are required. Some of these conditions are: lack of cleanliness; excessive moisture,
usually due to perspiration; and irritation of the skin, usually because of tight clothing.
(1) Dermatophvtosis pedis. Dermatophvtosis pedis (also called tinea pedis
and athlete's foot) may be recognized by the presence of superficial fissures between
and toes, and vesicles on the sides and beneath under the toes. If secondary bacterial
infection occurs, pustules appear, and ulceration may result.
(2) Dermatophvtosis (tinea) corporis, capitis, and cruris. These fungous
infections are commonly called ringworm. Dermatophytosis (or tinea) cruris is also
called "jock itch." The diagnosis of ringworm is made by the presence of a few (usually
not over two or three) circular, ring-like, red, scaling lesions, clearing at the center, with
advancing vesicular margins. Tinea cruris is distinguished by its location on the upper
surface of the thighs. Excessive perspiration and friction from clothing are important
contributing factors. Therefore, an important part of the treatment consists of exposing
the involved parts to the air as much as possible.
e. Arthropod Infestations and Infections. The arthropods are many-celled
animals with outer skeletons but without backbones, and include such organisms as
crayfish, spiders, mites, ticks, centipedes, and insects (lice, mosquitoes).
(1)
Pediculosis. Pediculosis is an infestation of the skin with lice.
(a) Diagnosis of louse infestation. Lice have a habit of living in the
clothes and bedding of patients and coming out only at the night to feed. This fact must
be taken into account when examining a patient suspected of being infested. The small
louse bites may be quite difficult to locate in the absence of the louse, although the
patient has usually scratched the skin in the area very vigorously, leaving scratch
marks.
(b) Treatment. Pediculosis is treat by application of gamma benzene
hexachloride (Lindane).
(2) Scabies. Scabies is a disease caused by a very small mite that burrows
into the skin. The infection often begins between the fingers, and spreads to the body,
especially the lower abdomen, buttocks, and genitalia. The mite causes much itching
(especially at night), and there is abrasion of the skin from scratching. Secondary
infection by bacteria may occur, with the formation of pustules. The abrasions and
pustules often obscure the typical lesions of scabies, which are threadlike, twisted
lesions with a small raised area at one end. All washable clothing should be thoroughly
laundered, and other clothing dry-cleaned.
f. Allergic Conditions. In allergic conditions, the patient is sensitive to certain
foreign substances that may contact his skin, or be introduced into his body in the food
he eats or the air he breathes. A first contact is necessary to produce the sensitization,
following which the patient reacts to contact with the foreign substances in an abnormal
manner. Some substances can provoke an allergic reaction in anyone contacting them.
MD0804
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