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13.9 Other Skin Diseases Conditions

Table of Contents

13.9.1 Pellagra

Is a disease caused by deficiency of a variety of specific factors, nicotinic acid being the most important. Cardinal signs: diarrhea, dermatitis (sites exposed to sun and pressure) and dementia.

Diagnostic Criteria

  • Casal’s necklace; hyper-pigmented scaling involving the neck region
  • Hyper-pigmented scaly lesions on sun exposed areas

Pharmacological Treatment

Treat both adults and children

C: Nicotinamide (PO) 500mg once daily for four weeks or until healing is complete; In children give 5mg/kg per day for four weeks or until healing is complete.

Note: The diet should be rich in deficient nutrients as well as protein (meat, groundnuts, and beans)

13.9.2 Vitiligo

Is a condition presenting with patchy depigmentation of skin.

Diagnostic Criteria

  • Depigmented patches commonly on the face, neck, trunk and extremities
  • Mucosal surfaces particularly oral and genital areas can also be depigmented

Pharmacological Treatment

  • There is no cure for vitiligo, but there are a number of treatments that can improve the condition.
  • Treatment options generally fall into the following groups:
    o Sun blocks:
    C: Sun Protective Factor (SPF) 30+ applied at 8 am and 2 pm
    o Skin camouflage
    o Topical steroids
    B: Betametasone valerate ointment 0.1% 12 hourly for 2–4 months

Note: Counsel the patient about the condition

13.9.3 Pruritic Papular Eruption (PPE)

A skin condition characterized by itchy papular eruptions on the extensor area of the upper and lower limbs which is associated with HIV infection.

Diagnostic Criteria

  • Papular lesions on the extensor areas
  • Extremely itchy
  • Excoriation
  • Lesions heal with hyperpigmented scars

Pharmacological Treatment

C: Betamethasone valerate cream 0.025% 12 hourly for 3–4 weeks

OR

D: Dapsone 100 mg once a day for one month

13.9.4 Oculo-cutaneous Albinism

A congenital disorder characterized by the complete or partial absence of pigment (melanin) in the skin, hair and eyes.

Diagnostic Criteria

  • Strabismus (crossed eyes)
  • Photophobia (sensitivity to light)
  • Nystagmus (involuntary rapid eye movements)
  • Impaired vision or blindness.
  • Astigmatism

Non-Pharmacological Treatment

  • Genetic counseling is very important to prevent further occurrences of the condition.
  • Protective clothing (long sleeved shirt, blouse, skirt and trousers and wide brimmed hats to prevent skin cancers)
  • Sun protective glasses with special ultraviolet B (UVB) filters
  • Advice on indoor income generating activities

Pharmacological Treatment

C: Sunscreen applications of SPF 30+ or above, applied twice a day at 8 am and noon

Referral: Refer the patient if suspected to have malignant lesions

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