Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete
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Infectious diseases of the skin have become rarer in industrialized nations, but they still affect a considerable part of the population in tropical regions. Skin diseases induced by protozoa, worms and ectoparasites are among the 17 "neglected tropical diseases" defined by the WHO (leishmaniasis, dracunculiasis, lymphatic filariasis, onchocerciasis). ⋯ Among the 12 most frequent skin diseases in travellers are cutaneous larva migrans, leishmaniasis and myiasis. In this review, diagnosis, treatment and prevention of some the most relevant tropical dermatoses due to protozoa, worms and ectoparasites are discussed.
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Aggregatibacter actinomycetemcomitans is a small, gram-negative, non-motile, coccobacillus. Aggregatibacter actinomycetemcomitans is known to cause periodontal disease and to be associated with actinomycosis. ⋯ The importance of Aggregatibacter actinomycetemcomitans in chronic wounds needs to be explored.
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Pruritus, especially chronic pruritus, has long been underestimated and leads to high psychological strain in the affected patients. Even today, in spite of receiving increased attention, the underlying etiology cannot always be identified. ⋯ With regard to the demographic development of the population with increasing life expectancy and the resulting increasing polypharmacy, drugs will have to be taken into account as a possible cause for pruritus more often in the future. It would be desirable to routinely assess pruritus as a possible adverse effect in regulatory drug studies.
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Postherpetic neuralgia is considered to be a neuropathic pain syndrome. Typically, patients experience pain in the dermatomes of skin lesions persisting for more than 3 months after skin restitution. About 10 % of patients with herpes zoster develop postherpetic neuralgia. ⋯ Clinical studies did show pain relief in postherpetic neuralgia after administration of antidepressants, antiepileptic drugs, opioids, and topical capsaicin and lidocaine. Nevertheless, about one third of patients do not respond to conventional treatment. Given the fact that postherpetic neuralgia is considered to be a chronic pain disease, a multidisciplinary treatment approach is necessary.
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As a rare antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis, eosinophilic granulomatosis with polyangiitis (EGPA, formerly Churg-Strauss syndrome) is characterized by asthma, severe peripheral eosinophilia and the presence of extravascular granulomas. Cutaneous involvement usually includes palpable purpura or cutaneous to subcutaneous nodes. We present the case of a 43-year-old woman with EPGA and the unusual cutaneous manifestation of livedo racemosa.