Folliculitis

What is Folliculitis?

When hair follicles become infected, folliculitis will form. Usually staphylococcus or other bacteria will be involved. Anyone can develop the condition, however one is more susceptible to the condition if:

  • they are obese
  • are exposed to hot water, such as a hot tub or heated swimming pool
  • have a pre-existing skin condition like acne or dermatitis
  • have trauma to the skin due to a surgery or an injury
  • use antibiotics long term for acne
  • have a medical condition that reduces the resistance to infection, such as HIV, diabetes or chronic leukemia
  • long term exposure to clothing that will trap heat, such as high boots

Folliculitis Symptoms

Mild or severe cases of folliculitis can form.  Mild cases usually do not case much complications but they may have a re-occurant or spreading infection. Large itchy patches of staph infection can be present on the skin.  With severe cases, there may be scarring or leave patches of skin that are darker than the rest of the skin.  Destruction of the hair follicles may take place, which will lead to permanent hair loss.  Furunculosis can form, which are many boils under the skin that start off small but get larger and more painful as they are filled with pus.

Types of Folliculitis

There are two types of folliculitis, superficial and deep folliculitis.  Superficial folliculitis effects the upper part of the hair follicle and may cause red clusters that could be filled with pus that form around the hair follicles, pus filled blisters that can break open and crust over, red and inflamed skin and tender or itchy skin.  Deep folliculitis causes pain with possible scarring once the infection clears up.  Pus filled blisters can break open and crust over, and there is usually a large swollen bump or mass.

A diagnosis will be made just by looking at the skin. A sample of the skin can also be taken to send to the lab for further testing. It will be checked for bacteria presence.

Folliculitis Treatment

Mild cases of folliculitis will usually require no treatment.  Severe cases will need to be treated.  Antibiotics can be prescribed to take either orally, topically or both.  It may be recommended not to shave the area until the infection is gone and it has healed properly.  If you must shave, use a gel instead of a cream,  use an electric razor as they do not cut as closely to the skin, and shave in the direction of the hair growth.  Afterward, apply a moisturizing aftershave.  Medication to help with itching could be prescribed.

Warm saline compresses could help with some forms of folliculitis.  Topical or oral antifungal medications could be prescribed.  If there are boils or carbuncles, the doctor may drain them, which will ease the pain and help the healing process go much faster. Topical corticosteroids could be prescribed for some types of folliculitis.

Home treatment for folliculitis include applying warm compresses to the effected area.  This can be done several times a day. This will relieve pain and also help with the drainage.  For severely itchy skin, one can try an oatmeal lotion or a hydro cortisone cream.  If the skin is irritated, do not shave it. Shave in the direction of the hair growth if you must shave and use a clean new blade each time.  Electric razors work the best as they do not get as close  to the skin as a regular razor blade would.

Folliculitis Prevention

As a preventative measure, never share your towels or washcloths with anyone.   Make sure after each use they are getting washed in hot, soapy water.  Wash all clothing that touches the effected area in hot, soapy water after each wash.

 

Reference Sources

1. Web MD

2. Medscape 

 

Fabry Disease

What is Fabry disease?

Fabry disease is a rare disease that is inherited.  It is a result of too much fat being built up in the body’s cells. The disease effects more males then females, with approximately 1 in 40,000 to 60,000 males having it. Milder cases are more common than severe cases. The disease is inherited by an X linked pattern.   The mutated gene is carried on the mother’s X chromosome, meaning her daughters will have a 50% chance of carrying the disease and her sons will have a 50% chance of getting the disease.

Fabry Disease Symptoms

Symptoms of Fabry disease include pain that is either localised or full body pain.  The localised pain will often happen in the extremities, and can be related to damage of the peripheral nerve fibers.  These fibers are responsible for transmitting pain. The painful burning sensation in the hands and feet is called acroparesthesia.  This pain is often severe and will worsen with exercise, stress, illness and a change in temperature.  This is usually one of the first symptoms that is present. Kidney complications are another symptom of fabry disease. Renal failure could get worse as the disease progresses. Proteinuria, which causes cloudy urine, is usually the first sign that the kidneys are involved in the disease. Renal failure is a common cause of death in the disease. Cardiovascular complications can occur and lead to hypertension and cardimyopathy.  These two conditions should be closely monitored. Glycolipids build up in the heart cells, and the condition can worsen with age. Tiny papules that are painless can occur on the thighs, around the belly button, lower abdomen, groin and buttocks.  They can also occur on the lips, tongue, hands and toes. This red rash can be confined to small areas on the body, but could also effect a larger portion of the body.  Anhidrosis, or lack of sweating, is a common symptom of fabry disease.  A less common symptom is hyperhidrosis, or excessive sweating.  Raynoud’s disease  like symptoms can also occur, such as burning extremity pain.  Clouding of the corneas could be a result of fabry disease, as could retinal vascular dilation, mascular edema, and posterior spoke like cataracts. Other common symptoms include ringing in the ears, fever, hearing loss, nausea, fatigue, neuropathy, inability to gain weight, chemical imbalances, vertigo, and diarrhea.  Early gastrointestinal symptoms also include frequent bowel movements after eating and abdomen cramps.

Diagnosing Fabry Disease

Fabry disease can be diagnosed with an enzyme assay.  This will measure the level of alphagalactosidase activity.  A kidney biopsy may also be done if there is excessive buildup of lipids.

Fabry Disease Treatment

Treatment for fabry disease could include Fabrazume, which was approved by the FDA in 2003.  This enzyme replacement therapy is used to provide the patient receiving the treatment with the enzyme  that is missing.  While this treatment is not a cure, it could reverse some of the symptoms and can prevent the prognosis of the disease.  This treatment is expensive, about $200,000 per patient. Pain management will be used with fabry disease.  NSAIDS (non-steroidal anti-inflammatory drugs), analgesics and anti-convulsants can be used.  If the disease has spread to the kidneys, a kidney transplant or dialysis may be needed. Males have a life expectancy of 58.2 years, while females have a life expectancy of 75.4 years.  People with fabry disease often live into adulthood, but may have an increased risk for stroke, heart attacks, heart disease, and kidney failure.  The most common cause of death for someone with fabry disease is cardiovascular disease.  Many patients who have died from cardiovascular disease that suffered from fabry disease do receive kidney transplants.   Reference Sources: 1. Fabry Australia 2. Department of Medicine

Erythema Multiforme

What is Erythema Multiforme?

Erythema Multiforme is a self limiting skin condition that can reoccur.  It is associated with infections that are caused by bacteria, fungus, parasites, or virus, certain medications, and other triggers. Medications that could cause erythema multiforme include Penicillin, Barbiturates, Phenytoin, and Sulfonamides.  Infections that could trigger it are herpes simplex and mycoplasma.  Virus infections that could trigger erythema multiforme include Adenovirus, Hepatitis viruses, and Cytomegalovirus.  It commonly infects adults aged 20 to 40, and while there is no racial bias, males are more susceptible to the skin condition than females.

Erythema Multiforme Sympotms

Symptoms of erythema multiforme can be mild to severe.  Symptoms include fever, chills, fatigue, bloodshot eyes, eye pain, mouth sores, dry eyes, vision problems, general ill feeling, weakness and painful joints.  Skin lesions will appear on the skin, a few to hundreds could erupt.  They typically develop over 2 to 3 days, and will look different on various places of the body.  They will appear equally on both sides of the body. They are usually first seen on the backs of the hands, the top of the feet, and then spread on the limbs to the trunk. Upper limbs are effected more than the lower limbs. Mild itching or burning could take place.   The skin lesions will appear to be red/pink and round at first, and then become raised, enlarging to form plaques that can be several cm in diameter. The center of the skin lesion will be dusky or dark red, which looks like a blister or has crusted over.  The next ring is a paler pink that is raised due to fluid swelling.  The outer ring will be a bright red.

More often than not, mucous membranes are involved in erythema multiforme.  It is most commonly seen in the lips, tongue and inside of the cheek, but can be seen on the gums, palate, and floor of the mouth.  Erythema multiforme could effect the eyes, anus or genitals, gastrointestinal tract and the trachea.

Erythema Multiforme Treatment

If you suspect you have erythema multiforme, have a doctor do an examination.  At the examination, your skin will be examined and you will be asked questions about the skin condition and your history.  A skin biopsy could be done, as well as a skin tissue examination under a microscope.

Treatment for erythema multiforme will include not only controlling the illness that is causing the infection, but preventing infection and treating any symptoms.  If a case of mild erythema multiforme is seen, antihistamines could be given to stop the itching.  Moist compressions can be applied to the skin, topical anesthetics could be applied to the skin to ease any discomfort, and oral antiviral medication could be prescribed if the reaction is caused by the herpes simplex virus.  Medicated mouthwash can be used for sores in the mouth, and acetaminophen can help to reduce fever and pain.  In cases of severe erythema multiforme, antibiotics will be prescribed for skin infections, corticosteroids will be given to control the inflammation, and intravenous immunoglobulins(IVIG) are used to stop the disease.

Erythema Multiforme Prevention

To prevent erythema multiforme, good hygiene will be needed. This will help to prevent any secondary infections.  Use sunscreen to prevent hyperpigmentation.  A Zinc sulfate solution can also be applied to the site of the herpes simplex to prevent any relapse from happening.  A daily dose of prescribed oral antiviral medication may be needed to prevent and manage erythema multiforme.

Usually, erythema multiforme will go away on its own in 4 to 6 weeks. If the case is mild enough, there many not be any course of action taken for treatment.

 

Reference Sources:

1. PubMed Health

2. Kids Help

Erythema Nodosum

What is Erythema Nodosum?

Erythema Nodosum (EN) is a skin condition that is characterised by inflammation of the fat cells under the skin. Red nodules that are tender will form, and are usually seen on both sides of the shin.  Within 3 to 6 weeks it will usually resolve itself, and is found most commonly in people ages 12 to 20 years of age.  It is more common in woman than in men, by as much as 3 to 6 times.  People with a family history of erythema nodosum and other skin conditions are at a higher risk for developing the skin condition.

What Causes Erythema Nodosum?

Causes of erythema nodosum include infections, such as Hepatitis C, cat scratch disease, Yersinia, Streptococcal infection, Mycoplasma Pneumoniae, and Tuberculosis.  It can be seen in those with autoimmune disorders, such as Bechet’s Disease, Chlamydia, Syphilis, Inflammatory Bowel Disease, and Sarcoidosis.  Pregnancy and oral contraceptives can also cause erythema nodosum.  Certain medications, such as Penicillin, Bromides, Sulfonamides, Progestin, and hepatitis B vaccinations can also cause erythema nodosum.  Cancers that have been linked to causing erythema nodosum include Non-Hodgkin disease, pancreatic cancer and carcinoid tumors. In about 30 to 50% of all cases, the cause is not determined.  Ulcerative colitis, leukemia, and rheumatic fever have also been linked to this skin condition.

 How do I know if I have Erythema Nodosum?

Erythema nodosum is most commonly found on the shins but can also be found elsewhere on the body, such as calves, arms, ankles, thighs and buttocks.  Lesions can be found on the skin that are flat, red and hot.  They are firm to the touch and are about an inch in diameter.  They are painful, and after a few days of first developing them, turn to a purple. Within a few weeks, they will fade into a flat brown patch.

Facelift-without-surgery

What are the Erythema Nodosum symptoms?

Signs of erythema nodosum include fever, joint aches, red skin that can be inflamed or irritated, general ill feeling, and swelling of the effected area.  The condition will be diagnosed by a doctor just looking at the skin, however, a punch biopsy may be performed.  The doctor may also order a throat culture to see if strep is present, and chest X-rays to rule out tuberculosis or sarcoidosis.

What are the available Erythema Nodosum treatments

The first step in treatment is to treat the underlying cause if there is one, such as treating strep throat.  Anti-inflammatory drugs can be used and cortisone can be taken orally or topically.  To reduce inflammation, Colchicine can be used. Rest will also be needed for the skin to heal.  Hot or cold compresses can be used for comfort, and elevating the sore area can be helpful.  A therapeutic option is using oral potassium iodine solution that is supersaturated.  Do note that this option could result in hyperthyroidism, so caution must be taken when using long term.

CAM therapies (complementary and alternative therapies) can also be used to treat erythema nodosum.  These are often used to reduce inflammation, prevent infections and boost the immune system. Do note that you should only use alternative therapies under the discretion of your doctor, as some may interact with medications and treatments also being provided.  Vitamin C can help to protect against damage from the sun, but can also negatively impact other health conditions.  Vitamin E can help to also protect against the sun, but will impact certain medications, such as blood thinners. Zinc will help to keep the skin healthy,  but can interfere with antibiotics.  High doses of zinc can be dangerous.

Erythema Nodosum Prevention

To prevent erythema nodosum, one should have proper hygiene.  This includes washing hands often with a good anti-bacterial soap.  Avoid sharing utensils, food, and drink with others as well to avoid infections. Avoiding the sun when taking certain medications can also help to prevent erythema nodosum.

 

Reference Sources:

1. Better Health Channel 

2. American Family Physician 

Erythema

What is Erythema?

Erythema is redness of the skin which is caused by hyperemia of superficial capillaries.   There are many types of erythema, such as erythema multiforme, erythema nodosum and photosensitivity.  Erythema multiforme is known for having raised red spots on the skin or other skin lesions. Causes for this include illness, medication,  or infections.  Erythema nodosum is characterized by tender bumps on the skin that is caused by medications or diseases.  It is often seen in the lower legs below the knees.  Photosensitivity is formed when there is a reaction to sunlight, and is usually seen when something such as a medication increases the sensitivity to UV rays.  Men are at a greater risk for developing erythema than woman in the case of erythema multiforme, while woman are at a greater risk for developing erythema nodosum.  Excessive and frequent exposure to the sun increases the risk for erythema multiforme, while those that are 20 to 30 years of age are at a higher risk for erythema nodosum.  Those that have a family history of skin conditions have a higher chance at developing either erythema multiforme or erythema nodosum.

Erythema Symptoms

There are signs and symptoms of both skin conditions.  Erythema multiforme signs and symptoms include fatigue, fever, itching, fifth disease(rash that lasts about 2 weeks on the arms and face), target lesions on the skin( spots that are surrounded by rings of both red and normal skin that resemble a target), and outbreaks of bumps, lesions, and spots on the skin, commonly found on the elbows, palms, hands and feet.  Signs of erythema nodosum include flu like symptoms with a fever, joint pain, arthritis, red lesions that are soft and bluish but eventually fade to a yellow or brown, and clusters of nodules or lesions that appear on the thighs, shins, trunk and forearms.

What are the causes of Erythema?

There are a variety of causes for each type of erythema.  Erythema multiforme is caused by infections and medications.  Causes of erythema nodosum include pregnancy, ulcerative colitis, medications like birth control pills, infections such as mononucleosis, a connective tissue disorder such as lupus, Crohn’s disease, and  Bechet’s disease.

If one suspects they have any form of erythema, they should schedule an appointment with their doctor.  At the appointment, the doctor will exam the skin and body, and could possibly have a skin biopsy done. Blood testing, throat cultures, and x-rays may also be needed to determine if one has any form of erythema.

Erythema Treatment

There are many forms of treatment for erythema.  First the doctor will determine what caused the disorder in the first place and will stop any medications that are resulting in erythema. Antihistamines may be prescribed for itching, and if there is an infection, an antibiotic will be given.  Should there be a virus, antiviral medication will be made available. Corticosteroids can be applied to the skin or taken orally for erythema nodosum.  Aspirin may be used as well, and Burrow’s compresses can be applied to the skin to help soothe skin.  Complementary and alternative therapies (CAM) can be used under the direction of the doctor to prevent infections, boost the immune system and reduce inflammation.  However, do note that some of these therapies will interact with other therapies and medications.

Best way to prevent Erythema

To help prevent any form of erythema, one can look at their nutrition.  Taking antioxidants can protect the skin against damage.  Include any of the following in the diet under the supervision of your doctor: Beta-carotene, Vitamin C, Vitamin B6, Vitamin E, Vitamin D, Zinc, and Melatonin. Green tea can also be used as it can protect against UV lights due to the high antioxidants that are in it.

 

Reference Sources:

1. University of Maryland Medical Center 

Erysipelas

What is Erysipelas?

Erysipelas is a skin infection that  involves the upper dermis, or upper layer of skin.  This bacterial infection is similar to cellulitis, which is an infection in the lower layers of the skin. It occurs commonly in the legs but can also effect the face. It is formed by bacteria that has penetrated into the outer layers of the skin. Normally the bacteria that causes erysipelas do not cause harm, but if you have a cut or sore, they can enter.  Often times when erysipelas is seen on the face, the bacteria has spread from the nasal passages after an infection in the nose or throat.  The skin disease is most commonly seen in infants, children and the elderly. People with diabetes,immune deficiencies, fungal infections, skin ulcerations, alcoholism, and impaired lymphatic drainage are at a higher risk for erysipelas.

Erysipelas Symptoms

Symptoms of erysipelas include fever, chills, fatigue, vomiting, shaking, blisters on the effected area, general unwell feeling,  swollen glands  and headaches.  The infection on the skin will appear to be warm, red, swollen and will be painful.   The skin lesion could have a raised border.  Sores can be seen on the bridge of the nose and both cheeks.   Causes of erysipelas include obesity, athletes foot, cuts and ulcers on the skin, insect bites, injecting illegal drugs, uncontrolled diabetes, anything that will suppress the immune system, swollen legs due to health problems like heart failure, surgical incisions, skin conditions like eczema, or having previous episodes with erysipelas.

If you suspect that you have erysipelas, contact your doctor.  The doctor will often times be able to tell just by looking at the area effected if erysipelas is the diagnosis.

 Erysipelas Treatment

Treatment for erysipelas often includes home treatment.  In severe cases, a patient with erysipelas could be hospitalized.  To begin home treatment, raise the effected area to reduce any swelling. Elevation may need to take place for several days to see an improvement in swelling.  Do note that it is important to stand and walk from time to time to get blood flowing and to make sure to drink plenty of fluids.

Antibiotics are usually prescribed for erysipelas.  For a less severe case, antibiotics will be prescribed for up to two weeks.  For severe cases, the patient may need to go  into the hospital for intravenous treatments.   For those with repeat episodes of erysipelas, long term antibiotics could be prescribed.  Painkillers will be given for severe pain and discomfort and to treat any fever. If athletes foot is the cause of erysipelas, anti-fungal medication may be prescribed.

Surgery is also another treatment that is used for erysipelas.  This is reserved for severe cases in which tissue that was once healthy has died. The dead tissue could need to be cut away.

Treatment will be needed to clear up erysipelas.  If treatment is not administered, one takes the risk of developing blood clots.  Other risks include gangrene, an abscess, infected heart valves, joint and bone infections, and blood poisoning.  If erysipelas is near the eyes, the infection could also spread to your brain.

How to help prevent Erysipelas?

There are things that one can do to prevent erysipelas.  If you do have a wound, keep it clean. Athletes foot should be treated as soon as you notice you have it or suspect that you have it.  Do not scratch your skin, especially if it is dry, and always use a good moisturizer to prevent the skin from cracking due to excessive dry skin.  If you do have any skin conditions such as eczema or dermatitis, treat those accordingly.

Outlook for erysipelas is very good.  The skin will usually take a few weeks to heal, but with proper treatment and prevention, the outcome can be very good.

 

Reference Sources:

1. About.com – Dermatology

2. Health in Plain English

Erythema Ab Igne

What is Erythema Ab Igne

Erythema Ab Igne is a skin condition that is caused by long term exposure to heat.  It is often referred to as hot water bottle rash, laptop thigh, granny’s tartan, toasted skin syndrome or fire stains. It is an uncommon skin disorder that has a fish net like pattern of hyper pigmentation on the skin. The name means redness from  fire.  Woman have a higher chance then men to contract erythema ab igne.  It was once seen commonly in elderly people who sat too close to open fires or heat sources, but is also seen in young individuals.

Caueses of Erythema Ab Igne

Causes of erythema ab igne include repeated exposure to heated car seats, space heaters, and fireplaces, repeated application of hot water bottles or heated blankets (often used to treat pain), or resting a laptop on the thighs.  Occupations that can cause erythema ab igne include bakers, chefs, blacksmiths and jewelers. The form of heat range to cause damage to the skin is from 43 degrees C to 47 degrees C.

Symptoms associated to Erythema Ab Igne

Lesions on the skin are usually asymptomatic, but can be associated with itching, burning and pain. Often times the condition will go unnoticed until it is seen with the eyes.  The lesions start on the skin as small pink patches but will progress into reddish or brown reticulated patterns.  Multiple stages of the lesions can be present on the skin.  The fish net or lacy patterns on the skin are caused from injuries to the super vascular networks and the outer layers of skin after exposure to heat. The skin will often become thinner as does the underlying tissue, causing the lesions to form.  They are often described as blotchy looking.

Treatments for Erythema Ab Igne

Treatments for erythema ab igne include stopping the contact from the heat source. Often times the condition will resolve itself if there is  a mild case of it. If the skin is severely damaged, there is often not a chance to resolve it. In this case, squamous cell carcinoma or neuroendocrine carcinoma could form. Sores that do not heal, or grow to form a lump with a rash may need a skin biopsy performed to rule out skin cancer. Topical tretinoin can help to improve the appearance of the skin, as can laser treatments. If pre-cancerous changes are being made to the skin, a 5 fluorouracil cream can be prescribed.

The prognosis for treating erythema ab igne (EAI) is very good if the heat source is removed right away. If the heat source is not removed quick enough, there is a chance that pigmentation abnormalities may persist on the skin. Complications of EAI include malignant degeneration, which should be closely monitored.

How to prevent Erythema Ab Igne?

To prevent erythema ab igne, you must stay away from prolonged exposure to heat sources.  Do not sit to close to fires, wood stoves, or space heaters.  If you use water bottles for injuries, limit the amount of time that a water bottle is used.  Try not to place a laptop on the thighs when working as this can cause the thighs to have exposure to heat.   The underside of laptops is often 50 degrees C or higher, which many do not realize. Heated seats should not be used in vehicles all the time.  If you must use a heated seat, only use it until your body has warmed up enough and then switch it off.  If your job requires you to be close to an open heat source, such as a chef or a blacksmith, wear protective clothing so the skin is not exposed to the heat and take frequent breaks.

 

Reference Sources:

1. Medical Dictionary

Dry Skin

What is Dry Skin?

Dry skin can be unsightly and bothersome to those that suffer with it. Dry skin can cause itching, fine cracks or lines, redness, deep cracks that can bleed, skin that looks and feels rough, a gray or ashy tone to the skin, and flakiness.  Often times it is a temporary condition due to the weather. Taking long baths or showers that are hot can cause dry skin, as can exposure to the sun. Those that use harsh detergent or soaps are at a higher risk for dry skin. Central heating, space heaters, fireplaces and wood burning stoves can all cause dry skin as well due to them reducing the humidity in the air. People with skin conditions such as eczema could also suffer from dry skin.

How to Treat Dry Skin

The good news is that there are many things that one can do for home treatments to help improve the quality of the skin. Try reducing the amount of time that you take in the bath or shower.   Limit the time to only 10 minutes or less. Or simply turn the water down a few degrees. If the skin is very dry and scaly, a doctor could suggest an over the counter cream that contains lactic acid or urea.  If the skin condition is due to something such as eczema, a cream might be prescribed in addition to doing home treatments.

How to Prevent Dry Skin

Avoid using harsh soaps and detergents.  These are often very drying on the skin.  Find a gentle cleansing cream. Avoid anything with alcohol, deodorant, or antibacterial agents in them.  These are very drying to the skin.  A great piece of advice is to treat the skin like a baby’s skin.  One could even opt to use baby cleansers and washes as they are not drying to the skin.

Moisturising the skin is one of the best things one can do for dry skin.  Thicker creams and lotions work the best for extremely dry skin.  One may opt to moisturise a few times a day.  The best time to apply a moisturiser is after a shower or bath when the skin is slightly damp. After patting skin dry, apply moisturiser.  Never rub the skin, as this will not help the dry skin, but could make it worse.   Baby oil is a great alternative to lotions and creams, or can be used in conjunction with them. Vaseline can also be used, but could leave a greasy feeling.

Using a humidifier at home can also help with dry skin.  Dry air can make dry skin flake and itch.  Running a humidifier in the home can help to put moisture into the skin by making the air less dry.

To prevent dry skin from happening, one can use a humidifier, moisturise the skin daily, take only one shower or bath a day, and use gentle soaps, cleansers and detergents.  Avoid wool clothing if at all possible and wear cotton or natural fibers.

If you have tried self treatment and the dry skin will just not go away, you may need to see a doctor for the condition.  See a dermatologist or doctor if the dry skin interferes with sleeping, you have large areas of the skin that crack and peel, dry skin that has redness to it, open sores or infections are forming, or the skin condition does not improve with self treatment.   The doctor will exam the skin, and will possibly want to know when the dry skin started as well as what your diet is, how you care for the skin, products that you have used on the skin, if anything makes the condition worse or better and what your bathing habits are.  Asking these questions will help the doctor advise a plan of action for your dry skin.

Discoid Lupus Erythematosus

What is Discoid Lupus Erythematosus

Discoid lupus erythematosus is a chronic skin condition which consists of sores that are inflamed with scarring.  They have a crusty and scaly appearance, and often times the center is a lighter colour with a dark rim on the outside.  The rash will usually be raised and does not itch. They usually appear on the face, ears, and scalp, but have been seen on the body as well. Most commonly it is seen on the nose and cheeks.   If the lesions develop on an area of the skin with hair, such as beards, scarring and hair loss could take place.  Changes in skin pigmentation will take place with this autoimmune disorder.  Woman are more likely than men to have Discoid Lupus Erythematosus (DLE) by 3 to 1 .  It is seen most commonly in the age group of 20 to 40 years of age. Between 17 to 48 out of every 100,000 people will have DLE. Often times discoid lupus erythematosus will run in families.

Discoid Lupus Erythematosus Symptoms

Symptoms of discoid lupus erythematosus  include inflammation of the skin and a rash.  Other symptoms that could be seen on either a daily occasion or from time to time include hair loss, permanent scarring or red patches that are disc shaped on the skin that are crusty and scaly. Other symptoms that could be life threatening include chest pain or pressure, pale or blue lips, irregular heartbeat, inability to urinate, rapid heart rate, or difficulty breathing or rapid breathing.  If one has been diagnosed with DLE, and any of these symptoms are occurring, seek medical attention asap.

The Cause of Discoid Lupus Erythematosus

There is no known cause of Discoid Lupus Erythematosus.  However,  this autoimmune disorder is believed that possible risk factors include exposure to sunlight and cigarette smoke. Complications from DLE include scarring that could be permanent as well as secondary infections of the skin or surrounding tissues.

Treatments available for Discoid Lupus Erythematosus

A biopsy will usually be done on the skin to determine if the skin lesion is Discoid Lupus Erythematosus.  Further blood work may be needed .

Treatments for Discoid Lupus Erythematosus could include corticosteroid drugs that can be used either topically or  injected into the skin lesion.   Injections of cortisone are usually more effective than a cortisone ointment, but the ointment will slow down the progression of the skin lesion and improve them in appearance. Very potent forms of corticosteroid drugs will be needed for the lesions.  One study has found that fluocinonide cream is very effective at treating those with DLE, and could possibly be more effective than hydro cortisone.   It has been found that systematic steroids do not seem to be that effective. If systematic steroids are needed, hydroxycholoquine is one that is often used.  Patients who use hydroxycholoquine need an eye exam once a year to prevent damage to the retinas of the eye and will also need periodic blood work done.   Imiquimod has been proven to be effective in some patients with DLE.

Discoid Lupus Erythematosus Prevention

One with Discoid Lupus Erythematosus can prevent flare ups by applying sunscreen when outdoors.  Always apply 30 minutes before sun exposure, and reapply every two hours. Wear sunglasses, hats and protective clothing when exposed to the sun.  If you smoke, quit smoking. Reduce your exposure to second hand smoke as well.  Keep on track with all follow up appointments with doctors as it is crucial to stop the spread of the disease.  These should be taking place every 6 months to a year.  At these appointments, the doctor will check to make sure that the disease is not spreading to the internal organs.

With early recognition and treatment, it is possible to live a quality life with Discoid Lupus Erythematosus.   With early treatment, it will be possible to eliminate the scarring in many cases.

 

Reference Sources:

1. Australasian Society of Clinical Immunology and Allergy

2. American Board of Family Medicine

Pyoderma Gangrenosum

What is Pyoderma Gangrenosum?

Pyoderma gangrenosum is an uncommon condition that causes tissues to become necrotic. This condition causes deep ulcers that happen most commonly on the legs. They can lead to chronic wounds that are very painful and could lead to scarring. They start off looking like a small bug bite then will transform into larger ulcers. They are often quick spreading reddish to purplish bumps or blisters. Once they have developed into ulcers, they will have a clearly defined blue or violet colored border on them. There is no definite size or depth to them. It was first discovered in 1930, and effects about 1 in 100,000 individuals. It can effect any age group, but happens most commonly in individuals in their 40s and 50s. Fever, joint tenderness, localised tenderness and a general feeling of not feeling well are all associated with pyoderma gangrenosum. Half of all cases are associated with other disorders, including inflammatory bowel disease, myeloid metaplasia, rheumatic arthritis, acute and chronic myelogenous leukemia, Crohn’s disease, and paraproteinemias. More females then males have pyoderma gangrenosum.

There are many types of Pyoderma Gangrenosum. These include:

  • Typical pyoderma gangrenosum– May also be referred to as classic PG, or Peristomal pyoderma gangrenosum. This commonly effects the legs or the trunk. Often occurs near surgical openings in the body. This unusual variation of the condition is seen exclusively with individuals that suffer from inflammatory bowel disease (IBD). Approximately 15% of all cases are peristomal.
  • Atypical pyoderma gangrenosum– This variation of the condition effects the hands and other portions of the body. It is more superficial than typical Pyoderma Gangrenosum. Commonly associated with IBD, but can occur with other systemic illnesses. Can also be referred to as Bulous Pyoderma Gangrenosum.
  • Pustular Pyoderma Gangrenosum– An uncommon clinical form of Pyoderma Gangrenosum.  Painful bumps are often found on the arms and legs. This is often associated with IBD as well.
  • Vegetative pyoderma gangrenosum– This condition is characterised by ulcers that are usually not painful. It can respond well to topical treatments. Lesions are usually found on the neck and head. Usually found as a single lesion on a healthy person.

What Causes Pyoderma Gangrenosum?

While there is no known cause to Pyoderma Gangrenosum, the condition is suspected to be an autoimmune disorder. Should you have Pyoderma Gangrenosum, a new injury to the skin could result in new ulcers forming.

Pyoderma Gangrenosum Treatment

A variety of tests might be needed when diagnosing for Pyoderma Gangrenosum. Blood may be taken to check for any infection, kidney, liver, or thyroid functions, and rheumatoid factors, which determine rheumatoid arthritis. A sample of the skin may be taken or a small amount of liquid from the ulcers to do a biopsy.

Medication can be prescribed to help treat Pyoderma gangrenosum. High doses of corticosteroids are often used as an effective treatment, however there are unwanted side effects, such as thinning bones, weight gain, and an increased infection rate. Sulfa drugs, such as dapsone or sulfapyridine, can be prescribed as well. Do note that with any treatment offered, it could take weeks or even months for the skin to heal.

Surgery is often another treatment used for this skin condition. Surgery is often not used as there could be more trauma to the skin, or make the existing ulcers worse. Skin grafting is sometimes needed after the inflammation has gone down and the wound begins to heal.

Pyoderma Gangrenosum Prevention

It is extremely hard to prevent Pyoderma Gangrenosum. Controlling the disorders that are associated with pyoderma gangrenosum is the best place to start. Avoid injury to the skin to avoid new ulcers from forming.