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Derm sct3


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types of fungi:
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dermatophyte yeast budding dimorphic molds

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Derm sct3 - Marcador

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Derm sct3 - Detalles

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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
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
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