Hailey-Hailey disease

What is Hailey-Hailey disease?

 

Hailey-Hailey disease is also known as familial benign chronic pemphigus. It is a rare inherited skin condition, in which red scaly areas or small blisters appear at sites of friction.

 

What causes Hailey-Hailey disease?

 

A small error in the DNA code for a gene on chromosome number 3 (one of the 46 chromosomes that we all have) has been shown to cause Hailey-Hailey disease. Normally this gene plays a part in ensuring that the cells in the outer layer of the skin (the epidermis) stick together properly. In Hailey-Hailey disease, this adhesion of cells is impaired, resulting in separation of the cells in the epidermis, especially in areas of skin prone to friction such as the groin and under the arms. The altered gene runs in families and affects both men and women. Hailey-Hailey disease is not contagious, or a result of allergies. There is a tendency for Hailey-Hailey disease to get worse with sweating and friction, as well as in hot weather.

 

Is Hailey-Hailey disease hereditary?

 

Yes – see above. The condition is inherited in a pattern known as 'dominant inheritance', which means that there is a 1 in 2 [50:50] chance that each child of an affected parent will inherit the skin problem.

 

What are the symptoms of Hailey-Hailey disease?

 

Affected skin may become uncomfortable and itchy if the skin surfaces are continually rubbing against each other, such as in the groin when walking. Outbreaks tend to settle down in a few days with appropriate treatment (see below), and may improve without treatment. Very rarely, a severe flare-up in an area such as the groin, genital area or in the crease of the buttocks may make walking and working so uncomfortable that a patient might need a few days rest.

 

What does Hailey-Hailey disease look like?

 

The first signs of the condition usually appear between the ages of 15 and 40 years, but it may begin outside this age range. The severity varies enormously and is unpredictable. Red, scaly areas or small blisters appear at areas of friction, especially at the sides of the neck or in the skin folds under the arms, the groin or under the breasts. The skin looks entirely normal inbetween active episodes, and does not scar. Many patients notice that their condition improves as they get older.

 

How will Hailey-Hailey disease be diagnosed?

 

It is very common for the condition to be mistaken for eczema, contact dermatitis (due to an allergy), a sweat rash, a fungal infection or impetigo (a bacterial skin infection). If required, the diagnosis of Hailey-Hailey disease can be confirmed by examining a sample of the skin (a biopsy) under the microscope.

 

Can Hailey-Hailey disease be cured?

 

No. The underlying genetic defect cannot be altered; however, treatment does help and long remissions are common.

 

For further information about Hailey-Hailey disease please see this page on the website of the British Association of Dermatologists

 

http://www.britishskinfoundation.org.uk/SkinInformation/AtoZofSkindisease/HaileyHaileydisease.aspx

Skin diseases on the rise

THERE is an increase in the number of people suffering from various forms of skin diseases in Fiji.

And the Ministry of Health has called on members of the public to take extra care of their personal hygiene.
The ministry deputy secretary for Hospital Services Doctor Metuisela Tuicakau confirmed the PJ Towmey Hospital in Tamavua — the only hospital providing specialised treatment for skin diseases — has been inundated with patients.
"Doctors here at the hospital see more than 2000 patients per month presenting themselves with various forms of skin diseases," Dr Tuicakau said.
He said skin diseases on the rise were fungal infections, bacterial infections, dermatitis and Eczema.
"The skin diseases are not only affecting children but adults as well but more are commonly found in children from one week old to two weeks," Dr Tuicakau said.
He said the risk factor of the increase in skin disease was that it could severely affect people with diabetes and high blood pressure. Dr Tuicakau said the quickest and safest care for skin disease was observing proper hygiene.
"People are advised to use soap and water to wash their skin," he said.
Dr Tuicakau said with Fiji currently experiencing hot weather conditions, people were advised to wear clothes that kept heir body cool.
He said it was also important to take care of one's diet and advised people to consume a lot of vegetables.
"If the sickness is getting worse and cannot be contained at home then those affected should immediately seek medical assistance," Dr Tuicakau said.

http://www.fijitimes.com/story.aspx?id=223738

Home Editions Queenswide Skin Cancer Treatment without surgery: Cut-less Dermatology

osted: Thursday, January 17, 2013 10:30 am | Updated: 9:52 am, Fri Jan 18, 2013.

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According to the Skin Cancer Foundation, one person dies from skin cancer every hour in the United States — a good reason why everyone should schedule regular skin examinations. But you may ask, how do dermatologists know when a skin growth or mole needs to be removed?
In the past, every worrisome skin lesion required a biopsy, meaning a small piece of tissue was surgically removed and sent to a pathology laboratory. If the biopsy showed cancer, additional surgery was needed. Even today, surgical biopsy and removal continues to be the standard of care for skin cancer. Fortunately, we have newer techniques that enable us to not only catch skin cancers earlier but also to help us prevent unnecessary biopsies. Total body photography, digital dermoscopy mole monitoring as well as handheld dermoscopy lesion evaluation are some examples of this vital technology. Dr. Orit Markowitz speaks around the globe on these topics and each year directs the Mount Sinai Greater NY Dermoscopy course for dermatologists in the New York and New Jersey area who are trying to hone in on these new important diagnostic tools.
How we approach skin biopsies and cancer surgery is therefore changing for the better. There are even newer devices being developed each year and Dr. Markowitz is at the forefront. An example of the most recent laser tool is called Optical Coherence Tomography (OCT). Dr. Markowitz, a pioneer in OCT research, recognizes its potential to eliminate the need for surgery in many cases. Dr. Markowitz is the Director of Pigmented Lesions and Skin Cancer at Mount Sinai, and she is also the newly appointed President of the International Optical Coherence Tomography Society.
“An important component of OCT is the laser’s ability to take live black and white pictures of deeper skin layers. By combining this technology with other lasers, I am discovering successful ways to both diagnose and treat skin cancer bloodlessly,” said Dr. Markowitz. The earlier a skin cancer is caught, the better the prognosis and outcome. Dr. Markowitz, through the use of non-ablative lasers, has been able to successfully treat — without cutting — both early and even more advanced non-melanoma skin cancers. Non-melanoma skin cancers are not as deadly as melanoma but they are the most common type of cancer and frequently occur in cosmetically sensitive areas such as the face. The possibility of using noninvasive lasers to both diagnose and treat without cutting is very appealing.
Among the advantages of OCT are improved comfort, greater convenience and less scarring. Dr. Markowitz’s research has enabled Mount Sinai to become the country’s leading center for the development and use of OCT.
According to Dr. Markowitz, “I’ve also found OCT to be useful for benign skin growths, thus preventing the need for unnecessary biopsies.” She notes some examples: harmless moles, warts, hemangiomas, seborrheic and actinic keratoses and cysts. Other dermatological diseases that can be diagnosed with OCT include psoriasis, scabies, and blistering diseases.
Dr. Markowitz currently offers OCT and other noninvasive diagnostic techniques to patients at the Mount Sinai Doctors Faculty Practice.
For more helpful tips from Mount Sinai dermatologists, visit the Faculty Practice website:
http://www.mountsinaifpa.org/patient-care/practices/dermatology and view the seasonable Skin Health Newsletter publication.

http://www.qchron.com/editions/queenswide/skin-cancer-treatment-without-surgery-cut-less-dermatology/article_3acfeb34-b89f-52fd-b247-da21c3e5bd99.html

Hirsutism

What is hirsutism?
Hirsutism is the term used when a woman grows too much body or facial hair in a pattern seen normally occurring only in men.
What causes hirsutism?
Androgens are often thought of as 'male hormones' but, in fact, both men and women produce them - men usually in greater amounts than women. Testosterone is the best-known androgen, but there are several others too. Hirsutism can be caused either by abnormally high levels of androgens, or by the hair follicles being more sensitive than usual to normal androgen levels.
A small minority of women with hirsutism produce too much androgen and sometimes this is due to an underlying medical condition. In addition, some medicines can cause hirsutism - these include hormones, anabolic steroids, and sometimes oral contraceptive pills.
In fact, most women with hirsutism have no hormone imbalance or underlying medical condition. Many women develop more facial or body hair gradually as they get older, especially after the menopause. Few realise how common this is - but at least 25% of normal middle-aged women remove unwanted facial hair. In addition, women from different ethnic backgrounds have different patterns of hair growth, in which it can be normal to have some hair on the face, nipples or stomach.
Is hirsutism hereditary?
A tendency to hirsutism does run in some families and is not associated with an excess of androgens. It is normal in some families with Mediterranean or Middle Eastern ancestry.
What are the symptoms of hirsutism?
Having too much hair can be highly embarrassing and cause great distress.
What does hirsutism look like?
The excess of thick, often dark, hair may be seen on the face, chest, abdomen and upper back. Women from certain ethnic groups tend to have more body hair than others and for them it may be quite normal to have some hair in these areas.
How will hirsutism be diagnosed?
Women with mild hirsutism and regular menstrual cycles seldom have an underlying medical problem. However, if a medical problem exists, your doctor should be able to detect it by asking you questions and then, if necessary, by performing blood tests.
It is important to see your doctor if your hirsutism is:
Severe
Developing quickly (over 1-2 years), or before puberty
Accompanied by menstrual problems
Associated with features suggesting an increase in androgens such as thinning of the scalp hair, baldness, or deepening of the voice
Accompanied by obesity or diabetes


Can hirsutism be cured?
Although a ‘cure’ is unlikely, local areas of excessive hair growth can often be cleared by electrolysis or laser therapy. The treatment of hirsutism with medication is usually less satisfactory as the problem often comes back when treatment stops.
For information about available treatments please go to this page on the website of the British Association of Dermatologists
http://www.britishskinfoundation.org.uk/SkinInformation/AtoZofSkindisease/Hirsutism.aspx

News Search Search Vitiligo

What is vitiligo?
Vitiligo is a condition in which areas of skin lose their normal pigment and so become white. It is common, and affects about 1% of the world’s population.
What causes vitiligo?
The pigment that gives your skin its normal colour is melanin, which is made by cells known as melanocytes. The cause of vitiligo is not yet fully known but many think that it is a disease in which the body makes antibodies to its own melanocytes, and in doing so destroys them. After that, the skin cannot make melanin properly, and vitiligo is the result. In support of this idea is the way that people with vitiligo are more likely than others to have diseases, caused in much the same way, of other organs such as the thyroid.
It affects men and women of all races equally, but is most easy to see in people with dark skins. It is not catching.
Is vitiligo hereditary?
Only about a fifth of people with vitiligo know of someone in their family who has it; but the exact type of inheritance has not yet been worked out. One problem here is that so many people have no idea if their relatives are hiding vitiligo under their clothing.
If you have vitiligo, it does not follow that your children are sure to get it too.
Diet. There is no medical evidence of any dietary link and vitiligo. Therefore no dietary changes are recommended.
What are the symptoms of vitiligo?
These fall into two groups:
The sun burns the pale areas very easily. This is sore, and when the burn has settled down, the pale areas of vitiligo will stand out, more strikingly than before, against a background of tanned skin.
Many people become embarrassed or depressed by the look of their vitiligo, and by the questions that other people ask them about it.
What does vitiligo look like?
The most common sites for vitiligo are:
The exposed areas – vitiligo often begins on the hands and face.
Around body openings: the eyes, nostrils, mouth, umbilicus, and genitals.
In body folds: the armpits and groin.
Anywhere your skin has been damaged, for example by a cut or a burn.
Areas around pigmented moles (as part of “halo naevi”).
In one rare (segmental) type, vitiligo crops up on just one part of the body.
Although vitiligo not more common in people with a dark skin is it much more obvious. Premature greying of the scalp hair can accompany vitiligo.
Course of the disease. Vitiligo can start at any age, but about half of those who get it do so before they are 20. Its course is hard to predict, but it tends to progress slowly, with periods of stability, often lasting several years. The patches slowly change their shape and size, and the skin around them may be darker than normal. The hairs growing out of a patch of vitiligo may keep their normal colour or turn white too.
Some pigment comes back in a few patients but seldom does so completely. If it returns via the hair follicles, the areas do not look much better when they turn from white to speckled.
How will vitiligo be diagnosed?
The diagnosis is usually easy to make on the basis of the look of the patches (white with a normal skin texture) and the fact that the areas of vitiligo on the left side of the body roughly mirror those on the right. An ultraviolet light  (Wood's lamp) can help to show up white areas that could have been missed in a pale-skinned person.
Once the diagnosis of vitiligo has been made, your doctor may want to check you for thyroid disease, and for other autoimmune conditions that are more common than usual in people with vitiligo.
Can vitiligo be cured?
Vitiligo occasionally goes away by itself, and some treatments may slow its progress, but a cure cannot be guaranteed.
For information about available treatments please visit this page on the website of the British Association of Dermatologists

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Pemphigus vulgaris

What is pemphigus vulgaris?
Pemphigus vulgaris is a rare autoimmune disease that causes severe blistering of the skin and of the mucous membranes lining the mouth, nose, throat and genitals. The blisters have thin roofs and break easily to leave raw areas (erosions) that can be extensive and painful. Pemphigus does not go away by itself, and always needs treatment by a specialist.
What causes pemphigus vulgaris?
We all have an immune system. It makes the antibodies that are needed to fight off infections. Normally these antibodies do not attack our own bodies.  However, in an autoimmune disease, the immune system makes a mistake and fights our own body instead. The mistake made by the immune system in pemphigus vulgaris is to view the cells in our skin and mucous membranes as ‘foreign’ and to make antibodies that damage them.
Pemphigus vulgaris is an ‘autoimmune’ disease. The antibodies that attack parts of our own body are called ‘autoantibodies’.
The autoantibodies in pemphigus vulgaris target proteins called desmogleins, which are present on the cells in the outer layer of the skin (the epidermis). Desmogleins act as a glue to stick these cells together.
When the autoantibodies formed in pemphigus vulgaris have combined with the desmogleins, the cells in the skin and mucous membranes no longer stick together properly and fall apart. This causes the blisters and erosions that are typical of pemphigus vulgaris.
Although it is known that antibodies to desmoglein cause pemphigus vulgaris, it is still not clear why some people develop these autoantibodies in the first place.
Pemphigus vulgaris affects both sexes equally. It can start at any age but is most common in middle-aged adults. It affects people of all races but is more common in some than others, for example in people of Jewish origin.  Pemphigus vulgaris is not an infection: it cannot be caught or passed on to anyone else.
Is pemphigus vulgaris hereditary?
Strictly speaking it is not, as it does not pass from generation to generation. Genetic factors are important, but other factors are needed to trigger pemphigus vulgaris into activity.
What are the symptoms of pemphigus vulgaris?
The raw unhealing erosions are painful and can disturb sleep.  Those in the mouth can interfere with eating and drinking, leading to loss of weight.
What does pemphigus vulgaris look like?
In most patients, the blisters and erosions start first in the mouth, and appear later on the skin. In a few, the skin is affected first. Most patients get erosions in their mouth at some time; but some never get blisters or erosions on their skin.
The skin:
The skin lesions start as thin-walled blisters (collections of clear fluid within the skin), arising on a background of normal-looking skin. Because they are so fragile, pemphigus blisters break very easily, leaving raw areas known as erosions.
Erosions are areas of skin (or mucous membrane), which lack its top (outer) layer. They look raw and feel sore - like a burn. Erosions can join together to create larger areas of raw skin that look as if the top layer has been scraped off.
Erosions can become crusty and scabbed. When they heal, those on the skin may leave discoloured marks.
The mouth:
Intact blisters are seldom seen in the mouth in pemphigus vulgaris because they get broken so easily. Erosions are seen there instead. There may be just one or two, or several that can join together.
Will pemphigus vulgaris go away?
No, it will not clear without treatment. There will be times when it flares up, and others when it gets better. There is no way of knowing when these flare-ups will happen or how bad they will be. However, pemphigus vulgaris can be controlled by long-term treatment and may eventually get better completely, so that it does not flare up when treatment stops.
How will pemphigus vulgaris be diagnosed?
Pemphigus vulgaris is rare and most general practitioners may have never seen it. Your own doctor will send you to see a dermatologist or an oral medicine specialist, who will make a provisional diagnosis of the condition on the basis of the changes seen on your skin and in your mouth. 
Next a biopsy will be taken. This is a sample of an unbroken blister. It will be processed in the laboratory and then examined under the microscope. The diagnosis of pemphigus vulgaris will be confirmed by finding cells in the epidermis that are rounding off and separating away from each other. 
As further confirmation of the diagnosis, part of the biopsy specimen is likely to be examined by a technique known as direct immunofluorescence to demonstrate the presence of pemphigus vulgaris autoantibodies in the skin.
Another useful test is to measure the levels of pemphigus vulgaris autoantibody in the blood. This is done by indirect immunofluorescence and is sometimes called an antibody titre test. It is a useful way of monitoring how active the pemphigus vulgaris is, and the results can suggest changes in treatment.


For information on treatments please visit this page on the website of the British Association of Dermatologists

http://www.britishskinfoundation.org.uk/SkinInformation/AtoZofSkindisease/Pemphigusvulgaris.aspx

Skin problems, osteoarthritis, top reasons patients sought nonacute health care

Skin disorders, followed by osteoarthritis and back pain, were the primary reason patients visited health care providers for nonacute conditions, according to study results.

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Researchers at Mayo Clinic in Rochester, Minn., used the Rochester Epidemiology Project (REP) medical records linkage system to review the records of 142,377 patients (53% female) in Olmsted County, Minn., on April 1, 2009. All ICD-9 codes noted in patients’ records between 2005 and 2009 were electronically extracted. The codes were grouped by clinical classification and then assigned to 47 more diverse disease groups linked with health-related quality of life.

 

Jennifer L. St. Sauver

The most prevalent disease groups were:

• skin disorders (42.7%)
• osteoarthritis and joint disorders (33.6%)
• back problems (23.9%)
• lipid metabolism disorders (22.4%)
• upper respiratory tract disease (22.1%, excluding asthma)

In patients aged 0 to 18 years, skin disorders were the most common condition, followed by upper respiratory tract disease, osteoarthritis and joint disorders. In patients aged 65 years and older, hypertension was the most prevalent disease, followed by lipid metabolism disorders and skin disorders.

Ten of the 15 most prevalent disease groups were more common across all ages among women; men showed higher prevalence for lipid metabolism, hypertension and diabetes disorders. Ethnic groups displayed varied prevalence.

“Unexpectedly, almost half of the … population of all ages received a diagnosis of skin disorders within approximately 5 years,” the researchers reported. “The skin disorders category was broad and included 19 different ICD-9 groupings (including actinic keratosis, acne and sebaceous cysts). No single skin disorder was highly prevalent.”

The findings present an opportunity to determine why skin-related diagnoses result in so many visits and if alternative care delivery approaches requiring fewer visits are possible, researcher Jennifer L. St. Sauver, PhD, at the Mayo Clinic Center for the Science of Health Care Delivery, said in a news release.

http://www.healio.com/dermatology/practice-management/news/online/%7B5EC78EC1-BF2C-4B3E-9A98-1389052287DB%7D/Skin-problems-osteoarthritis-top-reasons-patients-sought-nonacute-health-care

Epidermolysis Bullosa Simplex

What is epidermolysis bullosa simplex?
Epidermolysis bullosa (EB) simplex is a rare inherited skin disorder which causes blistering.  In the most common form, blisters tend to be confined to the palms and soles, although occasionally they arise in the mouth, and are most troublesome during warm weather. The more severe form is called EB simplex Dowling-Meara and those affected have more widespread blistering which does not vary according to the time of year. EB simplex is different from the junctional and dystrophic forms of EB, and if you have EB simplex you will not go on to develop these other types of EB.
What causes epidermolysis bullosa simplex?
The top layer of skin (the epidermis) is composed of layers of cells. Each cell has an internal skeleton formed from proteins (keratins), giving it strength and shape. In EB simplex, there is a weakness in one of these proteins (usually type 5 or type 14 keratin, but very occasionally another protein called plectin), which causes affected cells to be less resilient and to rupture when subjected to even minor physical stress. When the cells break, they separate from each other, fluid accumulates between them and a blister forms.
Weakness of the protein is caused by a minor abnormality (a mutation) in the gene responsible for producing that protein. A variety of such mutations have been identified in EB simplex, some of which are common amongst sufferers of the condition while others are only found in single families.

Is epidermolysis bullosa simplex hereditary?
Yes. It is inherited in a dominant fashion. This means that one parent of an affected person will also usually have the condition, although it is possible for EB simplex to appear for the first time in a person who has no other affected family member. Anyone who has EB simplex can pass the condition on to his or her children: there is a 50% chance that the child of an affected parent will inherit the blistering tendency. EB simplex affects men and women equally. It is not an infection, it is not contagious and it is not due to an allergy.
What are the symptoms of epidermolysis bullosa simplex?
The primary symptom of EB simplex is blistering, which is often painful and which can sometimes significantly affect daily activities of living and interfere with school and work.
Commonly, the blisters occur for the fist time during early childhood, affecting sites of friction such as under the elasticated areas of a nappy or, during the crawling stage, the hands and knees. Later, painful blisters tend to develop on the soles after walking only short distances. The formation of blisters is most troublesome during warm weather, and a few individuals may even be free of blisters during the winter. Writing with pens and pencils can cause blisters to appear on fingers, especially in children. Blisters may also appear under close fitting clothing such as waistbands, collars or the ribbing of socks. A few people find that hot food or drink will cause blistering within the mouth.
In the Dowling-Meara variant of EB simplex, blisters occur for the first time at an earlier age, usually within a few days of birth. They can occur anywhere on the body. In some, they may disappear for a short while during a feverish illness.
Thickened skin on the palms and soles, sometimes associated with an increased tendency to sweating at these sites, can be a feature of EB simplex.
Although abnormal blistering tends to be life long, it sometimes becomes a little less severe in adult life. Dowling-Meara EB simplex often improves dramatically after early childhood.
What does epidermolysis bullosa simplex look like?
The blisters of typical EB simplex look the same as the blisters that anyone can get as the result of friction to the skin. However, although they vary in size, they tend to be large and numerous, but heal without leaving any scars. In the Dowling-Meara variant, blisters tend to occur in clusters on the body and limbs, often healing to leave residual pigmentation.

How will epidermolysis bullosa simplex be diagnosed?
The diagnosis of EB simplex can usually be made on the basis of the individual’s history (especially if other family members are affected) and the distribution of the blisters. Occasionally, if there is uncertainty about the diagnosis, your dermatologist may suggest taking a small sample of skin for more detailed microscopic examination. A blood test may be suggested to look for mutations of the genes likely to be involved.
Can epidermolysis bullosa simplex be cured?
In the past 20 years, there has been exciting and rapid progress in the understanding of EB simplex, but at the moment there is no cure. Several laboratories around the world are exploring strategies that they hope will lead to an effective treatment.
For information about available treatments please visit this page on the website of the British Association of Dermatologists

Shingles

What is shingles?
Shingles (also known as herpes zoster) is a painful blistering rash caused by the same virus that causes chickenpox (the varicella zoster virus).
What causes shingles?
If you have had chickenpox the virus that caused it may live on afterwards in a dormant state in the nerves linked to your spinal cord. If the virus becomes active again, it will multiply and move along the nerve fibres to the area of skin supplied by those nerves; shingles then appears in this area. About 20% of people who have had chickenpox will have an attack of shingles later in life.
Shingles is not caught from someone who has shingles, but follows an earlier attack of chickenpox. However, a person with shingles can infect someone who has never had chickenpox, causing an attack of chickenpox but not shingles.

Most attacks of shingles occur for no obvious reason, but an attack is more likely if:
you are elderly.
you are under stress.
you have an illness that weakens the immune system, such as leukaemia, a lymphoma (for example, Hodgkin’s disease), or HIV.
you are taking treatments that suppress the immune system, including irradiation for cancer, chemotherapy, cortisone-like drugs, and drugs taken to prevent organ rejection.

Is shingles hereditary?
No.
What are the symptoms of shingles?
Pain is the first and predominant symptom and sometimes there is also a tingling or burning sensation. The rash usually appears a day or two after these symptoms. You may also feel ill and have a fever and a headache.
What does shingles look like?
The first sign is the appearance of groups of red spots on a pink-red background, which quickly turn into small fluid-filled blisters. Some of the blisters burst, others fill up with blood or pus. The area then slowly dries out, and crusts and scabs form. The scabs will drop off over the next 2-3 weeks.
The rash usually covers a well-defined area of skin on one side of the body only, and not crossing the midline. Its position and shape will depend on which nerves are involved. Shingles can affect any area, but common patterns include a band running round one side of the chest, or down an arm or leg. Sometimes pale or dark scars follow shingles, particularly after a severe attack.
A chickenpox-like rash occasionally comes up at the same time as shingles.  This may indicate a more serious and widespread attack of shingles or that there is an underlying reason for the shingles.
How is shingles diagnosed?
Early in the course of shingles, before the rash is present, it may be difficult to make the diagnosis. Later on the diagnosis is usually straightforward, based on the story of pain appearing before the rash, and on the typical appearance of the rash.
It takes several days to grow the virus in the laboratory to test for shingles so it is not often done as treatment needs to be started quickly. If there is doubt about the diagnosis, scrapings may be taken from a blister and looked at under a microscope.
Can shingles be cured?
Shingles resolves on its own within a few weeks. Oral medication  can make the rash of shingles clear more quickly and can reduce its unpleasant effects.
These effects depend largely on which nerve is involved:
Shingles of the area served by the nerve that carries sensation from the front of the eye can lead to ulceration there, and later to scarring.  Blisters coming up on the side of your nose will alert your doctor to this risk, and you should get advice from an eye specialist.
Muscles supplied by the nerves taking part in the shingles occasionally become weak. For example, a temporary facial paralysis can accompany a shingles rash on the ear. 
The pain of shingles may persist long after the rash has cleared (post herpetic neuralgia), particularly in the elderly. Usually this goes away within 6 months, but a few people are in pain for a year or more.
For information on available treatments please go to this page on the website of the British Association of Dermatologists

Poison Ivy

Poison ivy is known in medical terms as Rhus Dermatitis which is a type of contact dermatitis. As the name implies, a contact dermatitis is an irritation of the skin caused by contact with a specific irritant. In the case of poison ivy, the irritant is called urushiol which is a resin found in the plants in the Anacardiaceae family and the Rhus genus. Plants included in this classification are poison ivy, poison oak, and poison sumac. Also included are the cashew nut tree, mango tree, Japanese lacquer tree, and marking nut tree.
Poison Ivy
The appearance of poison ivy, oak, and sumac varies by regions and season. Poison ivy leaves are most likely to be in groups of three and notched, although they can be smooth edged. Poison ivy is usually found east of the Rocky Mountains growing as vines or shrubs.
Poison Oak
Poison oak leaves come in groups of three, five, or seven. They are smaller than poison ivy leaves and have smooth, rounded edges. Poison oak is usually found west of the Rocky Mountains as a small bushy plant or climbing vine.
Poison Sumac
Poison sumac has seven to thirteen leaves on one stem angled upward. They are smooth edged, oval and about 10 cm long. Poison sumac is found in boggy areas in the south.
Interesting Facts About Poison Ivy
In the United States poison ivy, poison oak, and poison sumac cause more cases of contact dermatitis than any other agents combined. Rhus dermatitis accounts for 10% of the US Department of Agriculture and Forestry Services lost time injuries. Twenty-five million to 40 million Americans require medical attention after being exposed to one of these plants.
Poison Ivy occurs from contact with the leaf or internal parts of the stem or root of the plant. Eight to 48 hours after exposure to urushiol the characteristic rash appears. This rash is typically red, contains blisters, and is in a linear or circular pattern. Urushiol can be found under fingernails, on clothing, and on tools unless it is deliberately removed. The resin itself can be active and cause a new rash for up to 3 weeks after exposure. Urushiol is not found in blister fluid and not responsible for spreading the rash. If untreated, the rash usually resolves in 3 weeks.
Treatment of Poison Ivy
The most common sites on the body for poison ivy are exposed areas on the arms, legs, and face. The intensity of the rash varies depending on the sensitivity of the person, and the amount and extent of exposure.

• Washing the skin with soap and water inactivates and removes the resin. Washing is most effective if it is done within 15 minutes of exposure.
• Cold, wet compresses are effective in the blistering stage. They should be used for 15 to 30 minutes several times a day for the first 3 days.
• Steroid creams or ointments are helpful to reduce redness and itching. Hydrocortisone can be used on the face, but is usually not strong enough for more than mild cases on the arms or legs. Typically, a prescription strength steroid is needed for these areas.
• Oral steroids are used for severe cases of poison ivy but must be used for at least a week.
• Short, cool tub baths with colloidal oatmeal (Aveeno) can be soothing and help control inflammation.
• Calamine lotion helps control itching but used too long can cause excessive drying of the skin and more inflammation.
• Antihistamines help reduce itching and the older types such as diphenhydramine (Benadryl) help encourage sleep.
• Any exposure to the eyes or eyelids or the development of a honey-colored crust should be evaluated by a health care provider.

Prevention of Poison Ivy

• Desensitization is not effective either by chewing leafs or having commercially prepared extracts injected.
• The most effective prevention is using a barrier to protect the skin. Clothing serves as an effective barrier but since the urushiol remains on the clothing, it must be removed carefully and laundered without contacting the skin.
• Urushiol can penetrate latex gloves but not rubber gloves.
• A lotion containing 5% quaternium-18 bentonite (IvyBlock) can be applied to the skin and provides a barrier for 4 to 8 hours. It must be washed off and reapplied for continued exposure. 

http://dermatology.about.com/cs/eczemadermatitis/a/poisonivy.htm

Lichen Planus

What is lichen planus?
Lichen planus is a fairly common, itchy, non-infectious type of rash that usually occurs in adults. Doctors use the word ‘lichen’ to mean small bumps on the skin. ‘Planus’ means ‘flat’, and tells us that the small itchy bumps that make up the rash of lichen planus have shiny flat tops.
What causes lichen planus?
The cause of lichen planus is still not known, but is likely to have something to do with the body’s defences – the immune system. Rashes that look like lichen planus – known as ‘lichenoid drug eruptions’ – are sometimes a reaction to taking medicines such as gold (used for arthritis) or antimalarial tablets. Lichen planus is not contagious.
Is lichen planus hereditary?
Usually it is not but, rarely, a few members of the same family can have it.
What are the symptoms of lichen planus?
Lichen planus on the skin is usually itchy.
What does lichen planus look like?
The rash is made up of shiny, 3-5mm, slightly raised purple-red spots. A close look is needed to see the irregular white streaks that lie on the flat surface of some of them. The spots arise most often on the fronts of the wrists, around the ankles and on the lower back, but can spread more widely. In addition, lichen planus sometimes comes up in lines where the skin has been scratched or cut.
Other types of lichen planus include a thickened ('hypertrophic') lichen planus, which tends to affect the shins, and a ring-shaped ('annular') lichen planus, which usually comes up in the creases such as the armpits. Lichen planus occasionally appears on the scalp where it can cause hair loss, or may damage the nails (thinning and grooving of the nail plate), though this is rare.
Lichen planus is common in the mouth and is present in about 30-70% of those who have it on their skin (see patient information leaflet for Oral Lichen Planus).
Lichen planus can affect the penis in men, causing purple-coloured or white ring-shaped patches. Unlike other patches of lichen planus, these often do not itch. Lichen planus can affect the genital area in women too, but this is less common.
Most patients with lichen planus clear up within 18 months and usually stay clear, although some have a second episode many years later. Unfortunately some types of lichen planus, such as oral, hair or nail involvement, can last for many years. Even after the active lichen planus has cleared up, pigmented stains in the skin may persist for a long time, particularly in Asian or Afro-Caribbean skin.
How will lichen planus be diagnosed?
Usually the diagnosis of lichen planus can be made easily enough just by the look of the rash. Confusion may arise with flat ‘plane’ warts, with some types of eczema, and with rashes due to some drugs. If there is real doubt, the diagnosis can be clinched by looking under the microscope at a small sample of skin (a biopsy specimen) removed after a local anaesthetic injection.     
Can lichen planus be cured?
No, treatment damps it down but does not switch it off. However, lichen planus usually goes away by itself.
For information about available treatments please visit this page on the website of the British Association of Dermatologists

Pyoderma Gangrenosum

What is pyoderma gangrenosum?
Pyoderma gangrenosum is a rare treatable cause of skin ulcers. It is not related to gangrene. Pyoderma gangrenosum is not ‘catching’ and cannot be transferred from or to another person by touching or in any other way.
What causes pyoderma gangrenosum?
For about half of the people with pyoderma gangrenosum there are no known reasons for it. It may start after minor skin damage or injury. Sometimes other conditions may be associated with pyoderma gangrenosum, such as inflammatory bowel disease (IBD), arthritis or certain blood disorders. It is important to know that having pyoderma gangrenosum does not mean that you have these diseases.
What does pyoderma gangrenosum look like?
Pyoderma gangrenosum usually occurs in young and middle-aged adults but the way it looks can vary from person to person. It may start as a small pimple, red bump or blood-blister. The skin then breaks down resulting in an ulcer which often oozes fluid. The ulcer can enlarge rapidly. The edge of the ulcer may look purplish. The most common places where pyoderma gangrenosum occurs are the legs, although it can be found anywhere on the body. Sometimes it may occur around the site of a stoma (e.g. colostomy), or in a surgical wound.
What are the symptoms of pyoderma gangrenosum?
In pyoderma gangrenosum, there is usually a single large ulcer but occasionally there may be multiple ulcers. Ulcers may become infected, oozing fluid or pus. Pain or discomfort are common symptoms. Pyoderma gangrenosum is not cancer and does not lead to cancer.
How is pyoderma gangrenosum diagnosed?
There is no specific blood test for pyoderma gangrenosum. Certain conditions such as venous ulcers, inflammation of blood vessels, infection, injury, inflammatory disorders and cancer can look like pyoderma gangrenosum. This is why your doctor may take a sample of skin (biopsy) to examine under the microscope in a laboratory to confirm the diagnosis. The wound should also be swabbed and cultured for bacteria to rule out associated infection. Your doctor may also request blood tests to check for conditions that may be associated with pyoderma gangrenosum.
It is not hereditary and is not passed from parents to sons or daughters.
To find out about available treatments please visit this page on the website of the British Association of Dermatologists.

http://www.britishskinfoundation.org.uk/SkinInformation/AtoZofSkindisease/PyodermaGangrenosum.aspx

Impetigo

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Impetigo

What is impetigo?
Impetigo is a bacterial infection of the surface of the skin. In the it is the most common skin infection seen in young children.
What causes impetigo?
In the , impetigo is usually due to a germ known as Staphylococcus aureus; in hot climates it may be due to Streptococcus pyogenes, or to a mixture of the two. These germs pass from person to person, and impetigo can spread rapidly through families and school classes - by skin-to-skin contact or, less often, by bedding, clothing and towels. However impetigo can also arrive out of the blue, with no hint of where it came from.
The germs that cause impetigo can invade normal skin, but can also take advantage of skin that is already damaged by cuts or grazes, insect bites, head lice, scabies, cold sores, or eczema.
Impetigo is most common in children, and in warm humid weather.
Is impetigo hereditary?
No, but several members of a family often get it at the same time.
What are its symptoms?
Impetigo can be sore and itchy but does not usually make you feel ill.
What does impetigo look like?
Impetigo can crop up anywhere, but is most common on exposed areas of skin such as the face - around the nose and mouth - and on the hands. It starts as groups of thin-roofed pus-filled blisters which tend to break quickly to leave round oozing patches covered with honey-coloured or brownish crusts. The patches are small at first – half an inch or so across - but slowly get bigger. Smaller ‘satellite’ patches can come up nearby and may enlarge too. As the patches clear up, their crusts fall off and the areas heal without leaving scars.
How will impetigo be diagnosed?
Your doctor will base the diagnosis on the way the rash looks, and will check to see if it has come up on top of another skin condition, such as scabies. A swab from a crusted area may be sent to the laboratory to see which germ is causing the impetigo and which antibiotic is most likely to help. However treatment should not wait until the results are through. If you are getting recurrent episodes of impetigo your doctor may take a swab from your nose to see if the infective bacteria are harbouring there.
Can impetigo be cured?
Yes. Usually it clears quickly; but it will not do so if it is based on an unrecognised underlying skin problem such as scabies or head lice.
For information about available treatments please go to this page on the website of the British Association of Dermatologists

Contact Dermatitis

What is contact dermatitis?
The words ‘dermatitis’ and ‘eczema’ are interchangeable and mean the same thing.  Contact dermatitis, therefore, is the same thing as contact eczema.  For simplicity we will stick to the word ‘dermatitis’ in this leaflet.
Dermatitis means an inflammation of the skin. The term ‘contact dermatitis’ is used when this inflammation is caused by contact with something in the environment.
What causes contact dermatitis?
Two main groups of things in the environment cause contact dermatitis: irritants and allergens.
Irritants are substances like detergents and solvents that strip the skin of its natural oils, and cause dermatitis to develop if contacted frequently and without skin protection. When this happens, the skin changes are known as an irritant contact dermatitis. The most important factor in causing this type of contact dermatitis is the amount of irritants to which you are exposed. It is particularly common in people who do a lot of wet work, for example nurses, hairdressers, those who work in bars, and those in the catering trade.
Allergens are things to which your immune system can develop a specific reaction after you have come into contact with them. Examples include substances such as nickel, rubber, and perfumes or preservatives used in some creams and cosmetics.  This type of dermatitis is called an allergic contact dermatitis.  It is not known why some people who are exposed to these allergens develop it while others do not.
Sometimes substances such as proteins in fruit and vegetables can cause an immediate allergic reaction leading to itchy skin swellings known as contact urticaria (hives), which in turn can aggravate your dermatitis.
Contact dermatitis cannot be caught from nor spread to other people.
Is contact dermatitis hereditary?
People with a tendency to asthma, eczema and hay fever develop irritant contact dermatitis more easily than others, and this tendency does run in families.
What are the symptoms of contact dermatitis?
Itching of the skin is the commonest symptom, and this can be intense. Sometimes the skin becomes sore, and painful cracks can develop over the backs of the fingers when dermatitis affects the hands.
What does contact dermatitis look like?
The commonest areas on which contact dermatitis occurs are the hands, arms, face and legs. During a flare, contact dermatitis inflames the skin surface making it look red and scaly. Sometimes, tiny water blisters develop and these leak fluid when scratched. When the contact dermatitis is less active, the skin looks thick and dry, and painful little cracks can form over joints.
How will it be diagnosed?

Irritant contact dermatitis is diagnosed simply by knowing which irritant substances your skin is exposed to, and how often this occurs.
Allergic contact dermatitis is diagnosed by a procedure available in specialist dermatology departments known as patch testing. This involves putting sticky patches containing different substances on your back. The patches are taken off 2 days later, and the doctor or patch test nurse will then look at your back to see which ones have reacted. They will need to look again after a further 48 hours to see if there are further reactions.

Can contact dermatitis be cured?
Yes - if you can greatly reduce your contact with irritants, then your irritant contact dermatitis will improve or clear.
If patch testing shows that you are allergic to a specific allergen, then avoiding that allergen will usually lead to a big improvement or even complete clearance of your allergic contact dermatitis.
To find out about available treatments please visit this page on the website of the British Association of Dermatologists
 http://www.britishskinfoundation.org.uk/SkinInformation/AtoZofSkindisease/ContactDermatitis.aspx

Opioids overprescribed to patients following dermatologic surgery

Thirty-five percent of patients who underwent dermatologic surgery did not use the opioids prescribed for them afterward, indicating an overprescribing of the pain medications, according to recent study data.

Researchers conducted a prospective observational study of 212 adults (mean age, 68 years; 72% men) who underwent single skin excision, including Mohs micrographic surgery. Patients were reachable by telephone on postoperative day 3 or 4. Main outcome measures were incidence of opioid medication after surgery, percentage of prescribed opioids used in the postoperative period, and patient and surgical characteristics associated with opioid prescription and use.
Surgeries were performed most frequently on basal cell carcinoma (67%), followed by squamous cell carcinoma (26%), and melanoma or melanoma in situ (5%). Patients had a mean maximum pain score of 3.5 (0 to 10 scale), with most reporting that maximum pain occurred on surgery day (51%) or on postoperative day 1 (26%).
Seventy-two patients (34%) were prescribed opioid medication (mean prescription, 8.9 pills). These patients were younger (mean age, 65 years), had larger mean defect size (3.6 cm2) and were more likely to have undergone wound closure (primary, flap or graft). Twenty-five patients (35%) did not use any prescribed opioids, with the most frequent reason being lack of need. Of the 57 patients who filled an opioid prescription, 49 (86%) had leftover pills, 26 of whom planned to keep the pills and two who planned to properly dispose of the unused medication.
“A minority of patients in our study required opioid analgesia after dermatologic surgery and, of those who did, most required five pills or fewer,” the researchers concluded. “Given the significant morbidity of opioid misuse and abuse, we advise cautious and limited use of opioids after dermatologic surgery. It is also important to instruct patients who are prescribed opioids about the appropriate disposal of unused pills.”

http://www.healio.com/dermatology/cutaneous-oncology/news/online/%7BBD5A87E8-94EA-4730-B7CA-DDF9955FE0D1%7D/Opioids-overprescribed-to-patients-following-dermatologic-surgery

"Other Dermatological Disorders - Pipeline Review, H2 2012" Now Available at Fast Market Research

Boston, MA -- (SBWIRE) -- 12/26/2012 -- Global Markets Direct's, 'Other Dermatological Disorders - Pipeline Review, H2 2012', provides an overview of the indication's therapeutic pipeline. This report provides information on the therapeutic development for Other Dermatological Disorders, complete with latest updates, and special features on late-stage and discontinued projects. It also reviews key players involved in the therapeutic development for Other Dermatological Disorders. Other Dermatological Disorders - Pipeline Review, Half Year is built using data and information sourced from Global Markets Direct's proprietary databases, Company/University websites, SEC filings, investor presentations and featured press releases from company/university sites and industry-specific third party sources, put together by Global Markets Direct's team.

Note*: Certain sections in the report may be removed or altered based on the availability and relevance of data for the indicated disease.

Scope

- A snapshot of the global therapeutic scenario for Other Dermatological Disorders.
- A review of the Other Dermatological Disorders products under development by companies and universities/research institutes based on information derived from company and industry-specific sources.
- Coverage of products based on various stages of development ranging from discovery till registration stages.
- A feature on pipeline projects on the basis of monotherapy and combined therapeutics.
- Coverage of the Other Dermatological Disorders pipeline on the basis of route of administration and molecule type.
- Key discontinued pipeline projects.
- Latest news and deals relating to the products.

Reasons to Get this Report

- Identify and understand important and diverse types of therapeutics under development for Other Dermatological Disorders.
- Identify emerging players with potentially strong product portfolio and design effective counter-strategies to gain competitive advantage.
- Plan mergers and acquisitions effectively by identifying players of the most promising pipeline.
- Devise corrective measures for pipeline projects by understanding Other Dermatological Disorders pipeline depth and focus of Indication therapeutics.
- Develop and design in-licensing and out-licensing strategies by identifying prospective partners with the most attractive projects to enhance and expand business potential and scope.
- Modify the therapeutic portfolio by identifying discontinued projects and understanding the factors that drove them from pipeline.

 

http://www.sbwire.com/press-releases/other-dermatological-disorders-pipeline-review-h2-2012-now-available-at-fast-market-research-188632.htm

Scarlett Johansson Studies Dermatology To Solve Her Skin Problems

Scarlett Johansson has become an amateur dermatologist after spending years looking for cures for her own skin conditions.
The Avengers star is prone to rashes so she often sits at home watching medical documentary shows on Tv to investigate possible remedies.
Johansson admits her fascination has become an obsession and she is now able to diagnose skin conditions for her friends.
She tells Britain's Elle magazine, "(I should be) a dermatologist. When you help someone heal their skin it gives them a new lease of life. I mean, have you ever met someone with a horrible skin condition? I'm good with that... I've had every problem. I always get these weird things (rashes)... At least I know how to cure them... I'm pretty good at diagnosing other people... It comes from watching a lot of medical programmes... Real medical programmes. Documentaries."

http://www.contactmusic.com/news/scarlett-johansson-studies-dermatology-to-solve-her-skin-problems_3433233