Different Diseases in Different Human Body Systems
Paronychia disease is an infection of the inflammation skin and soft tissue infections that surrounds a toenail or fingernail. It can start suddenly (acute paronychia) or gradually (chronic paronychia). There are two different types of paronychia, acute and chronic depending on the amount of time the infection has been present. The etiology, infectious agent, and treatment are usually different for each form, and the 2 forms are often considered separate entities. Acute paronychia develops over a few hours when a nail fold becomes painful, red and swollen. It is the most common hand infection in the United State.
Symptoms of Paronychia
A small collection of pus forms under the skin next to the nail, or underneath the nail itself. The area around the nail is tender, red and mildly swollen the cuticle is missing; and the skin around the nail feels moist or "boggy." Often, only one nail is affected. Acute paronychia starts as a red, warm, painful swelling of the skin around the nail. In chronic paronychia, the redness and tenderness are less noticeable than the acute infection. The nail may have a green discoloration due to Pseudomonas infection. It mainly occurs in people who have constantly wet hands, such as hairdressers, nurses, bartenders and housewives.
Causes of Paronychia
The causes of acute Paronychia and chronic Paronychia are defind follow :
· Acute paronychia usually results from a traumatic event, however minor, that breaks down the physical barrier between the nail bed and the nail; this disruption allows the infiltration of infectious organisms.
· Acute paronychia can result from seemingly innocuous conditions, such as hangnails, or from activities, such as nail biting, finger sucking, manicuring, or artificial nail placement.
· Staphylococcus aureus is the most common infecting organism. Organisms, such as Streptococcus and Pseudomonas species, gram-negative bacteria, and anaerobic bacteria are other causative organisms.
· Acute (and chronic) paronychia may also occur as a manifestation of other diseases, such as pemphigus vulgaris.
· Chronic paronychia is primarily caused by the yeast fungus Candida albicans .
· Other rare causes of chronic paronychia include bacterial, mycobacterial, or viral infection; metastatic cancer; subungual melanoma; and squamous cell carcinoma.
· Chronic paronychia most often occurs in persons whose hands are repeatedly exposed to moist environments or in those who have prolonged and repeated contact with irritants such as mild acids, mild alkalis, or other chemicals
Treatment of Paronychia
The treatment of choice depends on the extent of the infection. the treatment list of acute Paronychiaare below:
· Warm water soaks of the affected finger 3-4 times per day until symptoms resolve are helpful.
· Oral antibiotics with gram-positive coverage against S aureus, such as amoxicillin and clavulanic acid (Augmentin) or clindamycin (Cleocin), are usually administered concomitantly with warm water soaks.
· Cleocin and Augmentin also have anaerobic activity; therefore, they are useful in treating patients with paronychia due to oral anaerobes contracted through nail biting or finger sucking.
· Cleocin should be used instead of Augmentin in patients who are allergic to penicillin.
· If the paronychia does not resolve or if it progresses to an abscess, it should be drained promptly.
Treatment of chronic Paronychia are
· The initial treatment of chronic paronychia consists of the avoidance of inciting factors such as exposure to moist environments or skin irritants. Keeping the affected lesion dry is essential for proper recovery. Choice of footgear may also be considered.
· Any manipulation of the nail, such as manicuring, finger sucking, or attempting to incise and drain the lesion, should be avoided; these manipulations may lead to secondary bacterial infections. Mild cases of chronic paronychia may be treated with warm soaks.
· The initial medical treatment consists of the application of topical antifungal agents. Topical miconazole may be used as the initial agent. Oral ketoconazole or fluconazole may be added in more severe cases.
· Patients with diabetes and those who are immunocompromised need more aggressive treatment because the response to therapy is slower in these patients than in others.
· In cases induced by retinoids or protease inhibitors, the paronychia usually resolves if the medication is discontinued.
· Keep your hands and feet dry and clean.
· Wear rubber gloves with an absorbent cotton lining if your hands are exposed routinely to water or harsh chemicals.
· Be gentle when you manicure your nails. Avoid cutting your cuticles or pushing them back.
· Avoid biting your nails and picking at the skin around your nails.
· If you have diabetes, keep your blood sugar levels within a normal range by following your diet and taking your medications.
Rickets is an abnormal bone formation in children resulting from inadequate calcium in their bones. This lack of calcium can result from inadequate dietary calcium, inadequate exposure to sunshine (needed to make vitamin D), or from not eating enough vitamin D - a nutrient needed for calcium absorption. Vitamin D is found in animal foods, such as egg yolks and dairy products.
Rickets is a softening of bones in children potentially leading to fractures and deformity. Rickets is among the most frequent childhood diseases in many developing countries. The predominant cause is a vitamin D deficiency, but lack of adequate calcium in the diet may also lead to rickets (cases of severe diarrhea and vomiting may be the cause of the deficiency). Although it can occur in adults, the majority of cases occur in children suffering from severe malnutrition, usually resulting from famine or starvation during the early stages of childhood.Osteomalacia is the term used to describe a similar condition occurring in adults, generally due to a deficiency of vitamin D.The origin of the word "rickets" is probably from the Old English dialect word 'wrickken', to twist. The Greek derived word "rachitis" (ραχίτις, meaning "inflammation of the spine") was later adopted as the scientific term for rickets, due chiefly to the words' similarity in sound.
Symptoms of Rickets
The symptoms of rickets include bowed legs and bowed arms. The bowed appearance is due to the softening of bones, and their bending if the bones are weight-bearing. Bone growth occurs through the creation of new cartilage, a soft substance at the ends of bones. When the mineral calcium phosphate is deposited onto the cartilage, a hard structure is created. In vitamin D deficiency, though, calcium is not available to create hardened bone, and the result is soft bone. Other symptoms of rickets include particular bony bumps on the ribs called rachitic rosary (beadlike prominences at the junction of the ribs with their cartilages) and knock-knees. Seizures may also occasionally occur in a child with rickets, because of reduced levels of dissolved calcium in the bloodstream. Hypophosphatemic rickets usually begins in the first year of life. It ranges from so mild that it produces no noticeable symptoms to so severe that it produces bowing of the legs and other bone deformities, bone pain, and a short stature. Bony outgrowth where muscles attach to bones may limit movement at those joints. A baby's skull bones may close too soon, leading to seizures.
Treatment for Rickets
The treatment goals for rickets are to relieve symptoms and correct the cause of the condition. The underlying cause mustbe treated to prevent recurrence. The replacement of deficient calcium, phosphorus, or vitamin D will eliminate most symptoms of rickets. Dietary sources of vitamin D include fish, liver, and processed milk. Exposure to moderate amounts of sunlight is encouraged. Treating rickets caused by metabolic abnormalities may require a special prescription for vitamin D. A sufficient amount of sunlight each day and adequate supplies of calcium and phosphorus in the diet can prevent rickets. Darker skinned babies need to be exposed longer to the ultraviolet rays. The replacement of Vitamin D may correct rickets using these methods of ultraviolet light and medicine. Rickets heals promptly with 4000 IU of oral vitamin D per day administered for approximately one month.. During this treatment, the doctor should monitor the levels of 25-OH-D in the plasma to make certain they are raised to a normal value. The bone abnormalities (visible by x ray) generally disappear gradually over a period of 3-9 months. Parents are instructed to take their infants outdoors for approximately 20 minutes per day with their faces exposed. Children should also be encouraged to play outside. Foods that are good sources of vitamin D include cod liver oil, egg yolks, butter, and oily fish. Some foods, including milk and breakfast cereals, are also fortified with synthetic vitamin D.
How is rickets diagnosed?
Rickets is diagnosed by x-ray examination of leg bones. A distinct pattern of irregularities, abnormalities, and a coarse appearance can be clearly seen with rickets. A blood test may be done to measure the amounts of the minerals calcium and phosphorus. X-rays of the affected bones are obtained and a musculoskeletal examination reveals tenderness or pain of the bone itself, rather than in the joints or muscles. In some occasions, a bone biopsy, in which a small sample of bone tissue is removed for analysis, also may be needed to confirm the diagnosis.