Dermatology Case No 18. Molluscum Contagiosum

Hello I'm Raiyyan Tahsan

Brand Model and Executive

Dermatology Case No 18. Molluscum Contagiosum

Molluscum Contagiosum

•এটা এক ধরনের স্কিন ইনফেকশন যা Molluscum contagiosum নামক ভাইরাস দিয়ে হয়।

•আক্রান্ত ব্যক্তির সংস্পর্শে গেলে/আক্রান্ত ব্যক্তির ব্যবহার্য জিনিস ব্যবহার করলে এটি হতে পারে

•১০,০০০ জনে ১ জনের হতে পারে।

লক্ষণ:

সহজে চেনার উপায়—

-একটা dome shape papular lesion থাকবে,umbillical appearance অর্থাৎ umbilicus এর মত centrally dimple and pointed end থাকবে।

-Painless

-can be itchy

Herpes zoster থেকে আলাদা করব কিভাবে?

•hepes zoster এ vesicular lesion (fluid filled lesion) থাকে কিন্তু Molluscum contagiosum এ papular lesion হয়।

•herpes zoster lesion গুলো গ্রুপ করে থাকে।

চিকিৎসা

-topical salicylic acid (kerarolytic agent)

Cream salicid 6℅

Cream 1.Kerasol 6% 30gm Tube (AS A Salicylic Acid Topical salicylic preparation).

দিনে দুইবার আক্রান্ত স্থানে —–৮সপ্তাহ

Indications of Cream :-Kerasol 6% 30gm Tube (AS A Salicylic Acid Topical salicylic preparation).

6% Kerasol: This topical preparations treat the following common scaly conditions:

Chronic atopic dermatitis
Lichen simplex
Psoriasis
Seborrhoeic dermatitis
Ichthiosis

12% Kerasol: This topical preparations treat the following common scaly conditions:

Warts (small excessive growths of skin caused by a type of virus. Warts often occur on the fingers or on the back of the hands).
Verruca (occurs only on the sole of the feet and can be painful. It often looks like a small white ring of skin with a black dot in the centre).
Corns and Calluses (are hard, thick pads of skin caused by pressure and friction. They usually occur on the feet due to poorly fitting shoes and can occur on the hands).

2% Kerasol: This topical preparation is indicated in-

Mild to moderate acne
Blackheads and whiteheads
Redness & swelling of face
Pimples
To prevent future acne breakouts

Description of Cream :-Kerasol 6% 30gm Tube (AS A Salicylic Acid Topical salicylic preparation).

Kerasol is available by prescription only as a topical aid in the removal of excessive keratin in hyperkeratotic skin disorders including verrucae and the various ichthyoses (vulgaris, sex-linked and lamellar), keratosis palmaris and plantaris, keratosis pilaris, pityriasis rubra pilaris and psoriasis (including body, scalp, palms and soles).

Pharmacology of Cream :-Kerasol 6% 30gm Tube (AS A Salicylic Acid Topical salicylic preparation).

Salicylic Acid has a potent keratolytic & a slight antiseptic action when applied topically to the skin. In low concentrations, the drug has keratoplastic activity (correction of abnormal keratinization) & in higher concentrations, the drug has keratolytic activity (causes peeling of skin). Salicylic Acid softens & destroys the stratum corneum by increasing endogenous hydration (water concentration), probably because of decreased pH, which causes the cornified epithelium (horny layer of the skin) to swell, soften, & then desquamate. Necrosis of normal skin has been associated with overuse of the drug. At high concentrations, Salicylic Acid has a caustic effect. Moisture is essential for Salicylic Acid to exert its action on the skin and for maceration and desquamation of epidermal tissue to occur. The drug has weak antifungal & antibacterial activity.

Dosage & Administration of Cream :-Kerasol 6% 30gm Tube (AS A Salicylic Acid Topical salicylic preparation).

6% & 12% Salicylic Acid: Apply to affected area once daily. Hydrate area for 5 minutes prior to application if possible. Occlude the area at night. Wash off in morning. Salicylic Acid is used in children over 2 years.

2% Salicylic Acid: Apply enough medicine to cover the affected area once daily in 1st week then 2 to 3 times daily from 2nd week and rub gently. After 3-5 minutes rinse face with cool water. Salicylic Acid is used in children over 2 years.

Interaction of Cream :-Kerasol 6% 30gm Tube (AS A Salicylic Acid Topical salicylic preparation).

Do not use other topical preparations on the treated area unless otherwise directed by your healthcare provider. They may interfere with treatment or increase skin irritation.

Contraindications of Cream :-Kerasol 6% 30gm Tube (AS A Salicylic Acid Topical salicylic preparation).

It should not be used in any patient known to be sensitive to Salicylic Acid or any other listed ingredients.

Side Effects of Cream :-Kerasol 6% 30gm Tube (AS A Salicylic Acid Topical salicylic preparation).

An allergic reaction (shortness of breath, closing of the throat, swelling of the lips, face or tongue or hives) or severe skin irritation.

Pregnancy & Lactation of Cream :-Kerasol 6% 30gm Tube (AS A Salicylic Acid Topical salicylic preparation).

Pregnancy Category C. If used by nursing mothers, it should not be used on the chest area to avoid accidental contamination of the child.

Precautions & Warnings of Cream :-Kerasol 6% 30gm Tube (AS A Salicylic Acid Topical salicylic preparation).

For external use only. Avoid contact with eyes and other mucous membranes.

Overdose Effects of Cream :-Kerasol 6% 30gm Tube (AS A Salicylic Acid Topical salicylic preparation).

An overdose of Kerasol topical is unlikely to occur. If the medication has been ingested or an overdose is suspected, the patient needs to be hospitalized immediately.

Therapeutic Class of Cream :-Kerasol 6% 30gm Tube (AS A Salicylic Acid Topical salicylic preparation).

Topical salicylic preparation

-চুলাকানি থাকলে systemic antihistamine

Tablet 2. Fexo 120mg

2 Tablet- Fexo 120 mg (AS A – Fexofenadin Hydrochloride AS A Non-sedating antihistamines).

Indications of tab- Fexo 120 mg (AS A – Fexofenadin Hydrochloride AS A Non-sedating antihistamines).

Allergic rhinitis: Fexo is indicated for the relief of symptoms associated with seasonal and perennial allergic rhinitis, in adults and children 12 years of age and over. Symptoms treated effectively include sneezing, rhinorrhea, lacrimation, itchy, red eyes and itchy nose/palate/throat. Fexo improves health-related quality of life and work/activity productivity.

Chronic idiopathic urticaria: Fexo is indicated for the relief of symptoms associated with chronic idiopathic urticaria in adults and children 12 years of age and older. Fexo significantly reduces the signs and symptoms of chronic idiopathic urticaria, the number of wheals, and pruritus. Fexo improves health-related quality of life and work/activity productivity.

Pharmacology of tab- Fexo 120 mg (AS A – Fexofenadin Hydrochloride AS A Non-sedating antihistamines).

The H1 histamine receptor is responsible for mediating hypersensitivity and allergic reactions. Exposure to allergen results in the degranulation of mast cells and basophils, which then release histamine and other inflammatory mediators. Histamine binds to, and activates, H1 receptors, which results in the further release of pro-inflammatory cytokines, such as interleukins, from basophils and mast cells. These downstream effects of histamine binding are responsible for a wide variety of allergic symptoms, such as pruritus, rhinorrhea, and watery eyes.

Fexofenadine is considered an “inverse agonist” of the H1 receptor because it binds to and stabilizes the inactive form of the receptor, preventing its activation and subsequent downstream effects. It has a potent and selective affinity for H1 receptors, and there is no evidence that it carries antidopaminergic, antiserotonergic, anticholinergic, sedative, or adrenergic blocking activity. Fexofenadine does not cross the blood-brain barrier and thus is unlikely to cause significant CNS effects.

Dosage & Administration of tab- Fexo 120 mg (AS A – Fexofenadin Hydrochloride AS A Non-sedating antihistamines).

Allergic Rhinitis-

Adults and children 12 years and older:

Tablet: 60 mg twice daily or 120 mg once daily or 180 mg once daily
In case of impaired renal function: 60 mg once daily

Children from 6 to 11 years:

Tablet: 30 mg twice daily or 60 mg once daily
In case of impaired renal function: 30 mg once daily

Children from 2 to 11 years

Suspension: 30 mg or 5 ml twice daily
In case of impaired renal function: 30 mg or 5 ml once daily

Chronic Idiopathic Urticaria-

Adults and children 12 years and older:

Tablet: 60 mg twice daily or 120 mg once daily or 180 mg once daily
In case of impaired renal function: 60 mg once daily

Children from 6 to 11 years:

Tablet: 30 mg twice daily or 60 mg once daily
In case of impaired renal function: 30 mg once daily

Children from 6 months to less than 2 years:

Suspension: 15 mg or 2.5 ml (1/2 tsp) twice daily
In case of impaired renal function: 15 mg or 2.5 ml (1/2 tsp) once daily

Children from 2 to 11 years:

Suspension: 30 mg or 5 ml (1 tsp) twice daily
In case of impaired renal function: 30 mg or 5 ml (1 tsp) once daily

Interaction of tab- Fexo 120 mg (AS A – Fexofenadin Hydrochloride AS A Non-sedating antihistamines).

Fexo does not undergo hepatic biotransformation and therefore will not interact with other medicinal products through hepatic mechanisms. Coadministration of Fexo with erythromycin or ketoconazole has been found to result in a 2-3 times increase in the level of fexofenadine in plasma. The changes were not accompanied by any effects on the QT interval and were not associated with any increase in adverse reactions compared to the medicinal products given singly. No interaction between fexofenadine and omeprazole was observed. However, the administration of an antacid containing aluminium and magnesium hydroxide gels 15 minutes prior to Fexo caused a reduction in bioavailability, most likely due to binding in the gastrointestinal tract. It is advisable to leave 2 hours between administration of Fexo and aluminium and magnesium hydroxide containing antacids.

Contraindications of tab- Fexo 120 mg (AS A – Fexofenadin Hydrochloride AS A Non-sedating antihistamines).

Contraindicated in patients with known hypersensitivity to Fexofenadine Hydrochloride or any of its ingredients.

Side Effects of tab- Fexo 120 mg (AS A – Fexofenadin Hydrochloride AS A Non-sedating antihistamines).

The following frequency rating has been used, when applicable: Very common ≥1/10; Common ≥1/100 and <1/10; Uncommon ≥1/1,000 and <1/100; Rare ≥1/10,000 and <1/1,000; Very rare <1/10,000 and not known (frequency cannot be estimated from the available data). Within each frequency grouping, undesirable effects are presented in order of decreasing seriousness. In adults, the following undesirable effects have been reported in clinical trials, with an incidence similar to that observed with placebo: Nervous system disorders- Common: headache, drowsiness, dizziness; Gastrointestinal disorders- Common: nausea; General disorders and administration site conditions- Uncommon: fatigue. In adults, the following undesirable effects have been reported in post-marketing surveillance. The frequency with which they occur is not known (cannot be estimated from available data): Immune system disorders- hypersensitivity reactions with manifestations such as angioedema, chest tightness, dyspnoea, flushing and systemic anaphylaxis; Psychiatric disorders- insomnia, nervousness, sleep disorders or nightmares/excessive dreaming (paroniria); Cardiac disorders- tachycardia, palpitations; Gastrointestinal disorders- diarrhea; Skin and subcutaneous tissue disorders- rash, urticaria, pruritus

Pregnancy & Lactation of tab- Fexo 120 mg (AS A – Fexofenadin Hydrochloride AS A Non-sedating antihistamines).

There are no adequate data from the use of Fexofenadine hydrochloride in pregnant women. Limited animal studies do not indicate direct or indirect harmful effects with respect to effects on pregnancy, embryonal/foetal development, parturition or postnatal development. Fexofenadine hydrochloride should not be used during pregnancy unless clearly necessary.

There are no data on the content of human milk after administering Fexofenadine hydrochloride. However, when Terfenadine was administered to nursing mothers Fexofenadine was found to cross into human breast milk. Therefore, Fexofenadine hydrochloride is not recommended for mothers breast-feeding their babies. No human data on the effect of Fexofenadine hydrochloride on fertility are available. In mice, there was no effect on fertility with Fexofenadine hydrochloride treatment.

Therapeutic Class of tab- Fexo 120 mg (AS A – Fexofenadin Hydrochloride AS A Non-sedating antihistamines).

Non-sedating antihistamines

Common Questions about Fexo 120 mg Tablet

What is Fexo 120 mg Tablet?

Fexo 120 mg Tablet is an antihistamine. It works by blocking histamine that the body makes during an allergic reaction.

What are the uses of Fexo 120 mg Tablet?

Fexo 120 mg Tablet is used for the treatment of allergic rhinitis and urticaria. It relieves allergy symptoms such as runny nose, itching eyes/nose, sneezing, hives, and itching.

What are the Side Effects of Fexo 120 mg Tablet?

Fexo 120 mg Tablet has some reported side effects such as Vomiting, Headache, Coughing, Diarrhea, Painful menstruation, Pain in the arms and legs, Hives and redness of skin, Swelling of face, lips, eyelids, tongue, hands and feet.

What are the instructions for storage and disposal Fexo 120 mg Tablet?

Fexo 120 mg Tablet should be kept in a cool dry place and in its original pack. Make sure this medication remains unreachable to children and pets.

Can Fexo 120 mg Tablet make you sleepy?

Yes, Fexo 120 mg Tablet can make you feel sleepy, infect sleepiness is a common side effect of this medicine.

Can you overdose on Fexo 120 mg Tablet?

Do not take an overdose of Fexo 120 mg Tablet as this can cause adverse reactions and may increase the risk of side effects like dizziness, drowsiness, fatigue, and dry mouth.

How quickly does Fexo 120 mg Tablet work?

Fexo 120 mg Tablet starts working within 1 hour of consuming it. The peak benefit of Fexo 120 mg Tablet is observed within 6 hours.

Does Fexo 120 mg Tablet relieve symptoms of outdoor and indoor allergies?

Yes, Fexo 120 mg Tablet can help relieve symptoms that may be caused by outdoor and indoor allergens such as upper respiratory allergies, hay fever, watery eyes, runny nose, and sneezing, or itching of the nose or throat.

How to cope with dizziness caused by Fexo 120 mg Tablet?

Take some rest after taking Fexo 120 mg Tablet if you feel dizzy or sleep. Do not use heavy machinery or drive and move very slowly. Exercise caution and if there is extreme dizziness, then consult a doctor as soon as possible.

Can I take antacids while taking Fexo 120 mg Tablet?

Fexo 120 mg Tablet should not be used in combination with antacids as the interaction between them can result in a decreased absorption of Fexo 120 mg Tablet.

How should I take Fexo 120 mg Tablet?

Fexo 120 mg Tablet should be taken in dose and duration as recommended by the doctor. Do not take an overdose as this can affect your health adversely.

Is there any food or drink that I need to avoid while taking Fexo 120 mg Tablet?

Do not consume juices like grapefruit juice, orange juice and apple juice if you are on the course of medication with Fexo 120 mg Tablet.

Can Fexo 120 mg Tablet cause heart problems?

Those who suffer from heart disorders should exercise caution and must look out for some other alternative of this medicine.

Quick Tips

Fexo 120 mg Tablet is an antihistaminic medication. It treats allergy symptoms such as itching, swelling, and rashes by blocking the effects of a chemical messenger (histamine) in the body.
Fexo 120 mg Tablet is less likely to make you feel sleepy than some other similar medicines.
Do not take Fexo 120 mg Tablet with any fruit juices (such as apple, orange, or grapefruit) as they might make the drug less effective.
Fexo 120 mg Tablet may cause nausea. Stick to simple meals, and do not eat rich or spicy food.
Avoid using antacids 30 minutes before or after taking Fexo 120 mg Tablet. It can make it harder for your body to absorb this medication.

0+0+1—-৩সপ্তাহ

কারো ক্ষেত্রে ৩মাসে ভালো হয়ে যায়,কারো কারো ক্ষেত্রে ১বছরের মত সময় লেগে যেতে পারে।Lesion গুলো without treatment heal হয়ে যেতে পারে and rarely leaves scar.যেসব ডিজিজ ট্রিটমেন্ট ছাড়া ভালো হতে পারে,সেগুলো ট্রিটমেন্ট দিলেও ভালো হওয়ার সম্ভাবনা ৫০%

কাউন্সেলিং করা অনেক গুরুত্বপূর্ণ

Raiyyan Tahsan. Date:24-01-2025 Friday Time:3-42-55PM

Raiyyan Tahsan

Raiyyan Tahsan