Topical treatments for fungal infections of the skin and nails of the foot

Avoidance and management of stomal complications

The construction of an intestinal stoma is fraught with complications and should not be considered a trivial undertaking. Serious complications requiring immediate reoperations can occur, as can minor problems that will subject the patient to daily and nightly distress. Intestinal stomas undoubtedly will dramatically change lifestyles; patients will experience physiologic and psychologic detriment with stoma-related problems, however minor they may seem. Common complications include poor stoma siting, high output, skin irritation, ischemia, retraction, parastomal hernia (PH), and prolapse. Surgeons should be cognizant of these complications before, during, and after stoma creation, and adequate measures should be taken to avoid them. In this review, the authors highlight these often seen problems and discuss management and prevention strategies.

Peristomal dermatology

Inflammatory or infectious conditions affecting the skin around an intestinal stoma are common and may be a source of considerable aggravation to patients. Recognition and prompt appropriate treatment of these conditions improves their quality of life. Peristomal pyoderma gangrenosum represents a most unusual peristomal skin condition that is difficult to treat; resolution often requires diagnosis and therapy of underlying inflammatory bowel disease.

Reported incidence and treatment of dermatophytosis in children in general practice: a comparison between 1987 and 2001

INTRODUCTION

Dermatophytosis is a common skin infection in children. Although the epidemiology is relatively unknown it is becoming a major health problem in some countries. We determine the incidence and management of dermatophytosis in Dutch general practice in 1987 and 2001.

METHODS

We used data of all children aged 0-17 years derived from two national surveys performed in Dutch general practice in 1987 and 2001 respectively. All diagnoses, prescriptions and referrals were registered over a 12 months period by the participating general practitioners (GPs), 161 and 195 respectively. Data were stratified for socio-demographic characteristics.

RESULTS

Compared to 1987, in 2001 the total reported incidence rate of dermatophytosis in children in general practice increased from 20.8 [95%CI 18.9-22.8] to 24.6 [95%CI 23.5-25.7] per 1,000 person years. Infants (<1 year), girls, children in rural areas and children of non-western immigrants more often consulted the GP for dermatophytosis in 2001. In both surveys GPs treated the majority of children with dermatophytosis with topical drugs, especially with azoles.

CONCLUSIONS

The reported incidence rate of dermatophytosis in children in general practice increased; however it is unclear whether this is a consequence of an increasing prevalence in the population or a changing help seeking behaviour. GPs generally follow the national guideline for the treatment of dermatophytosis in children.

Skin manifestations of running

As the United States comes increasingly closer to being the heaviest nation on earth, many people are turning to exercise, especially running, to lose weight. Most runners, whether novice or professional, will have a skin disorder that may prompt them to seek medical attention. Although case reports and sports reviews have discussed, in a cursory fashion, the nature of these skin lesions, to our knowledge there has never been an extensive review of the literature that specifically addresses the skin diseases of runners. In this article, we present the epidemiology, origin, clinical characteristics, treatment, and prevention of skin diseases inherent to runners.

Extracts from "Clinical evidence": Athlete's foot and fungally infected toenails

Definition Athlete's foot is a cutaneous fungal infection that causes the skin to itch, flake, and fissure. Nail involvement is characterised by ungual thickening and discoloration.