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close this bookClinical Guidelines and Treatment Manual (Médecins Sans Frontières, 1993)
close this folderChapter 4 - Skin conditions
View the document(introductory text...)
View the documentDermatology
View the documentImpetigo and other purulent dermatoses
View the documentHerpes simplex, Herpes zoster
View the documentScabies
View the documentLeg ulcer
View the documentFungal infection
View the documentAnthrax
View the documentOther skin conditions
View the documentEndemic syphilis, Yaws & Pinta
View the documentLeprosy


Infections and infestations are by far the most frequent forms of skin pathology in tropical countries. As well as treating affected individuals, it is important to consider these conditions as indicators of the general standard of hygiene and sanitation and to define appropriate public health interventions (provision of water that is adequate in quality and quantity, health education, soap...).

Clinical assessment of the patient

The physical examination:

- Describe the basic lesions:
· macules
· papules
· vesicles
· bullae
· abscess
· pustules
· squames
· weeping lesions
· crusts...

- Look for pruritis.

- Look for regional or systemic manifestations: lymphangitis, adenopathy, fever, septicemia, metastatic infection...

- Look for a cause: mosquito bite, jewelry, allergy, scabies, lice, otitis media.

- Consider the nutritional status and the general health of the family, particularly for infectious dermatosis.

Patients with dermatological conditions often present late. At this stage, initial and specific signs are often replaced by infection. In these cases, treating the overlying infection is not enough.
Patients should be re-examined after the treatment of infection.