ICMR
 arrow Health Care of the Rural Aged Books

diminished resistance. Folliculitis of legs is called Bockhart's impetigo. Folliculitis in the face is called sycosis barbae.

Topical antibiotics: Penicillin, sulpha or synthetic penicillin. Recurrence is due to periodic discharge from carrier sites. Antibiotic therapy should be continued till the carrier stage is controlled.

(v) Fungal infections

These can be divided into superficial and deep fungi. The superficial fungi are either keratinolytic or non-keratinolytic.

(a) Taenia versicolar: This is a non-keratinolytic fungus. They are seen as hypo-pigmented scaly lesions,' called achromic type. Occasionally seen as coloured lesions called chromic type. Occurs in all age groups. It is not contagious. Usually asymptomatic but causes cosmetic disfigurement. Associated with diabetes melltius, Cushings syndrome and steroid therapy.

(b) Taenia corporis: It is akeratinolytic fungus annular, scaly lesions with a clear border. There is intense itching.

Treatment: Whitfield ointment. 1% Miconazole. Nitrate. Systemic griseofulvin 125 mgms, twice daily infection of the scalp should be for 2 months. Nail. T. Unguinum 500 mgms/day after food for 6 months.

Deep fungi

(a) Moniliasis: Lesions-Monilial paronychia, granuloma, oral thrush on the dorsal surface of the tongue, cheilitis, monilial balanoposthitis Occur in 99% of diabetics. In female, monilial vulvovaginitis or pruritus vulva Occur.

1% G. V. Paint or 1% Miconazole nitrate. Nystatin tablets oral or vaginal. In resistant cases Ketoconazole 200 mgms 1 tablet daily for 3 to 4 weeks. Ketoconazole can be used in those who are sensitive to griseofulvin in any deep fungal infection.

Papulosquamous

(a) Psoriasis (b) Lichen planus.

Psoriasis: Erythematous scaly lesions in the extensor surface, symmetrical in distribution, recurrent in nature. Exacerbation seen in winter. Itching may be mild or moderate. May occur in the form of exfoliative psoriasis, pustular lesions, psoriasis with arthropathy and psoriasis of the nails. Steroids are used externally or internally. Mostly occur as plaques on the scalp or limbs.

Salicylic ointment, Coal tar ointment and antihistaminics. PUV A is now used. Psoralin-20 mgs longwave UV rays - This has antimitotic effect.

Lichen planus: It is self-limiting disease, characterised by flat, blue to violet coloured papules occurring on the flexor surface of the forearm and extensor surfaces of the legs. The oral and genital mucosae are also involved. Itching is very severe. Topical salicylic acid ointment or coal tar ointment. Oral antihistaminics.

In extensive lesions involving scalp, steroids are useful.

Pityriasis roseae: Round or oval lesions occur in the trunk, the upper limbs upto elbow and in the lower limbs upto knee. Lesions disappear on their own within 6

<<Back | Index | Next>>