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Vaccipedia.admin がページ「Dermatology」を「Dermatology in the tropics」に移動しました
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==NTDs==
*preventative chemoTx and transmission control (PCT) ones
*morphology of each rash
*distribution
*sites on body
==leprosy==
*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
**''M. ulcerans'' itself is not pathogenetic
*WHO treatment category
**I lesions<5cm - 8 weeks antibiotics
**II lesions 5-15cm - 4 weeks antibiotics -> surgery -> 4 weeks
**III lesions >15cm
==Lesishmaniasis==
*''Leischmania'' spp. > 20 species
**intracellular protozoa
*transmitted by sandfly
*3 clinical types
**cutaneous
**mucocutaneous
**visceral (Kala-Azar)
==Onchoceriasis==
*''Onchocera volvulus''
*transmitted by blackfly
*mass drug administration in Central Africa region is dangerous because Loa loa is endemic, which may cause encephalitis by administration of ivermectin
==Lyphmatic filariasis==
*''Wuchereria bancrofti'', ''Brugia malayi'', ''Brugia timori''
==Yaws==
*イチゴ腫，フランベジア
**病変がフランボワーズ（ラズベリー）に似ているため
*''Treponema pallidum'' subsp. ''pertenue''
*more common in children
*direct contact transmission
*yellowish, raspberry-like nodule
**often develop ulceration
*diagnosis
**treponema pallidum rapid diagnostic test
**dual path platform (DPP) test of skin swab
*just one dose of azithromycin 30mg/kg or 2 gram for adults is effective
**resistant to azithromycin is rapidly increasing in yaws
==Mycetoma==
*syndrome, not a single etiology
*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==
*''Sarcoptes scabiei var. hominis''
*ivermectin
==Tungiasis (sand flea)==
*''Tunga penetrans''
**only female tunga invades human skin producing a large ovary
==Guinea worm==
*almost eliminated
**human cases only in 4 countries
**still exists as zoonosis
*''Dracunculus medinensis''
