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1 Atlas and Text of Skin and Soft Tissue Infections and Infestations Infections and infestations are the most common disorders seen by practitioners in India, this book focuses on many important components. Sailent features of the book: Concise overview of common infections Relevent text about diagnosis Details on therapies Tabular display of important facts Multiple flowcharts and diagrams Over 100 clinical images Relevant cross references Kabir Sardana MD, DNB, MNAMS is currently Professor,, Dr RML Hospital and PGIMER, New Delhi. He was previously a Professor at Maulana Azad Medical College (MAMC), New Delhi, from 2006 to He received his MBBS from MAMC in 1991 and MD from Lady Hardinge Medical College,, in He is a DNB holder and a member of the National Academy of Medical Sciences. He has been Secretary and Vice President, IADVL, Delhi branch, and Secretary, Society of Pediatric Dermatology, Delhi. He is author of more than 130 peer-reviewed scientific publications cited on Pubmed and author/editor of a number of books, some of which are Diagnosis and Management of Skin Diseases: An Evidence-Based Approach, Comprehensive Textbook of Dermatology, Lasers in Dermatological Practice, Clinical Approach to Pigmentary Disorders, Clinical Approach to Acne Vulgaris and Clinical Approach to Fungal Infections, Hair Loss : A Primer for Practitioners. His last book was a succinct and handy Systemic Drugs in Dermatology. His clinical research interests focus on acne vulgaris, psoriasis, alopecia areata and pigmentary disorders, lasers in dermatological practice, androgenic defects in dermatology, and pediatric dermatology. Pooja Arora Mrig MD, DNB, MNAMS is currently Assistant Professor,, Dr RML Hospital and PGIMER,. She has previously worked as Assistant Professor in Chacha Nehru Bal Chikitsalaya,, and in Hamdard Institute of Medical Sciences and Research, Delhi. She did her MBBS (2003) and MD (2008) from the prestigious Maulana Azad Medical College (MAMC). She obtained her DNB degree in 2009 and was awarded a gold medal. She is a member of the National Academy of Medical Sciences. She is presently the Joint Secretary for IADVL, Delhi branch. Dr Mrig has authored around 25 publications in national and international journals and has written numerous chapters for dermatology books. Her main areas of interest include acne vulgaris, pigmentary disorders, fungal infections and paediatric dermatology. Dedicated to Education CBS Publishers & Distributors Pvt Ltd 4819/XI, Prahlad Street, 24 Ansari Road, Daryaganj, , India delhi@cbspd.com, cbspubs@airtelmail.in; Website: Bengaluru Chennai Kochi Kolkata Mumbai Hyderabad Nagpur Patna Pune Vijayawada ISBN: Atlas and Text of Skin and Soft Tissue Infections and Infestations Sardana Mrig Atlas and Text of Skin and Soft Tissue Infections and Infestations Dedicated to Education CBS Publishers & Distributors Pvt Ltd Kabir Sardana Pooja Arora Mrig Foreword PK Sharma

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4 Kabir Sardana MD, DNB, MNAMS Professor Pooja Arora Mrig MD, DNB, MNAMS Assistant Professor CBS Publishers & Distributors Pvt Ltd Bengaluru Chennai Kochi Kolkata Mumbai Hyderabad Nagpur Patna Pune Vijayawada

5 Disclaimer Science and technology are constantly changing fields. New research and experience broaden the scope of information and knowledge. The authors have tried their best in giving information available to them while preparing the material for this book. Although all efforts have been made to ensure optimum accuracy of the material, yet it is quite possible some errors might have been left uncorrected. The publisher, the printer and the authors will not be held responsible for any inadvertent errors, omissions or inaccuracies. ISBN: Copyright Authors and Publisher First Edition: 2017 All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system without permission, in writing, from the authors and the publisher. Published by Satish Kumar Jain and produced by Varun Jain for CBS Publishers & Distributors Pvt Ltd 4819/XI Prahlad Street, 24 Ansari Road, Daryaganj, , India. Ph: , , Website: Fax: Corporate Office: 204 FIE, Industrial Area, Patparganj, Delhi Ph: Fax: Branches Bengaluru: Seema House 2975, 17th Cross, K.R. Road, Banasankari 2nd Stage, Bengaluru , Karnataka Ph: /79 Fax: Chennai: 7, Subbaraya Street, Shenoy Nagar, Chennai , Tamil Nadu Ph: , Fax: Kochi: Ashana House, No. 39/1904, AM Thomas Road, Valanjambalam, Ernakulam , Kochi, Kerala Ph: Fax: Kolkata: 6/B, Ground Floor, Rameswar Shaw Road, Kolkata , West Bengal Ph: , , Mumbai: 83-C, Dr E Moses Road, Worli, Mumbai , Maharashtra Ph: /41 Fax: mumbai@cbspd.com Representatives Hyderabad Nagpur Patna Pune Vijayawada Printed at

6 to my parents Amba Sardana and Maj Gen KN Sardana at Dehradun my wife Dr. Supriya Mahajan and my daughter Zoya My teachers, colleagues and students Kabir Sardana my family for their love and continuous support my mother Mrs Krishna Arora, for being my inspiration since childhood my husband Dr Sumit Mrig for being the pillar of support my Guru and Guide Dr Kabir Sardana for having faith in me in such projects Pooja Arora Mrig

7 Contributors Kabir Sardana MD DNB MNAMS Professor Khalid Mahmood Consultant Dermatologist Colchester General Hospital, UK Khushbu Mahajan MD Associate Professor North Delhi Municipal Corporation Medical College and Hindu Rao Hospital Manu Sehrawat MD Senior Resident Pooja Arora Mrig MD, DNB, MNAMS Assistant Professor Premanshu Bhushan MD Senior Consultant Skin Institute and School of Dermatology N Block, Greater Kailash Sonali Bajaj MBBS, MD, DNB, MNAMS Senior Resident Sukriti Sharma DNB Student, Hindu Rao Hospital

8 Government of India Ministry of Health & Family Welfare, STD & Leprosy Foreword This book is a sincere attempt to picturize and present some of the cutaneous disorders from the vast compendium of all known skin diseases. Its a bird eye s view of the skin disorders presented in a simplistic and comprehensible manner. There is an attempt for clinical and etiological relationship with beautiful pictorial display which makes the reader able to easily memorize and/or use it for comprehension as a ready reckoner. The classification and photographs are good and the general practitioner shall find it highly advantageous in their daily medical practice. The specialists working in dermatology field will also find it useful because of its beautiful illustrations along with simple treatment outlines and also some newer modalities. Dr (Prof.) PK Sharma MD Consultant and Head

9 Preface Infections and infestations are probably one of the most commonly seen skin disorders but there are a few books dedicated to this topic. In Asian skin, the manifestations and causes are different than in the west. The aim of this book was to succinctly cover the major types of these disorders focusing on Indian and Asian skin. Our aim was to cover the main disorders with relevant clinical and management details, with tables, boxes, images and relevant references. There is a varying level of emphasis on topics depending on their importance. We have detailed bacterial infections and infestations in greater detail than other topics. The book is not aimed to be a treatise and thus we have purposely left out the verbose pathogenesis and focused on the clinical approach and management concept of this dermatological series that had been supported by CBS Publishers, Mr SK Jain (Matta Ji CMD) and Mr YN Arjuna Senior Vice President. A big thanks to the team at CBS, including Mrs Ritu Chawla, Mr SK Verma and Mr Sunil Dutt, the artist, Sanjay Chauhan (Sanju), proof editor, Kshirod Sahoo and typesetter, Tarun Rajput and their great support staff at the office. Lastly a big thanks to the contributors and the support of the at RML Hospital and PGIMER and Head of the Department, Dr PK Sharma and the constant encouragement of Dr RK Gautam. Happy reading! Kabir Sardana Pooja Arora Mrig

10 Contents Contributors Foreword by Prof. PK Sharma Preface vii ix xi 1. Bacterial Infections 1 Kabir Sardana, Pooja Arora Mrig 2. Mycobacterial Infections 44 Premanshu Bhushan, Sonali Bajaj, Kabir Sardana 3. Viral Infections 71 Pooja Arora Mrig, Kabir Sardana 4. Superficial and Deep Fungal Infections 122 Khushbu Mahajan, Sukriti Sharma, Pooja Arora Mrig, Kabir Sardana 5. Parasitic Infestations and Insect Bite Reactions 180 Kabir Sardana, Manu Sehrawat, Khalid Mahmood, Pooja Arora Mrig Index 227