Bed sore Stages

Classification
The definitions of the four pressure ulcer stages are revised periodically by the National Pressure Ulcer Advisory Panel (NPUAP) in the United States. Briefly, however, they are as follows:

Stage I is the most superficial, indicated by non blanchable redness that does not subside after pressure is relieved. This stage is visually similar to reactive hyperemia seen in skin after prolonged application of pressure. Stage I pressure ulcers can be distinguished from reactive hyperemia in two ways: a) reactive hyperemia resolves itself within 3/4 of the time pressure was applied, and b) reactive hyperemia blanches when pressure is applied, whereas a Stage I pressure ulcer does not. The skin may be hotter or cooler than normal, have an odd texture, or perhaps be painful to the patient. Although easy to identify on a light-skinned patient, ulcers on darker-skinned individuals may show up as shades of purple or blue in comparison to lighter skin tones.

Stage II is damage to the epidermis extending into, but no deeper than, the dermis. In this stage, the ulcer may be referred to as a blister or abrasion.

Stage III involves the full thickness of the skin and may extend into the subcutaneous tissue layer. This layer has a relatively poor blood supply and can be difficult to heal. At this stage, there may be undermining damage that makes the wound much larger than it may seem on the surface.

Stage IV pressure ulcerStage IV is the deepest, extending into the muscle, tendon or even bone.

Unstageable pressure ulcers are covered with dead cells, or eschar and wound exudate, so the depth cannot be determined.

Skin Care for A Better You

SKIN CARE:

F
or Healthy Skin
Skin has three layers-epidermis ,dermis and hypodermis. Epidermis the top most layer. It has melanocytes which gives brown tint to the skin. Below it is dermis .It has fibrous tissue , collagen and elastin. Hypodermis the deepest layer containing connective tissue and fat cells keeps the skin warm and protects it.
TYPE OF SKIN:
NORMAL: Fine textured , soft and smooth.
DRY: Tight , flaky and predisposing to facial lines.
OILY: Greasy skin due sebum production.Looks shiny with enlarged pores leading to blemishes and blackhead.
SENSITIVE :Fine ,translucent,suffer from redness and irritation.
COMBINATION:T –Zone is oily and the rest of the skin is dry (cheeks ,eyes ,cheeks )
DAILY REGIME FOR A HEALTHY SKIN:

HealthySkin
CLEANSING: Helps to remove dirt ,sweat and make up .Must do atleast twice a day or more for oily skin. Use a cream cleanser for a dry skin. Apply cleansing for 1min in outward and upward in circulation motion.Soaps also can be used by everyone.Must see that they are not harsh.
Toning: Cleansing must be followed by toning . It helps to remove any leftover grease or make up .Closes the pores and refines the skin. Alcohol must be used for dry skin.
MOISTURING :Only time our body retains moisture is just after bath.pat the skin and apply moisturizer to the skin according to the skin type .It must even in oily skin.
SUN PROTECTION: Sun protecting factor(SPF) must be used according to the skin tyope and the intensity of the sun, Time you can stay out in the sun- multiply the SPF with 10 (e.g. 20 SPF means 200 mins i.e. 3 hrs and 20 mins ) recommended is 15-30 .
Tips for sun protection:
Avoid sun for long between 11:00am to 4:00pm in summer.
Drink plenty of water.
Cool yourself with warm shower (extreme temperature is bad for skin ) ,use uv blocking sun glasses ,use a umbrella or a hat.
WEEKLY REGIMEN:
EXFOLIATION: Removing dead skin as it the skin looks dull .must be frequent in older age. Fine grains are good.apricot,strawberries with milk,oat meal,rice bran with glycerine.
FACEMASK: They are stimulating for skin.
Fuller earth with egg white for oily skin.
Egg yolk with honey is for dry skin.
Article By- Dr. Akriti Sharma

Source : www.medchrome.com

Lupus Manifestations: SLE and skin

Lupus Manifestations

Bed Bug Bites

Disease transmission

Bedbugs seem to possess all of the necessary prerequisites for being capable of passing diseases from one host to another, but there have been no known cases of bed bugs passing disease from host to host. There are at least twenty-seven known pathogens (some estimates are as high as forty-one) that are capable of living inside a bed bug or on its mouthparts. Extensive testing has been done in laboratory settings that also conclude that bed bugs are unlikely to pass disease from one person to another. Therefore bedbugs are less dangerous than some more common insects such as the flea. However, transmission of Chagas disease or hepatitis B might be possible in appropriate settings.

The salivary fluid injected by bed bugs typically causes the skin to become irritated and inflamed, although individuals can differ in their sensitivity. Anaphylactoid reactions produced by the injection of serum and other nonspecific proteins are observed and there is the possibility that the saliva of the bedbugs may cause anaphylactic shock in a small percentage of people. It is also possible that sustained feeding by bedbugs may lead to anemia. It is also important to watch for and treat any secondary bacterial infection.

Contact Dermatitis

Contact dermatitis is a localized rash or irritation of the skin caused by contact with a foreign substance. Only the superficial regions of the skin are affected in contact dermatitis. Inflammation of the affected tissue is present in the epidermis (the outermost layer of skin) and the outer dermis (the layer beneath the epidermis).Unlike contact urticaria, in which a rash appears within minutes of exposure and fades a

way within minutes to hours, contact dermatitis takes days to fade away. Even then, contact dermatitis fades only if the skin no longer comes in contact with the allergen or irritant. Contact dermatitis results in large, burning, and itchy rashes, and these can take anywhere from several days to weeks to heal. Chronic contact dermatitis can develop when the removal of the offending agent no longer provides expected relief.

Causes

In North/South America, the most common causes of allergic contact dermatitis are plants of the Toxicodendron genus: poison ivy, poison oak, and poison sumac. Specific plant species that can induce

such contact dermatitis include Western Poison Oak, a widespread plant in the western USA. Common causes of irritant contact dermatitis are harsh (highly alkaline) soaps, detergents, and cleaning products.

Types of contact dermatitis

There are three types of contact dermatitis: irritant contact, allergic contact, and photocontact dermatitis. Photocontact dermatitis is divided into two categories: phototoxic and photoallergic.

Chemical irritant contact dermatitis

Physical irritant contact dermatitis

Low humidity

Plants

Allergic contact dermatitis


Common allergens implicated include the following:

• Nickel (nickel sulfate hexahydrate) - metal frequently encountered in jewelry and clasps or buttons on clothing
• Gold (gold sodium thiosulfate) - precious metal often found in jewelry
• Balsam of Peru (Myroxylon pereirae) - a fragrance used in perfumes and skin lotions, derived from tree resin (see also Tolu balsam)
• Thimerosal - a mercury compound used in local antiseptics and in vaccines
• Neomycin - a topical antibiotic common in first aid creams and ointments, cosmetics, deodorant, soap and pet food. Found by itself, or in Polysporin or Triple Antibiotic
• Fragrance mix - a group of the eight most common fragrance allergens found in foods, cosmetic products, insecticides, antiseptics, soaps, perfumes and dental products ^[15]
• Formaldehyde - a preservative with multiple uses, e.g., in paper products, paints, medications, household cleaners, cosmetic products and fabric finishes
• Cobalt chloride - metal found in medical products; hair dye; antiperspirant; metal-plated objects such as snaps, buttons or tools; and in cobalt blue pigment
• Bacitracin - a topical antibiotic found by itself, or as Polysporin or Triple Antibiotic
• Quaternium-15 - preservative in cosmetic products (self-tanners, shampoo, nail polish, sunscreen) and in industrial products (polishes, paints and waxes).^[16]
• Colophony (Rosin) - Rosin, sap or sawdust typically from spruce or fir trees
• Topical steroid - see steroid allergy

Photocontact Dermatitis

Sometimes termed "photoaggravated"(Bourke et al. 2001)^[17], and divided into two categories, phototoxic and photoallergic, PCD is the eczematous condition which is triggered by an interaction between an otherwise unharmful or less harmful substance on the skin and ultraviolet light (320-400 nm UVA) (ESCD 2006), therefore manifesting itself only in regions where the sufferer has been exposed to such rays. Without the presence of these rays, the photosensitiser is not harmful. For this reason, this form of contact dermatitis is usually associated only with areas of skin which are left uncovered by clothing. The mechanism of action varies from toxin to toxin, but is usually due to the production of a photoproduct. Toxins which are associated with PCD include the psoralens. Psoralens are in fact used therapeutically for the treatment of psoriasis, eczema and vitiligo.

Photocontact dermatitis is another condition where the distinction between forms of contact dermatitis is not clear cut. Immunological mechanisms can also play a part, causing a response similar to ACD.

Symptoms

Allergic dermatitis is usually confined to the area where the trigger actually touched the skin, whereas irritant dermatitis may be more widespread on the skin. Symptoms of both forms include the following:

• Red rash. This is the usual reaction. The rash appears immediately in irritant contact dermatitis; in allergic contact dermatitis, the rash sometimes does not appear until 24–72 hours after exposure to the allergen.
• Blisters or wheals. Blisters, wheals (welts), and urticaria (hives) often form in a pattern where skin was directly exposed to the allergen or irritant.
• Itchy, burning skin. Irritant contact dermatitis tends to be more painful than itchy, while allergic contact dermatitis often itches.

While either form of contact dermatitis can affect any part of the body, irritant contact dermatitis often affects the hands, which have been exposed by resting in or dipping into a container (sink, pail, tub, Sun, Swimming Pools With High chlorine ), containing the irritant.

Treatment

Self-care at Home

• Immediately after exposure to a known allergen or irritant, wash with soap and cool water to remove or inactivate most of the offending substance.

- Weak acid solutions [lemon juice, vinegar] can be used to counteract the effects of dermatitis contracted by exposure to basic irritants [phenol etc.].

• If blistering develops, cold moist compresses applied for 30 minutes 3 times a day can offer relief.
• Calamine lotion and cool colloidal oatmeal baths may relieve itching.
• Oral antihistamines such as diphenhydramine (Benadryl, Ben-Allergin) can also relieve itching.
• For mild cases that cover a relatively small area, hydrocortisone cream in nonprescription strength may be sufficient.
• Avoid scratching, as this can cause secondary infections.
• A barrier cream such as those containing zinc oxide (e.g. Desitin, etc.) may help to protect the skin and retain moisture.

Medical Care

If the rash does not improve or continues to spread after 2-3 of days of self-care, or if the itching and/or pain is severe, the patient should contact a dermatologist or other physician or physician assistant. Medical treatment usually consists of lotions, creams, or oral medications.

• Corticosteroids. A corticosteroid medication similar to hydrocortisone may be prescribed to combat inflammation in a localized area. This medication may be applied to your skin as a cream or ointment. If the reaction covers a relatively large portion of the skin or is severe, a corticosteroid in pill or injection form may be prescribed.
• Antihistamines. Prescription antihistamines may be given if nonprescription strengths are inadequate.

Prevention

Since contact dermatitis relies on an irritant or an allergen to initiate the reaction, it is important for the patient to identify the responsible agent and avoid it. This can be accomplished by having patch tests, a method commonly known as allergy testing. The patient must know where the irritant or allergen is found to be able to avoid it. It is important to also note that chemicals sometimes have several different names.^[18]

In an industrial setting the employer has a duty of care to the individual worker to provide the correct level of safety equipment to mitigate the exposure to harmful irritants. This can take the form of protective clothing, gloves or barrier cream depending on the working environment.

ALOPECIA: HAIR LOSS causes

Hair loss

loss of hair is called alopecia.

Facts:
Hair loss usually develops gradually and may be patchy or diffuse (all over).

Roughly 100 hairs are lost from your head every day.

The average scalp contains about 100,000 hairs.
Each individual hair survives for an average of 4-1/2 years, during which time it grows about half an inch a month. Usually in its 5th year, the hair falls out and is replaced within 6 months by a new one.

Genetic baldness is caused by the body's failure to produce new hairs and not by excessive hair loss.
Both men and women tend to lose hair thickness and amount as they age. Inherited or "pattern baldness" affects many more men than women. About 25% of men begin to bald by the time they are 30 years old, and about two-thirds are either bald or have a balding pattern by age 60.

male pattern baldness involves a receding hairline and thinning around the crown with eventual bald spots. Ultimately, you may have only a horseshoe ring of hair around the sides. In addition to genes, male-pattern baldness seems to require the presence of the male hormone testosterone . Men who do not produce testosterone (because of genetic abnormalities or castration) do not develop this pattern of baldness.

Some women also develop a particular pattern of hair loss due to genetics, age, and male hormones that tend to increase in women after menopause. The pattern is different from that of men. Female pattern baldness involves a thinning throughout the scalp while the frontal hairline generally remains intact.

Common Causes:
Baldness is not usually caused by a disease, but is related to aging, heredity, and testosterone. In addition to the common male and female patterns from a combination of these factors, other possible causes of hair loss, especially if in an unusual pattern, include:
Alopecia areata -- bald patches that develop on the scalp, beard, and, possibly, eyebrows. Eyelashes may fall out as well.
Autoimmune conditions such as lupus
Burns
Certain infectious diseases such as syphilis
Chemotherapy
Emotional or physical stress
Excessive shampooing and blow-drying
Fever
Hormonal changes -- for example, thyroid disease , childbirth, or use of birth control pills
Nervous habits such as continual hair pulling or scalp rubbing
Radiation therapy
Tinea capitis (ringworm of the scalp)
Tumor of the ovary or adrenal glands

Tinea Infection

RINGWORM (TINEA INFECTION)

Tinea Capitis

Tinea Corporis( Classical Picture)

Ringworm, also known as Tinea, is a contagious fungal infection of the skin. Contrary to its name, ringworm is not caused by a worm.
Ringworm is very common, especially among children, and may be spread by skin-to-skin contact, as well as via contact with contaminated items such as hairbrushes. Ringworm spreads readily, as those infected are contagious even before they show symptoms of the disease. Participants in contact sports such as wrestling have a risk of contracting the fungal infection through skin-to-skin contact.

Ringworm is also a common infection in domestic animals, especially cattle and cats. Humans can contract ringworm from animals; cats, cattle and dogs are common sources owing to close association with humans.

Types
A number of different species of fungi cause ringworm.

Dermatophytes of the genera Trichophyton and Microsporum are the most common causative agents. These fungi attack various parts of the body and lead to the following conditions:

* Tinea corporis affects the arms, legs, and trunk

* Tinea capitis affects the scalp

* Tinea cruris (jock itch) affects the groin area

* Tinea barbae affects facial hair

Tinea faciei (face fungus) affects the face

* Tinea pedis (athlete's foot) affects the feet

* Tinea unguium affects the fingernails and toenails

* Tinea versicolor

* Tinea manuum affects the hands and palm area

Symptoms and diagnosis
The best known sign of ringworm in people is the appearance of one or more red raised itchy patches with defined edges, not unlike the herald rash of Pityriasis rosea. These patches are often lighter in the center, taking on the appearance of a ring. If the infected area involves the scalp or beard area, then bald patches may become evident. The affected area may become itchy for periods of time. If the nails are affected, they may thicken, discolor, and finally crumble and fall off.

Doctors can diagnose ringworm on sight, or they may take a skin scraping, or in the case of animal ringworm or tinea capitis, examine plucked hairs for fungal elements. This is examined under a microscope, or put on an agar plate in a microbiology laboratory and allowed to grow.
Some of the fungi fluoresce under a black light examination.
In domestic animals, ringworm can cause a variety of symptoms, but most cases show scaling and patches of hair loss. Some cats can be carriers, but show no symptoms.

Treatment
Topical antifungal drugs containing miconazole and clotrimazole, available by prescription or over the counter, are used to clear up the infection. Fungal infections can take weeks or months to clear up.
Terbinafine is highly effective for Tinea corporis. It treats itching, burning, cracking, and scaling that accompany this condition. It cures most ringworm except the types affecting the nails or scalp, which are very difficult to treat.
Griseofulvin is another antifungal drug that can be used to treat ringworm. It can be very effective, but may produce side effects.

Skin Diseases: Basic Knowledge

Primary Lesion - A primary lesion is directly associated with the disease process and is described with established dermatological terminology. Identifying the primary lesion(s), whenever possible, is the first step towards identification of the disease or cutaneous process. Primary lesions include the macule, papule, patch, plaque, vesicle, bulla, nodule, tumor, wheal, and pustule. Secondary lesions are a modification of primary lesions.

Macule - A circumscribed flat area less than 1 cm of discoloration without elevation or depression of surface relative to surrounding skin.

Papule - A circumscribed, elevated, solid lesion, less than 1 cm.


Patch - A circumscribed area of discoloration, greater than 1 cm, which is neither elevated or depressed relative to the surrounding skin.

Plaque - A well-circumscribed, elevated, superficial, solid lesion, greater than 1 cm in diameter.

Vesicle - A small, superficial, circumscribed elevation of the skin, less than 0.5 cm, that contains serous fluid.

Bulla (pl. Bullae) - A raised, circumscribed lesion greater than 0.5 cm that contains serous fluid.


Nodule - A palpable, solid lesion, less than 1 cm in diameter. These are usually found in the dermal or subcutaneous tissue, and the lesion may be above, level with, or below the skin surface.

Tumor - Solid, firm lesions >1 cm that can be above, level with, or beneath the skin surface. Also known as a mass.

Wheal - Transient, circumscribed, elevated papules or plaques, often with erythematous borders and pale centers.


Pustule - A small (<>