Cellulitis is a bacterial infection of the deep dermis and subcutaneous tissue. It is most commonly caused by S. pyogenes and S. aureus.5 Bacteria may gain access to the dermis via a break in the skin barrier in healthy adults, whereas the hematogenous route is more common in immunocompromised patients.
The affected skin is usually erythematous, swollen, painful, and warm to the touch. Severe cellulitis can be complicated by bullae, pustules, or necrotic tissue. Damage to lymphatic vessels can lead to recurrent episodes of cellulitis.6 In areas of the world endemic for lymphatic filariasis, it is important to rule out this disease in cases of recurrent bouts of lower-extremity cellulitis and lymphangitis.
Skin, Soft Tissue, & Bone Infections Symposia - The CRUDEM FoundationThe CRUDEM Foundation
This is the Skin, Soft Tissue, & Bone Infections Symposia presented in Milot, Haiti at Hôpital Sacré Coeur in 2011. CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Cellulitis is a bacterial infection of the deep dermis and subcutaneous tissue. It is most commonly caused by S. pyogenes and S. aureus.5 Bacteria may gain access to the dermis via a break in the skin barrier in healthy adults, whereas the hematogenous route is more common in immunocompromised patients.
The affected skin is usually erythematous, swollen, painful, and warm to the touch. Severe cellulitis can be complicated by bullae, pustules, or necrotic tissue. Damage to lymphatic vessels can lead to recurrent episodes of cellulitis.6 In areas of the world endemic for lymphatic filariasis, it is important to rule out this disease in cases of recurrent bouts of lower-extremity cellulitis and lymphangitis.
Skin, Soft Tissue, & Bone Infections Symposia - The CRUDEM FoundationThe CRUDEM Foundation
This is the Skin, Soft Tissue, & Bone Infections Symposia presented in Milot, Haiti at Hôpital Sacré Coeur in 2011. CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Pruritus and its management by Sachin Dwivedi.pptxsachintutor
Pruritus is a medical term that means itching. It refers to a feeling or sensation on your skin that you want to scratch. Pruritus can be painful or irritating and could be localized to one area of your body or spread throughout several areas.
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.
Examination of the skin p 945
HTPE p 51 (skin hair and nails)
• Inspection
• Palpation
Skin HTPE p 52 hair
• Colour
• Lesions
• Texture / thickness
• Hydration
• Turgor / elasticity
• Vascularity / erythema
• Temperature
Examine nails HTPE p 946 p 54
• Inspect
• Palpate
Examine hair and skull p 946 HTPE p 54
• Inspect
• Palpate
Examine the head and neck p 54
Common skin lesions p 948 (define and identify)
• Acne
• Blister
• Bulla
• Cherry angioma
• Crusts
• Cyst
• Ecchymosis
• Keloid
• Lichen
• Macule
• Nodule
• Papule
• Patch
• Plaque
• Petichae
• Pustule
• Scale
• Scar
• Spider angioma
• Tumour
• Ulcer
• Urticuria
• Vesicle
• Wheal
Rashes PCCM p 246
• Dermatitis table 49.4
o Atopic dermatitis p 961
o Contact dermatitis p 962 / PCCM 246
Clinical features PCCM p 246
Management PCCM p 246
o Essential health information
o Topical therapies box 49.1
• Nappy rash p 964 box 49.2
o Causes
o Clinical features
o Management
• Allergic PCCM 248
o Clinical features
o Management
Infectious skin diseases p 957, table 49,1 PCCM 249
• Folliculitis p 957
o Clinical manifestations
o Management
• Impetigo p 957 table 49.1 PCCM 249
o Causes
o Clinical features p 957 / PCCM 249
o Management
• Cellulitis PCCM 250
o Clinical features
o Management
• Boil /Carbuncle / furuncle p 957 table 49.1
o Clinical features PCCM 250
o Management PCCM 250
Viral infections p 957, table 49.2, PCCM p 251
• Herpes Zoster shingles p 958 PCCM 251
o Causes
o Clinical features
o Management
• Warts p 958, table 49.2, PCCM 252
o Clinical features
Management
Fungal diseases p 959, PCCM p 254
• Tinea capitis
o Clinical features
o Management
• Tinea corporis
o Clinical features
o Management
• Tinea pedis
o Clinical features
o Management
• Tinea unguium
o Clinical features
o Management
• Tinea cruris
o Clinical features
o Management
Urticaria PCCM 256
• Causes
• Clinical features
Eczema PCCM p 258
• Definition
• Causes
• Clinical features
Psoriasis p 961 PCCM p 260
• Definition
• Causes p 961 /PCCM 260
• Pathophysiology
• Risk factors
• Types
• Clinical manifestations pp 962 / PCCM 260
• Management p 962 / PCCM 260
Acne vulgaris p 965, PCCM p 261
• Causes p 965 / PCCM 261
• Clinical features
• Risk / p 965 Influencing factors PCCM 261
• Management
• Essential health information p 965
Skin tumours
• Malignant melanoma P 961 PCCM p 263
o Clinical features
o Management
o Essential health information
Pruritus and its management by Sachin Dwivedi.pptxsachintutor
Pruritus is a medical term that means itching. It refers to a feeling or sensation on your skin that you want to scratch. Pruritus can be painful or irritating and could be localized to one area of your body or spread throughout several areas.
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.
Examination of the skin p 945
HTPE p 51 (skin hair and nails)
• Inspection
• Palpation
Skin HTPE p 52 hair
• Colour
• Lesions
• Texture / thickness
• Hydration
• Turgor / elasticity
• Vascularity / erythema
• Temperature
Examine nails HTPE p 946 p 54
• Inspect
• Palpate
Examine hair and skull p 946 HTPE p 54
• Inspect
• Palpate
Examine the head and neck p 54
Common skin lesions p 948 (define and identify)
• Acne
• Blister
• Bulla
• Cherry angioma
• Crusts
• Cyst
• Ecchymosis
• Keloid
• Lichen
• Macule
• Nodule
• Papule
• Patch
• Plaque
• Petichae
• Pustule
• Scale
• Scar
• Spider angioma
• Tumour
• Ulcer
• Urticuria
• Vesicle
• Wheal
Rashes PCCM p 246
• Dermatitis table 49.4
o Atopic dermatitis p 961
o Contact dermatitis p 962 / PCCM 246
Clinical features PCCM p 246
Management PCCM p 246
o Essential health information
o Topical therapies box 49.1
• Nappy rash p 964 box 49.2
o Causes
o Clinical features
o Management
• Allergic PCCM 248
o Clinical features
o Management
Infectious skin diseases p 957, table 49,1 PCCM 249
• Folliculitis p 957
o Clinical manifestations
o Management
• Impetigo p 957 table 49.1 PCCM 249
o Causes
o Clinical features p 957 / PCCM 249
o Management
• Cellulitis PCCM 250
o Clinical features
o Management
• Boil /Carbuncle / furuncle p 957 table 49.1
o Clinical features PCCM 250
o Management PCCM 250
Viral infections p 957, table 49.2, PCCM p 251
• Herpes Zoster shingles p 958 PCCM 251
o Causes
o Clinical features
o Management
• Warts p 958, table 49.2, PCCM 252
o Clinical features
Management
Fungal diseases p 959, PCCM p 254
• Tinea capitis
o Clinical features
o Management
• Tinea corporis
o Clinical features
o Management
• Tinea pedis
o Clinical features
o Management
• Tinea unguium
o Clinical features
o Management
• Tinea cruris
o Clinical features
o Management
Urticaria PCCM 256
• Causes
• Clinical features
Eczema PCCM p 258
• Definition
• Causes
• Clinical features
Psoriasis p 961 PCCM p 260
• Definition
• Causes p 961 /PCCM 260
• Pathophysiology
• Risk factors
• Types
• Clinical manifestations pp 962 / PCCM 260
• Management p 962 / PCCM 260
Acne vulgaris p 965, PCCM p 261
• Causes p 965 / PCCM 261
• Clinical features
• Risk / p 965 Influencing factors PCCM 261
• Management
• Essential health information p 965
Skin tumours
• Malignant melanoma P 961 PCCM p 263
o Clinical features
o Management
o Essential health information
THIRD STAGE OF LABOUR AND ITS MANAGEMENT.pdfDolisha Warbi
definition, duration, events, (placenta separation, descend of placenta, expulsion of placenta , the Schultz mechanisms, Mathew Duncan mechanisms, signs of separation, expectant management, active management, complexion , examination of placenta and its membrane, complication.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
US E-cigarette Summit: Taming the nicotine industrial complexClive Bates
I look back to 1997 and simpler time in tobacco control, then look at changes in trade, communications, technology and conclude the market is becoming ungovernable
TEST BANK For Advanced Practice Nursing in the Care of Older Adults, 2nd Edit...kevinkariuki227
TEST BANK For Advanced Practice Nursing in the Care of Older Adults, 2nd Edition by Laurie Kennedy-Malone, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK For Advanced Practice Nursing in the Care of Older Adults, 2nd Edition by Laurie Kennedy-Malone, Verified Chapters 1 - 19, Complete Newest Version.pdf
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
3. Causes:
§ Bacterial infection eg. Staphylococcus aureus or Streptococcus species.
§ Skin conditions, such as eczema, psoriasis, or acne.
§ Immune system disorders - HIV/AIDS or diabetes.
§ Lack of proper hygiene.
§ Exposure to hot and humid environments.
§ Certain underlying health conditions, such as obesity or peripheral vascular disease, can impair blood circulation to
the skin.
Signs and symptoms:
• Small, discolored (red, purple, blue, brown or black), pus-filled blisters that enlarge quickly.
• Open ulcers with distinct, raised borders.
• Inflammation and pain around your sores.
• Fever.
• Joint pain.
5. IMPETIGO:
Definition:
Impetigo is a common contagious skin infection. Bacteria like Staphylococcus aureus or Streptococcus pyogenes infect
the outer layers of the skin, called the epidermis. Face, arms, and legs are most often affected.
6. Types:
Non-bullous
Begin with the appearance of red sores – usually around the nose and mouth
but other areas of the face and the limbs can also be affected. The sores
quickly burst leaving behind thick, golden crusts typically around 2cm across.
Bullous impetigo;
Begins with small vesicles that become flaccid bullae. The exfoliative toxin A
produced by S. aureus causes loss of cell adhesion in the superficial epidermis.
The bullae contain a clear or yellow fluid which eventually progresses to
become purulent or dark.
Ecthyma;
Ecthyma is often called deep impetigo. Ecthyma is a skin infection similar to
impetigo, but more deeply invasive. Usually caused by a streptococcus
infection, ecthyma goes through the outer layer (epidermis) to the deeper layer
(dermis) of skin, possibly causing scars.
7. Causes:
Ø Bacterial Infection.
Ø Skin Trauma: Cuts, scratches, insect bites.
Ø Poor Hygiene.
Ø Direct skin-to-skin contact with an infected individual.
Ø Living in crowded area.
Ø Weakened immune system.
8. Signs and symptoms:
• Pus-filled and burst easily, fluid may be yellow or tan.
• Redness.
• Skin lesions present.
• Swollen lymph nodes near the infected area may develop.
• Raw, shiny areas that scab over with a yellowish-brown crust.
Diagnosis;
• Skin culture test.
• Physical examination.
• Blood test
9. Management;
• Topical antibiotic therapy. Mupirocin, retapamulin, and fusidic acid are the treatments of choice.
• Topical ointment – Neosporin.
• Oral antibiotics.
• Proper dressing to the injured area.
10. FULLICULITIES:
Definition;
Folliculitis is a common skin condition that's often caused by an infected or inflamed hair follicle.
It is typically due to an infection of the hair follicle and results in irritated pimple-like spots or pustules.
11. Causes:
Ø Infection by staphylococcus aureus bacteria, yeast, fungus, and viruses.
Ø Skin irritation
Ø Occlusion, or blockage, of the follicle
Ø Topical steroids
Ø Skin disorders, such as acne or dermatitis
Ø Some medications
Ø Irritant chemicals
Ø Immunosuppressive medications
Risk factors:
Ø History of diabetes
Ø Long-term antibiotic use
Ø Frequent shaving
Ø Using an unclean hot tub or swimming pool
Ø Weakened immune system from conditions, such as HIV or cancer
Ø Having overweight or obesity
12. Symptoms:
§ A rash, a patch of small bumps, or yellow- or white-tipped pimples, red, or purple hues.
§ Crusty sores
§ Itching or tender bumps
§ Pus-filled sores
§ Inflamed skin
§ Tenderness
§ Pain
Diagnosis:
§ Physical examination and medical history assessment.
§ Skin biopsy.
13. Management:
qLight therapy.
qLancing - drain a boil or carbuncle by making a small incision in the lesion to drain the pus.
qLaser therapy
qMedication involves;
Ø Topical antibiotic creams
Ø Oral antibiotics
Ø Topical antifungal creams
Ø Antifungal shampoos
Ø Oral antifungals
Ø Steroid creams
Ø Oral corticosteroids
Ø Cortisone injections
14. FURUNCLES:
“Furuncle” is another word for a “boil.” Boils are bacterial infections of hair follicles that also involve the surrounding
tissue.
An infection of a hair follicle that extends subcutaneously, forming an abscess.
15. Causes:
§ Staphylococcal infection,
§ Inadequate personal hygiene.
§ Conditions or medications that weaken the immune system, such as diabetes, HIV/AIDs, or immunosuppressive
drugs.
§ Friction from tight clothing.
§ Excessive sweating in hot and humid conditions
§ Close contact with infected individuals
§ Certain skin conditions, such as acne or eczema.
Risk factors:
• Obesity.
• Treatment with corticosteroids.
• Defects in neutrophil function or number.
• Diabetes mellitus.
16. Signs and symptoms:
• Swollen bump
• Painful bump
• Surrounding skin is red and warm
• Pus or fluid drains from the bump
• Fever
Prevention:
qEat a balanced diet of nutritious foods such as fruits, vegetables, protein, and whole grains.
qRegular exercise to maintain normal body weight and helps maintain the blood pressure and blood sugar to normal
level.
qMaintain proper hygiene
• Using fragrance-free soaps and cleansers
• Applying moisturizer daily to help prevent skin from becoming dry and cracked
• Using warm but not hot water when bathing or showering
• Drying the skin carefully
• Treating cuts, scrapes, and other skin issues immediately
17. Treatment:
• Warm compresses can help speed the rupturing of a furuncle.
• Apply a warm, moist compress throughout the day to facilitate drainage.
• First‐line oral antibiotics including dicloxacillin (250 mg four times daily) and cephalosporins (such as cefadroxil
500 mg twice daily).
• Apply a topical antiseptic such as povidone iodine or chlorhexidine cream to the boils and cover with a square of
gauze.
• Putting antibiotic ointment (Neosporin, Bacitracin, Iodine or Polysporin).
Nursing management:
• Monitor the patient skin condition.
• Apply ointment and do the proper dressing to the affected area.
• Educate the patient about dietary pattern, personal hygiene and skin care.
• Administered the prescribed medication.
• Provide psychological support to the patient.
• Instruct the patient for follow up.
18. CARBUNCLES:
Definition:
A carbuncle is an infection of the hair follicle(s) that extends into the surrounding skin and deep underlying
subcutaneous tissue.
A carbuncle is a red, swollen, and painful cluster of boils that are connected to each other under the skin.
19. Causes:
• Staphylococcus aureus.
• Friction from clothing or shaving
• Poor hygiene
• Poor overall health
Symptoms:
§ Develops over several days
§ Have a white or yellow center (contains pus)
§ Weep, ooze, or crust
§ Spread to other skin areas
§ Others symptom include;
§ Fatigue
§ Tightness when moving in the area where its infected.
§ Fever
§ General discomfort or sick feeling
§ Skin itching before the carbuncle develops
20. Diagnosis:
• History collection
• Physical examination
• Biopsy test
• Laboratory testing
Management:
§ Antibacterial ointment, soaps.
§ Over-the-counter pain relief medication, such as ibuprofen, acetaminophen to help manage the pain.
§ Oral antibiotics such as dicloxacillin.
§ Warm compressed can promote the drainage and healing of carbuncles.
§ Sterile bandage
21. Nursing management:
• Assess the general condition of the patient.
• Check the vital signs of the patient.
• Plan for the care plan
• Administered prescribed medication to the patient.
• Applying necessary cream to the patient
• Applying bandage to the affecting area to prevent from spreading.
• Educate the patient for proper skin hygiene.
• Manage the signs and symptoms
• Educate the patient about the diseases condition
• Advice for follow up care.