The structure and function of the skin details the individual components of the epidermis, dermis, and their roles in normal skin health. The individual cell types in the epidermis, the different epidermal layers, and the roles of the keratinocyte are explained. The epidermis and dermis, and their important relation to each other through the dermoepidermal junction are described. The dermal adnexal structures of hair follicles (pilosebaceous units), sweat glands, and nerves are all considered. The functions of skin and barrier function are also listed. Rare but important causes of disordered sweating (hyperhidrosis and hypohidrosis) are described. In addition, presentations of hyperhidrosis are discussed.

Structure and function of the skin

Nondermatologists fall naturally into two basic groups: those who minimize the importance of cutaneous disease and who try to ignore the skin, and those who do not. This book, the best of its genre, is for the latter, finding its primary niche as a dermatology text for generalists. Being thoroughly familiar with it would allow any physician to care for skin disease with a high degree of proficiency. By unburdening itself of lengthy histopathological descriptions and ponderous explanations of morphogenesis, the book achieves a lean, workmanlike style. Stripping away the esoteric leaves room for that which is more immediately useful. It is like a jeep, solid and reliable, or, perhaps more accurately, a shop manual for a jeep. The authors are not afraid of dispensing anecdotal reports or of generously sprinkling drug trade names when discussing treatment. This lends a feeling of informality and chattiness to the highly readable text.

Andrews' Diseases of the Skin: Clinical Dermatology

Herpes zoster is a major health burden that can affect individuals of any age. It is seen more commonly among individuals aged ≥50 years, those with immunocompromised status, and those on immunosuppressant drugs. It is caused by a reactivation of varicella zoster virus infection. Cell-mediated immunity plays a role in this reactivation. Fever, pain, and itch are common symptoms before the onset of rash. Post-herpetic neuralgia is the most common complication associated with herpes zoster. Risk factors and complications associated with herpes zoster depend on the age, immune status, and the time of initializing treatment. Routine vaccination for individuals over 60 years has shown considerable effect in terms of reducing the incidence of herpes zoster and post-herpetic neuralgia. Treatment with antiviral drugs and analgesics within 72 hours of rash onset has been shown to reduce severity and complications associated with herpes zoster and post-herpetic neuralgia. This study mainly focuses on herpes zoster using articles and reviews from PubMed, Embase, Cochrane library, and a manual search from Google Scholar. We cover the incidence of herpes zoster, gender distribution, seasonal and regional distribution of herpes zoster, incidence of herpes zoster among immunocompromised individuals, incidence of post-herpetic neuralgia following a zoster infection, complications, management, and prevention of herpes zoster and post-herpetic neuralgia.

Epidemiology, treatment and prevention of herpes zoster: A comprehensive review.

[Varicella-zoster virus infection].

Parasitic zoonoses (PZs) pose a significant but often neglected threat to public health, especially in developing countries. In order to obtain a better understanding of their health impact, summary measures of population health may be calculated, such as the Disability-Adjusted Life Year (DALY). However, the data required to calculate such measures are often not readily available for these diseases, which may lead to a vicious circle of under-recognition and under-funding.

https://dspace.library.uu.nl/bitstream/handle/1874/305043/journal.pntd.0002634.pdf;sequence=1

The Burden of Parasitic Zoonoses in Nepal: A Systematic Review

72 Introduction: Skin diseases are a common cause of morbidity in Nepal as per the health services report. There is limited information on the prevalence and pattern of skin diseases in the community. The objective of this study was to determine the pattern of skin diseases in a rural village development community of Nepal. Materials and methods:  Two  dermatologic  health camps were conducted, during which, the villagers were examined by dermatologists. The skin diseases diagnosed were recorded in a proforma. Results: There were 433 individuals examined and 359 (male-47.9%; female-52.1%) had skin disease identified clinically (camp prevalence- 83%). The age of patients ranged from 1 to 80 years (mean-24.5; SD±15.9), with majority in the age group of 10-19 years. The most common skin disease category was eczemas (36.4%), followed by infections (28.4%), acne (22%), pigment disorders (34%) and urticaria (12.3%). Conclusion: Skin diseases were common in the community. The five most common Skin disease categories were eczemas, infections, acne and pigment disorders were the more common conditions. DOI: http://dx.doi.org/10.3126/njdvl.v12i1.10595 Nepal Journal of Dermatology, Venereology & Leprology Vol.12(1) 2014 pp.41-44

/pdf/pattern-of-skin-diseases-in-a-rural-village-development-4mlmt27w17.pdf

Pattern Of Skin Diseases In A Rural Village Development Community Of Nepal

Keywords: Herpes zoster; Clinico-epidemiological profile; dermatomes DOI: http://dx.doi.org/10.3126/njdvl.v8i1.5710 Nepal Journal of Dermatology, Venereology & Leprology 8(1) 2009 1-4

/pdf/changing-profile-of-herpes-zoster-in-nepal-a-hospital-based-41252he817.pdf

Changing Profile of Herpes Zoster in Nepal: A Hospital-Based Study

Introduction: AUGIB is characterized by hematemesis or melena or both. Peptic ulcers and variceal bleed account for majority of cases. Use of proton pump inhibitors in current era is associated with a gradual reduction in burden of peptic ulcer disease. We conducted this study to look into the cause of AUGIB in our community.Methods: We studied 100 patients in one year period who presented to us with hematemesis or melena. The study was conducted in department of Gastroenterology, Bir hospital, Kathmandu. We identified the culprit lesions by upper gastrointestinal endoscopy.Results: The average age of patients with AUGIB was 51.6 years with 59 (59%) males. Duodenal ulcers are most common 29 (29%), followed by varices 23 (23%) and gastric ulcers 14 (14%). More than one lesion was identified in 38 (38%) patients. Patients with variceal bleed were more likely to present with hematemesis alone as compared to those with ulcer bleed (p=0.005). Variceal bleed patients presented earlier to the hospital (p=0.005), had lower MAP at presentation (p=0.0002), had lower hemoglobin level (p=0.0001) and higher serum creatinine level at presentation (p=0.001). Patients with variceal bleed were more likely to have consumed alcohol 20 (86.9%) and patients with ulcer bleed were more likely to be smokers 29 (67.4%) or consume tobacco 14 (32.5%) (p=0.006).Conclusions: Ulcer related bleeding is still the most common cause of AUGIB. Many patients with AUGIB have more than one lesions identified during upper gastrointestinal endoscopy.Keywords:  bleeding; endoscopy; peptic ulcer; upper gastrointestinal;varices. [PubMed]

/pdf/acute-upper-gastrointestinal-bleeding-in-a-tertiary-care-5f0yds0ffc.pdf

Acute Upper Gastrointestinal Bleeding in a Tertiary Care Centre of Nepal

Skin Diseases and Impact on Quality of Life in the Central Development Region of Nepal : A major public health problem

Skin Diseases and Impact on Quality of Life in the Central Development Region Of Nepal: A Major Public Health Problem

BackgroundHand eczema is a very common condition that has a significant effect on an individual’s life in terms of daily functioning including various occupations. Studies show that the point prevalence of hand eczema is around 4% and the lifetime prevalence is 15%.
ObjectiveThe objective of this study is to determine the prevalence and pattern of hand eczemas in patients attending the Dermatology outpatient department of Bir hospital.
Materials and methodsThis is a retrospective study, where all the cases of hand eczema who presented to the Dermatology Out-Patient Department of Bir Hospital during the period from Baisakh 2075 till Chaitra 2075 B.S were recorded.
ResultsEczema was diagnosed in 5,100 new cases (15.74%) and among them, hand eczema was seen in 494 cases, which accounts for 9.68% of all eczemas. The mean age was 37.43 years. Out of all the hand eczemas recorded, 334 (67.6%) were unspecified hand eczemas, pompholyx was seen in 92 (18.6%) cases, chronic hand eczema in 27 (5.5%), contact dermatitis in 20 (4%) patients and finger tip eczema was seen in 15 (3%) cases.
ConclusionHand eczema is one of the common dermatological conditions. Our study showed the prevalence of hand eczema to be 9.68%.

/pdf/prevalence-and-pattern-of-hand-eczema-in-a-tertiary-referral-1la4szxdei.pdf

R Shrestha

Papers

Pattern Of Skin Diseases In A Rural Village Development Community Of Nepal

Changing Profile of Herpes Zoster in Nepal: A Hospital-Based Study

Acute Upper Gastrointestinal Bleeding in a Tertiary Care Centre of Nepal

Skin Diseases and Impact on Quality of Life in the Central Development Region Of Nepal: A Major Public Health Problem

Prevalence and pattern of hand eczema in a tertiary referral hospital of Nepal