Diagnosis and Treating Skin Wounds - Medicine Paper Example

The concept of skin infection, diagnosis, and treatment of those diseases should be very clear in the mind of any medical practitioner. Many of the skin related conditions can be ignored as most of them come in mild form. Diagnosis of skin infections is a significant step in dealing with such conditions. Some skin conditions present noticeable symptoms while others remain undiscoverable under the skin, causing discomfort to the patient.

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Colonization is the presence of disease-causing organism or bacteria on the skin surface to the extent that they dont cause diseases to an individual (Olendorf & Jeryan, 2012). Presence of these bacteria is useful as it helps at times to fight disease causing and dangerous varieties. However, the location of the organism can be beneficial but in case of movement to a different area then it becomes a threat to the patient. Infection, on the other hand, is the invasion of the organisms body tissue by disease-causing organisms or as a result of interaction between pathogens and immune system of the body.

Cold sores, hair loss, blisters, chafing, sunburn, ingrown hair, rashes, itching just to list a few, characterize skin diseases. Cold sores are painful infections which are viral in nature. Its causative agent is herpes simplex virus. Rashes show an abnormal change in skin color or texture caused by skin inflammation. Various skin infections symbolize the presence of a disease or disorder in the body. Some result from individuals who are allergic. Allergy is a common disease that shows that a persons antigen is compatible with some environmental conditions or some foods, and it manifests itself on the skin. When a causative agent of any skin infection is not apparent, then the patient is subjected to diagnostic tests. Such tests include patch testing, Biopsy, scrapings, examination by wood light, Tzanck testing and Diascopy.

The situation might be slightly different for the aging people. In some cases, they need not pass through diagnostic tests. The medic needs to understand how the structure and function of the skin changes with age. Many skin infections become prevalent with age. The situation can be attributed to the fact that with age most people neglect their personal grooming and predispose themselves to significant bacteria that leads to contracting infections. Similarly most old aged people are on different drugs which may be the source of allergic reactions that interfere with the integrity of the skin.

Description of Steven Johnsons Syndrome

It is an immune-complex-mediated hypersensitive complex involving skin and the mucous membranes. Its classification depends on body surface area (BSA) detachment. A minor form of Steven Johnsons syndrome has less than 10% BSA, overlapping Steven Johnsons syndrome has a detachment of 10-30% and toxic epidermal necrolysis has more than 30% of the BSA.

Signs and Symptoms of Steven Johnsons syndrome

The most dominant indication of Steven Johnsons syndrome includes a cough productive of a thick, purulent sputum, headache, malaise, and arthralgia. Some patients may complain of rashes with burning sensation which appear symmetrically on the face and the upper side of the torso.

Signs of mucosal involvement may feature some or all of the following: erythema, edema, sloughing, blistering, ulceration and necrosis.

Advanced examination such as slip-lamp may reveal the following signs: trichiasis, distichiasis, Meibomian gland dysfunction and blepharitis, all of which occur on the eyelids. Other signs may also be discoverable around conjunctiva and cornea region.

Diagnosis of Steven Johnsons syndrome

Patients suffering from Steven Johnsons syndrome are very distinguishable, and the unique signs and symptoms are discoverable through Histopathologic examinations and Ocular examination.

Histopathologic examination reveals the following:

Apoptosis of keratinocytes

Dermal infiltrate which is superficial and perivascular in many cases.

Changes in the epidermal-dermal junction which ranges from vacuolar to subepidermal Predomination of CD4+ T lymphocytes in the dermis and CD8+ T lymphocytes in the epidermis.

The visual examination can show conjunctival biopsies from patients having the active ocular disease, and immunohistology of the conjunctiva will hold many HLA-DR-positive cells in the substantia propia, epithelium, and vessel walls.

Treatment and prevention of Steven Johnsons syndrome

Patients suffering from Steven Johnsons syndrome undergo symptomatic treatment which is similar to therapy application to patients with extensive burns. Particular attention to the respiratory tract, hemodynamic stability, fluid status, pain control, and wound care should be given to the patients during the treatment session.

Treatment involves a well-predefined procedure carried out by the medics. It begins by eliminating any suspected causative agents to prevent secondary infection. Oral lesions which may appear in some patients are handled with mouthwashes. Mouthwashes are nothing but just a typical anesthesia. Saline or Burow solution are preferably administered on areas of denuded skin. Finally, dressing of tetanus prophylaxis follows.

In cases of acute ocular manifestations, application of topical steroids, mechanical symblepharon lysis, or antibiotics are the most appropriate medication. The medication entails the following:

Grafting of mucous/amniotic membranes

Removal of plaque from the lid margins

Transplantation of limbal stem cell

Removal of conjunctival or keratinized ocular surface by superficial keratectomy.

Long-term lubrication may be sufficient in treating mild chronic superficial keratopathy.

References

Olendorf, D. & Jeryan, C. (2012). The Gale Encyclopedia of Medicine. Farmington Hills, MI. Emerald Group Publishing Limited.

Beauregard S, Gilchrest BA. (1987). A survey of skin problems and skin care regimens in elderly. Arch Dermatol. 123: 1638-1643

Elizabeth, H. (2017). Diagnostic Tests for Skin Disorders. Merck Manuals. Retrieved from

http://www.merckmanuals.com/professional/dermatologic-disorders/approach-to-the- dermatologic-patient/diagnostic-tests-for-skin-disorders

Katherine, B. (2005). Common Skin Disorders. Health Line. Retrieved from

http://www.healthline.com/health/skin-disorders

Foster, S. (2016). Stevens-Johnson Syndrome. Medscape. Retrieved from

http://emedicine.medscape.com/article/1197450-overview