Tag Archives: Skin Disorders

Rosacea

Definition:
Rosacea has been defined as a persistent redness of the central part of the face lasting for at least three months, and often including features such as flushing, red lumps and pustules, and small dilated blood vessels. Exactly which symptoms develop defines which particular subtype of rosacea is present.

It primarily affects Caucasians of mainly northwestern European descent and has been nicknamed the ‘curse of the Celts’ by some in Britain and Ireland, but can also affect people of other ethnicities. Rosacea affects both sexes, but is almost three times more common in women. It has a peak age of onset between 30 and 60.

Rosacea typically begins as redness on the central face across the cheeks, nose, or forehead, but can also less commonly affect the neck, chest, ears, and scalp. In some cases, additional symptoms, such as semi-permanent redness, telangiectasia (dilation of superficial blood vessels on the face), red domed papules (small bumps) and pustules, red gritty eyes, burning and stinging sensations, and in some advanced cases, a red lobulated nose (rhinophyma), may develop.

Clasifications:
There are four identified rosacea subtypes  and patients may have more than one subtype present :176:

1.Erythematotelangiectatic rosacea: Permanent redness (erythema) with a tendency to flush and blush easily. It is also common to have small blood vessels visible near the surface of the skin (telangiectasias) and possibly burning or itching sensations.

2.Papulopustular rosacea: Some permanent redness with red bumps (papules) with some pus filled (pustules) (which typically last 1–4 days); this subtype can be easily confused with acne.

3.Phymatous rosacea: This subtype is most commonly associated with rhinophyma, an enlargement of the nose. Symptoms include thickening skin, irregular surface nodularities, and enlargement. Phymatous rosacea can also affect the chin (gnathophyma), forehead (metophyma), cheeks, eyelids (blepharophyma), and ears (otophyma).   Small blood vessels visible near the surface of the skin (telangiectasias) may be present.

4.Ocular rosacea: Red, dry and irritated eyes and eyelids. Some other symptoms include foreign body sensations, itching and burning.
There are a number of variants of rosacea including:689

*Rosacea conglobata…....click & see
*Rosacea fulminans…...click & see
*Phymas in rosacea…….click & see

Symptoms:
Signs and symptoms of rosacea i.nclude:

*Red areas on your face

*Small, red bumps or pustules on your nose, cheeks, forehead and chin (but not the same as whiteheads or blackheads)

*Red, bulbous nose (rhinophyma)

*Visible small blood vessels on your nose and cheeks (telangiectasia)

*Burning or gritty sensation in your eyes (ocular rosacea)

*Tendency to flush or blush easily
click to see the pictures.>….(01).….(1)…..…(2).…...(3)....(4)…...(5)
Rosacea usually appears in phases:

*Pre-rosacea. Rosacea may begin as a simple tendency to flush or blush easily, and then progress to a persistent redness in the central portion of your face, particularly your nose. This redness results from the dilation of blood vessels close to your skin’s surface. This phase may sometimes be referred to as pre-rosacea.Vascular rosacea. As signs and symptoms worsen, vascular rosacea may develop — small blood vessels on your nose and cheeks swell and become visible (telangiectasia). Your skin may become overly sensitive.

* Vascular rosacea may also be accompanied by oily skin and dandruff.

*Inflammatory rosacea. Small, red bumps or pustules may appear and persist, spreading across your nose, cheeks, forehead and chin. This is sometimes known as inflammatory rosacea.

In addition, about 1 in 2 people with rosacea also experience ocular rosacea — a burning and gritty sensation in the eyes. Rosacea may cause the inner skin of the eyelids to become inflamed or appear scaly, a condition known as conjunctivitis.

Late in the course of rosacea, some people, mainly middle-aged men, may develop red, round, raised bumps (papules) and a bulbous nose, a condition known as rhinophyma.

Causes:
Although the cause isn’t known, a number of factors which may play a part have been identified.
CauseTriggers that cause episodes of flushing and blushing play a part in the development of rosacea. Exposure to temperature extremes can cause the face to become flushed as well as strenuous exercise, heat from sunlight, severe sunburn, stress, anxiety, cold wind, and moving to a warm or hot environment from a cold one such as heated shops and offices during the winter. There are also some food and drinks that can trigger flushing, including alcohol, food and beverages containing caffeine (especially, hot tea and coffee), foods high in histamines and spicy food. Foods high in histamine (red wine, aged cheeses, yogurt, beer, cured pork products such as bacon, etc.) can even cause persistent facial flushing in those individuals without rosacea due to a separate condition, histamine intolerance.

Certain medications and topical irritants can quickly trigger rosacea. Some acne and wrinkle treatments that have been reported to cause rosacea include microdermabrasion and chemical peels, as well as high dosages of isotretinoin, benzoyl peroxide, and tretinoin. Steroid induced rosacea is the term given to rosacea caused by the use of topical or nasal steroids. These steroids are often prescribed for seborrheic dermatitis. Dosage should be slowly decreased and not immediately stopped to avoid a flare up.

A survey by the National Rosacea Society of 1,066 rosacea patients showed which factors affect the most people:

*Sun exposure 81%
*Emotional stress 79%
*Hot weather 75%
*Wind 57%
*Heavy exercise 56%
*Alcohol consumption 52%
*Hot baths 51%
*Cold weather 46%
*Spicy foods 45%
*Humidity 44%
*Indoor heat 41%
*Certain skin-care products 41%
*Heated beverages 36%
*Certain cosmetics 27%
*Medications (specifically stimulants) 15%
*Medical conditions 15%
*Certain fruits 13%
*Marinated meats 10%
*Certain vegetables 9%
*Dairy products 8%

Cathelicidins
Richard L. Gallo and colleagues recently noticed that patients with rosacea had elevated levels of the peptide cathelicidin   and elevated levels of stratum corneum tryptic enzymes (SCTEs). Antibiotics have been used in the past to treat rosacea but they may only work because they inhibit some SCTEs.

Intestinal bacteria
Intestinal bacteria may play a role in causing the disease. A recent study subjected patients to a hydrogen breath test to detect the occurrence of small intestinal bacterial overgrowth (SIBO). It was found that significantly more patients were hydrogen-positive than controls indicating the presence of bacterial overgrowth (47% v. 5%, p<0.001).

Hydrogen-positive patients were then given a 10-day course of rifaximin, a non-absorbable antibiotic that does not leave the digestive tract and therefore does not enter the circulation or reach the skin. 96% of patients experienced a complete remission of rosacea symptoms that lasted beyond 9 months. These patients were also negative when retested for bacterial overgrowth. In the 4% of patients that experienced relapse, it was found that bacterial overgrowth had returned. These patients were given a second course of rifaximin which again cleared rosacea symptoms and normalized hydrogen excretion.

In another study, it was found that some rosacea patients that tested hydrogen-negative were still positive for bacterial overgrowth when using a methane breath test instead. These patients showed little improvement with rifaximin, as found in the previous study, but experienced clearance of rosacea symptoms and normalization of methane excretion following administration of the antibiotic metronidazole, which is effective at targeting methanogenic intestinal bacteria.

These results suggest that optimal antibiotic therapy may vary between patients and that diverse species of intestinal bacteria appear to be capable of mediating rosacea symptoms.

This may also explain the improvement in symptoms experienced by some patients when given a reduced carbohydrate diet.  Such a diet would restrict the available material necessary for bacterial fermentation and thereby reduce intestinal bacterial populations.

Demodex mites:
Studies of rosacea and demodex mites have revealed that some people with Rosacea have increased numbers of the mite, especially those with steroid induced rosacea.  When large numbers are present they may play a role along with other triggers. On other occasions demodicidosis (mange) is a separate condition that may have “rosacea-like” appearances.
Risk Factors:
Although anyone can develop rosacea, you may be more likely to develop rosacea if you:

*Have fair skin and light hair and eye color
*Are between the ages of 30 and 60, especially if you’re going through menopause
*Experience frequent flushing or blushing
*Have a family history of rosacea

Complications:
In severe and rare cases, the oil glands (sebaceous glands) in your nose and sometimes your cheeks become enlarged, resulting in a buildup of tissue on and around your nose — a condition called rhinophyma (ri-no-FI-muh). This complication is much more common in men and develops slowly over a period of years.

Diagnosis:
Most people with rosacea have only mild redness and are never formally diagnosed or treated. There is no single, specific test for rosacea.

In many cases, simple visual inspection by a trained person is sufficient for diagnosis. In other cases, particularly when pimples or redness on less-common parts of the face are present, a trial of common treatments is useful for confirming a suspected diagnosis.

The disorder can be confused with, and co-exist with acne vulgaris and/or seborrhoeic dermatitis. The presence of rash on the scalp or ears suggests a different or co-existing diagnosis as rosacea is primarily a facial diagnosis, although it may occasionally appear in these other areas.

Treatments:
Treating rosacea varies depending on severity and subtypes. A subtype-directed approach to treating rosacea patients is recommended to dermatologists.  Mild cases are often not treated at all, or are simply covered up with normal cosmetics. Therapy for the treatment of rosacea is not curative, and is best measured in terms of reduction in the amount of erythema and inflammatory lesions, decrease in the number, duration, and intensity of flares, and concomitant symptoms of itching, burning, and tenderness. The two primary modalities of rosacea treatment are topical and oral antibiotic agents.   While medications often produce a temporary remission of redness within a few weeks, the redness typically returns shortly after treatment is suspended. Long-term treatment, usually one to two years, may result in permanent control of the condition for some patients.  Lifelong treatment is often necessary, although some cases resolve after a while and go into a permanent remission.

Behaviour
Trigger avoidance can help reduce the onset of rosacea but alone will not normally cause remission for all but mild cases. It is sometimes recommended that a journal be kept to help identify and reduce food and beverage triggers..

Because sunlight is a common trigger, avoiding excessive exposure to sun is widely recommended. Some people with rosacea benefit from daily use of a sunscreen; others opt for wearing hats with broad brims.

People who develop infections of the eyelids must practice frequent eyelid hygiene. Daily, gentle cleansing of the eyelids with diluted baby shampoo or an over-the-counter eyelid cleaner and applying warm (but not hot) compresses several times a day is recommended.

A recent publication discusses how managing pre-trigger events such as prolonged exposure to cool environments can directly influence warm room flushing.

Medications:
Oral tetracycline antibiotics (tetracycline, doxycycline, minocycline) and topical antibiotics such as metronidazole are usually the first line of defense prescribed by doctors to relieve papules, pustules, inflammation and some redness.  Topical azelaic acid such as Finacea (15%) or Skinoren (20%) may help reduce inflammatory lesions, bumps and papules. Using alpha-hydroxy acid peels may help relieve redness caused by irritation, and reduce papules and pustules associated with rosacea.  Oral antibiotics may help to relieve symptoms of ocular rosacea. If papules and pustules persist, then sometimes isotretinoin can be prescribed.  Isotretinoin has many side effects and is normally used to treat severe acne but in low dosages is proven to be effective against papulopustular and phymatous rosacea.

The treatment of flushing and blushing has been attempted by means of the centrally acting ?-2 agonist clonidine, but this is of limited benefit on just this one aspect of the disorder.  The same is true of the beta-blockers nadolol and propranolol. If flushing occurs with red wine consumption, then complete avoidance helps. There is no evidence at all that antihistamines are of any benefit in rosacea. However: people with underlying allergies and who respond strongly to foods that are high in histamine or that release a lot of histamine in the body do find sometimes that their flushing symptoms diminish with oral antihistamines (for instance loratadine). Another medication that can help some people with facial flushing and burning is mirtazapine (remeron).

Recently, a clinically-trialled product range combining plant-sourced methylsulfonylmethane (MSM) and silymarin has been used to treat rosacea, skin redness and flushing.

Laser:
Dermatological vascular laser (single wavelength) or intense pulsed light (broad spectrum) machines offer one of the best treatments for rosacea, in particular the erythema (redness) of the skin.   They use light to penetrate the epidermis to target the capillaries in the dermis layer of the skin. The light is absorbed by oxy-hemoglobin which heat up causing the capillary walls to heat up to 70 °C (158 °F) , damaging them, causing them to be absorbed by the body’s natural defense mechanism. With a sufficient number of treatments, this method may even eliminate the redness altogether, though additional periodic treatments will likely be necessary to remove newly-formed capillaries.

CO2 lasers can be used to remove excess tissue caused by phymatous rosacea. CO2 lasers emit a wavelength that is absorbed directly by the skin. The laser beam can be focused into a thin beam and used as a scalpel or defocused and used to vaporise tissue. Low level light therapies have also been used to treat rosacea. Photorejuvenation can also be used to improve the appearance of rosacea and reduce the redness associated with it
Lifestyle & Homeremedies:
One of the most important things you can do if you have rosacea is to minimize your exposure to anything that causes a flare-up. Find out what factors affect you so that you can avoid them. Keep a list of things that trigger your flare-ups, and try to avoid your triggers.

Here are other suggestions for preventing flare-ups:

*Wear broad-spectrum sunscreen with a sun protection factor (SPF) of 30 or higher to protect your face from the sun.

*Protect your face in the winter with a scarf or ski mask.

*Avoid irritating your facial skin by rubbing or touching it too much.

*Wash problem areas with a gentle cleanser (Dove, Cetaphil).

*Avoid facial products that contain alcohol or other skin irritants.

*When using moisturizer and a topical medication, apply the moisturizer after the medication has dried.

*Use products that are labeled noncomedogenic. These won’t clog your oil and sweat gland openings (pores) as much.

*Avoid overheating.

*If you wear makeup, consider using green- or yellow-tinted pre-foundation creams and powders, because they’re designed to counter skin redness.

*Avoid drinking alcohol.

Alternative medicine:

Many alternative therapies — including colloidal silver, emu oil, laurelwood, oregano oil and vitamin K — have been touted as possible ways to treat rosacea. However, there’s no conclusive evidence that any of these alternative therapies are effective.

If you’re considering dietary supplements or other alternative therapies to treat rosacea, consult your doctor. He or she can help you weigh the pros and cons of specific alternative therapies.
Prognosis:
Rosacea tends to wax and wane over time but eventually, with the use of treatment, most people reach a fairly stable state of relative control of their condition.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.mayoclinic.com/health/rosacea/DS00308
http://www.bbc.co.uk/health/physical_health/conditions/rosacea1.shtml
http://en.wikipedia.org/wiki/Rosacea
http://www.rosacea.org/patients/allaboutrosacea.php
http://wegoodinfo.com/rosacea-symptoms/

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Pityriasis rosea

Definition:
Some people say Pityriasis rosea (also known as “Pityriasis rosea Gibert“) is a skin rash. It is non-dangerous but may inflict substantial discomfort on some sufferers.  Classically, it begins with a single “herald patch” lesion, followed in 1 or 2 weeks by a generalized body rash lasting about 6 weeks

Pityriasis rosea is common type of skin rash seen between the ages of ten and 35. It is a skin rash that often sweeps out from the middle of your body, with a shape that resembles drooping pine-tree branches. Pityriasis (pit-ih-RI-uh-sis) rosea usually begins as one large spot on your chest, abdomen or back and then spreads.

The cause isn’t known, but a viral infection is suspected (though it doesn’t seem to be contagious).The overall prevalence of  Pityriasis rosea in the United States has been estimated to be 0.13% in men and 0.14% in women.
You may click to see Pictures of Pityriasis rosea
Symptoms:
The symptoms of Pityriasis rosea include:

*An upper respiratory tract infection may precede all other symptoms in as many as 69% of patients

*A single, 2- to 10-cm oval red “herald” patch appears, classically on the abdomen.  Occasionally, the”herald” patch may occur in a ‘hidden’ position (in the armpit, for example) and not be noticed immediately. The “herald” patch may also appear as a cluster of smaller oval spots, and be mistaken for acne. Rarely, it does not become present at all.

*7-14 days after the herald patch, large patches of pink or red, flaky, oval-shaped rash appear on the torso. In 6% of cases an inverse distribution may occur, with rash mostly on the extremities. The more numerous oval patches generally spread widely across the chest first, following the rib-line in a characteristic “christmas-tree” distribution.  Small, circular patches may appear on the back and neck several days later. It is unusual for lesions to form on the face, but they may appear on the cheeks or at the hairline.

*About one-in-four people with PR suffer from mild to severe symptomatic itching. (Moderate itching due to skin over-dryness is much more common, especially if soap is used to cleanse the affected areas.) The itching is often non-specific, and worsens if scratched. This tends to fade as the rash develops and does not usually last through the entire course of the disease.

*The rash may be accompanied by low-grade fever, headache, nausea and fatigue. Over-the-counter medications can help manage these

Causes:
The cause of pityriasis rosea is not certain, but its clinical presentation and immunologic reactions suggest a viral infection as a cause.  Also, HHV-7 is frequently found in healthy individuals, so its etiologic role is controversial.

It is not contagious,  though there have been reports of small epidemics in fraternity houses and military bases, schools and gyms.

Complications:
Complications of pityriasis rosea aren’t likely, but if they do occur, they may include:

*Severe itching
*Lasting brown spots after the rash has healed, on dark skin

Diagnosis:
Identification of pityriasis rosea can be challenging for a number of reasons. The diagnosis is unclear at the onset of symptoms, and there are no noninvasive tests that confirm the condition. In at least one half of patients, the first symptoms of pityriasis rosea are nonspecific and consistent with a viral upper respiratory infection.1,5 A herald patch then appears, typically on the trunk. This large lesion is commonly 2 to 10 cm in diameter, ovoid, erythematous, and slightly raised, with a typical collarette of scale at the margin.....PIC-1 . At this stage, however, the diagnosis usually remains unclear. Microscopic examination of potassium hydroxide preparations shows no fungal elements. The lesion cannot be differentiated from eczema and often is treated as such.

A few days to a few weeks after the appear ance of the herald patch, crops of smaller lesions, 5 to 10 mm in diameter, develop across the trunk and, less commonly, on the extremities. These lesions are salmon colored, ovoid, raised, and have the same collarette of scale as the herald patch.…PIC-2... . At this stage, the diagnosis usually is clear, particularly if the physician can observe or elicit a history of the herald patch.
If the diagnosis is uncertain, especially if the palms and soles are affected and the patient is sexually active, the physician should consider the possibility of secondary syphilis. Appropriate evaluation includes direct fluorescent antibody testing of lesion exudates, a VDRL test, or dark-field microscopy.11 Other conditions in the differential diagnosis include diffuse nummular eczema, tinea corporis, pityriasis lichenoides, guttate psoriasis, viral exanthem, lichen planus, and medication reaction.

The smaller secondary lesions of pityriasis rosea follow Langer’s lines ..PIC-3.. When the lesions occur on the back, they align in a typical “Christmas tree” or “fir tree” pattern. Elsewhere on the body, the lesions follow the cleavage lines as follows: transversely across the lower abdomen and back, circumferentially around the shoulders, and in a V-shaped pattern on the upper chest12...PIC-4. Pruritus is variable. Except for mild to severe itching in 25 percent of patients, no systemic symptoms typically are present during the rash phase of pityriasis rosea.

Biopsy usually is not indicated in the evaluation of patients with suspected pityriasis rosea. Histology has shown that in addition to non-specific subacute and chronic inflammation, 55 percent of specimens contain epidermal cells that display dyskeratotic degeneration.14

Worsening of the rash or a second wave of lesions is not uncommon before eventual spontaneous resolution of the eruption. Recurrence of the condition later in life is rare.

Although no causal link has been established, multiple drugs have been associated with an extensive and often prolonged form of pityriasis rosea . A review of the literature shows that single case reports account for most of the drug associations.

Treatment:
No treatment is usually required.

Oral antihistamines or topical steroids may be used to decrease itching.[5] Steroids do provide relief from itching, and improve the appearance of the rash, but they also cause the new skin that forms (after the rash subsides) to take longer to match the surrounding skin color. While no scarring has been found to be associated with the rash, itching and scratching should be avoided. Irritants such as soap should be avoided, too; a soap containing moisturizers (such as goat’s milk) may be used, however, any generic moisturizer can help to manage over-dryness.

Direct sunlight makes the lesions resolve more quickly. According to this principle, medical treatment with ultraviolet light has been used to hasten resolution, though studies disagree whether it decreases itching or not. UV therapy is most beneficial in the first week of the eruption

Prognosis:
In most patients, the condition lasts only a matter of weeks; in some cases it can last longer (up to six months). The disease resolves completely without long-term effects. Two percent of patients have recurrence.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/pityriasisrosea.shtml
http://www.nlm.nih.gov/medlineplus/ency/article/000871.htm
http://www.mayoclinic.com/health/pityriasis-rosea/DS00720
http://www.aafp.org/afp/2004/0101/p87.html
http://en.wikipedia.org/wiki/Pityriasis_rosea

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Ichthyosis

Definition:

Ichthyosis (plural ichthyoses) is a heterogeneous family of at least 28, generalized, mostly genetic skin disorders. All types of ichthyosis have dry, thickened, scaly or flaky skin. In many types there is cracked skin, which is said to resemble the scales on a fish; the word ichthyosis comes from the Ancient Greek (ichthys), meaning “fish.” The severity of symptoms can vary enormously, from the mildest types such as ichthyosis vulgaris which may be mistaken for normal dry skin up to life-threatening conditions such as harlequin type ichthyosis. The most common type of ichthyosis is ichthyosis vulgaris, accounting for more than 95% of cases

CLICK & SEE THE PICTURES

Ichthyosis  is an inherited skin disorder in which dead skin cells accumulate in thick, dry scales on your skin’s surface. The scales of ichthyosis  can be present at birth, but usually first appear during early childhood. Sometimes ichthyosis  disappears entirely for most of the adult years, only to return later.

Types:
There are many types of Ichthyosis and an exact diagnosis may be difficult. Types of Ichthyosis are classified by their appearance and their genetic cause. Ichthyosis caused by the same gene can vary considerably in severity and symptoms. Some Ichthyosis don’t appear to fit exactly into any one type. Also different genes can produce Ichthyosis with similar symptoms. The most common or well-known types are as follows:

Genetic ichthyosisIchthyosis vulgaris
*X-linked ichthyosis
*Congenital ichthyosiform erythroderma (nbCIE)
*Epidermolytic hyperkeratosis (bullous ichthyosis, bCIE)
*Harlequin type ichthyosis
*Ichthyosis bullosa of Siemens
*Ichthyosis hystrix
*Ichthyosis lamellaris (lamellar ichthyosis)

Ichthyosis with additional characteristics:
*Carvajal syndrome
*CHILD Syndrome
*Conradi-Hünermann syndrome
*Darier’s disease
*Erythrokeratodermia variabilis (Erythrokeratodermia figurata variabilis, Mendes da Costa type erythrokeratodermia)
*IFAP syndrome (Ichthyosis follicularis)
*Keratitis-ichthyosis-deafness syndrome
*Netherton syndrome
*Neutral lipid storage disease (Dorfman-Chanarin syndrome)
*Refsum’s disease
*Rud syndrome
*Senter syndrome
*Sjögren-Larsson syndrome
*Tay syndrome (IBIDS syndrome, Trichothiodystrophy)

Non-genetic ichthyosisIchthyosis
*acquisita

Most cases of ichthyosis  are mild, but some are severe. Sometimes other skin diseases are associated with ichthyosis vulgaris, such as the rash-producing atopic dermatitis. No cure has been found for ichthyosis , and treatments focus on controlling the condition.

 

Symptoms:
In ichthyosis vulgaris, the skin cells are produced at the standard rate, but don’t separate normally as they reach the skin’s surface. This means skin cells aren’t shed as quickly as they should be, leading to a build-up of cells, which appear as scales. Just one or a few areas are usually affected, often the legs or lower body.


The face isn’t usually affected but, when it is, the scaling is usually limited to the forehead and cheeks. The scales are typically fine and white.

Most babies with ichthyosis vulgaris don’t have any sign of the condition when they’re newly born. But within the first year, skin abnormalities begin to develop.

The dry, scaly skin may then become a chronic, lifelong problem, although it can vary dramatically with age, weather and other factors. It often improves in the summer, for example, and also tends to get better with age.

Causes:
Ichthyosis vulgaris is characterized by chronic, excessive buildup of the protein in the upper layer of the skin (keratin). This buildup is a result of your skin’s natural shedding process being slowed or inhibited.


Ichthyosis vulgaris is most often caused by a genetic mutation, inherited in an autosomal dominant pattern. That means a child has to inherit only one copy of the affected gene to develop the disease. Children with the inherited form of the disorder usually have normal skin at birth, but develop scaling and roughness during the first few years of life. At times, ichthyosis vulgaris may disappear during the adult years, only to return later.

Ichthyosis not caused by genetic abnormalities, referred to as acquired ichthyosis, is rare. This type usually shows up in adulthood. It’s usually associated with other diseases, such as cancer, thyroid disease or chronic renal failure.

Complications:
Ichthyosis can affect more than the appearance of your skin; it can affect your skin’s ability to function normally. As a result, some people with ichthyosis may experience:

*Overheating. In rare cases, ichthyosis interferes with sweating. Skin thickness and scales prevent sweat from reaching the surface of your skin, which inhibits cooling.

*Secondary infection. Skin splitting and cracking may lead to infections, either on your skin or a wider infection in your body.

 

Diagnosis:
A physician often can diagnose ichthyosis by looking at the skin. A family history is very useful. In some cases, a skin biopsy is done to help to confirm the diagnosis. In a biopsy, a small piece of skin is removed and examined under a microscope. In some instances, genetic testing may be helpful in making a diagnosis. Diabetes has not been linked to acquired ichthyosis or ichthyosis vulgaris.

Ichthyosis is not more or less common in any ethnic group. As of now, there is no way to prevent ichthyosis since it is often of a genetic nature.

Treatments:
There are two main aims of treatment for ichthyosis:

•Keeping the skin moisturised and supple – the main aim is to prevent cracks from forming in the skin as these can allow micro-organisms to penetrate the barrier of the skin and so infection to establish. This is done using moisturising creams, and baths and lotions called emollients.

•Removing some of the layers of skin cells, either by mechanical means (rubbing gently with a pumice) or by treatments such as alpha hydroxy acids (AHAs), which help to break up the chemical ‘cement’ that glues skin cells together.
There may be other treatments aimed at the cause of ichthyosis if this can be identified – for example correcting nutritional deficiencies, stopping or changing medication or treating hormonal problems.
Life Style & Home Care:
Although self-help measures won’t cure ichthyosis, they may help improve the appearance and feel of damaged skin.  These measures can be considered to help:

*Take long soaking baths to soften the skin. Then use a rough-textured sponge, such as a loofa sponge, to remove the thickened scales.

*Choose mild soaps that have added oils and fats. Avoid deodorant and antibacterial soaps, which are especially harsh on dry skin.

*After showering or bathing, gently pat or blot your skin dry with a towel so that some moisture remains on the skin.

*Apply moisturizer or lubricating cream while your skin is still moist from bathing. Choose a moisturizer that contains urea or propylene glycol — chemicals that help keep your skin moist. Petroleum jelly is another good choice. Cover the treated areas with plastic wrap to keep the petroleum jelly from staining clothes and furniture.

*Apply an over-the-counter product that contains urea, lactic acid or a low concentration of salicylic acid twice daily. Mild acidic compounds help your skin shed its dead skin cells. Urea helps bind moisture to your skin.

*Use a portable home humidifier or one attached to your furnace to add moisture to the air inside your home.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

 

Resources:
http://www.mayoclinic.com/health/ichthyosis-vulgaris/DS00734
http://www.beltina.org/health-dictionary/ichthyosis-treatment-severe-diagnosis.html
http://en.wikipedia.org/wiki/Ichthyosis
http://www.bbc.co.uk/health/physical_health/conditions/ichthyosis.shtml

Ichthyosis Causes Fish-Like Scales on Your Skin

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Birthmarks

Definition:
Birthmarks are areas of discolored skin that are on a baby’s body at birth or that show up within a few months after delivery. Over 80 percent of babies have some kind of birthmark. Some endure for life, while others fade away over time.

click to see the pictures

Most birthmarks fall into one of two categories:

1.vascular  Vascular birthmarks are caused by blood vessels that have accumulated below the surface of the skin. They range in color from pink to red to bluish, depending on the depth of the blood vessels….click to see

2.Pigmented birthmarks — usually brown, gray, bluish, or black — result from an abnormal development of pigment cells…...click to see

Types:
A number of different types of birthmarks are known that include, but are not limited to, stork bites, Mongolian blue spots, strawberry marks, café au lait spots, congenital melanocytic nevi, and port-wine stains.

Café au lait spot:
While these birthmarks may occur anywhere on the body, they are most commonly oval in shape and light brown, or milk coffee, in color. These birthmarks may be present at birth, or appear in early childhood, and do not fade with age. One or two on an individual is common;however, four or more may be an indicator of neurofibromatosis.

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Congenital melanocytic nevus:
Congenital melanocytic nevus is a type of melanocytic nevus (or mole) found in infants at birth. Occurring in about 1% of infants in the United States, it is located in the area of the head and neck 15% of the time, but may occur anywhere on the body. It may appear as light brown in fair-skinned people, to almost black in darker-skinned people. Coming in a variety of sizes and appearances, they may be irregular in shape and flat, or raised and lumpy in appearance and feel.
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Mongolian blue spot:

A Mongolian blue spot is a benign flat congenital birthmark with wavy borders and irregular shape, most common among East Asians and Turks (excluding Turkish people), and named after Mongolians. It is also extremely prevalent among East Africans and Native Americans.  Authentic Mongolian blue spots do not disappear before puberty, and last well into adulthood. The most common color is blue, although they can be blue-gray, blue-black or even deep brown.
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Mongolian spot visible on six-month-old baby

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The Mongolian spot is a congenital developmental condition exclusively involving the skin. The blue colour is caused by melanocytes, melanin-containing cells, that are deep under the skin. Usually, as multiple spots or one large patch, it covers one or more of the lumbosacral area (lower back), the buttocks, flanks, and shoulders.  It results from the entrapment of melanocytes in the dermis during their migration from the neural crest to the epidermis during embryonic development.

Among those who are not aware of the background of the Mongolian spots, it may sometimes be mistaken for a bruise indicative of child abuse

Port-wine stain, or Nevus flammeus:

Port-wine stains are present at birth and range from a pale pink in color, to a deep wine-red. Irregular in appearance, they are usually quite large, and caused by a deficiency or absence in the nerve supply to blood vessels. This causes the blood vessels to dilate, and blood to pool or collect in the affected area. Over time, port-wine stains may become thick or develop small ridges or bumps, and do not fade with age. Such birthmarks may have emotional or social repercussions.
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.Port-wine stain visible on the head of Mikhail Gorbachev

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Port-wine stains occur in 0.3% of the population, equally among males and females. They frequently express unilaterally, i.e., on only one side, not crossing the midline of the body. Often on the face, marks on the upper eyelid or forehead may be indicative of a condition called Sturge-Weber syndrome. Additionally, port-wine stains in these locations may be associated with glaucoma and seizures.

Stork bite, or Telangiectatic nevus
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Colloquially called a “stork bite”, “angel’s kiss” or “salmon patch”, telangiectatic nevus appears as a pink or tanned, flat, irregularly-shaped mark on the knee, back of the neck, and/or the forehead, eyelids and, sometimes, the top lip. The skin is not thickened and feels no different from anywhere else on the body; the only difference remaining in appearance. Nearly half of all babies have such a birthmark

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Causes:
The cause of birthmarks is not fully understood. Birthmarks are a benign overgrowth of blood vessels, or melanocytes, or smooth musle, or fat, or fibroblast or keratinocytes. They are thought to occur as a result of a localized imbalance in factors controlling the development and migration of skin cells.

Folklore:
Birthmarks are called voglie in Italian, antojos in Spanish, and wiham in Arabic; all of which translate to “wishes” because, according to folklore, they are caused by unsatisfied wishes of the mother during pregnancy. For example, if a pregnant woman does not satisfy a sudden wish or craving for strawberries, it’s said that the infant might bear a strawberry mark.

In Dutch, birthmarks are called moedervlekken, in Danish modermærke and in German Muttermal (mother-spots) because it was thought that an infant inherited the marks solely from the mother. The Hungarian word for any flat mole (as opposed to only congenital birthmarks), anyajegy, is also derived from this belief.

Some myths associated with birthmarks are that they are caused when an expectant mother sees something strange, or experiences a great deal of fear. You may click to see:Maternal impression for more information.

In Iranian folklore, a birth mark appears when the pregnant mother touches a part of her body during a solar eclipse.

Treatment:

Birthmarks are common in children, and most disappear within a few years without any need for treatment. Any attempt to remove them runs an unnecessary risk of complications or scarring.

Of course, if the mark is very conspicuous, and lasts into toddler years, they may become more aware of it. But, again, treatment may not be the best option. Instead, it’s usually better to simply play it down as far as possible, and make efforts to ensure everyone at home and school understands it’s quite normal, and will go away eventually.

While your child is still young, it’s important to check with your GP whether a birthmark is a port wine stain for two reasons:

•Sometimes a port wine stain can be one visible sign of a syndrome of different problems. For example, a port wine stain around the eye and side of the face can be linked to an abnormality of the blood vessels in the brain. This condition, called Sturge-Weber syndrome can lead to blindness and epilepsy. Port wine stains around the eyelids may also be linked to glaucoma and problems with the optic nerve. Further tests may be needed to check for these possibilities.

 

•Laser treatments, using a technique known as pulse dye laser or PDL, can be used to destroy the abnormal blood vessels and produce good results, with minimal scarring, but are best done while a child is still an infant, before the birthmark grows. The treatment is lengthy and expensive.

Cosmetic treatments, including skin creams which cover the mark.


Helping Kids Deal With Birthmarks

It can be a shock at first to see a birthmark on your newborn. Nobody is perfect, yet many people have an image of a perfect baby in their heads. If the birthmark is clearly visible, people might ask questions or stare, which can feel rude. It helps to have a simple explanation ready to handle intrusions like this. Most people mean no harm, but it’s also OK to let them know if they’ve gone too far.

Even at a young age, kids watch how their parents respond to situations like this. This is how they lean how to cope with others’ reactions. Talking simply and openly about a birthmark with kids makes them more likely to accept one as just another part of themselves, like hair color. And practice simple answers they can use when asked about it: “It’s just a birthmark. I was born with it.” It’s also important emotionally for kids to be around supportive family and friends who treat them normally.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:

http://www.bbc.co.uk/health/physical_health/conditions/birthmarksstrawberrynaevi.shtml
http://en.wikipedia.org/wiki/Birthmark
http://www.babycenter.com/0_birthmarks_75.bc
http://kidshealth.org/parent/general/body/birthmarks.html#

http://www.i-am-pregnant.com/Birth/Birth-defects/Port-Wine-Stain

http://www.newbornbabyzone.com/newborn/whats-that-birthmark-on-my-newborn-baby/

http://www.webmd.com/skin-problems-and-treatments/picture-of-cafe-au-lait-spots

http://www.skincareguide.ca/glossary/c/congenital_melanocytic.html

http://worrybomb.com/2008/12/14/stork-mark/

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Albinism


Alternative Names
:achromia, achromasia, or achromatosis

Definition:
Albinism  is a congenital disorder characterized by the complete or partial absence of pigment in the skin, hair and eyes due to absence or defect of an enzyme involved in the production of melanin. Albinism results from inheritance of recessive gene alleles and is known to affect all vertebrates, including humans. The most common term used for an organism affected by albinism is “albino”. Additional clinical adjectives sometimes used to refer to animals are “albinoid” and “albinic”.

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Albinism is associated with a number of vision defects, such as photophobia, nystagmus and astigmatism. Lack of skin pigmentation makes the organism more susceptible to sunburn and skin cancers.

Several different genes are involved in albinism, depending on the specific type of the condition.

Classification in humans:

There are two main categories of albinism in humans:

*In oculocutaneous albinism Types 1-4 with different levels with pigmentation (despite its Latin-derived name meaning “eye-and-skin” albinism), pigment is lacking in the eyes, skin and hair. (The equivalent mutation in non-humans also results in lack of melanin in the fur, scales or feathers.) People with oculocutaneous albinism can have anything from no pigment at all to almost normal levels.

*In ocular albinism, only the eyes lack pigment. People who have ocular albinism have generally normal skin and hair color, although it is typically lighter than either parent. Many even have a normal eye appearance. Also, ocular albinism is generally sex-linked, therefore males are more likely to be affected. Males are without another X chromosome to mask recessive alleles on the X they inherit.

Other conditions include albinism as part of their presentation. These include Hermansky-Pudlak syndrome, Chediak-Higashi syndrome, Griscelli syndrome, Waardenburg syndrome, and Tietz syndrome. These conditions are sometimes classified with albinism. Several have sub-types. Some are easily distinguished by appearance, but in most cases genetic testing is the only way to be certain.

Albinism was formerly categorized as tyrosinase-positive or -negative. In cases of tyrosinase-positive albinism, the enzyme tyrosinase is present. The melanocytes (pigment cells) are unable to produce melanin for any one of a variety of reasons that do not directly involve the tyrosinase enzyme. In tyrosinase-negative cases, either the tyrosinase enzyme is not produced or a nonfunctional version is produced. This classification has been rendered obsolete by recent research.

About one in 17,000 children in the UK is born with some type of albinism.It affects people from all races and its frequency across the human population is estimated to be approximately 1 in 20,000.

Symptoms:
People with albinism are born with little or no pigmentation in their eyes, skin and hair (oculocutaneous albinism) or sometimes in the eyes alone (ocular albinism). But the degree of pigmentation varies (especially in oculocutaneous albinism) and some people gain a little pigmentation in their hair or eyes with age, or develop pigmented freckles on their skin.

Apart from their physical appearance, people with the condition can experience a number of associated problems, depending on which genetic type they have.

Skin

Although the most recognizable form of albinism results in milky white skin, skin pigmentation can range from white to nearly the same as parents or siblings without albinism.

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For some people with albinism, skin pigmentation never changes. For others, melanin production may begin or increase during childhood and adolescence, resulting in slight changes in pigmentation. With exposure to the sun, some people may develop:

*Freckles……CLICK & SEE
*Moles, with or without pigment
*Large freckle-like spots (lentigines)
*The ability to tan

Hair
Hair color can range from very white to brown. People of African or Asian descent who have albinism may have hair color that is yellow, reddish or brown. Hair color may also change by early adulthood.

 

Eye color
Eye color can range from very light blue to brown and may change with age.

CLICK & SEE

The lack of pigment in the colored part of your eyes (irises) makes them somewhat translucent. This means that the irises can’t completely block light from entering the eye. Because of this translucence, very light-colored eyes may appear red in some lighting. This occurs because you’re seeing light reflected off the back of the eye and passing back out through the iris again — similar to red eye that occurs in a flash photograph.

Vision
Signs and symptoms of albinism related to eye function include:

*Rapid, involuntary back-and-forth movement of the eyes (nystagmus)
*Inability of both eyes to stay directed at the same point or to move in unison (strabismus)
*Extreme nearsightedness or farsightedness
*Sensitivity to light (photophobia)
*Astigmatism

Causes:
The cause of albinism is a mutation in one of several genes. Each of these genes provides the chemically coded instructions for making one of several proteins involved in the production of melanin. Melanin is produced by cells called melanocytes, which are found in your skin and eyes. A mutation may result in no melanin production at all or a significant decline in the amount of melanin.

In most types of albinism, a person must inherit two copies of a mutated gene — one from each parent — in order to have albinism. If a person has only one copy, then he or she won’t have the disorder.

Impact of mutations on eye development
Regardless of which gene mutation is present, vision impairment is a common characteristic with all types of albinism. These impairments are caused by irregular development of the nerve pathways from the eye to the brain and from abnormal development of the retina.

Types of albinism
The system for classifying types of albinism is based primarily on which mutated gene caused the disorder rather than how it’s manifested. Nonetheless, most types of albinism have some features that distinguish them from each other. Types of albinism include:

*Oculocutaneous albinism.
Oculocutaneous albinism is caused by a mutation in one of four genes. These mutations result in signs and symptoms related to vision (ocular) and those related to skin (cutaneous), hair and iris color.

Oculocutaneous albinism 1 is caused by a mutation in a gene on chromosome 11. Most people with this type of albinism have milky white skin, white hair and blue eyes at birth. Some people with this disorder never experience changes in pigmentation, but others begin to produce melanin during childhood and adolescence. Their hair may become a golden blond or brown. Their skin usually doesn’t change color, but it may tan somewhat. The irises may also change color and lose some of their translucence.

Oculocutaneous albinism 2
is caused by a mutation in a gene on chromosome 15. It’s more common in Sub-Saharan Africans and African-Americans than in other population groups. The hair may be yellow, auburn, ginger or red, the eyes can be blue-gray or tan, and the skin is white at birth. In people of African descent, the skin may be light brown, and in those of Asian or Northern European descent, the skin is usually white. In either case, the skin color is generally close to the family’s coloring, but little bit lighter. With sun exposure, the skin may over time develop freckles, moles or lentigines.
Oculocutaneous albinism 3 (rare cases) is caused by a gene mutation on chromosome 9 and has been primarily identified in black South Africans. People with this disorder usually have reddish-brown skin, ginger or reddish hair, and hazel or brown eyes.

Oculocutaneous albinism 4, caused by a gene mutation on chromosome 5, is a rarer form of the disorder generally presenting signs and symptoms similar to those of type 2. This type of albinism may be one of the most common forms among people of Japanese descent.

*X-linked ocular albinism.
The cause of X-linked ocular albinism, which occurs almost exclusively in males, is a gene mutation on the X chromosome. People who have ocular albinism have the developmental and functional vision problems of albinism. But skin, hair and eye color are generally in the normal range or slightly lighter than that of others in the family.

*Hermansky-Pudlak syndrome. Hermansky-Pudlak syndrome is a rare albinism disorder caused by one of at least seven mutated genes. People with this disorder have signs and symptoms like those of oculocutaneous albinism, but they also develop lung and bowel diseases and a bleeding disorder.

*Chediak-Higashi syndrome. Chediak-Higashi syndrome is a rare form of albinism caused by a mutation in a gene on chromosome 1. Signs and symptoms are also similar to those of oculocutaneous albinism. The hair is usually brown or blond with a silvery sheen, and the skin is usually creamy white to grayish. People with this syndrome have a defect with white blood cells that results in a susceptibility to infections.

Compliccations:
Complications of albinism include physical risks as well as social and emotional challenges.

*In physical terms, humans with albinism commonly have vision problems and need sun protection. But they also face social and cultural challenges (even threats) as the condition is often a source of ridicule, discrimination, or even fear and violence. Cultures around the world have developed many beliefs regarding people with albinism. This folklore ranges from harmless myth to dangerous superstitions that cost human lives. Cultural challenges can be expected to be vastly higher in areas where pale skin and light hair stand out more from the ethnic majority’s average phenotype.

*In African countries such as Tanzania  and Burundi, there has been an unprecedented rise in witchcraft-related killings of albino people in recent years. This is because albino body parts are used in potions sold by witchdoctors. Numerous authenticated incidents have occurred in Africa during the 21st Century. For example, in Tanzania, in September 2009, three men were convicted of killing a 14-year-old albino boy and severing his legs in order to sell them for witchcraft purposes.[19] Again in Tanzania and Burundi in 2010, the murder and dismemberment of a kidnapped albino child is reported from the courts, as part of a continuing problem.

*Other examples: In Zimbabwe, belief that sex with an albinistic woman will cure a man of HIV has led to rapes (and subsequent HIV infection).

*Certain ethnic groups and insular areas exhibit heightened susceptibility to albinism, presumably due to genetic factors (reinforced by cultural traditions). These include notably the Native American Kuna and Zuni nations (respectively of Panama and New Mexico); Japan, in which one particular form of albinism is unusually common; and Ukerewe Island, the population of which shows a very high incidence of albinism.

All of these factors may contribute to social isolation, poor self-esteem and stress.

Treatment :
There’s no cure for albinism, but treatments and aids can help the symptoms and reduce the risk of damage to the skin and eyes.

For the most part, treatment of the eye conditions consists of visual rehabilitation. Surgery is possible on the ocular muscles to decrease nystagmus, strabismus and common refractive errors like astigmatism. Strabismus surgery may improve the appearance of the eyes. Nystagmus-damping surgery can also be performed, to reduce the “shaking” of the eyes back and forth. The effectiveness of all these procedures varies greatly and depends on individual circumstances. More importantly, since surgery will not restore a normal RPE or foveae, surgery will not provide fine binocular vision. In the case of esotropia (the “crossed eyes” form of strabismus), surgery may help vision by expanding the visual field (the area that the eyes can see while looking at one point).

Glasses and other vision aids, large-print materials and CCTV, as well as bright but angled reading lights, can help individuals with albinism, even though their vision cannot be corrected completely. Some people with Albinism do well using bifocals (with a strong reading lens), prescription reading glasses, and/or hand-held devices such as magnifiers or monoculars (a very simple telescope). Contact lenses may be colored to block light transmission through the iris. But in case of nystagmus this is not possible, due to the irritation that is caused by the movement of the eyes. Some use bioptics, glasses which have small telescopes mounted on, in, or behind their regular lenses, so that they can look through either the regular lens or the telescope. Newer designs of bioptics use smaller light-weight lenses. Some US states allow the use of bioptic telescopes for driving motor vehicles.

Although still disputed among the experts, many ophthalmologists recommend the use of spectacles from early childhood onward to allow the eyes the best development possible.

People with Hermansky-Pudlak and Chediak-Higashi syndromes usually require regular specialized care to prevent complications.
Home Remedies & Lifestyle
You can help your child learn self-care practices that should continue into adulthood:

*Use low-vision aids, such as a hand-held magnifying glass, a monocular or a magnifier that attaches to glasses.

*Apply sunscreens with a sun protection factor (SPF) of at least 30 that protects against both UVA and UVB light.

*Avoid high-risk sun exposure, such as being outside in the middle of the day, at high altitudes and on sunny days with thin cloud cover.

*Wear protective clothing, including long-sleeved shirts, long pants and broad-rimmed hats.

*Protect your eyes by wearing dark, UV-blocking sunglasses.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/albinism1.shtml
http://en.wikipedia.org/wiki/Albinism
http://www.mayoclinic.com/health/albinism/DS00941

http://health.howstuffworks.com/skin-care/problems/medical/albinism.htm/printable

http://health.howstuffworks.com/skin-care/problems/medical/albinism2.htm

http://www.makeupbykaty.com/freckles-i-want-more/

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