Other skin (Eczema, Urticaria, Pellagra)

Eczema

– Acute eczema: erythematous plaque, vesicular, oozing, itchy, to poorly demarcated and crumbly edges.

– Chronic eczema: erythematous scaly dry plate, poorly demarcated and pruritic.

– Look for a cause (contact allergic dermatitis, fungal or bacterial infection remotely, malnutrition) and family history.

Treatment:

– Clean with soap and water 2 times / day.

– Then apply:

• for acute eczema: calamine lotion 2 times / day

• for chronic eczema: ointment of zinc oxide 2 times / day

– Find and treat skin disease (scabies, lice, etc.).

– In case of secondary infections: treat as impetigo.

– If intense pruritus: promethazine PO

Children 2 to 5 years: 5 to 15 mg / day in 1 to 2 sockets

Children 5 to 10 years: 10 to 25 mg / day in 1 to 2 sockets

Children over 10 years and adults: 25 to 50 mg / day in 1-2 taken or chlorpheniramine PO

Children from 1 to 2 years: 1 mg 2 times a day

Children 2 to 6 years: 1 mg 4-6 times a day

Children 6 to 12 years: 2 mg 4-6 times a day

Adult: 4 mg 4 to 6 times per day

Hives

– Erythematous papules, edematous, pruritic: transient, resembling nettle stings.

– Look for a cause: food, medicines (antibiotics in particular), insect bites, bacterial or parasitic infection stage of invasion (ascariasis, strongyloidiasis, hookworm, schistosomiasis, loiasis) or viral (hepatitis B or C); general illness (cancer, lupus, thyroid disease, vasculitis).

Treatment:

– If intense itching, antihistamine (chlorpheniramine or promethazine PO PO at the dosages indicated above) for 7 days minimum.

– In case of angioneurotic edema: epinephrine (adrenaline) IM

Infants and children: 0.01 mg / kg / injection Adult: 0.25 to 0.75 mg / injection to be repeated every 5 minutes if necessary according to changes associated with hydrocortisone IM

Children: 2-4 mg / kg / injection

Adult: 100-500 mg / injection

– In case of anaphylactic shock.

Pellagra

Skin disease caused by a deficiency in niacin (vitamin PP) and / or tryptophan (in staple food is maize not treated with lime, sorghum; if malabsorption or famine).

Clinical signs:

Classically, “disease of the 3 D”: dermatitis, diarrhea and dementia:

– Dark red plaques, well demarcated, symmetric, located on exposed areas

(Forehead, neck, forearm, leg), fine cracked skin, pigmented, sometimes with haemorrhagic bullae.

– Getting combine Gastrointestinal (glossitis, stomatitis, diarrhea) and neuropsychiatric symptoms are severe.

Treatment:

– Nicotinamide (vitamin PP) PO

Children and adults: 300 to 500 mg / day in 2 divided doses, until complete healing in combination with a high protein diet.

– In the event of an outbreak of pellagra, for example in the refugee camp, it is imperative to change the diet (peanut intake or pulses) to cover the daily requirements (approximately 15 mg / day in the adult).

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Editor-in-chief of the Medical Actu website; general practitioner graduated from the Faculty of Medicine of Algiers in 2005 currently practicing as a liberal.

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