1 / 34

Dominican Republic

Dominican Republic. Common Health Problems. Skin Disorders. Fungal Infections (Candidiasis, Tinea) Contact Dermatitis Scabies Parasites. Fungal Infections Candidiasis. Erythematous, well-demarcated, maculopapular eruptions Satelite lesions Pruritic. Fungal Infections Candidiasis.

Samuel
Download Presentation

Dominican Republic

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Dominican Republic Common Health Problems

  2. Skin Disorders • Fungal Infections (Candidiasis, Tinea) • Contact Dermatitis • Scabies • Parasites

  3. Fungal Infections Candidiasis • Erythematous, well-demarcated, maculopapular eruptions • Satelite lesions • Pruritic

  4. Fungal Infections Candidiasis • Treatment: • Clotrimazole 2% cream • Miconazole cream • Educate on importance to keep areas at risk (skin folds, groin area) dry and clean. • Do not use hydrocortisone cream --(produces a burning sensation)

  5. Candidiasis

  6. Oral Candidiasis

  7. Oral Candidiasis • Treatment: • Nystatin oral (if available) • Avoid sweets until mouth clears up (yeast feeds on sugars)

  8. Fungal InfectionsTinea • Erythematous, scaling area with discrete border and central clearing • Usually very pruritic

  9. Fungal InfectionsTinea • Treatment: • Tinea Corporis: Miconazole or Clotrimazole bid x 2 weeks. • Tinea Capitis: more difficult to treat with topical agents. Usually po treatment is not available for us to take, so an attempt at treatment with cream is acceptable. • Educate on proper hygiene and that it is contagious (no sharing caps, towels, etc.)

  10. Contact Dermatitis • Erythematous, and edematous area • Usually localized and itches • Area is usually asymmetrical (not found in exactly the same spot on both sides of the body) • Area affected will relate to something the patient has “contacted”

  11. Contact Dermatitis This is a close-up of a dermatitis reaction. It consists of a large, red (erythematous) lesion (plaque) with numerous small pus-filled areas (pustules).

  12. Contact Dermatitis This is a typical early appearance of a poison ivy rash, located on the leg. These early lesions consist of multiple small blisters, often in a line where the skin has brushed against the poison ivy plant.

  13. Contact Dermatitis • Treatment: • Calamine Lotion (if vesicles or weeping to dry it up) • Topical Steroid creams (NOT used on the face) • Oral Antihistamines (may be warranted if itching is severe) • Removal of offending agent (if identifiable)

  14. Scabies • Primary lesions: typical burrows, vesicles and papules • Secondary lesions: chronic cases with scratching, scaling and erythema (this can be difficult to distinguish from parasites as the scratching and scaling make the burrows -black dots- difficult to identify. This is frequently the presentation of scabies in the D.R.) • VERY pruritic • Highly Contagious

  15. Scabies

  16. Scabies • Ivermectin: 100 mcg/kg as a single oral dose • May need Benadryl cream or po for the severe itching • Educate on no sharing of clothing, towels. Also, bed linens need to be washed (if they have the resources to do so.)

  17. Parasites • Tips to help you distinguish parasites from scabies: • Bites/irritation ABOVE the neck (this will clue you into the rest of the skin irritation on the body being parasites) • Hard nodules under skin • Hair-like fibers in the skin • May have Sores/open lesions that do not heal

  18. Parasites • Treatment : • Every patient we see will be treated with a standard dose of anti-parasitic medication. (Infants and young children will be given the Ivermectin based on a calculation of their estimated weight.) • VERY important to educate on drinking clean water and clean foods as well as personal sanitation. • Mild to moderate diarrhea is expected. If severe enough to cause concern for dehydration, patient may be given an anti-diarrheal medication.

  19. Antibiotic Use for Skin Infections • If scratching has become so severe that a break in the skin has lead to a strep or staph infection: • Folliculitis • Impetigo • Abscesses • Severe Boils

  20. Gripe • A general complaint for flu-like symptoms, nasal congestion, allergies, sore throat, ear stuffiness. • Requires further investigation of the root cause of the patient’s problem • The most common complaint!!!

  21. Gripe (cont’d) • Know which symptoms you are treating • Congestion • “Do your ears feel full?” • “Is your nose stuffy?” (I.e. “stopped up”) • Congestion can be relieved with “Decongestants” • Sinus congestion • Do they have tenderness upon palpation of the sinuses, above and below the eyes? • This along with fever may indicate a need for antibiotic therapy.

  22. Gripe (cont’d) • Allergy Symptoms • Runny nose • Watery eyes • Itchy eyes • Itchy nose • May also have a red, scratchy throat • Itchy ears • Sneezing • May have cough due to irritation

  23. Sore Throat • Post Nasal Drip • See drainage in the back of the throat • Frequently accompanied by clearing of the throat or an irritating cough • Strep Throat • Very red throat • Petechiae on Soft Palate • May have exudate on tonsils • Must be treated with an antibiotic

  24. Gripe • Treatment: • Congestion • Phenylephrine (Sudafed PE) • Preferable for those with high BP • Pseudoephedrine (Sudafed) • Dimetapp Cold and Allergy (for children)

  25. Gripe • Treatment: • Allergy Symptoms (Antihistamines) • Sedating: Diphenhydramine(Benadyl), Chlorpheniramine, Zyrtec, Tavist • Nonsedating: Claritin, Allegra, Clarinex, Alavert • Dimetapp Cold and Allergy is a wonderful combination antihistamine and decongestant for children.

  26. Gripe • Treatment: • Antitussives (for cough) and Expectorants: • Guaifenesin (Robitussin, Mucinex)

  27. When to use Antibiotics with Gripe Complaints • Suspect Bacterial infections • Sinus pressure with fever • Strep throat or a severe tonsillitis • Ear infection (Otitis Media) • External ear infection (Otitis Externa): swollen, tender ear canal • Swollen cervical lymph nodes • High fever (usually above 100.4)

  28. Anemia • Common manifestations: • Dizziness • Weakness • Pallor • Frequent complaint of young women and elderly women

  29. Anemia • Treatment • Give Vitamins with iron

  30. Vaginal InfectionsBacterial vs Fungal • Ask the following questions: • Discharge? If yes, color and amount? • Foul odor? • Itching? • This will lead you to distinguish between an actual bacterial vaginal infection and a yeast infection. This is important because treatment is different for each of these.

  31. Bacterial Vaginal Infection • Vaginal discharge (color varies: gray, greenish, yellowish) • May have a foul odor

  32. Bacterial Vaginal Infection • Treatment • Must be treated with an antibiotic

  33. Fungal Vaginal Infection • May complain of burning with urination (be sure to rule out a UTI) • White, curdy discharge • Very Very itchy

  34. Fungal Vaginal Infection • Treatment • Clotrimazole vaginal cream • Miconazole vaginal cream • Do NOT give an antibiotic for this. This can potentially make the itching much worse.

More Related