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Cervical Lymphadenitis

Cervical Lymphadenitis is inflammation in the lymph glands of the neck. This lymph gland enlargement is usually secondary to any viral or bacterial infections. This condition is often noticed with tonsillitis, pharyngitis or even dental infection. Cervical Lymphadenitis is commonly seen in children suffering from upper respiratory infection. Infections such as diphtheria, tuberculosis or wounds caused by cat-scratch disease or impetigo can bring on Cervical Lymphadenitis.


Symptoms of Cervical Lymphadenitis include pain and tenderness in the lymph glands of the neck. There might be cough, sore throat and fever. Often patients suffering from Cervical Lymphadenitis experience irritability and earache. In some cases, scalp infections or impetigo or dermatitis is noticed. Chest x-rays and skin tests are used to diagnose the cause for the swollen lymph nodes. The infected nodes are sometimes aspirated for further analysis. Biopsy might be done in some cases.


In most cases, Cervical Lymphadenitis does not need any treatment. Once the cause for the swollen lymph glands is identified, appropriate treatment is prescribed. Penicillin or dicloxacillin is often used.

Melanoma

Melanoma is a type of skin cancer that develops from abnormal moles, or the pigment skin present in the skin. Because of its nature to spread to other parts of the skin, melanoma is more serious that other forms of skin cancer. It can cause serious illness and death. Derived from Greek origin 'melas' which means 'dark', melanocytes are cells that produce dark pigment called melanin which is responsible for the color of the skin. Melanoma is a most common form of cancer and the risk can increase with age. However, melanoma affects people of all ages, races, and genders and ethnicity.


Signs and symptoms

As melanoma occurs in the skin and it can be seen, patients themselves are the first to detect many melanomas. If caught early, melanomas can be cured by relatively minor surgery. However, early diagnosis and detection are crucial as it may otherwise invade healthy tissues and spread to other parts of the body making it out of control. The ABCD of melanoma can be described as:

Asymmetry: that is the shape of one half does not match with the other half.
Border: the edges are blurred, irregular.
Color is uneven and includes shades of black, brown and tan.
Diameter: there is a change in size as it increases.


Causes of Melanoma

Researchers opine that a gene known as BRAF plays a lead role in causing melanoma. As BRAF is a switch gene, it allows other cells to divide and grow. Mutations in this gene can cause explosive growth and the resultant melanoma skin cancer.

  • Sunburns, especially slow daily sun exposure, even without burning.
  • White ancestry (Caucasian)
  • Fair skin, light hair and light colored eyes
  • Intense exposure to sun especially during childhood
  • Many moles in the body, to the tune of more than hundred
  • Large irregular funny looking moles
  • History of close relatives especially parents, siblings or children with melanoma- presence of close family melanoma is a high risk factor; although only 10% of cases run in families.

Melanoma can occur on any skin surface – it is common on the area between a man's shoulders and hips. For women, melanoma generally develops on the lower legs. People with darker skin develop melanoma on their palms and soles as well as under toe and fingernails.


Diagnosis of melanoma

Get the dermatologist to examine your body fully and find out whether the moles are odd. The medical term for such moles is 'atypical'. The dermatologist will perform a skin biopsy to evaluate if the mole is cancerous or not. The doctor will remove all or part of the skin under local anesthesia and send the specimen to a pathologist for analysis. The biopsy report will reveal:

  • A totally benign condition that requires no further treatment, as in the case of a regular mole.
  • An atypical mole which depends on the judgment of the pathologist to treat – either conservative removal by taking off a bit of the normal skin all around to make sure that the spot is completely out or
  • A melanoma requiring surgery
  • Some doctors may perform epiluminescence or dermatoscopy.

Melanoma treatment

Once melanoma is diagnosed as cancer and staged, then the doctor will discuss the treatment options with the patient. Treatment is based on the stage of cancer and other related factors. In case of normal moles, which are small brown spots or growths of skin that appear in the first few decades of life in almost everyone, no treatment is necessary.

People with classic atypical mole syndrome have more than 100 moles, with many moles over 8 mm diameter and one or more moles are atypical. Treatment options include Surgery, chemotherapy, and immunotherapy and radiation therapy. Sometime a combination of treatment is used. In general melanoma is treated by surgery alone. But surgery need not be extensive, as was some years ago. During early stages of melanoma, surgeons will remove only a centimeter or even less of normal tissue around the melanoma. Whereas, deeper and more advanced cancers would require extensive surgery. The removal of nearby lymph glands depend upon factors that include tumor thickness, body location, age etc. If the stage is pretty advanced, immunotherapy treatments are adopted.


Prevent melanoma

Reduce sun exposure. Perhaps avoidance of sun exposure is the best means to prevent melanoma. Wear hats and tightly woven clothing and apply sunscreens liberally when going out. Although there is a controversy among dermatologists about sunscreen protecting against melanoma, it is certainly preferred to unprotected sun exposure.

Early detection is the key to prevention. Get your skin checked at least once every few years. In the US, the American Academy of Dermatology sponsors free skin cancer screening clinics every year all over the country. Special pigmented lesion clinics have also been established in many medical centers to allow close clinical and photographic follow ups of patient with high risk. But a reference from a concerned dermatologist is essential to undergo the screening.

Any person with high risk and having a close relative who has/had melanoma should be screened by a doctor for cancer of the skin. As with any other cancer, early diagnosis and proper evaluation and treatment is the essence.



Plague

Plague is a bacterial infection caused by Yersinia pestis and is spread by rodents, especially rats. Exposure to rats, rabbits and squirrels increases the risk.


Types of Plague

Bubonic plague: is an infection of the lymph nodes. Symptoms of Bubonic plague symptoms include chills and high fever along with headache and swollen lymph glands (bubo).

Pneumonic plague: is an infection of the lungs. Symptoms of Pneumonic plague include severe cough, blood in sputum and difficulty in breathing.

Septicemic plague: is an infection of the blood. Symptoms of Septicemic plague include diarrhea, fever, low blood pressure, abdominal pain, bleeding and organ failure.

Diagnostic tests that are prescribed for plague are blood and sputum culture. Fluid from a lymph node is often examined. Antibiotics (streptomycin, gentamicin, doxycycline, or ciprofloxacin) are the first line of treatment. Pneumonic plague is infectious. If left untreated, plague can lead to meningitis or later death.

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Bibliography / Reference

Collection of Pages - Last revised Date: September 14, 2019