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Skin Discoloration

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81. Kwashiorkor

in addition to oedema. Kwashiorkor typically occurs in children around the time of weaning and up to 4 years of age, although it may present later, particularly when associated with tuberculosis (TB) or HIV. Oedema of kwashiorkor is evident in the soft tissues of the extremities, rather than as ascites. History and exam presence of risk factors low weight for height, low height for age, or a low mid upper arm circumference (MUAC) bilateral pitting oedema hair discoloration dermatosis/ulceration apathy (...) serum protein serum albumin blood glucose chest x-ray (CXR) urine culture blood culture stool culture tuberculosis (TB) skin testing HIV serology/polymerase chain reaction (PCR) malaria screen echocardiography Treatment algorithm ACUTE Contributors Authors Helene B. Roberson Professor of Pediatrics Washington University School of Medicine St Louis MO Disclosures MJM is an author of a number of references cited in this monograph. Medical Director Lao Friends Hospital for Children Luang Prabang Laos

2018 BMJ Best Practice

82. Necrotising fasciitis

). History and exam presence of risk factors anaesthesia or severe pain over site of cellulitis fever palpitations, tachycardia, tachypnoea, hypotension, and lightheadedness nausea and vomiting delirium crepitus vesicles or bullae grey discoloration of skin oedema or induration location of lesion inpatient contact with index case Varicella zoster infection cutaneous injury, surgery, trauma non-traumatic skin lesions intravenous drug use chronic illness immunosuppression non-steroidal anti-inflammatory (...) , and subcutaneous tissue infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. Philadelphia, PA: Elsevier; 2015:1194-215. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jul 15;59(2):e10-52. https://academic.oup.com/cid/article/59/2/e10/2895845 http://www.ncbi.nlm.nih.gov

2018 BMJ Best Practice

83. Actinomycosis

soft-tissue swelling multiple sinuses skin discoloration chewing difficulties constitutional symptoms change in bowel habits abdominal discomfort nausea and vomiting sensation of abdominal mass vaginal bleeding or discharge dry or productive cough blood-streaked sputum shortness of breath chest pain focal neurological defects male gender injury or inflammation of the oral cavity diabetes mellitus immunosuppression malnutrition local tissue damage by neoplasia, trauma, or irradiation intra-uterine

2018 BMJ Best Practice

84. Neonatal jaundice

includes phototherapy and/or exchange transfusion. The major complication of unconjugated hyperbilirubinaemia is kernicterus. Definition Neonatal jaundice is the yellowing discoloration of the skin and sclera of a neonate, which is caused by increased levels of bilirubin in the blood. A neonate refers to an infant in the first 28 days of life. This topic focuses on recognising and managing early neonatal jaundice, which is most commonly caused by unconjugated hyperbilirubinaemia. While prolonged

2018 BMJ Best Practice

85. Syphilis in pregnancy

, QSSS, midwife, nurse, nurse practitioner, obstetrician, personnel managing follow-up and/or contact tracing. Pinta/yaws/bejel Infections caused by bacteria that are closely related to Treponema pallidum. Pinta affects only the skin while yaws and bejel can also affect the joints and bones. Not endemic in Australia. QSSS Queensland Syphilis Surveillance Service (QSSS) is an important source of information, support and advice for health care providers engaged in the detection and management of women (...) is an obligate human parasite Transmission · Direct contact with infectious lesions of the mucous membranes or abraded skin 29,30 : o Almost always as sexually transmitted infection o Contact with moist mucocutaneous lesions of an infected baby · Vertical transmission (transplacental passage) during pregnancy: o Treponema pallidum readily crosses the placenta o Can occur as early as 9–10 weeks gestation o Can occur at any stage of disease, including during incubation, although risk is greatest in infectious

2019 Queensland Health

86. Clinically Suspected Vascular Malformation of the Extremities

approximately 10% of peripheral vascular malformations and may present with pain, skin discoloration, warmth, or mass with palpable thrill or bruit [6]. Compression neuropathy, soft-tissue ulceration, bleeding, arterial steal phenomenon, and high-output cardiac failure may be seen in extreme cases [4,7]. Low-flow lesions include capillary, venous, and lymphatic malformations and are overall more common than high-flow lesions. Of these, capillary malformations are the most common but rarely require imaging (...) for diagnosis because of their characteristic cutaneous manifestations [3,4]. Venous and lymphatic malformations have a reported prevalence of 1% in the general population with 40% involving the extremities [6]. Although symptomatology is variable, these lesions may present with focal or more generalized extremity pain, swelling, or compressible mass with or without associated skin discoloration. Involvement of the deep tissues, including bone, is not uncommon, and physical examination often underestimates

2019 American College of Radiology

87. Compression therapy after invasive treatment of superficial veins of the lower extremities

| eccentric and concentric, x 14 Ferrara, F. and Ferrera, G. Sclerotherapy in the patient with diabetes: indications and results. Phlebolymphology . 2012 ; 19 : 193–198 or tangential. x 15 Ragg, J. Film compression bandage: a new modality to improve sclerotherapy of superficial varicosities. Veins Lymphat . 2017 ; 6 : 6635–6636 | , x 16 Barnaby J, Azzam M, Choe E, Ash S, Kalodiki E, Lattimer CR. The effect of tangential skin compression with adhesive tape in reducing the size of bulging varicose veins (...) in the standing position. x 13 Mosti, G., Mattaliano, V., Arleo, S., and Partsch, H. Thigh compression after great saphenous surgery is more effective with high pressure. Int Angiol . 2009 ; 28 : 274–280 | Outcomes reported included postoperative pain at the end of 7 days, edema, complications (hematoma, bleeding through the dressings, skin irritation, phlebitis, and deep venous thrombosis [DVT]), and quality of life. Pain was assessed in all five studies, various combinations of complications in three, x 13

2019 American Venous Forum

88. Allopurinol / lesinurad (Duzallo) - Gout

skin (“leaking tophi”). Tophus forming in the kidney may lead to lithiasis and inflammation, and if uncontrolled, to renal failure. 2.1.5. Management Several urate lowering therapies (ULTs) are available for the prophylaxis of recurrent gouty attacks and reduction of tophi, which include: a) oral xanthine-oxidase inhibitors (XOI), allopurinol and febuxostat, which decrease the de novo synthesis of urate. b) oral uricosuric agents probenecid, benzbromarone, and sulphinpyrazone. Uricosuric agents

2018 European Medicines Agency - EPARs

90. Rucaparib camsylate - Ovarian Neoplasms

occurred at 40 mg/kg/day. Dose-related clinical observations included; decreased activity, defecation, increased respiratory rate, lateral recumbency, salivation, retching, vomiting, tremors and red skin discoloration. At 40 mg/kg/day, ECG abnormalities (persistent sinus tachycardia, atrioventricular nodal rhythm) were noted. Dose-related reversible reductions in platelets and reticulocytes were seen. Thymus weights were decreased across all groups. Dark discoloration in the left ventricular (...) in those tissues were low and near the LLOQ, which indicated that complete elimination was expected. Following a single PO dose of [14C]rucaparib in male pigmented LE rats, the radioactivity distribution pattern in pigmented and albino rats was qualitatively similar, with the exception of the uveal pigment of the eyes and the pigmented skin where a higher concentration of radioactivity was observed, suggesting an association of radioactive drug-related material with melanin. At 168 hours (7 days

2018 European Medicines Agency - EPARs

91. ASSESSING PERISTOMAL SKIN CHANGES IN OSTOMY PATIENTS. (PubMed)

ASSESSING PERISTOMAL SKIN CHANGES IN OSTOMY PATIENTS. Peristomal skin problems are common and are treated by a variety of health professionals. Clear and consistent communication among these professionals is therefore particularly important. The Ostomy Skin Tool (OST) is a new assessment instrument for the extent and severity of peristomal skin conditions. Formal tests of reliability and validity are necessary for its use in clinical practice, research, and education.To estimate inter (...) - and intra nurse assessment variability of the OST and validity by comparison to a 'gold standard' (GS) defined by an expert panel.Thirty photographs of peristomal skin were presented twice to 20 ostomy care nurses--10 from Denmark (DK) and 10 from Spain (ES)--to determine intra- and inter nurse assessment variability. The same photographs were presented to an international group of experts (dermatologist and ostomy care nurses), to establish a GS for comparison and validation of the results.A high intra

2010 British Journal of Dermatology

92. A Multiple-Dose Study to Evaluate Skin Irritation and Sensitization of Teriparatide Administered Transdermally in Healthy Postmenopausal Women

or bisphosphonates during the previous 3 months. Women receiving short-term hormone therapy for the treatment of moderate to severe menopausal symptoms may be enrolled if their postmenopausal status is confirmed by inclusion criterion. Have presence of a dermatologic disease that might interfere with the evaluation of the test site reaction; and clinically significant scars, wounds, or discoloration, or abnormalities of the skin at or near the intended site of electrode application (for example, porphyria, atopy (...) A Multiple-Dose Study to Evaluate Skin Irritation and Sensitization of Teriparatide Administered Transdermally in Healthy Postmenopausal Women A Multiple-Dose Study to Evaluate Skin Irritation and Sensitization of Teriparatide Administered Transdermally in Healthy Postmenopausal Women - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save

2010 Clinical Trials

93. Diagnosis and Treatment of Peripheral Arterial Diseases (Full text)

for Endarterectomy SAPT Single antiplatelet therapy SBP Systolic blood pressure SFA Superficial femoral artery SPACE Stent Protected Angioplasty versus Carotid Endarterectomy STAR Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function TAMARIS Efficacy and Safety of XRP0038/NV1FGF in Critical Limb Ischaemia Patients With Skin Lesions TAVI Transcatheter aortic valve implantation TBI Toe-brachial index TcPO 2 Transcutaneous oxygen pressure TIA Transient ischaemic attack

2017 European Society of Cardiology PubMed

94. Use of Silver Diamine Fluoride for Pediatric Dental Patients

, are antimicrobial. It also is theorized that SDF reacts with hydroxyapatite in an alkaline environment to form calcium fluoride (CaF 2) and silver phosphate as major reaction products. CaF 2 provides sufficient fluoride to form fluorapatite which is less soluble than hydroxyapatite in an acidic environment. 6, 7 A side effect is the discoloration of demineralized or cavitated surfaces. Patients and parents should be advised regarding the black staining of the lesions associated with application of SDF. Ideally (...) highlighting expected staining of treated lesions, potential staining of skin and clothes, and the need for reapplication for disease control, is recommended. 41 Careful monitoring and behavioral intervention to reduce individual risk factors should be part of a comprehensive caries management program that aims not only to sustain arrest of existing caries lesions, but also to prevent new caries lesion development. 42 Although no severe pulpal damage or reaction to SDF has been reported, SDF should

2018 American Academy of Pediatric Dentistry

95. Evaluation and Treatment of Hirsutism in Premenopausal Women (Full text)

not a method of hair removal, bleaching with products containing hydrogen peroxide and sulfates is a method for masking the presence of undesired hair, particularly facial hair. Side effects include irritation, pruritus, and possible skin discoloration. In addition to cosmetic and/or pharmacologic therapy, lifestyle changes for obese women with PCOS may improve their hirsutism. In a meta-analysis of four studies that included 132 subjects, lifestyle changes (diet, exercise, behavioral, or combination (...) hair removal therapy, we suggest photoepilation for those whose unwanted hair is auburn, brown, or black, and we suggest electrolysis for those with white or blonde hair. (2 |⊕⊕OO) 4.2. For women of color who choose photoepilation treatment, we suggest using a long-wavelength, long pulse-duration light source such as Nd:YAG or diode laser delivered with appropriate skin cooling (2 |⊕OOO). Clinicians should warn Mediterranean and Middle Eastern women with facial hirsutism about the increased risk

2018 The Endocrine Society PubMed

96. Evaluation and Treatment of Hirsutism in Premenopausal Women (Full text)

not a method of hair removal, bleaching with products containing hydrogen peroxide and sulfates is a method for masking the presence of undesired hair, particularly facial hair. Side effects include irritation, pruritus, and possible skin discoloration. In addition to cosmetic and/or pharmacologic therapy, lifestyle changes for obese women with PCOS may improve their hirsutism. In a meta-analysis of four studies that included 132 subjects, lifestyle changes (diet, exercise, behavioral, or combination (...) hair removal therapy, we suggest photoepilation for those whose unwanted hair is auburn, brown, or black, and we suggest electrolysis for those with white or blonde hair. (2 |⊕⊕OO) 4.2. For women of color who choose photoepilation treatment, we suggest using a long-wavelength, long pulse-duration light source such as Nd:YAG or diode laser delivered with appropriate skin cooling (2 |⊕OOO). Clinicians should warn Mediterranean and Middle Eastern women with facial hirsutism about the increased risk

2018 The Endocrine Society PubMed

98. Neonatal jaundice

in: o Impaired parent-baby attachment o Breast feeding interruption § Use fibreoptic or LED blanket or timed interruptions for breast feeding if jaundice is not severe o Baby and parent distress 18 · Very little evidence of clinically significant toxicity · Detailed long-term follow up studies are limited 18 have yet to be validated 11 · Babies with cholestatic jaundice and conjugated hyperbilirubinaemia receiving phototherapy may: o Develop dark grey-brown discoloration of the skin 8,70 § Known (...) ) delivered per unit area (cm 2 ) of exposed skin at a particular wavelength (nm) measured as microW/cm 2 /nm. 11 Standard phototherapy Phototherapy provided by light source(s) with irradiance of 25–30 microW cm -2 nm -1 over the waveband interval 460–490 nm -1 . 4,11 Total serum bilirubin The sum value of conjugated and unconjugated bilirubin. 17 Unconjugated hyperbilirubinaemia Increased levels of unconjugated (lipid soluble) bilirubin usually caused by haemolysis, immature liver or sepsis. 4 Refer

2018 Queensland Health

99. Onychomycosis

) cases are caused by the dermatophyte , T. rubrum . Candida albicans is involved in up to 5% of infections, most commonly in fingernails. Risk factors: Older age Gender – 2.4 times more common in males than females Tinea pedis infection (co-infection very common) Diabetes Peripheral vascular disease Immunodeficiency Psoriasis of the skin Nail trauma Occlusive footwear Sports or other activities involving bare feet Smoking Images: Anatomy of the nail Skinsight: Nail infections, fungal (Onychomycosis (...) ) DermnetNZ Fungal nail infections (Onychomycosis) Three major subtypes of OM: Distal and lateral subungual onychomycosis (DLSO) – infection is located under the tip and side of nail, . Most common type (90%) Nail thickening with white-yellowish discoloration Brittle, friable nail plate which may crumble leaving yellow debris Typical presentation is “butter”- coloured spikes descending vertically from the distal end (top) of the nail Onycholysis (separation of nail plate from nail bed) is common No change

2018 medSask

100. Use of Silver Diamine Fluoride for Dental Caries Management in Children and Adolescents, Including Those with Special Health Care Needs

and was below EPA oral reference dose in adults. 39 The following adverse effects have been noted in the literature: • Metallic/bitter taste. 24 • Temporary staining to skin which resolves in 2-14 days. 24 • Mucosal irritation/lesions resulting from inadvertent con- tact with SDF , resolved within 48 hours. 7 Esthetics The hallmark of SDF is a visible dark staining that is a sign of caries arrest on treated dentin lesions. This dark discoloration is permanent unless restored. A recent study that assessed pa (...) percent (i.e., higher than other comparable interventions), SDF pre- sents as an advantageous modality. Besides its efficacy, SDF is favored by its less invasive (clinically and in terms of behavior guidance requirements) nature and its inex- pensiveness. 5. The undesirable effects of SDF (mainly esthetic concerns due to dark discoloration of carious SDF-treated dentin) are outweighed by its desirable properties in most cases, while no toxicity or adverse events associated with its use have been

2017 American Academy of Pediatric Dentistry

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