Head lice, Warts, Ringworm and molluscum are by far the commonest presentation of skin problems in otherwise healthy children. Head lice, an infestation, presents often as itch, but can be symptom free, give away are the 1-4 mm sesame seed size life lice or the dandruff like nits (eggs of the female lice) which are different to dandruff cannot be brushed off, as they are tightly glued on. Wet combing (with a special tight nit comb) is effective in about 40% of cases. The use of insecticides (malathion , permethrin) based applications cures up to 80% infestations. It might be wise to study by pack-sheets and/or to discuss use with the pharmacist, as certain conditions (asthma / pregnancy …) will be contraindications. All family members have to be treated and treatment has to be repeated 7 -10 days later to kill surviving lice offspring. Cure is best confirmed by wet combing some days after 2nd treatment. Tea tree oil sounds a promising lice treatment, as it contains terpenoids a kind of neurotoxin to insects but safety of use or repeated use has never been formally investigated.
Another common endemic skin problem - typically in the up to 15 year olds - is impetigo or school rash in its honey crust or blistered pussy presentation. It is a highly contagious infection, which is normally treated with topical antibiotic creams if mild or systemic oral antibiotics if more severe. Topical antiseptic preparations might help by loosening the scab. Bedding and towels and all clothing require frequent change and personal hygiene special attention - very much like in head lice treatment.
Tinea of the head is a ringworm fungus presenting with localized baldness or blistery crusty head rash and requires review, testing and oral treatment by your GP.
Molluscum are also often run in school endemics. They are small blistery pink coloured lesions typically with a central crater or dent and filled with cheesy fluid. They are like warts caused by viruses. Single lesions only last for 8 weeks, but the disease carries on in average for 8 months. Cutting fingernails short and covering itchy lesions with plasters to avoid self spread are a good idea. Many treatments have been tried but lesions are best left alone as treatments have limited effectiveness can cause scarring and are often painful.
Warts are usually easily recognized mole like or embedded often hornified dry lesions. The most effective treatment remains simple salicylic acid in paint, creams, gels and plasters. Again other treatments might be promising but can like cryo-therapy for instance cause pain , burns and scarring and should be the exception rather than the rule for self limiting conditions ( they can last for years though)
Children with head lice should be kept from school til treated, Impetigo can return to classes when lesions are dry and healed. All other above mentioned conditions have no recommended school leave , sorry if you were hoping for the contrary.
Sources:- British Medical Journal, Common skin infections in children 2004
- www.gpnotebook.co.uk
- John Murtagh, General Practice, McGrawHill- www.dermatology.co.uk
Geraldton Medical Group
22 6 2009
Another common endemic skin problem - typically in the up to 15 year olds - is impetigo or school rash in its honey crust or blistered pussy presentation. It is a highly contagious infection, which is normally treated with topical antibiotic creams if mild or systemic oral antibiotics if more severe. Topical antiseptic preparations might help by loosening the scab. Bedding and towels and all clothing require frequent change and personal hygiene special attention - very much like in head lice treatment.
Tinea of the head is a ringworm fungus presenting with localized baldness or blistery crusty head rash and requires review, testing and oral treatment by your GP.
Molluscum are also often run in school endemics. They are small blistery pink coloured lesions typically with a central crater or dent and filled with cheesy fluid. They are like warts caused by viruses. Single lesions only last for 8 weeks, but the disease carries on in average for 8 months. Cutting fingernails short and covering itchy lesions with plasters to avoid self spread are a good idea. Many treatments have been tried but lesions are best left alone as treatments have limited effectiveness can cause scarring and are often painful.
Warts are usually easily recognized mole like or embedded often hornified dry lesions. The most effective treatment remains simple salicylic acid in paint, creams, gels and plasters. Again other treatments might be promising but can like cryo-therapy for instance cause pain , burns and scarring and should be the exception rather than the rule for self limiting conditions ( they can last for years though)
Children with head lice should be kept from school til treated, Impetigo can return to classes when lesions are dry and healed. All other above mentioned conditions have no recommended school leave , sorry if you were hoping for the contrary.
Sources:- British Medical Journal, Common skin infections in children 2004
- www.gpnotebook.co.uk
- John Murtagh, General Practice, McGrawHill- www.dermatology.co.uk
Geraldton Medical Group
22 6 2009
No comments:
Post a Comment