Vaccine Hesitancy Is Nothing New But It Can Be Overcome
Dermatology Course
The Cayetano Heredia – WC Gorgas Course in Tropical Dermatology is a one-week course constructed through the collaboration between the Gorgas Memorial Institute of the University of Alabama at Birmingham, the Alexander von Humboldt Tropical Medicine Institute of the Universidad Peruana Cayetano Heredia and the University of Pennsylvania. It was started as an effort to provide advanced subspecialty training in the field of tropical medicine. The course is held at the Alexander von Humboldt Tropical Medicine Institute in Lima, located next to the Tropical Diseases Unit of the Cayetano Heredia Hospital, the national tropical diseases referral center for Peru. Peru's diverse geography provides the participants the unparalleled opportunity for exposure to the wide spectrum of tropical diseases that are found in this national referral center.
Tropical Dermatologist Pores Over The Good, Bad And Ugly Of Sweaty Skin
Darwin broke an unwanted record on Tuesday night when the overnight minimum temperature reached a balmy 30C degrees.
This surpassed the previous maximum of 29.7C, making it the city's hottest night on record, while other weather records in the Top End tumbled last week.
Living in the tropics at this time of year means a sheen of sweat can accompany your every step outside of air conditioning, so if your skin's looking a little worse for wear, you're not alone.
The unsavoury conditions often joked about — fungal and bacterial infections, tinea, abscesses — are a day-to-day part of a dermatologist Dev Tilakaratne's work in the tropics
Understanding why comes back to the skin's role as a barrier to the environment, he told ABC Radio Darwin's Georgia Hitch.
"At the extreme — so extreme heat, extreme cold — our skin is there to facilitate and help us adjust to that," he said.
"The most basic mechanism that we have is that we get increased blood flow to the skin during times of heat.
"So you can imagine, with so much blood coming to our skin, it's able to radiate that heat out, dissipate it, and allow us to stay cooler."
Unfortunately, he said, sometimes we can more or less wear out that mechanism — enter sweat.
"There's only so much that that can do for us, so the sweating helps as well to kind of evaporate and cool that way."
"But unfortunately sometimes those processes go awry, and that's when disease can result."
Acne flaring up? This could be whyIn sweaty conditions, Dr Tilakaratne said, increased oil production could cause your skin to become a little macerated.
"[The skin] just kind of retains a bit too much moisture and the integrity of the surface layer of the skin or the epidermis starts to suffer a little," he said.
"Basically, the nasty bugs take advantage of that."
How to stop that rash in its tracksHe said tropical skin conditions could have any number of triggers — sweat, heat, environmental factors or predispositions — that needed to be examined on a case-by-case basis.
Urticaria (hives), Darier's disease (characterised by scaly, raised blemishes) and rosacea (skin inflammation) are among those that tended to be exacerbated by intense heat.
"And acne itself is probably a really big one up here," Dr Tilakaratne said.
"A lot of the time acne is just limited to the face, but in the heat we tend to see it then developing on the shoulders, back and even the chest.
"That is largely just a function of heat."
Dr Tilakaratne emphasised this is generic advice, but heat does keep him busy because of the way it interacts with the skin.
"When we think about where things happen on the body, in terms of tropical infection, it tends to be in skin folds — areas where the body temperature is a little higher," he said.
"The epidermis — the surface layer of the skin — is getting a little eroded."
Urticaria or hives and rosacea (L-R) are two skin conditions exacerbated by intense heat. (Supplied: Creative Commons)
An extra layer of clothing may helpWhile the common local coping strategy is to wear as little clothing as possible, Dr Tilakaratne said there were some instances when adding a second layer might help.
Lighter, more breathable fabrics — made of natural fibres rather than synthetic ones — will allow your skin to breathe and keep a lid on sweat in the first place.
"At the same time, depending on how much heat people are being exposed to, it can also be worthwhile wearing an underlayer of a very light cotton or a bamboo/cotton style of clothing," he said.
"The reason for that is that underlayer can then wick away that sweat as it forms on your body.
"If that can be changed a couple of times a day, then it means there's no real significant period of time where the sweat is just right up against the body, and there's no way for the sweat to kind of get congested and start back flowing down the sweat glands, which is when we start to see problems."
It's not all bad newsAt the other end of the scale, the tropical conditions can actually help some skin conditions.
Keeping cool in the tropicsDr Tilakaratne said eczema was much more burdensome down south than for his clients in the Territory.
This is largely because the humidity moisturises the skin and protects eczema suffers to some degree.
"There are a lot of people who are really plagued by eczema, especially atopic eczema, in the southern states who have moved to tropical climates deliberately and who have fared very well," he said.
"There is obviously a tipping point though," he added, saying that heat could exacerbate itchy conditions.
Above all, he stressed the exact cause of some conditions required thorough investigation to identify.
"Day-to-day, dealing with skin problems is like detective work, really.
"There are many factors that you have to take into consideration, and it's not like there is a standard formula or a tree diagram you can follow.
"You really have to piece together a lot of different parts of the situation."
Dermatologists Tackle Neglected Tropical Diseases
VANCOUVER, BC--(Marketwired - June 08, 2015) - Physicians at the World Congress of Dermatology (WCD) this week are sharing innovative solutions they have used to battle tropical diseases affecting the world's poorest people.
Of the 17 diseases designated as neglected tropical diseases by the World Health Organization (WHO), nine have significant dermatologic symptoms.
"These diseases affect millions of people who are already struggling with poverty, and who frequently have difficulty accessing medical care," said Dr. Rod Hay, Chairman of the International Foundation for Dermatology. "Dermatologists are committed to relieving the significant suffering caused by this situation."
One of the most widespread of the neglected tropical diseases is cutaneous leishmaniasis. According to the WHO, there have been about 1 million reported cases of cutaneous leishmaniasis in Asia, the Middle East, Africa and Latin America in the past five years. It is a disease that can cause ulcers on exposed parts of the body, leading to disfigurement, permanent scars, stigma and in some cases disability.
Bringing hope to Lebanese refugee camps
Though the disease is not endemic to Lebanon, the influx of refugees from Syria, where it does exist, has created a serious leishmaniasis problem in Lebanon's refugee camps. Given the conditions of the camps, providing care for these patients is challenging.
Dermatopathologist Dr. Ibrahim Khalifeh, from the American University of Beirut Medical Centre, has been working with a team of physicians to address this outbreak. Among other things, Dr. Khalifeh innovated a more rapid way of diagnosing patients.
"In studying this epidemic, we are seeing a new face of cutaneous leishmaniasis in times of war; stressful and unsanitary living conditions may account for the uncharacteristically high number of patients with extensive disease," said Dr. Khalifeh in his WCD abstract.
Using lasers to restore dignity
In Riyadh, Saudi Arabia, Drs. Huma khurrum and Khalid AlGhamdi, of King Saud University, are helping people heal from the after-effects of leishmaniasis. Many patients suffer from permanent scars that are not only disfiguring but also carry social stigma.
Dr. Khurrum has experimented successfully with a CO2 laser to improve the appearance of patients with this scarring, and has determined that it is a safe, effective and well-tolerated potential treatment.
Preventing leprosy in children
Leprosy remains one of the most feared and stigmatized diseases in the world. Though it is curable, contracting it can be a devastating experience.
Story Continues
In Indonesia, Dr. Cita Rosita Sigit Prakoeswa, of Airlangga University, was part of a team of physicians that set its sites on finding a way to prevent the disease while it was still "subclinical" -- in other words, before it becomes apparent through clinical manifestations.
Over two years, the team used a mix of antibiotics on school children in Java who tested positive for leprosy. None of the children went on to develop full-blown leprosy.
About the WCD
The World Congress of Dermatology is the world's oldest and continuous international dermatology meeting. The first WCD was held in 1889 and is presented under the auspices of the International League of Dermatological Societies. The 23RD WCD is the first to be held in Canada. For more information, contact the WCD press office at 778-331-7624 or www.Derm2015.Org. Follow the WCD on Twitter and Instagram at @Derm2015.
About the ILDS
The International League of Dermatological Societies is a non-governmental organization in official relations with the World Health Organization and was officially established in 1935 during the 9th International Congress of Dermatology and Syphilology held in Budapest. The objectives of the ILDS are to stimulate on a global basis the cooperation of societies of dermatology and societies interested in cutaneous medicine and biology; encourage the worldwide advancement of dermatological education, care, and science; promote personal and professional relations amongst dermatologists from around the world; represent dermatology in international health organizations; and, organize a World Congress of Dermatology every four years. For more information about the ILDS, connect with them on Twitter @ILDSDerm or visit www.Ilds.Org.
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