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Scabies
SCABIES, previously known as the SEVEN-YEAR ITCH, is a contagious skin infestation by the mite Sarcoptes scabiei . The most common symptoms are severe itchiness and a pimple -like rash. Occasionally, tiny burrows may be seen in the skin. Once infected, a never-before-infected person will usually develop symptoms in between two and six weeks. If a person has a second exposure later in life, the body's immune system will often respond much more quickly and symptoms may begin within as little as 24 hours. These symptoms can be present across most of the body or just certain areas such as the wrists, between fingers, or along the waistline. The head may be affected, but this is typically only in young children. The itch is often worse at night. Scratching may cause skin breakdown and an additional bacterial infection of the skin. Scabies
Scabies
is caused by infection with the female mite Sarcoptes scabiei var. hominis . The mites burrow into the skin to live and deposit eggs. The symptoms of scabies are due to an allergic reaction to the mites. Often, only between 10 and 15 mites are involved in an infection. Scabies
Scabies
is most often spread during a relatively long period of direct skin contact with an infected person (at least 10 minutes) such as that which may occur during sex. Spread of disease may occur even if the person has not developed symptoms yet
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The Seven-year Itch
THE SEVEN-YEAR ITCH is a psychological term that suggests that happiness in a relationship declines after around year seven of a marriage . The phrase originated as a name for irritating and contagious skin complaints of a long duration. Examples of reference may have included STD outbreaks that are known to significantly decrease in frequency after seven years, or mites that live under the skin (scabies ) and cause severe itching that is hard to get rid of. Later on in the 19th and early 20th centuries it was viewed as an expression of imagined appropriate punishment for antisocial behavior , or as a simile for a situation with little hope in relief. The phrase was first used to describe an inclination to become unfaithful after seven years of marriage in the play The Seven Year Itch by George Axelrod , and gained popularity following the 1955 film adaptation starring Marilyn Monroe
Marilyn Monroe
and Tom Ewell
Tom Ewell
. The phrase has since expanded to indicate cycles of dissatisfaction not only in interpersonal relationships but in any situation such as working a full-time job or buying a house, where a decrease in happiness and satisfaction is often seen over long periods of time. CONTENTS * 1 Divorce
Divorce
rates * 2 Media influences * 3 See also * 4 References DIVORCE RATES The seven-year itch can be analyzed quantitatively
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Specialty (medicine)
A SPECIALTY (or SPECIALITY) in medicine is a branch of medical practice. After completing medical school , physicians or surgeons usually further their medical education in a specific specialty of medicine by completing a multiple year residency to become a MEDICAL SPECIALIST. CONTENTS * 1 History of medical specialization * 2 Classification of medical specialization * 3 Specialties that are common worldwide * 4 List of specialties recognized in the European Union and European Economic Area * 5 List of North American medical specialties and others * 6 Physician
Physician
compensation * 7 Specialties by country * 7.1 Australia and New Zealand * 7.2 Canada * 7.3 Germany * 7.4 India * 7.5 United States
United States
* 8 Other uses * 9 Training * 10 Satisfaction * 11 See also * 12 Notes * 13 References HISTORY OF MEDICAL SPECIALIZATIONTo a certain extent, medical practitioners have always been specialized. According to Galen
Galen
, specialization was common among Roman physicians. The particular system of modern medical specialities evolved gradually during the 19th century. Informal social recognition of medical specialization evolved before the formal legal system. The particular subdivision of the practice of medicine into various specialities varies from country to country, and is somewhat arbitrary
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Infectious Disease (medical Specialty)
INFECTIOUS DISEASE, also known as INFECTIOUS DISEASES, INFECTIOUS MEDICINE, INFECTIOUS DISEASE MEDICINE or INFECTIOLOGY, is a medical specialty dealing with the diagnosis, control and treatment of infections. An infectious disease (ID) specialist's practice may consist largely of managing nosocomial (hospital-acquired ) infections, or it may be out-patient based. CONTENTS * 1 Scope * 2 History * 3 Investigations * 4 Treatments * 5 Training * 5.1 United States * 6 References * 7 External links SCOPEID specialists typically serve as consultants to other physicians in cases of complex infections, and often manage patients with HIV/AIDS and other forms of immunodeficiency. Although many common infections are treated by physicians without formal expertise in ID, the ID specialist may be consulted for cases where an infection is difficult to diagnose. They may also be asked to help determine the cause of a fever of unknown origin. ID specialists can practice both in hospitals (inpatient) and clinics (outpatient). In hospitals, ID specialists help ensure the timely diagnosis and treatment of acute infections by recommending the appropriate diagnostic tests to identify the source of the infection and by recommending the appropriate antibiotic to treat the infection. For certain types of infections, involvement of an ID specialists may improve patient outcomes
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Dermatology
DERMATOLOGY (from ancient Greek δέρμα, _derma_ which means skin and λογία, _logia)_ is the branch of medicine dealing with the skin , nails , hair and its diseases . It is a specialty with both medical and surgical aspects. A dermatologist treats diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails. CONTENTS * 1 Etymology * 2 History * 3 Training * 3.1 United States * 4 Fields * 4.1 Cosmetic dermatology * 4.2 Dermatopathology * 4.3 Immunodermatology * 4.4 Mohs surgery * 4.5 Pediatric dermatology * 4.6 Teledermatology * 4.7 Dermatoepidemiology * 5 Therapies * 6 See also * 7 References * 8 External links ETYMOLOGYAttested in English in 1819, the word _dermatology_ derives from the Greek δέρματος (_dermatos_), genitive of δέρμα (_derma_), "skin" (itself from δέρω _dero_, "to flay" ) and -λογία _-logia_. HISTORY Main article: History of dermatology Readily visible alterations of the skin surface have been recognized since the dawn of history, with some being treated, and some not. In 1801 the first great school of dermatology became a reality at the famous Hôpital Saint-Louis in Paris, while the first textbooks (Willan's, 1798–1808) and atlases (Alibert\'s , 1806–1814) appeared in print during the same period of time
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Itchiness
ITCH (also known as PRURITUS) is a sensation that causes the desire or reflex to scratch. Itch
Itch
has resisted many attempts to classify it as any one type of sensory experience. Modern science has shown that itch has many similarities to pain , and while both are unpleasant sensory experiences, their behavioral response patterns are different. Pain
Pain
creates a withdrawal reflex, whereas itch leads to a scratch reflex . Unmyelinated nerve fibers for itch and pain both originate in the skin ; however, information for them is conveyed centrally in two distinct systems that both use the same nerve bundle and spinothalamic tract . CONTENTS* 1 Signs and symptoms * 1.1 Contagious itch * 1.2 Pain
Pain
inhibition by itching * 2 Causes * 2.1 Infections * 2.2 Environmental and allergic * 2.3 Skin
Skin
disorders * 2.4 Medical disorders * 2.5 Medication * 2.6 Related to pregnancy * 2.7 Other * 3 Mechanism * 3.1 Dermal/pruritoceptive * 3.2 Neuropathic
Neuropathic
* 3.3 Neurogenic * 3.4 Psychogenic * 3.5 Peripheral sensitization * 3.6 Central sensitization * 4 Treatment * 5 Epidemiology * 6 See also * 7 References * 8 Further reading SIGNS AND SYMPTOMS Pain
Pain
and itch have very different behavioral response patterns
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Papular
A CUTANEOUS CONDITION is any medical condition that affects the integumentary system —the organ system that encloses the body and includes skin , hair , nails , and related muscle and glands . The major function of this system is as a barrier against the external environment. Conditions of the human integumentary system constitute a broad spectrum of diseases, also known as dermatoses, as well as many nonpathologic states (like, in certain circumstances, melanonychia and racquet nails ). While only a small number of skin diseases account for most visits to the physician, thousands of skin conditions have been described. Classification of these conditions often presents many nosological challenges, since underlying causes and pathogenetics are often not known. Therefore, most current textbooks present a classification based on location (for example, conditions of the mucous membrane ), morphology (chronic blistering conditions ), cause (skin conditions resulting from physical factors ), and so on. Clinically, the diagnosis of any particular skin condition is made by gathering pertinent information regarding the presenting skin lesion(s), including the location (such as arms, head, legs), symptoms (pruritus , pain), duration (acute or chronic), arrangement (solitary, generalized, annular, linear), morphology (macules, papules , vesicles ), and color (red, blue, brown, black, white, yellow)
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Sarcoptes Scabiei
_SARCOPTES SCABIEI_ or the ITCH MITE is a parasitic arthropod that burrows into skin and causes scabies . The mite is found in all parts of the world. Humans are not the only mammals that can become infected. Other mammals, such as wild and domesticated dogs and cats (in which it is one cause of mange ) as well as ungulates , wild boars , bovids , wombats , koalas , and great apes are affected. The discovery of the itch mite in 1687 marked scabies as the first disease of humans with a known cause. The Italian biologist Diacinto Cestoni showed in the 18th century that scabies is caused by the mite _ Sarcoptes scabiei_, variety _hominis_. The disease produces intense, itchy skin rashes when the impregnated female tunnels into the stratum corneum of the skin and deposits eggs in the burrow. The larvae , which hatch in three to 10 days, move about on the skin, moult into a nymphal stage, and then mature into adult mites. The adult mites live three to four weeks in the host's skin. CONTENTS * 1 Clinical significance * 2 Morphology * 3 Lifecycle * 4 See also * 5 References CLINICAL SIGNIFICANCEThe action of the mites moving within the skin and on the skin itself produces an intense itch that may resemble an allergic reaction in appearance. A delayed type IV hypersensitivity reaction to the mites, their eggs, or scybala (packets of feces) occurs approximately 30 days after infestation
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Mite
MITES are small arthropods belonging to the subclass Acari (also known as Acarina) and the class Arachnida . The scientific discipline devoted to the study of ticks and mites is called acarology . Many species live in soil as decomposers ; others are predatory or parasitic , these last including the commercially important Varroa mites of honeybees , and the scabies mite of humans. CONTENTS * 1 Diversity and ecology * 2 Medical significance * 3 See also * 4 References * 5 External links DIVERSITY AND ECOLOGY Lime nail galls on Tilia × europaea , caused by the mite Eriophyes tiliae Mites are among the most diverse and successful of all the invertebrate groups. They have exploited a wide array of habitats , and because of their small size (most are micro-animals ), go largely unnoticed. Some live freely in the soil or water, but many others live as parasites on plants, animals, and some that feed on mold . Some 48,200 species of mites have been described. Mites occupy a wide range of ecological niches . For example, Oribatida mites are important decomposers in many habitats. They eat a wide variety of material including living and dead plant and fungal material, lichens and carrion; some are predatory , though no oribatid mites are parasitic . Many mites are parasitic on plants and animals
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Risk Factor
In epidemiology , a RISK FACTOR is a variable associated with an increased risk of disease or infection . Sometimes, DETERMINANT is also used, being a variable associated with either increased or decreased risk. CONTENTS * 1 Correlation vs causation * 2 Terms of description * 3 Example * 4 General determinants * 5 Risk marker * 6 History * 7 See also * 8 References * 9 Further reading CORRELATION VS CAUSATION Risk factors or determinants are correlational and not necessarily causal , because correlation does not prove causation . For example, being young cannot be said to cause measles , but young people have a higher rate of measles because they are less likely to have developed immunity during a previous epidemic. Statistical methods are frequently used to assess the strength of an association and to provide causal evidence (for example in the study of the link between smoking and lung cancer ). Statistical analysis along with the biological sciences can establish that risk factors are causal. Some prefer the term risk factor to mean causal determinants of increased rates of disease, and for unproven links to be called possible risks, associations, etc. When done thoughtfully and based on research, identification of risk factors can be a strategy for medical screening
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Diagnostic Method
MEDICAL DIAGNOSIS (abbreviated DX or DS) is the process of determining which disease or condition explains a person's symptoms and signs . It is most often referred to as DIAGNOSIS with the medical context being implicit. The information required for diagnosis is typically collected from a history and physical examination of the person seeking medical care. Often, one or more DIAGNOSTIC PROCEDURES, such as diagnostic tests , are also done during the process. Sometimes Posthumous diagnosis is considered a kind of medical diagnosis. Diagnosis
Diagnosis
is often challenging, because many signs and symptoms are nonspecific . For example, redness of the skin (erythema ), by itself, is a sign of many disorders and thus doesn't tell the healthcare professional what is wrong. Thus differential diagnosis , in which several possible explanations are compared and contrasted, must be performed. This involves the correlation of various pieces of information followed by the recognition and differentiation of patterns. Occasionally the process is made easy by a sign or symptom (or a group of several) that is pathognomonic . Diagnosis
Diagnosis
is a major component of the procedure of a doctor\'s visit . From the point of view of statistics , the diagnostic procedure involves classification tests
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Differential Diagnosis
In medicine , a DIFFERENTIAL DIAGNOSIS is the distinguishing of a particular disease or condition from others that present similar clinical features. Differential diagnostic procedures are used by physicians and other trained medical professionals to diagnose the specific disease in a patient , or, at least, to eliminate any imminently life-threatening conditions. Often, each individual option of a possible disease is called a differential diagnosis (for example, bronchitis could be a differential diagnosis in the evaluation of a cough that ends up with a final diagnosis of common cold ). More generally, a DIFFERENTIAL DIAGNOSTIC PROCEDURE is a systematic diagnostic method used to identify the presence of a disease entity where multiple alternatives are possible. This method is essentially a process of elimination or at least a process of obtaining information that shrinks the "probabilities" of candidate conditions to negligible levels, by using evidence such as symptoms, patient history, and medical knowledge to adjust epistemic confidences in the mind of the diagnostician (or, for computerized or computer-assisted diagnosis, the software of the system). Differential diagnosis can be regarded as implementing aspects of the hypothetico-deductive method , in the sense that the potential presence of candidate diseases or conditions can be viewed as hypotheses that physicians further determine as being true or false
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Seborrheic Dermatitis
SEBORRHOEIC DERMATITIS, also known as SEBORRHOEIC ECZEMA, or simply SEBORRHEA, is a chronic, relapsing and usually mild dermatitis . It's a skin disorder affecting the scalp, face, and torso . Typically, it presents with scaly, flaky, itchy, and red skin. It particularly affects the sebaceous -gland-rich areas of the skin. In infants, seborrhoeic dermatitis is called "cradle cap ". In adolescents and adults, it usually presents as scalp scaling or as redness of the nasolabial fold . Dandruff is a type of seborrhoeic dermatitis where inflammation is not present. The topical antifungal medications ketoconazole and ciclopirox are both effective for the condition. It is unclear if other antifungals, such as miconazole , are equally effective as these have been poorly studied. CONTENTS * 1 Signs and symptoms * 2 Causes * 2.1 Fungal * 2.2 Other * 3 Prevention * 4 Management * 4.1 Medications * 4.1.1 Antifungals * 4.1.2 Antiandrogens * 4.1.3 Antihistamines * 4.1.4 Others * 4.2 Phototherapy * 5 Epidemiology * 6 See also * 7 References * 8 External links SIGNS AND SYMPTOMS Seborrhoeic dermatitis on scalp Acute form of seborrhoeic dermatitis on scalp Seborrhoeic dermatitis' symptoms appear gradually, and usually the first signs are flaky skin and scalp
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Dermatitis Herpetiformis
DERMATITIS HERPETIFORMIS (DH), or DUHRING\'S DISEASE, is a chronic blistering skin condition, characterised by blisters filled with a watery fluid. Despite its name, DH is neither related to nor caused by herpes virus : the name means that it is a skin inflammation having an appearance similar to herpes . DH was first described by Louis Adolphus Duhring in 1884. A connection between DH and celiac disease was recognised in 1967, although the exact causal mechanism is not known. DH is a specific manifestation of celiac disease. The age of onset is usually about 15-40, but DH can also affect children and the elderly. Men and women are equally affected. Estimates of DH prevalence vary from 1 in 400 to 1 in 10,000. It is most common in patients of northern European/northern Indian ancestry, and is associated with the HLA-DQ2 haplotype along with coeliac disease and gluten sensitivity . CONTENTS * 1 Signs and symptoms * 2 Pathophysiology * 3 Diagnosis * 4 Treatment * 5 Prognosis * 6 Notable cases * 7 See also * 8 References * 9 Further reading * 10 External links SIGNS AND SYMPTOMS Characteristic rash Dermatitis
Dermatitis
herpetiformis is characterized by intensely itchy , chronic papulovesicular eruptions, usually distributed symmetrically on extensor surfaces (buttocks, back of neck, scalp, elbows, knees, back, hairline, groin, or face)
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Pediculosis
PEDICULOSIS is an infestation of lice (blood-feeding ectoparasitic insects of the order Phthiraptera ). The condition can occur in almost any species of warm-blooded animal (i.e. mammals and birds ), including humans . Although pediculosis in humans may properly refer to lice infestation of any part of the body, the term is sometimes used loosely to refer to pediculosis capitis, the infestation of the human head with the specific head louse . CONTENTS * 1 Classification * 2 Head lice * 2.1 Presentation * 2.2 Diagnosis * 2.3 Treatment * 2.4 Epidemiology * 3 Body lice
Body lice
* 4 Pubic lice * 5 Other animals * 5.1 Treatment * 6 History * 7 See also * 8 References * 9 External links CLASSIFICATION Pediculosis
Pediculosis
may be divided into the following types: :446–8 * Pediculosis capitis ( Head lice infestation) * Pediculosis corporis ( Pediculosis
Pediculosis
vestimenti, Vagabond's disease) * Pediculosis pubis (Crabs)HEAD LICE Main article: Pediculosis capitis PRESENTATION Play media Head louse crawling on a hairbrush Pediculosis
Pediculosis
in the head of a 6-year-old boy caused by the crab louse , as confirmed by optical (c) and electron microscopy (d)
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Atopic Dermatitis
ATOPIC DERMATITIS (AD), also known as ATOPIC ECZEMA, is a type of inflammation of the skin (dermatitis ). It results in itchy , red, swollen, and cracked skin. Clear fluid may come from the affected areas, which often thicken over time. The condition typically starts in childhood with changing severity over the years. In children under one year of age much of the body may be affected. As children get older, the back of the knees and front of the elbows are the most common areas affected. In adults the hands and feet are the most commonly affected areas. Scratching worsens symptoms and affected people have an increased risk of skin infections . Many people with atopic dermatitis develop hay fever or asthma . The cause is unknown but believed to involve genetics , immune system dysfunction, environmental exposures, and difficulties with the permeability of the skin. If one identical twin is affected, there is an 85% chance the other also has the condition. Those who live in cities and dry climates are more commonly affected. Exposure to certain chemicals or frequent hand washing makes symptoms worse. While emotional stress may make the symptoms worse it is not a cause. The disorder is not contagious . The diagnosis is typically based on the signs and symptoms. Other diseases that must be excluded before making a diagnosis include contact dermatitis , psoriasis , and seborrheic dermatitis
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