Information for Patients
Your toenails and fingernails protect the tissues of your toes and fingers. They are made up of layers of a hardened protein called keratin, which is also in your hair and skin. The health of your nails can be a clue to your overall health. Healthy nails are usually smooth and consistent in color. Specific types of nail discoloration and changes in growth rate can be signs of lung, heart, kidney, and liver diseases, as well as diabetes and anemia. White spots and vertical ridges are harmless.
Nail problems that sometimes require treatment include:
- Bacterial and fungal infections
- Ingrown nails
Keeping your nails clean, dry, and trimmed can help you avoid some problems. Do not remove the cuticle, which can cause infection.
What are skin infections?
Your skin is your body's largest organ. It has many different functions, including covering and protecting your body. It helps keep germs out. But sometimes the germs can cause a skin infection. This often happens when there is a break, cut, or wound on your skin. It can also happen when your immune system is weakened, because of another disease or a medical treatment.
Some skin infections cover a small area on the top of your skin. Other infections can go deep into your skin or spread to a larger area.
What causes skin infections?
Skin infections are caused by different kinds of germs. For example,:
- Bacteria cause cellulitis, impetigo, and staphylococcal (staph) infections
- Viruses cause shingles, warts, and herpes simplex
- Fungi cause athlete's foot and yeast infections
- Parasites cause body lice, head lice, and scabies
Who is at risk for skin infections?
You are at a higher risk for a skin infection if you:
- Have poor circulation
- Have diabetes
- Are older
- Have an immune system disease, such as HIV/AIDS
- Have a weakened immune system because of chemotherapy or other medicines that suppress your immune system
- Have to stay in one position for a long time, such as if you are sick and have to stay in bed for a long time or you are paralyzed
- Are malnourished
- Have excessive skinfolds, which can happen if you have obesity
What are the symptoms of skin infections?
The symptoms depend on the type of infection. Some symptoms that are common to many skin infections include rashes, swelling, redness, pain, pus, and itching.
How are skin infections diagnosed?
To diagnose a skin infection, health care providers will do a physical exam and ask about your symptoms. You may have lab tests, such as a skin culture. This is a test to identify what type of infection you have, using a sample from your skin. Your provider may take the sample by swabbing or scraping your skin, or removing a small piece of skin (biopsy). Sometimes providers use other tests, such as blood tests.
How are skin infections treated?
The treatment depends on the type of infection and how serious it is. Some infections will go away on their own. When you do need treatment, it may include a cream or lotion to put on the skin. Other possible treatments include medicines and a procedure to drain pus.
Candida is the scientific name for yeast. It is a fungus that lives almost everywhere, including in your body. Usually, your immune system keeps yeast under control. If you are sick or taking antibiotics, it can multiply and cause an infection.
Yeast infections affect different parts of the body in different ways:
- Thrush is a yeast infection that causes white patches in your mouth
- Candida esophagitis is thrush that spreads to your esophagus, the tube that takes food from your mouth to your stomach. It can make it hard or painful to swallow.
- Women can get vaginal yeast infections, causing vaginitis
- Yeast infections of the skin cause itching and rashes
- Yeast infections in your bloodstream can be life-threatening
Antifungal medicines get rid of yeast infections in most people. If you have a weak immune system, treatment might be more difficult.
General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
- Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
- No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
- Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.
Index of Diseases and Injuries Definitions
- And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
- Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
- Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
- Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
- Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
- Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
- NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
- See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
- See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
- 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
- With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.