Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
The question was raised: What about Yeshiva boys who by
necessity must use public baths? How should they protect
themselves from fungi and warts?
First, hygiene in these places is very important. The
restrooms should be cleaned often, and towels that are used
to wash hands must be disposable. A towel that revolves on a
stick is unacceptable and a health risk. Second, showers
should be taken often, and drying off, especially between the
toes, is critical to avoid these diseases. Absorbent socks,
such as cotton, will help as well.
There remains much to be said about skin diseases, but we'll
just focus on some more common things, and leave the subject
for next week. Paronychias are infections of the nail fold.
They often come from biting little pieces of skin near the
nail. Antibiotics usually are not a help. The answer is to
lance these, and they resolve in a few days.
Foreign bodies in the nails are a problem sometimes, but
cutting the nail down is usually sufficient to remove these.
Sometimes anesthetizing the nail is necessary.
Likewise, lacerations of the nail can be tricky. Nails
sometimes need to be removed, and the nail bed reconstructed
-- difficult work, but often with good results. Bleeding
under the nail is usually due to a laceration or a fracture
of the tip of the finger. The fracture requires no care, and
a hole in the nail -- as scary as it sounds -- will provide
much relief by relieving the pressure under the nail and
allowing the blood to escape.
Amputations of the tips of the fingers are usually not viable
-- we let them heal as is. Exposed bone may need to be
removed.
IVs (vent flows) can cause infections. They need warm
socks.
Abscesses should not be dealt with at home and the same goes
with boils. Warm soaks are applied until a white spot
appears, and then the area is lanced under sterile
conditions. It hurts, and local anesthesia doesn't help much
here -- but it feels so much better after. Antibiotics,
again, offer little in the way of helping these heal.
These are the most common skin problems, with the exception
of acne and bites, both of which we have discussed in the
past. Write me in care of the Yated.
A message from Glaxo, sponsor of this column.
Resistance is a serious problem here in Israel, and sometimes
a stronger antibiotic is indicated, especially for skin
infections. Zinnat hits the spot, and its so easy to take --
only twice a day. Pneumonia especially responds well.
