Infectious Skin Diseases Research Articles

Cutaneous leishmaniasis associated with human immuno deficiency virus infection

Cutaneous leishmaniasis (CL) which was relatively unknown, has become one of the leading infectious skin diseases in Sri Lanka over last two decades. It is caused by dermotrophic Leishmania donovani species in Sri Lanka. There area number of case reports of CL associated with Human Immunodeficiency Virus(HIV) infection in literature but not reported yet in Sri Lanka. A male patient presenting with multiple lesions of CL was later found to be infected with HIV. He was treated with courses of intramuscular sodium stibogluconate injections on two separate occasions. Initially he responded well but developed recurrences on both occasions. Patient is awaiting further treatment for second recurrence. Managing the case has become a challenge due to patient’s poor compliance to treatment, and non-availability of more convenient treatment regime.

Fine-Mapping of the Major Histocompatibility Complex Region Linked to Leprosy in Northern China.

Background: Leprosy is a chronic infectious skin and neurological disease, and genetic background is considered to be one of the major factors of risk. The major histocompatibility complex (MHC) region not only affects susceptibility to leprosy but also its development and outcome. Given the complex traits of the MHC region, variants and the potential mechanism by which HLA influences leprosy development need to be further explored. Methods: We extracted previous genome-wide association study data from the Northern Han Chinese population to perform HLA fine-mapping. Using the 1,000 Genome Project Phase 3 dataset as the reference panel, single-nucleotide polymorphisms (SNP), insertion and deletion (INDEL) and copy number variant (CNV) imputation were carried out. HLA classical alleles and amino acids in the MHC region were imputed using the HAN-MHC database. Further stepwise regression analysis was conducted to analyze independent signals of variants related to leprosy. Results: We identified four independent variants: esv3608598, rs7754498, rs3130781 and rs144388449. Among them, esv3608598 is a CNV and the first HLA CNV associated with leprosy risk. SNP annotation using RegulomeDB, HaploReg, and rVarBase showed that three SNPs are likely to affect the pathogenesis of leprosy. Conclusion: In summary, this is the first study to assess the association between HLA CNV and leprosy susceptibility in a Northern Han Chinese population. By fine mapping of the MHC region in this population, our findings provide evidence for the contribution of HLA to leprosy susceptibility.

Indirect costs associated with skin infectious disease in children: a systematic review

BackgroundThere are limited data in the literature on the indirect costs associated with skin and soft tissue infections (SSTIs) in the pediatric population. This study aimed to conduct a systematic review of the indirect costs associated with SSTIs in children.MethodsThe search was conducted in PubMed, SCOPUS, and Web of Science up to January 2020. Thirteen search strategies were designed combining MeSH terms and free terms. SSTIs were defined as bacterial or viral infections, dermatomycoses, and parasitic infestations. Only primary studies were included. All analyzed costs were converted to 2020 Euros.ResultsThirteen of the identified publications presented indirect costs of SSTIs in children and were conducted in Argentina, Australia, Brazil, Hungary, New Zealand, Poland, Spain, Taiwan, and the USA. Nine studies described indirect costs associated with infection of Varicella-zoster virus: lost workdays by outpatient caregivers ranged from 0.27 to 7.8, and up to 6.14 if caring for inpatients; total productivity losses ranged from €1.16 to €257.46 per patient. Three studies reported indirect costs associated with acute bacterial SSTIs (community-associated methicillin-resistant Staphylococcus aureus) in children: total productivity losses ranged from €1,814.39 to €8,224.06 per patient, based on impetigo, cellulitis, and folliculitis. One study of parasitic infestations (Pediculus humanus capitis) reported total indirect costs per patient of €68.57 (formal care) plus €21.41 due to time lost by parents in purchasing treatment.ConclusionsThe economic burden of SSTIs is highly relevant but underestimated due to the lack of studies reporting indirect costs. Further cost studies will allow a better understanding of the magnitude of the financial burden of the disease.

Partially purified lead molecules from Dodonaea viscosa and their antimicrobial efficacy against infectious human pathogens

BackgroundThe utilization of medicinal plants and their drugs have the advantage of reducing side effects compared with manufactured antimicrobials. Artificial drugs have unpleasant side effects, further, the number of drug resistant pathogens is increasing, thus huge challenge for control of resistant pathogens. Therefore, the current research explores the potential of partially purified bioactive compounds from Dodonaea viscosa against certain human pathogens. MethodsHealthy leaves of D. viscosa (L.) were collected, extracted and optimized with different solvents. Preliminary phytochemical screening of the extracts was done and antibacterial activities were tested against human pathogens. The active crude extract was further purified by column chromatography and the homogeneity was confirmed by thin layer chromatography (TLC). The partially purified compounds were screened further for antibacterial, antibiofilm and anticancer activities. ResultsThe crude ethanol extract of D. viscosa leaves showed the presence of phytochemical like tannins, alkaloids, flavanoids, terpenoids, glycosides, steroids and phenols. Ethanol extract exhibited the maximum zone of inhibition (11 mm) against S. agalactiae, B. cereus, S. typhi and E. coli at 15 mg when compared with other bacteria. Column chromatography fractions Dv12 and Dv20 exhibited the maximum zone of inhibition against B. cereus. 1000 μg of Dv12 partially purified compound against streptococcus isolates in glass test tube showed biofilm inhibition range of 34.4%–63.1%. Whereas B. cereus, S. aureus, S. typhi, and K. pneumoniae showed 31.1%–53.6% biofilm inhibition compared to curcumin control. Active fractions of Dv12 and Dv20 increased concentration confirmed that the gradual decrease in cell density and possesses growth inhibition towards A 549 human lung adenocarcinoma cells. ConclusionWe have extracted the bioactive compounds from D. viscosa (L.) leaves and tested the activity of a partially purified compound against human pathogenic bacteria, biofilm formation and cytotoxicity against A 549 human lung adenocarcinoma cells. The purified bioactive compounds might be used as therapeutic agents against different microbial infections such as skin infection, throat infection and other infectious diseases.

Dermatovenereology of Russian Federation in 2020: Working Under a Pandemic

The article presents an analysis of the resources and activities of medical organizations providing medical care in the field of dermatovenereology for the period 20152020. Up-to-date data on the number of medical organizations and units providing specialized medical care in the field of dermatovenereology are provided. A description of the main changes in the provision of the population of the Russian Federation with dermatovenereologists, staffing with dermatovenereologists of medical organizations is given. Changes in the number of outpatient visits in 2020 are given. The dynamics of the bed fund of 24-hour and day hospitals of a dermatovenereological profile, the bed occupancy, the number of patients treated is described. The data on the incidence of sexually transmitted infections, infectious skin diseases are presented. Prevalence and incidence rates of diseases of the skin and subcutaneous tissue, including atopic dermatitis and psoriasis, are given. The impact of measures aimed at preventing the spread of a new coronavirus infection and organizing the provision of medical care to patients with COVID-19 on the performance rates of dermatovenereologic medical organizations has been demonstrated.

The burden of skin diseases in India: Global Burden of Disease Study 2017.

Background The prevalence of skin diseases has increased over the last few decades, and they contribute to a significant burden on health-care systems across the world. Aims/Objective This report looks at the burden of skin and subcutaneous diseases in terms of years lived with disability and agestandardised years lived with disability in India using the Global Burden of Disease Study results from 2017. Methods Data were obtained from the Global Burden of Disease online interactive tool. Updated estimates of the world's health for 359 diseases and injuries and 84 risk factors from 1990 to 2017 are available in this interactive tool. Results Years lived with disability due to skin and subcutaneous diseases accounted for 4.02% of the total years lived with disability in India in 2017. There was an increase of 53.7% in all age standardised years lived with disability for all the skin and subcutaneous diseases from 1990 to 2017. Among skin and subcutaneous diseases, dermatitis contributed maximum years lived with disability (1.40 million; 95% uncertainty interval, 0.82-2.21) in 2017, followed by urticaria (1.02 million; 95% uncertainty interval, 0.06-1.44) with percentage increases of 48.9% and 45.7% respectively. Conclusion The burden due to infectious skin diseases (e.g., scabies, fungal skin disease and bacterial skin disease) and non-infectious diseases (e.g., dermatitis, urticaria and psoriasis) has increased over the past three decades, however the age-standardised years lived with disability for leprosy, scabies, fungal infections, sexually transmitted infections and non-melanoma skin cancer (basal cell carcinoma) has decreased. The high burden of skin and subcutaneous diseases demand that they be given due importance in the national programmes and health policy of India.

Autophagy in skin barrier and immune-related skin diseases.

Autophagy is a process which is highly conserved in eukaryotes to degrade or recycle cytoplasmic components through lysosomes to maintain cellular homeostasis. Recent studies have shown that autophagy also plays critical roles in cell apoptosis, inflammation, pathogen clearance, and so on under stressed conditions and thereby has been linked to a variety of human disorders. The skin is the largest organ of the body and serves as the first line of defense against environmental insult. Skin as a nutrient-poor environment requires recycling of limited resources via the autophagy machinery to maintain homeostasis. Therefore, dysregulation of autophagy has been linked to skin diseases. In this review, we describe the molecular machinery and regulation of autophagy, discuss its role in keratinocytes and skin barrier, skin immune cells, and immune-related skin diseases including autoimmune skin disorders, allergic skin diseases, infectious skin disorders, and antitumor immunity against skin tumor. Finally, we highlight the potential of autophagy as a therapeutic target for immune-related skin diseases, and delivery of autophagy-related molecules (such as inducers, inhibitors, or nucleic acid molecules) by virtue of physical materials (such as nanoparticles) or biological materials (such as peptides) to skin topically may obtain clinical benefits in immune-related skin diseases. Moreover, developing autophagy-related gene product-based biomarkers may be promising to diagnose immune-related skin diseases.

Reflectance confocal microscopy in pediatric dermatology: A state-of-the-art review.

Reflectance confocal microscopy is an innovative imaging modality, which noninvasively provides an optical image to aid in the diagnosis of skin lesions. While performing a skin biopsy for histopathologic analysis is the gold standard to definitively diagnose skin disease, this may prove to be more difficult in the pediatric population. This will occasionally necessitate sedation or general anesthesia as an approach, which carries a number of different risks. Reflectance confocal microscopy is an exciting new avenue in the support of diagnosing skin pathology, with the goal of improving pediatric patient tolerance and experience when examining epidermal and superficial dermal skin lesions. This review discusses the utility of reflectance confocal microscopy for pediatric dermatology patients pertaining to melanocytic and non-melanocytic skin neoplasms and inflammatory and infectious skin diseases in children.

Isolation Of Dermatophytes From Infected Stray Cats In Selangor

Background: Dermatophytosis is the most prevalent fungal infection found in cats and one of the most serious infectious skin diseases that affect this species. Dermatophytosis can be endemic in cats, particularly in poor environments, and it is difficult to eradicate in such cases. Purpose: The aim of this research was to determine the macroscopic and microscopic identification of various types of dermatophytes present in stray cats. Methods: The research was designed as a laboratory-based study. The sample was determined through physical examination of stray cats infected with fungi and was selected based on the infection site (nail, hair, and skin) of infected cats. A total of 125 samples were collected from infected stray cats through skin scraping, haircutting, and nail clipping. The collected samples were then cultured in Sabouraud Dextrose Agar (SDA) medium and incubated for two weeks at 26°C. Following incubation, fungi were stained using Lacto-phenol Cotton Blue (LPCB) for microscopic identification. Results: The identification showed that Trichophyton spp. is the most common isolated fungal species on the hair, nails, and skin of stray cats. This is followed by Aspergillus spp. and Microsporum spp. The least common dermatophytes include Curvularia spp., Absidia spp., Epidermophyton spp., Neosytallidium spp., Alternaria spp., Scopulariopsis spp., Mucor spp., and Penicillium spp. Conclusion: The research focussed exclusively on stray cats with clinical evidence of mycotic lesions and confirmed the role of stray cats in transmitting dermatophytosis through their hair, nails, and skin. The prevalence of dermatophytes on stray cats was identified in the Selangor region.

Clinicoepidemiology of Skin Diseases in Children Seen at the University Hospital Center Morafeno, Toamasina, Madagascar.

Introduction The child's skin diseases are common and very diverse. Many studies concerning pediatric dermatoses have been carried out in Africa and the rest of the world. Few epidemioclinical data reflect these skin diseases in children, especially in the east coast of Madagascar. We aim to describe the pattern skin diseases among children seen at the University Hospital Center Morafeno, Toamasina, Madagascar. Patients and Methods. A retrospective study over a 3-year period from January 2017 to December 2019 was conducted in children seen in the Dermatology Department of University Hospital Center Morafeno, Toamasina, with skin diseases. Results During the study period, 347 children out of the 1584 new patients were retained with a sex ratio of 0.86. The mean age was 6.4 years old. The main diseases identified were skin infectious diseases (43, 23%), allergic dermatoses (24.21%), and autonomous dermatosis (15.56%). Conclusion Our study revealed the importance of infectious and allergic dermatoses in Toamasina. It is necessary to carry out simple preventive actions such as hygiene.

MANAGEMENT OF PSORIASIS: A COMPARATIVE CLINICAL STUDY OF STANDARD AYURVEDA & ALLOPATHIC PROTOCOLS

Psoriasis is a common, chronic and non- infectious skin disease characterized by well defined slightly raised, dry erythamatous macules with silvery scales Modern medicine offers treatment with PUVA, Corticosteroids & Anti mitotic Drugs but therapy gives serious side effects like Bone Marrow depletion, Liver & kidney Failure. While treating Kustha, Ayurvedic Classics especially focused on Panchakarma Treatment. So Vaman, Virechana & Laghu-Manjisthadi Ghan was selected for trial. Total 30 well diagnosed patients were selected & divided in two groups. One group receiving Ayurvedic Treatment & other Allopathic Regimen (Tb.Methotraxate7.5 mg/week) for 2 months & comparative study was done. Assessment was done on improvement in clinical symptoms as well as on Laboratory parameters.

Tridax procumbens pharmacological activities-An updated review

Tridax procumbens is also known as coat buttons belongs to family Asteraceace. It is the important medicinal plant which is mainly found in central and South America. It is also seen in tropical, subtropical and mild temperate regions worldwide. It is a flowering plant and widespread weed that contains several medicinal values. The whole plant extract is used as drug. Tridax procumbens has been described to use as antidiabetic, antioxidant, hepatoprotective, wound healing. It is also used in the treatment of infectious skin diseases, liver disorders and kidney stone diseases. The major active constituents of this plant are flavanoids, alkaloids, saponins, tannins, terpenes, kaempferol and isoquercetin. Traditionally it has been used for treating blisters, ulcer, jaundice, respiratory problems and gastritis.

Tissue-Resident Memory T Cells in Skin Diseases: A Systematic Review.

In health, the non-recirculating nature and long-term persistence of tissue-resident memory T cells (TRMs) in tissues protects against invading pathogens. In disease, pathogenic TRMs contribute to the recurring traits of many skin diseases. We aimed to conduct a systematic literature review on the current understanding of the role of TRMs in skin diseases and identify gaps as well as future research paths. EMBASE, PubMed, SCOPUS, Web of Science, Clinicaltrials.gov and WHO Trials Registry were searched systematically for relevant studies from their inception to October 2020. Included studies were reviewed independently by two authors. This study was conducted in accordance with the PRISMA-S guidelines. This protocol was registered with the PROSPERO database (ref: CRD42020206416). We identified 96 studies meeting the inclusion criteria. TRMs have mostly been investigated in murine skin and in relation to infectious skin diseases. Pathogenic TRMs have been characterized in various skin diseases including psoriasis, vitiligo and cutaneous T-cell lymphoma. Studies are needed to discover biomarkers that may delineate TRMs poised for pathogenic activity in skin diseases and establish to which extent TRMs are contingent on the local skin microenvironment. Additionally, future studies may investigate the effects of current treatments on the persistence of pathogenic TRMs in human skin.

COVID-19流行期间武汉某医院皮肤科门诊患者流行病学特点及疾病谱分析

Objective: To investigate epidemiological characteristics of outpatients and disease spectrum in the dermatology department during the COVID-19 epidemic Methods: A retrospective comparison of outpatient visits, gender, age and disease types in the dermatology department of Wuhan No.1 Hospital was performed between COVID-19 epidemic period (from 23th January 2020 to 15th April 2020) and the same period in 2019. Enumeration data were analyzed by Pearson's chi-square test. Results: During the COVID-19 epidemic, the number of outpatient visits to the dermatology department of the hospital decreased markedly, and the average daily number of outpatient visits (236 visits/day) was only 8.81% of that during the same period in 2019 (2 678 visits/day) ;the ratio of male to female patients was reversed from 1:1.37 in 2019 to 1.16:1 in 2020;the proportions of patients aged 0-6, 7-12, 13-17 and 18-45 years significantly decreased compared with those in 2019 (all P 69 years significantly increased (both P < 0.001). During the COVID-19 epidemic, there were 171 types of skin diseases in the dermatology outpatient department, and the number of disease categories decreased compared with that during the same period in 2019 (442 types) ;the number of patient visits for allergic skin diseases, erythematous papulosquamous skin diseases, viral infectious skin diseases and bacterial infectious skin diseases significantly increased compared with that during the same period in 2019 (all P < 0.001), while the number of patient visits for sebaceous and sweat gland disorders, pigmented skin diseases and physical skin diseases significantly decreased (all P < 0.001). Conclusion: Compared with the same period in 2019, the number of outpatient visits, patient sex ratio, age distribution and disease types in the dermatology department have undergone marked changes during the COVID-19 epidemic, and this study provides a reference for healthcare workers in dermatology department to respond to various epidemics and natural disasters in the future. Copyright © 2021 by the Chinese Medical Association.

Mucocutaneous diseases in the combined antiretroviral therapy era: prevalence and spectrum in HIV seropositive children and adolescents in Durban, South Africa.

Mucocutaneous diseases (MCD) have been commonly described among human immunodeficiency virus (HIV) infected patients before the combined antiretroviral therapy (cART) era. There is limited data on the frequency and type of MCD in the cART era in African children and adolescents. This study aimed to describe the prevalence and spectrum of MCD in South African children and adolescents seropositive for HIV on cART. A cross-sectional study of 310 participants aged 0-19 years attending a public sector ART clinic at King Edward VIII Hospital, Durban, South Africa, was conducted. Demographic, clinical, and laboratory information was obtained from the participants and hospital records. Participants were examined. Data were collated and analyzed with SPSS version 23. MCD were observed in 77.4% of HIV-infected children. The prevalence was higher among males and adolescents above 16 years old (83.9%). Infectious skin disorders (44.7%) were less common than noninfectious dermatoses (55.3%). More common disorders encountered included generalized pruritus (32.6%), fungal infections (20.9%), and inflammatory (20.4%) and pigmentary (20.4%) skin disorders. Tinea capitis and pedis were the most prevalent fungal infections, while oral candidiasis (0.2%) was the least. Inflammatory skin disorders and dyschromia appeared to be more common than in the pre-cART era. While MCD are still common in HIV-infected children and adolescents in the cART era, the pattern and types of disorders have changed to a predominance of non-infectious dermatoses.

An Insight into Biomolecules for the Treatment of Skin Infectious Diseases.

In assigning priorities, skin infectious diseases are frequently classified as minor when compared to infectious diseases of high mortality rates, such as tuberculosis or HIV. However, skin infections are amongst the most common and prevalent diseases worldwide. Elderly individuals present an increased susceptibility to skin infections, which may develop atypical signs and symptoms or even complicate pre-existing chronic disorders. When the skin fails to correct or inhibit the action of certain pathogenic microorganisms, biomolecules endowed with antimicrobial features are frequently administered topically or systemically to assist or treat such conditions. (1) Antibiotics, (2) antimicrobial peptides, or (3) natural extracts display important features that can actively inhibit the propagation of these pathogens and prevent the evolution of infectious diseases. This review highlights the properties and mechanisms of action of these biomolecules, emphasizing their effects on the most prevalent and difficult to treat skin infections caused by pathogenic bacteria, fungi, and viruses. The versatility of biomolecules’ actions, their symbiotic effects with skin cells and other inherent antimicrobial components, and their target-directed signatures are also explored here.

Pharmacological Potential of Sweet Violet (Banafsha) on Human Body

Sweet violet commonly known as Gul-e-Bafasha or Banafsha is a herb widely used as ethnomedicine in dried form in Pakistan for the treatment of various disease or symptoms. Viola odorata had phytochemicals constituents (flavonoids, flavanols, ascorbic acid, phenolics) and antioxidative property Objective: The goal of this research is to emphasize Viola Odorat's (Gul-e-Banafsha) therapeutic benefits on human health. Methods: This review literature is assessed from the previous data available from google scholar, Medline and PubMed. After going through the published articles, researches and literature, initially 104 articles were included, after excluding irrelevant and repeated articles, 37-full text articles and abstract were relevant and found eligible for the study. Results: Sweet violet scientifically known as Viola odorata has been widely used as ethnomedicine in rural areas of Pakistan for the treatment of skin infection, insomnia, inflammation, cough, fever and Cardio Vascular Diseases (CVD) with very low adverse side effects. Its leaves are used as antiseptic used as ointment and its flower has a laxative effect. It is rich in flavonoids like widely known for its therapeutic properties. Due to its phenolic property, it had antioxidant and antimicrobial property, presences of flavonoids had an anti-cancerous effect, it had tannins which reduces the mutagenic activity and it had saponins which reduces blood glucose levels in body. Presence of saponins in Sweet violet lead to the anticarcinogens, melanogenesis, neuroprotective, antimicrobial and anti-inflammatory property. Presence of Isoquinoline alkaloids constituent led to expectorant and antipyretic effect. Viola odorata is used as phytopharmaceuticals and nutraceutical agent. Conclusions: Sweet Voila had acclaimed the therapeutic effect on human health as antiseptic, antifungal, anti-inflammatory, antioxidant, antilipidemic and hepatoprotective activity due to the presences of phenolics, flavonoids, tannins, saponins, alkaloids and coumarins.

Antibacterial and antibiofilm activities of Mayan medicinal plants against Methicillin-susceptible and -resistant strains of Staphylococcus aureus

Ethnopharmacological relevanceSeveral medicinal plants are used in Mayan Traditional Medicine to treat skin, urinary, respiratory, and gastrointestinal infectious diseases. However, scientific studies that have supported the bioactivity of these Mayan medicinal plants are limited. Aim of the studyTo assess the in-vitro anti-Staphylococcus aureus growth and biofilm-formation activities of 15 Mayan medicinal plants that were selected based on their traditional uses for the treatment of infectious diseases. Materials and methodsMayan medicinal plants used traditionally to treat infectious diseases were preselected. For each part of the plants, four extracts were prepared with different solvents (water, n-hexane, ethyl acetate, and methanol). These were tested against two reference strains: a Methicillin-susceptible and -resistant S. aureus, and two clinical isolates, including a susceptible and multidrug-resistant S. aureus using a Resazurin Microtiter Assay. In addition, the plant extracts were evaluated in biofilm-formation inhibition on S. aureus by means of the Crystal Violet method. ResultsA total of 120 extracts from 15 Mayan medicinal plant species belonging to 12 different families were selected according their ethnopharmacological uses to treat infectious diseases. Among the selected plant species, 26 extracts obtained from eight medicinal Mayan plants exhibited significant anti-S. aureus against the four strains tested. The most active extracts were the Aq (aqueous) leaf extract of Krugiodendron ferreum (Minimal Inhibitory Concentration [MIC] = 125–250 μg/mL), the MeOH bark extracts of Matayba oppositifolia, Clusia flava, Gymnopodium floribundum, the MeOH leaf extract of Spondias purpurea with MIC values of 250 μg/mL, and the MeOH leaf and Aq bark extracts of K. ferreum (MIC = 250–500 μg/mL). Among the active extracts, 12 exhibited a bactericidal effect on S. aureus strains (Minimal Bactericidal Concentration [MBC] = 250–1000 μg/mL). Forty extracts from 13 plants have an effect on the anti-formation of biofilm, the most active were the MeOH leaf extract of M. oppositifolia (one-half Inhibitory Concentration [IC50] = 10.4 μg/mL) and the MeOH (IC50 = 17.7 μg/mL) and Hex (18.2 μg/mL) leaf extracts from S. purpurea. ConclusionAqueous and organic extracts from Mayan medicinal plants showed bactericidal and anti-biofilm activities even against drug-resistant S. aureus strains. The present study supports the traditional usage of some plants employed in Mayan medicine for illnesses such as skin, gastrointestinal, and urinary infections and suggest that these plants could be a good source of antibacterial phytochemicals.

EDUKASI PENYAKIT KULIT, PERILAKU HIDUP BERSIH, DAN CUCI TANGAN PAKAI SABUN UNTUK SANTRI PONDOK PESANTREN MODERN ASSA’ADAH SERANG BANTEN

Skin infection case is still highly found in Indonesia with prevalence at 4.6-12.95%. The highest prevalence rate was found in the pesantren. The skin infection disease that often observed in students that lives in pesantren mainly Scabies. The prevalence of scabies in pesantren found more than 43%. This shows that the spread of skin diseases in the pesantren is still high. Actually, this coundation that caused by a microorganism infection is can be prevented easily. Hand hygiene is of utmost concern to everyone and is the earliest and most effective method of preventing the transmission of health-related pathogenic microbes. Efforts to keep hands clean is one important step to prevent disease and prevent disease transmission to others. This activity is carried out through counseling using the lecture method through the help of video media and leaflets. After that, a demonstration of how to wash hands with soap was carried out through six steps, which were then followed by all activity participants who were students in the Assaaadah Islamic Boarding School, Serang Banten Regency. This activity was successfully carried out even though in a pandemic condition that caused the boarding school to be closed completely to visitors, but with these limitations, an online approach was made to carry out the activity. The results of the activity show that 50 students of the modern Assaadah Islamic boarding school have understood the importance of washing hands with soap, the theory scabies, and the principles of clean living in a communal environment.

Personalized high-intensity laser therapy for patients with abnormal skin scars

Background. Scars are an inevitable consequence and the final outcome of the restoration of the skin, after injuries, thermal effects on the skin, and are also formed as a result of the resolution of rash elements in various infectious skin diseases, with adverse wound healing after plastic surgery and cosmetic procedures. According to WHO data for 2020, scar complications affect about 10% of the world's population, which is approximately 600 million people. High-intensity laser therapy technologies are considered by experts to be the "gold" standard in the correction of pathological scars, but a significant number of them are updated by the personalized approach developed in the last decade, aimed at individualizing treatment, searching for predictors of the effectiveness of various methods, taking into account a number of basic mechanisms of pathogenesis.&#x0D; Aims: Scientific substantiation of the concept of personalized high-intensity laser therapy for patients with pathological skin scars.&#x0D; Materials and methods. We studied 306 patients with atrophic (n=115), hypertrophic (n=100) and keloid (n=91) scars, which were divided into subgroups with emerging (formation period up to 1.5 years) and mature scars. Genetic, phenotypic, clinical, instrumental, laboratory, and medical-sociological methods were used to study the patient's condition and scar tissue. Laser therapy combinations were used: fractional ablative photothermolysis, homogeneous photothermolysis, planar ablative photodestruction, selective angiophotothermolysis, and fractional selective photothermolysis.&#x0D; Results. It was found that various combinations of high-intensity laser therapy in patients with pathological skin scars cause a significant regression of clinical signs, restore the microrelief of tissues, improve the functional properties of scars (elasticity, elasticity, moisture, vascularization, etc.), which is accompanied by an improvement in the quality of life of patients. The complex of laser technologies forms a pronounced refibromodeling therapeutic effect in patients with pathological skin scars.&#x0D; Conclusion. The concept of personalized (variant) high-intensity laser therapy in patients with atrophic, hypertrophic and keloid scars, which determines the dependence of the effectiveness of various options for laser correction of pathological scars on the genetic, phenotypic, clinical, morphofunctional and medical-sociological characteristics of patients, is scientifically substantiated. The determinants of the effectiveness of laser technologies have been identified, taking into account which allows the productive use of high-intensity laser radiation in patients with atrophic, hypertrophic and keloid skin scars.