Rx Note

Introduction Miliaria, also known as heat rash, sweat rash or prickly heat, is a common skin disease caused by blockage and/or inflammation of eccrine sweat ducts. The blockage leads to backflow of eccrine sweat into the dermis or epidermis, resulting in a rash comprised of sweat-filled vesicles under the skin. The type of miliaria that develops depends on the depth at which the duct is blocked. Miliria crystallina - Occurs when the duct is blocked superficially, within or close to the stratum corneum. Miliaria rubra - The most common type; occurs when the duct is blocked deeper within the epidermis. Miliaria profunda - Occurs when the eccrine duct is blocked at or below the epidermal-dermal junction. Common triggers include hot and humid environments (especially shortly after moving to a tropical climate), strenuous physical activity, febrile illness and occlusion of the skin. Management The rash is usually self-limited and resolves without medical intervention. The primary treat...

Introduction Mpox (previously referred to as monkeypox) is a viral zoonotic infection that results in a rash similar to that of smallpox. However, historically, person-to-person spread outside the household and mortality from mpox are significantly less than for smallpox. Clinically, these 2 viral infections are difficult to distinguish. The virus belongs to the genus Orthopoxvirus in the family Poxviridae (other family member includes variola - causative agent of smallpox). It was first isolated in 1958 from a colony of sick monkeys. NOTE: Any case represents a public health emergency and suspicion of smallpox warrants immediate contact of local health departments. Transmission The virus can be acquired through contact with an infected animal's bodily fluids or through a bite . It can also be acquired through preparation of bushmeat (raw or minimally processed meat that comes from wild animals in certain regions of the world, including Africa). Monkeys and humans are incidental h...

Introduction Herpes zoster (also called shingles) is a localised, blistering and painful rash caused by reactivation of varicella zoster virus. After primary infection of chickenpox , varicella remains dormant in dorsal root ganglia nerve cells for years before it is reactivated and migrates down sensory nerves to the skin to cause herpes zoster. Triggering factors are sometimes recognised, such as Pressure on the nerve roots Radiotherapy at the level of the affected nerve root Spinal surgery An infection An injury (not necessarily to the spine) Contact with someone with varicella or herpes zoster Symptoms Herpes zoster is most often characterized by a painful, unilateral vesicular skin eruption arising in a single dermatome (or sometimes adjacent dermatomes). Commonly involved sites include thoracic, lumbar, cervical and trigeminal dermatomes. Skin eruptions are often preceded by a prodrome of pain or paraesthesias occurring 1-5 days prior to rash onset. Patients may experience nons...

Introduction Hand, foot and mouth disease is a highly contagious enteroviral infection (usually caused by Coxsackie virus A16 or enterovirus 71) , primarily affecting infants and children <10 years old . It spreads from person to person by coughing or sneezing, or by contact with mucus, saliva, blisters or the poo of an infected person. Children can also easily catch the disease by touching contaminated things (e.g. toys) and then putting their hands or toys in their mouth. Infected persons are most contagious during the first week of illness , but virus may be transmissible for weeks after symptoms have resolved (active virus may be shed in stool for up to 4-8 weeks). Symptoms Patients usually present with a maculopapular/vesicular rash on the extremities (predominantly the hands and to a lesser extent the feet) and painful oral lesions , which is often preceded by a 12-36 hour prodrome that may include fever (first sign) , sore throat, tiredness and loss of appetite. Converse...