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Tuesday, January 31, 2012

Eczema

Eczema-About eczema:

Eczema is a common internal and external factors caused by a variety of epidermal and dermal inflammatory skin disease eczema is characterized by intense itching, skin lesions and pleomorphic, symmetrical distribution, drainage, tendencies, chronic course, easy to repeated attacks .

Eczema - Features
Eczema can occur at any site, common in the face, ears, limbs, flexor side, breast, hands, scrotum, etc., symmetrical distribution. According to lesion characteristics can be divided into acute, subacute and chronic eczema. Three there is no clear boundaries, change each other. More complex causes of eczema, and allergic reactions are closely related, the main feature is recurrent, was the severity of different inflammatory skin condition, itching more severe, clinical divided into 3 types:

(1) acute eczema:
Consciously intense itching, skin lesions and polymorphous, erythema, papules, Qiu herpes or blisters into a dense film, easy to leaking, state of confusion, scattered around the small papules, Qiu herpes, often accompanied by erosion, crusting, such as secondary infection, pustule or scab may appear thick. Appropriate treatment is to reduce inflammation, skin lesions may subside after 2 to 3 weeks, but often recurrent and can be converted to sub-acute or chronic eczema.

(2) subacute eczema:
Reduce inflammation after acute eczema, there are still severe itching, skin lesions with papules, crusting and scaling mainly seen small mound herpes, mild erosion. Appropriate treatment can be cured within a few weeks, handled properly, can be acute or chronic eczema.

(3) chronic eczema:
Often due to acute, subacute eczema unhealed two chronic recurrent eczema; can also start was not obvious, due to frequent scratching, rubbing or other stimuli, which is the start of the incidence of chronic eczema. The lesion showed hypertrophy of skin infiltration, surface rough, dark red or with pigmentation, many of the limitations of plaque lesions, common in the hand, foot, leg, elbow fossa, breast, vulva, anus, etc., clear edge. Chronic disease, up to several months or years, can also be due to acute stimulation.

Eczema can occur at any site, common in the face, ears, limbs, flexor side, breast, hands, scrotum, etc., symmetrical distribution. According to lesion characteristics can be divided into acute, subacute and chronic eczema. Three there is no clear boundaries, change each other.

Upward trend in the incidence of eczema, which may be climate change, a large number of chemicals in the life of the application, mental stress, accelerate the pace of life, changes in diet have a relationship.


Eczema - etiology and pathogenesisThe incidence of eczema is caused by a variety of factors interact.
(A) Eczema - genetic factorsSome types of eczema and is closely related to the genetic.
(B) eczema - environmental factorsMany studies confirm that environmental factors are the increased prevalence of eczema is one important reason. Environment, including environmental and individual environmental groups, environmental groups, human pathogenic factor is the wide range of outdoor air, water, soil, radioactive sources, a large area of ​​allergenic pollen vegetation, a large source of bacteria and other airborne allergens. Individual small environment is the individual's living environment, because people's lives about 2 / 3 of the time indoors, so individual small environmental impact of eczema closer. The major impact of environmental factors is increasing and complex environmental allergens, including:
1, synthetic fabrics, leather goods, and clothing for the dyeing agent bleach, brighteners, anti-moth agents, preservatives, etc. modern clothing firm environment allergens.
2, artificial food, convenience food, food-season for the food production of chemical fertilizers, pesticides, artificial feed, feed additives, preservatives used in food processing, mineral oxidants, flavors, colors, ripening agents, thickeners, etc. modern eating environment allergens.
3, the man-made building components, chemical coatings, plastics, rubber, synthetic fibers, adhesives, waterproofing agents, home and office electronic equipment produced by electromagnetic radiation, room cleaners, pesticides, functional modern living in the environment variable should be original.
4, the chemical produced by the combustion of fuel gas, manufacturing automobiles, boats, aircraft materials, asphalt roads, roadside green plants, pollen and other modern transport environment allergens.
5, detergent manufacturing plant in all of the enzyme detergent, plastic plants toluene diisocyanate, latex rubber factories, pharmaceutical chemicals such as antibiotics and other modern professional environment allergens.
6, some of the modern lifestyle-related environmental allergens, such as the use of cosmetics and cats, parrots, etc. When the human body in such a long life under adverse environmental factors, can lead to immune dysfunction, eventually leading to environmental allergy, causing eczema.
(C) eczema - infection factors
Some eczema and microbial infection. These organisms include Staphylococcus aureus, Malassezia, air-borne fungi such as Alternaria mold, Neurospora crassa branching, point Penicillium, Aspergillus, Fusarium, Penicillium chrysogenum, Aspergillus and Rhizopus and other black . It is based mainly in three aspects:
1, some patients with eczema of the skin lesions of a higher detection rate of micro-organisms.
2, the skin micro-organisms are pathogenic for some eczema. Some scholars should be reported in nonatopic eczema dermatitis skin lesions of patients overall detection rate of S. aureus 31.6%, the overall detection rate of 70.6% of bacteria, other than in Staphylococcus aureus bacteria, Staphylococcus epidermidis accounted for 62.7%, accounting for 1.7 hemolytic streptococci, other bacteria accounted for 19.6, bacilli accounted for 5.1%. No clinically suspected bacterial infection in patients with eczema, dermatitis and eczema skin lesions of patients with acute Staphylococcus aureus and total positive rate of bacteria were 46.1%, 76.9%; higher than chronic eczema and dermatitis in patients with subacute eczema. Skin lesions of discoid eczema patients and Staphylococcus aureus-positive bacteria, the highest total, 52.9%, 100%; were higher than other types of eczema. In seborrheic dermatitis lesions of Malassezia detection rate of 81.3%; tinea versicolor lesions of Malassezia detection rate was 96.3%; eczema Malassezia dermatitis lesions was detected in 59.7 %; and acute eczema lesions Malassezia detection rate 56.3%; hand eczema lesions Malassezia detection rate of 47.6%. Some micro-organisms on the skin disease eczema role.Fujisanva other with Alternaria mold, Aspergillus versicolor, Penicillium and other air-borne fungi citron leaching fluid antigens in the recurrence or worsening of eczema summer dermatitis patients patch test, skin test and challenge test. Results of skin test-positive rate of speed made eczematous dermatitis, atopic dermatitis patients were higher than the control group, and to the highest in patients with atopic dermatitis, 68.2%, and delayed-type skin test reactions (72-hour observation )-positive rate of eczematous dermatitis and atopic dermatitis patients were higher than the control group, eczematous dermatitis up to 40%. The patch test and challenge test is also part of the patients were positive, the result shows that eczema and dermatitis on air-borne fungi, fungi can also cause local contact dermatitis, inhalation of fungi can cause dermatitis generation.
3, anti-microbial treatment for eczema and dermatitis in some effective. There are extensive exudative lesions of atopic dermatitis system, use of antibiotics can often receive better treatment because the lesion had a local bacterial infection. Now clear, Malassezia and seborrheic dermatitis; bacterial infections, particularly Staphylococcus aureus infection and discoid eczema, infected dermatitis occurs in the primary foci of skin around the eczema-like lesions, skin lesions often continue occur in primary skin infections; skin ringworm rash in patients with certain primary dermatophytes infections, lesions at finding out in the emerging fungus, skin lesions and skin dermatophytes with the primary foci of regression and regression.
(D) eczema - dietary factorsVarieties of human food very much, and can be divided into plant, animal, mineral type, in the modern food often apply some synthetic food such as saccharin, acetic acid, citric acid, flavors, synthetic dyes. These foods can cause food allergy, eczema resulting in the generation, has been reported in the country prone to food allergy are protein-rich foods such as milk, eggs, etc.; seafood, such as onions, garlic, onions, lamb, etc.; a special bland foods such as pepper, wine, mustard, pepper, ginger, etc.; some raw foods, such as raw onions, raw garlic, raw tomatoes, raw fruit of certain crustaceans, such as almonds, chestnuts, walnuts, and certain fruits such as peaches, grapes, litchi, banana, pineapple, longan, mango, strawberry, etc.; some of the bacteria-rich foods, such as dead fish, dead shrimp, dead crabs and fresh meat is not class, some of the fungi-rich foods such as mushrooms, lees, vinegar, etc.; some not digestible protein-rich foods such as clams class, squid, cuttlefish, etc.; seed foods, such as various beans, peanuts , sesame and so on. In addition to these foods cause food allergy, the recent biochemical studies have found food in the banana peel can be isolated histamine substances, in banana, pineapple, eggplant, wine, yeast is high in histamine ingredients, chicken liver, beef , sausage also contains very high in histamine, which led to the occurrence of eczema.
(E) Eczema - drug factorsDrug factors are some of the eczema, eczema, drug eruption, especially the main reason. Generally speaking, any drug has the possibility of drug eruption caused by eczema, but the common were mainly: 1, ethylenediamine class of antihistamines, such as aminophylline, piperazine; benzoin tincture inhalation; procaine, vinegar sulfur has been urea; amino acid; food and drugs, azo dyes; hydrochlorothiazide, methyl chloride C urea, tolbutamide, chloral hydrate, iodine, hydroxy chloride, iodide, and organic iodide, X-ray imaging agent; streptomycin, kanamycin, gentamicin, paromomycin, nitroglycerin, aminophylline suppositories and hydrochloric acid ethylenediamine, amino mercury, Peru balsam, benzene left Cain and amino acid glycerol, sunscreen, trichloro-tert-butyl alcohol, halogenated hydroxy quinoline cream, iodine, neomycin sulfate, nitroglycerin ointment and so on. Mainly caused by drug-induced systemic contact type dermatitis. ② ampicillin, amoxicillin, nickel, mercury mainly caused by heparin and Buddha hamadryad syndrome. ③ penicillin, methyldopa, allopurinol, indomethacin, sulfonamides, gold preparations, quinine, chloramphenicol, clonidine and other major cause of endogenous PYM contact eczema. Eczema, drug eruption generally have the following characteristics: ① eczema, drug eruption is acquired, although closely related, and genetic quality and allergy, drug allergy, but not directly inherited from the parent body; ② eczema, drug eruption generally occurs after repeated drug exposure , and rarely occurred in the first contact; ③ eczema, drug eruption of the first onset latency are generally at least 1 week after, and again there was no incidence of the incubation period, you can instantly disease; ④ eczema, drug eruption excitation dose generally low, once sensitized patients, are often very small amount of drug exposure by Landis attack; ⑤ eczema, drug eruption usually has the typical symptoms or signs; ⑥ eczema only in a small number of patients with drug eruption patients on the drug.
(F) eczema - other factorsStill produced by the depression of eczema, fatigue, anxiety, tension, agitation, insomnia and other neuropsychiatric factors and sunlight, UV, cold, wet, dry, friction, climate, caused by physical factors. In addition, chronic gastrointestinal disease, chronic alcoholism, intestinal parasites, and metabolic disorders, endocrine disorders and other factors are all the causes of eczema.


Eczema - Treatment

The first should try to find allergens. Sometimes hard to find allergen, also check the total is not clear, because people touch things too much. Disease from the mouth, you can look at their record, the first three days to eat something, if the times are increasing because of eating something rash, remember to not eat up.

Also pay attention to environmental factors, there are many flowers, pollen is not the place to go, and wear a mask out of pollen season. Also more common example of eye allergy box on the waistband decorations allergies, which should be avoided. Because after using some cosmetics that itch, usually on the inside shows the composition of cosmetic allergy, do not use this cosmetic. This is a prevention-oriented, try to find the cause. Can not find the cause of their own lives as much as possible to avoid some of allergic factors.
Second, suffering from eczema itch, scratching skin lesions tend to make more powerful. In fact the more itchy dermatitis more grasping, more itch more grasping, vicious cycle. So do not grab when itch, itch the more often the more grasping.

Third, see a doctor. Rash can eat some of the anti-allergy drugs, to itch so badly, you can eat chlorpheniramine, antihistamines. Doctors will prescribe medication outside, the most common use of corticosteroids. There are 20 kinds of hormone drugs, and hormones strength of the points. We do not start with the strongest advocate, and most of the drug is not suitable for long-term use, long-term use have side effects. You can also use some topical creams, syrup.


Rash - eczema causes repeated

Eczema is a common inflammatory skin disease, the clinical features of polymorphous rash, tend to exudation, symmetric division, while easy to relapse and chronic, severe itching and consciously.
The cause of eczema is more complex, more due to some external or body caused by the interaction of factors, other factors are found to be sound, and therefore contact eczema, the reasons for difficult to remove, easy to tend to relapse and chronic. Causes can be divided into external factors and in vivo factors:

(1) External factors: such as chemical reagents, cosmetics, fragrances, dyes, detergents, fish, animal toxins, eggs, pollen, dust, bacterial infection, sun, cold, scratching and so on.
(2) in vivo factors: allergic constitution, metabolic, endocrine or gastrointestinal disorders, neuropsychiatric dysfunction, fatigue, mental stress, focal infection, intestinal parasites, varicose veins, sweat and skin drying.
Developed eczema cures drugs - wet Corning says the old Chinese Zhong: "eczema may be due to exposure and sensitization caused by repeated factor; also may be due to fatigue and psychological stress caused by repeated; there may be a result of improper diet caused by repeated, so in order to completely cure eczema, we have improved on the basis of traditional remedy formula, which has now wet Corning, Corning during treatment in the wet as the sum of measures taken, the general treatment of the primary side are:
(1) search for possible cause of isolated allergens, the provision of free re-stimulation, removal of lesions, treatment of systemic chronic diseases, such as indigestion, intestinal parasites, diabetes, neuropsychiatric abnormalities, leg varicose veins.
(2) pay attention to skin health, do not use hot water or soap Lesions, without any irritating itch drugs.
(3) fasting alcohol, spicy spicy food, the provision of free fish and other easy-to-allergenic and non-digestible food, attention to diet and the incidence of police off the relationship.
(4) work and rest, the provision of free fatigue and psychological stress and so on. "



Eczema - Skin Nutritional therapy external
Nutritional therapy is the use of external skin dry alum, calamine, Sophora, Cnidium, Evodia, indigo, dandelion, soil Jing leather, herb, Phellodendron, gall, borneol with vitamin a, vitamin c, vitamin e, borage oil , vitamin b6, biotin, zinc and magnesium and other materials through nano-technology and other modern high-tech made through the skin and external supply of nutrients to skin cells and repair the skin deep in Chinese medicine preparations. In using this method, based on the same time to improve physical fitness, so that function back to normal.
Used methods include the spleen, dampness, promoting blood circulation, clear diarrhea, etc., depending on the patient's body may be. So as to achieve the purpose of cure eczema.
Usage: Use in accordance with medical advice
Main functions: Indications eczema, subacute eczema, chronic eczema.
Advantages: pure Chinese extraction, mild, non-irritating, especially for the scrotum, anus, breasts and other sensitive parts of the eczema.
Disadvantages: Relatively hormones, medicine products, the results come more slowly.
 
How to treat eczema?
Eczema - points [treatment]
Point injection (one)
(1) acupoints
Main points: divided into 2 groups. 1, the full three years, Qu pool; 2 long and strong.(B). TherapeuticLiquid: the first set of points with vitamin B12 (0.1 mg) injection; the second set point with phenergan (12.5 mg) and vitamin B1 (50 mg), mainly for the scrotum eczema.To 5 dental needle, piercing points was gas. The first group of points per hole injection into the liquid 1 needle, 1 day, 10 times for one course; second set of points, all of the liquid into a long and strong points, 3, 1, 2 times for one course.(C) EvaluationThe first set of points in the treatment of 50 cases of refractory eczema, the results markedly above 84%, the total effective rate was 96% [2]; second set point scrotal eczema treatment of refractory, 35 cases were cured in 26 cases, effective in 6 cases , 3 cases, total effective rate was 91.4% [3]. Generally, the shorter duration of good effect [3].
Body acupuncture
(1) acupointsThe main point: eczema points.(B) Governing LawFirst point to find eczema, so that patients back on the light and, looking carefully at the back below the skin out, gray shiny, needles, scattered dots, namely eczema points. Found, with his left hand thumb, food, raised middle finger pinching the skin, right hand holding an inch-long needle, piercing the point, the needle seven, eight, children can be shallow stab, and then withdrawing the needle inserted into the second and third, rapid out the needle is not the needle, the needle each time point of 10 to 15 eczema. Daily or every other day. The other can be used with vitamin C200 mg, promethazine 50 mg, prednisone 10 mg (children reduce it), 3 times a day.
(C) Evaluation
Rule of law for a total of 476 cases, 433 cases cured, the cure rate was 90.9% [4].

EA
(1) acupoints:The main point: Ashi points.Is the point here: lesion area (below).
(B) Governing LawLesion area with alcohol after disinfection, needle piercing the subcutaneous tissue from the edge of lesions, the needle parallel to the direction and leather, the number of needle lesions of different sizes per block, with 2 to 6 months. Then connected to electro-acupuncture device, with the density wave, frequency of 20 beats / min, the intensity can be gradually increased until the patient feels appropriate date. Each electro-acupuncture for 20 minutes daily or every other day, 10 times as a course of treatment interval of 3 to 5 days.
(C) EvaluationA total of 26 cases of chronic eczema (neurodermatitis patients included), cured, 8 cases, 14 cases markedly effective in 4 cases, the total effective rate was 100% [5].
Point injection (bis)
(1) acupointsMain points: divided into 2 groups. 1, Qu pool Zusanli, Feishu, Sanyinjiao, a sea of ​​blood; 2, Kei door.
(B) Governing LawGroup 1 point for the treatment of systemic eczema, 2 points for each election, alternating rotation sequence. With 10 ml syringe, the first arrest pumping 2.5% sodium citrate injection 0.6 ml, apply again and again the patient's own venous blood 6 ml, immediately shake, get gas after the injection of selected points. Once a week for treatment. Group 2 points with the governance of the scrotum eczema, alternately use two-Kei door hole to Angelica injection to get gas injection, injection Bi moxibustion 15 minutes. 1 or 2 times a day, 20 times for one course.
(C) EvaluationSystemic treatment of eczema were 46 cases cured in 40 cases, effective in 4 cases, 2 cases, the effective rate of 95.7% [6]; scrotum eczema 42 cases, effective 24 cases, improved in 13 cases, 5 cases, total effective rate was 88.1% [7].
Ear
(1) acupointsMain points: divided into 2 groups. 1, lung; 2 of the helix (ear area).Distribution Point: God the door, endocrine, sympathetic.
(B) Governing LawGroup 1 mm hole and with the use of acupuncture points, each taking 1 to 3 points. First soaked in 3% zinc sulfate liner close to the skin, then turn the electrode plate, cover with plastic sheeting and fixed with adhesive tape. Surgical needle into the ear will be mm, connected to the DC-pin device, the negative pole ear, then the positive plate; treatment for 15 minutes, switching polarity, and then treated for 5 minutes, 1, 6 times for one course. Group 2 with barbed Blood, bilateral were taken, fixed differentiation of the ear with his left hand, fully exposed to the Ministry of the helix, right hand holding a pen-style grip {10} pin (or lancets) needle handle, according to the helix arc tangent of the vertical direction, with the needle gently on cross-cut of the helix, the length is less than 5 mm, scratches spacing 2 mm, so that slight bleeding, and then disinfect the wound cotton cover, about 3 to 4 hours after removing , blood scab let it fall off naturally.
(C) Evaluation
Rule to the first group, 65 cases recovered, 45 cases markedly effective in 9 cases, effective in 13 cases, 4 cases, efficiency 93.8% [8]; treatment of 12 cases in group 2, all cured, cure rate was 100% [9] .

Bloodletting (1) acupointsThe main point: Feishu, appointed Yang.(B) Governing LawMake patients prone position, exposing the upper back and legs. Needle puncture Feishu first to point, and then squeeze the bleeding hole area, which in its on cupping. After the assassination of then appointed Yang bleeding points plus cans. Cans per hole to stay 10 to 15 minutes. Every other day, 3 times for one course.(C) EvaluationCohabitation refractory hand eczema in 38 cases, cured 26 cases, 10 cases, 2 cases, the total efficiency of 94.7% [10].
Skin needle(1) acupointsMain points: Ojo, bladder meridian (Dazhu to the white ring Yu above).Distribution Point: sea of ​​blood, the wind market, is the cave.
(B) Governing LawWill take the main points, with points Zhuojia, chronic patients should Qaa is the point. Make patients prone position or sitting position, with the skin puncture needle top-down play, focusing on back and waist section, call the assassination of moderate intensity, to the degree of skin flushing. Points within the area will be repeated in diameter 1cmm call to flush the assassination. A hole is pierced from the outside circumference, France ibid. 1 day, 5 to 10 times for one course.

(C) EvaluationCohabitation in 40 cases, clinical recovery in 28 cases, 8 cases were markedly effective in 3 cases, 1 patient, the total effective rate 97.5%.

Scabies

Scabies-About Scabies:

What is scabies?

Scabies is a contagious skin disease caused by scabies mites. Scabies mainly severe skin itching, rash, and multiple soft folds of the skin, especially the genitals. Scabies is spread through close contact with the disease, mainly outside the rule-based, generally do not need oral systemic medication.


Scabies - Introduction
Scabies is a mite parasitic on the human skin caused by chronic infectious skin disease through close contact, especially sexual contact, occurred in the skin delicate, folds, highly contagious, spreading quickly, easily spread in the family and the collective , often a collective fashion. Infected skin papules with blisters and severe itching tunnel, due to scratching prone to secondary infection, often cyclical. Scabies mites can also infect sheep, dogs, pigs, rabbits, cattle, horses and other animals caused by these animals suffering from scabies.
Scabies - Etiology
Scabies scabies mite pest species of human type, belonging to Arachnida, subclass tick mite, mite head, scabies mite Branch, scabies mites is an arthropod. Scabies mites back numerous transverse wavy wrinkles, the latter part of the trunk a few of the bristles and long rod-shaped bristles, abdomen, less than 40 pairs, after the edge of the central body is the anus. Scabies mites palatal body is very small, located in the trunk of the front half into the trunk, the chelicerae were clamp, suitable for edible skin keratin. Parasitic in the human body within the epidermis. It is absolutely parasitic, in appropriate host body, secreted protein decomposition and rodents eat the skin tissue, as a food source, rather than taking the blood, and the use of chelicerae and feet dug a tunnel in the skin. In the warm skin crawl speed 2.5cm/min.

Scabies insect life history is divided into egg, larva, nymph, adult four stages. Eggs oval, yellow, shell thin, translucent, often 4 to 6 eggs together in one place, the females dig in the middle of the tunnel. Discharge of stool when spawning, spawning, the adults die in the tunnel blind side. Larvae hatch from eggs and live in a tunnel, soon peeling into the adult, female nymphs and adult males after mating, females that lay eggs in the tunnel, while ovulation side forward, dig tunnels every day to move forward 0.5 ~ 5mm , migration is faster, eggs on the evacuation of the tunnel, the migration of slow, dense in the tunnel on the eggs. Another feature of scabies are nocturnal insects by day and, when active scabies mites and their droppings can cause mechanical irritation of skin itching, scabies mites as increased activity at night itching is usually more intense.

Scabies - epidemiology
The spread of scabies epidemic cycle
For 30 years, a popular end to the beginning of the next pandemic, the interval of 15 years.

Scabies predisposing factors
Poverty, poor hygiene, population density, sex dirty, etc.

Scabies - transmission
1, the direct infection
Directly with patients carrying scabies mites or animal infected after contact with the disease, is an important way to spread scabies. General home or unit, dormitory of scabies in patients after the others re-infection scabies are the way to the transmission of a highly infected population wide, adults, children, pregnant women, babies can be infected with scabies, all industries can lead to scabies spread of the disease, doctors, nurses, teachers, students, workers, civil servants, etc., occurred before the liberation of the poor living conditions in rural areas, raise the level of modern life, a lot of people and medical workers have neglected the occurrence and development of the disease, while the large urban migrants tended to increase.

2, indirect infection
Through indirect contact with scabies patients clothing, supplies, patients come into contact with furniture, goods and other infection, the most severe scabies spread strong enough to (scabies patients to take the money by other human contact are affected by scabies, bus scabies were arrested contact with other people over the railing will be infected with scabies), but a lot of people living with scabies patients without the disease, mainly related to the body's own immune system has a great influence. Incidence of scabies in patients with reduced immunity occurred in the case of their own.

Scabies - susceptible parts of the
Scabies mites tend to invade the fingers, wrists in front, Zhouye front, areola, female breast, the external genitalia, groin, inner thighs, lower back, buttocks and other parts of the skin soft.Scabies - pathogenesis
The formation of scabies scabies damage is caused by pregnant female scabies mites tunnel, itchy red papules Department larvae bore into the skin and directly due to the formation of blisters and pustules of scabies mites may be deposited in the cortical layer of the excretion of the table material as a substance acting on the epidermis and dermis capillaries due. Eczema-like reactions also increased from scabies mites and their products cause hypersensitivity, which means that the skin lesions of scabies scabies mite by direct or indirect effects caused by waste.

Scabies - the type of disease
Scabies 1. Adult scabies: The main symptoms are itching, red papules, Qiu herpes small blisters, tunnels, nodules and scarring.

2. Scabies elderly: severe itching of scabies mites response is weak, so no significant inflammatory response. Back common.

3. Infants and young children scabies; difficult to find tunnels and scabies mites, be rash not typical form, the head and face, pale and light in the tunnel, subtle, such as linear, mild inflammation and pink base, easily hydrated with disease, and easy to get a glimpse through the insect cuticle-point, white dot-like processes.

4. Nodular scabies: more common in the scrotum, buttocks, abdomen and thigh. Reddish brown to the festival, itching, a few months to 1 year or more before dissipating.

5. Norwegian scabies: (Norwegians cabies), also known as scabies scab resistance, this type of system 1844 Dabielsen, 1848 was first reported in a Norwegian scabies shaped, so called Norwegian scabies. Is an abnormal immune response. Mainly in frail patients. Expressed as dry skin, crusting, hyperkeratosis appeared scaly plaques of erythema, erosion can occur, pustules, odor, dry hair loss, nail thickening distorted, lymphadenopathy, scaly thick, severe illness, highly contagious.

6. Limitations of scabies.

Scabies - Clinical manifestationsneaosipu main symptoms scabies treatment1, consciously itching, worse at night. Paroxysmal nocturnal intense itching.2, the fingers can be seen scabies mites dig the tunnel, about 2 ~ 4mm, was gray-brown irregular curve. This is the scabies mites drill line traces.3, the rash occurs in the skin is thin and tender place, the size of lesions papules mainly corn or hill herpes.4, scabies nodules. In the scrotum, penis, labia, groin occurred soybean nodules the size of the red light, this is scabies nodules. Needless such nodules often prolonged, often accompanied by intense itching. Finally, genital scabies nodules.Associated symptoms1, the scratches blood scab. Because patients with scabies, itching, the patient unconsciously scratch, there are often scratches the skin and blood scab.2, secondary eczema of scabies mites secretions due to stimulate the skin, together with factors such as scratching, skin erythema, papules, blisters and other damage, which is of secondary eczema, often increase the itching.3, secondary infections due to scratching, poor sanitation, or hot weather, sweating, and other reasons, it is easy secondary skin infection, secondary impetigo, folliculitis, furunculosis, superficial lymph nodes symptoms.4, secondary nephritis secondary infection as scabies, scabies and insect secretions and bacterial infections and other factors can be used as antigens in the human body, followed by nephritis. Patients may feel fatigue, edema, back pain, etc.Special performanceInfants and young children scabies; difficult to find scabies mites tunnel and should not form the typical rash occurs in the head and face pale and light in the tunnel, such as linear faint pink base with mild inflammation and disease prone and easily inflated with a glimpse through the insect cuticle point white dot-like processes.Adult scabies: The main symptoms are itching red papules Hill tunnel nodules and small blisters herpes scab.Scabies elderly: severe itching reaction to the scabies mites weak back so significantly more common in the inflammatory response.Nodular scabies: more common in the scrotum and buttocks thigh abdomen red-brown nodules itching for several months to 1 year or more before dissipating.Norwegian scabies: also known as the crusts of scabies is an abnormal immune response in frail patients with multiple skin showed hyperkeratosis dry scab appeared erythematous scaly patches of erosion can also occur off the nails dry pustules stench thickening hair scales thick twisted lymphadenopathy highly contagious severe illness.

Scabies - CheckLooking for tunnelScabies tunnel with blue ink drops in suspicious skin lesions on the tunnel, and then rub a cotton swab for 30 seconds to 1 minute, then clean the surface with alcohol cotton balls black trace, showing traces of dyed light blue tunnel.
Needle to pick sidesOn that side, palm wrist wrinkles and blisters, pustules, etc. to find scabies mites tunnel. Carefully to find the end of the tunnel and found a white worm-point, where the most easily identified scabies mites rash.
Methods: the 6th injection needles, needle and skin surface into a 10 ° ~ 20 ° angle, the needle bevel up mouth. Point at the end of the tunnel worm, about 1mm from the insect point of the needle perpendicular to the long axis of the tunnel, the bottom line to the point and bypass the insect larvae, and then dry flat needle (to 5 ° -10 °) a little rotation, scabies insects that fall into the mouth of the needle hole slot, prick the skin and the needle slowly (or direct withdrawal). Go to the water (or 10% KOH, NS) of the slide, and then check the scabies mites under the microscope.Scabies - Laboratory testsScraping the surface of the skin papules, blisters, etc. dander, microscopic scabies mites or eggs found; If you find the tunnel, can be used directly to closed-end needle prick, pick the naked eye can see a large gray dots needles, can be found under the microscope scabies mites.Scabies - DiagnosisIn the diagnosis of scabies, the doctor for check tests to determine the diagnosis of scabies. So how to make check tests to determine the diagnosis it? Scabies in adults and more hidden in the skin of the tunnel, so be sure to check the tests to find the tunnel, then cut with a blade tunnel, the scabies mites scraped off, put in slide, and with the microscopic examination, it is easy to find scabies mites. Generally more common in hand-stitched tunnel, and sometimes can also be found in the wrist tunnel. Tunnel is in fact a blind tube, slightly curved, the top has tiny black spots, this is the scabies mites.

Scabies - Treatment
Mainly outside the rule-based, generally do not need oral systemic medication. The treatment of scabies with particular attention to bedding, underwear disinfection.

 Scabies - Treatment
 
Commonly used for external use
(1) sulfur ointment over the paint on the body from the neck the following, every night, once every 7 to 10 days. Adults, with 10% ointment of sulfur, sulfur 5% of children with ointment. Cayao period not bathe, do not change clothes. Observed 2 weeks after treatment to determine efficacy. If relapse should be treated.

(2) Scabies - Treatment
 
1% C-666, also known as scabies Ling cream, use half an hour to dry after bathing, Cayao 1, 24 hours after the bath can be. The drug is tasteless, odorless, non-stimulating drugs to kill the scabies mites, is effective, but absorbed through the skin potential hazards. Therefore, women, infants should not be used with broken skin are the best.


 (3) Scabies - Treatment
 
30% sodium thiosulfate solution, the body Cayao 2 times a day, 1 week may be more.

Scabies care:
A scabies - day care
(1) pay attention to personal hygiene, bathe, frequently changes underwear, regular laundry bedding.
(2) found that patients should be isolated promptly and thoroughly treated. Patients cured, it should be observed for 1 week, no new disease be considered cured, because scabies eggs develop into adults takes 1 weeks.
(3) family and a dormitory that patients should also be treated to prevent transmission of leaving the disease to each other repeatedly.
(4) contact with scabies patients, the playing hand washing with soap or sulfur soap to avoid infection. Scabies in patients with soiled clothing, bedding, bed sheets, pillow covers, towels, etc., must be sterilized by boiling, or in full sun exposure in order to kill the scabies mites and eggs.
(5) can be smoked using hot water immersion or intensive parts of charcoal, has a good effect.

Second, scabies - diet to restore the principles of
(1) diet should be light, eat more vegetables and fruit.
(2) heat and dampness should eat foods, such as gourd, wax gourd, bitter gourd, purslane, celery, Malan head, lotus, watermelon, Coix seed, mung bean, red bean and so on.
(3) do not eat or eat Zhu Tourou, lamb, goose, shrimp, crab, mustard made ​​objects, so as to stimulate the skin lesions and increased itching.
(4) Do not eat in spicy irritants such as pepper, Sichuan hot pot, a high degree of alcohol, etc., so as not to aggravate itching.

Measles Rash-Rubeola

Measles-What is measles?

Measles is a red skin rash and buccal mucosa on the measles rash spots and pigmentation left back with bran-like desquamation is characterized, measles is the most common acute viral infectious diseases, contagious, respiratory tract droplets as the main route of transmission. Lasting immunity after measles, relapses are rare, not found specific antiviral drugs. Patients clothing should be in the sun exposure; patients should have ventilation between the housing and UV irradiation, the epidemic season in propaganda work, susceptible children go to public places as little as possible.

                               measles rash pictures-measles rash picture children

Measles Rash/Rubeola - Overview:

Measles (or Rubeola) is the most common acute viral infectious diseases. Measles is highly infectious, in densely populated areas without general vaccination epidemic prone to occur about 2 to 3 years a pandemic. Persian physician Muhammad ibn Zakaria Razi first explain the disease, and smallpox to distinguish. Clinical disease with fever, upper respiratory tract inflammation, conjunctivitis, etc., to red skin rash and buccal mucosa on the measles rash spots and pigmentation left back with bran-like scaling of features. World Health Organization (WHO) estimates that globally there are still cases of measles each year about 40 million, of which 100 million children die from measles and its complications, the vaccine-preventable viral disease in the largest number of death cases.

Measles Rash/Rubeola - etiology
Measles virus is a virus, Vice mucosal viruses, is also a DNA virus, and other viruses, vice mucosa no special place for the neuraminidase.

Spherical electron microscopy of measles virus, diameter 150-300nm, capsid outside envelope, envelope with hemagglutinin (HL), hemolysis. Low resistance to this virus is not strong, dry, sun, are sensitive to heat, UV, peracetic acid, formaldehyde, such as lactic acid and ether are killing effect of measles virus.

Measles virus RNA is a single stock, Deputy mucus type virus, the virus with droplets of respiratory tract and conjunctiva invading epithelial cells of a small amount of propagation, causing local inflammation, into the blood by the local formation of viremia, widespread lesions. Small number of patients measles pneumonia. Because non-specific immunity in patients with measles is easy to reduce secondary bacterial infection.

Measles Rash/Rubeola - epidemiology
Measles - the source of infection
Patients with acute measles is the only source of infection, the incubation period from the last 1-2 days to 5 days after the rash are contagious. The patient's mouth, nose, throat, eye secretions contain the virus, and excreted with the droplets, it is the main route of transmission of respiratory droplets. Incidence of both seasons, winter and spring up to 6 months to 5 years the highest incidence in children. Illness lasting immunity, relapses are rare.

Measles - transmission
Measles virus with those infected droplets into the nasopharynx and eye or be inhaled directly to the trachea, bronchi, epithelial cells in the local breed, and after the flow of lymphatic cells reach the lymph node, continue to multiply and spread into the blood stream to form a The first viremia. After the virus enters the blood lymphocytes in lymphoid tissue to the body, liver, spleen organs, tissues and organs in the extensive proliferation of these again into the bloodstream, leading to a second viremia, widespread disease, skin and mucous membranes of the body capillary endothelial cells were also infected with measles virus.

Measles  Rash/Rubeola- susceptible
The disease is highly contagious, susceptible contacts are more than 90% after onset. In densely populated areas without general vaccination about every 2 to 3 years once popular, l-5-year-old children with the highest incidence. Measles incidence rates have dropped after use. But not lasting immunity, so the age of onset after the shift. Disease did not receive the vaccine in preschool children. Immune failure in children and young teens more common and even popular within the community can be formed.

Baby from the placenta to be the mother antibodies within 4-6 months after birth passive immunity. Then gradually disappeared, although the vast majority of infants at 9 months the mother of antibody within the blood could not have been measured, but some children are still there even sustainable for up to 15 months. Will affect the vaccination. Susceptible infants of mothers without immunity to measles may be sick before and after birth.

Measles - Pathogenesis
When inhaled measles measles patients susceptible nasopharyngeal secretions or droplets containing the virus, the measles virus in the local mucosal short-term breeding, while a small amount of virus invasion of the blood. Since then the virus in distant organs of the monocyte-macrophage cell system in the replication and infection after about 5-7 days into the blood that is, for a large number of clinical prodromal period. In this period, such as body tissue in children: airway epithelial cells and lymphoid tissues, can be found virus in nasopharyngeal secretions and urine and blood and other secretions and body fluids. At this point most contagious.

Rash appears, viral replication is reduced to 16 days after infection, the virus can still only in the urine for several days. 2 days after rash, serum antibodies is almost 100% positive clinical symptoms are significantly improved. As the systemic and local immune response at this time is still suppressed in some patients it is often secondary to sinusitis, otitis media and bronchopneumonia.

10% of children with cerebrospinal fluid lymphocytes was significantly increased by 50%. When in peak condition EEG changes, but only 0.1% had signs and symptoms of encephalitis, which often occurs several days after acute onset. At this time serum antibody has been increased and has not found the virus, so consider autoimmune encephalitis.

Incubation period of measles:

A typical incubation period of measles than the rule, usually 7 to 14 days, up to 21 days.

Measles - the type of
There are many types of measles:

Typical measles
1, the prodromal phase

To the onset of rash from about 3 to 5 days. The main symptoms are fever and upper respiratory catarrhal symptoms, generally low to moderate degree of fever, there are sudden high fever with seizures. Runny nose, irritating cough, conjunctival hyperemia, tearing, photophobia gradually increased, lethargy, anorexia, pulmonary rales could be heard to dry. Children often vomiting, diarrhea, in the soft palate, hard palate arch, there may be small in a transient red rash.

The onset of the first 2 to 3 days can be on the bilateral buccal mucosa occurred at near molar gray fine sand-like dots, around to flush, said early measles disease-oriented features of mucosal plaques. Mucosal plaques can be gradually increased, convergence, also seen in the lower lip and gum mucosa inside, occasionally in the palate, the general maintenance of 16 to 18 hours, sometimes until 1 to 2 days, mostly in 1 to 2 days after the rash disappears.

2, the rash phase

Onset of about 3 to 5 days later, symptoms and upper respiratory symptoms increased, body temperature can be as high as 40 ℃, listlessness, lethargy, anorexia. First, the ear hair skin rash, rapid development to the face and neck, top-down one day spread to the chest, back, abdomen and limbs, about 2 to 3 days throughout the palm of the hand, foot, head and facial rash have been available at this time begin retreat. Rash about 2 ~ 3mm size, the beginning of pale red, scattered, gradually after intensive bright red, then to dark red, rash normal skin between. Rash when the body lymph nodes, liver, spleen may be enlarged, the lungs dry coarse rales could be heard.

3, recovery

Rash by rash after a homogeneous order of retreat, leaving brown pigmented spots, with bran-like scaling, there are about 2 to 3 weeks. Retreat with the rash to reduce systemic symptoms, heat back, spirit, appetite improved, cough improved recovery. Throughout the course of about 10 to 14 days.

Light measles
More common in those who received the vaccine. Currently more common in patients with light. Low fever, mild upper respiratory symptoms, mucosal plaque measles is not obvious, less rash, with few complications.

Heavy measles
Benedict severe illness. High fever, delirium, convulsions were toxic for the measles; with those of shock and circulatory failure of measles; hemorrhagic rash, pressure of those who do not fade as hemorrhagic measles.

Atypical measles
Seen after vaccination with inactivated measles vaccine vaccinated again six months later. China with the live attenuated vaccine, therefore type is rare.

Measles - complications
The most common complications of bronchial pneumonia, myocarditis, laryngitis and otitis media, encephalitis can occur in other, subacute sclerosing panencephalitis, cardiovascular insufficiency and tuberculosis spread etc.

Measles/ Rubeola- diagnosis
Clinical diagnosis
Typical treatment of measles based on epidemiological data and clinical manifestations can be diagnosed. Susceptible in 2-4 weeks history of exposure to measles, fever, coughing, sneezing, runny nose, conjunctival hyperemia, tearing and other symptoms, should be suspected and measles, such as measles mucosal plaques can be diagnosed. Characteristics according to the rash after rash, rash, and rash distribution of the order is also easy to make a diagnosis. Rash with desquamation and pigmentation back in the recovery of diagnostic significance.

Laboratory tests
1, the blood: WBC normal or slightly higher prodromal period, rash period slightly reduced the relative increase in lymphocytes.

2, nasopharyngeal, or urine sediment smears stained looking multinucleated giant cells, 1-2 days before the rash can be positive, the positive rate of the first week of the course can be as high as 90%, and has important reference value. Can be found using immunofluorescence antigen measles, can be used as the basis for early diagnosis.

3, serum antibody detection: enzyme-linked immunosorbent assay or immunofluorescence assay of serum measles antibodies 2-3 days after the onset can be measured, can be used as an early specific diagnosis. Serum hemagglutination inhibition antibody, neutralizing antibodies and complement fixation antibodies, recovery increased by 4 times more side diagnosis, only as a retrospective diagnosis.

4, measles virus isolation: taking the patient's nasopharyngeal secretions or early blood leukocytes inoculated on monkey kidney, human embryonic kidney cells or other sensitive, separable to the measles virus, but positive rate of reduction.

Measles - treatment:
Of measles virus present (2011) have not yet found specific antiviral drugs, so treatment focuses on strengthening care, symptomatic treatment and prevention of complications.

Measles - Nursing -Measles Care:
Should rest in bed, single room isolation, indoor air fresh and maintain proper temperature and humidity, not too much clothing, eyes, nose, mouth, skin clean. Digestible diet should be nutritious and should be more warm water to feed. Can not avoid the mouth, there should be recovery snacks. Heat can be given a small dose of antipyretic, antitussive cough to be so when the drama. Early to frail ill may intramuscular gamma globulin, a small amount of repeated blood transfusion or plasma.

MeaslesRubeola/ - prevention
Prevention to improve population immunity against measles is the key, so the implementation of immunization susceptible people is very important. Found measles patients should take comprehensive measures to prevent spread and popular.

Autoimmune
Susceptible should receive live attenuated measles vaccine. First kind of not less than 8 months of age, due to fear from the mother's antibodies and the vaccine virus, so failure.

Passive immunity
Young frail and sick patients, such as exposure to measles, 5 days a passive immunization against disease, 5 to 9 days you can only alleviate the condition.

Intramuscular gamma globulin (10%) 0.2ml/kg, or placental globulin 0.5 ~ 1.0ml/kg, or adult plasma 20 ~ 30ml. Passive immunity can only maintain 3 to 4 weeks, 3 weeks after contact with measles patients had to be injected.

Comprehensive prevention
Found for the epidemic of measles cases should be immediately reported to the rash and 5 days after isolation, have complications until 10 days. Where contact with vulnerable children should be quarantine for 3 weeks, and under the circumstances to give auto-immune or passive immunization, immunization agents, shall be to extend the quarantine to four weeks. During the measles epidemic, should vigorously promote the patient does not go out, medicine sent home, susceptible children do not suffer from the door, the collective institutions to strengthen morning inspection of the suspect should be isolated for observation.

Cut off the transmission
Patients clothing should be in the sun exposure; patients should have ventilation between the housing and UV irradiation, the epidemic season in propaganda work, susceptible children go to public places as little as possible.