By Colette van Hees, Ben Naafs

This up to date, photo-illustrated advisor, which covers Southern, East and West Africa, presents a brief and simple reference for analysis and administration of universal epidermis illnesses, together with leprosy. pores and skin disorder is usually ignored as a trivial but if care is taken to make the right kind prognosis and institute the right kind remedy, the administration of dermis ailments frequently ends up in nice development and pride for the sufferer and wellbeing and fitness care paintings alike. Required remedies needn't be pricey and come in the neighborhood. in lots of situations epidermis sickness should be a hallmark of alternative difficulties, relatively if encouraged by means of concommitant HIV an infection. The common creation of antiretroviral remedy (ARV) has ended in particular dermis problems as a result of immune reconstitution syndrome (IRIS), for that reason right analysis and therapy provision are vital matters handled during this advisor.

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51. A HIV positive patient with seborrhoic eczema of the armpit and a scar from a previous herpes zoster infection. PITYRIASIS ROSEA This is probably an ide reaction to a viral infection ("a flu of the skin"). There is sometimes a flu-like prodromal episode. Skin symptoms start with a large "herald patch" or "mother patch" on trunk or arms, which many patients can point out to you. Soon after, many smaller oval lesions which scale at their borders appear on the trunk and (upper) arms. Typically the lesions take on the direction of the skin lines forming a "Christmas tree pattern" on the back.

For severe itch: calamine lotion and/or antihistamines. - Coal tar 2-6% ointment nightly. - Strong topical steroids combined with salicylic acid 5% once to twice daily. - Refractive lesions: Apply strong steroid at night and cover with plastic 2 nights a week (see lichen simplex). This improves penetration of the steroid. - Widespread, severe forms: a short course of prednisolone may be tried: start with 30 mg daily for a week then reduce to zero in two weeks.

66 Management of onchocerciasis - Treat secondary infection with antiseptics or antibiotics as impetigo and secondary lichenified eczema as lichen simplex. - Ivermectin kills microfilariae with a single oral dose. The adult worms are not affected however. A patient staying in an endemic area will therefore need repeated treatment every 3 to 12 months depending on the amount of itching. If the patient moves out of the endemic area repeated treatment may cure the infection as the adult worms will die after a few 91 years.

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