A Simple Guide to Vitiligo
-----------------------------------
What is Vitiligo?
---------------------------
Vitiligo is a skin disorder which presents as white spots or patches on the skin.
It is not contagious.
What are the causes of Vitiligo?
----------------------------------------
The cause of Vitiligo is not known.
However many people with Vitiligo may have associated auto immune disease including thyroid disease and pernicous
anemia.
Autoimmune conditions are conditions where the body's own cells attack its cells (in this case the skin cells)
There is a progressive loss of the pigment melanin which gives us our skin color.
The loss of pigment occurs when the pigment cells (melanocytes) are destroyed and melanin cannot be produced.
What are Signs and symptoms of Vitiligo?
---------------------------------------------
white spots or patches on the skin
Common sites affected by Vitilgo are:
1.Bony surfaces - back of hands and fingers,elbows and knees
2.Body orifices - around the eyes, mouth and nose
3.Body folds - armpits and groins
Vitiligo may also occurs over an area of injury such as a cut or burn.
The hair in the vitilgo patch may be white in color.
How is the diagnosis of Vitiligo made?
------------------------------------------
1.typical white patches or spots
2.skin biopsy for microscopic examination.
What is the treatment of Vitiligo?
------------------------------------
There are different treatments for Vitiligo:
1.Corticosteroid creams
---------------------------
Corticosteroid creams are effective against small patches or spot of vitilgo but there may be side effects such as skin thinning.
2.Topical Immunodulators
----------------------------------------
Tacrolimus or pimecrolimus are topical immunodulators which work by:
1.modulating the immune attack against the melanocytes on the skin and
2.stimulating the functions of the melanocytes
3. UltraViolet Light Treatments
a.Psoralen photochemotherapy(PUVA)
PUVA is a combination treatment involving
1.the use of the drug Psoralen(P)
2.and then exposing the skin to UltraViolet A light(UVA)
hence the term PUVA.
Psoralen makes the skin temporarily sensitive to UVA which is part of natural sunlight.
Psoralen can be applied to the skin as a solution or ingested orally with subsequent exposure to ultraviolet light A.
Patient treated with PUVA may need to undergo treatment for 1 year for satisfactory results.
Use of PUVA may result in sunburn and blister fromation.
b.Narrowband UVB
Narrowband UltraViolet light B treatment does not require Psoralen tablets before treatment.
In fact this treatment is safer and as effective if not better than PUVA. Again treatment may require 1 year before satisfactory results.
c.Focused Multiple Wavelength UltraViolet Therapy(Multiclear)
This is a form of targeted light therapy as only the vitiligo areas are treated.
It is useful for small localised lesions.
d.Excimer Laser
This laser emits a certain UVB wavelength but is more costly than Multiclear Light therapy.
4.Surgery
Surgical transplants are meant for patients with stable vitligo that fail to respond to topical or phototherapy.
Stable vitiligo means no new lesions or progressive lesions for 12 to 24 months.
Surgery involve tissue and cellular grafting.
5.Camuoflage Cosmetics.
Cover up camouflage provides good color and camouflage of vitiligo lesions.
They are particularly useful for white patches on the face ansd back of the hands.
6.Sunscreens
Areas of vitiligo exposed to the sun are very prone to sunburn as they lack protective pigments.
Patients should always use broad spectrum sunsceens to protected the affected vitiligo areas.
What is the prognosis of Vitiligo ?
------------------------------------------
Generally fair.
Treatment takes time and patience.
What are the Preventive measures taken for Vitiligo ?
--------------------------------------------------------
1.Sunscreens
2.Proper skin care
Showing posts with label skin. Show all posts
Showing posts with label skin. Show all posts
Tuesday, April 28, 2009
Saturday, October 25, 2008
A Simple Guide to Cutaneous Larva migrans
A Simple Guide to Cutaneous Larva migrans
----------------------------------------------
What is Cutaneous Larva migrans?
------------------------------------
Cutaneous Larva migrans is a common skin condition which appears as a red snake-like itchy rash caused by penetration and subsequent migration of larvae of various worm parasites.
The condition is benign and self-limited.
It is most commonly found in tropical countries.
Who is at risk from Cutaneous Larva migrans?
---------------------------------------
1.People of all ages are affected but it is more common in children
2.It is more common in hot tropical climates
3.Certain occupations that involve contact with warm, moist, sandy soil:
Farmer
Gardener
4.Certain hobbies that involve contact with warm, moist, sandy soil:
Tropical climate travellers
Barefoot beach goers
Children building sandcastles
What are the causes of Cutaneous Larva migrans?
--------------------------------------------------
The larvae usually hatch from eggs laid in animal faeces and then penetrate through the intact skin of the children or adults.
After shedding their covering, they begin migrating in the epidermis.
Because they are unable to penetrate through the dermis, the disease remains limited to the skin of humans.
THE MOST COMMON PARASITES ARE:
DOG HOOKWORMS:
Ancylostoma braziliense
Ancylostoma caninum
Uncinaria stenocephala
Rarer causes are:
Ancylostoma tubaeforme (cat hookworm)
Necator americanus (human hookworm)
Ancylostoma duodenale
What are Signs and symptoms of Cutaneous Larva migrans?
----------------------------------------------------------
Symptoms:
1.prickling sensation at the site within 30 minutes of larva penetration of the skin
2.Intense itchiness
3.Red linear lesions that moves
4.walking barefoot on the beach in a tropical location
Signs:
1.Itchy, red, raised papules or vesicles
2.snakelike, slightly elevated, red tunnels that are 2-3mm wide and 3-4 cm long from the penetration site
3.Vesicles with clear fluid
4.Tract movement of 1-2 cm/day
5.peripheral eosinophilia (Loeffler syndrome),
6.migratory lung infiltrates,
7.Lesions are typically present on the distal lower extremities,
the dorsa of the feet and the interdigital spaces of the toes,
anogenital region,
the buttocks,
the hands, and
the knees.
How is the diagnosis of Cutaneous Larva migrans made?
--------------------------------------------------------
Diagnosis is mostly based on the
1.classic clinical appearance of the eruption.
2.peripheral eosinophilia on a Complete Blood Count
3.increased IgE levels on total serum immunoglobulin determinations.
4. skin biopsy taken just before leading edge of a tract may show
a larva (periodic acid-Schiff positive) in a
suprabasalar burrow,
basal layer tracts,
spongiosis
intraepidermal vesicles,
necrotic keratinocytes,
an epidermal and upper dermal chronic inflammatory infiltrate with many eosinophils.
What are the complications of Cutaneous Larva migrans?
-----------------------------------------------
1. secondary bacterial infection, usually with Streptococcus pyogenes, may lead to cellulitis.
2. Allergic reactions may occur.
What is the treatment of Cutaneous Larva migrans?
---------------------------------------------------------
The condition is usually self-limiting.
The intense itchiness and risk for infection may require treatment.
Invasive treatment:
---------------------
1.liquid nitrogen cryotherapy for progressive end of larval burrow.
2.electrocautery
Medication:
----------------
1.Thiabendazole
Thiabendazole is the best medication
Topical application is used for early, localized lesions.
The oral route is preferred for widespread lesions or unsuccessful topical treatment.
2.Mebendazole (Vermox)
Broad-spectrum anthelmintic that inhibits microtubule assembly and irreversibly blocks glucose uptake, thereby depleting the parasites' glycogen stores.
Other effective treatments include
3.albendazole,
4.ivermectin.
In most cases there is decreased itchiness within 24-48 hours and lesions resolve in 1 week.
5.Antibiotics are given if there are secondary bacterial superinfections.
6.Antihistamines are given for severe itchiness
What is the prognosis of Cutaneous Larva migrans ?
----------------------------------------------------
The prognosis is excellent.
This is a self-limiting disease.
Humans are accidental hosts and the larva usually dies within 4-8 weeks.
The lesions usually will disappear within 8 weeks to 1 year depending on complications.
What are the Preventive measures taken for Cutaneous Larva migrans ?
-----------------------------------------------------------------------------
Travellers to tropical regions and pet owners should be made aware of this condition.
Prevention is by avoiding direct skin contact with possible faecally contaminated soil.
----------------------------------------------
What is Cutaneous Larva migrans?
------------------------------------
Cutaneous Larva migrans is a common skin condition which appears as a red snake-like itchy rash caused by penetration and subsequent migration of larvae of various worm parasites.
The condition is benign and self-limited.
It is most commonly found in tropical countries.
Who is at risk from Cutaneous Larva migrans?
---------------------------------------
1.People of all ages are affected but it is more common in children
2.It is more common in hot tropical climates
3.Certain occupations that involve contact with warm, moist, sandy soil:
Farmer
Gardener
4.Certain hobbies that involve contact with warm, moist, sandy soil:
Tropical climate travellers
Barefoot beach goers
Children building sandcastles
What are the causes of Cutaneous Larva migrans?
--------------------------------------------------
The larvae usually hatch from eggs laid in animal faeces and then penetrate through the intact skin of the children or adults.
After shedding their covering, they begin migrating in the epidermis.
Because they are unable to penetrate through the dermis, the disease remains limited to the skin of humans.
THE MOST COMMON PARASITES ARE:
DOG HOOKWORMS:
Ancylostoma braziliense
Ancylostoma caninum
Uncinaria stenocephala
Rarer causes are:
Ancylostoma tubaeforme (cat hookworm)
Necator americanus (human hookworm)
Ancylostoma duodenale
What are Signs and symptoms of Cutaneous Larva migrans?
----------------------------------------------------------
Symptoms:
1.prickling sensation at the site within 30 minutes of larva penetration of the skin
2.Intense itchiness
3.Red linear lesions that moves
4.walking barefoot on the beach in a tropical location
Signs:
1.Itchy, red, raised papules or vesicles
2.snakelike, slightly elevated, red tunnels that are 2-3mm wide and 3-4 cm long from the penetration site
3.Vesicles with clear fluid
4.Tract movement of 1-2 cm/day
5.peripheral eosinophilia (Loeffler syndrome),
6.migratory lung infiltrates,
7.Lesions are typically present on the distal lower extremities,
the dorsa of the feet and the interdigital spaces of the toes,
anogenital region,
the buttocks,
the hands, and
the knees.
How is the diagnosis of Cutaneous Larva migrans made?
--------------------------------------------------------
Diagnosis is mostly based on the
1.classic clinical appearance of the eruption.
2.peripheral eosinophilia on a Complete Blood Count
3.increased IgE levels on total serum immunoglobulin determinations.
4. skin biopsy taken just before leading edge of a tract may show
a larva (periodic acid-Schiff positive) in a
suprabasalar burrow,
basal layer tracts,
spongiosis
intraepidermal vesicles,
necrotic keratinocytes,
an epidermal and upper dermal chronic inflammatory infiltrate with many eosinophils.
What are the complications of Cutaneous Larva migrans?
-----------------------------------------------
1. secondary bacterial infection, usually with Streptococcus pyogenes, may lead to cellulitis.
2. Allergic reactions may occur.
What is the treatment of Cutaneous Larva migrans?
---------------------------------------------------------
The condition is usually self-limiting.
The intense itchiness and risk for infection may require treatment.
Invasive treatment:
---------------------
1.liquid nitrogen cryotherapy for progressive end of larval burrow.
2.electrocautery
Medication:
----------------
1.Thiabendazole
Thiabendazole is the best medication
Topical application is used for early, localized lesions.
The oral route is preferred for widespread lesions or unsuccessful topical treatment.
2.Mebendazole (Vermox)
Broad-spectrum anthelmintic that inhibits microtubule assembly and irreversibly blocks glucose uptake, thereby depleting the parasites' glycogen stores.
Other effective treatments include
3.albendazole,
4.ivermectin.
In most cases there is decreased itchiness within 24-48 hours and lesions resolve in 1 week.
5.Antibiotics are given if there are secondary bacterial superinfections.
6.Antihistamines are given for severe itchiness
What is the prognosis of Cutaneous Larva migrans ?
----------------------------------------------------
The prognosis is excellent.
This is a self-limiting disease.
Humans are accidental hosts and the larva usually dies within 4-8 weeks.
The lesions usually will disappear within 8 weeks to 1 year depending on complications.
What are the Preventive measures taken for Cutaneous Larva migrans ?
-----------------------------------------------------------------------------
Travellers to tropical regions and pet owners should be made aware of this condition.
Prevention is by avoiding direct skin contact with possible faecally contaminated soil.
Friday, October 24, 2008
A Simple Guide to Folliculitis
A Simple Guide to Folliculitis
----------------------------------------------
What is Folliculitis?
------------------------------------
Folliculitis is a bacterial infection of the skin hair follicle.
Who is at risk from Folliculitis?
---------------------------------------
People of all ages are affected .
It is more common in diabetes and people with low immune system.
What are the causes of Folliculitis?
--------------------------------------------------
1.The cause is infection of bacteria such as Staphylococcus aureus.
2.Poor skin hygiene
3.Skin damaged by eczema and dermatitis
4.Nasal transport of Staphylococcus aureus.
5.May complicate diabetes and low immune system patients like leukemia.
What are Signs and symptoms of Folliculitis?
---------------------------------------------
Symptoms:
1.Occurs at root of a hair follicle
2.superficial pustule or nodule
3.May become chronic at beard area.
4.May be painful
How is the diagnosis of Folliculitis made?
--------------------------------------------------------
1.pustule at root of hair.
2.Skin scraping for microscopic examination, culture and sensitivity.
3.Blood count.
What are the complications of Folliculitis?
-----------------------------------------------
1.Fungal infection
2.furuncle or carbuncle which are bigger and deeper areas of infection.
What is the treatment of Folliculitis?
------------------------------------
A. Skin hygiene
--------------------------
1. clean skin with antiseptic.
2. avoid scratching the skin
3. avoid plaster and poultices
4. cover with gauze after skin injury
B. Medicines:
-----------------
1. topical antibacterials such as bacitracin, neomycin, gentamycin, tetracycline creams
2. Oral Antibiotics may be given if necessary.
3. Complicated conditions such as carbuncles may require surgical debridement.
What is the prognosis of Folliculitis ?
------------------------------------------
Generally good to excellent but may recur.
Prompt treatment is important to prevent complication
What are the Preventive measures taken for Folliculitis?
--------------------------------------------------------
1.Good skin hygiene
2.Healthy lifestyle with balanced diet and adequate sleep.
3.Avoid scratching of skin
4.Use clean razors for shaving
5.Avoid plasters and poultices.
Thursday, October 23, 2008
A Simple Guide to Prickly Heat
A Simple Guide to Prickly Heat
----------------------------------------------
What is Prickly Heat?
------------------------------------
Prickly Heat(also known as miliaria) is a common non contagious disease which appears as acute itchy red rash on the body due to retained sweat.
Who is at risk from Prickly Heat?
---------------------------------------
People of all ages are affected but it is more common in children and infants due to their underdeveloped sweat glands.
It is more common in hot and humid conditions.
What are the types of Prickly Heat?
----------------------------------------------
I.Miliaria crystallina-
minute superficial vesicular lesions that normally do not cause any symptoms
2.Miliaria rubra -
deeper layer inflammatory lesions causing the typical appearance of redness (hence rubra) and larger blister-like lesions.
There is intense itching with a lack of sweating to affected areas.
This is the most common form of prickly heat.
3.Miliaria profunda-
the most severe form of miliaria due to the rapid spread and severe burning sensations.
The obstruction is deep in the structure of the sweat gland resulting in the sweat to leak between the superficial and deep layers of the skin.
The rash occurs within hours of an activity provoking sweating and disappear within hours when the stimulus for the sweating is removed.
The risk of heat exhaustion is higher.
What are the causes of Prickly Heat?
--------------------------------------------------
The cause is the result of the keratin or dead skin cells or bacteria such as Staphylococcus epidermidis of the skin blocking the sweat ducts.
The occluded sweat ducts ruptures when sweating occur and the sweat form an intraepidermal vesicle which leads to irritation(prickly sensation) and itchiness.
Secondary infection may occurs from invasion of staphalococcus.
What are Signs and symptoms of Prickly Heat?
---------------------------------------------
Symptoms:
1.Occurs in humid hot weather
2.Small red papulovesicular rashes
3.Occurs on the face, neck, under the breasts, trunk, under the scrotum, skin folds, behind knee and antecubital fossa.
4.Usually very itchy
5.Rash usually presents with prickly sensation
How is the diagnosis of Prickly Heat made?
--------------------------------------------------------
1.Symptoms and signs of small rashes occuring in hot humid condition with itchiness and prickly sensation
2.Skin scraping for microscopic examination.
What are the complications of Prickly Heat?
-----------------------------------------------
1.Fungal infection
2.bacterial infection
What is the treatment of Prickly Heat?
--------------------------------------------------
A. Cool Environment
--------------------------
1. air-conditioned environment
2. avoid heat and sweat-inducing activities
3. avoid occlusive clothing,
4. take frequent cool showers.
B. Medicines:
-----------------
1. topical antibacterials may reduce the symptoms in miliaria rubra
2. anti-itch preparations such as calamine or menthol preparations
3. topical steroid creams,
4. Avoid oil based preparations because they increase blockage to the sweat glands.
5. Oral Antibiotics may be given if there is secondary infection.
6. Oral antihistamines may be given if itch is troublesome.
7. VItamin C or A in high dosages have not been found to be effective
What is the prognosis of Prickly Heat ?
------------------------------------------
Generally good to excellent but may recur.
Environmental factors like humidty and heat should be avoided.
What are the Preventive measures taken for Prickly Heat ?
--------------------------------------------------------
1.Good skin hygiene
2.Healthy lifestyle with balanced diet and adequate sleep.
3.Wear light clothing
4.Reduce sweating (use air conditioner)
5.Frequent showers should help
6.Avoid heat and humidity.
----------------------------------------------
What is Prickly Heat?
------------------------------------
Prickly Heat(also known as miliaria) is a common non contagious disease which appears as acute itchy red rash on the body due to retained sweat.
Who is at risk from Prickly Heat?
---------------------------------------
People of all ages are affected but it is more common in children and infants due to their underdeveloped sweat glands.
It is more common in hot and humid conditions.
What are the types of Prickly Heat?
----------------------------------------------
I.Miliaria crystallina-
minute superficial vesicular lesions that normally do not cause any symptoms
2.Miliaria rubra -
deeper layer inflammatory lesions causing the typical appearance of redness (hence rubra) and larger blister-like lesions.
There is intense itching with a lack of sweating to affected areas.
This is the most common form of prickly heat.
3.Miliaria profunda-
the most severe form of miliaria due to the rapid spread and severe burning sensations.
The obstruction is deep in the structure of the sweat gland resulting in the sweat to leak between the superficial and deep layers of the skin.
The rash occurs within hours of an activity provoking sweating and disappear within hours when the stimulus for the sweating is removed.
The risk of heat exhaustion is higher.
What are the causes of Prickly Heat?
--------------------------------------------------
The cause is the result of the keratin or dead skin cells or bacteria such as Staphylococcus epidermidis of the skin blocking the sweat ducts.
The occluded sweat ducts ruptures when sweating occur and the sweat form an intraepidermal vesicle which leads to irritation(prickly sensation) and itchiness.
Secondary infection may occurs from invasion of staphalococcus.
What are Signs and symptoms of Prickly Heat?
---------------------------------------------
Symptoms:
1.Occurs in humid hot weather
2.Small red papulovesicular rashes
3.Occurs on the face, neck, under the breasts, trunk, under the scrotum, skin folds, behind knee and antecubital fossa.
4.Usually very itchy
5.Rash usually presents with prickly sensation
How is the diagnosis of Prickly Heat made?
--------------------------------------------------------
1.Symptoms and signs of small rashes occuring in hot humid condition with itchiness and prickly sensation
2.Skin scraping for microscopic examination.
What are the complications of Prickly Heat?
-----------------------------------------------
1.Fungal infection
2.bacterial infection
What is the treatment of Prickly Heat?
--------------------------------------------------
A. Cool Environment
--------------------------
1. air-conditioned environment
2. avoid heat and sweat-inducing activities
3. avoid occlusive clothing,
4. take frequent cool showers.
B. Medicines:
-----------------
1. topical antibacterials may reduce the symptoms in miliaria rubra
2. anti-itch preparations such as calamine or menthol preparations
3. topical steroid creams,
4. Avoid oil based preparations because they increase blockage to the sweat glands.
5. Oral Antibiotics may be given if there is secondary infection.
6. Oral antihistamines may be given if itch is troublesome.
7. VItamin C or A in high dosages have not been found to be effective
What is the prognosis of Prickly Heat ?
------------------------------------------
Generally good to excellent but may recur.
Environmental factors like humidty and heat should be avoided.
What are the Preventive measures taken for Prickly Heat ?
--------------------------------------------------------
1.Good skin hygiene
2.Healthy lifestyle with balanced diet and adequate sleep.
3.Wear light clothing
4.Reduce sweating (use air conditioner)
5.Frequent showers should help
6.Avoid heat and humidity.
Thursday, October 2, 2008
A Simple Guide to Ichthyosis
A Simple Guide to Ichthyosis
----------------------------------------------
What is Ichthyosis?
------------------------------------
Ichthyosis is a rare non contagious disease of the keratin of the skin where there is reduction of sweat and sebaceous secretions.
The word Ichthus means fish.
So Ichthyosis means fish like appearance of the skin.
Who is at risk of Ichthyosis?
----------------------------------------------
a family history of ichthyosis
What are the causes of Ichthyosis?
--------------------------------------------------
Most forms of ichthyosis are due to:
A.genetic conditions:
------------------------
1.Ichthyosis vulgaris 95% -autosomal dominant
2.X-linked ichthyosis -sex linked recessive
3.Ichthyosis lamellaris - autosomal recessive usually in newborns
4.Harlequins Ichthyosis -autosomal recessive
5.Bullous Ichthyosis - autosomal dominant
B.Acquired Ichthyosis
----------------------
6.Ichthyosis acquisita occur in :
leprosy,
hypothyroidism,
lymphoma,
sarcoidosis,
Hodgkin disease
7.Xeroderma - is a mild form of ichthyosis, occurs in middle aged and older patients.
What are Signs and symptoms of Ichthyosis?
---------------------------------------------
Symptoms:
1.extensor surface of limbs covered with dry scales(rarely the whole body is covered).
2.axilla and antecubal fossa (elbows,armpits,groins,back of knee)not affected
3.Usually symptoms present in childhood but improve during puberty to becoming worst again in later life.
4.Rashes can be extremely itchy in xeroderma
5.The condition is worse in colder weather.
6.Hair may be thin and dry.
7.Nails are brittle and dry.
How is the diagnosis of Ichthyosis made?
--------------------------------------------------------
1.Appearance of the skin
2.Family history of Ichthyosis
2.Skin biopsy for microscopic examination.
What are the complications of Ichthyosis?
-----------------------------------------------
1.keratisis with corneal and ocular surface disease
2.Ectropion of eyelids due to dehydration
3.Deafness in a Keratitis-Ichthyosis-Deafness (KID)Disease
What is the treatment of Ichthyosis?
------------------------------------
There is no cure for Ichthyosis.
1.Symptomatic treatment with emolient creams such as petroleum jelly my help to hydrate the skin.
2.Itch may be controlled with antihistamines
3.Hydration with propylene glycol solution will help
4.Urea in emulsion creams has also help the dry skin
5.Topical or oral retinoic acid has brought some improvement to the skin.
6.Exposure to the sun may improve or worsen the condition.
What is the prognosis of Ichthyosis ?
------------------------------------------
It is a lifelong condition and need continuous treatment.
What are the Preventive measures taken for Ichthyosis ?
--------------------------------------------------------
There is no known preventive measure for ichthyosis
----------------------------------------------
What is Ichthyosis?
------------------------------------
Ichthyosis is a rare non contagious disease of the keratin of the skin where there is reduction of sweat and sebaceous secretions.
The word Ichthus means fish.
So Ichthyosis means fish like appearance of the skin.
Who is at risk of Ichthyosis?
----------------------------------------------
a family history of ichthyosis
What are the causes of Ichthyosis?
--------------------------------------------------
Most forms of ichthyosis are due to:
A.genetic conditions:
------------------------
1.Ichthyosis vulgaris 95% -autosomal dominant
2.X-linked ichthyosis -sex linked recessive
3.Ichthyosis lamellaris - autosomal recessive usually in newborns
4.Harlequins Ichthyosis -autosomal recessive
5.Bullous Ichthyosis - autosomal dominant
B.Acquired Ichthyosis
----------------------
6.Ichthyosis acquisita occur in :
leprosy,
hypothyroidism,
lymphoma,
sarcoidosis,
Hodgkin disease
7.Xeroderma - is a mild form of ichthyosis, occurs in middle aged and older patients.
What are Signs and symptoms of Ichthyosis?
---------------------------------------------
Symptoms:
1.extensor surface of limbs covered with dry scales(rarely the whole body is covered).
2.axilla and antecubal fossa (elbows,armpits,groins,back of knee)not affected
3.Usually symptoms present in childhood but improve during puberty to becoming worst again in later life.
4.Rashes can be extremely itchy in xeroderma
5.The condition is worse in colder weather.
6.Hair may be thin and dry.
7.Nails are brittle and dry.
How is the diagnosis of Ichthyosis made?
--------------------------------------------------------
1.Appearance of the skin
2.Family history of Ichthyosis
2.Skin biopsy for microscopic examination.
What are the complications of Ichthyosis?
-----------------------------------------------
1.keratisis with corneal and ocular surface disease
2.Ectropion of eyelids due to dehydration
3.Deafness in a Keratitis-Ichthyosis-Deafness (KID)Disease
What is the treatment of Ichthyosis?
------------------------------------
There is no cure for Ichthyosis.
1.Symptomatic treatment with emolient creams such as petroleum jelly my help to hydrate the skin.
2.Itch may be controlled with antihistamines
3.Hydration with propylene glycol solution will help
4.Urea in emulsion creams has also help the dry skin
5.Topical or oral retinoic acid has brought some improvement to the skin.
6.Exposure to the sun may improve or worsen the condition.
What is the prognosis of Ichthyosis ?
------------------------------------------
It is a lifelong condition and need continuous treatment.
What are the Preventive measures taken for Ichthyosis ?
--------------------------------------------------------
There is no known preventive measure for ichthyosis
Wednesday, October 1, 2008
A Simple Guide to Pityriasis Rosea
A Simple Guide to Pityriasis Rosea
----------------------------------------------
What is Pityriasis Rosea?
------------------------------------
Pityriasis Rosea is a common non contagious disease which appears as numerous patches of red rash on the trunk of the body.
Who is at risk of Pityriasis Rosea?
----------------------------------------------
All ages and both sex are affected but occurs more between 10 -35 years of age.
What are the causes of Pityriasis Rosea?
--------------------------------------------------
The cause is unknown but a viral infection is suspected to cause it.
What are Signs and symptoms of Pityriasis Rosea?
---------------------------------------------
Symptoms:
1.A single red large patch of rashes or herald patch usually occur 1-20 days on the body before the onset of numerous small patches.
2.sore throat may occur before the onset of rashes
3.Numerous Large patches of red oval-shaped rash on the body may occur on the chest, back and neck.
4. As the rashes subside on the body, they may spread to the groin and extremities like the legs and arms
5.Rashes can be extremely itchy
6.breathlessness
7.low-grade fever
8.headache
9.nausea
10.fatigue.
How is the diagnosis of Pityriasis Rosea made?
--------------------------------------------------------
1.Symptoms and signs of typical herald patch followed by other patches of rashes
2.Skin scraping for microscopic examination.
What are the complications of Pityriasis Rosea?
-----------------------------------------------
1.Fungal infection
2.bacterial infection
What is the treatment of Pityriasis Rosea?
------------------------------------
1.No treatment may be necessary as the illness is self limiting
2.Itch may be controlled with antihistamines
3.Corticosteroid (oral or cream) may help reduce severe itching and inflammation
4.Soap should be avoided because it irritate the skin.
5.Moisturizer is better because of the dry skin
6.UV therapy sometimes help
7.Antibiotics may be given if there is secondary infection.
What is the prognosis of Pityriasis Rosea ?
------------------------------------------
Generally excellent but may recur.
What are the Preventive measures taken for Pityriasis Rosea ?
--------------------------------------------------------
1.Good skin hygiene
2.Healthy lifestyle with balanced diet and adequate sleep.
3.Proper skin care of the body.
Saturday, September 27, 2008
A Simple Guide to Intertrigo
A Simple Guide to Intertrigo
-----------------------------------
What is Intertrigo?
---------------------------
Intertrigo is a moist red seborrheic (oil gland) skin rash affecting body clefts such as armpits and groins.
What are the causes of Intertrigo?
----------------------------------------
The seborrheic glands (oil glands) in the skin secretes excessive sebum(oil) especially in areas which tends to rubs against each other such as armpits, groins, skin under the breasts, and navel.
Because of the irritation of the skin and secretion of sebum, a red moist form of rash appears.
What are Signs and symptoms of Intertrigo?
---------------------------------------------
Symptoms:
1.moist rash
2.red skin
3.may be oily
Signs:
1.Typical red moist macular rash
2.may have sebum present
3.appears mainly at axilla, groin, submammary skin
How is the diagnosis of Intertrigo made?
------------------------------------------
1.Symptoms and signs of moist red seborrheic type of rash
2.Skin scraping to exclude fungal infection.
What are the complications of Intertrigo?
-----------------------------------------------
1.Fungal infection
2.bacterial infection
What is the treatment of Intertrigo?
------------------------------------
1.Control of dandruff and other seborrheic conditions
2.Anifungal and antibiotic cream applied to skin lesions.
3.Corticosteroid cream may help reduce inflammation
What is the prognosis of Intertrigo ?
------------------------------------------
Generally excellent but may recur.
What are the Preventive measures taken for Intertrigo ?
--------------------------------------------------------
1.Lose weight in obese patient(less friction)
2.Good skin hygiene
3.Healthy lifestyle with balanced diet and adequate sleep.
4.Proper skin care of the axilla, groins, submammary ares, navel
-----------------------------------
What is Intertrigo?
---------------------------
Intertrigo is a moist red seborrheic (oil gland) skin rash affecting body clefts such as armpits and groins.
What are the causes of Intertrigo?
----------------------------------------
The seborrheic glands (oil glands) in the skin secretes excessive sebum(oil) especially in areas which tends to rubs against each other such as armpits, groins, skin under the breasts, and navel.
Because of the irritation of the skin and secretion of sebum, a red moist form of rash appears.
What are Signs and symptoms of Intertrigo?
---------------------------------------------
Symptoms:
1.moist rash
2.red skin
3.may be oily
Signs:
1.Typical red moist macular rash
2.may have sebum present
3.appears mainly at axilla, groin, submammary skin
How is the diagnosis of Intertrigo made?
------------------------------------------
1.Symptoms and signs of moist red seborrheic type of rash
2.Skin scraping to exclude fungal infection.
What are the complications of Intertrigo?
-----------------------------------------------
1.Fungal infection
2.bacterial infection
What is the treatment of Intertrigo?
------------------------------------
1.Control of dandruff and other seborrheic conditions
2.Anifungal and antibiotic cream applied to skin lesions.
3.Corticosteroid cream may help reduce inflammation
What is the prognosis of Intertrigo ?
------------------------------------------
Generally excellent but may recur.
What are the Preventive measures taken for Intertrigo ?
--------------------------------------------------------
1.Lose weight in obese patient(less friction)
2.Good skin hygiene
3.Healthy lifestyle with balanced diet and adequate sleep.
4.Proper skin care of the axilla, groins, submammary ares, navel
Thursday, September 25, 2008
A Simple Guide to Impetigo
A Simple Guide to Impetigo
-----------------------------------
What is Impetigo?
---------------------------
Impetigo is a vesiculopustular skin infection occurring mainly at all ages.
What are the causes of Impetigo?
----------------------------------------
Bacterial Infections:
----------------------------
1.Gram positive bacteria such as Streptococcus and Staphphylococcus are common
2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas,
What are Signs and symptoms of Impetigo?
---------------------------------------------
Symptoms:
1.vesicles that appears rapidly on the face, hands and knee
2.Yellow liquid or pus discharges from vesicles
3.form crusts
Signs:
1.Vesicles rash present on face, hand and knees
2.yellow crusts appeared and spread to surrounding tissues
3.Neighboring lymph nodes may be enlarged
How is the diagnosis of Impetigo made?
------------------------------------------
1.Symptoms and signs of vesiculopustular lesions of the skin.
2.Culture and sensitivity to antibiotics of the discharge or crusts from skin lesions
What are the complications of Impetigo?
-----------------------------------------------
1.cellulitis
2.abscess
3.carbuncle( a group of abscesses which join together to become a large abscess
4.lymphadenitis
What is the treatment of Impetigo?
------------------------------------
1.Removal of crusts with warm saline or liquid paraffin
2.Strong antibiotic cream applied to skin lesions.
3. Strong systemic antibiotics
a.cephalosporin, penicillin, ampicillin, erythromycin, tetracycline, for most streptococci,
staphalococci,
hemophilus
b.cephalosporins, gentamycin for
pseudomonas
4.surgery to drain abscess and carbuncles may be necessary
What is the prognosis of Impetigo ?
------------------------------------------
Generally excellent with good healing
What are the Preventive measures taken for Impetigo ?
--------------------------------------------------------
1.Avoid touching skin with dirty hands
2.Good hand hygiene
3.Healthy lifestyle with balance diet and adequate sleep.
4.Proper skin care
Thursday, August 28, 2008
A Simple Guide to Squamous Cell Carcinoma(skin)
A Simple Guide to Squamous Cell Carcinoma(skin)
----------------------------------------------------
What is Squamous Cell Carcinoma?
---------------------------------------
Squamous Cell Carcinoma is a progressive neoplastic tumor of the epithelial cells of thee skin which are found mainly in the late middle age and consists of a solitary skin lesion.
Who is affected by Squamous Cell Carcinoma?
---------------------------------------------------
Squamous Cell Carcinoma is more common in :
1.People with fair skin than in those with darker skin.
2.People who spend time outdoors under the sun than those staying indoors.
3.People with skin condition called xeroderma pigmentosa
4.People with autoimmune disease such as systemic lupus erythematosus
5.People with family history of Squamous Cell Carcinoma
What is the Cause of Squamous Cell Carcinoma?
-----------------------------------------------------
A.Sun exposure:
Exposure to the sun is one of the most common causes of Squamous Cell Carcinoma.
Risk factors are:
1.intensity of the sun
2.duration of sun exposure,
3.age when sun exposure takes place
4.degree of skin pigmentation
B.Familial:
1.skin condition called xeroderma pigmentosa (autosomal recessive)
2.family history of Squamous Cell Carcinoma
What are the Symptoms and signs of Squamous Cell Carcinoma?
-----------------------------------------------------------
Squamous Cell Carcinoma presents usually as:
1.single firm lesion
2.raised
3.red
4.indurated
5.scaling
6.ulceration may occur
7.rarely bleeding
8.found in sun exposed areas of body
9.regional lymph nodes may be enlarged
How do you make the Diagnosis of Squamous Cell Carcinoma?
------------------------------------------------------------
Biopsy show malignant epithelial cells with varying degrees of infiltration
What are the complications of Squamous Cell Carcinoma?
-----------------------------------------------------------------
Squamous Cell Carcinoma can spread to the organs and other parts of the body
What is the treatment of Squamous Cell Carcinoma?
---------------------------------------------------
Treatment is simple surgical removal of the skin lesion .
Sometimes the regional lymph nodes are also removed.
If the spread is further, chemotherapy and radiotherapy may be necessary.
What is the prognosis of Squamous Cell Carcinoma?
------------------------------------------------------
The prognosis is good if detected early and there is complete removal of the cancer.
If there is spread to the organs, prognosis is variable depending on the degree of metastases.
What are the preventive measures for Squamous cell carcinoma?
-----------------------------------------------------------------
1.Avoid the direct sun (long-sleeved shirts, long trousers, and broad-brimmed hats).
Use sunscreens.
2.Good nutrition and healthy lifestyle boost the immune system and helps prevent malignancy.
3.Patients with family history of skin cancer should be reviewed yearly
4.Recently a melanocyte-stimulating hormone called melanotan has been found to provide photo-protection against squamous cell carcinoma of the skin.
----------------------------------------------------
What is Squamous Cell Carcinoma?
---------------------------------------
Squamous Cell Carcinoma is a progressive neoplastic tumor of the epithelial cells of thee skin which are found mainly in the late middle age and consists of a solitary skin lesion.
Who is affected by Squamous Cell Carcinoma?
---------------------------------------------------
Squamous Cell Carcinoma is more common in :
1.People with fair skin than in those with darker skin.
2.People who spend time outdoors under the sun than those staying indoors.
3.People with skin condition called xeroderma pigmentosa
4.People with autoimmune disease such as systemic lupus erythematosus
5.People with family history of Squamous Cell Carcinoma
What is the Cause of Squamous Cell Carcinoma?
-----------------------------------------------------
A.Sun exposure:
Exposure to the sun is one of the most common causes of Squamous Cell Carcinoma.
Risk factors are:
1.intensity of the sun
2.duration of sun exposure,
3.age when sun exposure takes place
4.degree of skin pigmentation
B.Familial:
1.skin condition called xeroderma pigmentosa (autosomal recessive)
2.family history of Squamous Cell Carcinoma
What are the Symptoms and signs of Squamous Cell Carcinoma?
-----------------------------------------------------------
Squamous Cell Carcinoma presents usually as:
1.single firm lesion
2.raised
3.red
4.indurated
5.scaling
6.ulceration may occur
7.rarely bleeding
8.found in sun exposed areas of body
9.regional lymph nodes may be enlarged
How do you make the Diagnosis of Squamous Cell Carcinoma?
------------------------------------------------------------
Biopsy show malignant epithelial cells with varying degrees of infiltration
What are the complications of Squamous Cell Carcinoma?
-----------------------------------------------------------------
Squamous Cell Carcinoma can spread to the organs and other parts of the body
What is the treatment of Squamous Cell Carcinoma?
---------------------------------------------------
Treatment is simple surgical removal of the skin lesion .
Sometimes the regional lymph nodes are also removed.
If the spread is further, chemotherapy and radiotherapy may be necessary.
What is the prognosis of Squamous Cell Carcinoma?
------------------------------------------------------
The prognosis is good if detected early and there is complete removal of the cancer.
If there is spread to the organs, prognosis is variable depending on the degree of metastases.
What are the preventive measures for Squamous cell carcinoma?
-----------------------------------------------------------------
1.Avoid the direct sun (long-sleeved shirts, long trousers, and broad-brimmed hats).
Use sunscreens.
2.Good nutrition and healthy lifestyle boost the immune system and helps prevent malignancy.
3.Patients with family history of skin cancer should be reviewed yearly
4.Recently a melanocyte-stimulating hormone called melanotan has been found to provide photo-protection against squamous cell carcinoma of the skin.
Wednesday, August 27, 2008
A Simple Guide to Basal cell carcinoma
A Simple Guide to Basal cell carcinoma
----------------------------------------------------
What is Basal cell carcinoma?
---------------------------------------
Basal cell carcinoma is a localized malignant tumor of the basal cells of the skin which seldom spread beyond its location.
It is the most common skin cancer.
It usually occurs in fair skinned people above the age of 50.
It is never life threatening.
Who is affected by Basal cell carcinoma?
---------------------------------------------------
Basal cell carcinoma is more common in :
1.People with fair skin than in those with darker skin.
2.People who spend time outdoors under the sun than those staying indoors.
3.People with a family history of Basal cell carcinoma.
What is the Cause of Basal cell carcinoma?
-----------------------------------------------------
A. Familial:
Familial cases of Basal cell carcinoma with
1.autosomal dominant genes(basal cell nevus) and
2.xeroderma pigmentosum(autosomal recessive)
are more common especially in fair skin people.
B.Sun exposure:
Exposure to the sun is one of the most common causes of Basal cell carcinoma.
The majority of basal cell carcinomas occur on sun-exposed areas of the body.
Risk factors are:
1.intensity of the sun
2.duration of sun exposure,
3.age when sun exposure takes place
4.degree of skin pigmentation
C:Environmental causes:
1.Arsenic exposure in certain occupations(preparation of arsenic products)
2.Exposure to X-ray radiation especially radiotherapy
What are the types of Basal cell carcinoma?
-----------------------------------------------------------
1.Nodular: flesh-colored papule with capillaries which can become ulcerated ( called rodent ulcer )
2.Cystic: less common with a central cystic cavity.
3.Pigmented: pigmented nodular form
4.Sclerosing: looks like a keloid
5.Superficial: a red scaly flat lesion.
What are the Symptoms and signs of Basal cell carcinoma?
-----------------------------------------------------------
Basal cell carcinoma can present as:
1.firm nodule which grows within the skin and below it
2.Color may be like normal skin, dark brown or black.
3.Border is characteristic rolled up edge
4. red, flat, scaling areas similar to a patch of eczema.
How do you make the Diagnosis of Basal cell carcinoma?
------------------------------------------------------------
1.Skin biopsy under local anesthesia
2.small lesions can be totally removed
3.larger ones are biopsied first and surgically removed if there is confirmed malignancy.
What are the complications of Basal cell carcinoma?
--------------------------------------------------------
1.local growth and destruction of neighboring tissues (e.g. nose).
2.Growth into vital structures resulting in the loss of extension or function
3.rarely metastases or cause death.
What is the treatment of Basal cell carcinoma?
---------------------------------------------------
Surgery:
Most basal cell carcinomas are removed by surgical excision with margins of 4-6mm.
Chemotherapy:
local therapy with 5-fluorouracil(a chemotherapy agent) with 70-90% success rate
Radiation:
Radiation therapy may be used in older patients not suitable for surgery.
Cryosurgery:
Cryosurgery can be done for basal cell cancer that invades cartilage.
Mohs surgery:
Mohs micrographic surgery is an outpatient procedure in which the cancer nodule is surgically excised and then immediately examined under a microscope. The base and edges are microscopically examined to confirm no evidence of malignancy before repair is done.
Immunotherapy:
Immunotherapy research indicates that treatment with Euphorbia peplus, a common garden weed, may be effective against Basal cell carcinoma.
What is the prognosis of Basal cell carcinoma?
----------------------------------------------------
Prognosis of majority of cases is good if there is complete removal.
Sclerosing lesions are harder to treat because they invade deeper into the tissues.
What are the preventive measures for Basal cell carcinoma?
-----------------------------------------------------------------
1.Avoid the direct sun (long-sleeved shirts, long trousers, and broad-brimmed hats). Use sunscreens.
2.Good nutrition and healthy lifestyle boost the immune system and helps prevent malignancy.
3.Patients with family history of skin cancer should be reviewed yearly
----------------------------------------------------
What is Basal cell carcinoma?
---------------------------------------
Basal cell carcinoma is a localized malignant tumor of the basal cells of the skin which seldom spread beyond its location.
It is the most common skin cancer.
It usually occurs in fair skinned people above the age of 50.
It is never life threatening.
Who is affected by Basal cell carcinoma?
---------------------------------------------------
Basal cell carcinoma is more common in :
1.People with fair skin than in those with darker skin.
2.People who spend time outdoors under the sun than those staying indoors.
3.People with a family history of Basal cell carcinoma.
What is the Cause of Basal cell carcinoma?
-----------------------------------------------------
A. Familial:
Familial cases of Basal cell carcinoma with
1.autosomal dominant genes(basal cell nevus) and
2.xeroderma pigmentosum(autosomal recessive)
are more common especially in fair skin people.
B.Sun exposure:
Exposure to the sun is one of the most common causes of Basal cell carcinoma.
The majority of basal cell carcinomas occur on sun-exposed areas of the body.
Risk factors are:
1.intensity of the sun
2.duration of sun exposure,
3.age when sun exposure takes place
4.degree of skin pigmentation
C:Environmental causes:
1.Arsenic exposure in certain occupations(preparation of arsenic products)
2.Exposure to X-ray radiation especially radiotherapy
What are the types of Basal cell carcinoma?
-----------------------------------------------------------
1.Nodular: flesh-colored papule with capillaries which can become ulcerated ( called rodent ulcer )
2.Cystic: less common with a central cystic cavity.
3.Pigmented: pigmented nodular form
4.Sclerosing: looks like a keloid
5.Superficial: a red scaly flat lesion.
What are the Symptoms and signs of Basal cell carcinoma?
-----------------------------------------------------------
Basal cell carcinoma can present as:
1.firm nodule which grows within the skin and below it
2.Color may be like normal skin, dark brown or black.
3.Border is characteristic rolled up edge
4. red, flat, scaling areas similar to a patch of eczema.
How do you make the Diagnosis of Basal cell carcinoma?
------------------------------------------------------------
1.Skin biopsy under local anesthesia
2.small lesions can be totally removed
3.larger ones are biopsied first and surgically removed if there is confirmed malignancy.
What are the complications of Basal cell carcinoma?
--------------------------------------------------------
1.local growth and destruction of neighboring tissues (e.g. nose).
2.Growth into vital structures resulting in the loss of extension or function
3.rarely metastases or cause death.
What is the treatment of Basal cell carcinoma?
---------------------------------------------------
Surgery:
Most basal cell carcinomas are removed by surgical excision with margins of 4-6mm.
Chemotherapy:
local therapy with 5-fluorouracil(a chemotherapy agent) with 70-90% success rate
Radiation:
Radiation therapy may be used in older patients not suitable for surgery.
Cryosurgery:
Cryosurgery can be done for basal cell cancer that invades cartilage.
Mohs surgery:
Mohs micrographic surgery is an outpatient procedure in which the cancer nodule is surgically excised and then immediately examined under a microscope. The base and edges are microscopically examined to confirm no evidence of malignancy before repair is done.
Immunotherapy:
Immunotherapy research indicates that treatment with Euphorbia peplus, a common garden weed, may be effective against Basal cell carcinoma.
What is the prognosis of Basal cell carcinoma?
----------------------------------------------------
Prognosis of majority of cases is good if there is complete removal.
Sclerosing lesions are harder to treat because they invade deeper into the tissues.
What are the preventive measures for Basal cell carcinoma?
-----------------------------------------------------------------
1.Avoid the direct sun (long-sleeved shirts, long trousers, and broad-brimmed hats). Use sunscreens.
2.Good nutrition and healthy lifestyle boost the immune system and helps prevent malignancy.
3.Patients with family history of skin cancer should be reviewed yearly
Tuesday, August 26, 2008
A Simple Guide to Melonoma
A Simple Guide to Melonoma
----------------------------------------------------
What is Melonoma?
---------------------------------------
Melanoma is a progressive neoplastic tumor of melanocytes which are found mainly in the skin and can be present in the eye and the intestine.
It is a rare but dangerous cancer because of its rapid growth.
Who is affected by Melonoma?
---------------------------------------------------
Melonoma is more common in :
1.People with fair skin than in those with darker skin.
2.People with multiple atypical nevi(moles)
3.Persons born with giant congenital melanocytic nevi(moles)
4.People who spend time outdoors under the sun than those staying indoors.
5.People with a family history of melanoma
What is the Cause of Melonoma?
-----------------------------------------------------
A. Familial:
Familial cases of melanoma with autosomal dominant genes are more common especially in fair skin people.
B.Sun exposure:
Exposure to the sun is one of the most common causes of melanoma.
Risk factors are:
1.intensity of the sun
2.duration of sun exposure,
3.age when sun exposure takes place
4.degree of skin pigmentation
What are the types of Melanoma?
-------------------------------------
Types of primary melanomas:
1.superficial spreading melanoma
2.nodular melanoma
3.acral lentiginous melanoma
4.lentigo maligna melanoma
Melanomas occuring in non-skin areas:
5.clear cell sarcoma (Soft Parts)
6.mucosal melanoma (Intestines)
7.uveal melanoma (Eye)
What are the Symptoms and signs of Melanoma?
-----------------------------------------------------------
Symptoms & Signs:
--------------------
A skin mole which has the following features:
1.Asymmetrical features
2.Border of the mole is irregular.
3.Color: black, blue or brown with occasional reddish and white areas
4.Diameter: Any mole with a diameter of > 5 mm has a higher chance to become melanomas
5.Elevation: The mole is usually raised above the skin.
Any change in the mole appearance may suggest malignancy
Bleeding and ulcerations are late signs.
Loss of skin markings may be present.
There is rarely pain.
How do you make the Diagnosis of Melanoma?
------------------------------------------------------------
1.Moles that are irregular in color or shape
2.Excision biopsy of the suspected mole.
3.Lactate dehydrogenase (LDH) tests are used to detect metastases
4.chest X-rays - to exclude spread to lungs
4.CT, MRI, PET scans of body to exclude metastases.
What are the complications of Melanoma?
---------------------------------------------------
Metastases or spread of the melanoma can spread through the lymphatic or blood vessels to:
1.lymph nodes - if detected early and removed, survival rate is better
2.skin and lungs - have a better survival rate
3.brain , bone and liver - have the worst survival rates
What is the treatment of Melonoma?
---------------------------------------------------
Surgery is the only treatment for localized cutaneous melanoma.
The skin lesion must be totally removed with an adequate margin of surrounding skin and tissue.
The biopsy will include the epidermal, dermal, and subcutaneous layers of the skin,in order to determine the depth and any infiltration outside the lesion.
The lymph nodes nearest to the lesion are also removed.
Disseminated melanoma (Cancer has spread to other parts of body) requires chemotherapy.
Radiation therapy is also used after surgery for patients with local melanoma or for patients with un-operable distant metastases.
Immuno-therapy with interleukin-2 or interferon has also been used with encouraging good results.
Gene therapy is a new area where the genes are manipulated to help kill the melanoma cells.
What is the prognosis of Melonoma?
-----------------------------------------
Prognosis depends on the following factors:
1.tumor thickness
2.depth related to skin
3.type of melanoma,
4.ulceration presence
5.lymphatic spread
6.tumor infiltrating lymphocytes (if present, prognosis is better),
7.location of lesion,
8.distant metastasis
Early diagnosis, biopsy and surgery usually means better prognosis.
Prognosis also depends on the depth and thickness of the melanoma.
The smaller the thickness of the melanoma the better is the prognosis.
Regional node spread and distant metastases usually suggest poor prognosis.
What are preventive measures for Melanoma?
---------------------------------------------------
1.Avoid the direct sun (long-sleeved shirts, long trousers, and broad-brimmed hats)
2.Good nutrition and healthy lifestyle boost the immune system and helps prevent malignancy.
3.Patients with family history of skin cancer should be reviewed yearly
4.Israeli scientists from the Oncology Institute of the Hadassa Medical Center in Jerusalem in June 2008 announced the development of a new vaccine which can prevent recurrences and increase survival rates for melanoma patients.
----------------------------------------------------
What is Melonoma?
---------------------------------------
Melanoma is a progressive neoplastic tumor of melanocytes which are found mainly in the skin and can be present in the eye and the intestine.
It is a rare but dangerous cancer because of its rapid growth.
Who is affected by Melonoma?
---------------------------------------------------
Melonoma is more common in :
1.People with fair skin than in those with darker skin.
2.People with multiple atypical nevi(moles)
3.Persons born with giant congenital melanocytic nevi(moles)
4.People who spend time outdoors under the sun than those staying indoors.
5.People with a family history of melanoma
What is the Cause of Melonoma?
-----------------------------------------------------
A. Familial:
Familial cases of melanoma with autosomal dominant genes are more common especially in fair skin people.
B.Sun exposure:
Exposure to the sun is one of the most common causes of melanoma.
Risk factors are:
1.intensity of the sun
2.duration of sun exposure,
3.age when sun exposure takes place
4.degree of skin pigmentation
What are the types of Melanoma?
-------------------------------------
Types of primary melanomas:
1.superficial spreading melanoma
2.nodular melanoma
3.acral lentiginous melanoma
4.lentigo maligna melanoma
Melanomas occuring in non-skin areas:
5.clear cell sarcoma (Soft Parts)
6.mucosal melanoma (Intestines)
7.uveal melanoma (Eye)
What are the Symptoms and signs of Melanoma?
-----------------------------------------------------------
Symptoms & Signs:
--------------------
A skin mole which has the following features:
1.Asymmetrical features
2.Border of the mole is irregular.
3.Color: black, blue or brown with occasional reddish and white areas
4.Diameter: Any mole with a diameter of > 5 mm has a higher chance to become melanomas
5.Elevation: The mole is usually raised above the skin.
Any change in the mole appearance may suggest malignancy
Bleeding and ulcerations are late signs.
Loss of skin markings may be present.
There is rarely pain.
How do you make the Diagnosis of Melanoma?
------------------------------------------------------------
1.Moles that are irregular in color or shape
2.Excision biopsy of the suspected mole.
3.Lactate dehydrogenase (LDH) tests are used to detect metastases
4.chest X-rays - to exclude spread to lungs
4.CT, MRI, PET scans of body to exclude metastases.
What are the complications of Melanoma?
---------------------------------------------------
Metastases or spread of the melanoma can spread through the lymphatic or blood vessels to:
1.lymph nodes - if detected early and removed, survival rate is better
2.skin and lungs - have a better survival rate
3.brain , bone and liver - have the worst survival rates
What is the treatment of Melonoma?
---------------------------------------------------
Surgery is the only treatment for localized cutaneous melanoma.
The skin lesion must be totally removed with an adequate margin of surrounding skin and tissue.
The biopsy will include the epidermal, dermal, and subcutaneous layers of the skin,in order to determine the depth and any infiltration outside the lesion.
The lymph nodes nearest to the lesion are also removed.
Disseminated melanoma (Cancer has spread to other parts of body) requires chemotherapy.
Radiation therapy is also used after surgery for patients with local melanoma or for patients with un-operable distant metastases.
Immuno-therapy with interleukin-2 or interferon has also been used with encouraging good results.
Gene therapy is a new area where the genes are manipulated to help kill the melanoma cells.
What is the prognosis of Melonoma?
-----------------------------------------
Prognosis depends on the following factors:
1.tumor thickness
2.depth related to skin
3.type of melanoma,
4.ulceration presence
5.lymphatic spread
6.tumor infiltrating lymphocytes (if present, prognosis is better),
7.location of lesion,
8.distant metastasis
Early diagnosis, biopsy and surgery usually means better prognosis.
Prognosis also depends on the depth and thickness of the melanoma.
The smaller the thickness of the melanoma the better is the prognosis.
Regional node spread and distant metastases usually suggest poor prognosis.
What are preventive measures for Melanoma?
---------------------------------------------------
1.Avoid the direct sun (long-sleeved shirts, long trousers, and broad-brimmed hats)
2.Good nutrition and healthy lifestyle boost the immune system and helps prevent malignancy.
3.Patients with family history of skin cancer should be reviewed yearly
4.Israeli scientists from the Oncology Institute of the Hadassa Medical Center in Jerusalem in June 2008 announced the development of a new vaccine which can prevent recurrences and increase survival rates for melanoma patients.
Tuesday, December 18, 2007
A Simple Guide to Cellulitis
A Simple Guide to Cellulitis
-----------------------------------------
What is a Cellulitis?
--------------------------
Cellulitis is a condition where bacterial infection and inflammation spread through the skin and subcutaneous tissues.
What are the causes of Cellulitis?
--------------------------------
The bacteria that attack the skin and subcutaneous tissues are usually streptococci and staphylococci.
Rarely the bacteria can be clostridia.
Spread occurs as a result of
1.tissue damage
2.lower body immunity (eg, diabetes,AIDS)
3.virulence of the bacteria
What are the symptoms and signs of Cellulitis?
---------------------------------------------
1.Red painful hot and swollen skin with ill defined borders
2.Pain and tenderness on palpation
3.In anaerobic infections, crepitation may be present.
4.Pussy discharge may be foul smelling
5.Lymphangitis and lymphadenitis ma be present
What investigations are necessary in Cellulitis?
-----------------------------------------------
Wound swabs may be necessary to determine the bacteria and their resistance to antibiotics
Deep cellulitis may required Xrays and ultrasound scans to see the spread.
What is the treatment of Cellulitis?
------------------------------------
The underlying disease such as diabetes must be treated.
Cool compress may relieve local discomfort.
Analgesics and painkillers may help to relieve pain
Appropriate antibiotics may be taken orally or by skin applications.
Anaerobic infections require systemic antibiotics.
If fascilitis (infection of the fascia of muscles) is present, surgical debridement
(removal of damaged tissues and pus) is necessary.
What is the prognosis of Cellulitis?
-------------------------------------
The prognosis of Cellulitis is good with early detection and treatment.
-----------------------------------------
What is a Cellulitis?
--------------------------
Cellulitis is a condition where bacterial infection and inflammation spread through the skin and subcutaneous tissues.
What are the causes of Cellulitis?
--------------------------------
The bacteria that attack the skin and subcutaneous tissues are usually streptococci and staphylococci.
Rarely the bacteria can be clostridia.
Spread occurs as a result of
1.tissue damage
2.lower body immunity (eg, diabetes,AIDS)
3.virulence of the bacteria
What are the symptoms and signs of Cellulitis?
---------------------------------------------
1.Red painful hot and swollen skin with ill defined borders
2.Pain and tenderness on palpation
3.In anaerobic infections, crepitation may be present.
4.Pussy discharge may be foul smelling
5.Lymphangitis and lymphadenitis ma be present
What investigations are necessary in Cellulitis?
-----------------------------------------------
Wound swabs may be necessary to determine the bacteria and their resistance to antibiotics
Deep cellulitis may required Xrays and ultrasound scans to see the spread.
What is the treatment of Cellulitis?
------------------------------------
The underlying disease such as diabetes must be treated.
Cool compress may relieve local discomfort.
Analgesics and painkillers may help to relieve pain
Appropriate antibiotics may be taken orally or by skin applications.
Anaerobic infections require systemic antibiotics.
If fascilitis (infection of the fascia of muscles) is present, surgical debridement
(removal of damaged tissues and pus) is necessary.
What is the prognosis of Cellulitis?
-------------------------------------
The prognosis of Cellulitis is good with early detection and treatment.
Thursday, August 30, 2007
A Simple Guide to Eczema
A Simple Guide to Eczema
-------------------------------
What is Eczema?
--------------------
Eczema is a general term meaning inflammation of the skin with signs of redness, itch and swelling.
One of the most common forms of eczema is atopic eczema which affects 10-20% of the world population. It occurs at some point during childhood.
Fortunately, many children with eczema find that the disease clears and often disappears with age.
What causes Eczema?
--------------------------
There is no known cause for the disease.
It often affects people with a family history of allergies.
Many people who have eczema also suffer from allergic rhinitis and asthma, or have family members who do.
Those who are genetically predisposed may deverlop eczema when exposed to environmental and food triggers:
milk,egg white,nuts, shellfish
dust, chemicals,detergents,flowers,pollens,dyes in clothes,cosmetics
Who gets eczema?
----------------------
Eczema occurs in both children and adults, but usually appears during infancy.
Is Eczema contagious?
---------------------------
Eczema is not contagious and, like many diseases, currently cannot be cured.
For most patients the condition may be managed well with treatment and avoidance of triggers.
How common is eczema?
------------------------------
The condition is quite common.
About10-20% of all infants have eczema.
In nearly half of these children, the disease will improve greatly by the time they are between five and 15 years of age.
Others will have some form of the disease throughout their lives.
Where does Eczema appear?
-----------------------------------
Eczema can occur on just about any part of the body.
In infants, eczema typically occurs on the forehead, cheeks, forearms, legs, scalp, and neck.
In children and adults, eczema typically occurs on the face, neck, and the insides of the elbows, knees, and ankles.
In some people, eczema may form bubbles which breaks and ooze.
In others, the condition may appear more scaly, dry, and red.
Chronic scratching causes the skin to take on a leathery texture because the skin thickens (lichenification).
What are the symptoms and signs of eczema?
-----------------------------------------------------
Typically there are dry, red, extremely itchy patches on the skin.
Eczema is sometimes referred to as "the itch that rashes," since the itch, when scratched, results in the appearance of the rash.
What makes patients with eczema itch?
-----------------------------------------------
The triggers that causes a flare up of the eczema causes irritation to the skin.
When the skin becomes irritated, histamines are released into the skin causing the redness and itchiness.
For some, rough or coarse materials coming into contact with the skin causes itchiness. For others, feeling too hot and sweating will cause an outbreak.
Other people find that certain soaps, detergents, disinfectants, contact with juices from fresh fruits and meats, dust mites, and animal furs may trigger itching.
Upper respiratory infections (caused by viruses) may also be triggers.
Stress can also sometimes aggravate an existing flare-up,a condition called neurodematitis.
How can eczema be prevented?
-------------------------------------
Eczema outbreaks can usually be prevented with some simple precautions:
1.Moisturize frequently
2.Avoid sudden changes in temperature or humidity
3.Avoid sweating or overheating
4.Avoid scratchy materials (e.g., wool or other irritants)
5.Avoid harsh soaps, detergents, and solvents
6.Avoid environmental factors that trigger allergies (e.g., pollens, molds, mites, and animal furs)
7.Be aware of any foods that may trigger an attack and avoid those foods
8.Reduce stress
How can eczema be treated?
----------------------------------
The most important part of an eczema treatment routine is to avoid scratching because that will irritate the skin even more.
The most common treatment is the application of lotions or creams to keep the skin as moist as possible. These treatments are generally most effective when applied directly after bathing so that the moisture from the bath is remains in the skin.
Cold compresses applied directly to itchy skin can also help relieve itching.
Another effective treatment is the application of corticosteroid creams and ointments to reduce inflammation.To prevent side effects such as skin thinning, your doctor may limit the length of treatment time and locations where you can apply treatment.
For severe eczema, your doctor may prescribe oral corticosteroids, but be aware that side effects including new flare-ups can develop when treatment is discontinued (this treatment is not recommended for long-term use).
Skin affected by eczema may frequently become infected. A course of topical or oral antibiotics may be prescribed to kill the bacteria causing the infection.
For severe itching, sedative and non-sedative antihistamines are sometimes used to reduce the itch.
For day time activities as well as driving, non sedative antihistamine should be used.
Because drowsiness is a common side effect, sedative antihistamines are often used in the evening to help a person restless from eczema get to sleep.
Tar treatments and phototherapy are also used and can have positive effects. Phototherapy requires special equipment (lights).
Finally, in cases where eczema is resistant to therapy, your physician may prescribe the drug cyclosporine A, which modifies immune response.
This is used only in extreme cases because of its association with serious side effects.
What can be done for children with eczema?
----------------------------------------------------
Children are special because it is difficult for them to resist scratching their eczema.
For mild to moderate cases, the application of moisturizer on a regular basis can be very helpful. And, in most cases, the eczema will disappear as the child ages.
In the meantime, avoid as many eczema triggers as possible.
Keep your child’s skin moist. After bathing, apply moisturizer to retain the moisture in the skin.
Avoid sudden temperature changes.
Keep your child’s bedroom and play areas free of dust mites.
Use mild soaps – both on your child’s skin and on your child’s clothing.
Dress your child in breathable, preferably cotton, clothing.
-------------------------------
What is Eczema?
--------------------
Eczema is a general term meaning inflammation of the skin with signs of redness, itch and swelling.
One of the most common forms of eczema is atopic eczema which affects 10-20% of the world population. It occurs at some point during childhood.
Fortunately, many children with eczema find that the disease clears and often disappears with age.
What causes Eczema?
--------------------------
There is no known cause for the disease.
It often affects people with a family history of allergies.
Many people who have eczema also suffer from allergic rhinitis and asthma, or have family members who do.
Those who are genetically predisposed may deverlop eczema when exposed to environmental and food triggers:
milk,egg white,nuts, shellfish
dust, chemicals,detergents,flowers,pollens,dyes in clothes,cosmetics
Who gets eczema?
----------------------
Eczema occurs in both children and adults, but usually appears during infancy.
Is Eczema contagious?
---------------------------
Eczema is not contagious and, like many diseases, currently cannot be cured.
For most patients the condition may be managed well with treatment and avoidance of triggers.
How common is eczema?
------------------------------
The condition is quite common.
About10-20% of all infants have eczema.
In nearly half of these children, the disease will improve greatly by the time they are between five and 15 years of age.
Others will have some form of the disease throughout their lives.
Where does Eczema appear?
-----------------------------------
Eczema can occur on just about any part of the body.
In infants, eczema typically occurs on the forehead, cheeks, forearms, legs, scalp, and neck.
In children and adults, eczema typically occurs on the face, neck, and the insides of the elbows, knees, and ankles.
In some people, eczema may form bubbles which breaks and ooze.
In others, the condition may appear more scaly, dry, and red.
Chronic scratching causes the skin to take on a leathery texture because the skin thickens (lichenification).
What are the symptoms and signs of eczema?
-----------------------------------------------------
Typically there are dry, red, extremely itchy patches on the skin.
Eczema is sometimes referred to as "the itch that rashes," since the itch, when scratched, results in the appearance of the rash.
What makes patients with eczema itch?
-----------------------------------------------
The triggers that causes a flare up of the eczema causes irritation to the skin.
When the skin becomes irritated, histamines are released into the skin causing the redness and itchiness.
For some, rough or coarse materials coming into contact with the skin causes itchiness. For others, feeling too hot and sweating will cause an outbreak.
Other people find that certain soaps, detergents, disinfectants, contact with juices from fresh fruits and meats, dust mites, and animal furs may trigger itching.
Upper respiratory infections (caused by viruses) may also be triggers.
Stress can also sometimes aggravate an existing flare-up,a condition called neurodematitis.
How can eczema be prevented?
-------------------------------------
Eczema outbreaks can usually be prevented with some simple precautions:
1.Moisturize frequently
2.Avoid sudden changes in temperature or humidity
3.Avoid sweating or overheating
4.Avoid scratchy materials (e.g., wool or other irritants)
5.Avoid harsh soaps, detergents, and solvents
6.Avoid environmental factors that trigger allergies (e.g., pollens, molds, mites, and animal furs)
7.Be aware of any foods that may trigger an attack and avoid those foods
8.Reduce stress
How can eczema be treated?
----------------------------------
The most important part of an eczema treatment routine is to avoid scratching because that will irritate the skin even more.
The most common treatment is the application of lotions or creams to keep the skin as moist as possible. These treatments are generally most effective when applied directly after bathing so that the moisture from the bath is remains in the skin.
Cold compresses applied directly to itchy skin can also help relieve itching.
Another effective treatment is the application of corticosteroid creams and ointments to reduce inflammation.To prevent side effects such as skin thinning, your doctor may limit the length of treatment time and locations where you can apply treatment.
For severe eczema, your doctor may prescribe oral corticosteroids, but be aware that side effects including new flare-ups can develop when treatment is discontinued (this treatment is not recommended for long-term use).
Skin affected by eczema may frequently become infected. A course of topical or oral antibiotics may be prescribed to kill the bacteria causing the infection.
For severe itching, sedative and non-sedative antihistamines are sometimes used to reduce the itch.
For day time activities as well as driving, non sedative antihistamine should be used.
Because drowsiness is a common side effect, sedative antihistamines are often used in the evening to help a person restless from eczema get to sleep.
Tar treatments and phototherapy are also used and can have positive effects. Phototherapy requires special equipment (lights).
Finally, in cases where eczema is resistant to therapy, your physician may prescribe the drug cyclosporine A, which modifies immune response.
This is used only in extreme cases because of its association with serious side effects.
What can be done for children with eczema?
----------------------------------------------------
Children are special because it is difficult for them to resist scratching their eczema.
For mild to moderate cases, the application of moisturizer on a regular basis can be very helpful. And, in most cases, the eczema will disappear as the child ages.
In the meantime, avoid as many eczema triggers as possible.
Keep your child’s skin moist. After bathing, apply moisturizer to retain the moisture in the skin.
Avoid sudden temperature changes.
Keep your child’s bedroom and play areas free of dust mites.
Use mild soaps – both on your child’s skin and on your child’s clothing.
Dress your child in breathable, preferably cotton, clothing.
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