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Vaccipedia.admin がページ「Dermatology」を「Dermatology in the tropics」に移動しました
*transmission route unknown
**patients are often in proximity of stagnant water body
**reservoir - snails, fish, water insects, aquatic plants, koala & opposum in Australia
*undermined wound edges, thick necrotic tissue, pain is liminited
*3 months course
#edema - develops pain
#ulcer
*diagnosis - Ziehl-Neelsen stain and culture of ulcer base
*DDx - panniculitis, pyoderma gangreosum
*lipid toxin produced and secreted by ''M. ulcerans'' is pathogenetic
**highly hydrophobic
*bacterial
**''Actionomadura madurae'', ''Streptomyces somaliensis'', ''Actinomadura pelletieri'', ''Nocardia'' spp.
***actinomycetoma
*fungal
**''Madurella mycetomatis'', etc.
***eumaycetoma
**black dots are seen on lesions, clusters of fungi
*Txs differ depending on #medical for 3-6 months##itraconazole#surgical bulk reducion#medical for 6 months again*mainly in 20-40 y/o males*triad#painless subcutaneous mass#multiple sinuses#discharge containing grains*in earlier stage, painless nodule**look like the first stage of buruli ulcer*can invade deeper tissues and bones, leading to amputation ==Tinea imbricata==*''Trichophyton concentricum''*rare form or recurrent itchy ringworm (tinea)*in tropical, esp. remote villages*terbinafine 4 weeks
==Scabies==
