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Skin Deep

"Skin Diseases Brought by Flooding"
By: Risa Caldoza-De Leon MD, FPAPSHPISkin Deep

According to the Philippine Atmospheric, Geophysical and Astronomical Services Administration, eight or nine tropical cyclones make landfall in the Philippines each year. A whopping 19 typhoons were recorded in 1993. Climate change has resulted in typhoons crossing parts of our country not affected before, causing a dramatic rise in casualties and diseases. Intense rains like never before felt will become the new normal.

Put into the mix population and urbanization, we have a disaster. For example, Metro Manila floods come from both ends – the mountains and the sea. It floods because rain flows downwards from denuded and deforested uplands, all the way up to the Sierra Madres. Major areas of the metropolis have sunk too. Researchers say that this flattening of land makes storm surges from the seaside reach to as much as 20 kilometers inland.

Since Filipinos are more vulnerable to floods, it is no wonder that skin diseases are at an all-time high during the rainy season. An outbreak of skin disease is very common after severe tropical storms and flooding. Floodwaters and sewer overflows can contain bacteria, fecal material, viruses and other organisms that may cause disease.

The World Health Organization (WHO) warns that floods boost the chances of getting typhoid fever, cholera, leptospirosis and hepatitis A andvector-borne diseases, such as malaria and dengue. There is a rise in diseases contracted through direct contact with polluted waters, such as wound infections, dermatitis, conjunctivitis, and ear, nose and throat infections. Skin diseases may be divided into inflammatory skin disease such as irritant contact dermatitis; skin infections, which can be fungal or bacterial in origin; traumatic skin disease; and other miscellaneous ones such as insect bite reactions.

A Thai study found that the most common form of skin diseases due to floods are infectious dermatoses especially superficial fungal infection. Eczema is the most common dermatosis during floods. Eczema, also called atopic dermatitis, is an inherited skin condition that is common in children. It is characterized by itchy, red, and dry skin on the face or body.

Acute bacterial infections like impetigo, furunculosis (boils) and cellulitis occur more frequently in unhygienic environmental conditions. Impetigo causes tiny blisters that eventually burst, weep fluid and form brownish crusts. It can occur around the nose and mouth, hands, and forearms, and in young children, the diaper area. Impetigo is contagious and usually treated with antibiotic ointment.

Boils, are pus-filled infected lumps on the skin. A boil is an infection of a hair follicle so can develop in any hairy area of skin, like the neck, face, armpit, arms and buttocks. Treatment involves draining the pus and taking a course of antibiotics.

Fungal infections can affect the skin, hair and nails, and can be disfiguring if the spores penetrate deeper into the skin.A person that scratches the webs of his toes and soles of his feet may have Athlete’s foot or Tinea Pedis. Fungal infections of the feet are contagious and can be spread person to person or by stepping on contaminated objects and floors. The foot may be itchy, painful, flaky or scaly. Antifungal powders or creams that normally contain miconazole can address this scourge.

Trench foot, also called immersion foot, happens when the feet are kept wet for long periods of time and exposed to damp, unsanitary, and cold conditions. Symptoms include pain, tingling, cold skin, numbness and a heavy feeling in the foot. The foot may turn blue due to poor blood flow and may begin to have a decaying odor, a sign of early stages of necrosis. If left untreated, trench foot results in gangrene, which may result in cutting off the foot.

Heard of the seven-year-itch? An outbreak of scabies, a parasitic infestation can occur in over crowded living conditions such as in evacuation centers.WHO classifies scabies as a water-related disease.Scabies, which iscaused by a mite (think spiders and ticks), presents with very itchy papules and track in the skin. In developing countries, transmission commonly occurs in young children and infants and their mothers and is related to close contact, overcrowding, and shared sleeping areas. Treating scabies usually involves sulfur ointments and emulsions or creams, which are applied over the entire body and left on the skin for up to 24 hours before washing off.

The WHO and the DOH advise that those who have open cuts immersed in the floodwater for a long period of time should immediately contact their doctor.

Floods are a part of life, but don’t let skin disease be a part of it too.

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