Derm sct3
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| 🇬🇧 | 🇬🇧 |
| Types of fungi: | Dermatophyte yeast budding dimorphic molds |
| Fungi pathogenic mechanisms: | Toxins(amanita phalloide, muscarin molds mycotoxins) allergen( Cladosporium, Fusarium sepcies, mykides) tissue infection - mycosis(systemic, mucous membr) |
| Dermatophytes: | Obligate parasites/pathogens keratinase species: Trichophyton species Microsporum species Epidermophyton floccosum |
| Yeast: | Facultative parasite, opportunistic pathogens flora candida genus cycle: Budding, Conjugation ,Spore |
| Fddfxfvf | Dfdffdvsd |
| Fsasdafvcxy | SavdyxfFEWSDYV |
| #molds: | Not obligate pathogens tubular branching hyphae(mycelium) |
| ASDFADSVYV | SDVSDVDYXVYSD |
| Dimorphic fungi: | Obligate pathogen temperature dependent morphology |
| SDFVSYVSYX | SDVYDYÍDFSDVSDV |
| Mycosis pathomechanism: | Host defense function(skin) fungi(Accommodation to the host) |
| Mycoses (tinea) forms: | Superficial Deep mycosis Systemic |
| Superficial mycoses: | Dermatophytes candidiasis Malassezia furfur(Lipophilic yeast - microbiom on scalp) |
| Deep mycosis: | Dermis, subcutis, bone |
| Systemic: | Facultative parasites (Candida albicans) Inhalation |
| Dermatophytes: | Tricophyton, Microsporum, Epidermophyton 1-3 weeks, common infection sources are people, animals, or soil candidiasis begins erythematous, scaly plaque ---->central resolution, annular shape, inflammation, scale, crust, papules, vesicles, and even bullae , especially in the border, pain, Pruritus tropical and systemic therapy |
| Intertrigo: | Folds Dermatophytes and yeast - inflammation fungi: T. rubrum, T. mentagrophytes, T. interdigitale, Epidermophyton floccosum, Candida species Tinea capitis, Mycosis/Tineabarbae profunda Tinea pedis |
| Onychomycosis: | Involve: matrix, nail plate, nail bed cosmetic, pain, discomfort, disfigurement common risk factors: environmental ,occupational types: Dystrophic ,Dystal lateral subungual (DLSO), White superficial (WSO), Endonyx onychomycosis (EO), Proximal subungual (PSO) treatments: terbinafine, itraconazole, fluconasol (EUR) |
| Fungus: | Dermatophytes(T. rubrum 90%, T. mentagrophytes 20%) Molds (Fusarium species, Aspergillus species ) Candida – (Mucocutane candidiasis) |
| Candidiasis: | Candida Skin mucous membrane, systemic infections candidiasis oris, candida paronychia, vulvovaginitis candidosa, balanitis candidosa candida sepsis, candidiasis mucocutanea,candida abscess |
| Deep fungal infections: | Oppurtunistic Sporothrix schenckii(Sporotrichosis) rose thorn cutaneous pulmonary disseminated |
| Chromoblastomycosis: | A long term chronic subcutaneous mycosis tropical minor trauma Fonsecaea , Phialophora,Cladosporium azol e s and surgery. |
| Mycetoma(Madura leg): | Chronic subcutaneous infection caused by bacteria or fungi. Granulomatous can extend to the underlying bone. azoles, sulfamethoxazole |
| Opportunistic systemic mycosis: | Candidiasis Aspergillosis Cryptococcosis Zygomycosis |
| Topical pharmacokinetics: | Diffusion adsorption absorption resorption metabolism |
| Powders: | Inorganic: zinc oxide, titanium dioxide, talc Organic: starches, zinc stearate anti mycotic: antibacterial |
| Liquids(solutions): | Cooling, soothing, drying Burow’s Potassium permanganate Silver nitrate antiseptics: Povidone-iodine (Betadine) Octenisept (oktenidin-dihidroklorid and fenoxiethanol) |
| Bath, Wet dressings: | Cleaning (detergents,soaps, syndet) thermal bath (antiinflammatory) PUVA bath therapy (treatment of psoriasis) |
| Antiseptic solutions: | Povidone-iodine (Betadine) Octenisept (oktenidin-dihidroklorid and fenoxiethanol) |
| Psoriasis solutions(steroids): | Psoriasis solutions(steroids): Scalp psoriasis, seborrhoea capitis: mometasone (Elocom), hydrocortison butyrate (Locoid), salicylic acid + betametasone (Diprosalic) Androgenic alpopecia: estradiol + prednisolone (Alpicort F) |
| Spray (solution): | Anaesthetic: Lidocain - mucous membrane Antiinflammatory: Hydrocortison+tetracyclin (Oxycort) Antimycotic: Tolnaftat (Chinofungin), terbinafin (Lamisil) |
| Shake lotions: | Suspension of solid material in water, ethanol or oil two phase system wash off: with water or oil adhesion is improved by addition of glycerol erythematous exanthemas acut contact dermatitis, dyshidrosis ,pityriasis rosea, urticaria |
| Pastes: | Mixture of powder and ointment (2 phase system): Drying (liquid) pastes: drying, soothing, good vehicle for an active medicament Cream (soft) pastes , Protective (hard) pastes |
| Corticosteroids: | Inhibit: cytokine production, lipoid mediator synthesis of macrophages cytokine productions, eosinophile production, ig weak, moderate, strong, very strongstrong |
| Furthertopicaltreatments: | Sunscreens, chemical peeling, bleaching |
| Treatment of chronic wounds: | Treatment of chronic wounds Topical disinfectants Ointment containing salicylic acid, boric acid |
| Stimulation of granulation and epithelisation of thewound: | Hydrocolloid Medical honey |
| Herpes treatment: | – acut (within 4 days!) • acyclovir 5x 200mg 5 days, • famcyclovir 3x 250 mg 5 nap – recurrent (>6/y) • acyclovir 3-2x 200mg 6 months • famcyclovir 2x 250 mg 5 nap • local: acyclovir, antibiotics |
| VZV Pathogenezis : | Sensory nerves → sensory ganglion → latent infection(dormant virus Sensory ganglion → viral replication → sensory nerve → exanthema |
| Herpes zoster: | >50% trunk, 10-20% trigeminal, 10-20% lumbosacral and cervical Sensory and motoric nerve damage: – Ramsay-Hunt syndrome (facial and acoustic nerve) -Ophthalmic zoster acyclovir 5x 800mg 7 days per os vagy 3x 5-10 mg/kg/d iv, |
| Human papilloma viruses: | HPV-1 és HPV-4 verruca vulgaris HPV-6 és HPV-11 condylomata acuminata HPV-16 cervix carcinoma (E6→p53, E7→Rb) |
| Molluscum contagosum: | Poxvirus (DNA) skin/skin contact, Self limiting (spontaneous healing) Liquid nitrogen Curettage |
| Childhood cont. Diaseases: | "Morbilli Rubeola Erythema infectiosum (Parvovirus B19) Exanthema subitum (HHV-6) Roseola (Coxsackie)" |
| Gianotti–Crosti syndrome: " | "Gianotti–Crosti syndrome (/dʒəˈnɒti ˈkrɒsti/), also known as infantile is a reaction of the skin to a viral infection Hepatitis B virus and Epstein–Barr virus fever (27%) – lymphadenopathia (31%) – hepatosplenomegalia (4%) – pharyngitis, oropharyngeal ulcers and vesicles, tonsillitis |
| Heat injury: | The local action of excessive heat causes burns or scalds;# First-degree burns~ active cogestion of blood vessels --->erythema---> peeling |
| Second degree burn: | Superficial: vesicles beneath the outer layer of epidermis, recovery without scarring deep: pale, injury to reticular dermis, damage to appendages, healing more than month with scarring |
| Third degree burn: | Loss of full dermis+subcutneous tissue ---> ulcerating wound with no epithelium ----> scarring require grafting |
| Fourth degree burn: | All skin and subcut fat and tendons destroyed require grafting |
| Factors affecting burn symptoms: | Location depth size |
| Which group has greater death rate in burn injuries? | Infants and women and toddlers |
| Excessive scarring from burn can cause: | Contractures deformities and dysfunction of the joints chronic ulcerations from impairment of local circulation squamous cell carcinomas# |
| What are the key components of the critical care of burns? | Fluid resuscitation treatment of inhalation injury hypercatabolism monitoring early intervention of sepsis pain control environmental control nutritional support |
| Lightening injuries: | Lethal type of strike cardiac arrest or other internal injuries Linear burns in areas with sweat Burns in a feathery or arborescent pattern Punctate burns with multiple, deep, circular lesions Thermal burns from ignited clothing or heated metal |
| What to remove tar from burns with? | Polymyxin B ointment vitamin E ointment sunflower oil |