Reference no: EM133836287

Describe dermatitis, diagnostic criteria, and treatment modalities

Dermatitis is essentially an inflammatory reaction to an external factor. The skin reacts in an abnormal way to the external factor, sometimes there is a genetic factor playing a role in this as well. In many instances, dermatitis is an allergic response, but there are irritant forms of dermatitis that are not allergic in nature. With allergic contact dermatitis (ACD) a typical allergic response occurs, T cells are activated, which then release cytotoxins, cytokines, and chemokines, recruitment of immune cells like eosinophils and macrophages occurs. Atopic dermatitis shows an increase in immunoglobulin E and has a genetic factor that is attributed to the condition. Filaggrin (FLG) gene mutations are the genetic factor attributed to atopic dermatitis (Virginia Poole Arcangelo et al., 2017). Dermatitis is diagnosed based on clinical presentation. While there are tests that could be performed, such as blood work to determine eosinophil or immunoglobulin E levels, diagnosis is typically made based on what the provider sees (Kulthanan et al., 2021). In both irritant and allergic contact dermatitis, vesicles, pruritic blisters, and papules with line-like streaks may be observed. When it is an irritant causing dermatitis, the lesions will be localized to the area of exposure. When dermatitis is allergic in nature, the lesions may be less localized and more diffuse. Moisturizers should be applied liberally to improve skin hydration and repair damaged skin for those with irritant contact dermatitis. There are also barrier creams that can be utilized as well as switching to cotton and other soft fabrics. Prevention is key when it comes to contact dermatitis, however, when prevention is not achieved, there are therapeutics that can be utilized. For mild symptoms, oatmeal baths and cool compresses may alleviate symptoms. If these techniques do not alleviate the symptoms or if the symptoms are moderate to severe, medications may be utilized. Choosing the best medication option for the patient becomes essential. For instance, a patient may be opposed to putting a greasy ointment or gel on their face, a cream may be the best option for them. Ointments and gels are typically the best option as they provide the best protective barrier. Creams are a little more diluted and lotions are even more diluted. For the hair, an alcohol-based solution would be the best option as it can be applied without causing coating or clumping in the hair (Virginia Poole Arcangelo et al., 2017).

Describe the drug therapy for Conjunctivitis and Otitis Media
Conjunctivitis drug therapies are determined based on the type of conjunctivitis. For bacterial conjunctivitis, an ointment such as erythromycin or bacitracin is typically used.Vernal/Atopic and Seasonal conjunctivitis, or Hay Fever, can be treated with a topical antihistamine such as alcaftadine. The provider may decide to add a mild corticosteroid. If this is a recurrent issue for the patient, an antihistamine with mast cell stabilizer properties may be utilized and possibly the ophthalmic form of Toradol may be utilized for those with seasonal conjunctivitis. For viral conjunctivitis, topical antihistamines or artificial tears, or cold compresses. Giant Papillary Conjunctivitis is typically related to contact usage. Patients may be advised to change their contacts more frequently, use mast cell stabilizers, change the way they clean their contacts, or in severe cases, they may be advised to stop wearing contact lenses while they take a regiment of corticosteroids. For patients with keratoconjunctivitis sicca, or dry eye syndrome, is treated by trying to change the environmental factors that cause it, but if that is not successful, the patient may be prescribed artificial tears, ocular lubricants, cholinergics, and/or anti-inflammatory drops. For otitis media, the most common drug therapy prescribed is amoxicillin or amoxicillin-clavulanate. If a patient is allergic to penicillin based products, a cephalosporin or clindamycin may be prescribed in its place (Virginia Poole Arcangelo et al., 2017).

Discuss Herpes Virus infections, patient presentation, and treatment
There are seven types of herpes viruses that can infect humans. The most commonly known being herpes simplex virus (HSV) types 1 and 2, and herpes-zoster virus, the cause of chickenpox and shingles. More uncommonly known forms of herpes includes Epstein-Barr virus, cytomegalovirus, and human herpes viruses types 6 and 8. Usually HSV-1 is associated with the waist and above, typically being found in the mouth, eyes, and on and around the lips. HSV-2 is typically associated with the genitals and below the waist. Lesions are typically found on the genitals of males and females. Varicella-zoster (chickenpox) is typically associated with children but people of any age can be infected, and shingles is the re-activated form of herpes-zoster that typically appears in the elderly who have had chickenpox in the past. Epstein-Barr is closely associated with mononucleosis, HHV-6 is associated with roseola, and HHV-8 is associated with Kaposi sarcoma. Patients with HSV-1 typically have painful, tingling, itchy, burning vesicles on the face, mouth, lips, or pharynx. There may be one vesicle or several vesicles over an erythematous area. The vesicles become pustules and then crust over and erode. Lesions typically recur at the same site. HSV-2 presents with the same type of presentation, only in the genital area. Patients with chickenpox present with fever and muscle pain, followed by itchy vesicles over an erythematous area. The vesicles typically appear first on the trunk and spread to the extremities and face. Patients with shingles usually have neuralgia first, then vesicles on an erythematous area appear. The vesicles are typically unilateral and mainly on the trunk. Patients may also experience fever, localized pain, and muscle aches (Virginia Poole Arcangelo et al., 2017). Epstein Barr Virus presents as infectious mononucleosis. Patients present with fever, myalgia, swollen neck lymph nodes, and sore throat (Bhattacharjee et al., 2022). Cytomegalovirus can be difficult to diagnose as it can present in many different ways. Some symptoms can include fever of unknown origin, fatigue, night sweats, and weight loss. These symptoms paired with lymphocytosis and/or liver enzyme disturbances can suggest cytomegalovirus (Schattner, 2024). Patients with HHV-6 typically present with fever, seizures, altered mental status, and a rash (King & Al Khalili, 2020). HHV-8 on the other hand is typically asymptomatic and only found through tissue biopsy. It can have mononucleosis-like symptoms, but this is not common (Rewane & Tadi, 2022). There are different medications that can be used to treat the different forms of herpes. The most common medications prescribed are topical solutions such as acyclovir and penciclovir and systemic therapies such as acyclovir, famciclovir, and valacyclovir (Virginia Poole Arcangelo et al., 2017). Get professional assignment writing service now!

Describe the most common primary bacterial skin infections and the treatment of choice.
The more commonly treated primary bacterial skin infections are impetigo, cellulitis, folliculitis, felons, and paronychias. The bacteria associated with these conditions may be staphylococcus aureus, group A streptococcus, haemophiles influenzae B, streptococcus pneumoniae, pseudomonas aeruginosa, klebsiella species, Enterobacter species, and Escherichia coli. Treatment for these and most bacterial skin infections are accomplished with broad-spectrum penicillins such as amoxicillin-clavulanate, 1st, 2nd, and 3rd generation cephalosporins such as cephalexin, cefaclor, and ceftriaxone, fluoroquinolones, such as levofloxacin, and others such as clindamycin, linezolid, and vancomycin (Virginia Poole Arcangelo et al., 2017).