Cyst

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What is a Cyst?

PLEASE NOTE: Advanced Dermatology does not treat cysts at this current time. This article is for education and information purposes only. 

A cyst is a pocket of tissue that contains fluid, air, or other substances. Most of the time, cysts are non-cancerous. They can grow anywhere on your body. They will feel like large peas under the skin. They develop as a result of infection, clogging of the oil glands, or around foreign bodies, such as an earring. They are usually slow growing, smooth to the touch, and painless. They may only become painful if they are ruptured or if they become infected.  They may cause problems if they effect the function of an organ, or if they are growing in a sensitive area.  They vary in size.

What Causes Cysts?

There are many causes of cysts. They can be caused by an inherited disease, blockages in the ducts, chronic inflammation, or infections. There are many different kinds of cysts, however the following are the most common:

  • Ganglion cyst- These are benign that usually form on the wrist or hands. They have also been known to appear on the feet.  They tend to form along a tendon. More woman then men are effected by this type of cyst.
  • Breast cyst- When the milk ducts are blocked, a benign cyst can form. This happens very commonly in woman in their 30s and 40s. Pain or tenderness will usually take place with this type of cyst.
  • Chalazia- These are benign cysts that appear on the eyelids. They are formed when oil ducts are blocked. They can cause painful swelling, tenderness, and sensitivity to light.  They can also cause vision problems if they get too big.
  • Ovarian Cysts- These cysts form when the follicle that releases an egg does not open. Fluid then begins to build up. They occur most often in woman between puberty and menopause.
  • Sebaceous cysts-  These cysts are small bumps that are filled with sebum. They form often within the hair follicles. They can also be inherited, caused by Gardner’s syndrome.
  • Pilonidal Cysts-  These cysts form at the top of the buttocks. They happen more in men than woman, and are formed when loose hairs are embedded in the skin. They are filled with skin debris, hair and other matter. One should use caution if they have this type of cyst as they could increase the risk of getting squamous cell carcinoma, a type of skin cancer.

Cyst Treatment

In many cases, cysts will go away on their own. One should never squeeze a cyst.  Warm compresses over the cyst can help to speed up the healing process.   However some medical care may be needed. Anti-inflammatory medication may be needed.  Cortisone injections can be used for this.  A doctor may drain the cyst using a needle, but is usually reserved only if a cyst becomes infected or ruptures. This will allow all fluid in the cyst to be removed. Surgery can also be used to remove the cyst. This is used when draining of the cyst does not work. Internal cysts could need surgery to be removed since they are not able to be drained.  Cysts that reappear may need to have surgery to remove them as it is common to have  a cyst return after going away.

How Can I Prevent Cysts?

There is no way to really prevent cysts from appearing on the body. Although one can keep the eyelids clean to prevent oil ducts from blocking to prevent Chalazia.  Hormonal contraceptives may be prescribed to woman that are prone to developing ovarian cysts. Pilonidal can be prevented by keeping the skin in that area clean. Sitting for extended periods of time can cause Pilonidal cysts, so make sure to take frequent breaks from sitting if you sit for extended periods of time. Keeping a powder on this area will also keep it dry, which can help prevent the cyst from forming.

Reference Sources:

1. Better Health

2. Healthline

Chicken pox

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Chicken pox is a viral infection that was once considered to be a classic childhood illness. Extremely itchy blisters will form all over the skin. There is now a chicken pox vaccination available, making chicken pox much less likely to get. Chicken pox is caused by the varicella-zoster virus. This is a member of the herpes virus family.  This is also the same virus that causes shingles in adults. Chicken pox is highly contagious.  It is usually a mild disease, but it is always best to safe guard yourself when you are younger and get the vaccination.

Chicken Pox Symptoms

Symptoms and signs of chicken pox includes fever, loss of appetite,  sore throat, headache, fatigued,  and a feeling of unwellness.  They will usually last 5 to 10 days, with three stages.  In the first stage, the papules (red or pink raised bumps on the skin), will break out the skin over a course of several days. Vesicles (fluid filled blisters) will then form, and will be filled for about a day before breaking.  Scabs will then form on the skin, which will take several days to heal.  It is possible to have all three stages at once.  One will be contagious until all the spots have crusted over.  Many do not realize that they are contagious for up to 48 hours before the rash appears.  It spreads by sneezing, coughing, or sharing food and drinks. If you touch the fluid of a blister, you could also be infected.

Chicken pox are usually mild.  A doctor should be contacted if you suspect that you have chicken pox.  A doctor can prescribe medications to make the chicken pox not appear as severe. Should you see any of the following signs, let your doctor know:

  • a rash that is accompanied by rapid heartbeat, dizziness, shortness of breath, tremors,stiff neck, vomiting, a fever that is higher than 103 degrees, cough that is appearing to get worse, and loss of muscle coordination.
  • The rash spreads to either eye.
  • The rash is warm or tender.

Other Risks Associated to Chicken Pox

Chicken pox could cause problems for woman that are pregnant or those that have weakened immune systems.  Once you have the disease, it is not likely that you will have it again.  However, if the virus does appear again in the body, a painful outburst of shingles can take place.

Those who have a higher risk of chickenpox include those that have never had it before, those that have not been vaccinated for it, those that live with children, and those that work with children, such as daycare workers or teachers.

Chicken Pox Treatment

If you have come down with a case of the chickenpox, there are things that you can do at home to make yourself more comfortable. First off, avoid scratching the area.  This could damage the skin.  If you are finding yourself itching, cut fingernails short or wear gloves.  Wear clothes that will not aggravate the skin and that is not tight.  Cool, comfortable clothes are the best. Take lukewarm baths.  One can add oatmeal or baking soda to the bath to help comfort the skin.  Pat the skin dry when done, never rub as this will only aggravate the skin more. Try hydrocortisone cream to heal the itch, or use a moisturizer to cool the skin. Avoid exposure to heat, and if needed take some Benadryl or other antihistamines.

Chickenpox is hard to avoid since it is an airborne disease.  One can be vaccinated for it, but many times, people are exposed to chickenpox before the person knows they even have it. A vaccine will usually prevent the illness all together or just give a mild case of it.

 

Reference Sources:

1. NSW Health Department

2. Immunise

Cellulitis

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What is Cellulitis?

Cellulitis is a bacterial skin infection. It appears as a red, swollen area of the skin. It is hot to the touch and feels tender. It has a tendency to spread fast over the body. The lower legs are most commonly effected by cellulitis in adults, although it can occur anywhere on the body, even the face.   In children, it commonly affects the face and the anus.  It effects the surface of the skin, and in some cases effects the tissues underlying the skin, spreading to the bloodstream and the lymph nodes.  If not treated, it can spread and be fatal.

Cellulitis Symptoms

Symptoms of cellulitis include redness, swelling, tenderness, fever, warmth, and pain.  The redness of an area may spread over time. Red spots that are small can appear on top of the reddened skin, and small blisters might appear and then burst. If you have a fever, you will want to get medical attention asap, or if you have a rash that is tender, red and swollen or changing rapidly.  Muscle aches and pain, as well as chills could signal an infection of the skin. Fatigue and general ill feeling may accompany these. Nausea and vomiting, hair loss at the site of the infection, and joint stiffness caused by swelling of the tissue over the joint are all symptoms of cellulitis as well.

How does Cellulitis spread?

Cellulitis appears on the skin when bacteria enters the skin through a crack.  It commonly happens on the legs, with bacteria entering where there was a recent surgery, where there is an ulcer, a cut, a wound, athletes foot or dermatitis.  People that have recently got a tattoo or piercing should be concerned about cellulitis.  Those who have weakened immune systems are susceptible to cellulitis as well.   Do note that certain spider bites and insect bites can transmit the bacteria that starts cellulitis. Dry, flaky skin or swollen skin can also be an entry point for the bacteria to enter.

Other Skin Conditions and Diseases Associated to Cellulitis

There are many risk factors associated with cellulitis.  Those include skin conditions such as shingles, chicken pox, athletes foot, and eczema. When breaks appear in the skin, there is a place for the bacteria to enter. Swelling of the arms or legs may result in swollen skin the cracks. If one has had cellulitis before, they are more prone to get it again. If one is obese, this increases the likely that they will not only get cellulitis, but have repeat episodes.

Cellulitis Treatment and Prevention

An exam of the skin will be needed to determine if you have cellulitis.  Often times no other testing is done, however in some cases a blood culture, a complete blood count, or a culture of any other fluid inside the effected area may be done.   It will be treated with antibiotics.  Usually within 3 days, the cellulitis should start looking better. If it does not, let the doctor know.  Usually a round of antibiotics will be prescribed for up to 14 days. Keep taking the prescribed meds even if you do feel better or the skin clears up.   If the infection becomes severe, one may need to be hospitalized to have IV antibiotics to go directly into the bloodstream.  The effected area will need to be rested, and dead skin tissue may need to be cut away.

One can prevent cellulitis from happening. Keep the skin clean and take good care of it. Prevent skin from cracking by applying lotion. If you have diabetes, check the feet and legs often.  If you do have a wound, wash it daily with warm water and soap.  Dry well and then apply an antibiotic cream.  Be on the lookout for signs of infection, such as drainage, redness and pain.

 

Reference Sources:

1. Royal Childrens Hospital Melbourne

2. National Institutes of Health

 

Bowen’s Disease

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What is Bowen’s Disease?

Bowen’s disease is also known as squamous cell carcinoma in situ .  This disease is easily curable.  The cells make up the outer layer of skin. All the cancerous cells are in the top layer. The cancer cells may spread along the top layer, but it is a very slow moving process, and could take years to do.  Only 3 to 5 % of patients with Bowen’s disease experience the disease moving into deeper layers of the skin.  In this case, it would turn into another form of skin cancer. If left untreated, there are risks that could be associated with it.

Bowen’s Disease Symptoms

Bowen’s disease can effect any portion of the skin.  It is commonly seen on the arms, legs and trunk. It will most likely appear as a scaly patch on the skin that is red, and may or may not itch.  It is about 1 to 3 cm in diameter.  The skin can bleed, scab over and be sore. It is more common in woman then in men and will usually effect those that are in their 70s to 80s. More often than not, it will appear on those that have had lots of exposure to the sun, and is seen on many with fair skin.  However, it has been known to show up in areas that would not see exposure to sunlight, such as the genitals.   It is common to effect those that are taking medications to suppress the immune system.

Bowen’s Disease is not genetic, and it can not be passed through skin contact. It is rarely related to arsenic exposure.  One is at more of a risk for developing Bowen’s disease if they have had radiotherapy in the effected area.

Bowen’s Disease Treatments

There are many treatments available for Bowen disease.  A dermatologist will examine the skin, looking at the size and thickness, as well as the number of patches on the skin to determine the best treatment option.  Treatment options include:

  • Cryotherapy- The effected skin will be sprayed with nitrogen in a liquid form. The effected area could weep and blister, and a scab will form. The scab will fall off within a few weeks, and remove the effected skin.
  • Curettage and Cautery- The skin that is effected is scraped away. Local anesthetics are used. Heat or electricity will stop any bleeding.  The area will scab over, and heal within a few weeks.
  • Photodynamic Therapy- Effected skin will have a light sensitive cream applied to it.  A laser will be moved over the skin 4 to 6 hours later, which will destroy all abnormal cells. One will need more than one treatment with photodynamic therapy.  It takes about 45 minutes to do the process.  After the laser treatment  is done, a bandage will be applied to protect the skin from light.
  • Imiquimod Cream or Chemotherapy cream- The cream will be applied to the skin that is effected over a period of time.  Skin could become red and inflamed with use.
  • Surgery- Abnormal skin cells are cut out, with stitches needed more than likely. This works well if there is just a small patch.

Bowen’s disease is fully treatable, however, it is best to have it treated right away before damage is further done.  With a wide range of treatments, you and your dermatologist will be able to successfully remove the effected skin.  It will take time to heal back into normal skin.  Do note that if the effected treated skin begins to bleed or change in appearance, such as a lump developing, one should see their dermatologist immediately.  Always follow up protocol that the doctor has set up, such as applying sunscreen and wearing protective clothing.

 

Reference Sources:

1. Royal Australian College of General Practitioners

2. Cancer Council Australia

Bullous Pemphigoid

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What is Bullous Pemphigoid?

PLEASE NOTE: Advanced Dermatology does not treat  Bullous P. at this current time. This article is for education and information purposes only. 

Bullous Pemphigoid is a chronic skin disease that is rare. It causes fluid filled blisters that are very large on areas of the skin that flex.  The fluid is clear, but could also contain some blood. The skin around the blisters can be red, but sometimes appears to be normal.   The most common places are the upper thighs, armpits, and lower abdomen. It happens commonly in those that are over the age of 60. Skin can be very itchy.  Blisters or sores may also appear in the mouth. Mucous membranes may become red and sore, but this is very rare.   If the disease is not treated, it can last for months or even years.  If a blister ruptures and becomes infected, one can get Sepsis,  which is life threatening.  This usually occurs in adults that are in very poor health and are older.   It is a result of the immune system attacking a thin layer of skin that is below the outer layer of skin.

There are many forms of Bullous Pemphigoid.  They include:

  • infant form:  Blisters on the skin that frequent the palms, soles, and face.  About 60% of the cases will have generalized blisters. Blisters could also appear on the genitals.
  • Nodular form:  This is a rare form with blisters on normal appearing or nodular lesional skin. It resembles Prurigo nodularis.
  • Generalized bullous form:  This is the most common form of Bullous Pemphigoid.  Tense bullae(multiple blisters) form on any part of the skin, mainly on parts that flex.
  • Vesicular form:  This form is not as common as generalized. Small, tense blisters will form, usually on a urtical or erythematous base.
  • Generalized Erythematous form- This is a rare form that resembles psoriasis, generalized atopic dermatitis, or other skin conditions.
  • Acral form- Commonly effects the palms, face and soles, it is associated with vaccinations.
  • Vegative form-  Not common, effects the groin, neck, and other infra-mammary areas.

Causes of Bullous Pemphigoid

Causes of Bullous Pemphigoid is not fully known.  However, certain prescription drugs could be the culprit.  Those medications include penicillin, furosemide, etanercept, and sulfasalazine.  Radiation therapy can also be a cause, as can UV light therapy.

What if I have Bullous Pemphigoid?

If you suspect that you have Bullous Pemphigoid, you should see your doctor.  He or she will examine the skin and may also take a sample for testing. If confirmed for Bullous Pemphigoid, your doctor will prescribe some medications for treatment. This might include corticosteroids. This could be in a pill form, such as prednisone, or a cream that you could apply to the effected area.  Immunosuppressants could also be prescribed ,which will inhibit the production of white blood cells. Immunosuppressants are often used so one does not have to take as high of a dose of prednisone. Anti-inflammatories may also be prescribed to use alone or in conjunction with other treatments.

Should you be diagnosed with Bullous Pemphigoid, you will want to avoid exposure of the sun. If you must be out in the sun, keep the area effected covered. Watch the foods that you eat as well, especially if you have blisters in your mouth. Hard, crunchy foods will only aggravate the symptoms more. Skin is fragile due to not only Bullous Pemphigoid, but also from corticosteroid cream, so avoid injuring the area.  Should you have a blister break, cover it with a dressing to avoid infection.

Bullous Pemphigoid can be fully treatable, and many manage just fine with it.  In many cases, treatment is needed for many years.  Flareups can occur, but if one follows the treatment plan by their doctor, a good outlook can be seen.

Body Lice

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What are Body Lice?

Body lice are small insects that are about the size of a sesame seed.  They are about 2.3 to 3.6 mm in length. They are spread through close contact with other people who have become infected with the lice.  Pets do not have a role in transmitting body lice. Body lice live in seams and folds of clothing, and feed on the human skin. Waste matter and eggs are deposited onto human skin. They can live in clothing for up to one month, and will die within 5 to 7 days after they fall off a person if they are at room temperature.   They also like to live on bedding and will travel to the skin several times a day to feed on blood. The most common sites for body lice to live are places where seams in clothing are most likely to touch the skin, such as the groin, waist and armpit.

 How do I know if I have Body Lice?

The main symptom of body lice is itching. The itching is often intense.  If you suspect you do have body lice, and upping your personal hygiene does not help, contact your doctor.  A skin infection could also develop from excessive scratching, in which a doctor will also need to be seen then.

Those who are at the highest risk for body lice include those that work with homeless people, war refugees, or victims of a natural disaster. Complications can develop from body lice, such as secondary infections.  With secondary infections, the body lice will scratch and dig into the skin.  This causes the person infected with the body lice to itch. Skin could become irritated, and could be rubbed raw, causing secondary infections.  The skin could also change, becoming thicker and discolored if the body lice is allowed to live on the skin for a long time. The thicker skin and discoloration usually happen on the upper thighs, waist and groin area.  If the body lice are allowed to spread, it could carry some diseases that are bacterial, such as typhus.  This rarely happens.

Body Lice Treatment and Prevention

If you have body lice, your doctor will be able to tell from an exam of the skin. Your clothing could also be examined.  The doctor will most likely have you wash yourself with hot water and soap.  All clothing and bedding should also be washed in hot water and soap to kill the body lice.   The water should be at least 60 degree Celsius.  Use a high heat drying cycle.   If an item can not be washed, place in a sealed bag for two weeks to kill the lice.   An over the counter product can also be used, such as Nix or Rid. If these have not worked for you, tell your doctor and he or she may prescribe a prescription cream.  However, do note that these creams can be very toxic to humans, so only use as directed.  A body wash may also be prescribed.  These body washes and creams usually contain malathione, benzyl alcohol, or permethrin.

One can prevent body lice by washing or bathing daily.  Body lice tend to infect that do not wash on a regular basis and do not wash bedding and clothing on a regular basis.  Wash all bedding at least once a week to prevent body lice.  Do not share bedding with anyone that has body lice.  Towels and clothing should also not be shared.

Even the cleanest persons can have body lice.  An infected person with body lice could come close to you, and the lice could jump onto you, creating an infestation.  It is best to get the infestation taken care of before it becomes out of control.

Basal Cell Carcinoma

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What is Basal Cell Carcinoma?

Basal Cell Carcinoma is the most common type of skin cancer. However, it rarely kills anyone or metastasizes, but is still considered to be malignant due to the fact that it can cause significant damage and disfigurement. About 30% of Caucasians will develop basal cell carcinoma in their lifespan.

What are the symptoms of Basal Cell Carcinoma?

Signs of basal cell carcinoma include shiny, pearly nodules. But there can also be red patches that look similar to eczema. It is often difficult to tell if one has basal cell carcinoma unless the skin is examined by a doctor.  It often resembles acne scars, actinic keratosis, and cryodestruction inflammation. It most often occurs in areas that are exposed to the sun.  About 80% of cases are  seen on the head and neck.

To diagnose basal cell carcinoma, a doctor will do a skin biopsy.  This entails taking a small piece of the skin and sending it to a lab to be examined. Under local anesthesia, a shave biopsy could be done. Other methods could be used, but a shave biopsy is the most common.

Examine your skin on a monthly basis.  If you notice any of the following, schedule a doctor’s appointment to have your skin looked at:

  • An open sore that bleeds, oozes and crusts over could be a sign of Basal cell carcinoma (BCC). This sore could heal up and then bleed again. A sore that does not heal is often a sign of BCC.
  • Any reddish patches that are irritated, itch and crust over could also be a sign of BCC.  They may form on the face, shoulders, chest, arms and legs.
  • A shiny or pearly nodule that is either pink, white or red. These are often confused with moles and can be tan, brown or black in color in darker haired persons.
  • A pink growth on the skin that has blood vessels that are developing on the surface. It will have a slightly elevated rolled border and a crusted indentation in the center.
  • A scar like area could be a sign of BCC.  If it is white, yellow or waxy in appearance, and has poorly defined borders with shiny and taut skin, BCC may be present. This could signify that there is invasive BCC that is larger than it appears to be.

How to Prevent Basal Cell Carcinoma?

There are many things that one can do to prevent Basal Cell Carcinoma.  First off, do not allow the skin to burn, and always apply sunscreen. It is best to apply sunscreen 20 to 30 minutes before heading outdoors to allow it time to soak into the skin.  Reapply every 2 hours.  Use a sunscreen that is at least SPF 15, if not higher.   Seek shade when you are outdoors and avoid the sun from 10 AM to 4 PM.  Wear sunglasses and wide brimmed hats and light long sleeved clothing. Avoid tanning beds and booths at all costs.

Basal Cell Carcinoma Treatment

If you are unfortunate enough to have basal cell carcinoma, there are many treatment options you and your doctor can discuss.  Using local anesthesia, your dermatologist could perform Mohs Micrographic surgery. A very thin layer of the tissue with the tumor will be removed.  The tissue will be examined under a microscope, and if the tumor is still present in the layer examined, the process will be repeated until it is tumor free. This treatment has the highest cure rate.

Excisional surgery could also be done. Using local anesthesia, a scalpel will remove the growth along with normal skin around the cancer. The skin will be closed with stitches and the tissue is sent to a lab to determine if all the malignant cells have been removed. About 90% of patients have been cured using this treatment.

The good thing is that BCC is treatable.  However, it can be prevented just by taking proper precautions.

 

Reference Sources:

1. Australasian College of Dermatologists

2. Cancer Council Victoria

3. Cancer Council Australia

Boils

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What are Boils?

Boils are skin abscesses that are a collection of pus on the skin. It starts in the hair follicles or oil glands. The skin will turn red, and a lump that is tender will develop.  It will turn white in 4 to 7 days, as pus begins to form.  They will become more painful until they rupture and drain.   The most common places for boils to form are the face, armpits, shoulders, neck, and buttocks.  They usually form where  sweat is likely to form or there is friction.   If a boil forms on the eyelid, it is called a sty.  Boils are not contagious, however the bacteria that forms the boil is.

What Causes Boils?

There are many causes of boils.  Poor hygiene can cause a boil, as can diabetes.  Those with problems with the immune system are more susceptible to boils. Poor nutrition could also lead to boils.  Exposure to harsh chemicals can also make a boil form.

Boils usually start out about half an inch in size as a lump on the skin.  Within 48 hours or so, the lump becomes larger, softer and much more painful.  A pocket of pus will form. If a severe infection takes place one will notice that the skin around the boil has become infected. It will be painful to the touch, warm, red and swollen.  More boils may appear around the original boil.  The lymph nodes may become swollen and a fever could be present.  You will need to seek medical assistance if you start running a fever, have the swollen lymph nodes, the pain becomes very severe, the boil will not drain, another boil or boils appear, or if you have  a heart murmur, diabetes, have immune system troubles, or are using immune suppressing drugs. Also seek medical attention for a boil if you are in poor health or have chills with a fever.

Boils Treatment

Home treatment for a boil includes applying a warm compress or soaking the boil in warm water. This will draw the pus to the surface of the boil and also bring relief to it.  When the boil has come to a head, it will burst. When it does burst, it will have repeated drainings.  Once it has drained, wash well with an antibacterial soap, and then clean with rubbing alcohol. Then apply a topical ointment and bandage. One can also continue on with the warm compresses a few times daily. The area should be washed two to three times a day.  Never pop a boil yourself.  This could make the boil worse and lead to an infection.  If a boil does need to be popped, have a doctor lance it. The doctor will make a small incision at the tip of the boil.  If an infection can not be completely be drained, it may be packed with sterile gauze to help soak up the pus.

Tea tree oil can be applied to a boil.  Tea tree oil is an antiseptic that can heal boils.  Do note that tea tree oil can cause an allergic reaction to some, so take caution using it.

If a boil is severe, a doctor may prescribe antibiotics.  A culture may be done to see what type of bacteria caused the infection .

After treating a boil, make sure to wash hands well with soap and water. Make sure to wash all bedding and towels that have touched the boils.

It is not always possible to prevent a boil from happening, but there are a few things that you can do to try and prevent them.  Avoid  sharing  personal items, such as towels, and  razors.  Wash hands frequently, and keep all wounds covered  until they have healed.

Albinism

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What is Albinism?

Albinism is a condition in which people have little or no pigment in their eyes, hair, or skin.  There are two kinds of albinism:  those that effect only the eyes (ocular) and oculocutaneous, which effects the eyes, skin and hair.   It effects people of all races. Most that are born with albinism have parents that have normal hair and eye color for the ethnicity. A common myth is that those with albinism  have red eyes when in fact the amount of pigment in those that have albinism varies. Most of the people with albinism have blue eyes, but some have red violet eyes. However, do note that those with albinism suffer from eye issues, as well as problems with the skin.   People who have albinism have faced ridicule, and are often harassed due to those not understanding what the term means. Approximately one in 17,000 will be an albino. The highest population that have albinism is the people of the sub-Saharan desert.

Types of Albinism

There are four different forms of albinism.  Those include:

  • Oculocutaneous albinism type 1(OCA1):  Type 1 is a result of a genetic defect in which an enzyme called tyrosinase helps the body change amino acid tyrosine into a pigment. With OCA1, there are two types:  OCA1A and OCA1B.  With OCA1A, this enzyme is inactive and no melatonin is produced. White hair and very light skin are then formed. With OCA1B, the enzyme is active slightly, with a small amount of melatonin produced. The hair will then darken to blonde, yellow/orange, or light brown.  There will also be more pigmentation to the skin.
  • Oculocutaneous albinism type 2 (OCA2):  Type 2 results from a genetic defect. This defect is found in the P protein and will help the tyrosinase enzyme function.  Melatonin is produced at a minimum, so individuals can have light blonde to brown hair.
  • Oculocutaneous albinism type 3 (OCA3):  Type 3 is from a genetic defect from TYRP1, a protein that is related to tyrosinase. With type 3, there can be substantial amount of pigment to the skin.
  • Oculocutaneous albinism type 4: (OCA4):  Type 4 is also from a genetic defect, but is from the SLC45A2 protein.  This protein helps tyrosinase to help function.  There are small amounts of melatonin pigment produced.

If a person has albinism, they will always have eye problems.  These issues will not be correctable with glasses. How impacted the vision is depends on the different type of albinism a person has.  Many people with albinism are legally blind but do not read Braille.  They still use their vision in many ways. Some are even able to operate a vehicle.

Many will albinism will have astigmatism.  They can be far or near sighted, and may have a sensitivity to a bright light or glares ( this is referred to as photophobia).  They may have a lazy eye, or eyes that cross.  They may have optic nerve misrouting, in which the nerve signals from the retina to the brain do not follow the usual routes.

Another issue many face with albinism are skin issues. Many are very fair in complexion, so sun damage is a real concern. Those with albinism should always wear sunscreen, a wide brimmed hat and sunglasses to protect themselves.  They will also want to limit sun exposure and stay inside when the UV rays are at their peaks.   People with albinism should also have their skin checked out on a normal basis by the dermatologist.

Albinism Treatment

Treatment consists of visual rehabilitation. Surgery may also be done on the eyes.  Contact lenses might be prescribed to block out light transmission through the iris.   There is no cure for albinism.

Actinic Keratosis

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What is Actinic Keratosis

Actinic Keratosis is formed from years of exposure to the sun. It is rough, crusty, and scaly looking, and is commonly found on the face, ears, lips, forearms, scalp, neck, and back of the hands. Some also refer to it as solar keratosis.  It starts off slowly, and takes years to develop.  It will often first appear as a small spot on the skin.  Since it takes years to develop, it is usually only seen in older adults. The signs that one may have actinic keratosis are a dry, rough, scaly patch on the skin that is usually less than an inch in diameter. It could have a wart like surface, and is flat to slightly raised on the skin. It might itch or burn, and will be colored pink, brown, red or flesh colored.   One is more likely to develop actinic keratosis if they are over the age of 40, freckle or tend to burn in the sun, has pale skin, has red or blonde hair, has blue or light colored eyes, lives in a climate that is sunny, or has a weak immune system due to AIDS, chronic leukemia, organ transplant medications, or chemotherapy.   If one suspects they do have actinic keratosis, they should have the area checked out by a dermatologist before skin cancer develops. If not treated right away, the actinic keratosis could develop into squamous cell carcinoma, which is treatable if caught right away.  If left untreated, one has a 20% risk of progression to squamous cell carcinoma.

How to prevent Actinic Keratosis

Actinic keratosis can be prevented.  Sunscreen should always be worn, at least 20 minutes before sun exposure.  Reapply every 2 hours.  Limit your time in the sun and always make sure your SPF is at least 30.   Avoid the sun during the noon hours when the UV rays are the most powerful.  Wear hats and sunglasses, and long light sleeved clothing. Do not use tanning beds or booths, as they do cause actinic keratosis.

Actinic Keratosis Treatment

A doctor will usually just examine the area to determine if actinic keratosis is present.  However, in some cases biopsies or other testing may be done.  With a biopsy, a small segment of skin will be collected from the area after numbing it.  It will be sent to a lab to be examined.  Within a week one should have the results.

There are several medications that can be prescribed for actinic keratosis.  Those include any of the following:

  • Diclofenac gel
  • Ingenol mebutate gel
  • Imiquimod cream
  • Fluorouracil cream

In some cases, the dermatologist might recommend therapy be used on the effected area. Using photodynamic therapy, medication is applied to the skin to damage the skin cells that are sensitive to light. The skin will be exposed to laser light that is intense so it kills the damaged skin cells. Redness, swelling, or burning could take place during this treatment.

Cryotherapy can also be used for actinic keratosis. A substance will be applied to the skin that is extremely cold. The skin surface will then freeze, which will cause the skin to peel and blister. The skin will heal over time, causing the lesions to slough away. The therapy is relatively common and quick and easy to do. There may be blistering of the skin, scarring, changes in the texture of the skin, darkening of the skin, and infection.

Check your skin regularly for signs of damage.  If something does not appear right to you, or it is bothersome, schedule an appointment with your dermatologist.  Look for new growths on the skin, or moles that have changed in size or colors.  One should also check birthmarks, bumps and freckles.

 

Reference Sources:

1. American Academy of Dermatology