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Acute paronychia
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
Treatment of acute paronychia is determined by the degree of inflammation. If an abscess has not formed, the use of warm water compresses and soaking the affected digit in Burow’s solution (i.e., aluminum acetate), vinegar (acetic acid), or chlorhexidine may be effective. Acetaminophen or a nonsteroidal anti-inflammatory drug should be considered for symptomatic relief. Mild cases may be treated with an antibiotic cream (e.g., mupirocin, gentamicin, bacitracin/neomycin/polymyxin B) alone or in combination with a topical corticosteroid.
Leg, foot and nail disease in the elderly
Published in Robert A. Norman, Geriatric Dermatology, 2020
M. Alam, R. K. Scher, P. I. Schneiderman
In addition to compression, topical treatment may be of benefit13,14. Patients should be instructed on refraining from rubbing and scratching. Cool compresses, or cool saline or 2.5% Burow’s solution soaks, may relieve oozing and blistering. Lubricants, especially bland emollients like petrolatum, should be used at least twice a day to moisten the skin. Anti-inflammatory treatment with topical steroids should be used with caution since application to ulcers may impede healing. In general, medium-strength fluorinated steroids (e.g. triamcinolone 0.1%) can be used twice a day unless severe exacerbation necessitates stronger preparations. Topical antipruritic agents and topical antibiotic preparations should be used sparingly to minimize the risk of allergic contact dermatitis. Auto-eczematization, or ‘id’ reaction, can occur as a pruritic dermatitis on the face, neck and body as a result of severe stasis dermatitis of the lower extremities13. Id reaction may occur in one-third of patients with stasis17 and will persist until the stasis is controlled, possibly with a 1–2 week course of 40 mg/day of prednisone or by hospitalization for intensive treatment.
Vulvar therapies
Published in Miranda A. Farage, Howard I. Maibach, The Vulva, 2017
Natalie Moulton-Levy, Howard I. Maibach
Common habits can cause mucocutaneous irritation, and behavior modifications are necessary to reduce risk of vulvar irritation and ensure successful management. Modifications include, but are not limited to, use of cotton underwear, lubrication with sexual contact, washing with mild soap, keeping the vulva clean and dry, and avoidance of cosmetics, perfumes, or other caustic substances in this sensitive area. Aluminum acetate in water (e.g., Burow’s solution), topical creams (such as Sorbolene or aqueous cream), sitz baths with mild soap, and lubricants (such as petroleum jelly) are helpful in some cases. Secondary bacterial or Candida infections require specific treatment.
Wrong administration route of medications in the domestic setting: a review of an underestimated public health topic
Published in Expert Opinion on Pharmacotherapy, 2021
Maria Rosaria Gualano, Giuseppina Lo Moro, Gianluca Voglino, Dario Catozzi, Fabrizio Bert, Roberta Siliquini
Medication errors related to the incorrect route of administration are rarely considered in scientific works that analyze mistakes made by patients. However, case reports of adult patients who self-administered medications through the wrong route have been widely reported. For instance, in 1984, Huntley reported two accidental ingestions of topical drugs [8]. The first case concerned a 56-year-old woman with widespread psoriasis: she ingested two potassium permanganate tablets (325 mg each) with 300 mL of water instead of using these medications for dissolution in bathwater. In the second case, a 36-year-old man with tuberous sclerosis ingested one packet of Burow’s solution (aluminum triacetate) dissolved in a glass of water instead of using it topically on a wound infection. Fortunately, there were no severe consequences, but the author underlined the need for a change in packaging to prevent these types of errors [8]. In 1988, another case involved a 46-year-old man with hypertension who ingested nitroglycerin patches, thus showing that some patients require additional clarification to ensure the proper use of patches [9].
Optimal diagnosis and management of common nail disorders
Published in Annals of Medicine, 2022
Conservative therapies are often sufficient for treatment of acute paronychia without abscess. Warm soaks in water, vinegar or antiseptic solutions (Burow solution, chlorohexidine, povidone-iodine) are effective and may promote spontaneous drainage [49,51,58,65]. The affected digit should be soaked for 10–15 min, multiple times a day [54]. Topical antibiotics can be added if minimal erythema is present. Mupirocin, gentamicin and bacitracin are safe and effective options, but there is higher incidence of contact dermatitis with bacitracin [66]. If infection persists, oral antibiotics with gram-positive coverage should be initiated. Additional anaerobic coverage should also be included when oral flora is suspected [50].