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Chapter-26 Dermatology

BOOK TITLE: IAP Management Algorithms for Common Pediatric Illnesses

Author
1. Thomas Jayakar
2. Kumar Parimalam
ISBN
9789352501977
DOI
10.5005/jp/books/12810_27
Edition
1/e
Publishing Year
2016
Pages
8
Author Affiliations
1. Kanchi Kamakoti Childs Trust Hospital, Chennai, Sree Balaji Medical College, Chromepet, Chennai, Tamil Nadu, India, Sree Balaji Medical College and Hospital, Chromepet, Chennai, Tamil Nadu, India, Kanchi Kamakoti Childs Trust Hospital and Mehta’s Hospital, Chennai, Tamil Nadu, Childs Trust Hospitals, Chennai and Apollo Hospitals, Chennai, Sree Balaji Medical College, Chennai, Tamil Nadu, India, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, Sree Balaji Medical College and Hospital and Bharath University, Chennai, Tamil Nadu, India, Sree Balaji Medical College, Chennai, Tamil Nadu, India; Indian Society of Teledermatology; International Society of Teledermatology, Sree Balaji Medical College and Hospital, Bharath University, Chennai, Tamil Nadu, India, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India, Madras Medical College, Chennai, Kanchi Kamakoti CHILDS Trust Hospital, Chennai 2, West Mada Church Road, Royapuram, Chennai 600013
2. Stanley Medical College, Chennai, Tamil Nadu, India, Thanjavur Medical College, Thanjavur, Tamil Nadu, India, Villupuram Medical College, Villupuram, Tamil Nadu, India, Government Villupuram Medical College, Villupuram, Tamil Nadu, India, Government Villupuram Medical College, Villupuram, Tamil Nadu, Government Royapettah Hospital, Chennai, Tamil Nadu, India, Stanley Medical College and Hospital, Chennai, Tamil Nadu, India
Chapter keywords
atopic eczema, insect bite reaction, Scabies, decontamination protocol, bullous impetigo, Topical antibiotic ointment, noninfectious diseases, epidermal dwelling mite, superficial fungal infections, systemic therapy, autoinoculation

Abstract

This chapter provides an overview of scabies and impetigo, atopic eczema, superficial fungal infections, and insect bite reaction. Scabies is associated with an infestation of the skin by an epidermal dwelling mite, Sarcoptes scabiei. Scabies is a highly contagious condition that is primarily transmitted through close contact and occasionally through exposure to infested clothing, bedding or other household items. Risk factors for infestation include crowded living conditions, health care facilities and institutions. Initial therapy includes topical 5% permethrin cream, applied overnight to entire body except face. Rinse thoroughly and follow decontamination protocol. All clothing and bedding used prior treatment should be washed in hot water with detergent and dried in a dryer. Nonwashable garment, bedding and other items should be sealed in plastic bag for at least 72 hours or dry-cleaned if possible. Patients should remain in contact precautions for 24 hours following treatment. The major failure in managing scabies is not confirming the diagnosis by skin scrapings prior to treatment. Subsequent therapy must often be empiric. Since many persons must often be treated, undocumented diagnosis should be avoided. Impetigo is a contagious superficial epidermal infection that is common in children, with a peak incidence between ages 2 and 6. The two major forms of impetigo, bullous impetigo and nonbullous impetigo (impetigo contagiosa) can masquerade as noninfectious diseases, as both may lack characteristic signs of acute infection. Topical antibiotic ointment is applied thrice daily to infected lesions for 3–5 days is equally effective as systemic therapy. Atopic dermatitis can affect all age groups from newborns to adults, but is far more prevalent among children. The prevalence of atopic dermatitis in developing countries is estimated 15–20% for children and 2–10% for adults. Superficial fungal infections of the skin, nails, and hair are extremely common, with infection of the hands and feet being most prevalent. The spread is primarily from human to human, although contagion of animals to humans, autoinoculation, and spread through fomites are possible modes of transmission in some cases.

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