Infectious skin

Question 1

ring-shaped, scaly red rash

Answer 1

ringworm
CAUSES
direct contact with an infected person
direct contact with infected animal
indirect contact with fomites (clothing, towel, bed linen)
contact with soil (geophilic infections, rare)
MANAGEMENT/TREATMENT
wear loose fitting clothes (cotton)
maintain good hygiene
after washing, dry thoroughly
avoid scratching affected skin
do not share towels
wash clothes and bed linen frequently
not necessary to exclude from school
clotrimazole 1% cream (apply 2-3 times a day)
miconazole 2% cream (apply twice a day)
econazole 1% cream (POM)

Question 2

more likely to have autoimmune disease
likely to have autoimmune disease (eczema, asthma)
patchy hair loss
diffuse hair loss

Answer 2

Alopecia

CAUSES
family history
more common in people with chromosomal disorders
polygenic condition

TREATMENT
corticosteroids
topical immunotherapy
minoxidil 2% topical solution
finasteride 1mg (men only)

Question 3

scaling
sometimes itching and redness
flakes fall from scalp to shoulders

Answer 3

Dandruff

CAUSES
NOT caused by poor hygiene
stress and cold weather may make dandruff worse
dry skin
not shampooing enough
sensitivity to hair care products

MANAGEMENT/TREATMENT
use anti-dandruff shampoo
massage your scalp
avoid hot water
limit use of hair products
avoid scratching
OTC treatment:
salicylic acid
piroctone olamine
ketoconazole
Nizoral application:
use 3-4 days a week
small amount to wet scalp
leave on scalp for 5 minutes
rinse thoroughly

Question 4

intensely itchy skin rash
small papules on hands
old or young people may develop a rash on their head, neck, palms and soles of feet
crusted scabies (people with weakened immune system)-rare

Answer 4

Scabies- parasitic infestation (mite)

CAUSES
frequently sexually acquired
casual contact
high levels of poverty
crowded living conditions
winter months (prolonged survival of mites)

MANAGEMENT/TREATMENT
wash all bedding and clothing in the house
put clothing that cannot be washed in a sealed bag for 3 days until mites die
treat everyone in the household above 2 years
treat any sexual partners within 8 weeks
Do not have sex or close physical contact
Do not share bedding, clothing or towels
1st line: lyclear (permethrin) dermal cream
Derbac M (malathion) lotion

Symptomatic relief:
Crotamiton 10% cream (for itch)
Chlorphenamine (may help sleep and reduce scratching)