Skin diseases update

ALOPECIA autoimmune process associated with vitiligo thyroid and endocrine deficiency disorders Associated with Down's syndrom with emotional stress . Hair loss due to systemic disease, e.g., after acute febrile illnesses, surgical procedures systemic lupus erythematosus, syphilis low serum iron psoriasis . Toxic alopecia, e.g., with antimitotic drugs, heparin, thallium, warfarin, overdoses of vitamin A . Overprocessing hair loss from damage by hairdressing solutions Male-pattern baldness is familial; cause unknown Female-pattern hair thinning in the menopause; baldness rarely in old age Scarred alopecia following scar formation after inflammation and tissue destruction

ACNE ROSACEA Chronic inflammatory skin disease usually beginning in' middle age, characterized by telangiectasia, erythema, papules, and pustules, especially in center of face Causes Diet probably unimportant. May be evidence of vasomotor instability Psychological factors and menopausal flushing may be contributory Doubtful significance of alcohol consumption

Acne Vulgaris This is chronic condition associated with the blockage of the pilosebaceous duct by propioni bacterium acnes. It alter the cell mediated immune response aid to stimulate the classical and altemative complement pathways. Pro inflammatory mediators also induced by the organism on body .Such as the face, chest and back where sebaceous glands are most numerous and active. The Principle age of onset is at puberty when under the influence of androgenic hormones, sebaceous lards undergo hypertrophy and increased the production of sebum.

AMYLOID DISEASE Tissue infiltrates with insoluble proteins or protein-polysaccharide complexes leading to dysfunction of the organs involved Pathology and Causes 1: Primary (unknown etiology or that related to multiple myeloma) Approximately 70% of cases Plasma-cell dyscrasia with Bence Jones protein Tongue, heart, gastrointestinal tract, muscle, ligaments, and skin involved 2: Secondary (associated with chronic granulomatous diseases or infections, may also be hereditary, systemic as with rheumatoid arthritis or familial Mediterranean fever) Involves spleen, liver, kidneys, and adrenals . Mixed primary and secondary types occur in about 30% of cases Waxy appearance of intradermal amyloid deposition around the eye.

CELLULITIS Cellulitis refers to an infection involving not only the epidermis but also deeper layers of the skin: the dermis and subcutaneous tissueGroup A streptococcus and staphylococcus are the most common of cellulitis-causing bacteria, they are part of the normal flora of the skin but cause no actual infection until the skin is broken. Nevertheless other bacteria may cause cellulitis as well. The symptoms of cellulitis may resemble other dermatologic conditions. Location: Cellulitis frequently occurs on exposed ares of the body such as the arms and face, most often affects the legs. Predisposing conditions for cellulitis include insect bite, animal bite, pruritic skin rash, recent surgery, athlete's foot, swollen skin, dry skin, eczema, and burns. Patients with diabetes or impairment of the immune system are particularly susceptibile to developing cellulitis. Symptoms: cellulitis begins as a small area of tenderness, swelling, and redness on the skin. As this red area begins to spread, the person may develop a fever, headache, sometimes with chills and sweats, bruising and blisters on the affected area. Lymph nodes near the area of infected skin may become swollen.. Erysipelas - also called Saint Anthony's fire - is a form of rather superficial cellulitis caused by a species of hemolytic streptococcus; it is characterized by spreading hot, bright red circumscribed area on the skin with a sharp raised border accompanied by high fever and a feeling of general illness. Erysipelas in most cases affects the skin of the face, that is why when it strikes other parts of the body, it may often be misdiagnosed. Bacteremia (blood poisoning) and pneumonia are the most common complications. Erysipelas is a highly contagious disease that was formerly dangerous to life; however, it can now be quickly controlled by antibiotic therapy.

ECZEMA(DERMATITIS) Symptoms: thought to be related to allergies. Chronic forms of dermatitis tend to cause thickening, pigmentation, and scaling of the skin, whereas acute forms are characterized by a red, itching area of blisters and oozing. New research suggests that damage to the protective layer of the skin causes eczema. Use of a shielding lotion, which will replace this protective layer, is the best form of eczema treatment Atopic dermatitis - is a chronic disease affecting the skin, the most common of the many types of eczema, that is caused by general systemic allergic reactions, as opposed to contact with an irritant. Atopic dermatitis tends to run in families susceptible to asthma and hay fever and often occurs together with these diseases. Atopic dermatitis is characterized by itching and inflammation of the skin, causing scaling, thickening, pigmentation, redness, weeping, crusting and cracking. Contact dermatitis - is an allergenic reaction, the result of direct contact with an irritant. soap, detergents various household chemicals being handled or left on the clothes unrinsed, synthetic fibers, cosmetics and skin-care products, nail polish remover, antiperspirants. As well as wearing rubber gloves, unwashed new clothes, plated jewelry can also cause contact dermatitis. nickel-containing buttons and rivets on clothes(jeans). Among plants that may cause allergic reaction are: poison ivy, poison oak and poison sumac. .

Perioral dermatitis (muzzle rash) - is a common adult women problem, rarely occuring in men. It mainly affects persons with the oily skin, most frequently appear around the mouth, as groups of itchy or tender small red spots. These spots spare the skin bordering the lips, developing on the chin, upper lip and cheeks. The skin surface becomes dry and flaky. In cases when the skin around the nose and eyes is also involved, the condition is called periorificial dermatitis. This type of dermatitis may be induced by regular application of the moisturizing face creams, make-up foundations, sunscreens as well as usage of topical steroid creams to the area bounded by the cheek folds, chin and around eyes. Dermatitis herpetiformis (Duhring's disease) - is chronic disease of the skin characterized by severe itching and eruption of vesicles and groups of papules on the elbows, knees, back, and buttocks. In most cases, it is highly symmetric. Dermatitis herpetiformis is frequently associated with sensitivity of the intestine to gluten (a protein found in cereals) in the diet. Seborrh(o)eic dermatitis (dyssebacia, pityriasis alba, seborrheic dermatosis) - is a chronic form of dermatitis characterized by oily scales, crusty yellow patches, and itching. Seborrheic dermatitis occurs primarily on the scalp, face, upper body, as well as on the genitals, and in skin creases along the nose, under the breasts, and elsewhere, particularly affecting the sebum-gland rich areas of the skin. It is thought to be caused by a fungal infection caused by the yeast, Malassezia furfur (aka Pityrosporum ovale ) in individuals with decreased immunity and increased sebum production. Adult seborhheic dermatitis typically affects those between 20 and 40 years old. Infantile seborrh(o)eic dermatitis (cradle cap) - is a form of seborrheic dermatitis occuring in infants, it commonly begins sometime in the first 3 months and can affect any baby. Cradle cap is characterized by patchy, greasy, scaly and crusty skin rash on the scalp that is often prominent around the ear or the eyebrows (when it appears in other locations, it is called seborrheic dermatitis rather than cradle cap). It apparently doesn't itch and eventually goes away on its own. Cradle cap is supposed to be caused by hyperactive sebaceous glands in the skin of newborn babies, due to the mother's hormones still in the baby's circulation, there may also be a relationship with skin yeasts. Nummular dermatitis (discoid eczema) - is recurrent and chronic form of dermatitis, that may appear at any age, but is most common in people in their 60's. It is characterized by distinctive coin-shaped red itchy patches, that may affect any part of the body, but most commonly develop on the legs and buttocks. Flare-ups of the disease are associated with cold seasons, when the skin is getting dry. Stasis dermatitis (varicose eczema) - is the result of poor blood circulation in the lower legs, causing pooling of blood, fluid buildup and edema. This leads to unhealthy skin growth and irritation, especially around the ankles. It can happen later in life, in people with varicose veins, congestive heart failure, or other conditions.

PARONYCHIA The nail disease paronychia is an often-tender bacterial or fungal hand infection or foot infection where the nail and skin meet at the side or the base of a finger or toenail . The infection can start suddenly (acute paronychia) or gradually (chronic paronychia). The cuticle acts as a protective seal but if it's damaged in any way bacteria can enter the skin and cause infection. These infections can be extremely painful as the skin becomes inflamed, hot, red and throbs continually. Whitlows are common, especially for people who have to repeatedly wash their hands. Excess water weakens the seal, while soaps and detergents remove the protective skin oils leaving the skin dry and more liable to split. Most often, trauma to the cuticle allows infection in. Biting or picking at the cuticle, damage through work and overenthusiastic manicuring are the usual culprits. If someone has a cold sore and puts their finger in their mouth then a herpes infection whitlow may appear. Paronychia may be divided as follows: Acute paronychia Chronic paronychia Alternatively, paronychia may be divided as follows Candidal paronychia Pyogenic paronychia

MILIARIA RUBRA Miliaria (miliaria rubra, sweat rash, heat rash, or prickly heat) is a skin disease marked by small and itchy rashes . Miliaria is a common ailment in hot and humid conditions, such as in the tropics and during the summer season. Although it affects people of all ages, it is especially common in children and infants due to their underdeveloped sweat glands. Pathology Miliaria occurs when the sweat gland ducts get plugged due to dead skin cells or bacteria such as Staphylococcus epidermidis a common bacterium that occurs on the skin which is also associated with acne . The trapped sweat leads to irritation (prickling), itching and to a rash of very small blisters, usually in a localized area of the skin. Clinical features small red rashes- papules , which may itch or more often cause an intense 'pins-and-needles' prickling sensation These may simultaneously occur at a number of areas on a sufferer's body, the most common including the face, neck, under the breasts and under the scrotum. Other areas include skin folds , areas of the body that may rub against clothing, such as the back, chest, and stomach, etc. A related and sometimes simultaneous condition is folliculitis , where hair follicles become plugged with foreign matter, resulting in inflammation. The symptoms relating to miliaria should not be confused with shingles as they can be very similar. Shingles will restrict itself to one side of the body but also has a rash-like appearance. It is also accompanied by a prickling sensation and pain throughout the region. Those who suspect they have shingles and not miliaria should seek medical advice immediately as the sooner antivirals are taken, the better.

KELOID A keloid (also known as a "keloidal scar is a type of scar , which depending on its maturity, is composed of mainly either type III (early) or type I (late) collagen . It is a result of an overgrowth of granulation tissue (collagen type 3) at the site of a healed skin injury which is then slowly replaced by collagen type 1. Keloids are firm, rubbery lesions or shiny, fibrous nodules , and can vary from pink to flesh-coloured or red to dark brown in colour. A keloid scar is benign , non-contagious, and sometimes accompanied by severe itchiness and pains, and changes in texture. In severe cases, it can affect movement of skin. Keloids should not be confused with hypertrophic scars , which are raised scars that do not grow beyond the boundaries of the original wound.

PSORIASIS Psoriasis is a skin disease that causes itchy or sore patches of thick, red skin with silvery scales. You usually get them on your elbows, knees, scalp, back, face, palms and feet, but they can show up on other parts of your body. A problem with your immune system causes psoriasis. In a process called cell turnover, skin cells that grow deep in your skin rise to the surface. Normally, this takes a month. In psoriasis, it happens in just days because your cells rise too fast Things that make them worse include Infections Stress Dry skin Certain medicines Psoriasis usually occurs in adults. It sometimes runs in families. Treatments include creams, medications and light therapy..

SCABIES Scabies is an itchy skin condition caused by the microscopic mite Sarcoptes scabei . It is common all over the world, and it affects people of all races and social classes. Scabies spreads quickly in crowded conditions where there is frequent skin-to-skin contact between people. Hospitals, child-care centers and nursing homes are examples. Scabies can easily infect sex partners and other household members. Sharing clothes, towels, and bedding can also spread scabies. You cannot get scabies from a pet. Pets get a different mite infection called mange. Symptoms are Pimple-like irritations or a rash Intense itching, especially at night Sores caused by scratching Several lotions are available to treat scabies. The infected person's clothes, bedding and towels should be washed in hot water and dried in a hot dryer.

Pityriasis alba is a common skin disorder similar to very mild eczema . Causes The cause is unknown. The disorder is most common in children and adolescents -- particularly in children with dark skin. Symptoms Round or oval, colorless patches of skin appear on the face, upper arms, neck, and upper middle of the body. There may be flaky skin, called scales . The patches don't tan, but may get red quickly in the sun. Treatment Symptoms are treated with moisturizers and mild topical steroid creams. The patches usually clear up, but may return. Pityriasis alba

URTICARIA/nettle rash Hives are red and sometimes itchy bumps on your skin. An allergic reaction to a drug or food usually causes them. Allergic reactions cause your body to release chemicals that can make your skin swell up in hives. People who have other allergies are more likely to get hives than other people. Other causes include infections and stress Hives are very common. They usually go away on their own, but if you have a serious case, you might need medicine or a shot. In rare cases, allergic reactions can cause a dangerous swelling in your airways, making it hard to breathe - which is a medical emergency.

BASAL CELL CARCINOMA Basal cell carcinoma is the most common type of skin cancer . It rarely metastasizes or kills, but it is still considered malignant because it can cause significant destruction and disfigurement by invading surrounding tissues Pathophysiology Basal cell carcinomas develop in the basal cell layer of the skin . Sun light exposure leads to the formation of thymine dimers , a form of DNA damage. While DNA repair removes most UV-induced damage, not all crosslinks are excised. There is, therefore, cumulative DNA damage leading to mutations . Apart from the mutagenesis, sunlight depresses the local immune system , possibly decreasing immune surveillance for new tumor cells.

Seborrheic dermatitis Seborrheic dermatitis is a common, inflammatory skin condition that causes flaky, white to yellowish scales to form on oily areas such as the scalp or inside the ear. It can occur with or without reddened skin. Cradle cap is the term used when seborrheic dermatitis affects the scalp of infants. Causes Seborrheic dermatitis is thought to be due to a combination of an over production of skin oil and irritation from a yeast called malessizia. Seborrheic dermatitis appears to run in families. Stress, fatigue, weather extremes, oily skin, infrequent shampoos or skin cleaning, use of lotions that contain alcohol, skin disorders (such as acne), or obesity may increase the risk. Neurologic conditions, including Parkinson's disease , head injury , and stroke may be associated with seborrheic dermatitis. Human immunodeficiency virus (HIV) has also been linked to increased cases of seborrheic dermatitis.

Symptoms . Typically it forms where the skin is oily or greasy. Commonly affected areas include the scalp, eyebrows, eyelids, creases of the nose, lips, behind the ears, in the external ear, and along skin folds on the middle of the body. Seborrheic dermatitis in infants, also called cradle cap, is a harmless, temporary condition. It appears as thick, crusty, yellow or brown scales over the child's scalp. Similar scales may also be found on the eyelids, ear, around the nose, and in the groin. Cradle cap may be seen in newborns and small children up to age 3 . Cradle cap is not contagious, nor is it caused by poor hygiene. It is not an allergy, and it is not dangerous. Cradle cap may or may not itch. If it itches, excessive scratching of the area may cause additional inflammation, and breaks in skin may cause mild infections or bleeding. In general, symptoms of seborrheic dermatitis include: Skin lesions Plaques over large area Greasy, oily areas of skin Skin scales -- white and flaking, or yellowish, oily, and adherent -- "dandruff" Itching -- may become more itchy if infected Mild redness Hair loss

Burns and Scalds Burns are injuries to tissues caused by heat, friction, electricity, radiation, or chemicals. Scalds are a type of burn caused by a hot liquid steam Burns and Scalds - Description A first degree burn causes redness and swelling in the outermost layers of the skin. A second degree burn involves redness, swelling, and blistering. The damage may extend to deeper layers of the skin. A third degree burn destroys the entire depth of the skin. It can also damage fat, muscle, organs, or bone beneath the skin. Significant scarring is common, and death can occur in the most severe cases. causes hot objects a rope burn is caused by friction between the rope and a person's body. The rope itself is not hot, but the heat produced by friction is sufficient to cause a burn. Chemicals can also cause burns. The chemicals attack and destroy cells in skin tissue. They produce an effect very similar to that of a heat burn. signs redness, swelling, and pain in the affected area. blister. A burn may also trigger a headache and fever. The most serious burns may cause shock. The symptoms of shock include faintness, weakness, rapid pulse and breathing, pale and clammy skin, and bluish lips and fingernails.

Skin discolouration/dyschromia Definition Skin that has turned darker or lighter than normal is usually not a sign of a serious medical condition. Causes Infectious Disorders (Specific Agent) Bejel Neoplastic Disorders Melanoma, malignant Nevus, junctional Melanoma, juvenile Paraneoplastic syndrome/Oat cell cancer Neurofibroma Pituitary adenoma, ACTH secreting Metabolic, Storage Disorders Hemochromatosis Alkaptonuria/Ochronosis Hereditary, Familial, Genetic Disorders Dysplastic Nevus Syndrome, Familal Basal cell nevus syndrome ( Gorlin ) Neurofibromatosis Peutz-Jegher's intestinal polyposis Fanconi's pancytopenia-dysmelia synd Drugs Cushings secondary/drug-induced syndr .

Functional, Physiologic Variant Disorders Specific activity/hobby/occupation Vegetative, Autonomic, Endocrine Disorders Melanoderma Addison's disease (chronic adrenal ins) Cushing's disease/Syndrome Adrenocorticoid Deficiency Reference to Organ System Hyperpigmentation Urticaria pigmentosa Eponymic, Esoteric Disorders Blue rubber bleb nevus syndrome Poisoning (Specific Agent) Tobacco smoking/excess Acid ingestion Iodine poisoning Nitric acid poisoning Potassium permanganate poisoning

vitiligo Vitiligo is a chronic disorder that causes depigmentation in patches of skin . It occurs when the melanocytes , the cells responsible for skin pigmentation which are derived from the neural crest , die or are unable to function. Signs and symptoms depigmentation of patches of skin that occurs on the extremities. Although patches are initially small, they often enlarge and change shape skin lesions occur, they are most prominent on the face, hands and wrists Depigmentation is particularly noticeable around body orifices, such as the mouth, eyes, nostrils , genitalia and umbilicus . Some lesions have hyperpigmentation around the edges.In regards to psychological damage, vitiligo can have a significant effect on the mental health of a patient. Psychological stress , depression & mood disorders

Segmental vitiligo Segmental vitiligo (SV) differs in appearance Non-segmental vitiligo In Non-segmental vitiligo (NSV), there is usually some form of symmetry in the location of the patches of depigmentation. New patches also appear over time, and can be generalised over large portions of the body, or localised to a particular area pathogenesis Vitiligo is a complex, polygenic disorder characterized by patchy loss of skin pigmentation due to abnormal melanocyte function. Both genetic and environmental etiological factors have been proposed for vitiligo Vitiligo is sometime associated with autoimmune and inflammatory diseases commonly thyroid overexpression and underexpression.

warts A wart (also known as a verruca when occurring on the sole of the foot or on toes) is generally a small, rough tumor , typically on hands and feet but often other locations, that can resemble a cauliflower or a solid blister . Warts are common, and are caused by a viral infection, specifically by the human papillomavirus (HPV) [1] and are contagious when in contact with the skin of an infected person. It is also possible to get warts from using condoms or other objects used by an infected person. They typically disappear after a few months but can last for years and can recur.

Leprosy( hansen’s diseases) Leprosy is an infectious disease that has been known since biblical times. It is characterized by disfiguring skin sores, nerve damage, and progressive debilitation. Leprosy is caused by the organism Mycobacteriumleprae . It is not very contagious (difficult to transmit) and has a long incubation period (time before symptoms appear), which makes it difficult to determine where or when the disease was contracted. Children are more susceptible than adults to contracting the disease. Leprosy has two common forms, tuberculoid and lepromatous , and these have been further subdivided. Both forms produce sores on the skin, but the lepromatous form is most severe, producing large, disfiguring lumps and bumps ( nodules ). All forms of the disease eventually cause nerve damage in the arms and legs, which causes sensory loss in the skin and muscle weakness. People with long-term leprosy may lose the use of their hands or feet due to repeated injury resulting from lack of sensation. Symptoms include : Skin lesions that are lighter than your normal skin color Lesions have decreased sensation to touch, heat, or pain Lesions do not heal after several weeks to months Numbness or absent sensation in the hands, arms, feet, and legs Muscle weakness

hyperhydrosis Hyperhidrosis is a medical condition in which a person sweats excessively and unpredictably. People with hyperhidrosis may sweat even when the temperature is cool or when they are at rest Causes Sweating is physiological process n occur excessivly when one is nervous, angry, embarrassed, or afraid or after exercise Those with hyperhidrosis appear to have overactive sweat glands. The uncontrollable sweating can lead to significant discomfort, both physical and emotional. When excessive sweating affects the hands, feet, and armpits, it's called primary or focal hyperhidrosis . Primary hyperhidrosis affects 2 - 3% of the population, yet less than 40% of patients with this condition seek medical advice. In the majority of primary hyperhidrosis cases, no cause can be found. It seems to run in families. If the sweating occurs as a result of another medical condition, it is called secondary hyperhidrosis . The sweating may be all over the body, or it may be in one area. Conditions that cause second hyperhidrosis include: Acromegaly Anxiety conditions Cancer Carcinoid syndrome Certain medications and substances of abuse Glucose control disorders Heart disease Hyperthyroidism Lung disease Menopause Parkinson’s disease Pheochromocytoma Spinal cord injury Stroke Tuberculosis or other infections

Bromidrosis Body odor, often abbreviated as B.O. , or bromhidrosis (also called osmidrosis and ozochrotia and known alternatively as Apocrine bromhidrosis , Bromidrosis , Fetid sweat , Body smell , Malodorous sweating , and Osmidrosis ) is the smell of bacteria growing on the body . These bacteria multiply rapidly in the presence of sweat , but sweat itself is almost completely odorless to humans Body odor can smell pleasant and specific to the individual, and can be used to identify people, though this is more often done by dogs and other animals than by humans . An individual's body odor is also influenced by diet , gender , genetics , health and medication . Propionic acid (propanoic acid) is present in many sweat samples. This acid is a breakdown product of some amino acids by propionibacteria , which thrive in the ducts of adolescent and adult sebaceous glands. Because propionic acid is chemically similar to acetic acid with similar physical characteristics including odor, body odors may be identified as having a vinegar-like smell by certain people.[ citation needed ] Isovaleric acid (3-methyl butanoic acid) is the other source of body odor as a result of actions of the bacteria Staphylococcus epidermidis , which is also present in several strong cheese types Genetics Body odor is largely influenced by major histocompatibility complex (MHC) molecules. These are genetically determined and play an important role in immunity of the organism. The vomeronasal organ contains cells sensitive to MHC molecules in a genotype-specific way. Experiments on animals and volunteers have shown that potential sexual partners tend to be perceived more attractive if their MHC composition is substantially different

Onychatrophia Onychatrophia is very common nail diorder. Onychatrophia is an atrophy or wasting away of the nail plate which causes it to lose its luster, become smaller and sometimes shed entirely. Injury or disease may account for this irregularity. Onychatrophia Symptoms Here are the list of symptoms of Onychatrophia skin lesion located in the skin around the nail, often at the cuticle or at the site of a hangnail or other injury painful onset sudden (bacterial) or gradual (fungal, mixed infection) may persist (fungal, mixed infection) may be acute or chronic redness, localized swelling , localized pus-filled blisters (especially with bacterial infection) swelling of the finger or the cuticle nail changes discoloration distorted shape detached

Skin lacerations A cut refers to a skin wound with separation of the connective tissue elements. Unlike an abrasion (a wound caused by friction or scraping), none of the skin is missing the skin is just separated. A cut is typically thought of as a wound caused by a sharp object (such as a knife or a shard of glass). The term laceration implies a torn or jagged wound. Lacerations tend to be caused by blunt trauma (such as a blow, fall, or collision). Cuts and lacerations are terms for the same condition Cuts or Lacerations Symptoms Although it can be obscured by blood, a cut is one of the easiest medical conditions to diagnose. A deep cut, may reveal underlying tissues such as fat, tendon , muscle , or bone. Some people faint at the sight of their own blood (this is a neurological reaction in which a reflex slowing of the heart causes a low blood pressure called vasovagal syncope ). Physicians need to distinguish this common faint from people who pass out from loss of blood ( hemorrhagic shock ).

Cracks of skin * A crack goes all the way through the skin on your hand or foot. * A cracked area feels warm or sore, is swollen or red or discharges pus or fluid. * The skin on your lower legs starts to resemble fishlike scales or alligator skin. Scaling Itching Cracks in the skin Causes Dry skin is common. It happens more often in the winter when cold air outside and heated air inside cause low humidity. Forced-air furnaces make skin even drier. The skin loses moisture and may crack and peel, or become irritated and inflamed. Bathing too frequently, especially with harsh soaps, may contribute to dry skin. Eczema may cause dry skin.

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