopigmented
macules
31. Intertrigo
• Rash in body folds
• Moist environment
• Bacteria and yeast
thrive
• Range of different
causes
• Infections and
inflammatory
dermatoses
• Treat underlying cause
Candidal intertrigo
37. HSV type 1: key points
• Usually symptomatic treatment
• Patient initiated aciclovir tablets
• Long term aciclovir for recurrent episodes
• Suspect eczema herpeticum: treat and refer
38. Herpes zoster (shingles)
• Reactivation of
chicken pox virus
• Virus in vesicles
• Commoner in elderly
and immune
compromised
• Occurs in children
• Dermatomal pattern
39. Herpes zoster
• Pain precedes rash
• 1-3 days later crops of
blisters
• Chest neck and forehead
commonest sites
• Healing slow in the
elderly
• Post-herpetic neuralgia
40. Herpes zoster management
• If early, antivirals
orally
• Topical antiseptics or
antibacterials as
necessary
• Pain relief
• Capsaicin
• Gabapentin
45. Molluscum contagiosum: Cochrane 2010
• Cochrane review 2010
• 11 studies 495
participants
• Poor quality
• Australian lemon myrtle
oil ? Some benefit
• Overall no single
intervention
convincingly effective…
46.
47.
48. Viral warts
• Very common
• Self limiting
• Studies show 12% in 4-6 yr olds, 4.9% in 16
year olds
• Those with warts at 11yrs, 93% no warts at
16yrs old
• Commoner in butchers, abbatoir workers
• HPV self limiting
53. Cryotherapy for warts:
outcomes
• 3 month cure rate 52%
• Cure rate in second 3 months 41%
• Cryotherapy as effective as wart paint
after 3 months
• 25% are unresponsive
57. Scabies
• Sarcoptes scabeii mite
• Burrows fingers wrists
• 4-6 weeks later
eczematous reaction
• Intensely pruritic
• Widespread eczema
major feature
• Spreads between close
contacts
58. Scabies: treatment of mite
• Treat whole family/all
close contacts
• Permethrim cream
(lyclear)
• All at the same time
• Neck down, overnight
application
• Wash bedlinen
• Retreat one week later
59. Scabies: treat eczema
• Very important
• Eczema may persist for
4-6 weeks after clearing
mite
• Topical steroids and
emollients
• Extent of eczema
variable
60. Ivermectin and scabies
• Difficult to treat scabies
• Oral ivermectin
• Single oral dose 200mcg per kg
• Particularly crusted/Norwegian scabies
• https://www.nice.org.uk/advice/esuom29/cha
pter/Key-points-from-the-evidence
61. Pediculosis: Head lice
• Common
• Louse feeds on scalp
blood
• Nits on hair
• May be relatively
asymptomatic
62. Head lice
• Widespread problem
• Treatment difficult
• Chemical measures
• Physical methods
• Suffocation (!)
• New treatments
63. Head lice
• Isopropyl myristate 50% in cyclomethicone
solution
• Full Marks Solution – SSL International
• Physical mode of action
• 10-minute contact time
• Very effective
• First line treatment
• DTB article
http://dtb.bmj.com/content/47/5/50