Skin Infection Around a Fingernail or Toenail (Paronychia)

What is paronychia?

Paronychia is an infection of the skin next to a fingernail or toenail.

What is the cause?

The cutting or tearing of a hangnail or cuticle, nail biting, a splinter, or a thorn prick can cause a break in the skin near the nail. Bacteria or a fungus can then get into the skin and cause an infection.

A sudden painful infection is usually caused by bacteria commonly found on the skin. Infection that develops slowly is called chronic. It is usually caused by a fungus. You have a higher risk of having a chronic nail infection if:

• Your job involves a lot of exposure to water or chemical solvents. Examples of such jobs are housecleaning, nursing, food service, and dishwashing.
• You bite or tear your nails and cuticles.

These infections are more common and may be harder to treat in people who have diabetes or poor circulation, and in people whose immune systems are weakened by HIV, cancer, or other health problems.

What are the symptoms?

Symptoms may include:

• Painful, red, swollen skin around the nail
• Pus-filled blisters around the nail

If you have the infection for a long time, your nail may become thick and hard.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You may also have blood tests or a swab of the fluid from the sore to see what is causing the infection.

How is it treated?

For an infection caused by bacteria your healthcare provider may prescribe an antibiotic. For a fungal infection, your provider may prescribe an antifungal cream.

If you have pus-filled blisters, your healthcare provider may numb your finger or toe and then cut the pocket open to drain the pus. If the infection is beneath the nail, your provider may remove a section of the nail. Your provider may pack the wound with gauze to allow it to drain and heal.

Usually it takes about a week for a bacterial infection to heal. You may need to treat a fungal infection for several weeks with antifungal medicine before it heals.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. The best time to take care of an infection around your nails is as soon as it starts to develop.

• Wash the infected area with antibacterial soap and water and rinse it thoroughly.
• Soak your finger or toe in warm water or put a washcloth that has been soaked with hot water on the infected area.
• Put an antibiotic ointment on the area and cover it with a bandage.
• Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don’t take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.

Ask your healthcare provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent paronychia?

• Do not pick at your nails or cut the cuticles.
• Don’t bite your nails.
• If you want to push the cuticles of your nails back, use clean instruments and be careful not to push too hard.
• Wear gloves if your work or daily activities put your hands at risk for getting scratched, poked, or irritated.
• If you have infections around your nails often, talk to your provider.

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Treatment for Fungal and Bacterial Nail Fold Infections

Nail fold infections can be painful and interfere with daily activities. They may also spread around the nail to neighboring areas, or to other nails. It is therefore necessary to diagnose and treat them in time.

Most of these conditions are diagnosed clinically. Nail scrapings or clippings may help in doubtful cases, or if a culture needs to be taken. It is interesting that toenail infections take a longer time to heal than fingernail infections do.

Principles of Treatment

Acute paronychia

Antibiotics should be taken to treat bacterial infections of the nail fold. In most cases, acute bacterial paronychia is treated with a seven-day course of antibiotics. Hot fomentation in saline solution may also be helpful. Over-the-counter painkillers may be taken for severe pain. If the antibiotics are not working, a culture may need to be taken to test the bacterial sensitivity, and adjust the medication.

Penicillin and its derivatives such as ampicillin are the most effective antibiotics in nail infection, especially if caused by biting the nails or sucking the fingers. However, if the organisms are likely to be resistant, as with Staphylococcus or Bacteroides, Clindamycin or Augmentin (which contains ampicillin with clavulanate) are more appropriate.

In addition, a small incision may be required if a paronychial abscess forms. This is usually done under digital block anesthesia. If the skin over the abscess is yellowish-white the nerves are already dead and no anesthesia is required. The incision is made with a sterile small lancet, being careful to point the blade away from the nail. This will avoid inadvertent nail bed injury which will result in growth problems. The pus is expressed and the abscess cavity packed, while oral antibiotics are also prescribed. After 48 hours, the dressing is removed and regular warm soaks help to cleanse the cavity and promote healing. A light bandage is used in between soaks to keep it clean.

Chronic Paronychia

Chronic paronychia is caused by a combination of chemical irritation, trauma, exposure to wetness, and allergic reactions in some cases. Preventing future exposure is crucial, and gloves should be worn. The hands should be kept dry and clean. Topical steroids and antifungal ointment should be continued till it is healed. Antibacterial soaks are sometimes recommended to prevent secondary bacterial infection.

Surgery consists of marsupializing the cuticle or nail removal in cases when the medical treatment fails. The topical application of antifungal and steroid medication on the nail bed should be continued.

Fungal Nail Fold Infections

Antifungals are used to treat fungal nail infections. Since fungal infections are chronic, the medications should be continued for 3-6 months. In some cases, the topical antifungal is not effective, and oral antifungal therapy is required. If the infection affects the nail plate, treatment with oral antifungal tablets or antifungal paint is continued for up to 12 months.

Prevention of Recurrence

Any identified underlying condition or aggravating factor such as eczematous dermatitis or diabetes mellitus should be treated.

Nails should be carefully trimmed and future care should be advised. This includes:

• Keeping the hands dry and clean
• Wearing gloves with a cotton liner when working with chemicals or water
• Not covering your hands or nails (for instance, with artificial fingernails) all the time
• Avoid biting your nails

References

Further Reading

Paronychia Treatment at Home

Paronychia, also known as nail infection, refers to an infection that affects the skin around the nails, both toenails, and fingernails. It is the most common nail problem and is mostly caused by bacteria but a chronic paronychia is usually caused by a fungal infection. In essence, we have bacterial paronychia and fungal paronychia. Paronychia is more common with the hand, unlike onychomycosis which is more common with the foot. The location and appearance of paronychia distinguish it from other nail infections. Skin inflammation, pus, as well as pain are some of the indications of paronychia. This infection can develop in a few days and could also take a few weeks to develop depending on the cause.

Causes of paronychia

Paronychia often occurs as a result of irritation or injury to the skin adjacent to nails. When this adjacent skin is damaged, it becomes a thriving ground for germs including bacteria and fungi. The causes include the following:

·         Habitual sucking of the fingers

·         Biting or tearing off a hangnail

·         Any kind of trauma to the nail

·         Excessive trimming of the nail or the cuticle

·         Frequent soaking of the hands in water

·         Chemical irritants e. g. chemicals contained in the glue used for manicure

·         Underlying health issues such as diabetes

Symptoms of paronychia

Paronychia is very easy to distinguish yet can be confused with herpetic whitlow caused by a virus. When you notice the following symptoms around any of your nails, then you may have paronychia.

·         Inflammation of the skin surrounding the nail

·         Redness along the edges of the nail

·         Collection pus in the surrounding skin

·         The skin surrounding the nail becomes tender and is painful when touched.

Treatment of paronychia

Though paronychia is not an infection to lose sleep over, it can become serious by spreading to other fingers and toes if not treated promptly. It can even cause loss of nail(s). Fortunately, paronychia does not require medication most of the time; it can be successfully treated at home especially when it is a mild case. Let’s look at some of the effective home remedies for paronychia.

Home remedies for paronychia

Apple Cider Vinegar (ACV)

Apple Cider Vinegar is a natural remedy for paronychia. ACV is rich in antibacterial and antimicrobial properties. It contains active beneficial bacterial as well as antiseptic compounds which enable it to effectively destroy the bacteria responsible for paronychia.

Place a ball of cotton already soaked in ACV on the infected nail and leave it for about 20 to 25 minutes. Normally, you would feel some stinging effect; it is an indication ACV is combatting the infection. However, if the stinging is too painful for you, you can dilute ACV with water before using it next time.

Baking Soda

Both fungus and bacteria do well in an acidic environment hence increasing the pH of the skin around the nail will choke the bacteria and fungus causing paronychia. This is where baking soda comes in; it is highly alkaline hence when used in treating paronychia, it will reduce the acidity of the surrounding skin.

Make a paste by adding a few drops of water to baking soda, then apply the paste on the infected nail or finger and wrap with gauze. Do this about three times daily and paronychia will be gone into time.

Tea Tree Oil

Tea tree oil is an essential oil with numerous benefits. It combats a variety of infections. Flavonoids and terpenes contained in tea tree oil are loaded with antibacterial, antiseptic, and anti-inflammatory properties. Terpene-4-ol found in terpene is particularly good at curing paronychia.

Dilute tea tree oil with water or carrier oil such as coconut oil and apply a few drops of the mixture to gauze and wrap it around the infected area. If you can bear a level of stinging, you may not dilute tea tree oil. If the paronychia is caused by a fungus, add oregano oil to tea tree oil for greater antifungal properties.

 Aloe Vera Gel

Aloe Vera contains antiseptic and antibacterial properties. Polyphenol antioxidants contained in Aloe Vera takes care of the inflammation of the skin and soothes the nail bed and cuticle.

Get a fleshy leaf of aloe vera and it to the infected finger or toes. If you do not have fresh aloe vera leaves around you, you can purchase aloe vera gel from a local health store and apply it to the infected finger or toe.

Other home remedies include raw honey, garlic, echinacea, thyme, etc.

Conclusion

Paronychia can be successfully treated using any of the above home remedies. You must also pay attention to the risk factors and try as much as possible to reduce them in order to prevent paronychia.

Infections of the Hand and Fingers

By: Tom Gocke, DMSc, ATC, PA-C, DFAAPA

Infections of the hand and fingers are common medical problems that are seen in a variety of medical facilities. Like most things in medicine, we see the typical presentations for hand and finger infections. The infection responds to conventional therapy, and the patient recovers in a reasonable amount of time. However, on occasion, our patients throw us a curveball, and things don’t always go as planned. Please review this brief summary on hand and finger infections then, check out the link attached below. I trust this will help broaden your differential diagnosis the next time you treat a patient with a hand or finger infection. 

Many finger infections are superficial, self-limited, and respond well to early intervention. Common organisms associated with hand and finger injuries include Staphylococcus and Streptococcus species. The majority of Staphylococcus bacteria are methicillin-sensitive Staphylococcus aureus (MSSA). Methicillin-resistant Staphylococcus aureus (MRSA) organisms continue to pose a concern for clinicians who treat patients for skin-related infections. Traditionally, first-generation Cephalosporin antibiotics are mainstays in the treatment of bacterial hand and finger infections.1-6 When an MRSA infection is suspected, clindamycin, trimethoprim/sulfamethoxazole (TMP/SMX), and doxycycline are frequently used as oral antibiotic front-line therapy. Vancomycin remains the drug of choice in the empiric treatment of hospitalized patients with hand and finger infections.1-6 In this era of increasing antibiotic-resistant organisms, the use of culture-based organism identification and refined antibiotic coverage will limit the spread of drug-resistant organisms.2 The patient who is immunocompromised, takes immune-suppressing medications, uses tobacco, has poorly controlled diabetes, and has a history of IV drug abuse, are at an increased risk of developing infections.1-6 These contributing factors can exacerbate finger infections leading to treatment failures and severe long-term disabilities1,2. Paronychia (acute and chronic), bacterial Felon, and cellulitis are common finger infections.1-6 

Flexor tenosynovitis [FTS], also referred to as pyogenic, suppurative, or septic FTS and results from a closed space infection involving the finger flexor tendon sheath. This infection can spread and, if left untreated, can lead to septic arthropathy of the wrist. The diagnosis of septic FTS is based on clinical presentation and is not solely based on diagnostic imaging. Pathogens associated with septic FTS are predominantly MSSA with MRSA infections occurring in 15-30% of cases.1,2 Other organisms seen in septic FTS are Pseudomonas and other gram-negative bacteria. Injuries causing FTS are puncture wounds, bites wounds (animal/human), IV drug use, and other penetrating wounds to the finger/hand. Clinical presentation could include fevers, chills, erythema, finger(s) swelling, and painful finger(s) ROM. Kanavel signs are associated with FTS. They include swelling of the involved digit(s), tenderness on palpation of the flexor tendon, pain with passive finger extension, and fingers held in the flexed position. Tenderness on palpation of the flexor tendon and pain with passive finger extension is the most reliable of the Kanavel signs for predicting septic FTS.2 The patients who you suspect of having septic FTS should be admitted and started on appropriate empiric IV antibiotic (Vancomycin, or Piperacillin-Tazobactam). 1-4,6 Frequently, patients will respond to antibiotic therapy in 12 to 24 hours.2 However, patients who are diabetic, smoke, have a hx of IV drug abuse, who are malnourished, or are immunocompromised may not respond to IV antibiotic therapy. If patients fail to respond to antibiotic therapy or present with an advanced infection, they will require surgical intervention in addition to antibiotic therapy.1-4,6 

In summary, most patients presenting with paronychia, Felon, or cellulitis can be treated with warm soaks and oral antibiotic therapy. In those patients with recalcitrant paronychia infections, remember that this may be the result of nail-biting. Their infection is comprised of both skin and oral flora, requiring a broader spectrum of antibiotic therapy. For patients with advanced cellulitis or septic FTS, who fail to improve after 12 to 24 hours of empiric vs. organism-specific IV antibiotic therapy, may require surgical intervention to resolve their infection.  

https://www. nytimes.com/2020/12/16/magazine/mycobacterium-marinum.html?smid=em-share 

REFERENCES  

1. Patel DB, Emmanuel NB, Stevanovic MV, et al, Hand Infections: Anatomy, Types and Spread of Infection, Imaging Findings, and Treatment Options, RadioGraphics 2014;34(7):1968-1986 

2. Bilolikar VK, Seigerman DA, Ilyas AM, Diagnosis and Management of Common Hand Infections, JBJS Reviews 2020;8(4): E0188 

3. Rerucha CM, Ewing JT, Oppenlander KE, Cowan WC, Acute Hand Infections, Am Fam Physician 2019;99(4):228-236 

4. Rabarin F, Jeudy J, Cesari B, et al, Acute finger-tip infection: Management and Treatment, Orthopaedic & Traumatology & Research, 2017;103:933-936 

5. Nardi NM, Schaefer TJ. Felon. [Updated 2018 Dec 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019, accessed November 21, 2019 

6. Koshy JC, Bell B. Hand Infections. J Hand Surg Am. 2019 Jan;44(1):46-54  

See Tom Gocke, DMSc, ATC, PA-C, DFAAPA speak at a 2021 Skin, Bones, Hearts & Private Parts CME Conference in Destin, Myrtle Beach, Pensacola Beach , Orlando, or Las Vegas.

In-person, Live Stream, or On-demand

Nail fungus – Diagnosis and treatment

Diagnosis

Your doctor will examine your nails. He or she may also take some nail clippings or scrape debris from under your nail and send the sample to a lab to identify the type of fungus causing the infection.

Other conditions, such as psoriasis, can mimic a fungal infection of the nail. Microorganisms such as yeast and bacteria also can infect nails. Knowing the cause of your infection helps determine the best course of treatment.

Treatment

Fungal nail infections can be difficult to treat. Talk with your doctor if self-care strategies and over-the-counter (nonprescription) products haven’t helped. Treatment depends on the severity of your condition and the type of fungus causing it. It can take months to see results. And even if your nail condition improves, repeat infections are common.

Medications

Your doctor may prescribe antifungal drugs that you take orally or apply to the nail. In some situations, it helps to combine oral and topical antifungal therapies.

• Oral antifungal drugs. These drugs are often the first choice because they clear the infection more quickly than do topical drugs. Options include terbinafine (Lamisil) and itraconazole (Sporanox). These drugs help a new nail grow free of infection, slowly replacing the infected part.

  You typically take this type of drug for six to 12 weeks. But you won’t see the end result of treatment until the nail grows back completely. It may take four months or longer to eliminate an infection. Treatment success rates with these drugs appear to be lower in adults over age 65.

  Oral antifungal drugs may cause side effects ranging from skin rash to liver damage. You may need occasional blood tests to check on how you’re doing with these types of drugs. Doctors may not recommend them for people with liver disease or congestive heart failure or those taking certain medications.

• Medicated nail polish. Your doctor may prescribe an antifungal nail polish called ciclopirox (Penlac). You paint it on your infected nails and surrounding skin once a day. After seven days, you wipe the piled-on layers clean with alcohol and begin fresh applications. You may need to use this type of nail polish daily for almost a year.

• Medicated nail cream. Your doctor may prescribe an antifungal cream, which you rub into your infected nails after soaking. These creams may work better if you first thin the nails. This helps the medication get through the hard nail surface to the underlying fungus.

  To thin nails, you apply a nonprescription lotion containing urea. Or your doctor may thin the surface of the nail (debride) with a file or other tool.

Surgery

Your doctor might suggest temporary removal of the nail so that he or she can apply the antifungal drug directly to the infection under the nail.

Some fungal nail infections don’t respond to medicines. Your doctor might suggest permanent nail removal if the infection is severe or extremely painful.

Lifestyle and home remedies

Often, you can take care of a fungal nail infection at home:

• Try over-the-counter antifungal nail creams and ointments. Several products are available. If you notice white markings on the surfaces of the nails, file them off, soak your nails in water, dry them, and apply the medicated cream or lotion.
• Trim and thin the nails. This helps reduce pain by reducing pressure on the nails. Also, if you do this before applying an antifungal, the drug can reach deeper layers of the nail.

Before trimming or using a nail file to thin thick nails, soften them with urea-containing creams. If you have a condition that causes poor blood flow to your feet and you can’t trim your nails, see a health care provider regularly to have your nails trimmed.

Preparing for your appointment

You’re likely to start by seeing your family doctor or a general practitioner. In some cases when you call to set up an appointment, you may be referred immediately to either a doctor who specializes in skin conditions (dermatologist) or one who specializes in foot conditions (podiatrist).

To make the most of your time with your doctor, it’s good to prepare for your appointment.

What you can do

• List your symptoms, including any that may seem unrelated to nail fungus.
• List key personal information, including any major stresses or recent life changes.
• List all the medications, vitamins and supplements you’re taking.
• List questions to ask your doctor.

For nail fungus, your questions might include:

• What is likely causing my symptoms or condition?
• What are other possible causes for my symptoms or condition?
• What tests do I need?
• What is the best course of action?
• What are the alternatives to the primary approach you’re suggesting?
• I have other health conditions. How can I best manage them together?
• Is a generic alternative available for the medicine you’re prescribing?
• Do you have any brochures or other printed material that I can take home? Do you recommend any websites on nail fungus?

Don’t hesitate to ask any other questions you have.

A man with an infected finger: a case report | Journal of Medical Case Reports

A 23-year-old Caucasian man with no medical history was referred to our emergency department by his primary care physician because of swelling and erythema of the little finger of his left hand for ten days prior to presentation. He had been prescribed the antibiotic Augmentin® (amoxicillin-clavulanic acid), and the primary care physician had already incised the finger releasing clear liquid (no pus). Despite this therapy, his complaints persisted. He had no fever or itching, and had never had these complaints before (Figures 1 and 2).

Figure 1

Patient’s finger, dorsal view. Dorsal and radial side of the patient’s little finger, showing yellowish vesicles and erythema.

Figure 2

Patient’s finger, dorsal view (Figure 1) zoomed in.

We confirmed the erythema and swelling of the distal phalanx of his left little finger, with vesicles with a yellow translucent colour. From these vesicles, a clear fluid spontaneously discharged. There was no pus, bony tenderness or pain over his flexor tendons. The motion of his finger was unlimited, and he had no fever (Figures 3 and 4).

Figure 3

Patient’s finger, radial view. Radial side of the patient’s little finger, showing yellowish vesicles and erythema.

Figure 4

Patient’s finger, palmar view. Palmar side of the patient’s little finger, showing two yellowish vesicles.

On the basis of the clinical appearance we considered herpetic whitlow with superinfection. When asked, he confirmed he had also observed vesicles on his genitals. He denied ever having sexual intercourse or contact with infected individuals. A polymerase chain reaction on herpes simplex virus type 1 was positive on both the material from his genital vesicles and on material from his finger. We referred him to a dermatologist for further treatment. Because of spontaneous subsidence of his complaints, Fucidine® (fusidic acid) cream was chosen as primary treatment. In other cases, in which subsidence does not occur spontaneously, antiviral agents such as acyclovir or valacyclovir may also be used.

The herpes simplex virus causes two types of infections: primary and recurrent. Usually, a break in the skin barrier (for example a wound) allows the virus to enter the tissue and establish an infection. Appearing several days after a person’s first exposure, the sores of a primary infection last approximately 1 to 3 weeks. They heal completely, rarely leaving scars. Nevertheless, after the primary infection, the virus remains in the body, hibernating in nerve cells. Certain triggers can cause the hibernating (latent) virus to become active and travel back to the skin. Recurrent infections tend to be milder than primary infections, and generally occur in the same location as the primary infection [3,4].

Mucous Cyst of the Finger

A mucous cyst is a sac filled with fluid that appears on the finger, above the joint located next to the nail (the distal interphalangeal joint). The cyst can often thin the skin around the nail. The mucous cyst somewhat resembles a balloon on a stick, due to its fluid-filled appearance, and a stalk attached to this that connects the cyst to a joint.

The texture of the cyst is firm and is not easily malleable under the skin. Due to its nature, the cyst is often painful for the patient and is in danger of breaking open, increasing chances of infection.

As a result of the mucous cyst growing so close to the fingernail, the nail can grow with an indentation towards its base or grow irregularly.

Unless a cyst seems to be in danger of rupturing or is causing pain to the patient, it can be left alone without any harm caused to the patient.

Causes of Mucous Cyst

Mucous Cyst is commonly related to osteoarthritis affecting the joint where the cyst develops. Though it is not known exactly how they develop, it is thought that the cysts are formed when connective tissue that connects the tendons in the finger, wears away. When is happens, is it thought that collagen from the degenerated connective tissue is left behind and begins to collect in pools which then form cysts.

Since mucous cyst is most often found in relation to patients suffering from osteoarthritis, the main group of people at risk of this condition is patients between 50 to 70 years old.

It is possible that over time, these cysts will change in size or disappear completely without surgical removal. It is important to note that this type of cyst is not in danger of becoming cancerous or of spreading to any other area.

Symptoms of Mucous Cyst

A mucous cyst is found on the outer most joint of the finger, on the upper side where the nail is. It is usually visible just underneath the skin on the finger, sometimes having caused the skin to thin over the top. The cyst is a small bump, filled with clear fluid, but with a tough outer layer, limiting the movement of it, and feeling quite firm to the touch, unlike a blister or other such complaint.

In most cases of mucous cyst, the issue is not painful and quite often causes little to no problem or dysfunction. If the cyst begins to cause pain or dysfunction for the patient, or has recurrent drainage, or seems to be at risk of rupturing, then a doctor will assess the situation and decide on the treatment needed.

Diagnosis of Mucous Cyst

Despite the low risk for patients with suspected mucous cyst, it is recommended that a clear diagnosis be made by a doctor, to assess the condition and examine for any other underlying or related issues.  Diagnosis of mucous cyst is relatively simple for most doctors or hand specialists. A doctor will examine the fingers and discuss the history of the issue with the patient.

Since mucous cyst is most commonly related to the condition of arthritis, if the patient has never been diagnosed with this, a doctor will do a full assessment to determine if the root cause is an arthritic issue or if the cyst is simply an anomaly.

The doctor may also order an X-ray to examine the joint in the case of osteoarthritis to understand the level of joint degeneration. In the case where arthritis has not been previously diagnosed, the X-ray will confirm this also.

Treatment for Mucous Cyst

Often, the appropriate method of treatment for mucous cysts is to observe the cyst over time, paying attention to worsening symptoms or the possibility of it rupturing.

It is important for the patient to resist puncturing the cyst themselves, due to high risk of infection and lack of understanding on how to do this properly. If the cyst is becoming painful or close to rupturing, it is advised to be seen by a doctor who can take the next step in treating the issue.

If the cyst does rupture, it needs medical attention. At the base of the cyst is a stem connected to the joint, and when the cyst ruptures, it leaves a path directly into the joint that exposes it to possibility of deep infection inside the joint. In this case, a doctor will prescribe antibiotics that should be applied directly onto the site of the rupture, and the finger should be wrapped in a dressing. It is likely that a doctor will also prescribe oral antibiotics in addition. If the joint still develops an infection, the next step will be surgery.

Surgical Treatment for Mucous Cyst

If the site of the cyst causes significant pain prior to rupture, there are two main surgical options that can treat the root issue:

The first option is needle puncture, where a needle is used to puncture the cyst and then the cyst is aspirated (where the fluid is drawn out by suction). The problem with this procedure is that the recurrence rate is high, with over 50 percent of cases deemed unsuccessful in the long term.

The second option is to use excision (removal of the cyst), including the removal of its stem or connection to the joint itself. However, if the underlying cause of pain is not the cyst but osteoarthritis, it should be noted that the surgical removal of the cyst and its stem will not eliminate all pain.

In this procedure, the whole cyst, its stem and any bone spurs on the joint are fully removed. In cases where the skin on the finger is closely attached to the cyst, it may be necessary to remove a small portion of skin as well. In this situation, a small skin graft will be added to the spot where the skin is removed. In most cases, this surgical procedure can be performed using only regional anesthesia, numbing just the arm or even just the finger with lidocaine. The surgery can be done in-office and may take only fifteen minutes provided there are no complications.

Both of these procedures present a risk of infection. Also, even with the excision surgery, it is possible to experience a recurrence of a mucous cyst; however the cases of this are rare.

When the surgery is completed and in the cases where a skin graft is needed, a doctor will provide a cast or a splint for up to two weeks.

Once this is removed, there will be exercises given to the patient by a hand therapist in order to restore full movement and will be continued until the pain in the finger is completely gone.

Seeking Treatment for Mucous Cyst

Our goal at OSMI is to provide our patients quality, cutting-edge orthopedic treatments, both surgical and non-surgical. If you or someone you know has a growth on their finger matching the description of a mucous cyst and if you or they are already known to suffer from arthritis, please submit an online appointment request or contact our office at 817-529-1900.

90,000 Ways of HIV transmission – Federal Scientific and Methodological Center for the Prevention and Control of AIDS

Typical questions and answers to questions about HIV / AIDS.

Academician V.V. Pokrovsky answers questions.

How can you get AIDS?

Of course, they are not infected with AIDS (immunodeficiency), but with the virus that causes it (HIV). In order to infect a person, HIV must be transmitted to him from another, previously infected person.This can happen during sexual intercourse. It is the most common and natural way of HIV transmission. In addition, infection can occur when HIV-infected blood penetrates the internal environment of an uninfected person. This happens through a blood transfusion from an HIV-infected donor, with injections, which are given with needles and syringes, on which HIV-infected blood remains. Infected blood most often remains on needles and syringes used by drug addicts. There are cases when a similar thing happened in the hospital, if the doctors did not follow the precautionary rules.Finally, HIV can be passed from an infected pregnant woman to her unborn child. HIV is not transmitted in other ways

How do you get HIV from drug use?

Drug addicts are most often infected with HIV due to the fact that they use the same syringe and needle. First, one will inject, then the second, and a little blood of the first remains in the needle and in the syringe. If there is any virus in the blood of the first, it gets to the second. This is how not only HIV is transmitted, but also the viruses that cause hepatitis (inflammation of the liver) – hepatitis B and hepatitis C viruses, and many other microorganisms.HIV and other viruses can also get into the drug solution. If someone has already “tried” this solution, and for this he climbed into it with his dirty syringe. Sometimes drug addicts wash their syringes in the same bowl, not fearing that HIV will get into the wash water. It turns out that they do not rinse the syringe, but, on the contrary, infect him with HIV.

Can a drug be infected with HIV?

When purchasing a drug solution, you can never be sure that someone has not tried it and thus infected HIV or hepatitis viruses.

If HIV lives in human blood, then why is it in the liquid medium of the vagina and sperm, in breast milk?

All fluids that the human body produces are “products” originating from human blood. Cells in which HIV parasites pass into all these fluids from the blood.

Is it always possible to get HIV through contact with fluids from an infected person?

HIV needs not only to somehow “get out” from an already infected organism, but also to penetrate into a new victim.Moving to another person HIV is not so easy, because the CD4 cells that he needs to reproduce are in the deep layers of the skin, in the blood. Because of this, HIV is not transmitted in the household by shaking hands, hugging and similar contacts. Even if blood contaminated with HIV gets on intact skin, infection does not occur. The top layer of the skin, on which, among other things, there are special protective substances, serves as an obstacle to HIV. Sexual intercourse is a different matter, because with it, the smallest, sometimes invisible wounds always occur, and in addition, infectious material, semen or vaginal discharge, is also rubbed into these wounds.Inflammatory diseases of the genital organs also contribute to HIV infection. In places of inflammation, cells that carry CD4 accumulate. Inflammatory ulcers are the gateway for HIV to enter.

How long does HIV continue to act outside the body and is it possible to get HIV from contact with dried blood?

HIV remains active in frozen blood cells and semen for many years. And in dried blood it can stay “alive” for several weeks. Therefore, he can survive for quite a long time, for example, in a syringe with which an HIV-infected drug addict gave himself an injection.Hepatitis viruses live even longer.

For this reason, it is best not to touch blood in any form without rubber gloves. Boil laundry that has been exposed to blood or other liquids. Used plastic syringes and needles must not be reused! Glass syringes and needles used by others must be boiled for at least two hours before being used again, but this may not save you from the hepatitis virus.

Can you get infected during the first sexual intercourse?

The first sexual contact for men is no less dangerous than any other, and even more dangerous for girls, since it usually leads to more injuries.And wounds, as we have already said, are the gateways for HIV.

Does a condom help prevent AIDS and is it 100% safe?

A condom significantly reduces the likelihood of infection, but, unfortunately, it does not give a 100% guarantee. The fact is that even the highest quality condoms sometimes break or slip off. To reduce the likelihood of rupture, it is necessary to use condoms that have not expired.

In addition, pay attention to whether the packaging is not damaged.

Condoms that have stuck together, damaged or torn can not be used! It is dangerous to open the package with sharp objects, as this could damage the condom and rupture.

Do not use condoms without lubrication, this also increases the likelihood of rupture.

You cannot use the same condom twice, it will definitely break.

To reduce the likelihood of slipping, you need to put a condom on an already tense penis, but before contacting the partner’s body.

After ejaculation, the condom must be carefully removed from the still tense penis, so as not to spill its contents, tied in a knot, wrapped in paper and discarded.

If the condom breaks, you need to rinse the genitals with a weak solution of potassium permanganate, or vodka diluted in half with water, or just rinse well with water. This will reduce the chance of infection.

How do birth control pills work, do they prevent HIV infection?

Contraceptive pills act only on the process of oocyte formation, and therefore do not protect at all against HIV infection.

Special ointments and liquids have appeared on the market, on which it is written that they kill HIV.Is it really so?

These solutions and ointments kill HIV only in laboratory experiments. There is no reliable data that they kill HIV in natural conditions. Therefore, they are best used with condoms. Many of these solutions, especially those containing chlorine compounds, cause irritation and sores on the genitals. Well, ulcers, as you know, are the gateway for HIV.

Does saliva deactivate the virus?

Saliva contains substances that destroy HIV.But they, apparently, are not enough so that HIV infection through contact between the genitals and the mouth never occurs. One American, out of fear of AIDS, limited himself to only this type of sex, but still became infected. Therefore, condoms with flavors, mint, orange, etc. are available on the market.

Can a person get the AIDS virus when kissing?

There is no risk of infection with kisses on the cheek or forehead. Kisses on the lips can also be different: if, when kissing, lovers bite each other until they bleed, or some of them have bleeding gums, there is a minimal risk of transmission of HIV and the viruses that cause hepatitis.But reliable cases of HIV infection through kissing have not yet been registered.

Can HIV exist in the air?

HIV does not fly through the air. None of those who breathed the same air with those infected with HIV in the same, even the smallest room, became infected with HIV.

Can HIV be transmitted through food and drink?

HIV is not spread through food and drink. None of those who ate foods prepared by HIV-infected cooks became infected.

Do high temperatures destroy HIV?

Temperatures over 100 degrees per minute kill HIV. Even at a temperature of 56 degrees, HIV dies in half an hour. However, inside the human body, a constant temperature remains in the range of 35-45 degrees. Therefore, even the hottest bath does not kill HIV in the blood and internal organs of an infected person.

What ethnic groups are most infected with HIV?

The virus does not care what ethnic group a person belongs to (that is, what language he uses and what religious customs he observes).Linking HIV / AIDS with some special population groups can lead to tragic consequences. For example, in South Africa until 1991, HIV was detected only in white homosexual men. Therefore, the black population of South Africa thought that AIDS was a disease of white people, and did not take any precautions. Therefore, by 2000, it turned out that almost every fifth black resident of the country was already infected with HIV.

Who is most affected by HIV / AIDS?

The risk of HIV infection, and hence the risk of AIDS, varies among different population groups at different periods of the epidemic.The earliest and fastest spread of HIV is among homosexual men and among intravenous drug users and prostitutes. But then the entire population is at risk. In Russia, homosexual men were the first to be infected with HIV, then an epidemic began among drug addicts.

And now HIV threatens EVERYONE equally!

Can an infection occur when touched in a dance, in a gym?

Can’t. But if during exercise injuries occur, accompanied by bleeding, you need to handle the blood very carefully.

Can you get HIV through food, dishes?

Not allowed. None of those who ate from the same plate and drank from the same cup with HIV-infected people became infected.

What to do to avoid contracting HIV?

In order not to become infected with HIV, you must, firstly, not have sexual intercourse with just anyone. It should be borne in mind that drug addicts, homosexuals, prostitutes, and generally more sexually “experienced” people, had a greater risk of “picking up” HIV, hepatitis viruses, syphilis and other sexually transmitted diseases.At the same time, of course, in some cases it is difficult to learn anything about the past of specific people. It is ideal, of course, to find a friend who has not yet had time to become infected with HIV, and with whom you could then live your whole life. But in order to be completely sure, it is necessary to undergo an HIV test with him. If this does not work out, you need to remember about the condom. When going on a date that can go far, you need to stock up on condoms in advance. And it’s better to always have them with you.

What should you not be afraid of that does not pose a risk of HIV infection?

Ways of HIV transmission are limited, so there is no need to be afraid of accidental, domestic HIV infection. Even if an HIV-infected person is near you, it will not lead to infection. In the United States, doctors examined thousands of families with HIV-infected people and AIDS patients. It turned out that none of those who used the same dishes, the same toilet bowl, bathroom, none of those who slept in the same bed with an HIV-infected (and in the United States, poor families sleep in the same bed), but did not have sexual contact with infected with HIV, did not become infected.None of those who used the same toothbrush got infected either.

If your partner has AIDS, what is the likelihood of contracting it?

The sexual partner is sick with AIDS or is just infected with HIV, nevertheless, you can always get infected from him. The likelihood of infection depends on many factors, such as the amount of HIV in the partner’s blood, ulcers and inflammatory diseases of the genital organs in both partners and many others. For this reason, sometimes infection can occur with a single sexual intercourse, and sometimes sexual partners live together for years before infection occurs.

If an HIV-positive person takes antiretroviral drugs correctly, their risk of contracting HIV is significantly reduced. This risk is further reduced if you take antiretroviral drugs yourself (pre-exposure prophylaxis).

However, antiretroviral drugs only protect against HIV infection and do not protect against other viruses. Therefore, during sexual intercourse with an HIV-positive person, if you do not want to get infected with other infections, it is recommended to use condoms.

What to do if you have had sexual contact with a person whose HIV status is unknown?

After sexual contact with an unknown person, including after rape, you can take antiretroviral drugs to prevent HIV infection according to the scheme recommended by a specialist doctor at the local AIDS center

Can you get HIV when you get a tattoo?

Tattooing, ear piercing, persing and similar fashionable procedures are dangerous as they are often performed with dirty instruments.Who can be sure that a fashion lover infected with HIV has not been pricked with the same needle before?

When giving first aid to an injured person who is bleeding, can you get infected? I heard that a doctor who helps a patient in the ring can get infected?

There appears to be a risk of contracting HIV through exposure to blood, although there have been no reliable cases of HIV infection resulting from washing or dressing wounds.There is a much greater risk of contracting the viruses that cause hepatitis. Therefore, foreign blood that has got on the skin should be washed off as soon as possible (if there is soap, then with soap). If blood gets into your eyes, they should also be rinsed with clean water as soon as possible.

Artificial respiration is best done through a handkerchief or other fabric.

Can you get HIV through bites from humans or animals?

Animals are not infected with the human immunodeficiency virus, which means they cannot infect humans.But from their bites, you can catch some other infectious diseases: rabies, “rat bite disease”, “cat scratch disease.” Therefore, if you are bitten by animals, you should consult a doctor.

As for the bites of a person infected with HIV, the risk of infection is very small. Fortunately, people bite much less often than animals. But if this happens, then to prevent HIV infection, you can take antiretroviral drugs according to the scheme recommended by the specialist doctor at the local AIDS center

Can a person get infected if he shares a razor with an HIV-infected person?

If human blood is left on a straight razor or blade, cutting another person can become infected with viruses.So it’s not safe to share a razor with anyone.

How do children get AIDS?

HIV is transmitted to a child from an infected mother during pregnancy, childbirth and breastfeeding. If the mother is infected. The probability that a child will be infected is 25-30 percent. Taking antiviral drugs, prohibiting breastfeeding and some other techniques can reduce the risk of infection of the child from the mother by up to 1%.

That is, without examination and treatment of the mother, one or two out of four children born to HIV-infected mothers are born infected, and with appropriate treatment of the mother – only 1 out of 100.

Is it true that drug addicts are most often infected with AIDS, why?

Drug addicts often change syringes, take drugs from one dish, and therefore HIV from the blood of an infected drug addict can easily get into the blood of another. If HIV-infected blood gets into a syringe, needle or drug solution, then it is then injected directly into another person’s vein. The virus does not need anything else: it has entered the body of a new victim.

How long can a contaminated needle cause HIV infection?

HIV survives in a needle or syringe for up to a month, and the hepatitis virus even longer.It is best not to touch syringes and needles thrown by someone. Disposable plastic syringes are dangerous to reuse, and glass syringes need to be boiled for at least 2 hours.

If a pregnant woman is infected, will HIV be transmitted to her baby?

If the woman does not take precautions, the baby could be born infected with HIV. Pregnant HIV-infected women should take antiviral drugs, should not breastfeed, and then the risk of having an infected baby will be significantly reduced

90 000 Treatment of skin scars

Skin scar treatment

Skin scars (cicatrix) – secondary morphological elements that occur after inflammation, surgery or injury.After destruction, the skin acquires a focal pathological change in the form of an overgrown connective tissue with an unbalanced distribution of functional elements, therefore, any scars should be interpreted as a pathology, and not as a physiological norm. A scar is a product of incomplete regeneration of the skin after its damage and inflammation, at the site of cuts, injuries, burns, ulcerations, deep pustules, tubercles, knots, cracks. Unstable scars – cicatricial formations in places of increased alternating (stretching, compression) mechanical loads after secondary healed wounds (open fractures, infected or contaminated wounds) or split skin grafts, in which recurrent manifestations with infection occur without violating the integrity of soft tissues.They are distinguished by etiology (postoperative, post-traumatic, burns) and the level of growth of fibrous tissue from the skin surface. Scar classes: keloid, hypertrophic, normotrophic (normal), normo-atrophic, atrophic. Depending on the class of the scar, the methodology of treatment changes dramatically, and variations in the treatment of scars within each class are possible. It is believed that scarring is a 3-stage process that requires increased cell activity. Stage 1 lasts 2-3 months and is characterized by an increase in the volume of the scar.Stage 2 lasts 3-4 months, during which the volume of the scar decreases rapidly. Stage 3 lasts from several months to a year, and ends with the formation of a flat scar. The width of the scar is directly proportional to the volume of scar tissue formed during stage 1 of its development.

Keloid scar is a dense convex formation with a stretched smooth (at the beginning red, then paler) surface. Its edges are uneven with characteristic outgrowths in the form of crab claws, sticking out in different directions from the axis of the scar.Excessive scar tissue is called a keloid (from Greek: ???? – tumor and ????? – kind). A true keloid is also determined, which occurs without skin damage. Keloids do not cause pain. There are 4 types of keloid scars: star-shaped, cords, fan-shaped, array. Treatment of keloids is specific.

Hypertrophic scars are divided into 2 types: extensive and limited in area. They are somewhat smaller than keloid scars and normalize after a few years. With specialized treatment, normalization is much faster.

Normotrophic scars are flat formations almost indistinguishable from the surrounding skin. It is considered an excellent result if it became possible to transfer scars of other classes into normotrophic ones.

Normo-atrophic scars differ from others in that the collagen-depleted atrophic part is surrounded by annular normal scar tissue, which is absent in other classes of scars. It is generally recognized that the treatment of normo-atrophic scars is the most difficult task in cosmetology.The complexity of their treatment is aggravated by the fact that deep knowledge is required in several sciences at once, therefore, according to the rating of inventive problem solving and the classification of the level of dermatocosmetology problems, they belong to the 5 (highest) level of complexity. The class of normo-atrophic scars is extensive. Post-acne scars differ from postoperative scars mainly in shape (round in post-acne scars and linearly elongated or elliptical in postoperative scars), and post-traumatic scars can have a complex zigzag shape without axes of symmetry.They can be healed, albeit difficult. The most effective method is circular dermabrasion, developed at the Central Clinical Hospital of the SOCVD.

Unfortunately, atrophic scars are still not amenable to radical treatment. Among them are linear atrophies (striae distensae – striae), spotty atrophic dermatitis (anetodermia, dermatitis atrophicans maculosa – anetoderma) and Pasini – Pierini atrophodermia (atrophodermia Pasini – Pierini), in which atrophy of the epidermis and dermis is observed with the disappearance of elastin.

Treatment of skin scars is a multi-stage process that lasts a long time. it is required to restore the collagen structure of the skin.

90,000 Why in the XXI century it is worth stopping to be afraid of HIV diagnosis – Society

Almost 40 years have passed since scientists discovered the human immunodeficiency virus in 1983. Today, the diagnosis of HIV infection is not a sentence, but thanks to the discovery of highly active antiretroviral therapy, the disease itself has become a controllable one.

However, fears and prejudices associated with HIV and its terminal stage – AIDS, are still alive. The reason is the lack of knowledge. This is what leads to the fact that people who have received a positive test perceive the diagnosis tragically, and society stigmatizes HIV-infected people. In the TASS material – about the history of the emergence of the virus, the search for drugs and dangerous myths.

History of one virus

A terrible virus that came from monkeys was actively talked about in the 80s of the last century.It is assumed that he appeared in the Congo back in the 60s, and then spread from the African continent to America and went around the world. In the early 80s, when it became known about the first cases, no one understood what was happening to people and how to treat them.

In 1981, the first scientific article describing AIDS was published, and in 1983, scientists from two countries – from the Pasteur Institute in France and the National Cancer Institute in the USA – independently discovered the human immunodeficiency virus, which causes acquired immunodeficiency syndrome (AIDS) …Already in 1985, the first licensed HIV test appeared. Soviet people were among the last to learn about AIDS: the first case of the disease was registered in the USSR in 1986.

The virus was rapidly spreading across the planet: by 1991 it had been diagnosed in ten million, and by the beginning of the 21st century, AIDS had killed 21.8 million people.

Scientists have found that HIV is a retrovirus that attacks the cells of the immune system and makes the body vulnerable to external agents that attack the immune system.Immunodeficiency that develops as a result of HIV infection puts a person at an increased risk for a number of diseases that a healthy immune system can resist. HIV-infected people get sick with tuberculosis a hundred times more often than healthy people. In addition, they are more likely to develop oncology and opportunistic infections – diseases caused by opportunistic viruses, bacteria or protozoa. These include, for example, herpes, candidiasis and human papillomavirus.

For many years, information about the deadly danger of the disease caused panic and gave rise to myths.At the same time, the obvious danger of the disease forced scientists around the world to rally and begin to search for effective therapy.

Today, with more than 38 million people living with HIV in the world, such therapy exists and is available in many countries. We are talking about antiretroviral therapy (ART). And, although a drug for a complete cure for the virus has not yet been invented, thanks to modern drugs, the disease has become completely controllable. An HIV positive person lives a normal life while taking medications prescribed by a doctor.

The way to one tablet

The road to creating effective drugs has not been easy. At first, as in the case of the COVID-19 pandemic, scientists tried to use drugs that already existed on the market. Then hopes were pinned on an anticancer drug, but they were not justified.

The era of antiretroviral therapy began with the registration of a new drug in 1987. For many years it was included in the clinical guidelines for the treatment of patients, but over time it became clear that the virus is able to spontaneously mutate in the body and quickly acquire resistance to the drug.

The search for effective therapy continues. In the early 1990s, it became clear that one pill was not enough to treat this disease: scientists began to develop combinations of different drugs. New drugs from the group of nucleoside reverse transcriptase inhibitors (NRTIs) have appeared. These antiretroviral drugs are structurally similar to the organic compounds found in ribonucleic acid (RNA) and deoxyribonucleic acid (DNA) – they can competitively block a specific HIV enzyme and slow down viral DNA synthesis.

The fact is that all genes of this virus are stored in RNA, and in humans – in DNA. Therefore, for reproduction, a virus must rewrite its genes from one format to another using reverse transcriptase. NRTI drugs interfere with this process: they prevent the virus from transferring genes from RNA to DNA.

However, in 1993 at the International AIDS Conference, scientists announced research data, according to which the combination of drugs of this group alone does not give a long-term effect.Around the same time, a new group of drugs began to be used – protease inhibitors, which act on another enzyme of the virus. And in 1996, another class of antiretroviral drugs appeared – non-nucleoside reverse transcriptase inhibitors (NNRTIs). Like NRTIs, drugs in this class block the enzyme of the virus, interfering with the construction of HIV RNA, that is, the multiplication of the virus.

Scientists have found that a combination of drugs from several groups of drugs stops the multiplication of the virus in the body, since the drugs affect different enzymes of the virus, blocking its reproduction at different stages.

This discovery formed the basis for a new triple therapy for HIV infection, developed in 1996. It still remains the basis of most of the known ART regimens. It includes two NRTI drugs and a third, which is different in its action.

Since 1997, HIV has become a controlled chronic infection, and people who receive drugs stop dying of AIDS. The viral load in people taking antiretroviral therapy has been reduced to an undetectable level, they can create families with HIV-negative partners, give birth to healthy children, which was impossible to imagine back in the 80s.And now a new goal has appeared in the treatment of such patients: to provide people living with HIV with the most convenient drugs that will not affect their lives, will reduce the risk of developing resistance (resistance to therapy) and the appearance of side effects to a minimum.

Every year more and more new drugs and even new groups of drugs appear, the toxicity of therapy is constantly decreasing. So, in 2007, another new class of drugs appeared – integrase inhibitors, which block the introduction of HIV into the DNA of the host cell.There are currently five different drugs in this class.

Another major advance in pharmaceuticals is the development of two or three-in-one drugs that combine drugs from different groups. In 2006, the first combination drug entered the market that contains a three-component regimen in one tablet. Today there are about 30 such combination drugs on the market.

These drugs are effective for several reasons. First of all, such a scheme is much more convenient: a person drinks only one pill a day and can choose a time of admission that is comfortable for himself, there is no need to adjust the whole day to the therapy schedule.In addition, the risk of forgetting to take one tablet is much lower, and the percentage of patients who adhere to treatment is higher. When a person takes several pills several times a day, there is always a chance of accidentally not drinking one of the drugs in the scheme or skipping the entire therapy, and this increases the risk of developing drug resistance.

Another important point: the half-life of the drug from the body in the case of “one tablet once a day” regimens is longer, so even if a person for some reason cannot take the drug, then the next day he will have a sufficient concentration of active substances medications in the body to maintain adherence.And of course, most of the new drugs have fewer side effects.

By 2014, large-scale use of ART had helped prevent about 7.8 million deaths. Treatment tactics are also changing: if at first doctors prescribed therapy to patients with high viral load, now, according to the new WHO clinical guidelines, everyone should receive treatment as soon as possible after the diagnosis of HIV infection.

At the present stage, medicine faces new challenges: to achieve complete liberation from the virus.In addition, the world medical community is waiting for the first long-acting injectable therapy drugs to appear. Their development began in the 2010s. They will replace the daily pill intake with the injection of the drug once every two months, which will further simplify the treatment.

Modern ARVT consists of one combination drug or several monopreparations. In Russia, multicomponent therapy is more often prescribed. Combined drugs are received mainly by children, as well as by patients who have difficulties with taking therapy or are resistant to regimens consisting of mono-drugs.

True or False

When faced with a diagnosis for the first time, people search for information on the Internet and find unverified and outdated data, and sometimes outright lies. The HIV dissidents movement spreads information about the futility of treatment: in their opinion, therapy leads to health problems and even death.

The problem is that there is not a lot of available information on highly active antiretroviral therapy or it is written in complex scientific language.As a result, people still believe the myths surrounding HIV and ART. On closer inspection, these myths are easy to debunk.

1. HIV-positive people cannot have relationships with HIV-negative people, because they can infect loved ones.

Sometimes people are afraid to approach an HIV-infected person, to hug him. In fact, HIV is not spread by airborne droplets and through common household items. Human immunodeficiency virus is transmitted exclusively through blood, semen, breast milk and other biological fluids.When faced with oxygen, the virus dies.

At the same time, if an HIV-infected person takes the prescribed medications correctly, upon reaching an undetectable viral load, he will not infect a partner even with unprotected sex. Sometimes it is possible to achieve complete undetectability of the virus within two weeks of therapy, however, it is believed that a person does not transmit HIV only six months after the first analysis with an undetectable load. However, even in this case, you should not give up the means of barrier contraception: they protect against many other diseases.

2. You cannot have children with HIV.

Many HIV-positive couples today have healthy children. According to statistics, if an HIV-positive woman follows the recommendations of doctors during pregnancy, the chances of having a healthy baby are 98-99%. In the absence of antiviral prophylaxis in a pregnant woman during childbirth and during the first time of a child’s life, HIV is transmitted in 20-40% of cases. If a pregnant woman is diagnosed with HIV for the first time, she is immediately prescribed antiretroviral drugs to prevent perinatal transmission of the virus: to the woman during pregnancy and childbirth, to the child during the first four weeks of life.In addition, the newborn is transferred to artificial feeding immediately after birth to minimize the risk of infection.

3. People die from HIV.

Today, world medicine considers HIV to be a chronic, controllable infection. Experience has shown that if modern drugs are taken, HIV-positive people live as long as the average person.

People with HIV infection can take antiretroviral drugs and lead normal lives while scientists come up with a drug that can stop the virus once and for all.

4. HIV is spread only within traditional risk groups.

Last but most important myth. HIV has moved beyond traditional risk groups – people who inject drugs, LGBT people and sex workers. More than 60% of new infections are associated with heterosexual contact. Therefore, each person should take a responsible attitude towards their own health and the health of their loved ones: use barrier contraception and regularly, once every six months or a year, take an HIV test.Often, the transmission of the virus occurs precisely because of ignorance of their status and untimely initiation of antiretroviral drugs.

Arpimed

Driving and using machinery

The influence of Mebendazole on the ability to drive vehicles or operate machinery is unlikely.

How to take Mebendazole

Take the drug as recommended by your doctor. If you are in doubt about the correct use of a medicinal product, you should consult your doctor or pharmacist.

When using Mebendazole, you need to know:

• The drug is taken orally;
• The dose depends on the type of helminth you are affected;
• Crush tablet before giving to your child. Always monitor the child’s condition while taking the drug;
• 100 mg tablets can be chewed or swallowed whole;
• 500 mg tablets are recommended to be chewed before swallowing, it is not recommended to swallow the tablet whole;
• No need for laxatives or dietary changes.

How much to take

Adults and children over two years old.

Mebendazole 100 mg tablets

Filamentous helminths (pinworms):

• One tablet, single dose

One drug tablet can destroy this type of helminths. Your doctor may prescribe a second tablet after two weeks in case of reinfection.

Other common helminthic infestations (whipworm, roundworm, nematodes)

• One tablet twice daily (morning and evening) for three days, or as directed by a healthcare practitioner.

If you take more pills than needed

If you take more Mebendazole tablets than you should, inform your doctor immediately or go to the nearest emergency room.

If you forgot to take another tablet of the drug

• Do not take the missed dose;
• Take your next dose at the prescribed time, and then continue taking the drug as directed by your doctor.
• Do not take a double dose to make up for a missed dose.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

Remedy for fungus on toes

Remedy for fungus on toes

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Remedy for fungus on toes

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Where in St. Petersburg to buy a remedy for the fungus

Foot fungus treatment photo Treatment of the fungus on the toes depends on the degree of the disease.The initial stage can only be cured with external agents in the form of ointments or solutions. Neglected cases lend themselves only to a combination of tablet drugs with external ones to achieve maximum results in a short time. Why does a fungus appear between the toes? The fungus is transmitted through close communication with the pathogen carrier, using non-sterile manicure accessories, other people’s personal hygiene products and linen. The most popular treatments for fungus between the toes are ointments.Mycosan is an effective cream for fungus between the toes and nails. This medicine is able to restore the nail plate and remove unpleasant symptoms. The effect of the drug is. Treatment of interdigital fungus on the feet. A disease such as a fungus between the toes is very unpleasant and causes considerable discomfort. Nizoral is another well-known remedy for treating fungal infections between the toes. The active ingredient of the drug is ketoconazole. Apply one at a time every day. Fungus between the toes.Effective ointments for the fungus on the feet. It is worth knowing that there is no universal remedy for the fungus. For each form of fungal infection, the prescribed drug is used strictly for this pathology. It is for this reason that the help of an experienced doctor is so important. A remedy for the fungus between the toes should be prescribed by a doctor. What drugs effectively help against athlete’s foot. Antiseptic remedy for fungus on the feet between the toes. For effective treatment, it is important to get rid of infectious agents. In addition to special antifungal creams with this one.The most effective ointments for foot fungus. In therapy for the treatment of nail fungus, medicines of different groups are used. To obtain a good effect, a topical agent must be chosen correctly. A dermatologist, after an external examination, issues a referral for scraping. In contact with. Facebook. Twitter. Google+. Classmates. Mycotic lesion of the interdigital spaces is a very common phenomenon that causes severe discomfort. Treatment of the fungus between the toes should begin with an increase in immunity.After all, defense is required to fight the disease. After the remedy for fungus on the feet has been applied between the toes, physical activity should be avoided. It is recommended to carry out the procedure at night before going to bed that. Toenail fungus forum Effective remedy for fungus tablets Remedy for fungus and foot odor

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Ointment for toenail fungus list
How to cure a fungus on the big toe

I only use natural remedies to treat any disease.And when I contracted the fungus in the gym, I began to look for a remedy that would not contain chemical components that are dangerous to life and health. It was possible to use the recipes of alternative medicine, but I thought that there should be preparations with a natural composition, and I found Exolocin for nail fungus. The price and reviews were good, delivered quickly. I liked that the medicine is like a natural cream in smell and consistency. It is easily absorbed and acts quickly. As I expected, this turned out to be a great tool for people who understand formulations and will not use chemicals.Have you ever tried to get rid of toenail and foot fungus on your own? Judging by the fact that you are reading this article, the victory was not on your side. And of course you know firsthand what it is like to feel unbearable itching near the nail, burning between the fingers, peeling of the skin. Reviews for the drugs are positive. Most patients use it for prophylaxis, some manage to completely cure onychomycosis without the use of other drugs. Fungus between the toes: symptoms, how and what to treat.The most noticeable signs of mycosis of the skin are redness. Fungus is the itching and soreness of the skin between the toes. Fungal spores penetrate those areas of the foot where the skin is tender. The reasons for the development of flexion between the toes and the best drugs for treatment. Symptoms of the disease and folk remedies. Before treating the fungus on the feet between the toes, you need to know what it looks like and what symptoms appear. Most often, the disease manifests itself as follows. Fungus between the toes: the etiology of the disease.Stages and symptoms of the manifestation of pathology. It is better to prevent any disease than to cure it later. In order not to later wonder how to cure the fungus between the toes, do not neglect preventive measures. Fungus between the toes: how to treat and how to prevent the appearance. Fungus that appears between the toes. Often the fungus is not limited to skin lesions and spreads to the nail plates, they become thickened, change their color, lose transparency and exfoliate.If the fungus appears between the toes, you need to prevent its spread and take steps to treat it at home. How to cure fungus between toes at home. Causes of the fungus between the toes. Regardless of localization. Pathology of the skin of the feet and between the fingers. Wounds, scrapes and cuts in between. It is not recommended to treat the fungus between the toes at home without consulting a specialist. Note. Many medicines. Fungus of the feet and skin between the toes is a highly contagious fungal infection.You can get sick when trying on someone else’s shoes, if a person is infected. Based on the analysis of the scraping, the doctor will determine how to treat the fungus between the toes. There is also a general treatment regimen that includes. Treating the fungus between the toes. 09/07/2019. Content. Mycosis begins with cracking of the skin between the toes or at the base of the phalanx on the foot. Similar publications. Fungus on the skin (dermatomycosis): symptoms and how to treat. If a fungus appears in the ear? How and how to treat otomycosis. Toe fungus is a common problem that needs treatment.Every day the number of infected with fungus between the toes. Cracking of the skin on the fingers. The leg is sagging, which makes the spread of the fungus more intense. As they spread, they appear.

Remedy for fungus on toes

Fungus on the nails of the hands treatment with folk remedies

Strengthens the immune system to achieve a sustainable result. You need good nutrition, the use of foods rich in vitamins. These should be fruits, vegetables, milk, cottage cheese.After completion of treatment with Exolocin, take a break. After that, a short repeated course of the drug is carried out. This usually helps to avoid relapse. Treatment of nail fungus with green paint is not uncommon. Before treating the nail fungus on the toes or hands with brilliant green, it is recommended to first soften the affected tissue with a bath. For this purpose. How to get rid of fungus between your toes. Unfortunately, the fungus between the toes is a common problem, every second person suffers from it, due to the latent course of the disease, 90% of patients do not know about the disease, therefore they do not.Treatment of nail fungus with Zelenka is a folk method to overcome onychomycosis in. Zelenka (or brilliant green solution) is a drug most often used to disinfect wounds, cuts, or more simply. Also, foot fungus can resemble allergic dermatitis – the so-called skin manifestations of an allergic reaction. The skin turns red, the patient is itchy, and blisters may appear, as with a nettle burn. Peeling. Fungus between the toes. This place on the foot turns out to be the most convenient for the life of the microorganism.With this type of lesion, it is especially important to wear wide shoes with good ventilation. In clean conditions (at home) it is necessary. Treatment with green nail fungus allows you to get rid of painful sensations. When a fungal infection occurs, the nail plates turn yellowish and begin to crumble. With deformation of the nails. Iodine Iodine helps against fungus Alcohol solution of iodine is the most popular home remedy for treating toenail fungus. Let’s explain why. This strong antiseptic has proven fungicidal properties.Except. Fungus between the toes: photos, causes, symptoms and treatment – TOP-16. Green from the fungus between the fingers. Fungus is the itching and soreness of the skin between the toes. Treatment of skin lesions between the toes and feet. Symptoms Home ›Fungus› Zelenka from fungus on the legs. Sometimes I add Listerine to the foot bath for a disinfecting effect. Remedy for fungus on toes . An effective remedy for fungus tablets. Reviews, instructions for use, composition and properties. Toenail fungus is a fairly common problem that can affect anyone, regardless of age or gender.This unpleasant phenomenon occurs under the influence of pathogenic fungi and is transmitted from a sick person to a healthy one (through. Tablets from nail fungus. Preparations against fungal infection have long flooded the entire pharmaceutical market. Tablets from fungus on nails help if certain conditions are met: Correct dosage of the drug. What are the tablets for nail fungus? How do they differ? For the treatment of toenails, on average, 3 courses of therapy are prescribed with an interval of 3 weeks.Dosage form: capsules of 100 mg of the drug. Irunin capsules for nail fungus. Nystatin tablets for nail fungus. With a neglected situation on the legs or arms, they work better in combination. The drug is not prescribed for children and is not used with many other drugs, so consult a specialist before using it. But. With fungus of the nail plates, Irunin is taken for 3 months, 200 mg per day (2 capsules once). To combat mycotic lesions on the toenails, you will need 3 courses.Treatment with interruptions will take 9. List of effective pills for the treatment of foot and toenail fungus. As a rule, therapy lasts from several months to six months and takes place in courses – capsules are taken twice a day for 7 days, there can be 2-4 such courses, a break between them is 21 days. This drug. The scheme for taking pills against toenail fungus has its own characteristics. Most often used like this. Both of these drugs are available in capsule form with specific action against an extensive list of pathogenic fungi.Very often, the fungus affects the toenails, since the feet spend most of the day in socks, tights and shoes – sometimes stylish, but not very comfortable. Today we will talk about which pills for toenail fungus help the best, and how to take them correctly. When appointed. Effective fungus tablets: inexpensive remedies for treating infection. For other fungal diseases, 2 capsules 1 r / day for. If it is not possible to buy pills prescribed by a doctor for the fungus on nails or feet, look for analogues within the same active one.For the treatment of nail fungus, capsules are taken in a course: twice a day immediately after meals for a week. Such a drug for the treatment of toenail fungus fights well against fungal infection caused by dermatophytes.

90,000 reasons, treatment, prevention – Allergika Ukraine

Possible causes of itchy skin:

There are many different causes that can cause itchy skin. We will consider the most common ones below.

Contact dermatitis

With contact dermatitis, a person is more likely to experience itching of the palms.Contact dermatitis can be caused by any chemical, plastic or metal that a person touches or has direct contact. Contact dermatitis is often observed in beauty salon workers, medical workers, as a reaction to the frequent use of latex gloves.

Contact dermatitis is accompanied not only by itching, but also by other symptoms, such as:

• Rash: Small punctate to large red patches with scaling
• Cracks and wounds
• Irritation and redness

To diagnose allergic contact dermatitis, it is necessary to undergo skin tests – patch tests that will help determine what a person is reacting to.The feasibility of conducting patch tests is considered at an appointment with an allergist or dermatologist.

Common triggers for contact dermatitis include:

• aromas and fragrances
• metal jewelry, belts or watches
• Cobalt, found in hair dyes or deodorants
• some hand creams
• household disinfectants and detergents
• cosmetics, including decorative cosmetics

The best way to prevent contact dermatitis is to identify and avoid the irritant.

This can be difficult at times, so there are several products available to help relieve the itching of contact dermatitis.

Dyshidrotic eczema or dyshidrosis

A person with dyshidrotic eczema may notice tiny, itchy, fluid-filled blisters on the palms and fingers, and often on the toes and feet. The condition is thought to be related to stress, substances that can irritate the skin, and seasonal allergies.

A person with dyshidrotic eczema may notice:

• Small, liquid-filled blisters on fingers
• severe itching
• skin soreness
• redness and inflammation
• peeling and cracks on the palms

People who are sensitive to allergies are more likely to develop dyshidrotic eczema.In women, dyshidrotic eczema occurs twice as often as in men.

Psoriasis

Psoriasis is a skin disease characterized by increased formation of keratinocyte cells, which leads to the appearance of pink spots with scaly whitish plaques. Psoriasis most commonly affects the skin over the joints, the scalp, and the skin on the hands and nails.

• Along with itchy skin, a person with psoriasis may also notice:
• Skin irritation and redness
• White plaques with scaling and inflammation
• Skin dryness and cracks
• Soreness in the area of ​​rashes

Scabies

Itching of the skin of the hands and fingers is one of the important symptoms of scabies, a skin disease caused by the scabies mite.Infection with scabies through contact with a patient is the most common route of infection. But this can also happen when using dishes, towels and any objects that the patient has touched. Roughly speaking, you can get scabies even after traveling on public transport if you grab the handrails immediately after an infected person.

Ticks usually hide in folds of skin, including between the fingers and toes.

Scabies is common and extremely contagious. It is one of the most common skin conditions in developing countries.

When to see a doctor

Sometimes a person will independently cope with itchy skin of his hands at home, just by changing his lifestyle a little. If home remedies and topical treatments don’t work, you may need to see a doctor to rule out more serious skin conditions and to prescribe other medications.

Personal therapy – effective wound healing

Today there are many modern technologies, medical equipment, drugs and dressings.But they may not always be successfully applied in the case of chronic or severe infectious wounds. When the situation starts or if you do not seek medical help in a timely manner, amputation may be required in some cases.

Licinotherapy is a natural treatment for chronic and infected wounds, this method relieves patients from pain during dressing, unpleasant odor from necrotic ulcers and the risk of wound infection.

That’s right, it is the larvae that are used in the procedure, they eat dead cells and bacteria without harming healthy tissue.After such treatment, the wound will be clean, healing will accelerate and natural cell regeneration will begin.

Only clinically treated larvae are used in the procedure for medical purposes only. The number of larvae for treatment is selected individually and depends on the severity of the wound. 5-6 larvae will be used for a small wound, for example, on a finger, and for more serious wounds with a possible bone infection, 500-600 voracious invertebrates will be used. In this case, it will take about three days for processing.Physiotherapy is used to treat pressure ulcers, non-healing and chronic wounds, tissue infections, and burns.

Not only is it an effective and safe treatment for wound healing, it also stimulates cell regeneration. During the use of this therapy, no side effects have been identified. After treatment, the patient may have small blood spots, do not be afraid of this, as this is a good sign – the beginning of cellular activity. Tissue cleaning operations are no longer needed, the patient does not feel pain, he does not require additional medications, and the recovery time is reduced.