Other Important Dermatological Conditions
Actinic Keratoses a common, potentially serious skin condition that may be characterized by rough, red, scaly patches, crusts or sores. AKs are known as the early beginnings of skin cancer.
Allergy rashes Allergic contact dermatitis is caused by a reaction to substances called allergens that come into contact with your skin. In susceptible people, these contact allergens can cause itching, redness, and blisters that is known as allergic contact dermatitis.
Atopic eczema/dermatitis The terms eczema or dermatitis are used to describe certain kinds of inflamed skin conditions including allergic contact dermatitis, seborrheic dermatitis, photoallergic dermatitis and stasis dermatitis. Eczema can be red, blistering, oozing, scaly, brownish, or thickened and usually itches. A special type is called atopic dermatitis or atopic eczema.
Atypical nevus (also called a dysplastic nevus): a benign growth that may share some of the clinical or microscopic features of melanoma, but is not a melanoma or any other form of cancer. However, the presence of atypical nevi may increase the risk of developing a melanoma, or be a marker for someone who is at risk of developing melanoma
Basal cell carcinoma a skin cancer that develops in the basal layer of the skin-deeper than the surface layer. It is associated with aging and years of chronic sun exposure. Basal cell carcinoma seldom spreads to other parts of the body, but can be disfiguring if not treated early. Basal cell carcinoma is the most common form of cancer worldwide. In the vast majority of cases, it is thought to be caused by exposure to the harmful ultraviolet rays of the sun. It is becoming more common, perhaps because people may be spending more time outdoors. Some believe that the decrease in the ozone layer is allowing more ultraviolet radiation from the sun to reach the earth's surface. Basal cell cancer does not usually metastasize or travel in the bloodstream; rather it infiltrates the surrounding area destroying tissue. For this reason, basal cell cancer should be treated promptly by your dermatologist with dermatologic surgical techniques.
Contact dermatitis Contact dermatitis is characterized by redness, swelling, itching, and scaling caused by an allergic substance that makes direct contact with the skin. The condition can develop at any age, although the facial version of the disorder is most often seen in young and middle-aged adults.
Eczema The terms eczema or dermatitis are used to describe certain kinds of inflamed skin conditions including allergic contact dermatitis and nummular dermatitis. Eczema can be red, blistering, oozing, scaly, brownish, or thickened skin and usually itches. A special type is called atopic dermatitis or atopic eczema
Granuloma Annulare Granuloma annulare is a raised, bumpy or ring-shaped lesion which may occur singly or in groups on the skin. It is especially common in children and young adults, although it may affect people of all ages, and is twice as common in women as it is in men.
Herpes simplex The herpes simplex virus (HSV) causes blisters and sores around the mouth, nose, genitals, and buttocks, but they may occur almost anywhere on the skin or mucous membranes. HSV infections can be very annoying because they may reappear periodically. The sores may be painful and unsightly. For chronically ill people and newborn babies, the viral infection can be serious, but rarely fatal. There are two types of HSV - Type 1 and Type 2.
Herpes zoster (shingles) Herpes zoster, also known as shingles or zoster, is a viral infection caused by the same virus that causes chicken pox. Anyone who has had chicken pox can develop herpes zoster. The virus remains dormant (inactive), in certain nerve cells of the body, and when it reactivates it causes zoster. About 20 percent of those people who have had chicken pox will get zoster. Most people get zoster only once..
Hydrocortisone A less potent corticosteroid incorporated into creams, lotions and ointments used to treat skin inflammation
Hyperhidrosis (excessive sweating) Hyperhidrosis is a chronic medical disorder that results in the production of excessive sweat. A recent study determined that the condition - once thought to be rare - actually affects approximately 2.8 percent of the U.S. population, or 7.8 million people. Even more compelling, one out of three people surveyed with the condition said their sweating was intolerable or barely tolerable. Many sufferers said they were depressed and frustrated with daily activities, and they experienced interference with work and romance and had difficulty meeting people.
Impetigo Impetigo is a skin infection that is generally caused by one of two bacteria: staphylococcus aureus or group a streptococcus. Impetigo usually affects preschool- and school-age children, especially in the summer months. A child may be more likely to develop impetigo if his skin has already been irritated or injured by other skin problems, such as eczema, poison ivy, insect bites, or skin allergy to soap or makeup.
Lichen Planus Lichen planus is an inflammatory disease that usually affects the skin, the mouth, or sometimes both. It may affect the genital skin as well. The cause of lichen planus is not known. There are cases of lichen planus-type rashes occurring as allergic reactions to medications for high blood pressure, heart disease and arthritis. In those cases, identifying and stopping the use of the drug helps clear up the condition within a few weeks. Some people with lichen planus can also have hepatitis C. Lichen planus affects men and women equally, and occurs most often in middle-aged adults
Liver spots "Age spots" or "liver spots" are flat, brown areas called lentigines. They have nothing to do with the liver - they are caused by the sun and usually appear on the face, hands, back and feet. They are generally harmless. They may look like melanoma and therefore may require evaluation. Commercial "fade" creams will not make lentigines disappear, but effective prescription medications and surgical resurfacing treatments are available.
Lupus Patients with lupus erythematosus (LE) often have skin signs and develop many different types of lesions. LE skin diseases are divided into two broad categories: those skin lesions that occur only in people with LE, known as LE-specific skin lesions, and those skin lesions that can occur in people with LE, but can also occur in other diseases (LE-non-specific skin lesions). There are three broad categories of LE-specific skin lesions: chronic cutaneous LE (CCLE), or diseases limited to the skin, subacute cutaneous LE (SCLE), and acute cutaneous LE (ACLE). Another skin condition related to lupus is discoid LE, where unsightly red scaly patches develop which leave white scars. Discoid LE predominantly affects the cheeks and nose, but sometimes involves the upper back, V of neck, and backs of hands. Bald areas can develop if the hair follicles are involved. Discoid LE may affect the lips causing ulcers and scaling
Melanin Skin pigment (substance that gives the skin its color). Dark-skinned people have more melanin than light-skinned people.
Melanocytes cells that make the skin pigment melanin. Melanin is made in small granules, called melanosomes, within the melanocyte. Melanin is then transported to cells of the outer skin (keratinocytes), where the melanin is seen as "color" of the skin.
Melanoma Melanoma is a type of cancer that begins in the skin. It is completely curable when detected early, but can be fatal if allowed to progress and spread. Cancer is a condition where one type of cell grows without limit in a disorganized fashion, disrupting and replacing normal tissues and their functions, much like weeds overgrowing a garden. Melanoma is a cancer of the pigment producing cells in the skin, known as melanocytes. Normal melanocytes reside in the outer layer of the skin and produce the brown pigment melanin, which is responsible for the color of our skin. Melanoma is when melanocytes become cancerous, grow, and invade other tissues
The thickness of a melanoma (how deeply the tumor extends into the skin) has been related to 5-year survival after surgical removal of the tumor. A physician named Alexander Breslow made this observation in 1975, and the relationship between tumor thickness and 5-year survival has been documented to be valid in years since:
Breslow Thickness (millimeters)
less than 0.76
0.76-1.50
1.51-2.50
2.51-4.0
4.1-8.0
more than 8.0
|
5-Year Survival (%)
97
92
76
62
52
32
|
Survival rates, like insurance survival tables, are statistical aggregates. Please keep in mind, it is impossible to determine survival for an individual patient
Pruritus A sensation that provokes the desire to scratch. Itching can be a significant source of frustration and discomfort for patients. When severe, it can lead to loss of sleep, anxiety, and depression.
- What is pruritus?
Pruritus is an itch or a sensation that makes a person want to scratch. Pruritus can cause discomfort and be frustrating. If it is severe, it can lead to sleeplessness, anxiety, and depression. The exact cause of an itch is unknown. It is a complex process involving nerves that respond to certain chemicals like histamine that are released in the skin, and the processing of nerve signals in the brain. Pruritus can be a part of skin diseases, internal disorders, or due to faulty processing of the itch sensation within the nervous system.
- Who gets pruritus?
There are many skin diseases like urticaria (hives), varicella (chicken pox), and eczema which may have itching associated with a rash. Some skin conditions only have symptoms of pruritus without having an obvious rash. Dry skin can itch, especially in the winter, with no visual signs of a rash. Some parasitic infestations such as scabies and lice may be very itchy. Itchy, pigmented moles may be a sign of a malignant change.
Pruritus may be a manifestation of an internal condition. The most common example is kidney failure. Some types of liver disease like hepatitis, thyroid disease including both hyper (too much) and hypo (too little) thyroid hormone levels, some blood disorders such as lymphomas, iron deficiency anemia, polycythemia vera, multiple myeloma, and neurologic conditions such as pinched nerves and post herpetic neuralgia can cause itch. Infectious diseases like HIV can cause severe itching.
Scabies Scabies is caused by a tiny mite that has infested humans for at least 2,500 years. It is often hard to detect, and causes a fiercely, itchy skin condition. Dermatologists estimate that more than 300 million cases of scabies occur worldwide every year. The condition can strike anyone of any race or age, regardless of personal hygiene. The good news is that with better detection methods and treatments, scabies does not need to cause more than temporary distress.
Skin cancer Cancer is a condition where one type of cell grows without limit in a disorganized fashion, disrupting and replacing normal tissues and their functions, much like weeds overgrowing a garden. There are three main forms of skin cancer -- Basal Cell Carcinoma, Squamous Cell Carcinoma and Melanoma. Basal Cell and Squamous Cell cancers are curable. Melanoma is also completely curable when detected early, but can be fatal if allowed to progress and spread. Melanoma is a cancer of the pigment producing cells in the skin, known as melanocytes. Normal melanocytes reside in the outer layer of the skin and produce the brown pigment melanin, which is responsible for the color of our skin. Melanoma describes melanocytes that become cancerous, grow, and invade other tissues.
Topical Corticosteroids Millions of people are affected annually with skin diseases that cause marked discomfort, significant morbidity, and rarely death. When skin diseases are extensive or apparent to others, social isolation and difficulty in finding employment may occur. Since the early 1950s, when hydrocortisone cream was found to be an effective antiinflammatory agent, topical corticosteroids have become a mainstay of dermatologic therapy.
Skin diseases amenable to the effects of topical corticosteroids are usually characterized by inflammation, hyperproliferation, and/or immunologic phenomenon. Topical corticosteroids may also be effective in the treatment of skin symptoms, such as burning and itching.
Topical corticosteroids have been used extensively worldwide for the past four decades, resulting in the amelioration of skin disease with very few reports of adverse effects. During this time, products with increased efficacy and accompanying increased potential for adverse effects have been developed. Factors that increase clinical efficacy include enhancement of pharmacologic activity of the compound by altering molecular structure, increasing stratum corneum penetration of the compound, and increasing bioavailability of the compound from the vehicle. At present, attempts are being made to engineer compounds that are locally potent but are rapidly metabolized or otherwise designed to have less potential to cause harmful effects.
Topical Immunomodulators (TIMS) For over a decade, potent systemic immunomodulators have been used for the treatment of psoriasis and eczema. In the past two years, these medications have been incorporated into topical preparations. When applied topically, these therapies exert their powerful anti-inflammatory effects on the skin without hampering the immune system's ability to defend itself from bacteria, viruses, and disease. Two topical immunomodulators (TIMs), tacrolimus ointment and pimecrolimus cream, have been approved for the treatment of eczema, a chronic skin condition characterized by itchy, inflamed skin - typically on the insides of the elbows, backs of the knees and the face. These steroid-free treatments are effective in treating eczema without the side effects found with using corticosteroids, medications traditionally used to treat eczema that can cause thinning of the skin, formation of dilated blood vessels, stretch marks, and infection. By specifically interfering with the activation of T-cells, a type of white blood cell in the body responsible for triggering immune responses which contribute to the development of psoriasis, TIMs have been shown to effectively treat this common skin disorder. Studies have also shown that the side effects of topical corticosteroids on the face and other areas in patients with psoriasis can be avoided by treating those areas with TIMs. In addition, the use of TIMs on the eyelids has dramatically reduced the need for topical corticosteroids, which can cause glaucoma and cataracts.
Another breakthrough has been in the use of TIMs to treat actinic keratoses, or AKs, which are known as the early beginnings of skin cancer. Imiquimod, which is approved for the treatment of genital warts, has been shown in recent studies to dramatically improve the treatment of AKs as well as some skin cancers.
