Nail-Patella Syndrome (NPS) NAIL-PATELLA SYNDROME (NPS) by Justina May 15, 2024 written by Justina Nail-Patella Syndrome (NPS), also known as hereditary osteo-onychodysplasia (HOOD), is a rare genetic disorder characterized by abnormalities of the nails, knees, elbows, and pelvis. Although it primarily affects these areas, it can also involve other parts of the body. Causes of Nail-Patella Syndrome Nail-Patella Syndrome is caused by mutations in the LMX1B gene, which plays a key role in the development of various tissues and organs during embryonic development. These mutations disrupt the normal functioning of the gene, leading to the characteristic features of NPS. Prevalence NPS is a rare disorder, with an estimated prevalence of 1 in 50,000 individuals worldwide. However, the prevalence may vary among different populations. Symptoms Symptoms of Nail-Patella Syndrome can vary widely among affected individuals. Common features include: Abnormalities of the nails, such as absent or poorly developed nails (hypoplastic nails) or nails that are ridged, pitted, or discolored. Abnormalities of the knees, including underdeveloped or absent kneecaps (patellae), which can lead to instability and limited range of motion. Abnormalities of the elbows, hips, and pelvis, such as malformations or dislocations. Eye abnormalities, such as glaucoma or cataracts, in some cases. Risk Factors of Nail-Patella Syndrome Family History: The primary risk factor for Nail-Patella Syndrome (NPS) is inheriting a mutated copy of the LMX1B gene from one parent. The inheritance pattern of NPS is autosomal dominant, which means that only one copy of the mutated gene is sufficient to cause the disorder. Individuals with a family history of NPS are at an increased risk of developing the condition. If one parent carries the mutated LMX1B gene, each child has a 50% chance of inheriting the gene and developing NPS. De Novo Mutations: In rare cases, Nail-Patella Syndrome may occur due to de novo mutations, where the genetic mutation arises spontaneously in an individual with no family history of the disorder. These cases may not have a family history of NPS but still carry a risk of passing the condition to future generations. Diagnosis Diagnosing Nail-Patella Syndrome (NPS) typically involves several steps to assess various aspects of the condition. Here’s an overview of the diagnostic process: Clinical Evaluation: A comprehensive clinical evaluation is conducted, which includes a thorough review of the individual’s medical history and a detailed physical examination. During the physical exam, the healthcare provider may assess for characteristic signs and symptoms associated with Nail-Patella Syndrome, such as abnormalities of the nails, knees, elbows, and pelvis. Genetic Testing: Genetic testing may be recommended to confirm the diagnosis of Nail-Patella Syndrome. This typically involves analyzing DNA samples to identify mutations or variations in the LMX1B gene, which is known to be associated with NPS. Identifying mutations in the LMX1B gene helps establish a definitive diagnosis of the condition. Imaging Studies Imaging studies, such as X-rays or magnetic resonance imaging (MRI) scans, may be performed to evaluate skeletal abnormalities associated with Nail-Patella Syndrome. X-rays can help visualize structural abnormalities in the bones, joints, and pelvis, while MRI scans provide detailed images of soft tissues and can help assess the severity of joint abnormalities. Kidney Function Tests Since Nail-Patella Syndrome can affect kidney function in some individuals, kidney function tests may be conducted to assess renal involvement. These tests typically involve measuring levels of certain substances in the blood and urine, such as creatinine and protein, which can indicate kidney dysfunction or abnormalities. Ophthalmologic Evaluation In some cases, an ophthalmologic evaluation may be recommended to assess for ocular abnormalities associated with NPS. This may include a comprehensive eye examination to evaluate vision, eye structure, and potential abnormalities in the anterior segment of the eye. Referral to Specialists Depending on the specific signs and symptoms present in an individual with Nail-Patella Syndrome, referral to other medical specialists, such as orthopedic surgeons, nephrologists, or ophthalmologists, may be warranted for further evaluation and management of specific complications or manifestations of the condition. Treatments for Nail-Patella Syndrome There is no cure for Nail-Patella Syndrome, but various treatments can help manage the symptoms and complications associated with the condition. Treatment options may include: Physical therapy to improve joint mobility and strength. Orthopedic interventions, such as braces or surgery, to address skeletal abnormalities. Medications to manage pain and reduce inflammation, if necessary. Regular monitoring and management of associated conditions, such as glaucoma. Home Care Tips If you or your child has Nail-Patella Syndrome, there are steps you can take at home to promote overall health and well-being: Follow a balanced diet rich in nutrients, particularly calcium and vitamin D, to support bone health. Engage in regular physical activity to maintain joint flexibility and muscle strength. Practice good nail care to minimize the risk of infections or injuries. Prevention Since Nail-Patella Syndrome is a genetic disorder, it cannot be prevented. However, genetic counseling may be beneficial for individuals with a family history of NPS who are planning to have children. When to See a Doctor If you or your child exhibit any signs or symptoms of Nail-Patella Syndrome, such as nail abnormalities or joint problems, it is important to consult a healthcare professional for evaluation and diagnosis. Early intervention can help prevent or minimize complications associated with the condition. Outlook/Prognosis The outlook for individuals with Nail-Patella Syndrome varies depending on the severity of symptoms and associated complications. With appropriate management and support, many people with NPS can lead fulfilling lives and achieve optimal functioning. Sources: American Academy of Orthopaedic Surgeons. National Organization for Rare Disorders. Genetics Home Reference. NIH U.S. National Library of Medicine. (2022). Mayo Clinic. (2022). May 15, 2024 0 comment 0 FacebookTwitterPinterestLinkedinEmail
Nail Fungus NAIL FUNGUS by Justina May 15, 2024 written by Justina Nail fungus, medically known as onychomycosis, is a common condition affecting millions of people worldwide. It occurs when fungi infect one or more nails, leading to discoloration, thickening, and crumbling of the nail. While nail fungus is not usually painful, it can cause embarrassment and discomfort. Fungi, microscopic organisms, are responsible for this condition, similar to athlete’s foot but targeting the nails instead of the skin. While some types of fungi peacefully coexist on the skin, an overabundance in a specific area can lead to infection. Causes Nail fungus is primarily caused by dermatophyte fungi, including Candida and molds. These fungi thrive in warm, moist environments, making toenails more susceptible to infection than fingernails. Factors such as poor nail hygiene, trauma to the nail, weakened immune system, and wearing tight-fitting shoes contribute to its development. Fungal nail infections typically occur when fungus infiltrates a crack in the nail or the surrounding skin, finding an environment conducive to its growth. The warm and dark conditions commonly found in shoes create an ideal breeding ground for fungus, making toenails more susceptible to infection than fingernails. Additionally, the reduced blood flow to the toes compared to fingers hinders the body’s ability to detect and combat fungal growth effectively. Types of Nail Fungus There are four primary types of fungal nail infections, each exhibiting slightly different symptoms: Distal or Lateral Subungual Onychomycosis: This is the most common type, caused by a fungus known as a dermatophyte. It typically starts underneath the nail bed and manifests as a yellowish discoloration spreading from the edges to the center of the nail. The affected nail may separate from the nail bed. White Superficial Onychomycosis: Less common, this type affects the surface of the nail, particularly on the toes. It begins with white spots on the nail, which can become powdery and cause the nail to crumble. Proximal Subungual Onychomycosis: Initially, white spots appear in the center of the nail bed near the cuticle. These spots gradually move outward as the nail grows. This type is rare and predominantly affects individuals with compromised immune systems. Candidal Onychomycosis: Caused by yeast, this infection primarily affects fingernails. It often presents with swelling and inflammation around the nails, and the nails may detach entirely. Candidal onychomycosis is more likely to occur in nails that have been previously injured or infected. Though fungal nail infections may cause embarrassment, they are more common than many realize. Understanding the different types and their symptoms can help in seeking appropriate treatment and management strategies. Prevalence Nail fungus is a widespread condition, affecting approximately 10% of the global population. It is more common in older adults and individuals with certain medical conditions, such as diabetes and peripheral vascular disease. Symptoms Symptoms of fungal nail infections vary depending on the type but typically start out mild and progress over time. Initially, you may observe a white or yellow spot beneath your nail, which can gradually spread and change the color of the entire nail to white, yellow, green, or black. The infected nail may thicken, making it difficult to trim, and it might develop a hardened texture. As the infection advances, the nail may start to curve upward or downward, or it may loosen from the nail bed. The affected nail could become brittle and prone to crumbling upon touch. Changes in the nail’s shape, such as becoming misshapen, may occur. A foul odor may emanate from the infected nail. While fungal nail infections typically start without pain, ignoring them can lead to discomfort, especially when pressure is applied to the affected area. In severe cases, walking may become painful or challenging. Although fungal nail infections may seem inconsequential initially, untreated infections can worsen over time, leading to increased discomfort and potential difficulty in mobility. Thus, seeking timely treatment is essential to prevent complications. Risk Factors Certain factors increase the likelihood of developing a fungal nail infection: Gender: Men are more prone to these infections. Aging: Nails become more brittle and susceptible to cracking with age. Weakened immune system: Individuals with compromised immunity, such as those with diabetes or other health issues, are at higher risk. Footwear: Shoes that cause feet to become hot and sweaty create favorable conditions for fungal growth. Exposure: Walking barefoot in communal areas like gym showers, swimming pools, and locker rooms where fungi thrive increases the risk. Close contact: Living with someone who has a fungal infection can lead to transmission. Pre-existing conditions: Having athlete’s foot, which shares the same fungus, increases the likelihood of nail infection. Recent injury or surgery: Trauma to the nail or previous infections create openings for fungal entry. Prolonged exposure to moisture: Wearing plastic gloves or keeping hands wet for extended periods can contribute to fungal growth. If you suspect a fungal nail infection, seeking medical attention is advisable. Diagnosis Diagnosing nail fungus usually involves a physical examination and may include: Nail scraping or clipping for laboratory analysis Wood’s lamp examination to detect fungal infection Culture test to identify the specific fungus causing the infection Treatments Treatment for fungal nail infections typically requires medical intervention, especially for more severe cases. Here are some common treatment options: Oral antifungals: These medications are taken orally, allowing them to circulate throughout the body and target the fungal infection systemically. Treatment duration typically lasts several weeks to months, depending on the severity of the infection and whether it affects the fingernails or toenails. Topical antifungals: These medications are applied directly to the affected nails in the form of creams, gels, or solutions. While they may be effective for mild infections, they often struggle to penetrate deeply enough to eradicate more serious cases. Topical treatments are sometimes used in conjunction with oral antifungals for enhanced efficacy. Surgery: In cases where other treatments fail to resolve the infection, surgical intervention may be necessary. This involves the complete removal of the infected nail to allow a healthy nail to grow in its place. However, there is a risk of the new nail becoming infected as well. Laser or photodynamic therapy: Emerging treatments involve the use of specialized light therapy to target and destroy fungal cells. While these therapies show promise, further research is needed to determine their long-term effectiveness and safety. Home Care Tips To prevent nail fungus and promote nail health, consider the following tips: Keep nails clean and dry Trim nails straight across and file the edges Wear breathable footwear and moisture-wicking socks Avoid walking barefoot in public places Use antifungal powder or spray in shoes Change socks and shoes regularly Avoid sharing nail clippers or footwear Soaking the affected nail in vinegar or applying tea tree oil may help alleviate symptom Complications of Fungal nail infections Fungal nail infections can lead to various complications, some of which may persist even after treatment. Here are potential complications associated with fungal nail infections: Prolonged recovery: It may take a significant amount of time, often a year or more, for the nails to fully recover and return to their pre-infection appearance. Even with treatment, the healing process can be slow. Recurrence of the infection: Fungal nail infections have a tendency to recur, especially if preventive measures are not taken or if the underlying conditions promoting fungal growth persist. Despite successful treatment, there is a risk of the fungus returning, leading to a repeat infection. Permanent nail damage: In some cases, fungal nail infections can cause permanent damage to the nails, resulting in discoloration, thickening, or deformation. Even after the infection is resolved, the affected nails may remain discolored or misshapen. Spread of infection: If left untreated or inadequately managed, fungal nail infections can potentially spread to other nails or adjacent areas of the skin. The fungus may also spread to other parts of the body, leading to secondary infections or complications. Increased risk for individuals with diabetes: People with diabetes are particularly susceptible to complications from fungal nail infections. Diabetes compromises the immune system and impairs circulation, making individuals more prone to infections and delayed wound healing. If a fungal nail infection is left untreated in someone with diabetes, it can increase the risk of developing serious skin infections or complications. Prevention Preventing fungal nail infections involves practicing good hygiene and taking proactive measures to reduce the risk of exposure to fungi. Here are some preventive strategies: Maintain proper hygiene: Wash your hands and feet regularly with soap and water, ensuring to clean between your fingers and toes. Keep your nails trimmed short and file them straight across to prevent fungal growth. Wear appropriate footwear: Choose socks made of moisture-wicking materials to keep your feet dry, and change them regularly, especially if your feet tend to sweat excessively. Opt for breathable shoes and avoid wearing damp or tight-fitting footwear for extended periods. Use antifungal products: Apply antifungal powder or spray to your feet and inside your shoes to help prevent fungal growth. Replace old shoes that may harbor fungi and promote infection. Practice safe manicures: If you visit nail salons, ensure that they disinfect their tools after each client and consider bringing your own manicure tools from home. Avoid cutting your cuticles, as this can create openings for germs to enter. Avoid sharing personal items: Refrain from sharing towels, socks, shoes, or other personal items, especially if someone in your household has a fungal nail infection. Sharing items can facilitate the spread of the infection. When to See a Doctor It is advisable to see a doctor if nail fungus symptoms persist or worsen despite home treatment, or if there are signs of infection, such as redness, swelling, or pus. Individuals with underlying medical conditions, such as diabetes or compromised immune function, should seek medical attention promptly. Outlook/Prognosis The outlook for nail fungus varies depending on the severity of the infection and the effectiveness of treatment. While some cases may resolve with antifungal medication or laser therapy, others may require surgical intervention. With proper treatment and preventive measures, many people can successfully manage nail fungus and restore nail health. Sources American Academy of Dermatology Association. (n.d.). Nail Fungus and Nail Health. Mayo Clinic. (2021). Nail fungus. Centers for Disease Control and Prevention. (2020). Fungal Nail Infections. American Academy of Family Physicians. Nail Fungal Infections. National Health Service (U.K.) Cleveland Clinic. How You Can Stop Foot and Toenail Fungus In Its Tracks. American Podiatric Medical Association. Toenail Fungus. Medscape. Onychomycosis. May 15, 2024 0 comment 0 FacebookTwitterPinterestLinkedinEmail
Pressure Sores PRESSURE SORES by Justina May 14, 2024 written by Justina Pressure sores, also known as pressure ulcers or bedsores, are areas of damaged skin and tissue caused by prolonged pressure on the skin. These sores typically develop on bony prominences, such as the hips, heels, elbows, and back. They occur when you remain in one position for too long, causing the weight of your body to cut off blood supply against the surface of a bed or chair. This often happens during extended periods of bed rest or while using a wheelchair. Your doctor might discuss the “stage” of your pressure sores, which refers to how deep they are and can impact the treatment approach. When pressure sores are detected early, there’s a good chance they will heal within a few days with minimal discomfort. However, if left untreated, they can worsen over time. Causes Pressure sores, also known as pressure ulcers, develop when your skin experiences prolonged pressure against a surface such as a mattress or cushion. Also, this pressure hinders blood flow to the affected area, leading to the death of skin cells and increased sensitivity. Pressure sores can appear within a few hours or days. Several factors contribute to the formation of pressure sores: Pressure: Even if you don’t feel like you’re applying much weight to a particular body part, continuous pressure over time accumulates. This pressure compresses the skin, obstructing blood flow and depriving the skin of oxygen and nutrients, weakening it and causing cell death. Rubbing: Friction from bedding or clothing can harm delicate skin, particularly when it’s moist from perspiration. Skin Stretching: Movement between two surfaces can cause the skin to stretch or pull, exacerbating the risk of pressure sores. For instance, sliding down a raised bed can irritate the skin on the tailbone. Pressure sores commonly develop in bony areas of the body where there’s little fat or muscle padding. The specific areas where they occur depend on your position: When lying in bed, pressure sores are often found on the head (where it rests against the pillow), shoulder blades, hips, tailbone, buttocks, back of the knees, ankles, and heels. When using a wheelchair for extended periods, pressure sores may develop on the shoulder blades, spine, or on the arms or legs where they come into contact with the chair. Additionally, pressure sores can arise from devices that apply prolonged pressure to the skin. For instance, wearing an oxygen mask can lead to pressure sores on the nose, ears, or the back of the head. Similarly, poorly fitting oral devices like dentures can cause sores inside the mouth. Prevalence These sores are prevalent among individuals who are bedridden, wheelchair-bound or have limited mobility. They are common in hospitals, nursing homes, and long-term care facilities. Stages and Symptoms Pressure sores, also known as bedsores, progress through four stages, each indicating the severity of tissue damage: 1. Stage I: In this initial stage, the pressure sore affects only the upper layer of the skin. Symptoms include pain, burning, or itching, along with changes in skin texture compared to surrounding areas. A red area may be visible on the skin, though it may be challenging to discern in individuals with darker skin tones. The affected area remains discolored even after pressure is relieved, indicating compromised blood flow. 2. Stage II: This stage occurs when the sore penetrates deeper beneath the skin’s surface. Symptoms include broken skin, an open wound, or a blister filled with pus. Surrounding skin may appear discolored, and the area may be swollen, warm, and tender. 3. Stage III: Pressure sores progress to this stage when they extend through the second layer of skin into the underlying fat tissue. Symptoms include a visible “crater-like” appearance of the sore and signs of infection such as redness, pus, odor, heat, and drainage. The tissue surrounding the sore may appear black if it has become necrotic (dead tissue). 4. Stage IV: This is the most severe stage, with pressure sores extending deep into the muscles, ligaments, or even bones. Symptoms include a large, deep sore with blackened skin and signs of infection. Tendons, muscles, and bones may be visible through the wound. Additionally, there are two other stages of pressure sores: Unstageable: Occurs when the bottom of the sore is covered by a layer of dead skin, making it impossible to determine its depth until the dead tissue is removed. Suspected deep tissue injury: The skin’s surface resembles a Stage I or II sore, but underlying tissues are at Stage III or IV, indicating significant damage. It’s essential to monitor pressure sores closely and seek medical attention for proper staging and treatment. Risk Factors Several factors can increase the risk of developing pressure sores, also known as bedsores. These include: Immobility: Difficulty moving can lead to spending extended periods in one position, subjecting certain body parts to pressure. Incontinence: Lack of control over bladder or bowel movements can result in moisture from urine and feces, which may irritate the skin, especially if prompt cleaning is not possible. Poor nutrition and hydration: A healthy diet providing sufficient nutrients and hydration is essential for maintaining skin health and overall bodily function. Without proper nutrition and hydration, the skin becomes weak and prone to damage. Loss of physical sensation: Conditions such as spinal cord injuries can diminish the ability to feel pain or discomfort, making it difficult to recognize when pressure is building up on certain body parts, increasing the risk of pressure sores. Blood flow problems: Conditions like diabetes and vascular disease can impair blood circulation, making it easier for certain positions to cut off blood supply to tissues, leading to pressure sores. Thin or weakened skin: Wearing casts or prosthetic devices can weaken the skin, making it more susceptible to pressure and irritation. Additionally, certain health conditions elevate the risk of pressure sores due to their impact on mobility, blood flow, and other contributing factors. These conditions include: Cancer Cerebral palsy Coma Dementia Diabetes Heart failure Kidney failure Malnutrition Paralysis Spinal cord injury or spina bifida Vascular problems Individuals with these conditions often face challenges in movement and circulation, increasing their susceptibility to pressure sore development. Diagnosis Diagnosing pressure sores involves a thorough examination by a doctor, along with consideration of symptoms and medical history: Physical Examination: The doctor will visually inspect the skin and ask questions regarding the sore, including when it appeared, whether it causes pain, and how frequently positions are changed. Past occurrences of pressure sores are also relevant. Staging: Based on the examination and symptoms, the doctor determines the stage of the pressure sore, which helps guide treatment. They may document the sore’s progress with photographs. Additional Tests: If infection is suspected, further tests may be conducted: Blood tests: To check for signs of infection. Biopsies: Taking a tissue sample from the sore for testing. Imaging: X-rays or MRIs to assess the extent of tissue damage beneath the skin. Treatments Treatment for pressure sores varies depending on the stage of the sore: 1. Stage I: The primary goal is to relieve pressure on the affected area. Change positions frequently and utilize foam pads, pillows, or special mattresses. Maintain skin hygiene by washing the sore with mild soap and water and drying it gently. Follow a diet rich in protein, vitamins A and C, iron, and zinc, and stay hydrated. 2. Stage II: Clean the wound with a saline solution and cover it with an appropriate bandage recommended by your doctor. Monitor for signs of infection, such as pus, fever, or increased redness, and inform your doctor promptly. 3. Stage III: Seek medical attention for stage III sores. Your doctor may perform debridement to remove dead tissue either through a surgical means or with special ointments. Antibiotics may be prescribed to treat or prevent infection. Specialized beds or mattresses may be recommended for better wound management. Stage IV: Immediate medical attention is crucial for stage IV pressure sores, which may require surgery. Surgical interventions may include skin grafts, where tissue from another part of the body is used to cover the wound and promote healing. Medications and pain management: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help alleviate pain and inflammation. Take them before changing positions or cleaning the wound. Topical pain relievers in the form of creams or ointments may be prescribed by your doctor. Antibiotics may be necessary if the sore becomes infected. Surgical treatments: Skin graft surgery may be recommended for large, persistent pressure sores. This procedure involves transplanting muscle or skin from another area of the body to cover the wound and facilitate healing. Home Care Tips If caring for someone with pressure sores at home, consider the following tips: Ensure proper nutrition with a balanced diet rich in protein and vitamins. Keep the skin clean and dry, avoiding prolonged exposure to moisture. Encourage regular movement and repositioning to relieve pressure on vulnerable areas. Use cushions or padding to protect bony prominences. Seek medical advice if there are signs of infection or worsening of the sore. Prevention Preventing pressure sores is essential, and there are several simple steps you can take: Regularly change positions: Reposition yourself every 15 minutes if you’re in a wheelchair, or every hour if you’re in bed. Don’t hesitate to ask for assistance if needed. Use specialized equipment: Consider getting a wheelchair that can tilt back, allowing you to shift your weight more easily. Use cushions and specialized mattresses to distribute your weight evenly and support your body in comfortable positions. Avoid doughnut cushions, as they can increase pressure on surrounding areas. Keep the head of your bed low: Avoid raising the head of your bed or tilting your pillows to more than a 30° angle to prevent sliding down the bed, which can strain the skin around the tailbone. Lift yourself if possible: If you have enough upper body strength, perform wheelchair push-ups by pressing your forearms against the chair’s arms to lift your body. Maintain cleanliness and dryness: Use daily cleansing towels to wipe away sweat, dirt, and other buildup, and pat dry afterward. Apply moisture barrier ointment if you have incontinence to protect your skin from urine and feces. Avoid skin irritation: Check for buttons, zippers, or bumps in fabric that could cause rubbing and wash your blankets and clothes frequently. Eat a healthy diet and stay hydrated: Proper nutrition and hydration are essential for maintaining strong, healthy skin. Monitor your skin: Regularly check for signs of pressure sores and seek treatment promptly if any are detected. Complications of untreated pressure sores Complications of untreated pressure sores can be severe: Skin Infections: Open wounds are susceptible to bacterial infections like cellulitis or septicemia, characterized by warmth, swelling, and inflammation. Sepsis: Untreated infections can escalate to sepsis, where the body attacks its own tissues instead of fighting the bacteria, potentially leading to life-threatening complications. Amputation: Severe sepsis may necessitate limb amputation. Bacteremia: Bacteria entering the bloodstream can cause serious conditions like bacterial meningitis or endocarditis, affecting the brain and heart. Bone and Joint Infections: Pressure sores can facilitate infections in nearby bones or joints, impairing mobility and causing tissue damage. Cancer: Prolonged non-healing wounds may rarely develop into squamous cell carcinoma, a type of skin cancer. Signs of an infected pressure sore include: Fluid leakage from the sore Fever Foul odor Warmth around the wound Changes in skin color Swelling Pain Early detection and proper treatment are crucial to prevent complications associated with pressure sores. Regular monitoring and prompt medical attention for any signs of infection are essential for managing pressure sore complications effectively. When to See a Doctor It’s essential to consult a healthcare professional if you notice any signs or symptoms of these sores, especially if you are at increased risk due to immobility or chronic health conditions. Early intervention can prevent complications and promote faster healing. Outlook/Prognosis The outlook for these sores depends on various factors, including the severity of the sore, underlying health conditions, and the effectiveness of treatment. With prompt medical care, proper wound management, and preventive measures, many pressure sores can heal successfully. However, severe or untreated pressure sores can lead to complications such as infection, tissue necrosis, and even death. Sources National Institute on Aging. “Pressure Sores (Bedsores).” Mayo Clinic. “Pressure Sores (Bedsores).” Clevland clinic National Health Service. “Pressure Sores (Pressure Ulcers).” Centers for Disease Control and Prevention. “Pressure Ulcers in Healthcare Settings.” American Academy of Dermatology Association. “Bedsores: Overview May 14, 2024 0 comment 0 FacebookTwitterPinterestLinkedinEmail
Psoriasis PSORIASIS by Justina May 9, 2024 written by Justina Psoriasis is a chronic skin condition that affects millions of people worldwide. Characterized by red, scaly patches on the skin. This chronic skin condition can be both physically and emotionally distressing. Psoriasis is a skin condition where skin cells grow much faster than usual, resulting in bumpy patches. These patches can look different depending on your skin tone, ranging from red with white scales on lighter skin to purplish or brown with gray scales on darker skin. They typically show up on the scalp, elbows, knees, and lower back. Importantly, psoriasis isn’t contagious, although it can run in families. Causes of Psoriasis The cause of this chronic skin condition is not entirely understood, but experts believe it involves a combination of factors. Something triggers the immune system, leading to inflammation, which in turn prompts the rapid formation of new skin cells. Normally, skin cells are replaced every 10-30 days, but in psoriasis, this process accelerates to every 3-4 days, resulting in the accumulation of old cells and the formation of scales. This chronic skin condition often runs in families, although it may skip generations. For example, it may affect a grandfather and his grandson but not the child’s mother. Several factors can trigger psoriasis flare-ups, including cuts, scrapes, emotional stress, strep infections, and certain medications such as blood pressure drugs, antimalarials, lithium, antibiotics, and NSAIDs. Importantly, psoriasis is not contagious. It’s an internal disease related to the immune system, even though it manifests externally on the skin. Prevalence of Psoriasis Psoriasis is a common skin condition, affecting approximately 2-3% of the global population. It can occur at any age, but most commonly develops between 15 and 35. Both men and women are equally affected by this chronic skin condition. Types of Psoriasis This chronic skin condition comes in various types, each with its own characteristics: Pustular psoriasis: This type presents as discolored, scaly skin with small pustules, typically found on the palms of the hands and soles of the feet. Guttate psoriasis: Often starting in childhood or early adulthood, this type manifests as small spots that can be pink, red, brown, or purple in color. They usually appear on the torso and limbs and can be triggered by respiratory infections, stress, skin injuries, or certain medications. Inverse psoriasis: This type causes shiny lesions in skin folds like the armpits, groin, and under the breasts. On lighter skin, these lesions are bright red, while on darker skin, they may appear darker than the surrounding skin, ranging from purplish to brown. Erythrodermic psoriasis: Characterized by intense skin discoloration and shedding of scales in sheets, this type requires immediate treatment due to its potential to cause severe illness. Triggers can include severe sunburn, infections, certain medications, or stopping some psoriasis treatments. Symptoms of Psoriasis This chronic skin condition symptoms can vary depending on the type of psoriasis you have. Here are some common symptoms of plaque psoriasis, which is the most prevalent type: Plaques: These are raised, red patches of skin that may have silver-colored scales on lighter skin tones. On darker skin tones, plaques may appear dark brown or purplish with gray scales. These plaques can be itchy, painful, and may even crack and bleed. In severe cases, they may grow and merge, covering larger areas of the skin. Nail Issues: Psoriasis can affect the nails, leading to changes such as discoloration, small pits, crumbling, or loosening from the nail bed. Scalp Involvement: Plaques, scales, or crusts may appear on the scalp, causing discomfort and sometimes leading to hair loss. Additionally, individuals with psoriasis may develop psoriatic arthritis, a type of arthritis characterized by joint pain and swelling. It’s estimated that between 10% to 30% of people with psoriasis also experience psoriatic arthritis, according to the National Psoriasis Foundation. Risk Factors for Psoriasis Several factors can influence your risk of developing psoriasis: Stress Obesity Certain medications, such as lithium and beta-blockers Genetics: Your DNA contains genes that control various aspects of your body’s functions, including your immune system. In people with psoriasis, certain genes related to immune system signaling become dysregulated. Instead of protecting the body, the immune system triggers inflammation and accelerates the production of skin cells. Scientists have identified over 80 genes associated with this chronic skin condition and believe that multiple genes contribute to the development of the disease. However, not everyone with these genes will develop this chronic skin condition; it’s estimated that about 10 out of 100 individuals have genes that predispose them to this chronic skin condition, but only a fraction of them develop the condition. Alcohol Consumption: Heavy alcohol consumption, particularly among younger men, is linked to an increased risk of psoriasis. Additionally, alcohol can reduce the effectiveness of these chronic skin condition treatments. Smoking: Smoking can double the risk of developing psoriasis. Individuals who have relatives with psoriasis and smoke are nine times more likely to develop the condition. Smoking also complicates the management of psoriasis symptoms and is closely associated with a challenging-to-treat type called pustular psoriasis, which affects the palms of the hands and soles of the feet. As for the demographics affected by psoriasis: Psoriasis affects approximately 2%-3% of the global population. In the United States, around 3% of people have psoriasis. Psoriasis prevalence varies among different cultures, with the condition being most common in northern Europe and less common in eastern Asia. Diagnosis of Psoriasis Diagnosing psoriasis typically involves: Physical Examination: Your doctor will conduct a thorough examination and inquire about your family history to determine if psoriasis runs in your family. The characteristic plaques of psoriasis, especially when present on specific areas such as the scalp, ears, elbows, knees, belly button, and nails, are usually easily recognizable during the physical exam. Lab Tests: In some cases, your doctor may perform a biopsy, which involves removing a small sample of skin for testing. This helps rule out other skin conditions or infections that may mimic psoriasis. Stages of Psoriasis Psoriasis doesn’t have distinct stages like some other conditions. Instead, it can progress over time, with symptoms fluctuating in severity. It’s crucial to monitor your symptoms closely and communicate any changes to your doctor promptly. Treatments for Psoriasis Psoriasis treatment options are diverse, aiming either to slow down the rapid growth of skin cells or to alleviate symptoms like itching and dryness. Your doctor will tailor a treatment plan based on factors such as the size and location of your rash, your age, overall health, and personal preferences. Here’s an overview of common treatments: Medications for Psoriasis: Steroid creams Prescription topical cream roflumilast (Zoryve) Moisturizers for dry skin Salicylic acid Coal tar (available in various formulations for scalp psoriasis) Vitamin D-based cream or ointment (prescription-strength) Retinoid creams Calcineurin inhibitors Anthralin For moderate to severe psoriasis, treatment options may include: Methotrexate: Requires close monitoring due to potential side effects on bone marrow, liver, and lungs. Retinoids: Available in various forms but may cause serious side effects, especially in pregnant or planning-to-be-pregnant women. Cyclosporine: Can be prescribed for severe cases unresponsive to other treatments but requires careful monitoring due to kidney and blood pressure concerns. Biologic treatments: These target specific parts of the immune system involved in psoriasis, including various drugs such as adalimumab (Humira), etanercept (Enbrel), and ustekinumab (Stelara). Non-biologic treatments: Includes medications like tofacitinib (Xeljanz) and enzyme inhibitors such as apremilast (Otezla). Light Therapy: Ultraviolet (UV) light therapy, administered by a doctor, can slow down skin cell growth. PUVA (psoralen plus ultraviolet-A radiation) is one type of light therapy combining a medication called psoralen with UV light. Alternative Treatments and Home Remedies: While not scientifically proven to be 100% effective, some natural therapies and home remedies may help alleviate psoriasis symptoms. These include using Oregon grape topical creams, maintaining humidity levels, applying capsaicin topical creams, consuming omega-3 fatty acids, using aloe vera, and taking oat baths. Before starting any treatment regimen, it’s essential to consult with your doctor to discuss the most suitable options based on your individual circumstances and preferences. Regular communication with your healthcare provider ensures personalized care and effective management of psoriasis symptoms. Home Care Tips To manage this chronic skin condition effectively and improve quality of life, consider implementing the following strategies: Skincare Routine: Take short, daily baths with warm water and allergen-free soap, and avoid drying your skin too roughly. Moisturize regularly with a thick, rich cream or ointment. Light Therapy: Your doctor may recommend a light therapy box or advise getting at least 15 to 30 minutes of daily sunlight exposure. Healthy Lifestyle: Incorporate regular exercise, prioritize sufficient sleep, and explore relaxation practices such as meditation. Identify Triggers: Keep a journal to track what triggers your psoriasis flare-ups, helping you identify and avoid potential triggers in the future. When living with psoriasis, it’s crucial to prioritize your mental health, as individuals with psoriasis have a higher risk of experiencing certain mental health conditions. Be open with your doctor about any symptoms you may be experiencing. Some common mental health conditions associated with this chronic skin condition include anxiety, depression, sexual dysfunction, substance use disorders, sleep disorders, eating disorders, and psychosis. Taking proactive steps to address mental health concerns can significantly improve overall well-being when managing this chronic skin condition. Prevention of Psoriasis While this chronic skin condition cannot be prevented entirely, certain lifestyle changes may help reduce the risk of developing the condition or experiencing flare-ups. These include: Avoiding known triggers, such as stress and smoking Maintaining a healthy lifestyle with regular exercise and a balanced diet Managing chronic conditions, such as obesity and high blood pressure Seeking prompt medical attention for any skin problems or symptoms Health disparities Psoriasis can affect different racial and ethnic groups in varying ways. Studies indicate that White individuals have the highest rates of this chronic skin condition compared to other groups. However, some studies suggest that individuals from other racial and ethnic backgrounds may underreport their symptoms compared to White individuals. This discrepancy could stem from a lack of trust in the healthcare system and the financial burden associated with accessing treatment. Complications This chronic skin conditions can also lead to several complications, so it’s essential to discuss these potential risks with your doctor upon receiving a diagnosis. These complications may include: Eye conditions such as pinkeye Psoriatic arthritis Certain cancers Obesity Heart disease Mental health issues like low self-esteem and depression Type 2 diabetes High blood pressure Other autoimmune diseases like Crohn’s disease, celiac disease, and sclerosis When living with this chronic skin condition, dietary choices can play a role in managing symptoms. While no specific foods are known to cause this chronic skin condition, certain types of foods and beverages may exacerbate symptoms. These include: Alcohol Dairy products Refined carbohydrates Saturated fats and trans fats Added sugars Gluten Adopting a balanced and nutritious diet, along with discussing any dietary concerns with your healthcare provider, can contribute to better management of this chronic skin condition symptoms and overall health. When to See a Doctor It is essential to consult a doctor if you experience symptoms of this chronic skin condition or if your condition worsens despite home care measures. A dermatologist can provide an accurate diagnosis and recommend appropriate treatment options based on your individual needs. Outlook/Prognosis While psoriasis is a chronic condition with no cure, many individuals can effectively manage their symptoms with proper treatment and self-care measures. By working closely with healthcare providers and adopting healthy lifestyle habits, most people with this chronic skin condition can lead fulfilling lives without significant interference from their condition. Sources National Psoriasis Foundation. American Academy of Dermatology Association. National Institute of Arthritis and Musculoskeletal and Skin Disease. The Psoriasis Foundation. UpToDate FDA Medscape PubMed Health World Health Organization CDC Johns Hopkins Medicine The Center for Biosimilars NHS UK JAMA Dermatology Mayo Clinic May 9, 2024 0 comment 0 FacebookTwitterPinterestLinkedinEmail
Pimples (Acne) PIMPLES (ACNE) by Justina May 4, 2024 written by Justina Pimples, medically known as acne vulgaris, are a common skin condition affecting millions worldwide at some point in their lives. It typically begins during puberty when the skin’s sebaceous glands produce excess oil, leading to plugged pores. If the pores remain open, they form blackheads, while closed pores result in whiteheads. These plugged pores can become inflamed, leading to the development of pimples, lumps, or nodules. Severe cases, known as cystic acne, involve firm swellings below the skin’s surface that can become tender and infected. While acne is often associated with adolescence, about 20% of cases occur in adults. It commonly starts during puberty, lasting for five to 10 years and typically improving in the early 20s. Acne affects both sexes, with teenage boys often experiencing more severe cases. Women are more likely than men to have mild to moderate forms of acne into their 30s and beyond. Acne lesions can appear on various parts of the body, including the face, neck, chest, back, shoulders, and upper arms. Contrary to popular belief, acne is not caused by factors such as diet, hygiene, or sexual activity. Instead, genetics and hormonal changes play significant roles in its development. Avoiding certain foods or excessive scrubbing of the skin will not alter one’s predisposition to acne. Causes of pimples Acne is a complex skin condition with various contributing factors, though its exact cause is not fully understood. Here are some key factors involved in the development of acne: 1.Hormones: During puberty, the surge in androgens (male hormones) stimulates the oil glands in the skin, leading to increased sebum production. This excess oil can clog pores and contribute to acne formation. 2. Genetics: While not directly inherited, there may be a genetic predisposition to acne. Family history can play a role in determining an individual’s susceptibility to acne and their skin’s response to hormonal changes and environmental factors. 3. Excess Oil Production: Sebum, the natural oil produced by the skin’s sebaceous glands, can become trapped in hair follicles and mix with dead skin cells, creating a favorable environment for acne-causing bacteria to thrive. 4. Bacteria: Propionibacterium acnes, a type of bacteria commonly found on the skin, can proliferate within clogged pores, leading to inflammation and the formation of acne lesions. 5. Inflammation: When bacteria multiply within blocked pores, the body’s immune response triggers inflammation, resulting in the characteristic redness, swelling, and tenderness associated with acne. 6. Dietary Factors: While certain foods like chocolate and greasy foods were previously believed to worsen acne, current research suggests that high glycemic index foods and dairy products may contribute to acne development in some individuals. 7. Cosmetics and Skincare Products: Certain cosmetics and skincare products containing comedogenic ingredients can clog pores and exacerbate acne. Opting for non-comedogenic products can help prevent pore blockage and minimize breakouts. 8. Environmental Factors: Environmental factors such as pollution, humidity, and exposure to industrial substances like cutting oils can aggravate acne by increasing oil production and pore congestion. Hormonal Fluctuations: Hormonal changes associated with menstrual cycles, pregnancy, or conditions like polycystic ovary syndrome (PCOS) can influence sebum production and contribute to acne flare-ups. 9. Medications: Some medications, including corticosteroids, hormonal contraceptives, and certain anticonvulsants, may exacerbate acne or trigger acne-like eruptions as a side effect. 10. Other factors: Acne can manifest in different subtypes, including acne neonatorum and acne infantum, which may affect newborns and infants. Additionally, some individuals may experience adult-onset acne later in life, even if they had relatively clear skin during their teenage years. Overall, acne is a multifactorial condition influenced by hormonal changes, bacterial activity, genetic predisposition, and environmental factors. The interplay of these factors varies among individuals, leading to differences in the severity and persistence of acne outbreaks. Prevalence Acne is one of the most prevalent skin conditions globally, affecting approximately 9.4% of the global population. It predominantly impacts adolescents, with around 85% of individuals aged 12-24 experiencing acne at some point. However, acne can persist into adulthood, with approximately 40-55% of adults aged 20-40 experiencing some form of acne. Symptoms of pimples (acne) Pimples (acne) can manifest with a variety of symptoms, including: Persistent red spots or swelling on the skin, commonly referred to as pimples. These may become inflamed and filled with pus, leading to a painful and tender sensation. Pimples often appear on the face, chest, shoulders, neck, or upper back. Dark spots with open pores at the center, known as blackheads. These occur when the hair follicles become clogged with excess oil and dead skin cells, resulting in the oxidation of melanin, which gives them their characteristic dark color. Tiny white bumps under the skin, known as whiteheads. Unlike blackheads, whiteheads do not have an obvious opening and may appear as small, flesh-colored bumps on the skin’s surface. Red swellings or lumps, referred to as papules, that are visibly filled with pus. Papules are inflamed lesions that may be tender to the touch and can contribute to the overall redness and inflammation of the affected area. Nodules or lumps under the skin that are inflamed, fluid-filled, and often tender. These nodules may become as large as an inch across and can be deeply embedded within the skin, causing significant discomfort and pain. Risk Factors Hormonal Fluctuations: Puberty, menstruation, pregnancy, and hormonal disorders. Family History: Genetic predisposition to acne. Certain Medications: Some medications, including corticosteroids and lithium, can exacerbate acne. Environmental Factors: Exposure to pollutants and high humidity Diagnosis Diagnosing acne typically involves a visual examination by a dermatologist or healthcare provider. They may also inquire about the individual’s medical history and any medications they are taking. In some cases, additional tests, such as hormone level assessments, may be conducted to identify underlying hormonal imbalances contributing to acne. Treatments for pimples (acne) There are several treatments available for Pimples (acne), ranging from over-the-counter products to prescription medications and procedures. The choice of treatment depends on the severity of the acne, individual skin type, and response to previous treatments. Here are some common treatments for acne: Topical treatments: Benzoyl peroxide: Available over-the-counter and by prescription, benzoyl peroxide helps to kill acne-causing bacteria, reduce inflammation, and unclog pores. Salicylic acid: Found in many over-the-counter acne products, salicylic acid helps to exfoliate the skin, remove dead skin cells, and prevent pores from becoming clogged. Retinoids: Prescription-strength retinoid creams, gels, or lotions, such as tretinoin (Retin-A) or adapalene (Differin), help to unclog pores, prevent new acne lesions, and reduce inflammation. Antibiotics: Topical antibiotics, such as clindamycin or erythromycin, can help to reduce acne-causing bacteria and inflammation when applied to the skin. Oral medications: Oral antibiotics: Antibiotics like doxycycline, minocycline, or tetracycline may be prescribed for moderate to severe acne to reduce bacteria and inflammation. Oral contraceptives: Birth control pills containing estrogen and progestin can help regulate hormone levels in women and reduce acne by decreasing sebum production. Isotretinoin (Accutane): Reserved for severe, cystic acne, isotretinoin is a powerful oral medication that reduces sebum production, shrinks oil glands, prevents clogged pores, and reduces inflammation. However, Isotretinoin is associated with potential side effects, including dry skin, lips, and eyes, as well as more serious complications such as birth defects, elevated cholesterol levels, and liver abnormalities. It requires close monitoring and stringent pregnancy prevention measures due to its teratogenic effects. Procedures: Chemical peels: Chemical peels containing alpha-hydroxy acids (AHAs) or beta-hydroxy acids (BHAs) are used to exfoliate the skin, unclog pores, and improve acne and acne scars. Extraction: Dermatologists may perform manual extraction of blackheads and whiteheads using a sterile tool to remove the contents of clogged pores. Laser therapy: Various laser and light-based treatments, such as photodynamic therapy (PDT) or laser resurfacing, can target acne-causing bacteria, reduce oil production, and improve skin texture and tone. Other treatments: Corticosteroid injections: Intralesional corticosteroid injections are used to reduce inflammation and rapidly shrink large, painful acne cysts or nodules. Comedone extraction: A dermatologist may perform gentle extraction of comedones (blackheads and whiteheads) using a sterile tool to remove blockages from pores. It’s important to consult a dermatologist for personalized treatment recommendations based on your individual acne type, severity, and medical history. They can help determine the most appropriate treatment plan to effectively manage your acne and minimize the risk of scarring or other complications. Nonprescription treatments for acne can be effective for mild cases and can help prevent new breakouts. Here are some commonly used nonprescription treatments: 1. Soap and water: Gentle cleansing of the face with soap and water, no more than twice a day, can help with pimples (acne). However, aggressive scrubbing can injure the skin and cause other problems. 2. Cleansers: There are many cleansers and soaps advertised for treating acne. They often contain ingredients like benzoyl peroxide, glycolic acid, salicylic acid, or sulfur. 3.Benzoyl peroxide: This compound works by destroying the bacteria associated with pimples (acne). It usually takes at least four weeks to work and must be used continuously to keep acne at bay. Benzoyl peroxide is available in various forms such as creams, lotions, washes, foams, and gels. It can cause dry skin and may bleach fabrics. 4. Salicylic acid: Helps unclog pores to resolve and prevent lesions. It does not affect sebum production or kill bacteria and must be used continuously to maintain its effects. 5. Sulfur: Helps prevent pores from being clogged and inhibits the growth of bacteria. It is often combined with other substances in over-the-counter acne medications. 6.Topical retinol gel or creams: Retinol works to keep pimples from forming by affecting cell growth and turnover. It may take 8-12 weeks to see results and must be used continuously. 7. Alcohol and acetone: These substances are mild antibacterial agents and can remove oils from the skin’s surface. However, they can dry out the skin and are generally not recommended by dermatologists. 8. Herbal, organic, and “natural” medications: While marketed to treat or prevent acne, the effectiveness of these agents is not proven and they are unlikely to have much benefit. It’s important to note that when dealing with pus-filled pimples, it’s best to let them break naturally or have them opened by a healthcare professional to avoid further inflammation and scarring. Squeezing pimples yourself can worsen the condition. Always consult with a dermatologist before starting any new acne treatment regimen, especially for persistent or severe acne. Prescription treatments for acne are often necessary for more severe cases and may include the following: 1. Antibiotics: Available in topical or oral forms, antibiotics work by clearing the skin of acne-causing bacteria and reducing inflammation. Topical antibiotics are applied directly to the skin, while oral antibiotics circulate throughout the body. Common options include clindamycin, erythromycin, doxycycline, minocycline, and tetracycline. Topical antibiotics are often used in combination with benzoyl peroxide or retinoids to reduce the risk of antibiotic resistance. 2. Retinoids: Also known as vitamin A derivatives, retinoids are available as topical or oral medications. Topical retinoids affect the way the skin grows and sheds, helping to clear moderate-to-severe acne. Common topical retinoids include tretinoin, adapalene, and tazarotene. Oral retinoids like isotretinoin (Accutane) are reserved for severe cystic acne and can effectively clear acne that hasn’t responded to other treatments. However, they have significant side effects and must be used with caution, especially in women of childbearing age. 3. Azelaic acid: Available in gel, cream, or foam formulations, azelaic acid has antibacterial and anti-inflammatory properties. While more commonly used for rosacea, it may also help mild acne. 4. Dapsone: This topical gel has antibacterial and anti-inflammatory effects and can be used to treat acne. 5. Oral contraceptives: Birth control pills containing female hormones can help counteract the effects of male hormones on acne. They are particularly beneficial for female patients with acne that worsens around menstruation or menopause. 6. Spironolactone (Aldactone): This oral medication blocks the action of hormones on the skin’s oil glands and is especially helpful for women with hormonal acne. 7. Clascoterone (Winlevi): A newly approved topical treatment for moderate to severe acne, clascoterone targets the hormones that cause acne. It has been found to reduce acne in both males and females over the age of 12. It works by blocking the effects of androgens on the skin, reducing sebum production, and preventing the development of acne lesions. 8. Corticosteroid injections: Triamcinolone, a type of corticosteroid solution, may be injected directly into acne nodules to reduce inflammation and promote healing. These prescription treatments address various factors contributing to acne, including bacterial overgrowth, inflammation, and hormonal imbalances. They are typically recommended for individuals with moderate to severe acne or those who haven’t responded to over-the-counter treatments. It’s essential to consult with a dermatologist to determine the most appropriate treatment plan based on your specific needs and medical history. Pimples (acne)treatment Precautions It’s important for patients undergoing acne treatment to be aware of potential side effects and interactions with other medications or herbal remedies. Here are some important considerations: Topical retinoids and benzoyl peroxide: These treatments can leave the skin reddened, dry, and sensitive to sunlight. It’s essential to use sunscreen and avoid excessive sun exposure when using these products. Oral antibiotics: Oral antibiotics may cause sensitivity to sunlight and stomach upset. Patients should take precautions to protect their skin from the sun and consider taking them with food to minimize stomach discomfort. Interaction between benzoyl peroxide and topical retinoids: Benzoyl peroxide may inhibit the effects of some topical retinoids, so it’s recommended not to apply them at the same time of day. Instead, they can be used at different times of the day or as directed by a healthcare professional. Yeast infections: Long-term use of oral antibiotics may increase the risk of yeast infections in women. Patients should be vigilant for symptoms and consult their healthcare provider if they experience any discomfort or unusual symptoms. Allergic reactions: Some over-the-counter acne products can cause rare but serious allergic reactions or severe irritation. Patients should seek immediate medical attention if they experience symptoms such as throat tightness, difficulty breathing, feeling faint, swelling of the face or tongue, hives, or itching after using these products. Regarding acne scar treatments, various procedures can help improve the appearance of scars. These may include dermabrasion, laser therapy, chemical peels, microneedling, subcision, and fillers. It’s important to discuss these options with a dermatologist to determine the most suitable treatment based on individual needs and the type of scarring present. Additionally, patients should be aware of potential risks, necessary precautions, and expected results before undergoing any procedure. It’s essential to follow your dermatologist’s recommendations and adhere to the prescribed treatment regimen for optimal results. Regular follow-up visits may be necessary to monitor progress and adjust treatment as needed. Home Care Tips Gentle Cleansing: Cleanse the face twice daily with a mild, non-comedogenic cleanser to remove excess oil, dirt, and impurities without stripping the skin’s natural oils. Avoid Harsh Products: Steer clear of abrasive scrubs and harsh skincare products that can irritate the skin and exacerbate acne. Moisturize: Use a lightweight, oil-free moisturizer to keep the skin hydrated without clogging pores. Hands Off: Avoid picking, squeezing, or popping pimples, as this can lead to scarring and further inflammation. Sun Protection: Apply a broad-spectrum sunscreen with an SPF of 30 or higher to protect the skin from harmful UV rays, which can worsen acne and cause hyperpigmentation. Prevention of pimples (acne) Preventing acne involves adopting a consistent skincare routine and making lifestyle changes to minimize factors that contribute to acne development. Here are some tips to help prevent acne: 1. Use a gentle cleanser: Choose a mild, non-abrasive cleanser formulated specifically for acne-prone skin. Look for products containing salicylic acid or benzoyl peroxide, which can help unclog pores and prevent acne breakouts. Avoid harsh scrubbing or using abrasive materials that can irritate the skin and worsen acne. 2. Wash your face regularly: Cleanse your face twice daily, in the morning and before bedtime, to remove excess oil, dirt, and impurities that can contribute to acne formation. Be gentle when washing your face. Using your fingertips or a soft washcloth, and avoid overwashing, which can strip the skin of its natural oils and lead to irritation. 3. Moisturize with non-comedogenic products: Use lightweight, oil-free moisturizers and skincare products labeled as “non-comedogenic,” meaning they are less likely to clog pores and exacerbate acne. Hydrating the skin is essential to maintain its moisture balance without aggravating acne. 4. Avoid pore-clogging cosmetics: Choose makeup and skincare products labeled as oil-free, non-comedogenic, and water-based to minimize the risk of pore blockage and acne breakouts. Remove makeup before bedtime and cleanse your skin thoroughly to prevent buildup and congestion. 5. Practice good hygiene: Keep your hair clean and away from your face, as oils from the scalp can contribute to acne along the hairline and forehead. Avoid touching your face with dirty hands or resting your chin or cheeks on dirty surfaces to prevent transferring bacteria and dirt to the skin. 6. Maintain a healthy lifestyle: Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Limit consumption of sugary, greasy, and processed foods, which may exacerbate acne. Stay hydrated by drinking plenty of water to keep the skin hydrated and flush out toxins. 7. Manage stress: Stress can trigger hormonal changes that may exacerbate pimples (acne), so practice stress-reduction techniques such as deep breathing, meditation, yoga, or regular exercise to promote relaxation and overall well-being. 8. Protect your skin from the sun: Use a broad-spectrum sunscreen with SPF 30 or higher daily to protect your skin from harmful UV rays, which can worsen pimples (acne) and increase the risk of post-inflammatory hyperpigmentation (dark spots). Opt for oil-free, non-comedogenic sunscreen formulations suitable for acne-prone skin. 9. Exercise regularly: Regular exercise promotes overall health, including skin health. Shower or bathe after exercise to remove sweat and prevent skin irritation. 10. Manage stress: Stress can exacerbate acne, so find ways to manage stress through relaxation techniques, exercise, and seeking support from friends and family. When to See a Doctor It’s important to seek medical attention if you experience any of the following concerning symptoms related to acne: Your acne is causing emotional distress or affecting your quality of life. Your acne is resulting in scarring or dark patches on the skin. You have severe acne characterized by the presence of nodules, persistent pimples, or widespread inflammation. Over-the-counter remedies have been ineffective in managing your acne, indicating the need for medical intervention or prescription medications. You have concerns about your acne’s impact on your skin health and appearance, prompting you to consult a dermatologist for evaluation and treatment options. Outlook/Prognosis With proper treatment and skincare regimen, most cases of acne can be effectively managed, and the appearance of the skin can significantly improve over time. However, it may take several weeks to months to see noticeable results, and consistency with treatment and skincare practices is essential for long-term control of acne. In severe cases, pimples (acne) may leave behind scars or hyperpigmentation, but dermatological procedures can help improve the appearance of the skin. Sources American Academy of Dermatology Association. (n.d.). Acne. Nguyen, Q. American Family Physician, 1994. Chiu, A. Archives of Dermatology, 2003. Teenagers Today.com website. Best Face Forward. About.com web site: “Acne FDA. Mayo Clinic. (2023). Acne. National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2022). American Academy of Dermatology. The Merck Manual, Seventeenth Edition. National Institute of Arthritis and Musculoskeletal and Skin Diseases. News release, FDA. Stathakis. V. Australasian Journal of Dermatology, 1997. May 4, 2024 0 comment 0 FacebookTwitterPinterestLinkedinEmail
Pilonidal Disease PILONIDAL DISEASE by Justina May 4, 2024 written by Justina Pilonidal disease, often referred to as pilonidal cyst, is a common yet misunderstood condition affecting the skin at the top of the buttocks cleft. Though it may seem harmless at first, it can lead to discomfort, pain, and even infection if left untreated. it is a type of cyst that can develop at the bottom of the tailbone or coccyx. This cyst can become infected and filled with pus, causing discomfort and pain. Causes Historical Perspective: During World War II, a significant number of soldiers developed pilonidal cysts, leading to hospitalization. This phenomenon was attributed to irritation from riding in bumpy Jeeps, and the condition was colloquially referred to as “Jeep disease.” While this theory may have historical significance, it’s essential to recognize that pilonidal cysts can arise from various factors beyond wartime vehicle transportation. Sacral Dimple: Some individuals may be predisposed to pilonidal cysts if they have a small dimple in the skin between their buttocks, known as a sacral dimple. Although typically harmless, this dimple can become infected, potentially leading to the formation of a cyst. While the exact connection between sacral dimples and pilonidal cysts is not fully understood, individuals with sacral dimples should remain vigilant for signs of infection and consult a doctor if symptoms arise. Hereditary Factors: There may be a hereditary component to the development of pilonidal cysts. For instance, individuals with a family history of thick, coarse body hair may be more predisposed to developing cysts. While genetics can play a role, other environmental and lifestyle factors also contribute to cyst formation. Bowel Problems: Pilonidal cysts typically do not cause direct issues with bowel function. However, due to the presence of bleeding as a symptom of pilonidal cysts, individuals may notice blood on toilet paper after a bowel movement, especially if they inadvertently aggravate the cyst during hygiene practices. This bleeding is a result of the cyst’s irritation and should prompt medical evaluation to address the underlying condition. Prevalence While exact numbers vary, pilonidal disease is relatively common, particularly among young adults. Men are more likely to develop this condition than women, and it tends to occur more frequently in individuals with a lot of body hair. Symptoms Pain, Redness, and Swelling: The onset of a pilonidal cyst often manifests as pain, redness, and swelling at the base of the spine. This discomfort may progressively worsen, particularly with prolonged periods of sitting or pressure on the affected area. Drainage of Pus or Blood: A characteristic symptom of a pilonidal cyst is the presence of pus or blood draining from the cyst. This drainage may have a foul odor, particularly if the cyst is infected, indicating the need for prompt medical attention. Tenderness and Sensitivity: The affected area may exhibit tenderness and sensitivity to touch. Patients may experience discomfort or pain upon palpation of the cyst or surrounding tissues. Systemic Symptoms: In cases of infection or severe inflammation, individuals may experience systemic symptoms such as fever, nausea, or fatigue. These symptoms suggest a more advanced or complicated presentation of the cyst and necessitate immediate medical evaluation. Risk Factors Several factors increase the risk of developing pilonidal cysts. Here are some key risk factors associated with this condition: Prolonged Sitting: People who spend most of their day sitting, especially in jobs that involve prolonged sitting, such as office workers or truck drivers, have a higher risk of developing pilonidal cysts. This is because constant pressure on the tailbone area can contribute to the formation of cysts. Prolonged sitting or lack of physical activity can promote the accumulation of sweat and debris in the buttock crease, leading to the formation of cysts. Obesity: Being severely overweight is another risk factor for pilonidal cysts. Excess weight can increase pressure on the tailbone area, leading to irritation and the development of cysts. Coarse or Thick Body Hair: Individuals with coarse or thick body hair may be more susceptible to pilonidal cysts. The presence of dense hair can increase the likelihood of ingrown hairs, which are believed to be a contributing factor to cyst formation. Gender: Men are at a higher risk of developing pilonidal cysts compared to women. In fact, men are three to four times more likely to experience this condition. The reasons for this gender disparity are not entirely clear but may be related to hormonal differences or variations in hair growth patterns. Age: Pilonidal cysts most commonly occur in individuals aged 20 to 35 years. While they can develop at any age, this demographic group is at the highest risk. Poor hygiene: Inadequate cleansing of the tailbone area can allow bacteria and debris to accumulate, increasing the risk of infection and inflammation. Researchers believe that pilonidal cysts are often caused by ingrown hairs, hence the term “nest of hair.” Inside the cyst, doctors may find hair follicles, further supporting this theory. Is It Safe to Squeeze a Pilonidal Cyst? No, squeezing a cyst can worsen the infection, cause bleeding, and lead to further irritation. It’s best to have it evaluated and treated by a doctor. Diagnosis Physical Examination: Your doctor will conduct a thorough examination, focusing on the crease of your buttocks, to assess for signs of a pilonidal cyst. They will inspect the area for the presence of a pimple, dimple, or bump that may be oozing fluid, indicative of a cyst. Patient History: Your doctor may inquire about the duration and progression of symptoms, such as changes in the appearance of the cyst, the presence of leakage, and any associated symptoms you may have experienced. In some cases, imaging tests such as ultrasound or MRI may be used to assess the extent of the cyst or abscess. A healthcare provider may also perform a procedure called needle aspiration to drain fluid from the cyst for analysis. Treatments Treatment options for pilonidal disease vary depending on the severity of the condition and may include: Natural Drainage: In some cases, a pilonidal cyst may open and drain spontaneously. If this occurs, it’s essential to maintain proper hygiene by keeping the area clean and dry to prevent infection. Antibiotics: Antibiotics may be prescribed if there is inflammation surrounding the pilonidal cyst. However, antibiotics alone will not resolve the cyst or promote its disappearance. Laser Therapy: Laser therapy can be utilized to remove hair from the affected area, reducing the likelihood of ingrown hairs and potentially preventing the recurrence of cysts. While it does not cure existing cysts, it may help prevent future ones. Medical Procedures Drainage: For initial or uncomplicated cysts, drainage may be performed. This involves making an incision into the cyst, draining its contents, and removing any hair follicles. The wound is left open and packed with gauze to facilitate healing. This procedure is typically performed under local anesthesia. Surgery: Surgery may be necessary for chronic or recurrent pilonidal cysts or in cases where complications have arisen. Different surgical techniques may be employed, including: Marsupialization: During this procedure, the cyst is drained, and the wound edges are stitched together to create a pouch. This outpatient surgery is performed under local anesthesia, and while it requires a longer healing time, it minimizes the need for daily gauze packing. Incision, Drainage, and Closure: In this approach, the cyst is drained, and the wound is fully closed after surgery. While it avoids the need for postoperative gauze packing, it may increase the risk of cyst recurrence and is typically performed in an operating room by a specialized surgeon. What is the best treatment for a Pilonidal Cyst? Draining is typically the preferred initial treatment for pilonidal cysts. This involves making a small incision to drain the cyst and packing the wound with gauze. It’s performed under local anesthesia and may take several weeks to heal. Home Care Tips Warm Water Soaks: Soaking in a tub of warm water can help alleviate pain and promote drainage of the cyst. This can provide temporary relief and aid in the healing process. Over-the-Counter Pain Medication: Nonprescription pain relievers, such as acetaminophen or ibuprofen, can be taken according to the recommended dosage to manage discomfort associated with the cyst. Hygiene and Wound Care: Keeping the cyst and the surrounding area clean and dry is essential for preventing infection and promoting healing. Gently cleansing the area with mild soap and water and patting it dry can help maintain proper hygiene. Will a Pilonidal Cyst Go Away on Its Own? In some cases, a cyst may spontaneously open and drain. However, it’s important to keep the area clean and dry if this occurs. Pilonidal Cyst Recovery Follow Instructions: Adhere to your doctor’s guidance regarding home care, especially if gauze packing is required. Maintain cleanliness in the area and monitor for signs of infection. Regular Check-ups: Attend scheduled follow-up appointments to allow your doctor to monitor the healing progress of your cyst. Precautions: Even after successful treatment, be aware that pilonidal cysts can recur. Remain vigilant for any symptoms indicating a potential recurrence. Complications Infected Pilonidal Cyst: An infected cyst, known as an abscess, can be extremely painful and may exhibit symptoms such as foul-smelling pus, fever, and nausea. In severe cases, the infection can spread systemically, posing a life-threatening risk. Recurrence: Despite medical intervention, some individuals may experience chronic pilonidal disease characterized by the recurrent formation of cysts. This condition necessitates ongoing management and surveillance to mitigate complications. Prevention Avoid Prolonged Sitting: Stand up or walk around periodically to reduce prolonged pressure on the buttocks, which can contribute to the development of pilonidal cysts. Maintain Hygiene: Regularly wash the area around your buttocks to keep it clean and minimize the risk of infection. Healthy Weight: Aim to maintain a healthy weight, as being overweight can increase your risk of developing pilonidal cysts. When to See a Doctor Increased Pain with Prolonged Sitting: If you notice escalating pain, particularly after extended periods of sitting, it is advisable to contact your healthcare provider for further assessment and management. Visible Signs of Inflammation: Any swelling, redness, or soreness along the buttock crease or the presence of a dimple in the area warrants medical attention, as these may indicate the development or exacerbation of a pilonidal cyst. Drainage of Pus or Blood: If you observe any discharge of pus or blood from the cyst, it is essential to seek medical care promptly to prevent infection or complications. Systemic Symptoms: The onset of systemic symptoms such as fever, nausea, or profound fatigue suggests a more severe infection or inflammation and requires immediate medical intervention to prevent further complications. Outlook/Prognosis The prognosis for pilonidal disease varies depending on the severity of the condition and the effectiveness of treatment. With proper medical care and lifestyle modifications, many individuals can experience relief from symptoms and a reduced risk of recurrence. Sources Mayo Clinic. (2022). Pilonidal Cyst. My Health Alberta, Canada: “Skin Cyst. Home Treatment. NIH National Library of Medicine, Clinics in Colon and Rectal Surgery. Pilonidal Disease. American Society of Colon & Rectal Surgeons. Pilonidal Disease. Cleveland Clinic. Pilonidal Cyst, Sacral Dimple. The University of Texas at Austin University Health Services. Pilonidal Cyst. American Academy of Dermatology Association. (2022). Pilonidal cyst: Who gets and causes. May 4, 2024 0 comment 0 FacebookTwitterPinterestLinkedinEmail
Roseola ROSEOLA by Justina April 24, 2024 written by Justina Roseola, also known as roseola infantum or sixth disease, is a common viral illness that primarily affects infants and young children below the age of 2. Typically, it poses no significant concern as children tend to recover on their own. Causes Roseola is typically caused by the human herpesvirus 6 (HHV-6) or, less commonly, human herpesvirus 7 (HHV-7). These viruses belong to the herpes family and are highly contagious. Roseola spreads through respiratory secretions, such as saliva and nasal discharge, as well as through close contact with an infected individual. Roseola Rash Within 24 hours of the fever breaking, your child may develop a rash. On lighter skin tones, it appears as pinkish-red spots, while on darker skin tones, it may be less noticeable. The rash can be flat or have both flat and raised areas. Pressing on the spots will cause them to fade or turn white. Initially, the rash typically appears on the chest, back, and abdomen, then spreads to the face, neck, arms, and legs. Although seeing a rash spread over your baby’s body can be concerning, remember that a roseola rash does not cause itching or discomfort and usually resolves within two to four days. Unlike some other rashes, a key characteristic of a roseola rash is that it only emerges after the child’s fever has subsided. Is Roseola Contagious? Yes, roseola is contagious and spreads through saliva and respiratory droplets, particularly from coughing or sneezing, of individuals who have a fever or are asymptomatic carriers. Symptoms typically appear 5 to 15 days after exposure to the virus. A child with roseola can transmit the virus to others while experiencing a fever and for 24 hours after the fever subsides. A fever is considered a temperature of 100.4 degrees F (38 degrees C) or higher. Even if the child appears alert and well, it’s advisable to refrain from sending them to daycare or play dates until their temperature has remained normal for at least 24 hours. It’s important to note that the child cannot spread roseola solely through the rash. If uncertain about whether it’s safe for a child to be around others, consulting a pediatrician is recommended. This caution is particularly crucial when avoiding contact with children who have compromised immune systems, as roseola can lead to more severe complications for them. Can You Get Roseola Twice? While it’s possible to contract roseola more than once, it’s rare. Typically, individuals develop immunity to roseola after experiencing it, reducing the likelihood of reinfection. However, immunocompromised children or adults may be susceptible to multiple episodes of roseola. Symptoms The primary symptom of this viral illness is a sudden and high fever, typically ranging from 103 to 105 degrees Fahrenheit (39.5 to 40.5 degrees Celsius). Following the fever’s resolution, a rash may emerge all over the child’s body. Additional Symptoms and Signs: Before the onset of the roseola rash, some children may experience: Vomiting. Diarrhea. Loss of appetite. Cough. Sore throat. Runny nose. Pink eye. Swelling of the eyelids or the area around the eyes. Swollen lymph nodes in the neck or the back of the head. Small pink or red spots along the throat. Risk Factors Children between the ages of 6 months and 3 years are most susceptible to sixth disease due to their immature immune systems. Additionally, exposure to an infected individual increases the risk of contracting the virus. Prevalence Roseola is highly prevalent, affecting nearly all children by the time they reach their second birthday. In the United States, roseola accounts for up to 45% of all fevers in infants. Additionally, approximately 12% of infants requiring care for a fever in an emergency room (ER) are diagnosed with roseola. Although roseola can potentially affect individuals of any age, it primarily occurs in babies and toddlers. Instances of roseola in older children or adults are rare. Diagnosis Healthcare providers diagnose sixth disease through a combination of discussing your child’s symptoms and conducting a physical examination. Laboratory tests, such as blood tests or viral cultures, may be conducted to confirm the presence of HHV-6 or HHV-7, although these are typically not necessary for diagnosis. Your pediatrician will typically rule out other potential causes of your child’s symptoms, including: Allergic reaction to medication. Ear infection. Measles. Rubella. Scarlet fever. Your pediatrician will provide guidance on managing your child’s fever and advise when to seek medical attention if necessary. Treatments No Specific Treatment: Healthcare providers do not have a specific treatment for roseola. Since roseola is a viral infection, antibiotics are ineffective as they only treat bacterial infections. Fever Management: The focus of treatment is on managing symptoms at home. Your pediatrician may recommend children’s acetaminophen or ibuprofen to reduce your child’s fever. However, aspirin should not be given to children under 17 due to the risk of Reye’s syndrome. Rash Management: Typically, the rash associated with roseola does not cause itching or pain, so it does not require treatment. Special Considerations: If your child is taking immunosuppressant medication, consult your pediatrician to determine if any special treatment is needed. Seeking Guidance: If you have any questions or concerns about managing roseola, don’t hesitate to talk to your pediatrician. They are available to answer your questions and provide guidance on how best to care for your child. Complications of Roseola Most children experience no complications from this viral illness. However, for those who do, the most common complication is a febrile seizure. Approximately 10% to 15% of children aged 6 to 18 months with roseola may experience febrile seizures, typically occurring on the first day of fever. Febrile seizures typically last less than 15 minutes and do not cause lasting harm to the child. The key signs of a febrile seizure include: The child’s body shakes, stiffens, or tenses up. Loss of consciousness, or the eyes rolling back in the head. Loss of control over basic bodily functions, such as vomiting, drooling, urination, or defecation. If a child displays these signs and has never experienced a febrile seizure before, it’s essential to call 911 or the local emergency number immediately. Attempting to treat a first-time febrile seizure at home is not advisable, as the child requires immediate medical attention to rule out more serious types of seizures. For children who have had febrile seizures before, pediatricians provide guidance on how to manage future occurrences. It’s crucial to follow these guidelines closely, and when in doubt, seek emergency assistance. It’s important not to exceed recommended doses and frequencies of acetaminophen or ibuprofen in an attempt to prevent febrile seizures. Excessive use of these medications can lead to liver damage or failure (with acetaminophen) or kidney damage and stomach problems (with ibuprofen). While rare, more severe complications can occur, especially in children with weakened immune systems due to conditions such as cancer or autoimmune diseases. Potential complications include: Infection and inflammation in the lungs, leading to pneumonia. Inflammation of the delicate tissue surrounding the brain and spinal cord, known as aseptic meningitis. Inflammation of the brain itself, termed encephalitis. Other conditions affecting the central nervous system, which comprises the brain and spinal cord. Home Care Remedies To ease symptoms at home, encourage rest and provide a cool, comfortable environment. Dress the child in lightweight clothing and offer lukewarm baths to help reduce fever. Use a humidifier to moisten the air and soothe respiratory symptoms. Expectations if Your Child Has Roseola: Variability in Symptoms: Symptoms of this viral illness can vary among children. Some may remain alert, playful, and exhibit their usual behavior, while others may experience restlessness or irritability, particularly during periods of high fever. Recovery Time: Most babies and children with roseola recover within about one week and typically do not experience any complications. Possible Complication: It’s important to be aware that febrile seizures are a potential complication of roseola. While these seizures usually last for a short duration and do not cause lasting harm, they can be alarming. If your child has a medical condition that weakens their immune system, discuss with your pediatrician what steps to take if they develop a fever. Guidance from Pediatrician: Your pediatrician will guide recognizing signs of complications and when to seek medical assistance. It’s essential to follow their advice closely and communicate any concerns or changes in your child’s condition promptly. Possibility of Unnoticed Roseola: Yes, it is possible to have this viral illness without being aware of it. Many children may have experienced a virus that causes roseola without displaying noticeable symptoms. Since children can develop fevers for various reasons, if a child does not manifest the characteristic roseola rash, the fever may be attributed to another illness, and the presence of roseola may go unrecognized. Prevention Preventing the spread of this viral illness involves practicing good hygiene, such as frequent handwashing with soap and water, especially after coughing, sneezing, or caring for a sick child. Additionally, avoiding close contact with individuals who have symptoms of roseola can help prevent transmission. Comparison with Measles Rash Both roseola and measles can result in a rash, but there are notable differences between them: Color of the Spots: A roseola rash is typically pink-red, while a measles rash tends to be red or red-brown. Additionally, a measles rash may have small, raised white spots atop the red spots. Connectivity of Spots: Roseola rash spots are usually separate and do not merge, whereas measles rash spots are more likely to join together. Location of Rash Onset: Roseola rash starts on the chest, back, and abdomen, spreading outward. In contrast, a measles rash begins on the face and moves downward to cover the body. Skin Peeling During Resolution: A roseola rash does not cause skin flaking or peeling, whereas a measles rash does. If there are concerns about measles, contacting a pediatrician promptly is crucial, as measles is a more serious illness than roseola and can lead to severe complications. Measles is highly contagious and spreads through the air. Preventive Measures Against Measles: Protection against measles can be achieved by administering either the Measles, Mumps, Rubella (MMR) vaccine or the Measles, Mumps, Rubella, Varicella (MMRV) vaccine. When to See a Doctor While roseola is typically a mild, self-limiting illness, it’s essential to consult a doctor if a child develops a high fever or rash. Seek medical attention if the child shows signs of dehydration, difficulty breathing, or other concerning symptoms. Outlook/Prognosis In most cases, roseola resolves on its own without complications within a week. Once the fever breaks and the rash fades, the child is no longer contagious. However, complications such as febrile seizures can occur in rare cases. Overall, the prognosis for roseola is excellent, and most children recover fully with supportive care. Sources American Academy of Pediatrics. (2018). Roseola. In Red Book: 2018 Report of the Committee on Infectious Diseases (31st ed.). Centers for Disease Control and Prevention. (2021). Roseola (Human Herpesvirus 6 and 7). National Health Service (U.K.). Roseola Mayo Clinic. (2022). Roseola. UpToDate. (2022). Clinical features and diagnosis of roseola infantum (exanthem subitum). Emerging Infectious Diseases: “Human Herpesvirus 6: An Emerging Pathogen.” HealthyChildren.org: “Roseola Infantum.” Children’s National Health System: “Pediatric Viral Exanthems (Rashes).” American Osteopathic College of Dermatology. Roseola Infantum Canadian Paediatric Society. Roseola Merck Manual (Consumer Version). Roseola Infantum April 24, 2024 0 comment 0 FacebookTwitterPinterestLinkedinEmail
Rosacea ROSACEA by Justina April 24, 2024 written by Justina Rosacea, a common skin condition, manifests as redness or flushing of the skin, often accompanied by small pus-filled bumps, resembling acne or other skin issues. While it’s not life-threatening, rosacea can significantly impact one’s quality of life due to its effects on appearance and sometimes discomfort. Symptoms vary depending on skin color; while flushing is more evident on light skin, it may be less noticeable on brown or Black skin, potentially leading to misdiagnosis in individuals with darker skin tones. While seeking medical advice is crucial for proper diagnosis and treatment, there are also steps individuals can take at home to alleviate symptoms. Causes The exact cause of rosacea is unknown, but several factors may contribute to its development: Mites: Microscopic insects known as Demodex folliculorum inhabit human skin, typically without causing harm. However, some individuals may be more sensitive to these mites or harbor a higher-than-average population, leading to skin irritation. Bacteria: Studies suggest a potential link between Helicobacter pylori, a bacterium residing in the gut, and rosacea. It’s proposed that H. pylori may elevate levels of gastrin, a digestive hormone, resulting in facial flushing. Genetics: A family history of rosacea increases the likelihood of developing the condition. Environmental Triggers: Exposure to certain environmental factors, such as sunlight, hot or cold weather, wind, or spicy foods, can exacerbate symptoms. Dysfunction of Blood Vessels: Abnormalities in blood vessels near the surface of the skin may play a role in rosacea’s development. Immune System Response: Some researchers believe that an abnormal immune system response may contribute to inflammation in the skin. Who is at higher risk of developing rosacea? While this skin condition can affect anyone, certain groups are more prone to the condition, including: Middle-aged and older adults Women Light-skinned individuals, though it may be overlooked by doctors in individuals with darker skin tones due to the camouflage effect of this skin tone on discolored areas. Types Rosacea presents in four main types, and it’s possible to experience symptoms from more than one type simultaneously. These types include: Erythematotelangiectatic Rosacea: This type features persistent redness on the face, accompanied by enlargement and increased visibility of small blood vessels beneath the skin. Symptoms tend to fluctuate over time, but without treatment, the redness may worsen or become permanent. Papulopustular Rosacea: Characterized by the presence of pus-filled “whiteheads” and swollen red bumps resembling acne, often appearing on the forehead, cheeks, and chin. In severe cases, these symptoms may take a considerable amount of time to improve. Phymatous Rosacea: A rare form of rosacea where the skin becomes thickened and scarred, commonly affecting the nose and causing swelling, bumpiness, and sometimes discoloration. Ocular Rosacea: This type affects the eyes, leading to irritation, a bloodshot appearance, and increased tear production. Dryness and sensitivity in the eyes are common, along with the potential development of cysts on the eyelids. When this skin condition affects the face, the skin typically appears more flushed, accompanied by the presence of broken blood vessels (spider veins) and pus-filled bumps. Erythematotelangiectatic, papulopustular, and phymatous rosacea are all varieties that manifest on the face. Symptoms of Rosacea For individuals with lighter skin tones, rosacea typically manifests as redness primarily on the cheeks, nose, chin, and forehead (papules). Occasionally, the redness may also extend to areas such as the neck, head, ears, or chest. Over time, broken blood vessels may become visible through the skin (telangiectasia), leading to thickening and swelling. Additionally, approximately half of individuals with rosacea experience eye-related issues such as redness, swelling, and discomfort (ocular rosacea). It’s essential to seek a proper diagnosis for rosacea since it can resemble other conditions. The redness is more pronounced in individuals with lighter skin tones, making diagnosis easier. However, diagnosing rosacea in individuals with darker skin tones might pose challenges. Common symptoms of this skin condition, regardless of skin tone, include: Stinging and burning sensations on the skin Red or pus-filled bumps resembling pimples (pustules) Areas of rough, dry skin Swollen, bulb-shaped nose(rhinophyma) Enlarged pores Broken blood vessels on the eyelids Eyelid bumps Vision problems Risk Factors for Rosacea Several factors may increase the risk of developing this skin condition, including: Fair skin Age (typically onset between 30 and 50) Family history of rosacea Female gender (though men may experience more severe symptoms) History of acne Triggers This skin condition can be aggravated by various factors, including: Exposure to sunlight Extreme temperatures, such as very hot or cold weather Consumption of alcohol Spicy or hot foods Vigorous physical activity Stress Certain cosmetic, skincare, or hair products Additionally, menopause and certain medications may induce flushing. To pinpoint your specific triggers, it’s helpful to maintain a diary documenting when symptoms occur, your activities at the time, environmental conditions, and potential triggers. Discussing this information with your doctor can aid in managing your condition effectively. Prevalence of Rosacea Rosacea is a common condition, affecting an estimated 5-10% of the population worldwide. While it can occur in people of any ethnicity, it is more commonly diagnosed in individuals with fair skin. Diagnosis of Rosacea Diagnosing this skin condition usually involves a physical examination of the skin and a discussion of symptoms with a healthcare provider. In some cases, additional tests may be performed to rule out other conditions that mimic rosacea, such as lupus or eczema. Treatments for Rosacea While there isn’t a cure for rosacea, various treatments are available to help manage its symptoms like redness and bumps. Your doctor can recommend different types of medications to address the condition. Topical Treatments: These are medications applied directly to the skin, known as topicals. They work to combat acne, inflammation, and bacteria. Some commonly prescribed topicals include: Azelaic acid: Available as a gel or foam, it helps clear up bumps, swelling, and redness while preventing bacteria growth. Brimonidine (Mirvaso): This gel tightens blood vessels in the skin, reducing redness. Calcineurin inhibitors like pimecrolimus and tacrolimus Clindamycin and erythromycin: Antibiotics that kill bacteria on the skin. Ivermectin (Soolantra): Reduces inflammation. Metronidazole and doxycycline: Also antibiotics. Oxymetazoline (Rhofade): A cream that helps alleviate symptoms. Sodium sulfacetamide and sulfur: Antibiotics. Oral Medications: Isotretinoin is an acne medication sometimes prescribed for rosacea, but it’s not safe to use during pregnancy due to the risk of birth defects. Improvement in your skin may take several weeks or months of consistent medication use. Laser Treatment: Laser therapy is another option for treating rosacea. It utilizes intense light to target enlarged blood vessels and reduce skin redness. Laser resurfacing can also help in removing thickened skin associated with this skin condition. Other Procedures: In addition to laser therapy, your doctor may recommend other procedures such as: Dermabrasion: Removes the top layer of skin to promote regeneration. Electrocautery: Uses an electric current to eliminate damaged blood vessels. These treatments, whether topical, oral, or procedural, can help manage rosacea symptoms effectively under the guidance of a healthcare professional. Home Care Remedies for Rosacea In addition to medical treatments, Improving rosacea symptoms can often be achieved through self-care practices. Start by identifying triggers that may provoke flare-ups and strive to avoid them. Keeping a journal to track activities and flare-ups can assist in this process. Follow these self-care tips to protect your skin and reduce redness: Sunscreen Protection: Shield your skin from sunlight-triggered symptoms by using a broad-spectrum sunscreen with SPF 30 or higher every time you venture outdoors. Additionally, wear a wide-brimmed hat for added protection. Gentle Skin Care: Opt for gentle cleansers and moisturizers without harsh ingredients like alcohol or fragrance. After washing your face, pat it dry gently with a soft cloth. Moisturize: Especially in cold weather, moisturize your skin to counteract dryness caused by low temperatures and wind. Choose oil-free moisturizers for best results. Cosmetic Caution: Use high-quality, oil-free makeup products to minimize irritation to your skin. Facial Massage: Massage your skin in a circular motion, starting from the center of your face and moving outward towards your ears. Conceal Redness: To conceal redness and broken blood vessels, consider using a green-tinted cover-up specifically designed for the face. Seek Shade: Avoid prolonged exposure to heat and sunlight. Seek refuge in air-conditioned environments when possible. Eye Care: If rosacea affects your eyes, gently cleanse your eyelids daily with diluted baby shampoo or an eyelid cleaner. Applying warm compresses to your eyes several times a day can also provide relief. Dietary Considerations: Some individuals find relief from rosacea symptoms by adopting an anti-inflammatory diet, such as the Mediterranean diet. Emotional Well-being: Addressing emotional well-being is crucial to managing skin issues. If you feel embarrassed or notice a decline in self-esteem due to your appearance, don’t hesitate to seek support from your doctor, or counselor, or join a support group where you can connect with others experiencing similar challenges. Prevention of Rosacea While rosacea cannot be prevented entirely, individuals can reduce their risk of flare-ups by: Identifying and avoiding triggers known to exacerbate symptoms. Adopting a gentle skincare routine to minimize irritation. Seeking early treatment for symptoms to prevent worsening of the condition. When to See a Doctor It’s essential to see a healthcare provider if you experience persistent redness, bumps, or irritation on your face, as early intervention can help manage symptoms and prevent complications. Does rosacea itch? While not always present, rosacea can sometimes cause itching or a tight sensation. Symptoms of rosacea may fluctuate, with periods of flare-ups followed by periods of remission. Seeking treatment for rosacea is crucial. Without proper care, symptoms can worsen and potentially become permanent. Therefore, it’s important to consult with a healthcare professional for appropriate management. Outlook/Prognosis for Rosacea With proper management and treatment, many individuals with rosacea can control their symptoms and maintain a good quality of life. However, the condition is chronic and may require ongoing care to manage flare-ups effectively. Sources National Rosacea Society. “What is Rosacea?” American Academy of Dermatology Association. “Rosacea: Signs and Symptoms. Clinical, Cosmetic and Investigational Dermatology: “New developments in the treatment of rosacea – role of once-daily ivermectin cream.” FDA. Mayo Clinic. “Rosacea: Symptoms & Causes.” National Library of Medicine: “Azelaic Acid Topical.” International Rosacea Foundation. DermNet NZ. “Rosacea.” Cleveland Clinic: “Sulfacetamide; Sulfur topical skin cleanser or emulsion,” “Rosacea,” “Azelaic Acid Gel. April 24, 2024 0 comment 0 FacebookTwitterPinterestLinkedinEmail
Rashes SKIN RASHES by Justina April 19, 2024 written by Justina Skin rashes are pretty common occurrences where the skin becomes red, inflamed, and bumpy. Some rashes can be dry and itchy, while others might even be painful. Various factors like viruses, bacteria, allergens, and skin conditions like eczema can trigger these rashes. Almost everyone experiences a skin rash at least once in their lifetime. It’s quite usual to feel itchy or notice red, bumpy skin for a little while. Skin rashes don’t discriminate based on age. They can affect everyone, from infants to seniors. For instance, infants often deal with diaper rash and cradle cap. Children might experience atopic dermatitis or catch viruses like fifth disease that can cause rashes. Even older kids and adults can develop contact dermatitis, where the skin becomes sensitive to allergens or irritants over time. Causes of skin rashes Skin rashes can be triggered by a variety of factors, including: Allergens in the Environment: Substances like pollen, dust mites, pet dander, and certain foods can provoke allergic reactions leading to skin rashes. Bacterial Infections: Infections caused by bacteria, such as strep throat or staphylococcus bacteria, can sometimes manifest as skin rashes. Skin Conditions like Eczema: Chronic skin conditions like eczema can cause persistent rashes due to inflammation and irritation of the skin. Irritants: Exposure to irritants like harsh chemicals, soaps, detergents, and certain fabrics can irritate the skin and trigger rashes. Viruses: Various viral infections, including herpes simplex, influenza, and human papillomavirus (HPV), can cause viral rashes as a symptom of the infection. Types of skin Rashes Skin rashes come in various forms, each with its own characteristics and triggers. Here are some common types: Contact Dermatitis: This occurs when your skin reacts to a substance it doesn’t agree with. Many people are allergic to fragrances, preservatives, nickel (often found in costume jewelry), and plants like poison ivy. Irritants like soaps, detergents, chemicals, and household cleaners can also cause contact dermatitis. Eczema (Atopic Dermatitis): Often appearing in infancy, eczema can improve as a child grows but tends to run in families due to genetic factors. People with asthma or allergies are more prone to eczema. It causes dry, itchy, and inflamed skin patches. Hives (Urticaria): These are raised, red, and itchy welts on the skin. Hives can occur due to allergic reactions to airborne allergens, insect stings, extreme temperature changes, or certain bacterial infections. Psoriasis: A chronic skin disorder characterized by thick, scaly rashes. Psoriasis commonly affects areas like the elbows, knees, lower back, scalp, and genitals. It often has a genetic component and can be inherited. Viral Rashes: Many viral infections, such as chickenpox, measles, and molluscum contagiosum, can cause skin rashes as a symptom. These rashes vary in appearance and severity depending on the specific virus involved. Symptoms of skin rashes Symptoms of a skin rash can vary depending on its type and underlying cause. Some common symptoms include: Dryness of the skin. Formation of blisters. Skin appearing blotchy or discolored. Sensation of burning or stinging in the affected area. Flakiness or scaling of the skin. Presence of hive-like welts. Inflammation or swelling of the skin. Persistent itching. Pain or discomfort in the rash area. Redness or discoloration of the skin. When to see a doctor Knowing when to seek medical attention is crucial. Contact your healthcare provider immediately or seek emergency care if: The rash is accompanied by severe difficulty breathing, which could indicate anaphylaxis. The rash appears suddenly, covers a large area of your body, spreads rapidly, or is accompanied by a fever. Blisters or open sores develop within the rash, or if it appears infected (red, warm, swollen, with yellow pus). Diagnosis Diagnosing a skin rash can be a bit tricky due to the multitude of potential causes. Here’s how healthcare providers typically go about it: Physical Examination: Your healthcare provider will start by examining the rash and noting its characteristics. They’ll also ask about your symptoms and medical history to gather more information. Biopsy: In some cases, your healthcare provider might perform a biopsy by taking a small sample of your skin or other tissue from the affected area. This sample is then examined under a microscope to check for the presence of viruses, bacteria, or other abnormalities. Allergy Tests: If allergies are suspected as the cause of the rash, allergy tests such as skin prick (scratch) tests or patch tests may be conducted. During these tests, small amounts of potential allergens are applied to your skin to see if they provoke a reaction. Redness, swelling, or the development of a rash at the test site indicates an allergy to the substance. Blood Tests: Blood tests may be ordered to detect antibodies circulating in your bloodstream, which could be indicative of certain skin diseases or systemic illnesses. These tests can help identify underlying conditions contributing to the rash. Treatments Managing and treating a skin rash depends on its underlying cause. Here are some common treatment options: Treating skin rashes involves addressing the underlying cause and managing symptoms. Here are some common treatment options your doctor might recommend: Over-the-Counter and Prescription Creams/Ointments: Moisturizers free of fragrance and containing ingredients like ceramides, glycerin, and mineral oil can help soothe rashes caused by conditions like eczema. Over-the-counter hydrocortisone creams, such as Cortizone-10, can control itching, swelling, and redness associated with eczema. Prescription-strength cortisone creams may be necessary for severe cases. Steroids: Topical steroid creams or oral steroids like prednisone may be prescribed may be prescribed for persistent symptoms to alleviate itching and inflammation. Topical Immunomodulators: Prescription medications like tacrolimus ointment (Protopic) and pimecrolimus cream (Elidel) can help manage mild-to-moderate eczema by modifying the body’s immune response to allergens, reducing flare-ups. Injections: Dupilumab (Dupixent) is an injectable medication used for moderate-to-severe atopic dermatitis to quickly relieve itching. Cortisone shots may also be administered in severe cases. Phototherapy (Light Therapy): Ultraviolet light therapy, either UVA or UVB, administered through special lamps, can benefit individuals with severe eczema by reducing inflammation and itchiness. Risks include mild sunburn-like symptoms, dryness, itching, freckling, and potential premature skin aging. Anti-Itch Products or Allergy Medications: Antihistamines like Diphenhydramine (Benadryl) can help alleviate itchiness associated with rashes. Immunosuppressive Medications: Steroid shots, prednisone, or other immunosuppressive drugs may be prescribed to suppress the immune system and clear up rashes. Oatmeal Baths: Soaking in a warm bath with colloidal oatmeal, found in products like Aveeno, can provide relief for dry, itchy skin rashes. Complications Complications associated with skin rashes are usually rare but can include: Anaphylaxis: In severe cases of allergic reactions, a life-threatening condition called anaphylaxis may occur. This can lead to extreme swelling, including swelling of the air passages, necessitating immediate treatment with epinephrine (EpiPen). Infection: Scratching an itchy rash can break the skin, increasing the risk of bacterial skin infections. It’s important to avoid excessive scratching to prevent infections from developing. Prevention Preventing skin rashes involves taking proactive steps to avoid triggers and maintain good skincare practices. Here are some tips: Avoid Known Triggers: Identify and avoid substances that trigger allergic reactions or irritation, such as allergens and irritants in personal care products, household cleaners, and plants like poison ivy. Limit Exposure to Contagious Agents: Refrain from sharing personal items or clothing with individuals who have viral infections known to cause rashes, such as chickenpox or measles. Use Gentle Skincare Products: Opt for mild, fragrance-free, hypoallergenic soaps, cleansers, and moisturizers to minimize the risk of irritation or allergic reactions. Practice Good Hygiene: Wash your hands promptly after coming into contact with known allergens or irritants to prevent them from spreading to other parts of your body. Outlook The prognosis varies depending on the cause of the rash. Some rashes resolve with appropriate treatment, while others, like eczema and psoriasis, may require ongoing management. Treatments aimed at relieving pain, inflammation, and itching can improve the quality of life for individuals with chronic or recurring skin conditions. Sources American Academy of Dermatology (AAD). Rashes. American Academy of Family Physicians (AAFP). Skin Rashes and Other Skin Problems. National Eczema Association. What Is Eczema? WebMD: Rashes Clevland Clinic: Skin Rashes American College of Allergy, Asthma and Immunology Merck Manual. Rashes in Children. April 19, 2024 0 comment 0 FacebookTwitterPinterestLinkedinEmail
Sweet Syndrome SWEET SYNDROME by Justina April 18, 2024 written by Justina Sweet syndrome is a rare inflammatory skin condition characterized by the sudden onset of fever and a painful rash that can appear on the arms, legs, trunk, face, or neck. It is also referred to as acute febrile neutrophilic dermatosis. Experiencing a fever for several days followed by the sudden onset of a rapidly spreading, painful rash can be concerning and may indicate various health conditions, including one less commonly known: Sweet syndrome. Sweet syndrome is a rare skin condition that typically resolves on its own without treatment. However, it can be triggered by underlying health issues such as infections or, in some cases, cancer. It’s important to note that Sweet syndrome is not contagious, meaning it cannot be transmitted from person to person. Prevalence of Sweet Syndrome Acute febrile neutrophilic dermatosis is considered a rare medical condition, with only several hundred cases reported to date. Causes Sweet Syndrome Acute febrile neutrophilic dermatosis can occur spontaneously without an identifiable cause in most cases. However, in some instances, it may be associated with various underlying conditions or triggers, including: Blood Cancer: Sweet syndrome may manifest in individuals with blood cancers such as leukemia or lymphoma. Bowel Diseases: Conditions like ulcerative colitis or Crohn’s disease can be linked to the development of acute febrile neutrophilic dermatosis. Respiratory Infections: Infections affecting the chest, such as strep throat, have been associated with acute febrile neutrophilic dermatosis. Cancer: Certain types of cancers, including colon or breast cancer, may trigger acute febrile neutrophilic dermatosis. Skin Injury: acute febrile neutrophilic dermatosis. may develop at the site of skin injuries, such as needle pricks or insect bites. Pregnancy: Sweet syndrome can occur during pregnancy, although it is relatively rare. Rheumatoid Arthritis: Individuals with rheumatoid arthritis may be at risk of developing acute febrile neutrophilic dermatosis. Drug Reactions: Sweet syndrome can be triggered by certain medications. Common drugs like nonsteroidal anti-inflammatory drugs (e.g., Advil, Motrin), and antibiotics like Bactrim may induce acute febrile neutrophilic dermatosis. However, the most common culprit is granulocyte-colony stimulating factor, a medication used to boost immune function in some cancer patients. Symptoms of Sweet Syndrome The primary indicator of acute febrile neutrophilic dermatosis is the sudden appearance of a rash, often occurring a few days to weeks following a fever. Rash Characteristics: The rash typically presents as small red or purple bumps or lumps, initially appearing on the arms, legs, face, or neck, although they can emerge in other areas as well. These lesions tend to proliferate rapidly, eventually merging to form larger patches on the skin. Rash Presentation: The rash can be accompanied by pain, and individuals may develop blisters or pimple-like bumps, which have the potential to rupture and become infected. Other Associated Symptoms: In addition to the rash and fever, individuals with acute febrile neutrophilic dermatosis may experience a range of additional symptoms, including: Flu-like Symptoms: Feeling unwell, akin to having the flu, characterized by generalized malaise and fatigue. Headaches: Individuals may experience headaches of varying intensity. Joint Pain: Joint pain or discomfort may be present, contributing to overall discomfort. Mouth Sores: Some individuals may develop sores or lesions within the mouth. Pink Eye: Conjunctivitis, or pink eye, may occur concurrently with the rash and other symptoms. Risk Factors Sweet syndrome can affect individuals of any age or gender, but it is most commonly observed in women aged between 30 and 50 years. Diagnosis Diagnosing acute febrile neutrophilic dermatosis typically involves a combination of clinical evaluation and diagnostic tests to confirm the condition and rule out other possible causes. Diagnostic procedures may include: Visual Examination: Your doctor may be able to identify Sweet syndrome based on the characteristic appearance of the rash. However, additional tests are usually conducted to confirm the diagnosis and determine the underlying cause. Skin Biopsy: A small sample of the rash is collected and examined under a microscope to look for specific features consistent with Sweet syndrome. Blood Tests: Blood samples may be analyzed to assess levels of white blood cells, particularly neutrophils, and to check for any abnormalities indicative of underlying blood disorders or systemic inflammation. Imaging Tests: In cases where an underlying condition is suspected, your doctor may recommend imaging studies such as X-rays or computed tomography (CT) scans. These imaging tests provide detailed images of internal organs and structures to help identify any potential contributing factors or complications associated with acute febrile neutrophilic dermatosis. Treatment for Sweet Syndrome Sweet syndrome may resolve spontaneously without treatment if it is not associated with an underlying health condition, although this process can take several weeks or even months. Corticosteroids: Corticosteroid pills are commonly prescribed to alleviate symptoms such as redness, itching, swelling, and allergic reactions associated with Sweet syndrome. Additionally, steroid creams or gels may be recommended, particularly for smaller lesions, to provide relief from pain and inflammation. In cases of severe pain or swelling, your doctor may administer steroid injections directly into the affected areas. Addressing Underlying Conditions: If Sweet syndrome is secondary to an underlying health problem such as cancer or a drug reaction, treating the underlying cause is essential for resolving the skin manifestations. Discontinuing the medication responsible for triggering acute febrile neutrophilic dermatosis often leads to the resolution of the rash. Follow-Up and Monitoring: After treatment, most cases of acute febrile neutrophilic dermatosis heal without leaving scars, unless there are open sores present. However, skin discoloration may persist for several months following resolution of the rash. It’s important to note that acute febrile neutrophilic dermatosis may recur, especially if cancer is the underlying cause. Therefore, regular follow-up appointments with your doctor are necessary for monitoring and early detection of any recurrence or associated health issues. Post-Treatment Expectations: Following treatment, most individuals experience resolution of the rash and skin lesions associated with Sweet syndrome without scarring. However, skin discoloration may persist for several months after symptom disappearance. Complications of Sweet Syndrome In some instances, Sweet syndrome may lead to complications involving other organ systems in the body, including the nervous and gastrointestinal systems. Eye problems are among the most frequent complications associated with acute febrile neutrophilic dermatosis. These may encompass: Eye inflammation Increased eye pressure (glaucoma) Corneal ulceration is characterized by the development of sores on the cornea. Prevention As the exact cause of Sweet syndrome remains unknown, preventive measures are not currently available. The prognosis for Sweet Syndrome For the majority of individuals, symptoms of Sweet syndrome either resolve spontaneously or with appropriate medical intervention. The duration of symptoms can vary, lasting for weeks or months. Prolonged symptom duration may occur if Sweet syndrome is secondary to an underlying medical condition or medication. Living With Sweet Syndrome Contact your doctor if you experience symptoms of acute febrile neutrophilic dermatosis or if your symptoms worsen. Seeking prompt medical attention can facilitate timely diagnosis and appropriate management of the condition. Sources Clevland Clinic: “Sweet’s Syndrome.” Multiple Myeloma Research Foundation: “What are colony-stimulating factors?” British Association of Dermatologists: “Sweet’s Syndrome (Acute Febrile Neutrophilic Dermatosis).” WebMD: “Sweet’s Syndrome.” Mayo Clinic: “Sweet’s Syndrome.” National Organization for Rare Disorders: “Sweet Syndrome.” National Institutes of Health; Genetic and Rare Diseases Information Center: “Acute Febrile Neutrophilic Dermatosis.” April 18, 2024 0 comment 0 FacebookTwitterPinterestLinkedinEmail