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Hidradenitis Suppurativa

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Definition:
Hidradenitis suppurativa or HS is a skin disease that affects areas bearing apocrine sweat glands and hair follicles; such as the underarms, groin and buttocks. It is more commonly found in women and can be present under the breasts.

Hidradenitis suppurativa is a chronic skin inflammation marked by the presence of blackheads and one or more red, tender bumps (lesions). The lesions often enlarge, break open and drain pus. Scarring may result after several occurrences.

The cause of hidradenitis suppurativa isn’t known. But it’s considered a severe form of acne (acne inversa) because it occurs deep in the skin around oil (sebaceous) glands and hair follicles. The parts of the body affected — the groin and armpits, for example — are also the main locations of apocrine sweat glands.

Click to see pictures…>..(1)….…(2).……..(3).……...(4).…….(5)……..(6)……….…(7)

Hidradenitis suppurativa tends to start after puberty, persist for years and worsen over time. There is no cure for hidradenitis suppurativa. But early diagnosis and treatment can help manage the symptoms and prevent new lesions from developing.

Other names for HS
Hidradenitis suppurativa has been referred to by multiple names in the literature, as well as in various cultures. Some of these are also used to describe different diseases, or specific instances of this disease.

*Acne conglobata – not really a synonym – this is a similar process but in classic acne areas of chest and back

*Acne Inversa (AI) – a new term which has not found favour.

*Apocrine Acne – a misnomer, out-dated, based on the disproven concept that apocrine glands are primarily involved

*Apocrinitis – another misnomer, out-dated, based on the disproven concept that apocrine glands are primarily involved

*Fox-den disease – a catchy term not used in medical literature, based on the deep fox den / burrow – like sinuses

*Hidradenitis Supportiva – a misspelling

*Pyodermia sinifica fistulans – an older term, considered archaic now, misspelled here

*Velpeau’s disease – commemorating the French surgeon who first described the disease in 1833

*Verneuil’s disease – recognizing the French surgeon whose name is most often associated with the disorder as a result of his 1854-1865 studies

Stages
HS presents itself in three stages.

1.Solitary or multiple isolated abscess formation without scarring or sinus tracts. (A few minor sites with rare inflammation; may be mistaken for acne.)

2.Recurrent abscesses, single or multiple widely separated lesions, with sinus tract formation. (Frequent inflammations restrict movement and may require minor surgery such as incision and drainage.)

3.Diffuse or broad involvement across a regional area with multiple interconnected sinus tracts and abscesses. (Inflammation of sites to the size of golf balls, or sometimes baseballs; scarring develops, including subcutaneous tracts of infection – see fistula. Obviously, patients at this stage may be unable to function.)
Sign and Symptoms:

Hidradenitis suppurativa commonly occurs around hair follicles where many oil and sweat glands are found, such as the armpits, groin and anal area. It may also occur in areas where skin rubs together, such as the inner thighs, under the breasts or between the buttocks. Hidradenitis suppurativa can affect a single area or multiple areas of the body.

Click to  SEE THE PICTURES
Hidradenitis suppurativa usually appears as one or more red, tender bumps that fill with pus. It commonly occurs where oil (sebaceous) and apocrine sweat glands are found, such as the armpits, groin and anal area.

 

Signs and symptoms of hidradenitis suppurativa include:

*Small pitted areas of skin containing blackheads, often appearing in pairs or a “double-barrel” pattern.

*One or more red, tender bumps (lesions) that fill with pus. The bumps often enlarge, break open and drain pus. The drainage may have an unpleasant odor. Itching, burning and excessive sweating may accompany the bumps.

*Painful, pea-sized lumps that grow under the skin. These hard lumps, which may persist for years, can enlarge and become inflamed.

*Painful bumps or sores that continually leak fluid. These open wounds heal very slowly, if at all, often leading to scarring and the development of tunnels under the skin.

For some people, the disease progressively worsens and affects multiple areas of their body. Other people experience only mild symptoms. Excess weight, stress, hormonal changes, heat or excessive perspiration can worsen symptoms.

Causes:
Hidradenitis suppurativa develops when the oil glands and hair follicle openings become blocked. When oils and other skin products become trapped, they push into surrounding tissue. Bacteria can then trigger infection and inflammation. It’s not known why this occurs, but a number of factors — including hormones, genetics, cigarette smoking and excess weight — may all play a role.

Sometimes hidradenitis suppurativa occurs with other diseases, such as Crohn’s disease, herpes simplex or Grave’s disease.

As this disease is poorly studied, the causes are controversial and experts disagree. However, potential indicators include:

*post-pubescent

*females are more likely than males

*genetic predisposition

*plugged apocrine (sweat) gland or hair follicle

*excessive sweating

*bacterial infection

*sometimes linked with other auto-immune conditions

*androgen dysfunction

*genetic disorders that alter cell structure

*stress can bring on outbreaks

*being overweight makes it worse, however this condition is not caused by obesity and weight loss will improve but not cure it.

*cigarette smoking tends to encourage outbreaks as well

The historical understanding of the disease is that there is a misfunction in either the apocrine glands or hair follicles, possibly triggered by a blocked gland, creating inflammation, pain, and a swollen lesion. More recent studies imply there is an autoimmune component.

HS is not caused by any bacterial infection — any infection is secondary. Most cultures done on HS lesions come back negative for bacteria, so antibiotics should be used only when a bacterial infection has been confirmed by a physician.

Hidradenitis suppurativa is not contagious.

Screening and Diagnosis:
To make a diagnosis, your doctor may ask about your symptoms and medical history, examine your skin, and order blood tests. If pus or drainage is present, your doctor may send a sample of the fluid to a laboratory for testing. This test is known as a culture. Such tests may be necessary to rule out other skin conditions, such as tuberculosis of the skin, a carbuncle or a pilonidal cyst.
General Complications:
Hidradenitis suppurativa often causes complications when the disease is persistent and severe. These complications include:

*Sinus tracts or tunnels that connect and form a network under the skin. The tracts prevent the sores from healing and cause more sores to develop.

*Scars and skin changes. Severe hidradenitis suppurativa may leave thick, raised scars, pitted skin or patches of skin that are darker than normal (hyperpigmentation).

*Restricted movement. The disease may cause limited or painful movement, especially when it affects the armpits or thighs.

*Cellulitis. This potentially serious bacterial infection appears as an area of swollen, red skin that feels hot and tender and that may spread rapidly. Although the initial infection may be superficial, it eventually can affect the tissues underlying your skin or spread to your lymph nodes and bloodstream.

Severe complications:
Left undiscovered, undiagnosed, or untreated, the fistulas from severe stage-3 HS can lead to the development of squamous cell carcinoma in the anus or other affected areas.

Treatments:

There is no cure for hidradenitis suppurativa. But early treatment can help manage the symptoms and prevent new lesions from developing.
Treatments may vary depending upon presentation and severity of the disease. Due to the poorly-studied nature of this disease, the effectiveness of the drugs and therapies listed below is not yet clear, and patients should discuss all options with their doctor or dermatologist. Nearly a quarter of patients state that nothing relieves their symptoms. A list of treatments that are possible treatments for some patients is as follows.

*lifestyle

*changes in diet.

*warm compresses, baths (to induce drainage)
medication
*ntralesional corticosteroid injections (to reduce inflammation)

*oral antibiotics (to treat inflammation and bacterial infection)

*isotretinoin (Accutane), a prescription-only oral acne treatment (benefits for HS are very controversial, but it is generally considered to be ineffective)

*anti-androgen therapy

*sub-cutaneous injection or IV infusion of anti-inflammatory (anti-TNF-alpha) drugs such as infliximab (Remicade), etanercept (Enbrel), and adalimumab. This use of the drugs is not currently Food and Drug Administration (FDA) approved and is

*somewhat controversial, and therefore may not be covered by insurance.
Acitretin

*Zinc gluconate taken orally has been shown to induce remission
surgery (But Obesity, incomplete removal and ongoing skin infections can increase the chances that hidradenitis suppurativa returns, even after surgical treatment.)

*incision and drainage or lancing

*wide local excision (with or without skin grafting), or laser surgery

*radiotherapy

Self-care:
The following suggestions may help relieve discomfort, speed healing and prevent the infection from spreading:

*Apply a warm washcloth or compress to help reduce swelling.

*Gently wash the affected areas with antibacterial soap. After washing, apply an over-the-counter antibiotic.

*Wear loosefitting clothes and underwear to prevent skin irritation.

*Avoid shaving the affected areas to prevent skin irritation.

*Don’t smoke. Smoking can worsen symptoms and trigger new outbreaks.

Excess weight increases the number of areas where skin rubs together — for example, between skin folds — causing friction, increased perspiration and bacterial growth. Though weight loss won’t cure the disease, it may improve symptoms.

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://en.wikipedia.org/wiki/Hidradenitis_suppurativa
http://www.mayoclinic.com/health/hidradenitis-suppurativa/DS00818/DSECTION

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Hemangioma

DEFINITION:
Hemangiomas are simply a collection of extra blood vessels in the skin. They may have different appearances depending on the depth of the increased numbers of blood vessels.

A hemangioma is a benign self involuting tumour of endothelial cells (the cells that line blood vessels) Haemangiomas of infancy They are connected to the circulatory system and filled with blood. The appearance depends location. If they are on the surface of the skin the look like a ripe strawberry, if they are just under the skin the present as a bluish swelling. Sometimes they grow in internal organs such as the liver or larynx. In most cases, hemangiomas will disappear over time. They are formed either during gestation or most commonly they are not present at birth but appear during the first few weeks of life. They are often misdiagnosed, initially, as a scratch or bruise but the diagnosis becomes obvious with further growth. Typically at the earliest phase in a superficial lesion one will see a bluish red area with obvious blood vessels and surrounding pallor. Sometimes they present as a flat red or pink area. Hemangiomas are the most common childhood tumor occurring in approximately ten percent of Caucasians, and are less prevalent in other races. Females are three to five times more likely to have hemangiomas than males. They are also more common in twin pregnancies. Approximately eighty percent are located on the face and neck, with the next most prevalent location being the liver. Although hemangiomas are benign, some serious complications can occur.

Before considering the hemangioma it is important to understand that there have been recent changes in the terminology used to define vascular anomalies (abnormal lumps made up of blood vessels). The term hemangioma was originally used to describe any vascular tumour both present around birth or appearing later in life. Mulliken et al separated these conditions into a family of self involuting tumours (growing lesions that eventually disappear) from the family of malformations (enlarged or abormal vessels present at birth and essentially permanent. The importance of this separation is that allows us to differentiate early in life between lesions that will resolve versus those that are permanent. Examples of permanent malformations include Port-wine stains (capillary vascular malformation) and masses of abnormal swollen veins (venous malformations).Hemangiomas and Vascular Malformations in Infants and Children: A Classification Based on Endothelial Characteristics. Unfortunately many textbooks and dictionaries are not up to date creating great confusion.

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Types:
1.Strawberry Hemangioma is an abnormal collection of blood vessels in the skin characterized by a bright red color and well-defined border.

2.A Deep or Cavernous Hemangioma is a large, collection of blood vessels beneath the skin surface characterized by a soft, bluish, or skin colored mass.

3.A Combined Hemangioma is a combination of a deep and superficial (strawberry) hemangioma.

There are two types of liver hemangioma: cavernous and hemangioendothelioma. Hemangioendotheliomata are generally seen only in children.Click learn about cavernous hemangioma,

HOW COMMON ARE THEY?

Hemangiomas are one of the most common birthmarks in newborns. Most hemangiomas are not present at birth but develop within the first few weeks to months of life. They are found in up to 10 percent of babies by the age of one.

CAUSES:
The cause of hemangioma is currently unknown; however, several studies have suggested the importance of estrogen signaling in hemangioma proliferation. In 2007, a paper from the Stanford Children’s Surgical Laboratory revealed that localized soft tissue hypoxia coupled with increased circulating estrogen after birth may be the stimulus. There is also a hypothesis presented by researchers at Harvard and the University of Arkansas that maternal placenta embolizes to the fetal dermis during gestation resulting in hemangiomagenesis, yet Duke researchers conducted genetic analyses of small nucleotide polymorphisms in hemangioma tissue compared to the mother’s DNA that contradicted this notion. More research is required in order to fully understand the explosive nature of hemangioma growth which will hopefully yield targeted therapeutics to treat its most complicated presentations.
In very rare instances they may run in families, but in general they are not inherited. For a parent with a child with this birthmark, there is no increased risk of having a subsequent child with a hemangioma. Hemangiomas are more common in girl babies than boys. They are also more commonly seen in premature infants.
TYPICAL GROWTH PATTERN OF HEMANGIOMAS:

Age of Child..………..Hemangiomas
Birth………………… often not present or noticeable
1-2 months……… becomes noticeable
1-6 months……… grows most rapidly
12-18………………. months begins to shrink (involute)


WHEN WILL THEY GO AWAY?
Hemangiomas usually involute (shrink away) in time. 30% of hemangiomas will resolve by 3 years of age 50% by 5 years of age, and 80%-90% by 9 years of age. Over one-half of hemangiomas heal with an excellent cosmetic result without treatment.

COMPLICATIONS:

The vast majority of hemangiomas are not associated with complications. Hemangiomas may break down on the surface to form ulcers. If the ulceration is deep, significant bleeding may rarely occur. Ulceration on the diaper area can be painful and problematic.

If a hemangioma develops in the larynx, breathing can be compromised. A hemangioma can grow and block one of the eyes, causing an occlusion amblyopia. Very rarely, extremely large hemangiomas can cause high-output heart failure due to the amount of blood that must be pumped to excess blood vessels. Lesions adjacent to bone can also cause erosion of the bone.

The most frequent complaints about hemangiomas, however, stem from psychosocial complications: the condition can affect a person’s appearance and can provoke attention and malicious reactions from others. Particular problems occur if the lip or nose is involved, as distortion can be difficult to treat surgically.

Some hemangiomas can cause significant problems, however. Scenarios that may be more complicated and require treatment include:

1) Involvement of a vital organ, like the eye or ear, or windpipe
2) Bleeding
3) Ulceration
4) Crusting or infection
5) Rapid growth and deformity of the surrounding tissues

Hemangiomas in certain areas may have a higher risk of complications. These areas include the face (especially nose and lips), body folds, and groin. Hemangiomas in certain locations, which affect function, or are complicated by infection or ulceration, may be treated with laser, medication, or injections. If any worrisome signs appear such as these listed above, please contact your physician.

TREATMENT:

Most hemangiomas disappear without treatment, leaving minimal or no visible marks. Large hemangiomas can leave visible skin changes secondary to severe stretching of the skin or damage to surface texture. When hemangiomas interfere with vision, breathing, or threaten significant cosmetic injury, they are usually treated. The mainstay of treatment is oral corticosteroid therapy. Other drugs such as interferon or vincristine are sometimes considered if the corticosteroids do not work. If this fails, surgical removal often becomes necessary. Blockage of the airway will often require a tracheostomy to be performed (insertion of an external airway through the front of the neck into the trachea below the level of the obstruction). Smaller raised lesions are sometimes treated with injection of corticosteroid directly into the lesion. Pulsed dye laser can be useful for very early flat superficial lesions if they appear in cosmetically significant areas or for those lesions that leave residual surface blood vessels in the case of incomplete resolution. Unfortunately raised lesions or lesions under the skin do not respond to laser.

Ulceration will usually heal with topical medication and special dressings under medical supervision. Sometimes pulsed dye laser can be used to accelerate healing.

HEMANGIOMAS THAT NEED TREATMENT:
Some hemangiomas can cause significant problems, however. Scenarios that may be more complicated and require treatment include:

1) Involvement of a vital organ, like the eye or ear, or windpipe
2) Bleeding
3) Ulceration
4) Crusting or infection
5) Rapid growth and deformity of the surrounding tissues

Hemangiomas in certain areas may have a higher risk of complications. These areas include the face (especially nose and lips), body folds, and groin. Hemangiomas in certain locations, which affect function, or are complicated by infection or ulceration, may be treated with laser, medication, or injections. If any worrisome signs appear such as these listed above, please contact your physician.

In many instances no treatment will be indicated. If treatment is needed, however, it may include:

Cortisone: Injected into the hemangioma or given orally by mouth. If given orally for prolonged periods has side effects including increased risk of systemic infection, high blood pressure, diabetes, increased appetite, stomach irritation, growth suppression, etc.

Pulsed Dye Laser Therapy: This therapy treats the superficial blood vessels best. If this treatment is recommended it is usually reserved for the superficial component of hemangioma, characterized by a flat, red lesion. It is usually administered in a series of laser treatments spaced 2-4 weeks apart.

Antibiotics: If the hemangioma is infected and open it may be treated with a short course of antibiotics and daily wound cleansing.

Alpha Interferon: This therapy is limited to the most severe and potentially life threatening hemangiomas. It involves administering systemic medication via daily shots, usually into the leg, for several months. It is usually given to the baby by the parents under physician direction and supervision. This therapy has serious potential side effects including neurologic effects, blood abnormalities and others.

Surgical removal: In rare instances, hemangiomas may be surgically removed especially if they are not likely to resolve spontaneously or lead to significant tissue distortion and deformation.

PROGNOSIS:
Hemangiomas go through three stages of development and decay:

1.In the proliferation stage, a hemangioma grows very quickly. This stage can last up to twelve months.

2.In the rest stage, there is very little change in a hemangioma’s appearance. This usually lasts until the infant is one to two years old.

3.In the involution phase, a hemangioma finally begins to diminish in size. Fifty percent of lesions will have disappeared by age five with the vast majority gone by puberty.

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://en.wikipedia.org/wiki/Hemangioma
http://childrensspecialists.com/body.cfm?id=498
http://cpmcnet.columbia.edu/dept/gi/hemangioma.html

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Blepharitis

Other Names: Granulated eyelids.

Definition:
Blepharitis is a common condition that causes inflammation of the eyelids. The condition can be difficult to manage because it tends to recur.It is characterized by inflammation of the eyelid margins. Blepharitis usually causes redness of the eyes and itching and irritation of the eyelids in both eyes. Its appearance is often confused with conjunctivitis and due to its recurring nature it is the most common cause of “recurrent conjunctivitis” in older people. It is also often treated as ‘dry eye‘ by patients due to the gritty sensation it may give the eyes – although lubricating drops do little to improve the condition.

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Causes:-

There are two types of Bepharitis:
1.Anterior blepharitis affects the front of the eyelids near the eyelashes. The causes are seborrheic dermatitis (similar to dandruff) and occasional infection by Staphylococcus bacteria and scalp dandruff.

It is a type of external eye inflammation. As with dandruff, it is usually asymptomatic until the disease progresses. As it progresses, the sufferer begins to notice a foreign body sensation, matting of the lashes, and burning. Usually, the primary care physician will prescribe topical antibiotics for staphylococcal blepharitis. Unfortunately this is not an effective treatment.This ailment can sometimes lead to a chalazion or a stye.
2.Posterior blepharitis or Rosacea associated blepharitisaffects the back of the eyelids, the part that makes contact with the eyes. This is caused by the oil glands present in this region. It is by far, the most common type of blepharitis.

Posterior blepharitis affects the inner eyelid (the moist part that makes contact with the eye) and is caused by problems with the oil (meibomian) glands in this part of the eyelid. Two skin disorders can cause this form of blepharitis: acne rosacea, which leads to red and inflamed skin, and scalp dandruff (seborrheic dermatitis).It is the most common type of blepharitis, is usually one part of the spectrum of seborrheic dermatitis seborrhea which involves the scalp, lashes, eyebrows, nasolabial folds and ears. Treatment is best accomplished by a dermatologist.

This most common type of blepharitis is often found in people with a rosacea skin type. The oil glands in the lid (meibomian glands) secrete a modified oil which leads to inflammation at the gland openings which are found at the edge of the lid.

Symptoms:
Symptoms of either form of blepharitis include a foreign body or burning sensation, excessive tearing, itching, sensitivity to light (photophobia), red and swollen eyelids, redness of the eye, blurred vision, frothy tears, dry eye, or crusting of the eyelashes on awakening.

Other conditions associated with blepharitis:

Complications from blepharitis include:

Stye: A red tender bump on the eyelid that is caused by an acute infection of the oil glands of the eyelid.

Chalazion: This condition can follow the development of a stye. It is a usually painless firm lump caused by inflammation of the oil glands of the eyelid. Chalazion can be painful and red if there is also an infection.

Problems with the tear film: Abnormal or decreased oil secretions that are part of the tear film can result in excess tearing or dry eye. Because tears are necessary to keep the cornea healthy, tear film problems can make people more at risk for corneal infections.

Treatment and management:
The single most important treatment principle is a daily routine of lid margin hygiene as described below. Such a routine needs to be convenient enough to be continued lifelong to avoid relapses as blepharitis is a lifelong condition.

A typical lid margin hygiene routine consists of 3 steps:
1. Softening of lid margin debris and oils:
Apply a warm wet compress to the lids – such as a washcloth with hot water – for about 2 minutes.

2. Mechanical removal of lid margin debris:
At end of shower routine, wash your face with a wash cloth. Use facial soap or non-burning baby shampoo (make sure to dilute the soap solution 1/10 with water first). Gently and repeatedly rub along the lid margins while eyes are closed.

3. Antibiotic reduction of lid margin bacteria (at the discretion of your physician):
After lid margin cleaning, spread small amount of prescription antibiotic ophthalmic ointment with finger tip along lid fissure while eyes closed. Use prior to bed time as opposed to in the morning to avoid blurry vision.

The following guide is very common but is more challenging to perform by visually disabled or frail patients as it requires good motor skills and a mirror. Compared to above it does not bear any advantages:

.
1. Apply hot compresses to both eyes for 5 minutes once to twice per day.

2. After hot compresses, in front of a mirror, use a moist Q-tip soaked in a cup of water with a drop of baby shampoo. Rub along the lid margins while tilting the lid outward with the other hand.

3. In front of mirror, place small drop of antibiotic ophthalmic ointment (e.g. erythromycin) in lower conjunctival sack while pulling lid away from eye with other hand.

Often the above is advised together with mild massage to mechanically empty glands located at the lid margin (Meibomian glands, Zeiss glands, Moll glands).

Depending on the degree of inflammation of the lid margin, a combination of topical antibiotic and steroid drops or ointments can be prescribed to provide instant relief. However, this harbors significant risks such as increased intraocular pressure and posterior subcapsular cataract formation. Since cataract formation is irreversible and even intraocular hypertension might be (harboring the risk of glaucoma with permanent visual loss), both need to be checked for monthly. Steroid-induced cataracts and ocular hypertension can affect all ages.

If acne rosacea coexists, treatment should be focused on this skin disorder as the underlying cause together with the above lid margin hygiene routine. Typically, 100 mg doxycycline by mouth twice per day is prescribed for four to six weeks which can be tapered to 50 mg once daily for several years. Some physicians use a lower starting dose. Patients are instructed to continue use for at least two months before symptoms improve significantly. Contrary to common belief, use of tetracycline-type antibiotics is not primarily to treat bacterial infection but rather to inhibit matrix metalloproteinases resulting in thinning of oil gland secretions and change of the characteristic prominent capillary pattern.

Dermatologists treat blepharitis similarly to seborrheic dermatitis by using safe topical anti-inflammatory medication like sulfacetamide or brief courses of a mild topical steroid. Although anti-fungals like ketoconazole (Nizoral) are commonly prescribed for seborrheic dermatitis, dermatologists and optometrists usually do not prescribe anti-fungals for seborrheic blepharitis.

4. Ocular Antihistamines and allergy treatments:
If these conventional treatments for blepharitis do not bring relief, patients should consider allergy testing. Allergic responses to dust mite feces and other allergens can cause lid inflammation, ocular irritation, and dry eyes. Prescription optical antihistamines like Patanol, Optivar, Elestat, and over the counter optical antihistamines like Zaditor are very safe and can bring almost immediate relief to patients whose lid inflammation is caused by allergies.

Click to learn more about Belpharitis:->.……………………………..(1)...(2)...(3)

Herbal Remedies of Bepharitis

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://en.wikipedia.org/wiki/Blepharitis
http://www.nei.nih.gov/health/blepharitis/index.asp

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Acne

Serious skin conditions affect around seven million of people in the UK alone.They can cause significant emotional distress as well as physical discomfort.

.Acne causes unsightly spots

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What is it?

Acne is an inflammatory skin condition that causes spots.

Spots result from the build up of dead skin cells and grease that block the pores or hair follicles, typically on the face, upper arms, upper back and chest.

It is not contagious and is nothing to do with not being clean.

Hormonal changes, such as those related to puberty, menstruation and pregnancy, can contribute to acne.

Some medicines will also make it worse, including some contraceptive pills and steroids.

CLICK TO SEE DIFFERENCE BETWEEN PIMPLE & ACNE

Who gets it?

Most people experience acne at some time in their lives, typically as young adults. Girls tend to develop it slightly earlier than boys – around the ages of 14-17 compared to 16-19 years, respectively.

Acne can occur later in life. Around five per cent of women and one per cent of men aged 25-40 continue to have acne after adolescence.

What are the symptoms?

As the pores of the skin become blocked, blackheads develop and small, tender, red spots appear. These can turn into pimples or whiteheads filled with pus.

What is the outlook?

Usually it is a mild condition, most commonly during young adulthood, and will resolve by itself. But for 15% of people it is severe.

The spots can become infected and cause significant scarring, particularly if they are scratched or squeezed.

How can it be treated?

Mild acne does not need treating as each inflamed spot will eventually heal. Eating a healthy diet and drinking plenty of water will help keep the skin healthy.

Keeping spot-prone areas clean by washing the affected area twice daily with an unperfumed cleanser can help. However, excessive washing and scrubbing of the skin will not help and may make the inflammation worse.

More severe acne may need treatment. The aim is to clear the spots and prevent scarring.

Treatments work by either unblocking blocked pores, reducing the amount of grease or sebum made by the skin, reducing the inflammation or fighting the bacterium that infects the lesions.

Creams, gels and lotions that can be applied to the skin are available to buy at pharmacies without a prescription. These usually contain antibacterial agents such as benzoyl peroxide, which also works by drying out the skin and encouraging it to shed the surface layer of dead skin.

There are several more potent oral tablets that can be prescribed by a doctor if the acne persists.

Make-up can be used to cover blemishes but heavy use of concealer may make acne worse.

Any scarring will improve with time. Laser therapy, chemical peels, dermabrasion and other treatments have been suggested for acne scarring.

Acne can be extremely distressing and it is important to seek help if you are anxious or depressed about it.

Natural Acne Treatment

Click for Ayurvedic Treatment of Acne………………………..….(1)…….(2).………(3)

Acne Home Remedy

Click for Homeopathic Remedies of Acne …………………………..(1)……...(2).….(3)

Click to learn more about Acne

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.

Sources: BBC NEWS (9th.March’06)

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Hindradenitis Suppurative

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Definition:
Hidradenitis is a chronic disease of the scent or apocrine glands which causes chronic scarring and pus formation of the axillae and groin areas. It is similar to acne which is a disease of the sebaceous glands. This condition is slightly more common in African-Americans and women. Hidradenitis usually starts as one or more red, tender, swellings in the groin or axilla. Over a period of hours to days the lesions enlarge and often open to the skin surface draining clear to yellow fluid. The involved area then heals with scarring. The condition usually continues for years with periods of flare and remission.

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Hidradenitis Suppurativa (HS), also known as ‘Acne Inversa‘, is a physically, psychologically, and socially disabling disease affecting inverse areas of the body (those places where there is skin-to-skin contact – armpits, groin, breasts, etc.), and where apocrine glands and hair follicles are found. It is non-contagious and recurrent; typically manifesting as a progression from single boil-like, pus-filled abscesses, or hard sebaceous lumps, to painful, deep-seated, often inflamed clusters of lesions with chronic seepage (suppuration — hence the name) involving significant scarring.

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Causes and Associations:

For unknown reasons, people with hidradenitis develop plugging or clogging of their apocrine glands. This leads to bacterial infection which can produce pain and odor.
Hidradenitis is made worse by being overweight, however this condition is not caused by obesity.

Hidradenitis is more common in people who have had acne.

Hidradenitis may become worse under stress.

Hidradenitis is not caused by poor hygiene.

Hidradenitis is a chronic disease of the apocrine glands (a form of sweat gland found on certain parts of the body). For unknown reasons, people with hidradenitis develop plugging or clogging of their apocrine glands. It causes chronic scarring and pus formation of the underarms (axilla) and groin/inner thigh areas. In women it can also occur under the breasts. It is similar to acne, which is also a disease of the sebaceous glands. Hidradenitis is more common in people who have had acne. It may be an unusual type of adult acne.

This condition is slightly more common in women and African-Americans. Hidradenitis usually starts as one or more red, tender, swellings in the groin or armpits. Over a period of hours to days the lesions enlarge and often open to the skin surface draining clear to yellow fluid. The involved area then heals with scarring. The condition usually continues for years with periods of flare and remission.

Bacterial infection produces the pain and odor. Hidradenitis is made worse by being overweight, however this condition is not caused by obesity and weight loss will improve but not cure hidradenitis. Hidradenitis may become worse under stress. Hidradenitis is not caused by poor hygiene.

Symptoms
Hidradenitis suppurativa usually develops in otherwise healthy people, but it has been associated with Crohn’s disease in some individuals. It is a non-contagious skin disease that usually appears on the body in skin folds of the underarms, groin, or perianal area. It has three main stages, beginning with boils or pockets of infection (abscesses). These become hard, painful, inflamed lumps with drainage (suppuration). Tunnels (sinus tracts) may form around and between the lumps.

Scars form. The last stage is the most debilitating, because large areas of skin are affected by the abscesses, sinus tracts, lumps, and scars.


Worsens over time
Hidradenitis suppurativa usually develops slowly over time, with flare-ups, but in some people the disease progresses quickly. The course of the disease varies for each person. Some will stay at one stage most of the

Treatment:

Topical antibiotics (applied to the skin) are the treatment of choice. Systemic (by mouth) antibiotics are at times necessary when the condition is flaring or when a patient has a severe case.
Tight-fitting clothing is to be strictly avoided.

Dirt does not cause hidradenitis. The involved areas should be cleaned daily using an antibacterial soap, such as the liquid form of Lever 2000. Some patients have found that the liquid form of Lever 2000, applied to the involved areas as a lotion after bathing, can help reduce the odor associated with this condition.

There is no medical cure for hidradenitis. Hidradenitis can be controlled, but not cured. Sometimes surgery is required to drain infected areas or to remove scarred tissue or even large areas of skin.
Weight loss will improve but not cure hidradenitis.

Initial treatments are usually oral antibiotics (minocycline, tetracycline, erythromycin, Augmentin, others) and topical antibiotics (clindamycin or erythromycin). Intralesional injections into the affected places reduce swelling and tenderness within days. Anti-inflammatory pills (Celebrex, Advil, Naprosyn, Alleve, and others) are helpful in addition to the antibiotics, especially if it is a severe case. Some women respond to high estrogen birth control pills (Demulen 1/50 Ortho Novum 1/50) and spironolactone pills.

Tight fitting clothing and shaving the areas are to be strictly avoided. Dirt does not cause hidradenitis. The involved areas should be cleaned daily using an antibacterial soap, as this will reduce any odor associated with this condition. Retin-A cream, a prescription, helps some people. Accutane, a drug for severe acne, offers modest help for moderately bad cases. There is medical control, but not cure for hidradenitis.

Surgery is the most effective treatment for recalcitrant hidradenitis. Aggressive surgery will cure an area of severe, chronic hidradenitis but it has to remove scarred tissue or even large areas of skin. Skin grafts may be needed. Incision (lancing) and draining will reliably help smaller affected areas. Because surgery scars and may have complications, medical treatments are usually tried first.

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Homeopathy & Hidradenitis Suppurativa

Click Here for Medical and Research Articles on Hidradenitis Suppurativa

Resources:
http://www.skinsite.com/info_hidradenitis_suppurativa.htm
http://www.aocd.org/skin/dermatologic_diseases/hidradenitis_suppu.html
http://www.hs-usa.org/hidradenitis_suppurativa.htm

http://rarediseases.about.com/cs/hidradenitissupp/a/072703.htm

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