Pharmacotherapy/Treatment Of Non-infectious Skin Disease

Not all skin disease are caused by an infection either macro or microorganism. Many are non infectious. However, they may not be significant to require medical intervention.

Dermatitis

Dermatitis is a group of skin conditions that cause inflammation of the skin. They are allergic in nature with few of unknown origin.

Contact Dermatitis

This is as a result of physiological reaction when the skin comes in contact with irritants or allergens. It is more common from irritants which make up about 80 percent than allergens which make up the remaining 20 percent. Irritants are the major cause of adults who contract dermatitis.

Treatment of contact dermatitis
Contact dermatitis
FOTO gallery

Symptoms

1. Mild redness and swelling of the skin

2. Blistering of the skin

3. Itch

4. Scaling and temporary thickening of the skin

Cause

Irritants include soap, saliva, food, detergent, lotions, perfumes, creams, poison ivy, latex, cosmetics, medication like neomycin and over 3000 chemical agents (Mikel, chrome and mercury).

Pharmacotherapy/Treatment Of Contact Dermatitis

Wash the part that came in contact with the reactant with water and soap before irritation begins. The use of cold compress can relieve symptoms. Best to prevent contact with irritants.

Atopic Dermatitis

This is popularly called eczema. It is more common in children. It rarely persists after adolescent age and adulthood. However, few persons still experience it at old age.

Treatment of atopic dermatitis
Atopic dermatitis
FOTO gallery

Read Also: Treatment of Parastic skin Infection

It is kind of hereditary. Parents with eczema may most likely have children with the disease. About 65 percent of children under one year will show symptoms while at least 90 percent under five will show symptoms.

Symptoms

It is a dry scaly skin with small raised bumps. It can open and weep when scratched because it can be itchy sometimes. Others are red swelling of the skin with a thickened skin which is characteristic of a chronic eczema. Other symptoms may show if there is secondary infection.

Symptoms are common on the face, outside the elbows and on the kneel of children. Adults normally find eczema on the hands, feet and back of the kneel.

Cause

1. Environmental stress

2. Allergies

3. Sweating

Diagnosis

Blood test

Pharmacotherapy/Treatment Of Atopic Dermatitis

There is no cure for eczema. Treatment is aimed at reducing symptoms. The choice of treatment is based on the age of the person, health and medical conditions. Other considerations are severity of the disease, target result and adherence to the treatment method.

Topical immunomodulatory steroids are steroid free preparation for relieving itch, redness and pain caused by eczema. Topical steroids can also  reduce itch and inflammation. Moisturizer can protect the skin from secondary infection. Two creams, tacrolimus and pimecrolimus are the best treatment for eczema but not for children below two years of age. Oral antihistamine to decrease the itch. The use of oral antibiotics is to treat secondary bacteria infection.

Prevention is simply to avoid known irritants. Fingernails should be cut short to prevent injury when scratching the areas. Also, it is wrong to scratch when it itches. Gentle tap on the area can relieve the itch.

Diaper Dermatitis

Diaper dermatitis is also known as diaper rash. It is a term used to describe rash in the diaper area of children. Since children are the only ones that wear diapers, this condition affects only children. It is common in children between the age of two to twelve months but more from nine months.

Diaper rash is the irritation of the skin that is common in babies. In the United States of America (USA), it is estimated that about 35% of children below 2 years of age will suffer diaper rash. Do you know that diaper rash is also called toilet dermatitis? Yes it is.

Treatment of diaper rash
Irritant diaper rash
Source: wiki

Causes

Diaper rash is caused by different things. It could be irritants or infection. Irritants such as faeces or urine from the baby can trigger allergic dermatitis. Urine is acidic and this leads to irritation of the skin and also allows yeast and bacteria to thrive. Sitting too long on a soiled diaper from urine and faeces or from sitting in a moist environment can lead to diaper rash. Tight diapers make this condition worse. Some chemical use in washing diapers or found in pampers can trigger it too.

Low immune systems of the baby can predispose the child to diaper rash. Things that can reduce immunity is dehydration. It is also common in children just introduced to solid food or take antibiotics.

Other triggers are soap and detergent. Seborrheic diaper dermatitis (dandruff) is another form of diaper dermatitis. Doctors don't yet know the exact cause of seborrheic dermatitis. It may be related to:

1. A yeast (fungus) called malassezia that is in the oil secretion on the skin

2. An irregular response of the immune system

Symptoms

Seborrheic diaper dermatitis affects the skin folds in the groin area with pink colour. It can also be found on the face, scalp or neck. It is characterized by white fine white scales on the head and scalp. It is common in infants and clear within the first year.

Contact diaper dermatitis appears on the buttocks to the thigh, stomach and waist with shiny red colour. It appears as burning and red bumps that may feel warm to touch. It is sometimes accompanied with a strong urine odour. Serious cases involve blisters, weepy rash with fever.

Diagnosis

Observation of the location and the appearance of the rash. Also, skin biopsy.

Pharmacotherapy/Treatment Of Diaper Dermatitis

There are medicated diaper creams containing zinc oxide (10-40 percent). They should be applied to the affected part as it helps relieve symptoms. Non steroidal anti inflammatory creams help with the inflammation while moisture resistant diaper creams can relive as well as treat diaper rash. Corticosteroids such as hydrocortisone, desonide, clobetasol and fluocinonide cream, lotion or shampoo help with the itching and inflammation.

Pimecrolimus and tacrolimus cream is effective for most types of rash. 2% ketoconazole or 1 ciclopirox antifungal cream is also indicated for diaper dermatitis 

Hygiene remains the best method to prevent diaper rash. Soiled diapers should be changed quickly. The baby should be allowed to go on for some time without diapers.

Acne

Acne is a skin disease that affects a large population of people estimated to be over 17 million worldwide. It is common among adults and begins mostly after puberty. It occurs in the face, neck and chest. Rarely occur in the back, shoulders and upper arm. It is commonly called pimples. However, pimples is one of the symptoms of acne. Not all acne present with pimples as symptoms.

Treatment of acne
Acne
Source: wiki

Symptoms

1. Black head

2. White head

3. Nodules (solid raised bumps)

4. Pus filled lesions that may be painful (pimples)

Cause

Acne begins with incomplete blockage of the hair follicle which results in black head. A complete blockage resulted in white head. The major cause of white head is irritation and infection. The clogged follicle burst open releasing its content (oil, bun and bacteria) onto the nearby skin causing further irritation and spread.

Acne is also caused by clogged sebaceous glands in pores of the skin. The sebaceous glands produce oil (sebum) which normally travels via hair follicles. Blocking the oil, skin bacteria called propionibacterium acnes or p. acnes grow inside the follicle. The skin is elastic in nature. As the bacteria multiple, the skin stretches to accommodate them causing inflammation.

In most people, it begins during puberty. It is triggered by the make sex hormone that grows in boys and girls. The hormone increases the activity of the sebaceous glands. This in turn makes the sebaceous glands produce more sebum or oil.

Other causes are the use of certain drugs (corticosteroids) or reactions to drugs. Oil, grease from scalp, cooking oil or cosmetic may worsen acne. Bacteria inside the pimples, squeezing or scrubbing the skin too hard are also some of the cause.

Pharmacotherapy/Treatment Of Acne

Topical medication comes in the form of creams, lotion, gels, solution and lotion. These products are either benzoyl peroxide, clindamycin and tretinoin. These products are meant to stop the development of new lesions and encourage each turnover unplugging pimples. Adapalene decreases acne format.

Oral medications contain antibiotics for treating pimples which include clindamycin, doxycycline, erythromycin and tetracycline. Oral isotretinoin is to reduce the skin size of the sebaceous gland and increase skin shredding. It clears off up to 40 percent of pimples but it's side effect calls for concern like psychosis.

Drug Rash

Drug rash is any rash that appears in any part of the body associated with any medication. Medication could be topical, oral, injectables. They appear due to allergic reaction, unusual side effects or hypersensitivity to sunlight due to medication use.

Treatment of drug rash
Drug rash

Cause

Acne: anabolic steroids, corticosteroids, phenytoin, etc

Exfoliative dermatitis: antibiotic with sulfa, penicillin, isoniazid and phenytoin

Hives: aspirin, some drug dyes, penicillin, etc

Fixed drug eruption: antibiotic and phenolphthalein (laxative)

Morbilliform/maculopapular rash: antibiotic and barbiturates

Purpuric eruption: certain anticoagulant and diuretic

Steven Johnson syndrome: Antibiotics with sulfa, barbiturates, penicillin, etc.

How It Happen

Drug rashes and reactions happen for several reasons, including:
1. an allergic reaction
2. a buildup of the drug that causes toxicity to the skin
3. a drug makes the skin more sensitive to sunlightinteraction of two or more drugs

Diagnosis

This is not an easy task. Symptoms similar to other skin diseases of which  no laboratory result will give anything. The only way to know is to do a thorough medication history.

Pharmacotherapy/Treatment Of Drug Rash

The use of corticosteroids and antihistamine to reduce inflammation and itching. Suspected medication should be stopped immediately except for drugs necessary to sustain life and the patient is put under observation.

Read Also: Treatment of virus Infection

A couple of complications are possible such as wheezing, difficulty in breathing, chests pain, fainting, nausea and vomiting, tightness in the heart and chest.

Poison Ivy/Poison Oak

Poison ivy, poison oak and sumac is a tree that causes allergic reactions in about 85 percent of the people who come in contact with it.

Pharmacotherapy of poison oak rash
Poison oak rash
FOTO gallery

Symptoms

Contact dermatitis that occurs several hours, days or weeks after exposure. It always begins with a rash, bumps and the blisters that itch. The final symptom is that the blister bleeds, oozes and the crust over.

Cause

Urushiol oil is the culprit in the tree. Contact with the tree itself or the oil result in the condition. The oil can retain its potency on any surface for up to a year and it can spread by smoke from burning the trees.

Pharmacotherapy/Treatment Of Poison Oak, ivy

Steroid cream, oral steroid or steroid injection can help relieve the itching and swelling. Calamine lotion is also indicated for poison oak rash. Prevention is avoiding the tree. Contaminated skin should be washed within 8 hours of contact with soap and water. When there is no soap and water, an alcohol based solution should be used. Contaminated surface should be cleaned.

Topical Epidermal Necrolysis

Blistering and peeling skin of unknown origin. In rare cases, it is caused by antibiotics and anticonvulsants.

Treatment of topical Epidermal Necrolysis
Topical Epidermal Necrolysis
FOTO gallery

Symptoms

Skin levels in the sheet leave large raw areas. The area can become infected after losing fluids and salt. It feels discomfort and can be accompanied by fever which progress within 3 days

Pharmacotherapy/Treatment Of Topical Epidermal Necrolysis

To prevent infection, the first step is to isolate in a sterile ward or room. Protect the damage area. Give intravenous (IV) fluids to replace lost electrolyte. IV Immunoglobulin G is effective in relieving symptoms. Oral or parenteral antibiotics may be needed in case of secondary infection.

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