Dermatology Problems & Solutions

Dermatology Description

  • Papule
  • Macule
  • Nodule
  • Patch
  • Vesicle
  • Bulla
  • Plaque

Papule

  • Small palpable circumscribed lesion
  • <0.5cm

 

 

 

 

Macule

  • Flat, circumscribed non-palpable lesion

 

 

 

 

 

 

Pustule

  • Yellowish white pus-filled lesion

 

 

 

Nodule

  • Large papule >0.5cm

 

 

Plaque

  • Large flat topped elevated palpable lesion

 

 

Patch

  • Large macule

 

 

 

Vesicle

  • Small fluid filled blister

 

 

 

Bulla

  • A large fluid filled blister

 

 

 

ECZEMA

  • Synonymous with dermatitis
  • Large proportion of skin disease in developed world
  • 10% of population at any one time
  • 40% of population at some time

Features of Eczema

  • Itchy
  • Erythematous
  • Dry
  • Flaky
  • Oedematous
  • Crusted
  • Vesicles

 

Contact and Irritant Eczema

  • Exogenous
  • Unusual
  • Worse at workplace
  • History of exacerbations
  • Can occur in any individual
  • Repeated exposure to irritants
  • Common in housewives, hairdressers, nurses

Psoriasis

  • Affects 2%of population
  • Well-demarcated red scaly plaques
  • Skin inflamed and hyperproliferates
  • Males and females equally
  • Two peaks of onset (16- 22) and later (55-60)
  • Usually family history
  • Chronic Plaque
  • Extensor surfaces
  • Sacral area
  • Scalp
  • Koebners phenomenon

Erythrodermic & Pustular Psoriasis

  • More severe
  • Need dermatologist!
  • Usually need oral therapy

 

 

Rosacea

  • Onset middle age
  • Facial flushing / erythema
  • Inflammatory papules
  • Pustules
  • No comedones
  • Telangectasia
  • Blepharitis
  • Rhinophyma

 

 

 

Melasma

  • Macular hyper pigmentation of the skin patch.
  • Etiology: Photo-exposure, Female hormonal fluctuation during pregnancy or usage of birth control pills.

 

Seborrheic Keratosis

  • Benign light tan to dark brown pigmented smooth stuck-on appearance plaque, most of cases, rarely before 30 years of age and more common with skin maturing process.
  • Theses lesions are hereditary with Autosomal dominant inheritance.

Keloid

  • Etiology :unknown
  • Incidence: Equal in males and females
  • Prevalence: More common in blacks than whites
  • Diagnosis: are made by clinical presentation and biopsy usually not warranted.

 

Warts (Human Papillomavirus Infections)

  • Types of Warts
  1. Verruca Vulgaris (common wart), hyperkeratotic papules on skin
  2. Plantar & Palmar wart, Thick hyperkeratotic plaques affecting Soles and palms, maybe painful upon applying of pressure
  3. Verruca Planae (flat wart), Small flat surfaced hyper pigmented multiple papules affecting face, hands and knees
  4. Condyloma Acuminatum (Anogenital)

Condyloma Accuminatum

  • HPV type 6, 11, 42-44
  • Sexually transmitted
  • Increase risk of developing cervical dysplasia in female patients, strongly recommend Pap-smear

Genital Herpes (Simplex type II)

  • HSV 2 is considered to be STDs usually involving genital areas, although HSV1 and HSV2 can affect both oral and genital areas.
  • Educate HSV 2 patients on routine use of condom, asymptomatic shedding and suppression treatment.

Herpes Simplex

  • HSV is transmitted by direct contact of the infected surface skin from one individual to the other.
  • HSV I is usually associated with oral herpes (fever blisters, cold sores).
  • Diagnosis is made by presence of multi-nucleated giant cell under the Tzanck prep

Varicella (Chicken Pox)

  • Chicken pox is the primary infection with varicella zoster virus.
  • It is very contagious.
  • Clinical presentation is characterized by the appearance of diffused mildly pruritic vesicles, papules and scabs all at once.
  • The incubation period is about 10 days and the patients are considered to be contagious 4 days prior to the onset of lesions until all lesions have crusted over with the scabs which can take up to 1 week.

 

Chicken Pox

Burns

  • A burn is tissue damage inflicted by intense heat, electricity, radiation, or certain chemicals, all of which denature cell proteins and cause cell death to infected areas.
  • The most immediate threat to a burn patient is dehydration and electrolyte imbalance due to fluid loss.
  • Leads to renal shutdown and circulatory shock (inadequate blood circulation due to reduced blood volume).
  • To save the patient, the lost fluids must be replaced immediately.

Critical Burns

  • Burns are considered critical if any of the following conditions exists:
  1. Over 25% of the body has second-degree burns
  2. Over 10% of the body has third degree burns
  3. There are third-degree burns of the face, hands, or feet
  • Facial burns introduce the possibility of burned respiratory passageways, which can swell and cause suffocation
  • Burns at joints are also troublesome because scar tissue formation can severely limit joint mobility

Skin Cancer

  • Most tumors that arise in the skin do not spread (metastasize) to other body areas
  • Some tumors are malignant, or cancerous, and invade other body areas
  • A crucial risk factor for the skin cancers is over-exposure to the UV radiation in sunlight, which appears to disable a tumor suppressor gene
  • However, frequent irritation of the skin by infections, chemicals, or physical trauma seems to be a predisposing factor
  • Sunburned skin accelerates its production of a protein that causes genetically damaged skin cells to commit suicide, thus decreasing the risk of mutations that will cause sun-linked skin cancer
  • It is the death of these gene-damaged cells that causes the skin to peel after a sunburn
  • NEW lotions are being produced that will fix damaged DNA before the involved cells can develop into cancer cells
  • These lotions contain tiny oily vesicles (liposomes) filled with enzymes that initiate repair of the DNA mutations most commonly caused by sunlight

Acne … Causes

  • Common facial rash
  • Usually adolescents
  • May occur in early and mid adult life
  • Blockage of pilosebaceous unit with surrounding inflammation
  • Androgens lead to increase sebum production
  • Increased colonisation by propionibacterium acnes

Acne … Types

  • A skin disease due to oil glands.
  • The acne vulgaris is known to be a chronic inflammatory type of acne that has over active oil glands.
  • The hair follicles are filled with oil that cannot escape.
  • Starts at an early age and affects mainly the face and other parts of the body with blackheads, pimples and cysts.
  • Another type of acne is called acne excoriee.
  • It happens due to a nervous situation. It starts out small but can worsen if it is scratched or picked at a lot.
  • One more type of acne is called cystic acne.
  • It is a severe type of acne that happens when a pimple breaks open under the skin and not on top of the skin.
  • This acne can cause pain and swelling as the body fights the infection.

  • It can start on the back, neck, arms, and shoulders.
  • One more type of acne is called occupational acne.
  • This acne effects people who work at a job that involves oil and grease.
  • It can cause blackheads to form in the skin that is sometimes hard to get rid of.

Acne …. Treatment

  • Avoid irritants especially soap
  • Frequent emollients
  • Topical steroids
  • Sedating antihistamines …. oral hydroxyzine
  • Treat infections
  • Bandages
  • Second line agents

Triple Combination of Therapy

  • Topical steroid bd as required
  • Emollient frequently
  • Bath oil and soap substitute

Creams

  • Cosmetically more acceptable
  • Water based
  • Contain preservatives
  • Soap substitutes

Ointments

  • Oil based
  • Do not contain preservative
  • Feel greasy
  • Good for hydrating

Keep Pimples Away Forever!

  • Here are some tips to make sure they do not recur and you can live a pimple free life!
  • Never touch your pimples. Continuous touching can spread the bacteria on your face and cause pimples elsewhere.
  • Change the sheets of your bed and pillow regularly. At times, bacteria present on your pillow cover can lead to pimples.
  • Have a lukewarm water bath instead of piping hot water as it removes the essential oils from your skin.
  • After a bath, never rub harshly with a towel as you will only strip away essential skin cells and make it even drier and prone to infections.
  • Remember, you should never share make up tools. You never know whose infection might ruin your skin.
  • Drink at least 6 to 8 glasses of water daily to flush out the toxins in your body that cause pimples and other skin problems.

Tackling the Pimple Threat

  • Tone, Wash, And Moisturize
  • Its best to use an anti-bacterial face wash, a fragrance-free and oil-free face wash.
  • Apply an oil free, vitamin E-enriched cream that is useful to heal pimple-prone and ruptured skin. You need to remove the impurities from your face to allow it to breathe.
  • Never forget to use an alcohol-free toner and a face wash daily after returning from outside.
  • When A Pimple Strikes:
  1. Rule of thumb, never squeeze a pimple as this may cause scarring and infection. Instead, every half an hour, apply a cold compress on the pimple.
  2. Even if it gives you the chills, hold the ice on the affected area for a couple of minutes. Cold compress does wonders in reducing redness, swelling, and pain.
  3. Wash your face at least three times a day with anti-acne soap. Follow it up with an anti-acne cream containing benzyl peroxide.
  • Hide it:
  1. Always go for water-based products as they are lighter on oily skin.
  2. Preferably choose a medicated concealer with anti-acne properties.
  3. First dab some rosewater (Arq-e-Gulab) with cotton wool on the pimples.
  4. Once you have applied the concealer, allow it to dry and use a powder brush to set it.
  5. Once done, apply oil-free foundation and compact to complete the picture. Ensure the foundation has a yellow base to reduce the redness of the pimples.
  6. Eat healthy balanced diet rich with fruits & vegetables.

Prevent from Stretch Marks

  • Here is a good recipe:
  • 1/2 cup Olive Oil.
  • 1/4 cup Aloe Vera gel.
  • Liquid from 6 capsules of Vitamin E.
  • Liquid from 4 capsules of Vitamin A.
  • Mix all the ingredients together in a blender.
  • Pour the mixture into a jar and store it in the fridge.
  • Apply the oil externally all over the places where the stretch marks commonly appear (abdomen, hips, thighs and breasts).
  • If you do this consistently every day, you may prevent stretch marks.
  • You can also try this homemade recipe:
  • Mix one ounce of Almond or Olive oil with seven drops of lavender and five drops of chamomile.
  • Apply cocoa butter and/ or Elastin cream throughout the body as directed on label. These are very good for stretch marks.
  • Massaging your body with olive oil or Vitamin E may help.
  • Nutrition: Foods that are rich in vitamins A, C and E provide nutrients for your skin to remain elastic.
  • These vitamins can be found in fruits, vegetables almonds, fish and eggs.
  • Water Therapy: Keep your body hydrated by drinking plenty of water.
  • It will keep your skin healthy and elastic to reduce your skin stretching and scarring.
  • Moisturizers: Aloe Vera is great at diminishing existing marks and stopping them from ever appearing on your body.

Cucumber and Acne:

  • Cucumber has natural salt and has a repair and cell growth property.
  • It is high mineral and powerful anti-oxidant which hydrates the skin and makes it healthy.
  • Blend the cucumber and simply apply it on your face for an hour.
  • Mix some table salt to the blended cucumber.
  • Rinse your face with lukewarm water.

Foods That Cure Eczema

  • The foods include cow’s milk, wheat, shellfish, peanuts, soybeans, eggs, chocolate, corn and oranges.
  • Anti-inflammatory Foods: Include beneficiary foods such as flaxseed powder or oil, and evening primrose oil.
  • Consume 1 tbsp. of flax seed oil daily to obtain adequate amounts of the essential omega-3 fatty acid, to reduce eczema-related inflammation.
  • Evening primrose oil is beneficial due to its high percentage of the omega-6 fatty acid known as gamma linolenic acid, or GLA.
  • Vitamin-Rich Foods: Use vitamins A and C to strengthen the skin, and vitamin E and zinc for wound healing.
  • Eat foods rich in vitamins A and C, such as broccoli, tomatoes, watercress and melons.
  • Obtain vitamin E and zinc from nuts, seeds and dark green leafy vegetables.
  • Vitamin B-Rich Foods: Good sources of vitamin B3, or niacin, include tomatoes, mushrooms, salmon, tuna and chicken.
  • Cauliflower, squash and asparagus are good sources of vitamins B3 and B6.
  • Other sources for vitamin B6, or pyridoxine, include seeds, nuts, onions and bananas.

Bacterial Vaginosis Treatment

  • For quick relief from bv use garlic in raw form.
    Just peel the garlic, wrap the it in small gauze (cotton) and tie a dental floss to it.
    Insert the garlic directly inside the vagina.
    Ensure that the dental floss is long enough for you to easily pull out the garlic from the vagina after one day.

Herbal Treatments for Baldness

  • Saw Palmetto: This is known to block dihydrotestosterone (DHT) which attaches to hair follicles and starves the hair of nutrients.
  • Gotu kola (Centella Asiatica-Brahmi): This herb is known to improve the health of the skin and hair, and is especially beneficial to the scalp. It helps to provide nutrients to the hair follicles.
  • Nettle Root: It as been shown to block an enzyme called 5-alpha reductase the chief agent in the production of DHT.
  • Black Cohosh: This herb is beneficial for women suffering from hair loss following menopause.
  • Cucurbita Maxima: Various types of cultivated squash or pumpkins from which oil is extracted from the seeds.
  • This is also effective at blocking DHT thereby halting further hair loss.
  • For any type of hair loss treatment to work effectively, it is important to recognize the signs early. Things like diet, physical activity and low stress levels also play a role in keeping a healthy head of hair.

Home Remedies For Skin Tags

  • Herbs from extracts, for instance Dermisil, can be used to cure skin tags;
  • Dermisil is a topical remedy that has been shown to work.
  • The herb extract offers a smooth feel on the tag and fades it away after a short period without causing any damage on the surrounding healthy tissues.
  • Fingernail polish is yet another home remedy that gets rid of skin tags and used two times in a day;
  • The polish as it dries also shrinks the skin tag to disappearance.
  • Castor oil and baking soda has also shown positive results in fighting skin tags and can therefore be used.
  • Both are blended into paste and applied on the skin tag area with a three times a day dosage.
  • Vitamin E is great for dry, irritated skin. Simply combine mineral or almond oil with Vitamin E and apply it. This natural home remedy will soothe the skin.

Home Remedies For Acid Reflux

  • The common potato is a natural alkaline. It contains potassium salt which can be used to restrict the acidity.
  • You can naturally treat or keep acid reflex away by regularly eating roasted or boiled potatoes.
  • The lemon is another food that contains potassium.
  • Drinking a glass of warm water with a lemon, five minutes before a meal will help with the digestion of the meal.
  • Remember that the best treatment for anything is to be proactive and eat the right foods that help to keep the body balanced.

Home Remedies For Cold Sore

  • The garlic is effective in healing cold sores and wounds.
  • Just mix salt with water and use it for gargling.
  • Tea bag is also a remedy for cold sore. You can use warm tea bag for warm compress on the affected area.
  • The ice can also be used to relieve soreness caused by symptoms of a pre-outbreak.

Remedy for Blackheads

  • Mixing 1 tsp. of ground nut oil and 1 tsp. of fresh lime juice. Apply the mixture to the face to prevent the development of blackheads.
  • Mixing 1/4 cup of hot water with 1 tsp. of Epsom salt (Magnesium Sulphate). Add 4 drops of iodine. Stir well and let the mixture cool down. Use a cotton ball, dip it into the mixture and apply to blackheads and the area surrounding it. Let it dry then remove gently using a clean cloth. This method is one of the excellent home remedies for blackheads.
  • Apply a mixture of fresh lime juice and grounded drumstick pods and leaves on blackheads
  • Apply a paste made of fresh methi (fenugreek) leaves on your face every night for 10 to 15 minutes then wash with warm water.
  • Make a facial wash by mixing fresh lime juice and a glass of boiled milk. Apply to face and wash off with water afterwards.
  • Make a paste made of ground radish seeds in water and apply on blackheads.
  • Apply a paste made up of 5 grams red sandalwood (صندل) and turmeric (ہلدی) with milk on blackheads.
  • Utilize green tea as facial scrub to loosen blackheads.
  • Make a poultice of grated potatoes and apply on the affected parts.

Remedy For Toenail Fungus

  • Soaking the infected nails on a mixture of warm water and vinegar (apple cider vinegar) twice daily until the symptoms disappear is a simple remedy that anyone can do at home.
  • Another home remedy for toenail fungus is tea tree oil which is extract from a medicinal tree called Melaleuca alternifolia, has antifungal, antibacterial and antiviral properties that relieves nail fungal infection.
  • The oil can be applied directly on the affected area or can be mixed with water if you want to soak the affected area.
  • This is only used as an external application because tea tree oil is toxic when swallowed.
  • Listerine mouthwash is another home remedy for toenail fungus.

 

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