Skin disesae

The SKIN
DISEASE
By
Dr .safia A. AL-rezami.

The Skin
The skin consist of 4layers
1-epidermis layer of stratified sqamous
keratinized Epi .T
2-the dermis; layer of C.T
3-subcutaneous tissue; layer loose C.T may
contain adipose tissue
4-muscle Dr .safia A. AL-rezami.

THE FUNCTION
•1-protection
•2-receptor organ
.i3- give nice shape of body .

Subject;
.I1-Scabies
2-lmpetigo -
3-Smallpox
4-pityriasis versicolor
5-Anthrax

Scabies
Scabies

SCABIES
Scabies also known as "the itch" is an
intensely itching rash caused by a tiny mite
(bug) that lives in the skin. A very small, hard
to see, zigzag blister usually marks the trail of
the insect as she lays her eggs
Definition:

Scabies
•Scabies is very contagious and is usually
•spread by: shaking hands close contact,
usually starting at the wrist caused b .
holding hands with a person who has ,
scabies. close contact with infected ,
clothing, bedding.
–personal contact .
Transmission

Scabies
1- intense itching especially at night
2- red rash can occur at the area that has
been scratched.
3- Skin may become crusty or scaly
Scabies usually begins in the body's folds
such as:
between the fingers
Elbows
Symptoms

Scabies
Also in :
inner thighs.
skin under rings, bracelets or watch bands
Wrist .
*Children usually have more itching on the
palms of hands
soles of feet

Scabies

Scabies
When large areas of the body, hands and feet
are scaly and crusted the disease is
called crusted scabies where symptoms are
far more severe than usual. These crusts
hide thousands of live mites and eggs ,
making treatment difficult.
This type of scabies occurs mostly among
the elderly and in AIDS patients . .
Complications

Scabies
1-Microscope Test
The most common test involves the
suspected area being mixed with sterile ,
mineral oil and the scrapings viewed .
under a microscope to detect scabies mites,
eggs and/or feces.
Diagnosis

Scabies
2-Ink Test
An ink test is where a blue or black felt-
tipped pen is applied to the suspected
,areas. After the skin is cleaned mite ,
burrows can be located if the ink sinks into
them.

Scabies
Prompt action is required as scabies is
very hard to eradicate once infected.
Currently three main types of solutions are
used for scabies All are applied to the e
whole body except the head and neck, and all
whole family should be
1-Permethrin
Used because of its relative safety and low
irritant quality. ,
Treatment

Scabies
2-Benzyl benzoate emulsion
Is washed off after 24 hours and repeated 2
or 3 times .
Has to be diluted in 2 to 3 times more
water in infants or young children the
solution to help reduce skin irritation .

Scabies
3-Malathion
Brand Names: Ovide
Is washed off after 24 hours Kills the mites but
their bodies remain in the skin causing the itch
to persist until our r own natural defense
systems break down n and remove what is left
of the mites which takes about 2 weeks
The itch continues for about 2 weeks after the
treatment.

Scabies
4-Sulfur
Has been used since Roman times (6-10% in
lotion or cream) .
Some people have an allergic reaction
treated .
For young children with scabies
A medicated cream such as Elimite.

Scabies
Method
Apply a thin layer of cream from the neck down
avoiding the face and scalp before going to bed
The cream should be applied between the fingers
and toes and beneath the tips of the fingernails
(the eggs may be under the nails due to
scratching , Wash off with soap and water 8-12
hours later

Scabies
Do not treat scabies with:
hard soaps
home remedi i
Kerosene

–
Impetigo
What is impetigo?
Impetigo is a bacterial skin infection. It is often called
school sores because it most often affects children. It is
quite contagious.
What is the cause of impetigo?
While the bacteria causing impetigo may have been caught
from someone else with impetigo or boils, impetigo
usually begins out of the blue without any apparent source
of infection.

Impetigo presents with pustules and round, oozing patches
which grow larger day by day. There may be clear blisters
(bullous impetigo) or golden yellow crusts. It most often occurs
on exposed areas such as the hands and face, or in skin folds
particularly the armpits
Impetigo
What does it look like?

Impetigo

•Natural treatments such as Dermisil-I can safely and effectively eliminate
Impetigo.
•Antibiotics taken by mouth usually clear up impetigo in four or five days.
It's important for the antibiotic to be taken faithfully until the prescribed
supply is completely used up.
•An antibiotic ointment, such as Polysporin, should be applied thinly four
times daily. Polysporin can be purchased without a prescription.
•Crusts should be removed before the ointment is applied. Soak a soft, clean
cloth in a mixture of one-half cup of white vinegar and a quart of lukewarm
water. Press this cloth on the crusts for 10-15 minutes three or four times
daily. Then gently wipe off the crusts and apply a little antibiotic ointment.
•You can stop soaking the impetigo when crusts no longer form. When the
skin is healed, stop the antibiotic ointment
Impetigo
. Treatment

•Impetigo is contagious when there is crusting or oozing. While it's
contagious, take the following precautions:
•Patients should avoid close contact with other people.
•Children should be kept home from school until the lesions crust
over.
•Use separate towels for the patient. The patient's towels,
pillowcases, and sheets should be changed after the first day of
treatment. His or her clothing should be changed and laundered
daily for the first two days.
•Usually the contagious period ends within two days after treatment
starts. If the impetigo doesn't heal in one week, please return for
another evaluation.
Impetigo
Precautions

The name, smallpox is derived from the latin
word for ((SPOTTED)) and is regaered from
serious and spreaded disease and refers to the
raised bumps that appear on the face and limes
and trunk and then all of body of an infected
person.
smallpox

c
It is casused by VARIOLA VARUSES. There are
two types:
Variola major (fatality rate varying from 10-50 %)
which causes a severe from of the disease.
Variola minor (fatality rate less than 1%) which
causes mild disease called * alastrim*.
Cause

p
The virus by inhalation of
infected particles (crusts )
from a patientdirectly or
from patient formites
indirectly __ lymph node ___
blood , then the virus
localized in the skin . the incubation period are
12-14 days .
pathognesis

pathognesis
followed by fever and appearance of rash and
turning to vesicles to pustules and forming
crusts.All stages of the rash are infectious as well
as respiratory discharges and saliva. Death may
present.

-Backache.
-Delirium .
-Diarrhea , Severe headache .
-Excessive bleeding.
-Vomiting ,Fatigue .
-High fever .
-Malaise.
-Raised pink rash -- turns into sores that become
crusty on day 8 or 9.
Symptomes

Possible complication
-Arthritis and bone infections wellig
(encephalitis).
-Brain swelling (encephalitis).
-Death.
-Eye infections, Scarring .
-Pneumonia.
-Severe bleeding.
-Skin infections (from the sores).

d
1- material collected from the skin lesion is used
to :
*Detection of virus by electron microscopy
*Detection of viral antigen by
immunofluorescence
*Isolation of the virus using chick embryo or
tissue culture
*PCR
diagnosis

BackExams and Tests
Tests include:
DIC panel
Platelet count
White blood cell count

Treatment
there are no drug to used for
treatment of smallpox but occur
some vaccin:
Vaccination

Calf lymph vaccine
This is prepared by inoculation of vaccinia virus
(naturally attenuated for man ) when vesicles
appear the fluid is collected from the resulting
vesicles and after addition of 40%glycerol and
.,4% phenol (to prevent bacterial contamination )
the vaccine ready for use .

Asymptomatic superficial infwction of the skin characterized by
macular lesions of different coloration .
pityriasis versicolor
Definition :
Causative fungus. A Dimorphic fungus known as Pityrospon.m
orbicular» in iLS yeast-like form (saproph}'tic stage, present on normal
skin) and as Mal ass erla furfur when it forms hyphae (pathogenic
stage. causing pityriasis versicolor lesions
Etiology :
Superficial candidiasis infections are limited to the skin and mucous membranes

•Humid warm climate
•Genetic predisposition
•Pregnancy .
Predisposing factors :
Age. Mainly adults .
Sex. More in males than females.
Symptoms. Asymptomatic.
Site. Mainly on the trunk It may extend to the neck. arms, forearms and
the face. The axillae may be affected and the scalp causing line scaling
(dandruff(
Clinical picture :

•Lesion Macules which may he confluent together forming patches. Their color
varies in the same individual and in different patients. It may be brownish -
yellow. Erythematous or hypo pigmented covered with fine scales. The scales
are better seen on gentle scraping of the lesion with a glass-slide.
wood's light examination. It gives a golden yellow fluorescence
 Mycological examination of skin scraping.
Direct microscopic examination or KOH prcpararion.
Ccllotupe stripping, stained with parker Quink blue /black ink
Both reveal budding spores . and short thick hyphae (Spores and meat ball
appearance).
Culture is difficult and is not necessary as the previous methods are
satisfactory
Special Diagnostic methods:

Topical treatment
- The previously mentioned antifungals.
- Aqueous solution of sodium thiosulfate 25%.
- Sclinium sulfide suspension applied to the affected area and left for 10 minutes
then washed.
- Kctoconazole in the form or a shampoo applied on the scalp and body, to be
washed after few minutes.
Systemic treatment :
Treatment
Rarely needed, may he used in extensive cases.
- Kcroconazole.
- Treasures: luaconazole and fluconazolc.
Ultraviolet rays (UVB)
. Can be used in cases of post-inflamrnatory -hypo pigmentation to
enhance repigmentation of the skinDr .safia A. AL-rezami.

Anthrax
Anthrax is an acute disease caused by the
bacteria Bacillus anthracis. Most forms of the
disease are lethal, and it affects both humans
and other animals. There are effective vaccines
against anthrax, and some forms of the disease
respond well to antibiotic treatment

Anthrax
What are the types of anthrax infection?
Anthrax infection can occur in three forms :
cutaneous (skin), inhalation, and .
gastrointestinal l
Cutaneous anthraxf: Most (about 95%) anthrax
infections occur when the bacterium enters a cut or
abrasion on the skin, such as when handling
contaminated wool, hides, leather or hair products
(especially goat hair) of.

Anthrax
infected animals. Skin infection begins as a raised
itchy bump that resembles an insect bite but
within 1-2 days develops into a vesicle and then a
painless ulcer, usually 1-3 cm in diameter, with a
characteristic black necrotic (dying) area in the
center. Lymph glands in the adjacent area may.
swell. About 20% of untreated cases of cutaneous
anthrax will result in death. Deaths are rare with
appropriate antimicrobial therapy.

Anthrax
What are the symptoms for anthrax?
These symptoms can occur within 7 days of
Infection :
*Fever (temperature greater than 100 degrees F
The fever may be accompanied by chills or
night sweats.
*Flu-like symptoms
*Cough, usually a non-productive cough, chest
discomfort, shortness of breath, fatigue, muscle
ache .

Anthrax
*Sore throat, followed by difficulty swallowing,
enlarged lymph nodes, headache, nausea, loss
of appetite, abdominal distress, vomiting, or
diarrhea .
*A sore, especially on your face, arms or hands,
that starts as a raised bump and develops into a
painless ulcer with a black area in the center

Anthrax
• Is anthrax contagious? .
No. Anthrax is not contagious; the illness cannot be
transmitted from perAnthrax .
• Treatment .
• The preferred way to treat anthrax is with antibiotics.
The goal of antibiotics is to destroy the infection and
prevent complications and death .
•Many antibiotics are effective against B anthracis
and include the followingson to person .

Anthrax
Doxycycline (Vibramycin )
PenicillinAmoxicillin (Trimox, Amoxil, Biomox)
Ampicillin (Marcillin, Omnipen, Polycillin
Principen, Totacillin)
Ciprofloxacin (Cipro)
Levofloxacin (Levaquin)
Gatifloxacin (Tequin)
Chloramphenicol (Chloromycetin)

Anthrax
Day 4

THE END
THANK YOOOU

Skin disesae

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