All cases in Skin Infections

Gray-patch tinea capitis

tinea-capitis

An 8-year-old boy presented with multiple scaly patches with hair loss on the scalp of two months duration. O/E; the hairs in the involved areas were lusterless and easily and painlessly pulled-out of their follicles. It was diagnosed as gray-patch tinea capitis on clinical background and was given oral griseofulvin 20 mg per day in 2 divided doses taken with fatty meals. One month later, a dramatic response was seen and the patient was advised to continue his treatment for further 2 weeks.

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Herpes zoster

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A 24-year-old man suffered a painful vesicular rash involving the left side of the chest of 5 days duration. One day before, the rash was preceded by severe left- sided chest pain with burning sensation. On examination, a classical zosteriform vesicular rash on erythematous background  involving T3-T4 dermatomes was seen.

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Napkin’s candidiasis

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A 6-month-old female infant presented with red glazed rash involved the groin area including the inguinal flexures. It started as as napkin irritant contact dermatitis with superimposed candidiasis of one month duration. The rash is well-demarcated erythemtous with peripheral scales and many characteristic satellite papules and pustules. KOH smear yielded short wide hyphae and budding candidal cells Nustatin cream plus Hydrocortisone 2.5% cream applied twice daily for 2 weeks have cured the rash.

 

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Onychomycosis

Onychomycosis
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A 36-year-old house-wife woman presented with an asymptomatic, cosmetically-disfiguring nail discoloration involved all fingernails of many years duration. On examination: yellowish greenish nails’ discoloration particularely at the lateral borders and the base of the nail plates, paronychia and longtudinal split of the middle fingernail of the right hand. Nail clippings with KOH mounting showed fungal hyphae and spores and short budded hyphae and culture on Sabouraud’s agar yielded growth of both Candida albicans and Trichophyton rubrum. A prolonged course of  oral Terbinafine (Lamisil) 250 mg single oral daily dose for 4 months gave good result.

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Varicella

Varicella

A 14-year-old boy presented with fever, malaise, and myalgia followed one day later by sudden eruption of generalized rash involving mainly the face and trunk. O/E, polymorphous rash with many vesicular lesions on red base assuming an appearance of “dew drops on rose petals) the characteristic of chicken pox. Varicella occurring in late childhood or adulthood may present with more severe prodromal symptoms and rash.

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