Discussion Prompt 1
Describe the pathophysiology, clinical manifestations, evaluation, and treatment of atopic dermatitis, impetigo contagiosum, tinea capitis, thrush, and molluscum contagiosum.
The pathophysiology of atopic dermatitis is associated with several factors including IgE mediated hypersensitivity, increase in trans-epidermal water loss due to filaggrin losing their mutation functions and an imbalance in Th2 cytokines. Clinically, atopic dermatitis manifests itself in the form of dry, itchy skin on the face, behind knees or inside elbows. Though no cure exists, the condition is treated using topical steroids, phototherapy, or using topical calcineurin inhibitors (Clebak& Malone, 2018). Impetigo Contagiosum results from the action of exfoliative toxins which contain serine proteases on desmoglein 1, a peptide bond that holds epidermal cells in a molecule. This condition manifests itself in the form of red sores around the nose that burst to form a yellowish-brown crust. The treatment options are either application of mupirocin cream for mild cases while in severe cases, oral antibiotics and certain cephalosporins are used (Habif et al., 2017).
Tinea Capitis results from the Trichophyton and Microsporum species of fungi. This condition manifests either as round, bald patches or as dandruff or black dots. The standard treatment for this condition is oral griseofulvin or a newer oral antifungal agents like itraconazole that take shorter treatment courses (Clebak & Malone, 2018). The disruption of either normal immunity or normal host flora results to the overgrowth of yeast, making the epithelial cells to peel. Bacteria and keratin ten accumulates here until it ultimately causes thrush. Thrush manifests in the form of white Kurdish-like lesions on the gingiva, tongue, palate and buccal mucosa. Mild cases are treated using topical antifungal agents or using nystatin oral suspension (Habif et al., 2017). Molluscum contagiosum is a condition caused by the poxvirus (molluscum contagiosum virus) and is replicated in the epithelial cells to produce cytoplasmic inclusions and an enlargement of the infected cells. This condition manifests in the form of small, shiny white or painless pink lesions on the skin. In a majority of the cases, these lesions fade away without any medical intervention. However, in extreme cases, treatment options include topical therapy, laser therapy or cryotherapy (Clebak& Malone, 2018).
References
Clebak, K. T., & Malone, M. A. (2018). Skin infections. Primary Care: Clinics in Office Practice, 45(3), 433-454.
Habif, T. P., Chapman, M. S., Dinulos, J. G., & Zug, K. A. (2017). Skin disease e-book: diagnosis and treatment. Elsevier Health Sciences.
Discussion Prompt 2
Multiple Organ Dysfunction Syndrome
Multiple Organ Dysfunction Syndrome (MODS) is not an event but a process that is characterized by the gradual increment of physiologic derangements which can either be mild organ dysfunction to complete organ failure. In this condition, the organ functions are altered entirely to the extent of requiring medical intervention to achieve homeostasis (Marshall, 2016). For this reason, MODS falls in the list of among the leading causes of death in patients in ICU care. Up to date, the pathophysiology of MODS remains an issue of speculation following an array of situations such as infections, tissue ischemia and inflammatory responses. A severe trauma that results in massive tissue damage leads to the activation of an overwhelming and uncontrolled inflammatory response not to mention the individual’s defence and clotting mechanisms. These cause several cellular cascades which then result in the loss in the ability to localize the inflammation. The result is derangement in oxygen utilization, increased permeability and severe tissue damage, which ultimately to MODS. The main players in this process are oxidants, neutrophils, endotoxin, cytokines, and macrophages (Maier, 2016).
Clinically, MODS manifests itself in the form of widespread capillary damage, systemic inflammation, and even apoptosis. The more easily observable signs and symptoms of MODS include confusion, fatigue, malaise, and anxiety. However, these are not specific to MODS as they are not pathognomonic to the infection. Additionally, since the infection belongs to a clinical continuum that includes systemic inflammatory response syndrome (SIRS), sepsis, and septic shock, specific features depend on the position of the patient in the continuum (Marshall, 2016). Therefore, having a deep understanding of MODS’ pathophysiology and the resulting organ dysfunction is essential in developing a suitable treatment plan for the condition. Some of the treatment approaches for MODS include use of antimicrobial therapy or surgery, disruption of the pathogenesis of the condition. In extreme situations, the patient is resuscitated from septic shock as a way of correcting hypoxia, hypotension and impaired tissue oxygenation (Marshall, 2016). The success of either of these treatment plans is dependent on the treatment and control of the underlying disease processes.
References
Maier, R. V. (2016). Pathogenesis of multiple organ dysfunction syndrome-endotoxin, inflammatory cells, and their mediators: cytokines and reactive oxygen species. Surgical infections, 1(3), 197-205.
Marshall, J. C. (2016). The multiple organ dysfunction syndromes. In Surgical treatment: evidence-based and problem-oriented. Zuckschwerdt.