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Dermatological Conditions

Skin, along with hair and nails, is the protective covering of the body. Skin prevents germs from entering the body and damaging internal organs. It supports the life of all other body parts and plays a role in maintaining the immune system.

Skin also helps to regulate body temperature through the sweat glands. When the body becomes overheated, sweat glands give off moisture, which cools the body as it evaporates. As the body part responsible for the sense of touch, skin works with the nervous system to alert the body to potential dangers by detecting pressure, pain, heat and cold. It is also the largest organ of the body.

Visit your dermatologist regularly to find out if you have any skin disease or damage.

Actinic keratosis

For many people sunlight is a source of wellbeing. Sunlight provides warmth, vitamin D and the release of 'feel-good' hormones like serotonin. However, many people still underestimate the risk of skin cancer. Skin cancer is the most common cancer of the Caucasian population. Around 240,000 people are diagnosed yearly and the number is rising rapidly. Combined with a diminishing ozone layer, sunlight exposure becomes an increasing health risk.

What is actinic keratosis?
Actinic keratosis appears on continously sun-exposed areas of the skin. This condition represents an early form of squamous cell carcinoma and a variant of non-melanoma skin cancer. Actinic keratoses are also known as 'solar keratoses'. 

The biggest risk factor for the development of actinic keratoses is a long exposure to UV light. However, other factors are also important. People with fair skin are at risk due to the poor pigmentation, and therefore poor protection, of the skin. Immunosuppression is another major risk factor for the development of actinic keratoses.
Self-examination
Early detection of actinic keratoses can save your life. Fortunately, you can easily examine yourself at home. The best time to check yourself is once a month after a bath or shower, standing in front of a full-length mirror. A hand-held mirror can help you view areas that are difficult to see. Here is an easy self-check guide:
 
If you notice any odd-looking mole or marking, contact your doctor. The majority of skin cancers are actinic keratoses, but both basal cell carcinoma or squamous cell carcinoma are easily treated. However, there is a chance that what you see is a melanoma, the most serious form of skin cancer. In any case, an annual dermatologic skin examination is a good idea.
 
  • Examine your body front and back in the mirror, then your sides with your arms raised.
  • Bend your elbows. Look carefully at your forearms, back of your upper arms and the palms of your hands. Do not forget to check your nails as well.
  • Inspect the backs of your legs and your feet, including your soles and between your toes.
  • Examine the back of your neck and your scalp with a hand mirror, not forgetting behind your ears.
  • Finally, check your back and buttocks with a hand mirror.

Using the Correct Sun Protection
The first step towards preventing actinic keratoses is by using the right sun screen whenever you go out in the sun. Your sun screen should protect against UVA- and UVB radiation. The sun protection factor (SPF) indicates by which factor the skin's innate protective ability is multiplied. In other words, it tells you how long your skin can be exposed to the sun without getting a sunburn.
 
Generally, the SPF indicates the protection against UVB radiation, the major cause of sunburn. Sun protective agents should have a SPF of at least 25 in the UVB range and a high protection against UVA radiation. It is generally recommended to apply them 20-30 minutes before sun exposure. 

Find out where your skin fits in.
 
10 Sun Protection Tips
  • Avoid sun exposure between 11am and 3pm.
  • Use sun screen regularly.
  • Use sun screen with >30 SPF, effective for UVB and UVA rays.
  • Apply sun screens 20-30 minutes prior to sun exposure.
  • Consider wearing sun protective textiles.
  • Wear a hat or cap.
  • Protect your eyes with sunglasses.
  • Drink enough water to stay hydrated.
  • Avoid artificial sunlight (sun beds/tanning salons).
  • Schedule an annual dermatologic skin exam.

You can find further information and details at the European Skin Cancer Foundation.

 
 

Psoriasis [+info]

Nearly three percent of the world's population, men, women, and children, even new-born babies, endure the symptoms of psoriasis. Many tolerate constant pain from cracking and bleeding skin. Some wrestle with a crippling form of arthritis.

Yet, much of the world's population finds psoriasis a trivial matter requiring little understanding or sympathy. Some people still equate psoriasis with being unclean or self imposed and shun those who bear its mark when, in fact, many people with psoriasis isolate themselves because of such a deep sense of shame.

What is psoriasis?
Psoriasis is a life-long skin disorder that causes red, scaly patches called lesions to appear on your skin. The lesions can show up on any area of the skin. There are several different kinds of psoriasis.
  • Plaque psoriasis is the most common form of psoriasis and it is characterised by red-looking skin lesions topped with silvery white scales.
  • Guttate psoriasis is also fairly common and it is characterised by red, small, dot-like lesions covered with silvery white scale.
  • Pustular psoriasis has blister-like lesions of fluid, which is not infectious, and intense scaling. It can appear anywhere on the body, but often it appears on the palms of the hands and the soles of the feet. 
  • Inverse psoriasis produces very red lesions with little or no scales and appears in the skin folds, such as the arm pits, creases in the groin and under the breasts. 
  • Erythrodermic psoriasis is rare but painful and is characterised by red, swollen skin and a lot of shedding of dead skin. 
  • About 30 to 50 percent of people with psoriasis also get psoriatic arthritis, which causes pain, stiffness and swelling in and around the joints. This type of arthritis most often affects the hands, feet, wrists, ankles and lower back.
Psoriasis can be mild (limited to a few areas of the skin) or moderate / widespread and severe. A normal skin cell matures in 28 to 30 days and sheds from the skin unnoticed. Psoriatic skin cells mature within seven days. They ‘heap up' and form scaly lesions. Psoriasis lesions can be painful and itchy and they can crack and bleed. 
Psoriasis affects nearly three per cent of the world's population. It can develop in men or women of any race or age. It often appears between the ages of 15 and 35, although it can strike at any age including infants and the elderly. 
What Causes Psoriasis?
No one knows exactly what causes psoriasis. Doctors believe it is related to the body's immune system and that it is genetic, meaning that it can run in families.  In people with psoriasis, the immune system is mistakenly 'triggered', causing skin cells to grow too fast. The rapidly growing cells pile up in the skin's top layers, leading to the formation of lesions on the surface. 
How Do I Know I Have Psoriasis?
There is no specific medical test for psoriasis. To make a diagnosis, your doctor will look at your skin and possibly take a skin biopsy for examination under a microscope. Pitting of the nails is sometimes a sign of psoriasis. 
What Are the Treatments for Psoriasis? 
Psoriasis is a disorder that most often needs lifelong treatment. As there are so many different medications, it may take some time to find the treatment or combination of treatments that work best. Sometimes psoriasis becomes worse (called a 'flare'). In some cases, it can go away for a while, known as a 'spontaneous remission'.
 
There are many topical (external) and systemic (medicines taken internally) ways to treat psoriasis and psoriatic arthritis. Phototherapy is another treatment option and there are practical ways to care for the skin that may help to remove psoriasis scales, improve the skin's ability to move and bend or make the skin feel better.
 
Your doctor will give you the best advice. If you need some support, find your local patient association here.
 

Eczema [+info]

Living with eczema can be an ongoing challenge for both patients and family members. The word ‘eczema' is derived from a Greek word meaning ‘to boil over', which is a good description for the red, inflamed, itchy patches that occur during flare-ups of the disease. The skin disease can range from mild or moderate, to severe.

What is eczema?
Although the term eczema is often used for atopic dermatitis, there are several other skin diseases that are eczemas as well. A partial list of eczemas includes: atopic dermatitis, nummular eczema (coin shape), dyshidrotic eczema, seborrheic dermatitis, irritant contact dermatitis, and allergic contact dermatitis. All types of eczema cause itching and redness and some will blister, weep or peel.
 
Atopic dermatitis often affects people who suffer from asthma and/or hay fever or have family members who do. The word 'atopic' was originally used to describe the allergic conditions asthma and hay fever.
 
Atopic dermatitis is not contagious. It almost always begins in childhood, usually during infancy. Its symptoms are dry, itchy, scaly skin, cracks behind the ears, and rashes on the cheeks, arms and legs. It alternately improves and worsens. During flare-ups, open weeping or crusted sores may develop from scratching or from infections.
 
Atopic dermatitis is a common disease, present worldwide, though it is more common in urban areas and developed countries. An estimated 10 percent of all people are at some time affected by atopic dermatitis (this may not apply in the tropics). It affects men and women of all races equally.
 
Types of Eczema
All types of eczemas cause itching and redness and some will blister, weep, or peel. There are several skin diseases that are eczemas. A partial list includes:
 
  • Atopic dermatitis: the most severe and chronic (long-lasting) kind of eczema.
  • Contact dermatitis: a reaction that can occur when the skin comes in contact with certain substances, which can cause skin inflammation.
  • Dyshidrotic eczema: a blistering type of eczema, which is twice as common in women. It is limited to the fingers, palms and soles of the feet.
  • Nummular eczema: non-itchy round patches of dry skin often appearing in the winter months. It can affect any part of the body, particularly the lower leg.
  • Seborrheic dermatitis: a red, scaly, itchy rash that can appear in various locations on the body. The scalp, sides of the nose, eyebrows, eyelids, and skin behind the ears and on the middle of the chest are the most common areas affected.
  • Stasis dermatitis: a type of eczema that can develop in people when the veins in their lower legs don't properly return blood to their heart.

 
Triggers
Trigger factors may be different in different people. Most eczema patients can get worse when they have a cold or infection. Some patients have worse problems in the winter, while others simply cannot stand the sweating during hot, humid summer weather. Common eczema triggers include following:
  • Dry skin – wind, low humidity, cold temperature, excessive washing without use of moisturisers, and use of harsh, drying soaps can all cause dry skin and aggravate eczema.
  • Irritants – these are any substances outside the body that can cause burning, redness, itching or dryness of the skin.
  • Allergens – these are materials (such as pollen, pet dander, foods, or dust) that cause allergic responses and can worsen eczema.
  • Stress – people with eczema often react to stress (frustration, anger, fear, embarrassment) by having red flushing and itching. Eczema itself, and its treatments, are also a source of stress. The challenge is to recognise stress and find stress reduction techniques that work for you.
  • Heat and sweating – Most people with atopic dermatitis notice that when they get hot, they itch. They have a type of prickly heat that doesn't occur just in humid summertime but anytime they sweat.
  • Infections – Bacterial ‘staph' infections are the most common, especially on arms and legs. Such infections might be suspected if areas are weeping or crusted or if small ‘pus-bumps' are seen. If some lesions look different, consult your doctor.
Genetic Factors
Researchers have found that some people with eczema have a genetic defect that causes a lack of filaggrin in the skin. Filaggrin is a type of protein that helps form the protective outer layer of our skin. This skin barrier protects the body from germs and other foreign substances. A lack of filaggrin dries out and weakens the skin barrier. This makes skin vulnerable to irritants such as soap and detergents. A weak skin barrier also makes it easier for allergens like pollen to enter the body. Scientists believe that this exposure may cause sensitivity to allergens and even certain foods.
Care
The most important treatment for dry skin is to put water back into it. The goal of bathing and moisturising is to help heal the skin. The best way to hydrate your skin is to have a brief bath or shower and to moisturise immediately afterwards.
 
Use of an effective moisturizer several times every day hydrates your skin and improves its barrier function. Moisturiser should be applied to the hands every time they are washed or come in contact with water.
 
Once inflammation begins, see your doctor as soon as possible, as prompt treatment is needed. 
 
 


NOTE: SCRATCHING OPEN A HEALING LESION MAY RESULT IN SCARRING AND CAN EXACERBATE THE RASH