hereditary. Psoriasis is found in two thirds of all adult white males but is rarely found in blacks.
- It is clearly defined erythematous papules covered with shiny or opalescent scales. The patient may complain of itching. The lesions are usually self-healing and heal without scarring. The scalp, extensor surface of extremities, back and buttocks, and the nails
are the most common sites. A secondary bacterial infection may occur.
There is no known cure for psoriasis. The existing treatments may produce temporary relief. Corticosteroid cream is the most widely acclaimed of the various treatments and should be applied at bedtime. Cover the lesions with polyethylene strips during the night. In the morning scrub the lesions thoroughly with a soft brush to remove scales. Repeat the treatment until the sysmptoms are relieved. Refer the patient to a dermatologist for routine evaluation. There are other treatments that may prove effective in t resting psoriasis. Request advice on them from a dermatologist.
Acne is probably the most commonly encountered dermatitis. It is an inflammatory disease occurring in areas where sebaceous glands are the largest, most numerous, and most active. Human sebum is a tissue irritant. Overfilling of the sebaceous glands or squeezing by the patient causes this irritant to escape into the surrounding tissue and develop a papule. A secondary bacterial infection occurs, leading to pustule or cyst formation. These formations may lead to pitting and scarring.
The initial treatment
of acne should include advice to the patient to avoid contributing foods, such as chocolate, nuts, and colas. Vitamin A supplements are sometimes given for 3-month periods, with a l-month interruption to avoid hypervitaminosis. Intruct the patient to thorougly wash twice daily with an antibacterial, abrasive soap. A drying lotion may be used. A broad-spectrum antibiotic administered systemically may be given during episodes of severe acne. Tetracycline is the most widely used of these drugs
. Use of this regimen should be restricted to only the most severe cases due to the side effects of tetracycline or other antibiotics of this type.
This is an acute or chronic scaly inflammation of the skin that usually affects the scalp, face, presternal and interscapular areas, and body folds. It occurs in persons with oily skin. Also, hereditary factors appear to play a part in this condition.
These include scaling that may be greasy or dry and sometimes pruritic. Redness, fissuring, and infection may be secondary.
A well-balanced diet with the reduction of sweets is indicated. Steroid creams and lotions are often beneficial, and the patient should be advised to wash with an antiseborrheic cleanser, such as Fostex®
This is an acute or chronic allergic inflammatory skin reaction. It is normally the result of ingesting certain foods or drugs (commonly shellfish, eggs, milk, and penicillin).
Raised wheals may occur over any or all of the body and itch intolerably. The patient may run a mild fever and experience general malaise. Swelling may cause laryngeal obstruction.
Antihistamines are indicated for itching. Urticaria is usually self-limiting, but may last for years. Caution the patient to avoid reexposure to sensitizing foods or drugs. Epinephrine 1:1000 may be administered for laryngeal obstruction.
Calluses and Corns
These are callous skin lesions that normally occur on the feet or toes. Faulty fitting shoes are the common cause.
There is usually tenderness or sensitivity to pressure. These lesions may be differentiated from plantar warts by their glassy cores.
Soak the affected area in warm water and carefully pare the callus. Correct any orthopedic abnormalities, and make sure the patients shoes fit correctly.