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Saturday, May 25, 2013

The Developing Baby

First trimester (week 1-week 12)

diagram of a fetus at 4 weeks

At four weeks:

  • Your baby's brain and spinal cord have begun to form.
  • The heart begins to form.
  • Arm and leg buds appear.
  • Your baby is now an embryo and one-twenty-fifth inch long.
diagram of a fetus at 8 weeks

At eight weeks:

  • All major organs and external body structures have begun to form.
  • Your baby's heart beats with a regular rhythm.
  • The arms and legs grow longer, and fingers and toes have begun to form.
  • The sex organs begin to form.
  • The eyes have moved forward on the face and eyelids have formed.
  • The umbilical cord is clearly visible.
  • At the end of eight weeks, your baby is a fetus and looks more like a human. Your baby is nearly 1 inch long and weighs less than one-eighth ounce.
diagram of a fetus at 12 weeks

At 12 weeks:

  • The nerves and muscles begin to work together. Your baby can make a fist.
  • The external sex organs show if your baby is a boy or girl. A woman who has an ultrasound in the second trimester or later might be able to find out the baby's sex.
  • Eyelids close to protect the developing eyes. They will not open again until the 28th week.
  • Head growth has slowed, and your baby is much longer. Now, at about 3 inches long, your baby weighs almost an ounce.

Second trimester (week 13-week 28)



diagram of a fetus at 16 weeks

At 16 weeks:

  • Muscle tissue and bone continue to form, creating a more complete skeleton.
  • Skin begins to form. You can nearly see through it.
  • Meconium (mih-KOH-nee-uhm) develops in your baby's intestinal tract. This will be your baby's first bowel movement.
  • Your baby makes sucking motions with the mouth (sucking reflex).
  • Your baby reaches a length of about 4 to 5 inches and weighs almost 3 ounces.
diagram of a fetus at 20 weeks

At 20 weeks:

  • Your baby is more active. You might feel slight fluttering.
  • Your baby is covered by fine, downy hair called lanugo (luh-NOO-goh) and a waxy coating called vernix. This protects the forming skin underneath.
  • Eyebrows, eyelashes, fingernails, and toenails have formed. Your baby can even scratch itself.
  • Your baby can hear and swallow.
  • Now halfway through your pregnancy, your baby is about 6 inches long and weighs about 9 ounces.
diagram of a fetus at 24 weeks

At 24 weeks:

  • Bone marrow begins to make blood cells.
  • Taste buds form on your baby's tongue.
  • Footprints and fingerprints have formed.
  • Real hair begins to grow on your baby's head.
  • The lungs are formed, but do not work.
  • The hand and startle reflex develop.
  • Your baby sleeps and wakes regularly.
  • If your baby is a boy, his testicles begin to move from the abdomen into the scrotum. If your baby is a girl, her uterus and ovaries are in place, and a lifetime supply of eggs have formed in the ovaries.
  • Your baby stores fat and has gained quite a bit of weight. Now at about 12 inches long, your baby weighs about 1½ pounds.

Third trimester (week 29-week 40)


diagram of a fetus at 32 weeks

At 32 weeks:

  • Your baby's bones are fully formed, but still soft.
  • Your baby's kicks and jabs are forceful.
  • The eyes can open and close and sense changes in light.
  • Lungs are not fully formed, but practice "breathing" movements occur.
  • Your baby's body begins to store vital minerals, such as iron and calcium.
  • Lanugo begins to fall off.
  • Your baby is gaining weight quickly, about one-half pound a week. Now, your baby is about 15 to 17 inches long and weighs about 4 to 4½ pounds.
diagram of a fetus at 36 weeks

At 36 weeks:

  • The protective waxy coating called vernix gets thicker.
  • Body fat increases. Your baby is getting bigger and bigger and has less space to move around. Movements are less forceful, but you will feel stretches and wiggles.
  • Your baby is about 16 to 19 inches long and weighs about 6 to 6½ pounds.
diagram of a fetus at Weeks 37-40

Weeks 37-40:

  • By the end of 37 weeks, your baby is considered full term. Your baby's organs are ready to function on their own.
  • As you near your due date, your baby may turn into a head-down position for birth. Most babies "present" head down.
  • At birth, your baby may weigh somewhere between 6 pounds 2 ounces and 9 pounds 2 ounces and be 19 to 21 inches long. Most full-term babies fall within these ranges. But healthy babies come in many different sizes.



Pregnancy

Pregnancy lasts about 40 weeks, counting from the first day of your last normal period. The weeks are grouped into three trimesters (TREYE-mess-turs). Find out what's happening with you and your baby in these three stages.

Stages of pregnancy

  • First trimester (week 1-week 12)
  • Second trimester (week 13-week 28)
  • Third trimester (week 29-week 40)

First trimester (week 1-week 12)

First trimester
diagram of a fetus during the First trimester (week 1-week 12)
During the first trimester your body undergoes many changes. Hormonal changes affect almost every organ system in your body. These changes can trigger symptoms even in the very first weeks of pregnancy. Your period stopping is a clear sign that you are pregnant. Other changes may include:
  • Extreme tiredness
  • Tender, swollen breasts. Your nipples might also stick out.
  • Upset stomach with or without throwing up (morning sickness)
  • Cravings or distaste for certain foods
  • Mood swings
  • Constipation (trouble having bowel movements)
  • Need to pass urine more often
  • Headache
  • Heartburn
  • Weight gain or loss
As your body changes, you might need to make changes to your daily routine, such as going to bed earlier or eating frequent, small meals. Fortunately, most of these discomforts will go away as your pregnancy progresses. And some women might not feel any discomfort at all! If you have been pregnant before, you might feel differently this time around. Just as each woman is different, so is each pregnancy.

Second trimester (week 13-week 28)

Second trimester
diagram of a fetus during the Second trimester (week 13-week 28)
Most women find the second trimester of pregnancy easier than the first. But it is just as important to stay informed about your pregnancy during these months.
You might notice that symptoms like nausea and fatigue are going away. But other new, more noticeable changes to your body are now happening. Your abdomen will expand as the baby continues to grow. And before this trimester is over, you will feel your baby beginning to move!
As your body changes to make room for your growing baby, you may have:
  • Body aches, such as back, abdomen, groin, or thigh pain
  • Stretch marks on your abdomen, breasts, thighs, or buttocks
  • Darkening of the skin around your nipples
  • A line on the skin running from belly button to pubic hairline
  • Patches of darker skin, usually over the cheeks, forehead, nose, or upper lip. Patches often match on both sides of the face. This is sometimes called the mask of pregnancy.
  • Numb or tingling hands, called carpal tunnel syndrome
  • Itching on the abdomen, palms, and soles of the feet.(Call your doctor if you have nausea, loss of appetite, vomiting, jaundice or fatigue combined with itching. These can be signs of a serious liver problem.)
  • Swelling of the ankles, fingers, and face. (If you notice any sudden or extreme swelling or if you gain a lot of weight really quickly, call your doctor right away. This could be a sign of preeclampsia.)

Third trimester (week 29-week 40)

Third trimester
diagram of a fetus during the Third trimester (week 29-week 40)
You're in the home stretch! Some of the same discomforts you had in your second trimester will continue. Plus, many women find breathing difficult and notice they have to go to the bathroom even more often. This is because the baby is getting bigger and it is putting more pressure on your organs. Don't worry, your baby is fine and these problems will lessen once you give birth.
Some new body changes you might notice in the third trimester include:
  • Shortness of breath
  • Heartburn
  • Swelling of the ankles, fingers, and face. (If you notice any sudden or extreme swelling or if you gain a lot of weight really quickly, call your doctor right away. This could be a sign ofpreeclampsia.)
  • Hemorrhoids
  • Tender breasts, which may leak a watery pre-milk called colostrum (kuh-LOSS-struhm)
  • Your belly button may stick out
  • Trouble sleeping
  • The baby "dropping", or moving lower in your abdomen
  • Contractions, which can be a sign of real or false labor
As you near your due date, your cervix becomes thinner and softer (called effacing). This is a normal, natural process that helps the birth canal (vagina) to open during the birthing process. Your doctor will check your progress with a vaginal exam as you near your due date. Get excited — the final countdown has begun!


Monday, May 6, 2013

Acne


Acne is a common skin condition that affects most people at some point. It causes spots to develop on the skin, usually on the face, back and chest.
The spots can range from blackheads and whiteheads which are often mild, to inflamed pus-filled pustules and cysts, which can be severe and long lasting and can lead to scarring. 

Causes Acne

  • Hormones   
  •  Bacteria
Acne has many subtypes. Acne neonatorum and acne infantum occasionally affect newborns and infants, usually boys. A pimply rash appears on the face and usually clears within weeks with no lasting effect. However, acne infantum may last longer, be more severe, and cause scarring. 
People who escaped their teen years almost pimple-free may develop persistent adult-onset acne as they get older. Despite the normal increase in androgen levels during puberty, some doctors believe that flare-ups of acne have less to do with androgen levels than with how a person's skin responds to an increase in sebum production or to the bacteria that causes acne. The bacteria Propionibacterium acnes occurs naturally in healthy hair follicles. If too many of them accumulate in plugged follicles, they may secrete enzymes that break down sebum and cause inflammation. Some people are simply more sensitive than others to this reaction. Sebum levels that might cause a pimple or two in one person may result in widespread outbreaks -- or even acute cystic acne -- in another person.

Acne Treatment
Self-Care at Home


  • Wash once or twice daily with soap and water to remove excess oil from the skin. An acne cleanser purchased over-the-counter in any drug store can also be helpful. Avoid scrubbing or using abrasives because this can actually irritate the skin and cause acne to worsen.
  • Over-the-counter acne medications can be used either at bedtime or during the day. Always follow the directions on any acne product. These products generally do not have any beneficial effects on inflammatory lesions, pimples, and are essentially used to prevent the development of new lesions. Therefore they should be applied to all of the skin in affected areas.
  • Many cover-up products are available without a prescription to improve the appearance of blemishes while they have a chance to heal. Most work well and should not worsen acne. If makeup is worn, it should be water-based, and the ingredients of the makeup should list water as a major component.
  • Some cosmetics and other skin-care products, however, can cause acne to worsen. Look for makeup, cosmetics, and skin-care products labeled with the word noncomedogenic. This means that it does not cause or worsen acne.
  • Recent, very preliminary, reports seem to associate cow's milk with more severe cases of acne.
  • It is of major importance that the patient with acne does not manipulate their lesions. Manipulation (pinching, squeezing, etc) of any type is almost uniformly going to result in worsening of any existing disease, potentially enhancing the chance for scarring and producing more long-lasting pimples.
  
Medical Treatment
The purpose of medical care is to prevent scarring until the disease characteristically spontaneously remits after the conclusion of puberty. Many treatment options are available to treat all forms of acne. Medications are the main treatment for acne and usually work well. Several preparations are available over the counter, while others require a prescription from a doctor.
  • Over-the-counter medications: Nonprescription or over-the-counter medications for acne are plentiful and can be effective for milder forms of acne. They come in the form of soaps, washes, and cleansers.

    • Many contain benzoyl peroxide, which does two things. First, benzoyl peroxide kills the acne-causing bacteria, which are thought to play a role in acne. Second, benzoyl peroxide can cause drying and flaking off of skin, which can help prevent the pores from becoming plugged. Plugged pores can develop into acne blemishes.
    • Scrubbing excessively with any over-the-counter preparation can actually cause acne to worsen by additionally irritating the hair follicles.

  • Prescription medications: Doctors can prescribe medications when acne becomes moderate to severe or is not controlled by over-the-counter medications. Prescription drugs can be used effectively alone or in combination with other prescription and nonprescription medications.

    • Azalaic acid products: These products are useful in mild acne composed mostly of comedones. The are unlikely to produce inflammation and are applied twice a day.
    • Antibiotics: Antibiotics can be effective in treating most inflammatory acne (papules and pustules). They work by decreasing inflammation caused by bacteria and other irritating chemicals present in the sebaceous follicle.
      • Antibiotics may be applied to the skin in the form of gels and lotions or by way of pills. Giving an antibiotic by mouth is often needed for acne that is more extensive, red, and tender.
      • Antibiotics may be combined with benzoyl peroxide, which is contained in over-the-counter medications, to form a topical solution that can be obtained with a doctor's prescription.
      • Antibiotics taken by mouth for relatively extended periods can be very effective in controlling acne. Although the development of resistant bacteria is a theoretical concern as a result of protracted courses of antibiotics, this does not seem to occur commonly for the antibiotics used most frequently by dermatologists for acne. As with any systemic medication they can be associated with more side effects than if applied to the skin and may interact with other drugs. Sensitivity to the sun can result in a "bad sunburn" in some people who take antibiotics in the tetracycline family.
    • Retinoids: Medicines structurally similar to vitamin A are useful in preventing several types of acne lesions. Topical retinoids are effective in treating the noninflammatory types of acne (blackheads and whiteheads).
      • Topical retinoids (applied directly to the skin) help to open clogged pores and produce a mild peeling effect. Drying and redness of the skin can be a frequent side effect and in some patients limit its usefulness.

      • An oral retinoid (isotretinoin) may be prescribed for treating the more extensive nodular type of acne or severe inflammatory acne, which has not responded to other treatments. All patients on isotretinoin will experience a peeling and drying of the skin. Most patients who take the appropriate dosage for an appropriate duration should expect a permanent remission in their acne. Isotretinoin is associated with a number of serious side effects, including birth defects in babies of women who become pregnant while taking the medicine. The drug can also cause elevated blood lipids and damage to the liver. Your doctor must perform certain blood tests to check for these problems and to make sure you are not pregnant (assuming that it is possible) if you are given oral retinoids. Depression and inflammatory bowel disease have been reported while taking oral retinoids. All patients on isotretinoin in the United States must be registered in a government-mandated program, the I PLEDGE PROGRAM, which is accessible online or by telephone. Beside the patient, the patient's physician and the dispensing pharmacy must also register with this program.
    • Other medications: A doctor may recommend other types of drugs or therapy to improve acne. For women, medications such as birth control pills or certain "water pills" may be helpful. These drugs counteract the acne-causing effect of male hormones. Newer treatments for acne include the use of light or zinc. Your doctor can advise you whether these types of acne therapy might be good for you.

Reference: http://www.emedicinehealth.com/acne/page6_em.htm#medical_treatment
http://www.webmd.com/skin-problems-and-treatments/guide/skin-problems-treatments-symptoms-types
http://www.webmd.com/skin-problems-and-treatments/guide/understanding-acne-basics?page=2
http://www.nhs.uk/Conditions/Acne/Pages/Introduction.aspx

Psoriasis


PathologyKeratinocyte hyperproliferation: differentiation, or ‘skin cell going from basal layer to horny layer’, reduced from 4 weeks to 4 days [approximately!]
Histopathological features:
  • Parakeratosis: retained nuclei
  • Acanthosis: thick epidermis
  • Absent granular layer
  • Lengthened rete ridges
  • Thin dermal papillae
  • Dilated, tortuous capillaries
  • Munro’s micro-abscesses
  • T-cells in upper dermis
 
Clinical featuresAge: 15-40 years; esp. in 30s
Types
  • Classical [or typical]
    • Plaques: Well-circumscribed erythematous plaques with silver scaling
    • Distribution: Esp. on extensor surfaces [elbow, knee], scalp/hairline, sacral
    • Features: Pain, itch [but less than eczema/dermatitis]
    • Auspitzs sign: Bleeding on scale removal
  • Guttate
    • Age: Young
    • Onset: Follows streptococcal tonsillitis
    • Plaques: Multiple discoid erythematous and scaly macules and plaques on trunk
  • Palmoplanar pustular
    • Plaques: Yellow-brown pustules on palms and soles
  • Flexoral
    • Plaques: Erythematous, but not scaly
    • Distribution: Submammary, axillary, anogenital, umbilical
    • Epidemiology: Esp. women; also the elderly and HIV +ve
  • Erythrodermic [emergency!]
    • Features: Acute onset of erythroderma and pustular plaques
    • Management: Methotrexate
    • Others: only scales; only nails; and napkin
Nails
  • Features: Pitting, onycholysis [nail lifting off the bed]; subungal hyperkeratosis; Beaus lines [horizontal, across the nail]
  • Differential diagnosis: fungal infection, alopecia areata
Psoriatic arthropathy
  • Patterns: [1] AnkSpond-like/spondylitis; [2] RA-like/symmetrical; [3] Asymmetrical, <3 joints;[4] DIP joints, hands; [5] Arthritis multilans

Differential diagnosis
  • Dermatitis/eczema: discoid or seborrhoeic
  • Lichen planus
  • Pityriasis rosea [esp. guttate psoriasis]
  • 2o stage of syphilis
  • Reiter’s syndrome [Esp. palmoplanar psoriasis]
  • Discoid lupus
 
Precipitating factors
  • Trauma [known as Koebner’s phenomena]
  • Drugs: β-blockers, lithium, anti-malarials; NSAIDs and ACE-Is
  • Stress
  • Sunlight
  • ‘Genetic’
 
ManagementTopical
  • Emollients
  • Vit. D analogues
    • Calcipotriol, tacalcitol and calcitriol
    • Mechanism: ↓ cell proliferation
    • Side-effects: Skin irritation, hypercalaemia if overdose
  • Coal tar preparations
    • Mechanism: Inhibit DNA synthesis
    • Problems: Smelly, messy
  • Dithranol
    • Anthralin
    • Mechanism: ↓ cell proliferation
    • Side-effects: Irritates neighbouring normal skin, stains clothes purple
  • Keratolytics
    • Salicylic acid
  • Corticosteroids
    • Caution: Not alone, as may cause brittle psoriasis on rebound
  • Retinoids
    • Tazarotene
Systemic
  • Immunosuppressants
    • Methotrexate
    • Also ciclosporin, azathioprine, and hydroxyurea
  • Retinoids
    • Acitretin
    • Note: Therapeutic effect after 4-6 weeks; used for <6 months
    • Side-effects
      • Teratogenic for up to 3 years
      • Dry mucous membranes: skin, eyes, lips [may cause epistaxis]
      • Others: hepatotoxicity; deranged lipid profile
  • Photo[chemo]therapy
    • UVB for classic/plaque and guttate types
    • PUVA [psoralen] for palmoplanar type
  • Treating classic/typical psoriasis
    • 1st line: Dithranol
    • 2nd line: Vit. D analogues or topical steroids + tar or salicylic acid ± UVB
    • 3rd line: Retinoids, PUVA + immunosuppressants
    • Goekerman regime = Tar + UVB
    • Ingram regime = Goekerman + dithranol

Reference: http://almostadoctor.co.uk/content/systems/dermatology/psoriasis
http://www.webmd.com/skin-problems-and-treatments/guide/skin-problems-treatments-symptoms-types

Eczema (aka Dermatitis)


Eczema (aka Dermatitis) presents as a poorly demarcated, itchy rash. There are several causes. By far the most common is atopic eczema, but irritants and venous stasis can also cause the condition.
Atopic Eczema
This results from an IgE-mediated, T-cell auto-immune response.
Epidemiology and Aetiology
  • Affects approximately 5% of children in developed countries. Incidence is highest in developed countries in urbanised areas.
  • History of atopy (70% of cases)
  • Family history – genetic component
  • Breast feeding – breast feeding a child as the sole nutrition in the first 3 months of life decreases risk in those with a FH
Pathology
  • The Hygeine hypothesis is commonly used to explain the increasing incidence of eczema and other atopic disorders. It is believed that in developed countries, increased cleanliness around the home, early childhood vaccination, and small family groups reduced the exposure of young children to pathogens. This results in the over-production/expression of pro-allergic T-cells, increasing the likelyhood of the child becoming atopic.
  • In a genetically susceptible individual, there is an IgE-mediated T-cell immune response, after exposure to allergens.
  • Follows a chronic / relapsing-remitting course
Clinical features
  • Rash, typically on the flexor surfaces (inside of the elbows, wrists and knees), around the eyes, and on the neck. Can also involve the scalp and abdomen.
    • Infants – typically, scalp, face and flexor surfaces
    • Adults – typically chest, neck and flexural
  • Pruritus! – this is the main feature, and is worse with dry air, sweating, local irritation, stress, and sometimes wool clothing.
  • Onset is usually within the first 3 months of life, but it can occur later
Diagnosis
Diagnosis is clinical.
It can be difficult to distinguish contact dermatitis from atopic dermatitis, so a good history, including work life, washing products (for skin and clothes) and any other social factors is important.
Psoriasis may also present similarly, but is usually on the extensor surfaces (outside of the elbows, knees etc). Psoriasis also has a more ‘shiny’ appearance, and there may be fingernail signs.

Prognosis
  • Usually improves throughout childhood, and many patients are asymptomatic by age 5.
  • Even if there is apparent regression, symptomatic flare-ups still tend to occur throughout childhood and adolescence
Complications
Lichenification –this is where the skin becomes thickened and leathery, as a result of epidermal hypertrophy, usually as a consequence of excessive scratching and rubbing.
Staphylococcal infection of lesionsEczema herpeticum
  • Widespread herpes infection of eczema lesions
  • Typically occurs in children
  • Presents with vesicular lesions, typically around the site of a recent dermatitis flare up, although can occur anywhere on the body.
  • Patient may become particularly ill, with fever and lymphadenopathy, usually about 5 days after the vesicles appear
  • The lesions may later become infected with staphylococci
  • Very rarely, there may be a viraemia, which can be fatal
Cataracts – are a risk in those with long-term disease. Can be a feature of the disease itself, but also result from the use of steroid agents around the eyes, so don’t prescribe steroids for eczema around the eyes!
Eythrodermic eczema – eczema involving >90% of the body!
 ManagementRemoval of identified precipitating factors
  • These can be difficult to identify
  • Dust mite faeces is thought to be a common cause, but is very difficult to control. Some may benefit from measures to control this, such as limiting exposure to carpets, high-filtration vacuuming of mattresses, and use of a Gore-Tex mattress cover
  • Avoidance of dietary factors is not thought to be beneficial
The aim of treatment is to keep the skin as moist as possible, and thus the mainstay of treatment is the use of moisturising agents –emollients. These come in a variety of forms:
  • Creams –these are water based, and least potent
  • Lotions – these have both water and oil components and are moderately potent
  • Ointments – these are oil based and are the most potent
  • For example, you might start a patient on e45 cream, and step this up to oil based creams, such as Vaseline (and other petroleum based products – tar is the most potent!), if this is ineffective. Typically, the more potent the emollient, the more greasythe product is (and thus the more unpleasant it is to have it sitting on your skin!)
  • Emollients should be used liberally and regularly! – this may mean >500ml/week
  • Special bath/shower emollient products are also available
  • Avoidance of soaps if possible. Soaps are very drying to the skin. Wash hands and bathe as little as possible, and use luke-warm water.
    • Some advise the use of emollient as a soap – e.g. patients may be encouraged to apply the emollient as an alternative to washing their hands with soap and water.
Use of steroids – steroid creams are widely used to bring an exacerbation under control. Note that steroids should be applied before emollients! – otherwise, no steroid gets to the surface of the skin!
  • Mild corticosteroids – e.g. 1% hydrocortisone, or 0.05% clobetasone (Eumovate – this is more potent than 1% hydrocortisone)
    • On the face – use for <5 days – AVOID AROUND THE EYES – (causes cataracts).
    • On the rest of the body – use for <2 weeks
  • Potent corticosteroids – e.g. 0.1% betamethosone, or clobetasone (Dermovate – highly potent!)
    • NOT FOR USE OF THE FACE
    • On the rest of the body – useful for persistent rash, and in those with lichenification.
  • Other preparations – Haelan tape – fludroxycortide – is useful for the fingers, and healing of fissures
  • Typical side effects of topical steroids:
    • Side effects are rare with topical agents, so don’t be afraid to use them!
    • Skin thinning
    • Striae formation
    • Telangectasia
    • Adrenal suppression – cushing’s syndrome – rare!
Treatment of staphylococcal infection
  • Usually with the use of oral Fluticasone
  • Topical fusidic acid has fallen out of favour as it is of little proven benefit
Immune modulating agents      
  • Pimecrolimus and tacrolimus – are immune modulators (T-cell suppressants) that are licensed for use in moderate to severe eczema. They are usually used as alternatives to topical steroids, and are available as topic or oral preparations.
  • Can cause local stinging / flushing of the skin, but this tends to subside after several days use
Phototherapy
  • May be useful for many patients
  • Sunlight is beneficial
  • UVA/UVB therapy is effective in treating disease resistant to topical agents. It can cause sun damage, and thus is avoided in children
Systemic therapy
  • Very rarely, systemic therapy, such as systemic steroids may be used

Asteatotic eczema
  • “Crazy paving” eczema -
  • Fissures and cracks on dry skin. Particularly scaly.
  • Usually occurs on the shins, typically in elderly patients, but may also be on the trunk.
  • Thought to be the result of dehydration of the epidermis
  • More common in winter
  • Just moisturise and it should go away!
Lip lickers dermatitis
  • Soreness around the mouth due to excess lip licking
  • Just use moisturiser – moisturises the area, and discourages the habit of lip-licking as it tastes bad

Reference : http://almostadoctor.co.uk/content/systems/dermatology/eczema-dermatitis
http://www.webmd.com/skin-problems-and-treatments/guide/skin-problems-treatments-symptoms-types

Common Diseases



Common Diseases
1. Malaria
 An insect-borne tropical disease.
Cause Malaria parasite (Plasmodium) which enters the blood through a mosquito bite (female anopheles).
Symptoms Shivering, fever, repeated attacks lead to enlargement of spleen. Also leads to anaemia, pigmentation of the face, and general weakness.
Cure/Prevention Administration of quinine or plaudrine. Prevented by keeping the surroundings free of mosquitoes.
2. Tuberculosis An infectious and endemic disease, both air-borne and caused by food, unhealthy living and working conditions.
Cause Mycobacterium tuberculosis
(detected by Robert Koch in the mid 19th century), a type of bacteria. It attacks a person suffering from malnutrition, weak chest, unhealthy living and working conditions.
Symptoms General weakness, regular fever (generally in the evening and not very high), coughing, bloodstained sputum.
Cure/Prevention Streptomycin and surgery.
Prevented by BCG inoculation and healthy living and working atmosphere.
BCG The vaccine was developed in 1922 by Leon Calmette and Camille Guerrin in Paris and called BCG after them. (Bacillus Calmette-Guerin).
3. Cholera An acute epidemic, water and  food-borne disease. Cause Cholera vibrio or Vibriocholerae which attacks during exposure to chill, when stomach is empty for a long duration, eating of unripe or overripe fruits, and stale food.
Symptoms Vomiting, stomach ache, frequent loose stools followed by fever and unconsciousness.
Cure/Prevention Avoiding consumption of cut fruits exposed to flies, and contaminated water. Anticholera drugs are administered.
4. Tetanus
Cause Bacillus tetanus and Clostridium tetani which live in soil, dust, cow and horse dung. It attacks an open wound exposed to dust and soil.
Symptoms Painful contraction of muscles, usually of neck and jaws, followed by paralysis of thoracic muscles.
Cure/Prevention Preventing exposure of wounds to dust and administering of Anti-Tetanus (ATS) injection.
5. Diphtheria An acute infectious disease of the throat.
Cause Acute infection by diphtheria bacillus/corynebacterium diphtheria causing infection of throat.
Symptoms Inflammation of throat where a grey membrane (a false membrane on mucous surface) is formed. Pain and swelling of throat, with fever.
Cure/Prevention Immunisation vaccine of diphtheria antitoxin within 12-24 hours of appearance of symptoms.
6. Typhoid A food- and water-borne infectious disease.
Cause Salmonella typhi bacillus transmitted through contaminated food and water, either directly by sewage or indirectly by hands and faulty hygiene.
Symptoms Temperature, slow pulse, abdominal tenderness, rosecoloured rash.
Cure/Prevention Rest and administration of chloromycetin, proper sanitation, protection of eatables.
7. Plague A contagious disease which takes the form of an epidemic.
Cause Pasteurella pestis, spread by infected rats. Transfer of infection from rat to man through flea bite or accidental contact with infected rats.
Symptoms Acute body ache, reddish eyes, sudden rise in temperatue, inflammation of neck glands and glands in armpits, and
thighs.
Cure/Prevention Antiplague inoculation, isolation of patient, disinfection of patient’s clothes and utensils, burning of killed rats. Sulpha drugs and streptomycin administration.
8. Typhus A viral infection Cause Rickettsia prowazekii, usually caused by poor hygiene and malnutrition.
Symptoms High fever, skin eruptions, and
severe headache.
Cure/prevention Sulphonamides and antibiotics.
9. Pneumonia
Cause Diplococus pneumonia
Symptoms Chills, pain in chest, rusty sputum, rapid breathing, abdominal pain.
Cure/Prevention Antibiotics
10. Gonorrhoea A venereal disease Cause Neisseria gonorrhea, through sexual intercourse with infected person.
Symptoms Redness, swelling, pus discharge through urethra, painful urination. 
 
Cure Penicillin G, tetracycline.
11. Syphilis
Cause Treponema pallidum transmitted through sexual contact.
Symptoms A hard painless sore on the genitalia, skin eruption.
Cure/Prevention Penicillin, protected sexual intercourse.
12. Whooping Chiefly occurs among infants Cough and children.
Cause Nemophilus pertusis transmitted through air.
Symptoms Severe cough, usually at night.
Cure/Prevention Immunisation of infants with immunity serum

Reference:  http://www.jagranjosh.com/general-knowledge/common-diseases-1291971498-1

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