moluscum contageosum

Molluscum contagiosum is an infection caused by proxy virus.The lesions, known as Mollusca, are small, raised, and usually white, pink, or flesh-colored with a dimple or pit in the center. They often have a pearly appearance. They’re usually smooth and firm. In most people, the lesions range from about the size of a pinhead to as large as a pencil eraser (2 to 5 millimeters in diameter). They may become itchy, sore, red, and/or swollen.

Mollusca may occur anywhere on the body including the face, neck, arms, legs, abdomen, and genital area, alone or in groups. The lesions are rarely found on the palms of the hands or the soles of the feet.

Dermatitis Herpitiforms

Dermatitis herpetiformis (DH) is a rare but persistent immunobullous disease that has been linked to coeliac disease

• DH predominantly affects Caucasians aged 15–40 years, but may occur in those younger or older and in other races.
• There is a 2:1 male-to-female ratio.
• More females under the age of 20 are affected than males.
• There is a genetic predisposition and association with human leukocyte antigens (HLAs) DQ2 and DQ8.
• Some patients have a personal or family history of other autoimmune disorders such as viteligo, type 1 DM, alopasia
• DH and coeliac disease are due to intolerance to the gliadin fraction of gluten found in wheat, rye and barley.
• Gluten triggers production of IgA antibodies and an autoimmune process that targets the skin and gut.
• In coeliac disease, gluten causes intestinal inflammation resulting in diarrhoea, tiredness, weight loss and abdominal discomfort.

What are the clinical features of dermatitis herpetiformis?

• DH has a symmetrical distribution.
• Lesions most commonly appear on scalp, shoulders, buttocks, elbows and knees.
• It is characterised extremely itchy papules and vesicles on normal or reddened skin.
• They often appear in groups or serpiginous clusters.
• Blisters are often eroded and crusted due to immediate scratching.
• DH may also present initially as digital petechiae.
• Flat red patches, thickened plaques and wheals may occur resembling other inflammatory skin conditions such as dermatitis, scabies and papular urticaria. 
• Lesions resolve to leave postinflammatory hypopigmentation and hyperpigmentation.

Lichen planus

Lichen planus is a chronic skin condition. It causes itchy, flat, scaly patches on the wrists, legs, trunk, or genitals. It can also affect the inside of the mouth and vagina. There it resembles a white spider web. It may ulcerate. Rarely, it can also become cancerous. The scalp and fingernails can also be affected. It may become wart-like in thickness. Lichen planus may continue on and off for months or years. Scratching makes this condition worse.
A 53-year-old woman presents with intensely itchy skin lesions and burning in her
mouth, which makes eating difficult. These signs and symptoms have become progressively
evident during the past several weeks. Examination of her skin and oral
cavity reveals violaceous, polygonal papules, mainly on the flexural aspect of the
wrists and ankles and in the lumbar region, as well as erosions associated with a lacelike,

white-line network apparent in the posterior buccal mucosa. How should this manage?
The major burdens of lichen planus are itching and residual hyperpigmentation in the cutaneous form and pain and
difficulties with eating in the oral erosive form.
• With the exception of the cutaneous form, which generally heals within 1 year, lichen planus is a chronic condition.
• Given reports of a significant association between lichen planus and infection with the hepatitis C virus (HCV), HCV
serologic testing should be considered in all affected patients.
• In the case of lesions that persist despite treatment, biopsy specimens should be assessed for early dysplasia or
squamous-cell carcinoma, since these conditions have been reported in association with lichen planus.

Most lichen planus is relatively mild. Affected individuals who do not have symptoms do not need treatment. Ultimately, there is no agreed-upon cure for this condition.

https://www.blogger.com/blogger.g?blogID=6294202302428872992#editor/target=page;pageID=6940748946264721553;onPublishedMenu=pages;onClosedMenu=pages;postNum=3;src=pagenameIf the itch or appearance of the rash are unpleasant, topical corticosteroid creams may be of help. Topical steroid creams that, for example, are unwrapping or taped at bedtime may also be useful when practical. For localized, itchy, thick lesions, injections ofmay be given.may blunt the itch, particularly if it is only moderate. This effect is in part due to the sedative effect of antihistamines.

Scabies

Scabies 
What is scabies?Scabies is a parasitic infestation in which Sarcoptes scabei mites burrow under the skin and cause intense itching.

What are the symptoms of scabies?Aside from intense itching, which usually is worse at night, symptoms may include hive-like bumps on the skin. These lesions tend to first appear between the fingers or on the elbows, wrists, buttocks, or waist. The mites can also burrow under fingernails or around the skin near watchbands or rings. The itching of scabies results primarily from the body's allergic reaction to the mites, their eggs and their waste.

Vigorous scratching can break the skin and allow a secondary bacterial infection to occur. Superficial infections of the skin, known as impetigo, are caused most often by staph (staphylococcal) and occasionally strep (streptococcal) bacteria. These bacterial infections can cause localized inflammation marked by redness, swelling, heat and pain as well as a honey-colored exuded fluid.

Scabies can become a serious problem in those with weakened immune systems, such as people with HIV or cancer. Scabies can also be an issue for those with chronic illnesses or living in institutionalized settings such as hospitals, rehabilitation centers, childcare facilities and nursing homes. If the condition becomes chronic, a more severe and very contagious form of scabies may develop called crusted scabies, which causes a hard, scaly rash that covers large areas of the body and can be difficult to treat.

Prevention: To prevent re-infestation and the spread of mites to other people, use hot, soapy water to wash all clothing, towels and bedding that were used at least two days before treatment. Machine-dry with high heat. Dry-clean items you can't wash at home. Vacuum the whole house carefully and throw away the vacuum cleaner bag to prevent any mites from escaping into the house.

Apply permethrin 5% cream or  benzyle benzoate 25% immulsion . For children less than 2 months use sulfer 5% cream for 2-3 days or crotamitone 10% cream for 3-5 days.For infected scabies use flucloxacilline or erythromycine. 

Consider placing items you can't wash in a sealed plastic bag, and leaving it