Yacht Charters

CONTAGIOUS MOLLUSCUM Contagious molluscum - the virus dermatosis, observed to a thicket at children. Aetiology and pathogenesis. Disease causes a filtered virus, pathogenic only for the person and transferred or at direct contact (at adults quite often at sex communications), or oposredovanno at using the general sanitary articles (basts, sponges, towels, etc.). In children's collectives epidemic flashes of illness are possible. The incubation interval fluctuates from 2 ned to 2 3 months At persons of an average and advanced age the provoking factor contributing to disease, there can be a long treatment by corticosteroids and cytostatics. Clinical picture. In places of an inoculation of a virus arise smooth, shining, as though translucent, pink or serovato yellow nodules in the size from prosjanogo grains to a pea with characteristic vdavleniem in the centre. The quantity of elements can be various - from individual, located to a thicket on the person, a neck, back of brushes, to numerous, randomly scattered on all integument or grouped in separate ochazhki. At adults at sexual infection of a rash can be localised on a pubis, genitals, an internal surface of hips. Subjective sensations are absent. Sometimes rashes merge in large rough tumorous formations ("a huge molluscum"). For nodules of a contagious molluscum allocation belesovatoj kashitseobraznoj masses from the central excavation of papules is characteristic at squeezing by their forceps. Treatment: expression of nodules by a forceps or a currettage a spoon the Folk god-send with the subsequent processing of 2 % a spirituous solution of iodine. The diathermocoagulation of elements is possible also. At disseminirovannyh disease forms use antiviral agents: Methisazonum - on 0,1 - 0,6 g depending on age sick 2 once a day within 7 days, interferon - on 3-4 drops in a nose of 4-5 times a day. Without treatment disease lasts some months and more, and one elements can spontaneously disappear (especially after a pyesis), others arise in earlier not amazed areas as a result of an autoinoculation. The child for whom the contagious molluscum is diagnosed, isolate from children's collective to an absolute recovery. To the healthy children contacting to the patient, with the preventive purpose 3 times a day are recommended zakapyvanie in an interferon nose on 1-2 drops.
Head H CHRONIC INFECTIOUS DISEASES.
TUBERCULOSIS CUTIS The tuberculosis cutis is caused by introduction in a skin of micobacteria of a tuberculosis.
Aetiology and pathogenesis. Distinguish 4 types of micobacteria: human, bull, bird's and holodnokrovnyh. For the person are pathogenic the two first type, however at sick of a tuberculosis cutis find out micobacteria of human type is more often. Among all dermatoses a tubercular lesion of a skin - the phenomenon rare enough, however it is possible to note recently the tendency to constant growth of a case rate both in Russia, and in the countries of Europe. The healthy skin is adverse medium for micobacterium vital activity, but certain conditions can promote disease development. To them carry hormonal dysfunction, a pathology of nervous system, a vitamin disbalance, disorders of a water and mineral exchange, vascular disturbances (for example, venous zastoi), unsatisfactory socially household and environmental conditions, infectious diseases. All listed factors reduce protective forces of an organism and raise it a susceptibility to tuberculosis micobacteria. At the present stage of the important it is caused immunity depressions is a HIV. Micobacteria get into a skin various ways. The exogenous way through the damaged false skin immediately from the patient or through what or subjects is possible. However the endogenous way of diffusion meets considerably to a bowl of the first. In this case the originator is brought in a skin hematogenically or limfogenno from a tuberculous focus in other organ. Are possible also originator diffusion per continuitatum from the next organs amazed with tubercular process or by an autoinoculation with urine, a feces, a sputum. Gistologicheski in a skin tap infectious granulomas from the epithelial cells surrounded with Yacht Charters, presence of huge cells of Langhansa, a caseous necrosis and micobacteria in the granuloma centre is characteristic also. Clinical picture. Dermatological forms of a tuberculosis include various on a clinical picture pathological processes, basic of them are classified as follows: the localised forms (a tubercular lupus, kollikvativnyj, warty, miliarno an ulcerative tuberculosis), disseminirovannye forms (a papulonecrotic, indurative, lichenoid tuberculosis).
Lupus tubercular (lupus vulgaris) - the most widespread form of a tuberculosis cutis. It is characterised by formation specific soft bugorkov (ljupom), lying in a derma, pink colouring with a clear boundary in diameter of 2-3 mm. The basic morphological element - bugorok (ljupoma), representing an infectious granuloma. Bugorki are inclined to peripheric growth and merge to formation of the continuous centres (the flat form). At vitropressii (pressing by subject glass) colour bugorka becomes yellowish (a phenomenon of "apple jelly"), and at pressing on bugorok the bellied probe easily fails, leaving an excavation in bugorke (Pospelov's symptom). Gradually bugorki are exposed to fibrosing with destruction of collagenic and elastic fibers and formation of a cicatrical atrophy. At exudative character of process and under the influence of various traumas bugorki can izjazvljatsja (the ulcerative form) with formation superficial with soft rough edges and easily bleeding ulcers. Are possible also tumorous, verrukoznaja, Yacht Charters and other forms of a tubercular lupus. Rashes are localised usually on the person, but can be also on a trunk and extremities. The mucosa of a nasal cavity, firm and a soft palate, labiums, a gum quite often is surprised. To a bowl disease meets at women. The vulgar lupus is characterised by a flaccid, long current and can become complicated development ljupus carcinomas.
Yacht Charters cutis kollikvativnyj (sin. A scrofuloderma) - the form of a tuberculosis cutis second for frequency. Rashes are presented dense maloboleznennymi lying in deep layers of a skin and the knots quickly enlarged in volume reaching 3-5 sm in diameter and densely soldered to appropriate tissues. The skin over them gets a cyanotic shade. Further knots are softened, forming a cold abscess, and opened with allocation through fistulous courses krovjanistogo contents with includings nekrotizirovannoj tissues. On a knot place the ulcer with soft podrytymi edges and yellowish scurf with flaccid granulations at the bottom is formed. After healing of ulcers there are rather characteristic "lacerated" cicatrixes of the wrong form covered sosochkovidnymi vyrostami of a skin, intersections. The scrofuloderma arises mainly as a result of entering of micobacteria in a skin from the amazed lymph nodes and on lymphatic vessels from other centres of a tuberculosis which are available for the patient. To bowl the neck area is surprised, extremities are more rare. Women are ill mainly.
The tuberculosis cutis warty is characterised by painless nodules (more precisely bugorkami) reddish colour with the cyanotic shade, surrounded with a perifocal inflammation and forming at the expense of peripheric growth the centre with three zones in which centre warty growths with cornual masses are located, then there is an infiltrate zone, free from growths, and surrounds its peripheric inflammatory reddish obodok. Rashes settle down more often on fingers of arms, back and palmar surfaces of brushes, soles. In certain degree the warty tuberculosis can be carried to occupational diseases as it meets at workers on slaughter-houses, the veterinary surgeons contacting to animals sick of a tuberculosis. The Yacht Charters miliarno the ulcerative arises as result of an autoinoculation at patients with an active tuberculosis of other organs - eliminators of bacilli. Usual localisation - mucosas of natural foramens and a skin surrounding them (a mouth, a nose, a fundament). Rashes are presented fine zheltovato red bugorkami which quickly izjazvljajutsja, merge among themselves, forming painful superficial easily bleeding ulcers with the rough bottom covered with yellowish nodules, representing fine abscesses - "grains of Trelja". The tuberculosis cutis papulonecrotic is characterised disseminirovannymi by soft roundish semiball-shaped papules (more precisely bugorkami) the size 2-3 mm, reddish colour with a cyanotic shade in which central part there is a necrosis. Necrotic masses shrink in densely sitting crust in the centre of each element after which tearing away remain characteristic pressed, or "stamped", scars. Rashes settle down absent-mindedly on anticnemions, hips, breeches, razgibatelnyh surfaces of the top extremities, mainly in the field of joints. Disease is observed more often at women.
Tuberculosis cutis indurative (sin. The erythema indurative Bazena) - the widespread form of a tuberculosis cutis, on a clinical picture reminds a nodose vasculitis. A basic element at an indurative erythema is dense, soldered to a skin maloboleznennyj the knot in diameter 1-3 see the Skin over it in the beginning is not changed, later in process of growth of knot the skin over it becomes reddish colour with a cyanotic shade. Then the knot is exposed to retrogress, leaving after itself the sunk down brownish site of a cicatrical atrophy of various degree of expression. Sometimes the knot is softened and izjazvljaetsja (type of Getchinsona). Ulcers superficial, painful, flaccid, their bottom is covered is yellow green scurf. Knots are localised on anticnemions, hips, the top extremities, a stomach. Women is more often are ill.