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Ichthyosis
vulgaris | Idiopathic guttate hypomelanosis
| Impetigo | Ingrown
toenails | Intertrigo
ICHTHYOSIS VULGARIS
The term ichthyosis
(Ichthyus is a Greek word meaning "fish") refers
to a group of hereditary disorders characterised by dryness and
scaling. The most common and mildest form is known as ichthyosis
vulgaris and is described in greater detail below. More severe
and rare forms include X-linked ichthyosis which is transmitted
by the X-chromosome (hence, only males are affected and women
are carriers), lamellar ichthyosis which is transmitted
by an autosomal recessive gene (which means both parents of the
affected person carry the defective gene) and epidermolytic
ichthyosiform dermatosis (which is transmitted by an autosomal
dominant gene). The latter two forms can appear at birth and involve
the whole body causing an erythroderma.
Cause
- Ichthyosis vulgaris
is inherited in an autosomal dominant manner which means about
half the offsprings will be affected if one parent carries the
gene for ichthyosis vulgaris.
Symptoms
- Ichthyosis vulgaris
appears at or soon after birth, usually around 3 months of age
and gets better with age.
- Fish-like scales on
the shins (most commonly), arms and back.
- The rest of the skin
may show fine powdery scaling or xerosis.
- The creases on the
palms are often accentuated.
- Keratosis
pilaris is
frequently present.
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Ichthyosis vulgaris.
Click
on mage for larger view |
- What you can do
- You should consult
a doctor.
- Apply moisturisers
as for xerosis.
- Avoid drying soaps.
What the doctor
may do
- Confirm the diagnosis.
- Prescribe keratolytics
(products that facilitate the removal of scales from the skin
surface).
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IDIOPATHIC GUTTATE HYPOMELANOSIS
This condition causes
depigmentation of the skin. It usually affects middle-aged.
Cause
- Sun-damage.
Symptoms
- 2 - 5mm porcelain
white spots with clearly defined borders.
- Affects the sun-exposed
skin on the back of the hands and forearms, the shins and occasionally,
the back.
What you can do
- You should consult
a doctor as vitiligo needs to
be excluded.
- Protect your skin
against sun-damage (see sun
protection).
What the doctor
may do
- Exclude vitiligo.
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IMPETIGO
Impetigo a superficial
bacterial infection of the skin, seen most commonly in children.
Ecthyma is a deep, ulcerative form
of impetigo. Impetigo is contagious and may spread form one person
to another or from one site to another. Any part of the body may
be affected, especially exposed areas such as the face (commonly
around the nose and mouth), buttocks and limbs. Impetigo may develop
after minor skin trauma such as a scratch, a cut or an insect
bite or in areas of skin affected by eczema and scabies (secondary
impetigo). Bullous impetigo is a variety of impetigo that begins
as large flaccid blisters.
Cause
- Streptococcal bacteria,
staphylococcal bacteria or both.
- Bullous impetigo is
caused by the staphylococcal bacteria.
Predisposing factors
- Overcrowding.
- Poor personal hygiene.
- Family members harbouring
the bacteria (healthy carriers).
- Neglected skin trauma.
- Itchy skin disorders
which cause scratching such as eczema and scabies.
Symptoms
- Pustules (pusheads)
or small blisters that rupture easily, releasing a yellow exudate
that dries into golden-yellow crusts.
- The crusts can be
removed easily, leaving a raw weeping surface that rapidly becomes
encrusted again.
- Bullous impetigo begins
as larger flaccid blisters. These rupture easily and leave a
lacquer like base.
- Itch may be present.
- Lymph glands draining
the area may become enlarged.
Complications
- Glomerulonephritis
(kidney inflammation) may complicate impetigo caused by the streptococcal
bacteria.
What you can do
- You should consult
a doctor.
- Cover the area with
gauze.
- Wash the area with
soap and water three times a day and gently remove the crusts.
Warm compresses for
about 10 minutes will aid the removal of crusts.
- Change soiled dressing
frequently.
- Change the sheets
daily.
- Observe careful hygiene.
Do not share personal items such as towels and clothes.
- Infected children
should stay away from school for at least 48 hours after the
start of antibiotics.
- Key points
- Recurrent impetigo
may be due to a carrier who may be carrying the bacteria in the
nostrils. Family members may need to be screened for infection
and treated accordingly.
What the doctor
may do
- Take a swab for bacterial
culture and sensitivity.
- Treat with antibiotics.
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INGROWN
TOENAILS
Ingrown toenails are
caused by the one or both edges of the nail growing into the skin.
Causes
- Poor nail cutting
technique.
- Poor fitting shoes,
especially high-heeled pointed women's shoes.
Symptoms
- Pain, swelling and
inflammation of the nail folds.
- Pus draining out from
under the nail folds.
Complications
- Bleeds if traumatised.
- Pyogenic
granuloma.
What you can do
- You should consult
a doctor.
- Lift the corners of
the nails with a wad of cotton.
- In future, cut the
nail straight across.
What the doctor
may do
- Prescribe antibiotics.
- Surgery to remove
all or a strip of nail with the adjacent skin.
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INTERTRIGO
Intertrigo refers to
an inflammation of the skin in body fold areas.
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