DOCSLIB.ORG

Lumps, Bumps and Scratches

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Lumps, Bumps and Scratches Lumps, Bumps and Scratches A guide to common equine skin diseases Overview of Lecture • Skin structure and function • Why is my horse itchy? • Ectoparasites: Mites (chorioptic/sarcoptic mange) Lice • Autoimmune/Allergic: Allergies Sweet Itch Pemphigus • Photodermatitis • Fungal disease • Bacterial disease • Neoplasia/tumors • Barrier to water loss and protection from environment • Allows motion and provides shape • Produces glands, hair, hoof, secretions • Storage • Temperature regulation • Pigmentation • Immuno- surveillance/antimicrobial • Sensory perception • Indicator of general health Skin – what a marvelous organ! Ringworm Hives Quiz Pastern dermatitis/Scratches Squamous cell carcinoma Quiz continued • Alopecia – hair loss • Pruritus - itchy • Crusting – exudate stuck to skin, scabs • Scaling – accumulation of loose fragments of the skin • Wheals – raised edematous transient lesions, hair stands up Dermatology terms Symptoms: • Change in behavior • Hair loss +/- excoriations • Hives or other lesions Causes: • Ectoparasites • Allergies • Bacterial/ Fungal The Itchy Horse infections Chorioptic mange: • (leg and tail) – breeds with feathered fetlocks • Symptoms – itching, stamping feet, biting legs, crusts • Diagnosis – skin scrapings to Psoroptic Mange (body or ear examine under microscope mange): • Treatment: Lime sulfur rinses, • Symptoms – evidence of itching, esp fipronil (Frontline) spray, near mane and tail ivermectin can help but not • Diagnosis same as Chorioptes curative • Treament – ivermectin works well. Parasites – mites • Mites and lice more common during cold weather, when there has been crowding, prolonged stabling and suboptimal nutrition. • Lice can be seen in the haircoat, mild- moderate pruritis, alopecia and scaling • Treament – 1% selenium sulfide shampoos, insecticide sprays and powders. Ivermectin effective against sucking lice Lice – sucking and biting • Atopic dermatitis (hypersensitivity to environmental or food allergens) • Culicoides hypersensitivity (Sweet Itch) • Other insect hypersensitivities Allergies • TB’s and Arabs – higher incidence • Multifactorial, genetic • Can be seasonal or non-seasonal • No sex predilection • Younger horses Primary Symptoms: • Pruritis • Urticaria (hives) Secondary Symptoms: • Coat color changes (distorted melanocytes) • Self trauma, excoriations lead to alopecia • Lots of things cause these symptoms so often diagnosed after ruling out other causes. Atopic dermatitis • Intradermal Skin Testing • Gold standard • Performed by a dermatologist (TUSVM) • Allergens used specific for NE region • Does not check for food allergies (dietary trial) • Blood test • Getting better but still inaccurate Diagnostics • Allergen specific immunotherapy (allergy shots) • 2-3 months to see improvement • No cure – • 60-80% of horses improve lifetime of • Injections for life (once monthly treatment for maintenance) • Symptomatic treatments: • Topical sprays • Corticosteroids • Antihistamines • Omega fatty acids • Skin supplements Treatment Options • Insect hypersensitivity • Culicoides (midges, gnats, no-see- ums) • Spring through late Fall • Gets worse each year • Two main patterns • Mane and tail • Ventral midline (belly) • VERY itchy • Excoriation, alopecia, crusting, lichenification • Secondary bacterial infections • Weight loss/anxiety Sweet Itch Insect Control: • Stable during peak times (dawn and dusk) • Flysprays, feed through insecticides • Eliminate larva • Manure pile, fly predators, water sources • Box fans, mesh screens, ceiling fans • Special fly sheets Other treatment options: • Corticosteroids (Prednisolone/Dexamethasone) • Immunotherapy (allergy shots) can help • Dermoscent Essential 6 (“spot on” FA’s, vit E) • Treat secondary bacterial infections • Plethora of remedies… Management • Most common autoimmune disease in horses (though still relatively rare) • Antibodies attack the intracellular cement causing separation of epidermal cells • No breed, age, or sex predilection • May follow a triggering event such as drug administration, illness, or severe stress • Reported in horses with longstanding sweet itch Pemphigus Foliaceus • Clinical signs include: • Severe crusting, scaling and alopecia, usually on the head and legs but can become generalized within 1-3 months • 50% have limb and ventral abdomen edema • 50% have systemic signs such as depression, lethargy, fever, wt loss • Diagnosis: • Rule out other causes such as bacteria or dermatophytes • Biopsy • Treatment: • Corticosteroids (Prednisolone/Dexamethasone) • Avoid sunlight • Shampoo to control pruritis Pemphigus 1. Phototoxicity – classic sunburn 2. Photosensitivity – increased susceptibility to UV radiation • Ingestion/production/contact with photodynamic agents • Primary - Plants: ex. St Johns Wort, rye grass • Hepatic – liver disease or hepatotoxic • Diagnosis: Hx, PE, investigate plants increase levels of pasture, labwork to assess liver phylloerythrin in skin ex: ragwort, disease rape, kale • Treatment: ID and eliminate • Light skinned, sparsely haired areas cause • Avoid UVL • Symptomatic treatment Photodermatitis for skin Dermatophytosis (fungal) • Fall/winter • Young horses • Very contagious – direct contact or fomites • Hair can be contagious for months to years! • Face, neck, girth, classic ring lesions • Not usually pruritic • Tufted papules→scaling, crust → alopecia Ringworm/Girth Itch Rarely transmitted to humans Fungal infections Diagnosis: • Fungal culture on hair plucks • Biopsy Treatment: • Ringworm infections are self-limiting but can take weeks to months • Topical therapy: • 2% Lime sulfur, Enilconazole (Canada), Malaseb shampoo or plegetts • Daily treatment for 5-7 days then 2x/week until resolved • Systemic treatment with antifungals is rarely necessary Control: • Disinfect tack ,brushes, etc with bleach diluted 1:10 Fungal diagnosis & management • Often the result of skin trauma secondary to other disease processes Bacterial infections • Gram + bacteria, likes moisture Symptoms: • Painful crusts • Paintbrush lesions, hair pulls off easily Diagnosis: • Impression smear – looks like train tracks under microscope • Culture Treatment: • Dry weather, dry horse • Bathe with iodine, chlorhex, lyme sulfur, vetericyn • Severe cases may need systemic antibiotics • No immunity so get recurrent cases Rainrot - Dermatophilus congolensis • Caused by same bacteria that causes Rainrot! • Chronic problem • Can be difficult to treat/cure • White legs prone • Can develop into cellulitis (systemic antibiotics) Pastern Dermatitis “scratches/mud fever” In horses skin is the most common site of neoplasia (50%) and most of these are benign Most common tumors: • Sarcoids • Melanoma • Squamous cell carcinoma (eyelid and external genitalia) * Biopsy is the key to diagnosis Treatment options – often multimodal (combination) • Surgery to remove or debulk tumor • Intralesional chemotherapy • Cryotherapy/hyperthermia • Laser therapy • Radiation therapy • Topical biologics ie Aldara • Systemic chemo (rare cases) Neoplasia (skin masses) • Common, locally aggressive, do not metastasize • Not usually life threatening but can affect use of the horse due to location • Etiology thought to be viral, can occur in areas of trauma, wounds • Head, neck, legs and ventrum • Categories: 1. Verrucous (wart-like) 2. Fibroblastic (proudflesh-like) 3. Mixed 4. Occult/flat Sarcoids • Typically locally invasive, slow to metastasize • Increased prevalence in light colored draft breeds, Appaloosas, Paints and Pintos, geldings more often affected. • Most common tumor of eyelid and external genitalia • May look like proudflesh at first • Often painful and may have foul odor Squamous cell carcinoma SCC • Grey horses (although dark horses can get them and they are more likely to be malignant), no sex predilection • Estimated that 80% over 15yrs • Around the eye, under the tail and parotid glands • Usually firm/nodular • Some have a tarry discharge • Cause unknown but thought to be related to abnormal melanin metabolism Melanomas • Three recognized growth patterns: 1) Slow for years without metastasis 2) Slow for years with sudden rapid growth and metastasis 3) Rapid growth and malignancy from the onset • Many horses have metastatic disease on necropsy but most have no clinical signs related to it Treatment options similar for other tumors • Cimetidine – antihistamine with immunomodulatory effects – may help slow the progression of the disease. Melanomas • No breed, age or sex predilection • Many horses have concurrent systemic illness but some can have lesions for months to years before they are sick • Subcutaneous lesions are multiple and widespread • Usually firm nodules involving head, neck, trunk and upper part of limbs Diagnosis – biopsy nodules Treatment – Prednisolone, chemotherapy? Cutaneous Lymphoma • Many skin disorders/infections looks similar • Accurate history from the owner can be very helpful • It is often difficult to diagnose them based on appearance alone • Further diagnostics are often warranted. Take home message: Any Questions? .
Load more

Recommended publications
  • Sweet Itch Factsheet Update April 2020
    Sweet Itch Factsheet Update April 2020 __________________________________________ Clinical Signs In the summer months, it is estimated that over Sweet itch usually presents as a constant severe 50,000 horses suffer from skin allergies. This can be itchiness with multiple crusts and scaling, broken a management nightmare for owners. Some breeds hairs, hair loss and skin thickening. The lesions are of horse are genetically more prone to allergies, normally isolated to mane and tail, and sometimes including Icelandic ponies and Cob types. Allergic on the underside of belly, but can occur anywhere skin disease may be caused by a number of on the body that is in possible contact with the allergens, including feed hypersensitivity. However, allergen. Skin abrasions/wounds can occur from self the most common allergen is the saliva from insect trauma, when the horse or pony rubs on bites, in particular from the Culicoides midge. surrounding available surfaces e.g. fencing/trees. Horses may show irritability, restfulness and weight loss. Culicoides midge What causes Sweet Itch? After exposure to the allergen (saliva from the midge bite), the horse develops a Type 1 hypersensitivity reaction. The allergen binds to mast cells in the skin and causes histamine release. This is Bald tailhead due to intense itching an exaggerated immune response to the bite and results in the clinical signs of intense itchiness or pruritus, and swelling. Clinical signs are Diagnosis characteristically seasonal (April to October). Diagnosis is frequently made based on season and Culicoides midges prefer to land and bite along the clinical signs. However, other allergies can have a mane, back and tail root which corresponds with the similar appearance.
    [Show full text]
  • Genital Lichen Simplex Chronicus (Eczema, Neurodermatitis, Dermatitis) !
    Libby Edwards, MD Genital Lichen Simplex Chronicus (eczema, neurodermatitis, dermatitis) ! Lichen simplex chronicus (LSC), or eczema, is a common skin condition that is very itchy. Although not dangerous in any way, both the itching, and the pain from rubbing and scratching, can be miserable. Eczema/LSC of the genital area most often affects the scrotum of men, the vulva of women, or the rectal skin of both. Many people with eczema/LSC have had sensitive skin or eczema/LSC on other areas of the skin at some point, and many have a tendency towards allergies, especially hay fever or asthma. ! The skin usually appears red or dark, and thick from rubbing and scratching, sometimes with sores from scratching. ! The cause of eczema/LSC is not entirely clear. However, eczema/LSC starts with irritation that triggers itching. Often, at the office visit with the health care provider, the original infection or other initial cause of irritation is no longer present. Common triggers include a yeast or fungus infection, an irritating medication, moisturizer or lubricant, a wet bathing suit, anxiety or depression, over-washing, panty liners, sweat, heat, urine, a contraceptive jelly, an irritating condom, or any other activity or substance that can irritate the skin and start the itching. ! Although rubbing and scratching often feel good at first, rubbing irritates the skin and ultimately makes itching even worse, so that there is more scratching, then more itching, then more scratching. This is called the “itch-scratch cycle.” Treatment is very effective and requires clearing any infection and avoiding irritants as well as using a strong cortisone.
    [Show full text]
  • Lichen Simplex Chronicus
    LICHEN SIMPLEX CHRONICUS http://www.aocd.org Lichen simplex chronicus is a localized form of lichenified (thickened, inflamed) atopic dermatitis or eczema that occurs in well defined plaques. It is the result of ongoing, chronic rubbing and scratching of the skin in localized areas. It is generally seen in patients greater than 20 years of age and is more frequent in women. Emotional stress can play a part in the course of this skin disease. There is mainly one symptom: itching. The rubbing and scratching that occurs in response to the itch can become automatic and even unconscious making it very difficult to treat. It can be magnified by seeming innocuous stimuli such as putting on clothes, or clothes rubbing the skin which makes the skin warmer resulting in increased itch sensation. The lesions themselves are generally very well defined areas of thickened, erythematous, raised area of skin. Frequently they are linear, oval or round in shape. Sites of predilection include the back of the neck, ankles, lower legs, upper thighs, forearms and the genital areas. They can be single lesions or multiple. This can be a very difficult condition to treat much less resolve. It is of utmost importance that the scratching and rubbing of the skin must stop. Treatment is usually initiated with topical corticosteroids for larger areas and intralesional steroids might also be considered for small lesion(s). If the patient simply cannot keep from rubbing the area an occlusive dressing might be considered to keep the skin protected from probing fingers. Since this is not a histamine driven itch phenomena oral antihistamines are generally of little use in these cases.
    [Show full text]
  • Insect Bite Hypersensitivity (Sweet Itch)
    Kafkas Univ Vet Fak Derg Kafkas Universitesi Veteriner Fakultesi Dergisi 25 (2): 277-279, 2019 ISSN: 1300-6045 e-ISSN: 1309-2251 Journal Home-Page: http://vetdergikafkas.org Case Report DOI: 10.9775/kvfd.2018.20330 Online Submission: http://submit.vetdergikafkas.org Insect Bite Hypersensitivity (Sweet Itch) in a Non-Descript Riding Local Breed Mare Tanveer AHMAD 1 Muhammad Saleem AKHTAR 1 Muhammad Mazhar AYAZ 2 Muhammad Mudassar NAZIR 2 Ejaz AHMAD 1 Muhammad Raza HAMEED 2 Maqbool HUSSAIN 1 1 Department of Clinical Sciences, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, PAKISTAN 2 Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, PAKISTAN Article ID: KVFD-2018-20330 Received: 09.06.2018 Accepted: 19.11.2018 Published Online: 23.11.2018 How to Cite This Article Ahmad T, Akhtar MS, Ayaz MM, Nazir MM, Ahmad E, Hameed MR, Hussain M: Insect bite hypersensitivity (sweet itch) in a non-descript riding local breed mare. Kafkas Univ Vet Fak Derg, 25 (2): 277-279, 2019. DOI: 10.9775/kvfd.2018.20330 Abstract Summer itch or insect bite hypersensitivity is common problem during summer in all animals. Some horses are allergic to insect saliva. A 13 year old mare kept for riding purpose at livestock farm FVS, BZU, Multan was examined with a condition characterized by little bumps, papules and abrasions on neck, abdomen, thighs and tail, anaemic mucous membranes, concentrated urine, partial anorexia and generalized emaciation. There was a history of chronic lesion of about more than one year old and many therapies were tried but all non-responsive.
    [Show full text]
  • The Dyshidrotic Eczema Area and Severity Index – a Score Developed for the Assessment of Dyshidrotic Eczema
    Clinical and Laboratory Investigations Dermatology 1999;198:265–269 Received: September 29, 1998 Accepted: February 19, 1999 The Dyshidrotic Eczema Area and Severity Index – A Score Developed for the Assessment of Dyshidrotic Eczema E. Vocks a S.G. Plötz b J. Ring a aDepartment of Dermatology and Allergology Biederstein, Technical University München, and bResearch Center Borstel, Center for Medicine and Bioscience, Borstel, Germany Key Words factors, such as atopic eczema, contact allergy or mycosis, Severity index • Dyshidrotic eczema • Pompholyx • but many cases are also classified as idiopathic [1–3]. As it Treatment study can be very resistant to treatment [4], studies with regard to new therapeutic modalities in dyshidrotic eczema are important. The evaluation of therapeutic effects is carried Abstract out by different methods. In most studies global assessment Background: Dyshidrotic eczema of the palms and soles methods like grading of improvement [5–8] are used. Hand is a common condition, which can be rather resistant to eczema scoring systems which are applied to eczema on the treatment. Therapy studies and their comparability are of palmar and dorsal hands are not specific for the distinct fea- clinical importance. Objective: As standardized assess- tures of dyshidrotic eczema [9]. Since the assessment meth- ment methods for the severity of this particular form of ods for dyshidrotic eczema are not standardized, therapeutic eczema are lacking, we developed a severity index for studies are not comparable and data cannot be utilized for dyshidrotic eczema. Methods: The Dyshidrotic Eczema epidemiologic purposes. As there is no specific scoring sys- Area and Severity Index (DASI) is based on the severity tem existing, we developed a severity index for dyshidrotic grade of single items – number of vesicles per square eczema on the occasion of a half-side treatment study with centimetre (V), erythema (E), desquamation (S) and itch tap water iontophoresis [10].
    [Show full text]
  • Skin Signs of Rheumatic Disease Gideon P
    Skin Signs of Rheumatic Disease Gideon P. Smith MD PhD MPH Vice Chair for Clinical Affairs Director of Rheumatology-Dermatology Program Director of Connective Tissue Diseases Fellowship Associate Director of Clinical Trials Department of Dermatology Massachusetts General Hospital Harvard University www.mghcme.org Disclosures “Neither I nor my spouse/partner has a relevant financial relationship with a commercial interest to disclose.” www.mghcme.org CONNECTIVE TISSUE DISEASES CLINIC •Schnitzlers •Interstitial •Chondrosarcoma •Eosinophilic Fasciitis Granulomatous induced •Silicone granulomas Dermatitis with Dermatomyositis Arthritis •AML arthritis with •Scleroderma granulomatous papules •Cutaneous Crohn’s •Lyme arthritis with with arthritis •Follicular mucinosis in papular mucinosis JRA post-infliximab •Acral Anetoderma •Celiac Lupus •Calcinosis, small and •Granulomatous exophytic •TNF-alpha induced Mastitis sarcoid •NSF, Morphea •IgG4 Disease •Multicentric Reticul •EED, PAN, DLE ohistiocytosis www.mghcme.org • Primary skin disease recalcitrant to therapy Common consults • Hair loss • Nail dystrophy • Photosensitivity • Cosmetic concerns – post- inflammatory pigmentation, scarring, volume loss, premature photo-aging • Erythromelalgia • Dry Eyes • Dry Mouth • Oral Ulcerations • Burning Mouth Syndrome • Urticaria • Itch • Raynaud’s • Digital Ulceration • Calcinosis cutis www.mghcme.org Todays Agenda Clinical Presentations Rashes (Cutaneous Lupus vs Dermatomyositis vs ?) Hard Skin (Scleroderma vs Other sclerosing disorders) www.mghcme.org
    [Show full text]
  • Swimmer's Itch Fact Sheet
    Fact Sheet for the general public Swimmer’s Itch (Cercarial Dermatitis) What is swimmer's itch? Swimmer's itch, also called cercarial dermatitis (sir-CARE-ee-uhl der-muh-TIGHT-iss), appears as a skin rash caused by an allergic reaction to certain parasites that infect some birds and mammals. These microscopic parasites are released from infected snails into fresh and salt water (such as lakes, ponds, and oceans). While the parasite’s preferred host is the specific bird or mammal, if the parasite comes into contact with a swimmer, it burrows into the skin causing an allergic reaction and rash. Swimmer’s itch is found throughout the world and is more frequent during summer months. How does water become infested with the parasite? The adult parasite lives in the blood of infected animals such as ducks, geese, gulls, swans, and certain aquatic mammals such as muskrats and beavers. The parasites produce eggs that are passed in the feces of infected birds or mammals. If the eggs land in or are washed into water, the eggs hatch, releasing small, free-swimming larvae. These larvae swim in the water in search of a certain species of aquatic snail. If the larvae find one of these snails, they infect the snail, multiply and undergo further development. Infected snails release a different type of larvae (or cercariae, hence the name cercarial dermatitis) into the water. This larval form then swims about searching for a suitable host (bird, muskrat) to continue the life cycle. Although humans are not suitable hosts, the larvae burrow into the swimmer’s skin, and may cause an allergic reaction and rash.
    [Show full text]
  • Understanding Eczema / Atopic Dermatitis
    Understanding Atopic Dermatitis An educational health series from National Jewish Health If you would like further information about National Jewish Health, please write to: National Jewish Health 1400 Jackson Street Denver, Colorado 80206 or visit: njhealth.org Understanding Atopic Dermatitis An educational health series from National Jewish Health IN THIS ISSUE About Atopic Dermatitis 2 What Causes Atopic Dermatitis? 3 Do You Have Atopic Dermatitis? 3 Should You Go to an Expert? 4 What Are Your Goals? 4 Avoiding Things that Make Itching and Rash Worse 5 Treatment and Medication Therapy 9 Soak and Seal 9 What Medicines Will Help? 10 Action Plan for Atopic Dermatitis 13 What to Do When Symptoms Are Severe 14 Living with Atopic Dermatitis 15 Remember Your Goals 15 Glossary 16 Note: This information is provided to you as an educational service of National Jewish Health. It is not meant as a substitute for your own doctor. © Copyright 2018, National Jewish Health About Atopic Dermatitis Atopic dermatitis is a common chronic skin disease. It is also called atopic eczema. Atopic is a term used to describe allergic conditions such as asthma and hay fever. Both dermatitis and eczema mean inflammation of the skin. People with atopic dermatitis tend to have dry, itchy and easily irritated skin. They may have times when their skin is clear and other times when they have rash. INFANTS AND SMALL CHILDREN In infants and small children, the rash is often present on face, as well as skin around the knees and elbows. TEENAGERS AND ADULTS In teenagers and adults, the rash is often present in the creases of the wrists, elbows, knees or ankles, and on the face or neck.
    [Show full text]
  • How to Treat Dandruff
    HOW TO TREAT DANDRUFF Dandruff is a common scalp condition in which small pieces of dry skin flake off of the scalp. The most effective way to treat and control dandruff is to use dandruff shampoo and scalp treatments. Follow these tips from dermatologists to get the best results. Dandruff is a common scalp condition in which small pieces of dry skin flake off of the scalp. If you have dark hair or you’re wearing dark colors, you may notice the flakes in your hair or on your shoulders. Dandruff may also make your scalp itch. Many people believe that dandruff is caused by poor hygiene, but this is not true. Although infrequent shampooing can make dandruff more obvious, researchers are still studying the causes, which appear to be complex. The most effective way to treat and control dandruff is to use dandruff shampoo and scalp treatments. Follow these tips from dermatologists to get the best results: 1. Follow the instructions on the dandruff shampoo bottle. There are many different dandruff shampoos, and each contains different active ingredients for controlling symptoms. To get the best results, always follow the instructions on the bottle. For example, some dandruff shampoos require that you lather the shampoo into the hair and scalp and leave the shampoo in for about five minutes before rinsing. Others should not be left on the scalp. 2. If you are Caucasian or Asian, shampoo daily and use dandruff shampoo twice a week. If using one dandruff shampoo does not bring relief, try alternating between dandruff shampoos with different active ingredients.
    [Show full text]
  • Or Moisture-Associated Skin Damage, Due to Perspiration: Expert Consensus on Best Practice
    A Practical Approach to the Prevention and Management of Intertrigo, or Moisture-associated Skin Damage, due to Perspiration: Expert Consensus on Best Practice Consensus panel R. Gary Sibbald MD Professor, Medicine and Public Health University of Toronto Toronto, ON Judith Kelley RN, BSN, CWON Henry Ford Hospital – Main Campus Detroit, MI Karen Lou Kennedy-Evans RN, FNP, APRN-BC KL Kennedy LLC Tucson, AZ Chantal Labrecque RN, BSN, MSN CliniConseil Inc. Montreal, QC Nicola Waters RN, MSc, PhD(c) Assistant Professor, Nursing Mount Royal University A supplement of Calgary, AB The development of this consensus document has been supported by Coloplast. Editorial support was provided by Joanna Gorski of Prescriptum Health Care Communications Inc. This supplement is published by Wound Care Canada and is available at www.woundcarecanada.ca. All rights reserved. Contents may not be reproduced without written permission of the Canadian Association of Wound Care. © 2013. 2 Wound Care Canada – Supplement Volume 11, Number 2 · Fall 2013 Contents Introduction ................................................................... 4 Complications of Intertrigo ......................................11 Moisture-associated skin damage Secondary skin infection ...................................11 and intertrigo ................................................................. 4 Organisms in intertrigo ..............................11 Consensus Statements ................................................ 5 Specific types of infection .................................11
    [Show full text]
  • Lichen Simplex Chronicus (Lsc)
    Buffalo Medical Group, P.C. Robert E. Kalb, M.D. Phone: (716) 630-1102 Fax: (716) 633-6507 Department of Dermatology 325 Essjay Road Williamsville, New York 14221 LICHEN SIMPLEX CHRONICUS (LSC) Lichen simplex chronicus is a form of eczema in the skin. It produces red inflamed scaling and itching areas. The first part of the word lichen refers to the fact that the area is slightly raised. The second part of the word simplex means it is the simple form of the condition. The third word chronicus refers to the fact that the problem tends to be present for many months or in some cases years. The exact cause of lichen simplex is unknown. In many cases the problem, which caused the original skin condition, has long since gone away. The original condition, however, set up a pattern where the skin was itched and scratched. This caused more itching and more scratching. Eventually this creates an itch/scratch cycle, which allows the condition to persist. This is despite the fact that the original problem is gone. In many cases, nerves and stress contribute to this itch/scratch cycle. Patches of lichen simplex can be seen in any area of the body. Some of the more common areas are the neck, private area, and around the ankles. Some patients have only one spot on the skin. Some patients have a large number of areas. Lichen simplex is not a sign of an internal problem. It is not a sign of cancer or any contagious skin problem. Fortunately, lichen simplex can be controlled in most cases.
    [Show full text]
  • Exanthems and Drug Reactions
    Dermatology Exanthems and Morton Rawlin drug reactions ‘Well, Mr Jones, I think we should put you on this tablet to Background fix this problem. Now, the things you need to look out for Drug reactions are a common cause of rashes and can vary are any rashes…’ from brief, mildly annoying, self limiting rashes to severe conditions involving multiple organ systems. How often in general practice do you hear yourself Objective offering this advice? Why do almost all drugs list rash as This article outlines an approach to exanthems that a side effect? How do they occur and what can you do to may be related to drug reactions and details appropriate recognise and manage them? management. The skin is the largest organ of the body and, from a diagnostic Discussion viewpoint, we can see it change to various stimuli. Medications Rashes related to drug reactions are both nonallergic and allergic. Nonallergic rashes are usually predictable and are commonly used and are integral to the general practitioner’s may be avoidable. Allergic rashes include morbilliform armamentarium for treating most ills. However, it is also important erythema, urticaria and angioedema, erythema multiforme to note that increasing access to medications by consumers through and vasculitic rashes. The vast majority of cases are other health professionals (eg. naturopaths) and the self prescribed rapidly resolving and self limiting once the offending use of over-the-counter, complementary and alternative medicines agent is removed. Early recognition and supportive should be remembered in the history taking of a patient presenting measures are the keys to care in the majority of cases.
    [Show full text]