Skin lesions types

Immunological abnormalities were reported in 23 adults in Woburn, Massachusetts, who were exposed to contaminated well water and who were family members of children with leukemia (Byers et al. 1988). These immunological abnormalities, tested for 5 years after well closure, included persistent lymphocytosis, increased numbers of T-lymphocytes, and depressed helper suppressor T-cell ratio. Auto-antibodies, particularly anti-nuclear antibodies, were detected in 11 of 23 adults tested. This study is limited by the possible bias in identifying risk factors for immunological abnormalities in a small, nonpopulation-based group identified by leukemia types. Other limitations of this study are described in Section 2.2.2.8. A study of 356 residents of Tucson, Arizona, who were exposed to trichloroethylene (6-500 ppb) and other chemicals in well water drawn from the Santa Cmz aquifer found increased frequencies of 10 systemic lupus erythematosus symptoms, 5 (arthritis, Raynaud s phenomenon, malar rash, skin lesions related to sun exposure, seizure or convulsions) of which were statistically significant (Kilbum and Warshaw 1992). 

Ingested arsenic localizes to the skin [2, 7], where it may alter cutaneous immune responses. The delayed type hypersensitivity (DTH) response to 2,4-dinitrochlorobenzene (DNCB) was suppressed in Bowen s disease patients [8], Langerhans cells (LC) in skin lesions and perilesioned skin from arsenic-induced Bowen s disease and carcinomas were reduced in number and were morphologically altered, having a notable loss of dendrites [9], These data suggest that chronic exposure to arsenic in drinking water may... 

In chronic lichenified atopic dermatitis skin lesions, fewer IL-4 and IL-13 mRNA-expressing cells are present, but greater numbers of IL-5, GM-CSF, IL-12, and IFN-y mRNA-expressing cells are detected. The rise in IL-5 expression during the transition from acute to chronic atopic dermatitis likely plays a role in the prolongation of eosinophil survival and function. Some of the other cytokines mentioned above support the function of macrophages and promote the Th-1-type... 

Among the symptoms seen in patients with type I NF are hyperpigmented skin lesions (cafe-au-lait spots), benign skin tumors (neurofibromas), dysplasia of the sphenoid bone, and benign tumors of the iris (hamartomas or Lisch nodules). 

This formula can clear heat and eliminate heat-toxin, reduce swelling and promote discharge of pus. It can also invigorate blood and alleviate pain. This formula is used in the early metaphase of Yang-type boils and carbuncles due to fire-toxin and phlegm-fire in the body. This manifests as red, swollen, hot and painful skin lesions that are usually accompanied by fever, mild chills and headache. The patient has a thin, yellow or white tongue coating and a rapid and forceful pulse. 

This formula can clear heat, relieve fire-toxin, cool the blood and reduce swelling. It is used for treating Yang-type boils and carbuncles in metaphase. The skin lesions are very red, swollen, hot and painful, and are usually accompanied by fever and chills. This formula especially treats a hard lesion which is small in size but deep-seated and very painful. The patient often has a red tongue with a yellow coating and a rapid pulse. 

The skin lesions of urticarial disease are caused by an inflammatory reaction in the skin, causing leakage of capillaries in the dermis and resulting in an oedema which persists until the interstitial fluid is absorbed into the surrounding cells. Types of urticaria include ... 

Skin lesions and eruptions of different types have been attributed to chloroquine, including occasional cases of epidermal necrolysis (24). 

A spectrum of cutaneous lesions has been described distant from sites of interferon alfa injection. The clinical and histological characteristics of inflammatory skin lesions that occurred away from injection sites have been investigated in 20 patients treated with interferon alfa-2a or 2b plus ribavirin for chronic hepatitis C (299). Cutaneous lesions developed between 2 weeks and 4 months and consisted of pruritic papular erythematous eruptions with occasional vesicles. These eczema-like skin lesions predominated on the distal limbs, the head, and the neck. Photosensitivity was also noted in four patients and mucous lesions in two. Skin biopsy mostly showed non-specific mononuclear infiltrates. The skin lesions were promptly reversible in 10 patients who required treatment withdrawal, while others improved after symptomatic treatment. Two of the three patients who again received the same or another type of interferon alfa had recurrence of their lesions. Skin tests performed in six patients were negative, including the two patients who relapsed after rechallenge with interferon alfa, and were therefore considered unhelpful. 

Two distinct types of skin lesions have been described in patients taking pentazocine scleroderma-like changes, subcutaneous abscesses, cellulitis, ulceration, muscle atrophy and granulomas (all of which are well-recognized consequences of pentazocine abuse), and a generalized erythematous desquamative rash. 

Two forms of heparin-induced thrombocytopenia (HIT) have been observed. The first (HIT I) is a transient, mild, and benign thrombocytopenia seen soon after initiation of heparin therapy (normally within 2 days) and is felt to be due to inherent plateletaggregating properties of heparin. A second, more severe form of HIT (HIT II) is typically seen later and is immune-mediated. The incidence of HIT II is estimated at 3-5%. The onset is generally 3-14 days after initiation of heparin therapy but may occur sooner with repeat exposure. HIT II may occur with any dose and type of heparin, but the frequency is highest with continuous intravenous infusions of unfractionated heparin. HIT with subsequent thrombosis is a feared complication. These thrombi can form in the venous or arterial circulation. Thrombotic complications include necrotic skin lesions, myocardial infarction, stroke, and gangrene. Hyperkalemia may be seen with heparin therapy due to aldosterone synthesis inhibition. 

Flat-type refers to the characteristic lesions, which are flush with the skin rather than raised vesicles. In outbreaks in India, flat-type smallpox was responsible for between 5 and 10% of cases, with most of the flat-type cases (72%) occurring in children (25). Constitutional symptoms associated with the 3 day prodrome are more severe than in ordinary smallpox and continue after the rash develops. Patients have a high fever and appear toxic throughout the course of the illness. Oral lesions tend to be extensive, and the skin lesions evolve slowly. By the 7 or 8 day, the flat skin lesions appear buried in the skin. In comparison to ordinary smallpox, the vesicles contain little fluid and do not develop the characteristic umbilication. Unlike ordinary smallpox, flat-type smallpox lesions are soft and velvety in texture. The lesions may contain hemorrhages. Respiratory complications are common, and the prognosis for flat-type smallpox is grave. Most cases are fatal (25). 

M. oleifera extracts inhibits plaque formation of anti-herpes simplex vims type 1 (HSV-1) more than 50% at 100 ag/ml in a plaque reduction assay (55). M. oleifera extracts are also effective against thymidine kinase-deficient HSV-1 and phosphonoacetate-resistant HSV-1 vims strains. The extract ofM. oleifera at a dose of 750 mg/kg body weight per day significantly delays the development of skin lesions, prolongs the mean survival times and reduces the mortality of HSV-1 infected mice. Compared to the synthetic compound acyclovir, M. oleifera extracts delay the development of skin lesions and has mean survival times as acyclovir. A polysaccharide from hot aqueous extract of mature pods (fruits) of M oleifera with a structural repeating unit [->4)-a-D-GlCp(l->] has immunoenhancing properties (76). 

Urticants produce instant, almost intolerable pain. They cause local tissue destruction immediately on contact with skin and mucous membranes. Sensations range from mild prickling to almost intolerable pain resembling a severe bee sting. Direct contact of the agent with the skin produces a corrosive type lesion. Skin lesions may not fully heal for over 2 months. Inhalation of Urticant vapor can cause lung membranes to swell and become filled with liquid (pulmonary edema). Death may result from lack of oxygen. 

Manifestations in the skin are nearly as common as those involving the musculoskeletal system. " The most well known of these is the butterfly rash, which occurs over the bridge of the nose and the malar eminences. The classic butterfly rash is seen in approximately one-half of patients and often is observed after sun exposure. In fact, photosensitivity is common to many SLE patients who present with cutaneous manifestations. Skin lesions characteristic of discoid lupus occur in 10% to 20% of patients with SLE and may occur without other clinical or serologic evidence of lupus. Some individuals are said to develop subacute cutaneous lupus erythematosus, the nature of whose lesions falls between discoid (one type of chronic... 

Severity, lesion types, scarring, and skin discoloration, as well as previous treatment history, helps to determine a treatment approach to acne vulgaris (see Table 95-1). Most treatments reduce or prevent new eruptions and may take up to 8 weeks to produce visible results. During the first few weeks of therapy, acne may appear to worsen as existing acne lesions may resolve more rapidly. Patients must understand the need to continue therapy for optimal outcome. 

Intense itching (pruritus) and skin reactivity are the hallmarks of AD. " Typically, three different types of skin lesions are associated with AD acute, subacute, and chronic. 

The acute rash lesions are intensely pruritic, erythematous papules and vesicles over erythematous skin. These itchy lesions are subsequently associated with scratching that results in excoriations and exudates. Subacute lesions are typically thicker, paler, scaly, erythematous, and excoriated plaques. Chronic lesions are characterized by thickened plaques, accentuated skin markings (licheniflcation), and fibrotic papules. Most patients exhibit all three lesion types. At all phases, the atopic skin usually has a dry luster. ... 

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