Skin infections are bacterial and fungal infections of skin diseases, the disease in patients with mild to severe, light and easy treatment of serious treatment is not easy. Common skin infections are Staphylococcus aureus infection, clinical manifestations of skin boils carbuncle, gangrene, cellulitis, folliculitis, etc.. Fungal infections, including various dermatophytoses and skin mucosal candidiasis, such as vulvitis, balanitis, glans erosion and nail ingrowing.
Skin infection - an overview of pathology
Skin infections, skin is composed of the epidermis, dermis and subcutaneous tissue is rich in blood vessels, lymphatic vessels, nerves, muscles, and a variety of skin adnexa. The skin covering the entire surface, is the largest organ in the mouth, nose, urethra, vagina, anus, etc., with the body lumen mucosal phase. The skin is the body contact with the outside world the first layer of the barrier, it has a sensory function, such as: pain, cold, heat, so that the body away from the noxious stimulus; skin through the relaxation of vascular contraction, increase or reduce body heat dissemination, in order to regulate body temperature; skin, there are many crucial but we ignore the role. The skin is vulnerable to invasion of external mechanical, physical, chemical and biological factors, suffering from a variety of disorders. Avoid contact with the outside world a noxious stimulus to keep the skin clean, effective way to avoid a variety of skin diseases.
Skin infections - to explore the cause of
Skin infection pathogens from the skin invasion, such as all kinds of warts caused by a virus, fungi caused by dermatophytes. Purulent skin disease cocci. Bacillary leprosy TB. Schistosome cercaria dermatitis caused by animal schistosome cercariae. Caused by the scabies mite scabies. Also spread by the respiratory tract: rubella, measles, coccidioidomycosis, has organized histoplasmosis and other communicators: such as syphilis, gonorrhea, inguinal lymph granuloma, some pathogens into the intermediate host, such as cutaneous leishmaniasis, filariasis, and so on, some organisms can also damage the skin and cause skin problems, such as caterpillar dermatitis, mite dermatitis, scorpion stings, snake bites.
Skin infections - diagnosis and treatmentSkin due to sweating, damp, resulting in a relatively hot and humid environment, provided good conditions for microbial growth and reproduction, so the relatively high incidence of skin infections, a common fungal infections and bacterial infection two. The following detailed description of the appropriate diagnosis and treatment.
1, fungal infections
Hands, tinea pedis
The cause of tinea pedis: hands, tinea pedis due to the pathogenic fungus infection (toe) between palmoplantar skin is one of the most common skin disease. Motherland medicine called ringworm of the "Schefflera wind". Tinea pedis commonly called athlete's foot "or" feet ". Common pathogenic fungi Trichophyton rubrum, Trichophyton mentagrophytes and Epidermophyton floccosum in recent years, Candida albicans and other yeast-like fungal infections are not uncommon. The main route of transmission of tinea pedis slippers, share, shared Foot bathtub, public baths, fitness facilities, flooring and towel channels such as cross-infection; the ringworm mostly from tinea pedis infection often caused by the rubbing foot.
Tinea pedis divided into three types according to different symptoms:Vesicular: plantar cluster or scattered blisters, tip or the size of a grain of rice. More common in summer. Blisters reaction can be localized. Blisters may rupture, after drying, leaving a collar-like desquamation. Can also be due to intense scratching, skin lesions and erosion, exudation showed eczema-like performance. This type itching heavier, often due to scratching and secondary infection, can cause erysipelas or lymphangitis. Acute inflammatory vesicular tinea pedis can be combined to hand blisters allergic reactions, (dermatophytes rash). Khan herpes-like reactions more common in severe acute inflammatory tinea pedis.
Intertrigo type: mainly seen in between the toes, usually the fourth and fifth toes of the most commonly involved, and the serious can all toes are involved. The wet, impregnated leaving the skin white, stripped of the epidermis, basal red erosion. Patients often feel the irritation and itching. Summer or in hot and humid conditions, work and life of common people. Tinea pedis usually bacterial infection between the toes dipping serious fungal microscopy-positive rate.
Scaly keratotic: this type of dry scaly, chapped mainly skin keratosis heavier, dry, rough, common cold season, prone to chapped hand, foot, causing pain.
Treatment: the preferred topical antifungal therapy, the choice of the solution, cream, ointment formulations, treatment for 2-4 weeks. Acute damage to avoid using stimulant medication. Dipping erosion type tinea pedis should be topical powder dry, use the antifungal cream. Ciclopirox olamine cream (Central Lee ointment), Miconazole Nitrate Cream (Miconazole Nitrate), bifonazole cream (Fu Qi cream or US g), hydrochloric special terbinafine cream (blue America express, DINK). Keratinized hypertrophic damage can choose ciclopirox olamine, terbinafine ointment or salicylic acid benzoic acid ointment. Secondary to tinea pedis infection, bacterial infection should first be treated with antibiotics. Tinea pedis the secondary ringworm rash, eczema should first line anti-allergy treatment, for external use containing a corticosteroid and antifungal compound. Avoid stimulating drugs, such as salicylic acid alcohol. Stubborn cases may be the system of local therapy, anti-fungal treatment, especially compared to naphthalene fen 250mg / day, 2-4 weeks; or itraconazole 200mg / day, two weeks or 400mg / day, 1 week.
Jock itch tinea, jock itchEtiology: tinea is smooth on the skin caused by superficial fungal fungal infection. The major pathogens causing the disease is Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum. When the damage was caused by Microsporum canis by a fungus addicted animals, the inflammation is more intense. Ringworm of the body suffering from ringworm through contact with infectious patients or cats, dogs, can also be made through the clothing, appliances, and other indirect infection. Diabetes, wasting disease and immunocompromised patients susceptible to the disease.
Jock itch is dermatophytes violated the inner thighs, perineum, buttocks caused by a fungal skin disease, Chinese medicine called "Yin ringworm.
Clinical manifestations: more than a ring or coin-shaped, so the Chinese called "ringworm" round ringworm. Children and middle-aged, predominantly male, occur in the wet, sweating or vulnerable to friction parts of the face, waist, inner thighs and buttocks. Rash small piece of a cluster at the beginning of the pinhead-sized red papules or Confucius herpes, after getting to the surrounding development, to form a ring or ring of concentric circles like dry scaly patches. The edge is clearly active center of healing orientation or pigmentation, and long-term scratching can cause local skin hypertrophy, chronic eczema-like changes. Consciously itching or itching, fungal test was positive.
Jock itch is more common in men, to the thigh from the inguinal fold erythema, the edge scaling was active damage. Most cases double the vastus medialis typical phenomenon tinea ring damage. And often involving the scrotum candidiasis, jock itch usually involving the skin of the scrotum but can be involved to the hips. Tinea corporis is rare in children.
Treatment: topical antifungal, 1-2 times daily for 2-4 weeks. See 1.1.3. System in the treatment of cases of skin lesions can be used: such as griseofulvin (ultramicron), 250-500mg, 2 times a day, 2-4 weeks; or Iraq itraconazole 100mg / day for 2 weeks, or 200mg / day for one week; or special terbinafine 250mg / day, the course of one week.
Tinea versicolorTinea versicolor is caused by addicted to fat yeast called Malassezia.Clinical manifestations: the chest, upper back, armpits, neck and groin area can be generalized body. The rash of brown, pink or white spotted. Diameter 4-5mm to large areas of confluent rash. Early rash scaly, after scratching a little scaly. Generally asymptomatic, a few mild itching. Legacy of mild hypopigmentation spots after the rash subsided, often persist, known as parasitic leukoplakia.
Treatment with drugs other than treatment: anti-fungal topical formulations apply, sooner or later, topical 1, 2 to 4 weeks of treatment. 2% selenium sulfide lotion used for the evening, next morning wash, 1 to 6 weeks of treatment. 2% ketoconazole lotion twice daily for 5 consecutive days, the lotion applied to the skin, 3 to 5 minutes after the wash. For relapsed or refractory oral ketoconazole 200 mg / day, 2 times a week for 1 day, 2 to 3 consecutive weeks; or oral itraconazole 100mg / day for 2 weeks.
Tinea capitis
Cause of tinea capitis: Tinea capitis is a disease of the scalp and hair due to dermatophytes infection. Occur in children, one barber equipment and transmitted to wear hats, shared pillow covers. Depending on the types of pathogens and host responses, divided into three types of yellow ringworm, ringworm white and black spots of ringworm, the inflammatory reaction Kerion.
White ringworm: The most common scalp gray scales hair loss patches. Damage can be presented to the satellite-like distribution of hair from the scalp 3-4mm at the break, the disease around the sheath surrounding the visible gray hair. The disease generally after puberty, self-healing without leaving scars. Pathogens are mostly of animal origin, canis, mostly for exposure to a cat suffering from ringworm, transmitted by dogs.
Yellow ringworm: typical damage dish yellow scab, the center throughout the hair, hair dull, of varying lengths. Long can be formed of atrophic scars, causing permanent hair loss. Pathogen Ashland Trichophyton.
Black spots of psoriasis: the majority of scattered punctate scaly issued the scalp that is broken, was a small black dot named because of the disease. Pathogen is mostly purple dermatophytes or off Trichophyton.
Kerion: Department of inflammatory tinea capitis, mostly secondary to the white ringworm. The typical damage is suppurative folliculitis, forming a clear dark red realm of invasive erythema, soft surface, after rupture may have multiple honeycomb pus holes. Mostly pro-animal pathogens or pro-Soil fungi, such as Microsporum canis.
Treatment: comprehensive treatment, oral and topical combination. Internal medicine preferred griseofulvin, children 15-20mg/kg / day, adult 0.6-0.8g / day, orally 2-3 times, 3-4 weeks of treatment. Griseofulvin treatment failure or allergies, can be used ketoconazole, itraconazole or special than the naphthalene-fen. The adults of ketoconazole 200mg / day, child weight 40kg below those 2.5mg/kg / day, 3-4 weeks of treatment, medication, pay attention to check liver function. Terbinafine in children less than 20kg body weight 62.5mg / day, weight 20-40kg by 125mg / day, weight> 40kg, 250mg / day, the course of 2-4 weeks. Itraconazole 100-200mg / day, the course of 2-4 weeks. Kerion: In addition to oral antifungal agents, the acute phase can be short-term oral administration of small doses of corticosteroids (15-20mg / day), if the bacterial infection need to add antibiotics to avoid incision and drainage. With the topical treatment: every morning lesions topical tinea capitis ointment or other anti-fungal agents, shampoo with hot water at night, then Waicha 2.5% iodine, continuous 1-2 months. Patients should be hair all cut off. Patients with items such as pillow covers, hats, etc. should always be sterilized by boiling. After taking three weeks the surface of the skin hair review fungus in microscopy, after review once every 10-14 days, after three consecutive negative before considered cured. Collective units in the elementary school or nursery to deal with the children to take a certain amount of isolation measures to prevent the occurrence of infection. If so infected pets should be treated at the same time.
Onychomycosis OnychomycosisEtiology: A fungal disease refers to infection caused by fungi of the deck. Pathogens, including dermatophytes, yeasts and some molds. The most common infection caused by dermatophytes, called onychomycosis. Common pathogen was Trichophyton rubrum. Often secondary to tinea or trauma.
Clinical manifestations: There are two types of onychomycosis: A type and superficial type. Former invasive pathogens from a remote or side edge, deck thickening of the brittle, subungual debris accumulation, thickening of the deck, a separation, deck destruction and color abnormalities. The latter fungi from a surface intrusion, forming depressions dot damage and irregular white spots, spread in a shallow part of the deck can also be deformed. Non-dermatophytes and onychomycosis the deck was black or brown.
Treatment: A fungal disease of the limitations of remote topical 30% glacial acetic acid or 3% -5% iodine, 2 times a day. Or amorolfine, ciclopirox olamine A Paint weekly topical one. Each paint in front of the drug are advised with a blade to scuffing crunchy disease A, to facilitate the drug penetrate. Nail fungal disease treatment at least 6 months, and toenail fungus disease course of 9-12 months. Can be applied 40% urea ointment and topical dressing, to be the softening of the disease A, stripping removal of Seoul before continuing outside the drug treatment. If more than one refers to the nail lesions may be oral itraconazole 200 mg / 2 times a day, even for 1 weeks, and three weeks, so repeat medication, hand onychomycosis 2-3 courses, foot onychomycosis 3-4 courses. Or oral terbinafine 250 mg / day, hand onychomycosis and even served six weeks, foot onychomycosis and even served 12 weeks. Recently advocated a combination of oral and topical treatment methods to improve the cure rate and reduced toxicity.
(2), bacterial infections
ErysipelasSkin erysipelas erysipelas caused by hemolytic streptococcus, acute lymphatic vessels in the subcutaneous tissue and surrounding tissue of skin inflammation. The major pathogens of group A beta-hemolytic streptococcus, cause injury after the skin and mucous membrane of the micro-invasive tissue infections, so the nasal inflammation, pull the nose, the dig ears, tinea pedis, chronic eczema and other factors often become the incentive of erysipelas.Clinical manifestations: erysipelas occur in the dorsum of the foot, leg, face, etc., mostly unilateral. Rapid onset of skin lesions of flaky red swollen patches, rapidly to expand around the state clearly, severe blisters or blood blister, perceived pain, elevated skin temperature, angle pain. Some patients Sentinel lymph node enlargement and tenderness. Fever, chills, body temperature can be as high as 39-40 ° C, obvious symptoms of systemic poisoning. Children and the elderly and infirm may be secondary to sepsis. General acute process, the small number of patients can be recurrent, chronic erysipelas, the legacy of chronic lymphedema. Occurred in the leg by a high degree of swelling, rough skin thickening known as elephantiasis.
Treatment: the principle of active antimicrobial. Early, adequate and effective antibiotic treatment may be discharged by systemic symptoms, control inflammation from spreading, and prevent recurrence.Systemic therapy: first choice penicillin 480 800 U / d static point. Who are allergic to erythromycin-1.5g / d of static points, or selection of ciprofloxacin 0.2g / time, 2 times a day static point. Tarivid oral 0.2g / time, 2 times a day can also be used to 6g / d of static points or the use of antimicrobial cefazolin wide spectrum of II generation or III generation cephalosporins. The general course of 10-14 days, should be maintained for some time after the skin lesions subsided. While strengthening the supportive therapy, high fever, systemic symptoms should be given symptomatic treatment.
Local treatment: the blisters rupture, the available 1:2000 berberine, 50% magnesium sulfate, or 0.5% nitrofurazone solution wet compress can be topical antibiotic ointment such as more than a state ointment, such as norfloxacin ointment. Has purulent surgical incision. With physical therapy such as ultraviolet radiation, electrical stimulation of the audio, FM, infrared, etc., proved to be effective. Aggressive treatment of localized lesions, such as tinea pedis, rhinitis, lower limb damage should raise wounded limb.
Prevention: should pay attention to look for recurrent cases without chronic lesions in the vicinity. The Zhu Huanzhe not dig the nose. Aggressive treatment of tinea pedis and other easy to induce erysipelas disease.
Impetigo ImpetigoThe cause: The main cause, followed by coagulase-positive Staphylococcus aureus infections caused by Streptococcus, a mixture of both infections are not uncommon. The disease was more common in summer and autumn, occurred in children, can be transmitted through scratching and other self-inoculation or through contact with the pus of the patient's easy to pop in a group of children.
Clinical manifestations: the majority of impetigo occurred in the face, perioral, around the nostrils and limbs, mostly secondary to prickly heat, eczema. The typical damage soybeans pustules, blisters walls were very thin and easy to rupture, a red erosion surface dried pus formed honey yellow crust, pustules fusion with each other. There are varying degrees of itching, severe can be associated with the nearby lymph nodes, fever, chills and other systemic symptoms. Left untreated can cause nephritis.
Treatment: patients with impetigo should be noted that isolation, to avoid scratching to prevent infection. While topical anti-inflammatory drugs, such as: compound neomycin ointment, bacitracin ointment erythromycin ointment ointment Dawei Bang, or more than one hundred state ointment and so on. Severe impetigo, such as the lymph nodes, fever, and should be intravenous or oral antibiotics, the best drug is based on the drug sensitivity test, generally preferred higher sensitivity such as oxacillin intramuscular or intravenous 0.5-1.0g / time, 4-6 times a day, Children's 50-100.mg/kg.d these antibiotics for staphylococcus aureus-induced effective. Second, we can choose the Vanguard ADM V adult intramuscular injection of 0.5-1.0g / time, 2 times a day. Or second-generation macrolides such as roxithromycin. Over the age of 15 can also be new quinolone efficacy.
Swollen boilsFuruncle swollen cause: acute suppuration of the entire hair follicle and its affiliated sebaceous glands caused by Staphylococcus aureus invasive infection. Most pathogenic bacteria Staphylococcus aureus beads bacteria. The inflammation often expand the development into the surrounding tissue. More often in the hot season, skin dirty, hot, humid, sweating and local skin abrasions or by friction to stimulate the incidence of incentives, in frail health, anemia, diabetes, long-term use of corticosteroids and immunosuppressive agents, such as easy to concurrent disease.
Clinical manifestations: swollen boil since the beginning of a painful swelling nodules, after the gradual enlargement of cone-shaped uplift. A few days later, the central organization of the nodules necrosis, softening, appears at the top of the yellowish-white pus, swelling, pain expand the scope. A few days later, the rupture of the pus, pus discharge, pain immediately reduced, the swelling gradually subsided, wound healing in about one week. Boil swelling often occurs in the hair follicles and sebaceous gland-rich parts, such as head, face, back, genitals and lower leg. If a majority of boils, swelling, may be fever, malaise and other systemic symptoms.
Treatment: swollen boils avoid early hand squeeze or pick needle, inflammatory nodules can be used to heat or coated with 10% ichthyol ointment, pus head, painted at the top of a 2.5% tincture of iodine or with ciprofloxacin ointment than 100 state ointment. When the nodule or a sense of volatility incision, topical petrolatum gauze drainage. Occur on the face, especially avoid extrusion of the nose around the casual incision to avoid the bacteria along the blood line to enter the intracranial infection spread
1, fungal infections
Hands, tinea pedis
The cause of tinea pedis: hands, tinea pedis due to the pathogenic fungus infection (toe) between palmoplantar skin is one of the most common skin disease. Motherland medicine called ringworm of the "Schefflera wind". Tinea pedis commonly called athlete's foot "or" feet ". Common pathogenic fungi Trichophyton rubrum, Trichophyton mentagrophytes and Epidermophyton floccosum in recent years, Candida albicans and other yeast-like fungal infections are not uncommon. The main route of transmission of tinea pedis slippers, share, shared Foot bathtub, public baths, fitness facilities, flooring and towel channels such as cross-infection; the ringworm mostly from tinea pedis infection often caused by the rubbing foot.
Tinea pedis divided into three types according to different symptoms:Vesicular: plantar cluster or scattered blisters, tip or the size of a grain of rice. More common in summer. Blisters reaction can be localized. Blisters may rupture, after drying, leaving a collar-like desquamation. Can also be due to intense scratching, skin lesions and erosion, exudation showed eczema-like performance. This type itching heavier, often due to scratching and secondary infection, can cause erysipelas or lymphangitis. Acute inflammatory vesicular tinea pedis can be combined to hand blisters allergic reactions, (dermatophytes rash). Khan herpes-like reactions more common in severe acute inflammatory tinea pedis.
Intertrigo type: mainly seen in between the toes, usually the fourth and fifth toes of the most commonly involved, and the serious can all toes are involved. The wet, impregnated leaving the skin white, stripped of the epidermis, basal red erosion. Patients often feel the irritation and itching. Summer or in hot and humid conditions, work and life of common people. Tinea pedis usually bacterial infection between the toes dipping serious fungal microscopy-positive rate.
Scaly keratotic: this type of dry scaly, chapped mainly skin keratosis heavier, dry, rough, common cold season, prone to chapped hand, foot, causing pain.
Treatment: the preferred topical antifungal therapy, the choice of the solution, cream, ointment formulations, treatment for 2-4 weeks. Acute damage to avoid using stimulant medication. Dipping erosion type tinea pedis should be topical powder dry, use the antifungal cream. Ciclopirox olamine cream (Central Lee ointment), Miconazole Nitrate Cream (Miconazole Nitrate), bifonazole cream (Fu Qi cream or US g), hydrochloric special terbinafine cream (blue America express, DINK). Keratinized hypertrophic damage can choose ciclopirox olamine, terbinafine ointment or salicylic acid benzoic acid ointment. Secondary to tinea pedis infection, bacterial infection should first be treated with antibiotics. Tinea pedis the secondary ringworm rash, eczema should first line anti-allergy treatment, for external use containing a corticosteroid and antifungal compound. Avoid stimulating drugs, such as salicylic acid alcohol. Stubborn cases may be the system of local therapy, anti-fungal treatment, especially compared to naphthalene fen 250mg / day, 2-4 weeks; or itraconazole 200mg / day, two weeks or 400mg / day, 1 week.
Jock itch tinea, jock itchEtiology: tinea is smooth on the skin caused by superficial fungal fungal infection. The major pathogens causing the disease is Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum. When the damage was caused by Microsporum canis by a fungus addicted animals, the inflammation is more intense. Ringworm of the body suffering from ringworm through contact with infectious patients or cats, dogs, can also be made through the clothing, appliances, and other indirect infection. Diabetes, wasting disease and immunocompromised patients susceptible to the disease.
Jock itch is dermatophytes violated the inner thighs, perineum, buttocks caused by a fungal skin disease, Chinese medicine called "Yin ringworm.
Clinical manifestations: more than a ring or coin-shaped, so the Chinese called "ringworm" round ringworm. Children and middle-aged, predominantly male, occur in the wet, sweating or vulnerable to friction parts of the face, waist, inner thighs and buttocks. Rash small piece of a cluster at the beginning of the pinhead-sized red papules or Confucius herpes, after getting to the surrounding development, to form a ring or ring of concentric circles like dry scaly patches. The edge is clearly active center of healing orientation or pigmentation, and long-term scratching can cause local skin hypertrophy, chronic eczema-like changes. Consciously itching or itching, fungal test was positive.
Jock itch is more common in men, to the thigh from the inguinal fold erythema, the edge scaling was active damage. Most cases double the vastus medialis typical phenomenon tinea ring damage. And often involving the scrotum candidiasis, jock itch usually involving the skin of the scrotum but can be involved to the hips. Tinea corporis is rare in children.
Treatment: topical antifungal, 1-2 times daily for 2-4 weeks. See 1.1.3. System in the treatment of cases of skin lesions can be used: such as griseofulvin (ultramicron), 250-500mg, 2 times a day, 2-4 weeks; or Iraq itraconazole 100mg / day for 2 weeks, or 200mg / day for one week; or special terbinafine 250mg / day, the course of one week.
Tinea versicolorTinea versicolor is caused by addicted to fat yeast called Malassezia.Clinical manifestations: the chest, upper back, armpits, neck and groin area can be generalized body. The rash of brown, pink or white spotted. Diameter 4-5mm to large areas of confluent rash. Early rash scaly, after scratching a little scaly. Generally asymptomatic, a few mild itching. Legacy of mild hypopigmentation spots after the rash subsided, often persist, known as parasitic leukoplakia.
Treatment with drugs other than treatment: anti-fungal topical formulations apply, sooner or later, topical 1, 2 to 4 weeks of treatment. 2% selenium sulfide lotion used for the evening, next morning wash, 1 to 6 weeks of treatment. 2% ketoconazole lotion twice daily for 5 consecutive days, the lotion applied to the skin, 3 to 5 minutes after the wash. For relapsed or refractory oral ketoconazole 200 mg / day, 2 times a week for 1 day, 2 to 3 consecutive weeks; or oral itraconazole 100mg / day for 2 weeks.
Tinea capitis
Cause of tinea capitis: Tinea capitis is a disease of the scalp and hair due to dermatophytes infection. Occur in children, one barber equipment and transmitted to wear hats, shared pillow covers. Depending on the types of pathogens and host responses, divided into three types of yellow ringworm, ringworm white and black spots of ringworm, the inflammatory reaction Kerion.
White ringworm: The most common scalp gray scales hair loss patches. Damage can be presented to the satellite-like distribution of hair from the scalp 3-4mm at the break, the disease around the sheath surrounding the visible gray hair. The disease generally after puberty, self-healing without leaving scars. Pathogens are mostly of animal origin, canis, mostly for exposure to a cat suffering from ringworm, transmitted by dogs.
Yellow ringworm: typical damage dish yellow scab, the center throughout the hair, hair dull, of varying lengths. Long can be formed of atrophic scars, causing permanent hair loss. Pathogen Ashland Trichophyton.
Black spots of psoriasis: the majority of scattered punctate scaly issued the scalp that is broken, was a small black dot named because of the disease. Pathogen is mostly purple dermatophytes or off Trichophyton.
Kerion: Department of inflammatory tinea capitis, mostly secondary to the white ringworm. The typical damage is suppurative folliculitis, forming a clear dark red realm of invasive erythema, soft surface, after rupture may have multiple honeycomb pus holes. Mostly pro-animal pathogens or pro-Soil fungi, such as Microsporum canis.
Treatment: comprehensive treatment, oral and topical combination. Internal medicine preferred griseofulvin, children 15-20mg/kg / day, adult 0.6-0.8g / day, orally 2-3 times, 3-4 weeks of treatment. Griseofulvin treatment failure or allergies, can be used ketoconazole, itraconazole or special than the naphthalene-fen. The adults of ketoconazole 200mg / day, child weight 40kg below those 2.5mg/kg / day, 3-4 weeks of treatment, medication, pay attention to check liver function. Terbinafine in children less than 20kg body weight 62.5mg / day, weight 20-40kg by 125mg / day, weight> 40kg, 250mg / day, the course of 2-4 weeks. Itraconazole 100-200mg / day, the course of 2-4 weeks. Kerion: In addition to oral antifungal agents, the acute phase can be short-term oral administration of small doses of corticosteroids (15-20mg / day), if the bacterial infection need to add antibiotics to avoid incision and drainage. With the topical treatment: every morning lesions topical tinea capitis ointment or other anti-fungal agents, shampoo with hot water at night, then Waicha 2.5% iodine, continuous 1-2 months. Patients should be hair all cut off. Patients with items such as pillow covers, hats, etc. should always be sterilized by boiling. After taking three weeks the surface of the skin hair review fungus in microscopy, after review once every 10-14 days, after three consecutive negative before considered cured. Collective units in the elementary school or nursery to deal with the children to take a certain amount of isolation measures to prevent the occurrence of infection. If so infected pets should be treated at the same time.
Onychomycosis OnychomycosisEtiology: A fungal disease refers to infection caused by fungi of the deck. Pathogens, including dermatophytes, yeasts and some molds. The most common infection caused by dermatophytes, called onychomycosis. Common pathogen was Trichophyton rubrum. Often secondary to tinea or trauma.
Clinical manifestations: There are two types of onychomycosis: A type and superficial type. Former invasive pathogens from a remote or side edge, deck thickening of the brittle, subungual debris accumulation, thickening of the deck, a separation, deck destruction and color abnormalities. The latter fungi from a surface intrusion, forming depressions dot damage and irregular white spots, spread in a shallow part of the deck can also be deformed. Non-dermatophytes and onychomycosis the deck was black or brown.
Treatment: A fungal disease of the limitations of remote topical 30% glacial acetic acid or 3% -5% iodine, 2 times a day. Or amorolfine, ciclopirox olamine A Paint weekly topical one. Each paint in front of the drug are advised with a blade to scuffing crunchy disease A, to facilitate the drug penetrate. Nail fungal disease treatment at least 6 months, and toenail fungus disease course of 9-12 months. Can be applied 40% urea ointment and topical dressing, to be the softening of the disease A, stripping removal of Seoul before continuing outside the drug treatment. If more than one refers to the nail lesions may be oral itraconazole 200 mg / 2 times a day, even for 1 weeks, and three weeks, so repeat medication, hand onychomycosis 2-3 courses, foot onychomycosis 3-4 courses. Or oral terbinafine 250 mg / day, hand onychomycosis and even served six weeks, foot onychomycosis and even served 12 weeks. Recently advocated a combination of oral and topical treatment methods to improve the cure rate and reduced toxicity.
(2), bacterial infections
ErysipelasSkin erysipelas erysipelas caused by hemolytic streptococcus, acute lymphatic vessels in the subcutaneous tissue and surrounding tissue of skin inflammation. The major pathogens of group A beta-hemolytic streptococcus, cause injury after the skin and mucous membrane of the micro-invasive tissue infections, so the nasal inflammation, pull the nose, the dig ears, tinea pedis, chronic eczema and other factors often become the incentive of erysipelas.Clinical manifestations: erysipelas occur in the dorsum of the foot, leg, face, etc., mostly unilateral. Rapid onset of skin lesions of flaky red swollen patches, rapidly to expand around the state clearly, severe blisters or blood blister, perceived pain, elevated skin temperature, angle pain. Some patients Sentinel lymph node enlargement and tenderness. Fever, chills, body temperature can be as high as 39-40 ° C, obvious symptoms of systemic poisoning. Children and the elderly and infirm may be secondary to sepsis. General acute process, the small number of patients can be recurrent, chronic erysipelas, the legacy of chronic lymphedema. Occurred in the leg by a high degree of swelling, rough skin thickening known as elephantiasis.
Treatment: the principle of active antimicrobial. Early, adequate and effective antibiotic treatment may be discharged by systemic symptoms, control inflammation from spreading, and prevent recurrence.Systemic therapy: first choice penicillin 480 800 U / d static point. Who are allergic to erythromycin-1.5g / d of static points, or selection of ciprofloxacin 0.2g / time, 2 times a day static point. Tarivid oral 0.2g / time, 2 times a day can also be used to 6g / d of static points or the use of antimicrobial cefazolin wide spectrum of II generation or III generation cephalosporins. The general course of 10-14 days, should be maintained for some time after the skin lesions subsided. While strengthening the supportive therapy, high fever, systemic symptoms should be given symptomatic treatment.
Local treatment: the blisters rupture, the available 1:2000 berberine, 50% magnesium sulfate, or 0.5% nitrofurazone solution wet compress can be topical antibiotic ointment such as more than a state ointment, such as norfloxacin ointment. Has purulent surgical incision. With physical therapy such as ultraviolet radiation, electrical stimulation of the audio, FM, infrared, etc., proved to be effective. Aggressive treatment of localized lesions, such as tinea pedis, rhinitis, lower limb damage should raise wounded limb.
Prevention: should pay attention to look for recurrent cases without chronic lesions in the vicinity. The Zhu Huanzhe not dig the nose. Aggressive treatment of tinea pedis and other easy to induce erysipelas disease.
Impetigo ImpetigoThe cause: The main cause, followed by coagulase-positive Staphylococcus aureus infections caused by Streptococcus, a mixture of both infections are not uncommon. The disease was more common in summer and autumn, occurred in children, can be transmitted through scratching and other self-inoculation or through contact with the pus of the patient's easy to pop in a group of children.
Clinical manifestations: the majority of impetigo occurred in the face, perioral, around the nostrils and limbs, mostly secondary to prickly heat, eczema. The typical damage soybeans pustules, blisters walls were very thin and easy to rupture, a red erosion surface dried pus formed honey yellow crust, pustules fusion with each other. There are varying degrees of itching, severe can be associated with the nearby lymph nodes, fever, chills and other systemic symptoms. Left untreated can cause nephritis.
Treatment: patients with impetigo should be noted that isolation, to avoid scratching to prevent infection. While topical anti-inflammatory drugs, such as: compound neomycin ointment, bacitracin ointment erythromycin ointment ointment Dawei Bang, or more than one hundred state ointment and so on. Severe impetigo, such as the lymph nodes, fever, and should be intravenous or oral antibiotics, the best drug is based on the drug sensitivity test, generally preferred higher sensitivity such as oxacillin intramuscular or intravenous 0.5-1.0g / time, 4-6 times a day, Children's 50-100.mg/kg.d these antibiotics for staphylococcus aureus-induced effective. Second, we can choose the Vanguard ADM V adult intramuscular injection of 0.5-1.0g / time, 2 times a day. Or second-generation macrolides such as roxithromycin. Over the age of 15 can also be new quinolone efficacy.
Swollen boilsFuruncle swollen cause: acute suppuration of the entire hair follicle and its affiliated sebaceous glands caused by Staphylococcus aureus invasive infection. Most pathogenic bacteria Staphylococcus aureus beads bacteria. The inflammation often expand the development into the surrounding tissue. More often in the hot season, skin dirty, hot, humid, sweating and local skin abrasions or by friction to stimulate the incidence of incentives, in frail health, anemia, diabetes, long-term use of corticosteroids and immunosuppressive agents, such as easy to concurrent disease.
Clinical manifestations: swollen boil since the beginning of a painful swelling nodules, after the gradual enlargement of cone-shaped uplift. A few days later, the central organization of the nodules necrosis, softening, appears at the top of the yellowish-white pus, swelling, pain expand the scope. A few days later, the rupture of the pus, pus discharge, pain immediately reduced, the swelling gradually subsided, wound healing in about one week. Boil swelling often occurs in the hair follicles and sebaceous gland-rich parts, such as head, face, back, genitals and lower leg. If a majority of boils, swelling, may be fever, malaise and other systemic symptoms.
Treatment: swollen boils avoid early hand squeeze or pick needle, inflammatory nodules can be used to heat or coated with 10% ichthyol ointment, pus head, painted at the top of a 2.5% tincture of iodine or with ciprofloxacin ointment than 100 state ointment. When the nodule or a sense of volatility incision, topical petrolatum gauze drainage. Occur on the face, especially avoid extrusion of the nose around the casual incision to avoid the bacteria along the blood line to enter the intracranial infection spread
Skin infections - NotesDrug administrationSkin infections, skin disease should pay attention to caution the oral drugs, oral visceral metabolism will not only increase the burden on the liver, kidney, spleen, stomach, and drug waste can make the disease worsened, especially minors and women of childbearing age To strictly prohibited caution. The summer sweating, hard paste drugs may not be suitable for long-term use, topical spray is more suitable for patients. In addition, summer skin drug absorption, lesions of the area is too large patients, drug concentrations should be carefully, if necessary, before the local trial, to prevent allergies and in vivo excessive absorption. Prior to administration, should be cleaning the local skin, to avoid improper usage and reduce efficacy or increase the incidence of adverse reactions. Wash the affected area when the action should be gentle, do not force the divestiture of dander, so as not to cause local infection, such as red, swollen, hot, pain, it will affect the treatment, and the extension of the course.Living conditionsPatients in the treatment process to eliminate mental stress factors, to avoid fatigue, adequate rest. Living conditions are dry, ventilated, easy bathing. Daily medication, anti-malarial drugs, beta-blockers can induce or aggravate the condition. Endocrine changes of pregnancy can also induce skin or made it worse.
Some patients in the treatment of skin infections is very impatient and want to get well, and would often choose to increase the amount of drug, this approach is very unscientific, doctors advise strictly in accordance with your doctor or medication instructions, according to treatment for treatment.In terms of dietMust pay attention to diet, such as spicy food, seafood, wine, cattle and sheep meat, in particular, be careful not to eat fish products with no scales class, eat more vegetables, fruits, soy products and other food is better contain vitamins, more than a day drink boiled water, to promote the body metabolism.
Habits and customsPay attention to try to use baby detergent bath, after a certain washing with water bath, shampoo, rinse; sleep will emit large amounts of perspiration due to hot summers, bedding should always dry and keep dry underwear should be changed every day best placed in the sun under the sun about two hours, washing clothes.Patients with skin infections must maintain a good healthy attitude, mood, to ensure adequate sleep, Also note that the skin disease is often itchy skin phenomenon: try to avoid using the clutch, resulting in fungal infections, leading to a vicious cycle to aggravate the condition, should pay attention to scratching sure your hands clean to avoid secondary infection.Skin infections - general nursingSkin infections, for general good health, no systemic symptoms, the free exercise of life of patients can take care of themselves, may be appropriate to carry out cultural, sports activities, learning about the disease care knowledge.2, general skin infections in patients with normal diet, fast progression of skin disease or exacerbated by diet, such as allergic skin infections need fast seafood, eggs and other food; neurodermatitis, itching psychosis forbidden to drink tea , alcohol, spicy spicy food; photosensitive skin disease to avoid the sun, eat milk vetch, rape, snail; herpetiform dermatitis disable the valley amine food.
3 patients with itching, persuade the patient not to scratch lesions, to avoid grasping rub hot wash with hot soapy water and allow patients to nails 2 times a week. The itching seriously affect the patient sleep and mood, as appropriate, given antihistamines or sedative drugs.
4, a lot of oozing, scaling, crusting skin lesions of patients, with lots of outside drug treatment, often contaminated clothing and bedding, the need for timely replacement of the bed clothes, and patient comfort.
Allergic patients, ward avoid placing flowers and avoid contact with the easy to allergens.6, photosensitive dermatitis, and systemic lupus erythematosus patients with beds should be arranged close to the window to avoid direct sunlight, or easy to promote disease progression.7, if the skin infection is a local manifestation of systemic diseases, such as systemic lupus erythematosus, dermatomyositis, scleroderma, pemphigus, drug-induced dermatitis, skin tumors, in addition to the general care of the skin disease, routine medical care to prevent complications.8 patients with a large area of skin lesions, dressing should pay attention to aseptic room temperature, warm, prevent complications and to master the concentration of the dose to avoid the whole body wet compress or wet dressing for too long, resulting in drug absorption poisoning.9, dressing first pay attention to clean the wound, drug absorption and wound healing. Purulent infection in patients with 1:5000 potassium permanganate solution for cleaning, soak; original coating powder available warm water; paste available paraffin oil wipe; around the mouth, eyes, nostrils 3% boric acid solution to clean; external auditory canal secrete things for a long time the available hydrogen peroxide cleaning. Attention in patients with warmth and dressing comfort dressing, dressing clear of dirt for incineration or special treatment, rigorous disinfection of utensils, patients with infectious skin disease, in addition to the above requirements, the line bed barrier nursing.10, the equipment used by the sexually transmitted diseases and other infectious patients, dressings sent after disinfection cleaning, and finally sent a high-pressure disinfection. General surgery patients used equipment, articles cleaned, sterilized.
Skin infections - drug informationSkin infections in order to understand the skin infection medication, good prevention and treatment of skin diseases, you should first understand the structure of the skin. Followed by the epidermis, dermis, subcutaneous tissue, the epidermis can be subdivided into five levels, has rubbing the skin from outside to inside, easy to damage, proliferation characteristics; dermis contains blood vessels, nerves, sweat glands, sebaceous glands, hair follicles, and itching. pain, heat, cold, tactile and other sensory nerve endings; subcutaneous tissue containing mainly fat. The main objective performance of the skin disease in the epidermis, the main symptoms are caused due to violations of the dermis layer of blood vessels, nerves, sweat glands, sebaceous glands.Should first confirm the diagnosis before treatment, there is no clear, do not blind to the abuse of hormone drugs. Some people Fuqing Song as a panacea, as long as the skin appear abnormal with Fuqing Song, I do not know its use improper, would not only increase the disease, may also cause various adverse reactions. Such as tinea, jock itch, tinea, tinea versicolor and other fungal infections caused by skin disease, skin damage range will increase the use Fuqing; some Fuqing cause skin atrophy, pigmentation and other. Therefore, skin diseases, choice of drugs is very important, usually in the acute phase, skin redness, papules, vesicles, powder or lotion available; subacute phase in addition to the local hair infrared, mild skin infiltration, the available cream; chronic phase skin thickening, or hyperkeratosis, available cream, ointment; hyperkeratosis of the skin can also be used alcoholic preparations, in order to promote the penetration of drugs.
Skin infections in addition to the above medication, usually also pay attention to diet, especially those with itching, oozing liquid more skin pruritus, urticaria, all kinds of dermatitis, eczema etc., eat spicy food such as wine, pepper, onion , garlic, ginger, coffee, etc., can irritate the skin sensory nerve make itching heavier, while stimulating the skin blood vessels, increased its dilatation and congestion of fluid exudation, and made it worse. Allergic skin disease, should avoid exposure to allergens, often lead to allergic substances in addition to a number of drugs, as well as some animal foods such as fish, shrimp, crab, etc..
In short, the complex causes of skin infections, the event should be as soon as possible please dermatologist for treatment, and strive to be cured at an early stage in case transferred to a chronic condition stubborn and more difficult the treatment.
Some patients in the treatment of skin infections is very impatient and want to get well, and would often choose to increase the amount of drug, this approach is very unscientific, doctors advise strictly in accordance with your doctor or medication instructions, according to treatment for treatment.In terms of dietMust pay attention to diet, such as spicy food, seafood, wine, cattle and sheep meat, in particular, be careful not to eat fish products with no scales class, eat more vegetables, fruits, soy products and other food is better contain vitamins, more than a day drink boiled water, to promote the body metabolism.
Habits and customsPay attention to try to use baby detergent bath, after a certain washing with water bath, shampoo, rinse; sleep will emit large amounts of perspiration due to hot summers, bedding should always dry and keep dry underwear should be changed every day best placed in the sun under the sun about two hours, washing clothes.Patients with skin infections must maintain a good healthy attitude, mood, to ensure adequate sleep, Also note that the skin disease is often itchy skin phenomenon: try to avoid using the clutch, resulting in fungal infections, leading to a vicious cycle to aggravate the condition, should pay attention to scratching sure your hands clean to avoid secondary infection.Skin infections - general nursingSkin infections, for general good health, no systemic symptoms, the free exercise of life of patients can take care of themselves, may be appropriate to carry out cultural, sports activities, learning about the disease care knowledge.2, general skin infections in patients with normal diet, fast progression of skin disease or exacerbated by diet, such as allergic skin infections need fast seafood, eggs and other food; neurodermatitis, itching psychosis forbidden to drink tea , alcohol, spicy spicy food; photosensitive skin disease to avoid the sun, eat milk vetch, rape, snail; herpetiform dermatitis disable the valley amine food.
3 patients with itching, persuade the patient not to scratch lesions, to avoid grasping rub hot wash with hot soapy water and allow patients to nails 2 times a week. The itching seriously affect the patient sleep and mood, as appropriate, given antihistamines or sedative drugs.
4, a lot of oozing, scaling, crusting skin lesions of patients, with lots of outside drug treatment, often contaminated clothing and bedding, the need for timely replacement of the bed clothes, and patient comfort.
Allergic patients, ward avoid placing flowers and avoid contact with the easy to allergens.6, photosensitive dermatitis, and systemic lupus erythematosus patients with beds should be arranged close to the window to avoid direct sunlight, or easy to promote disease progression.7, if the skin infection is a local manifestation of systemic diseases, such as systemic lupus erythematosus, dermatomyositis, scleroderma, pemphigus, drug-induced dermatitis, skin tumors, in addition to the general care of the skin disease, routine medical care to prevent complications.8 patients with a large area of skin lesions, dressing should pay attention to aseptic room temperature, warm, prevent complications and to master the concentration of the dose to avoid the whole body wet compress or wet dressing for too long, resulting in drug absorption poisoning.9, dressing first pay attention to clean the wound, drug absorption and wound healing. Purulent infection in patients with 1:5000 potassium permanganate solution for cleaning, soak; original coating powder available warm water; paste available paraffin oil wipe; around the mouth, eyes, nostrils 3% boric acid solution to clean; external auditory canal secrete things for a long time the available hydrogen peroxide cleaning. Attention in patients with warmth and dressing comfort dressing, dressing clear of dirt for incineration or special treatment, rigorous disinfection of utensils, patients with infectious skin disease, in addition to the above requirements, the line bed barrier nursing.10, the equipment used by the sexually transmitted diseases and other infectious patients, dressings sent after disinfection cleaning, and finally sent a high-pressure disinfection. General surgery patients used equipment, articles cleaned, sterilized.
Skin infections - drug informationSkin infections in order to understand the skin infection medication, good prevention and treatment of skin diseases, you should first understand the structure of the skin. Followed by the epidermis, dermis, subcutaneous tissue, the epidermis can be subdivided into five levels, has rubbing the skin from outside to inside, easy to damage, proliferation characteristics; dermis contains blood vessels, nerves, sweat glands, sebaceous glands, hair follicles, and itching. pain, heat, cold, tactile and other sensory nerve endings; subcutaneous tissue containing mainly fat. The main objective performance of the skin disease in the epidermis, the main symptoms are caused due to violations of the dermis layer of blood vessels, nerves, sweat glands, sebaceous glands.Should first confirm the diagnosis before treatment, there is no clear, do not blind to the abuse of hormone drugs. Some people Fuqing Song as a panacea, as long as the skin appear abnormal with Fuqing Song, I do not know its use improper, would not only increase the disease, may also cause various adverse reactions. Such as tinea, jock itch, tinea, tinea versicolor and other fungal infections caused by skin disease, skin damage range will increase the use Fuqing; some Fuqing cause skin atrophy, pigmentation and other. Therefore, skin diseases, choice of drugs is very important, usually in the acute phase, skin redness, papules, vesicles, powder or lotion available; subacute phase in addition to the local hair infrared, mild skin infiltration, the available cream; chronic phase skin thickening, or hyperkeratosis, available cream, ointment; hyperkeratosis of the skin can also be used alcoholic preparations, in order to promote the penetration of drugs.
Skin infections in addition to the above medication, usually also pay attention to diet, especially those with itching, oozing liquid more skin pruritus, urticaria, all kinds of dermatitis, eczema etc., eat spicy food such as wine, pepper, onion , garlic, ginger, coffee, etc., can irritate the skin sensory nerve make itching heavier, while stimulating the skin blood vessels, increased its dilatation and congestion of fluid exudation, and made it worse. Allergic skin disease, should avoid exposure to allergens, often lead to allergic substances in addition to a number of drugs, as well as some animal foods such as fish, shrimp, crab, etc..
In short, the complex causes of skin infections, the event should be as soon as possible please dermatologist for treatment, and strive to be cured at an early stage in case transferred to a chronic condition stubborn and more difficult the treatment.
