Eczema

 Eczema, also known as atopic dermatitis, is a chronic inflammatory skin disease characterized by itching, redness, dryness, and cracking. Eczema can occur in people of all ages, but is most common in children. Eczema often occurs in cycles, with flare-ups and remissions. 

Types of Eczema :

1. Atopic Dermatitis: 

• most common eczema, associated with allergies, asthma or hay fever.

2. Contact Dermatitis: -

• Irritant Contact Dermatitis: caused by direct skin contact with an irritant (soap, chemical, etc.).
• Allergic contact dermatitis: caused by allergic reactions to substances such as nickel, perfumes, poison ivy, etc.

3. Dyshidrotic eczema: small itchy blisters on the hands and feet.

4.Coinoid eczema: mostly on legs, arms, or torso, 

5. Seborrheic dermatitis: scaly, greasy patches on the scalp, face, or chest;

 6. Stasis dermatitis: stasis dermatitis: occurs on the lower extremities due to poor circulation and fluid buildup; 

causes :

 The exact cause of eczema is unknown, but a combination of genetic, environmental, and immune factors are involved. Common triggers include:

• Irritants Irritants: soaps, detergents, fragrances, or certain fabrics.
• Allergens Allergens: pollen, dust mites, pet dander, or certain foods. 
• Environmental factors: cold, heat, humidity. 
• Stress: Can aggravate symptoms.
• Heredity: Family history of eczema, asthma, or hay fever increases risk.
• Immune system dysfunction: overreaction to external stimuli. 

Symptoms - 

Itching: often intense, especially at night. 

Red or brownish-gray spots: often on hands, feet, ankles, wrists, neck, upper chest, eyelids, elbows, or inner knees.

Dry, cracked skin: may bleed or fester.

Thickened skin: from prolonged scratching or friction.

Liquid-filled blisters: may ooze and crust over. 

Diagnosis:

• Eczema is usually diagnosed by: Based on the appearance of the skin. 
• Medical history: includes allergies, asthma, family history of eczema. 
• Patch test: identifies specific allergens if contact dermatitis is suspected. 
• Skin biopsy: In rare cases, to rule out other conditions. 

 Treatment:

There is no cure for eczema, but treatment is aimed at managing symptoms and preventing flare-ups:

 1. Topical treatment: 

• Moisturizers (emollients): keep skin moist and protect barrier function. 
•  Corticosteroid creams or ointments: reduce inflammation and itching. 
• Calcineurin inhibitors(e.g., tacrolimus, pimecrolimus): for sensitive areas such as the face.

2. Oral medications: - 

• Antihistamines: for nighttime itching;
• Systemic corticosteroids:Used for severe flare-ups. 
• Immunosuppressants(e.g., cyclosporine, methotrexate): for severe, refractory eczema.

3 Biological therapies: -

 

• Dupilumab (Dupixent): monoclonal antibody for moderate to severe atopic dermatitis.

4 Lifestyle and home therapy: -

 

• Warm bath: after warm bath, Apply moisturizer immediately after warm bath. 
• Wet wrap therapy: After applying the medication, wrap the skin with a wet bandage. -
•  Avoid triggers: Identify and eliminate allergens and irritants. 

5. Phototherapy: - 

•  Controlled exposure to ultraviolet light. 

 Complications :

•  Infections: - Scratching and skin breakage can lead to bacterial, viral,   and fungal infections. 
• Chronic itching and scratching: can lead to lichenification (thickened, leathery skin). 
• Sleep disturbances: Severe itching may affect sleep. 
• Psychological effects: stress, anxiety, depression. 

Prevention :

• 1. Regular moisturizing: use a thick cream or ointment after bathing;
• 2. Avoid harsh soaps and detergents: use fragrance-free, non-irritating products; 
• 3. Wear soft, breathable fabrics: cotton, etc.; 
• 4. Stress management: practice relaxation techniques such as yoga and meditation;
• 5. Allergy management: avoid allergens and keep living conditions free of dust mites and pet dander; 

prognosis:

• Many children will outgrow eczema by puberty, but others will experience periodic recurrences throughout their lives.  
• With proper treatment and prevention strategies, most can effectively manage their symptoms and lead comfortable lives.

Folliculitis

 Folliculitis is an inflammation or infection of the hair follicle, a small pocket in the skin where hair grows. It is common on the face, scalp, neck, chest, chest, back, buttocks and thighs, but can occur anywhere on the body where there is hair. It can range from mild inflammation to severe infection.

Causes of folliculitis :

 Folliculitis can be caused by several factors, including  

1. infectious causes:

•  bacteria: most commonly Staphylococcus aureus.
•  Fungi: for example Malassezia and Candida.
•  Viruses: herpes simplex virus can cause folliculitis. 
• Parasites: rare cases caused by mites and other organisms.

2. Non-infectious causes:

• irritation from shaving, waxing, tight clothing.
•  Blockage of hair follicles by sebum, sweat or cosmetics. 
• Friction and heat, common in 'hot bath folliculitis' caused by Pseudomonas aeruginosa.

Symptoms of folliculitis : 

• Small, red or white bumps that look like pimples, often with hair in the center.
•  The pus-filled blisters may crust over. 
• Itching, tenderness or burning sensation.
•  Swelling and pain in the skin around the affected area. 
• In severe cases, large boils or abscesses may form.

 Types of folliculitis

1. Superficial folliculitis:

• Affects only the top part of the hair follicle.
•  It appears as small red bumps or pustules. 

2. Deep folliculitis:

• Affects the entire hair follicle, including the deeper layers of the skin. 
• It can cause painful, larger lesions and abscesses.

 The specific types are:

•  Bacterial folliculitis: Caused by Staphylococcus aureus, it appears as pus-filled bumps. 
• Pseudofolliculitis Barbae: Common in people who shave. It is caused by ingrown hairs that cause irritation and inflammation.
•  Hot tub folliculitis: Associated with Pseudomonas aeruginosa and appears as red, itchy bumps after immersion in a neglected hot tub or swimming pool.
•  Fungal folliculitis: Caused by a fungal infection such as Malassezia.
•  Gram-negative folliculitis: usually develops after long-term antibiotic treatment of acne.

 Diagnosis

 Health professionals usually diagnose folliculitis by looking at its appearance. In more severe or persistent cases.

•  the diagnosis is made by taking a skin sample to identify bacteria, fungi or other organisms. 
• If the cause is unclear, a biopsy is performed to confirm the diagnosis.

 Folliculitis treatment :

Mild cases:

•  warm compresses: reduce inflammation and promote drainage.
•  Gentle cleansing: use antibacterial or antifungal cleansers.

 Topical treatment:

• antibiotic creams such as mupirocin or clindamycin for bacterial infections.
•  Antifungal creams such as ketoconazole for fungal infections. 

Oral:

• Oral antibiotics such as cephalexin for bacterial folliculitis. 
• Oral antifungals such as fluconazole for fungal folliculitis. 

Other treatments: 

• For pseudofolliculitis: stop shaving or use hair removal creams or lasers.
•  For hot tub folliculitis: mild cases usually heal on their own.

 Home remedies and personal care

•  Avoid shaving or irritating the affected area.
•  Use a clean, sharp razor or switch to electric clippers. 
• Wash with antibacterial soap and apply an over-the-counter cream. 
• Avoid tight clothing that rubs the skin.
•  Soothe the skin with bath salts containing aloe vera or oatmeal.

 Complications :

 If left untreated or poorly managed, 

• folliculitis can lead to rash or abscess.
•  Permanent scarring or dark spots (hyperpigmentation).
•  Recurrent infections or chronic folliculitis. 
• Cellulitis, a deeper skin infection.

 Prevention : 

• Maintain hygiene and keep your skin clean.
•  Avoid sharing personal items such as razors and towels.
•  Use non-comedogenic skin care products to prevent clogged pores. 
• Avoid tight clothing, extreme heat and friction. 

If folliculitis persists or worsens despite treatment, consult a health care professional for further evaluation and management.

Impetigo

Impetigo is a highly contagious bacterial skin infection that mostly affects babies, but can affect people of all ages. Impetigo is caused by two types of bacteria: staphylococcus aureus (staphylococcus) and Streptococcus pyogenes (streptococcus). It is usually transmitted by scratching a small cut, insect bite or eczema-like rash, but it can also develop on healthy skin.

Types of impetigo:

There are two main types of impetigo

1.Non-bullous infectious impetigo (more common type):

It starts as small red sores or blisters that quickly break and ooze, forming honey-colored crusts. These sores usually appear around the nose and mouth, but can also spread to other parts of the body.

2.Bullous impetigo:

Larger fluid-filled blisters (bullae) that take longer to rupture and leave a yellowish crust. This type is more common in babies and tends to appear on the trunk (abdomen) and around the diaper area.

Symptoms of contagious impetigo:

• Red sores that quickly turn into yellow-brown scabs.

• Itching and discomfort in the affected area.

• In some cases, swelling of the lymph nodes in the infected area.

• Blisters filled with fluid (bullous impetigo).

• Spread of sores to other parts of the body through touching, scratching or close contact with others.

• Direct skin contact with an infected person.

• Contact with contaminated surfaces, towels, clothes and bed linen.

• Touching other parts of the body or other people after scratching or touching sores.

• Young children: especially children aged 2-5 years are more prone to cuts and abrasions.

• Crowded environments: schools, kindergartens and sports fields increase the likelihood of spreading germs.

• Skin damage: cuts, insect bites, eczema and other skin conditions can allow bacteria to enter the skin.

• Hot, humid climates: In these environments, impetigo is more likely to develop through sweating and rubbing against the skin.

• Impetigo contagiosa is usually treated with antibiotics to eliminate the infection and prevent it from spreading. Treatment may include

• Mupirocin (Bactroban) or retapamulin (Altavax) ointment is usually prescribed and applied directly to the affected area.

• For more common or severe cases, oral antibiotics such as cephalexin or dicloxacillin are prescribed.

• Wash affected areas with soap and water and keep clean.

• Avoid scratching or touching the wounds.

• Cover wounds with gauze or loose bandages to prevent the spread of infection.

• Wash your hands often and practice good hygiene, especially with children.

• Wash towels, clothes and bed linen of infected people separately using hot water.

• Avoid sharing towels, razors, clothes and other personal items.

• Cellulitis: deep bacterial infection of the skin and underlying tissues.

• Post-streptococcal glomerulonephritis: A rare condition in which the infection affects the kidneys, causing inflammation and sometimes damage.

• Scarring: In severe cases, impetigo can leave scars.

Causes and transmission:

Infectious impetigo occurs when bacteria invade the skin through wounds or cuts. Impetigo is highly contagious and is spread through the following infection routes

It is more common in warm, humid environments and spreads easily in schools, kindergartens and sports teams.

Risk factors:

Diagnosis:

Impetigo is usually diagnosed by examination by a health professional. Fluid may be taken from wounds to identify the causative organism, especially if the infection is severe or not responding to treatment.

Treatment of impetigo:

Topical antibiotics:

Oral antibiotics:

Home care and prevention

Complications:

Impetigo contagiosa is usually mild and can be improved with treatment, but if left untreated or treated incorrectly it can lead to complications such as

Prognosis:

With prompt treatment, impetigo usually heals within 1-2 weeks and leaves no sequelae. Antibiotics shorten the duration of infection and most people are no longer infected after 24-48 hours of treatment.

If you suspect infectious impetigo or see skin sores that do not heal, it is important to consult a health care professional for proper diagnosis and treatment.

Nipah virus (NiV)

 Nipah virus (NiV) is a zoonotic virus transmitted from animals to humans and was first identified in Malaysia in 1998 in an outbreak among pig farmers and people in close contact with pigs. Since then, outbreaks have occurred regularly in South and Southeast Asia.

Below are some highlights of the Nipah virus :

• Transmission: The main reservoir of Nipah virus is its natural host, the fruit bat, especially species of the genus Pteropus. Transmission to humans occurs through direct contact with infected bats and their feces (e.g. saliva and urine). Human-to-human transmission can also occur through close contact, especially with infected individuals.

• Symptoms: symptoms of nipah virus infection range from asymptomatic or mild respiratory illness to severe encephalitis (inflammation of the brain) characterized by fever, headache, lethargy, disorientation and mental confusion. In severe cases, coma can occur within 24-48 hours.

• Prevention: Prevention includes avoiding contact with bats and their habitat, avoiding consumption of fruit that may have been contaminated by bats, and practicing strict infection control in healthcare settings during outbreaks.

• Treatment: there is no specific antiviral treatment for nipah virus infection. Supportive care is important, focusing on symptom management and intensive supportive care for patients.

• Outbreaks: Nipah virus outbreaks have occurred sporadically in Bangladesh, India and other parts of Southeast Asia. The World Health Organization (WHO) is monitoring and responding to outbreaks and providing technical assistance to affected countries.

Nipah virus is recognized as a serious public health concern due to its high mortality rate (up to 75% in some outbreaks) and potential for human-to-human transmission. Vigilance in surveillance, early detection and rapid response is essential to contain the outbreak and prevent its spread.

Basic treatment and therapy for Nipah virus :

There is currently no specific antiviral treatment or therapy for Nipah virus infection. Treatment mainly involves supportive and symptomatic therapies. Important aspects of managing Nipah virus infection include

• Supportive care: supportive care: patients with nipah virus infection require intensive supportive care to address symptoms and complications. This includes measures to maintain hydration, electrolyte balance and adequate nutrition.

• Symptomatic treatment: depending on the situation, medication may be used for antipyretics, analgesia, management of respiratory difficulties and treatment of complications such as seizures.

• Infection control: strict infection control measures are essential to prevent viral infections in healthcare settings. These include the use of personal protective equipment (PPE) by healthcare workers, isolation of infected persons and the implementation of appropriate hygiene practices.

• Experimental treatments: Experimental treatments, such as antiviral drugs or monoclonal antibodies, may be considered on a case-by-case basis during outbreaks. However, these treatments are still in the research phase and are not widely available.

• Prevention: Prevention strategies focus on avoiding contact with infected animals (especially bats), practicing effective hygiene practices, and maintaining awareness in infected communities to reduce the risk of human-to-human transmission.

Given the severity and epidemic potential of Nipah virus infection, early detection, rapid response and public health measures are crucial to reduce the spread of the virus and provide supportive care to infected individuals.