The Itch That Rashes Cynthia Griffith MPAS, PA-C
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Update on Challenging Disorders of Pigmentation in Skin of Color Heather Woolery-Lloyd, M.D
Update on Challenging Disorders of Pigmentation in Skin of Color Heather Woolery-Lloyd, M.D. Director of Ethnic Skin Care Voluntary Assistant Professor Miller/University of Miami School of Medicine Department of Dermatology and Cutaneous Surgery What Determines Skin Color? What Determines Skin Color? No significant difference in the number of melanocytes between the races 2000 epidermal melanocytes/mm2 on head and forearm 1000 epidermal melanocytes/mm2 on the rest of the body differences present at birth Jimbow K, Quevedo WC, Prota G, Fitzpatrick TB (1999) Biology of melanocytes. In I. M. Freedberg, A.Z. Eisen, K. Wolff,K.F. Austen, L.A. Goldsmith, S. I. Katz, T. B. Fitzpatrick (Eds.), Dermatology in General Medicine 5th ed., pp192-220, New York, NY: McGraw Hill Melanosomes in Black and White Skin Black White Szabo G, Gerald AB, Pathak MA, Fitzpatrick TB. Nature1969;222:1081-1082 Jimbow K, Quevedo WC, Prota G, Fitzpatrick TB (1999) Biology of melanocytes. In I. M. Freedberg, A.Z. Eisen, K. Wolff, K.F. Austen, L.A. Goldsmith, S. I. Katz, T. B. Fitzpatrick (Eds.), Dermatology in General Medicine 5th ed., pp192- 220, New York, NY: McGraw Hill Role of Melanin-Advantages Melanin absorbs and scatters energy from UV and visible light to protect epidermal cells from UV damage Disadvantages Inflammation or injury to the skin is almost immediately accompanied by alteration in pigmentation Hyperpigmentation Hypopigmentation Dyschromias Post-Inflammatory hyperpigmentation Acne Melasma Lichen Planus Pigmentosus Progressive Macular Hypomelanosis -
A Diagnostic Approach to Pruritus
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by DigitalCommons@University of Nebraska University of Nebraska - Lincoln DigitalCommons@University of Nebraska - Lincoln U.S. Air Force Research U.S. Department of Defense 2011 A Diagnostic Approach to Pruritus Brian V. Reamy Christopher W. Bunt Stacy Fletcher Follow this and additional works at: https://digitalcommons.unl.edu/usafresearch This Article is brought to you for free and open access by the U.S. Department of Defense at DigitalCommons@University of Nebraska - Lincoln. It has been accepted for inclusion in U.S. Air Force Research by an authorized administrator of DigitalCommons@University of Nebraska - Lincoln. A Diagnostic Approach to Pruritus BRIAN V. REAMY, MD, Uniformed Services University of the Health Sciences, Bethesda, Maryland CHRISTOPHER W. BUNT, MAJ, USAF, MC, and STACY FLETCHER, CAPT, USAF, MC Ehrling Bergquist Family Medicine Residency Program, Offutt Air Force Base, Nebraska, and the University of Nebraska Medical Center, Omaha, Nebraska Pruritus can be a symptom of a distinct dermatologic condition or of an occult underlying systemic disease. Of the patients referred to a dermatologist for generalized pruritus with no apparent primary cutaneous cause, 14 to 24 percent have a systemic etiology. In the absence of a primary skin lesion, the review of systems should include evaluation for thyroid disorders, lymphoma, kidney and liver diseases, and diabetes mellitus. Findings suggestive of less seri- ous etiologies include younger age, localized symptoms, acute onset, involvement limited to exposed areas, and a clear association with a sick contact or recent travel. Chronic or general- ized pruritus, older age, and abnormal physical findings should increase concern for underly- ing systemic conditions. -
Seborrheic Dermatitis: an Overview ROBERT A
Seborrheic Dermatitis: An Overview ROBERT A. SCHWARTZ, M.D., M.P.H., CHRISTOPHER A. JANUSZ, M.D., and CAMILA K. JANNIGER, M.D. University of Medicine and Dentistry at New Jersey-New Jersey Medical School, Newark, New Jersey Seborrheic dermatitis affects the scalp, central face, and anterior chest. In adolescents and adults, it often presents as scalp scaling (dandruff). Seborrheic dermatitis also may cause mild to marked erythema of the nasolabial fold, often with scaling. Stress can cause flare-ups. The scales are greasy, not dry, as commonly thought. An uncommon generalized form in infants may be linked to immunodeficiencies. Topical therapy primarily consists of antifungal agents and low-potency steroids. New topical calcineurin inhibitors (immunomodulators) sometimes are administered. (Am Fam Physician 2006;74:125-30. Copyright © 2006 American Academy of Family Physicians.) eborrheic dermatitis can affect patients levels, fungal infections, nutritional deficits, from infancy to old age.1-3 The con- neurogenic factors) are associated with the dition most commonly occurs in condition. The possible hormonal link may infants within the first three months explain why the condition appears in infancy, S of life and in adults at 30 to 60 years of age. In disappears spontaneously, then reappears adolescents and adults, it usually presents as more prominently after puberty. A more scalp scaling (dandruff) or as mild to marked causal link seems to exist between seborrheic erythema of the nasolabial fold during times dermatitis and the proliferation of Malassezia of stress or sleep deprivation. The latter type species (e.g., Malassezia furfur, Malassezia tends to affect men more often than women ovalis) found in normal dimorphic human and often is precipitated by emotional stress. -
FIG. 4A © O O Wo 2015/042110 Al III III II II III III 1 1 II III II II III III II III
(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date W O 2015/042110 A l 2 6 March 2015 (26.03.2015) P O P C T (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61P 37/00 (2006.01) kind of national protection available): AE, AG, AL, AM, AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, (21) International Application Number: BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, PCT/US20 14/056021 DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (22) International Filing Date: HN, HR, HU, ID, IL, ΓΝ , IR, IS, JP, KE, KG, KN, KP, KR, 17 September 2014 (17.09.2014) KZ, LA, LC, LK, LR, LS, LU, LY, MA, MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, OM, (25) Filing Language: English PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, SC, (26) Publication Language: English SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (30) Priority Data: 61/880,522 20 September 2013 (20.09.2013) (84) Designated States (unless otherwise indicated, for every kind of regional protection available): ARIPO (BW, GH, (71) Applicant: CHILDREN'S MEDICAL CENTER COR¬ GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, ST, SZ, PORATION [US/US]; 55 Shattuck Street, Boston, Mas¬ TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, sachusetts 021 15 (US). -
Genital Lichen Simplex Chronicus (Eczema, Neurodermatitis, Dermatitis) !
Libby Edwards, MD Genital Lichen Simplex Chronicus (eczema, neurodermatitis, dermatitis) ! Lichen simplex chronicus (LSC), or eczema, is a common skin condition that is very itchy. Although not dangerous in any way, both the itching, and the pain from rubbing and scratching, can be miserable. Eczema/LSC of the genital area most often affects the scrotum of men, the vulva of women, or the rectal skin of both. Many people with eczema/LSC have had sensitive skin or eczema/LSC on other areas of the skin at some point, and many have a tendency towards allergies, especially hay fever or asthma. ! The skin usually appears red or dark, and thick from rubbing and scratching, sometimes with sores from scratching. ! The cause of eczema/LSC is not entirely clear. However, eczema/LSC starts with irritation that triggers itching. Often, at the office visit with the health care provider, the original infection or other initial cause of irritation is no longer present. Common triggers include a yeast or fungus infection, an irritating medication, moisturizer or lubricant, a wet bathing suit, anxiety or depression, over-washing, panty liners, sweat, heat, urine, a contraceptive jelly, an irritating condom, or any other activity or substance that can irritate the skin and start the itching. ! Although rubbing and scratching often feel good at first, rubbing irritates the skin and ultimately makes itching even worse, so that there is more scratching, then more itching, then more scratching. This is called the “itch-scratch cycle.” Treatment is very effective and requires clearing any infection and avoiding irritants as well as using a strong cortisone. -
Pompholyx Factsheet Pompholyx Eczema (Also Known As Dyshidrotic Eczema/Dermatitis) Is a Type of Eczema That Usually Affects the Hands and Feet
12 Pompholyx factsheet Pompholyx eczema (also known as dyshidrotic eczema/dermatitis) is a type of eczema that usually affects the hands and feet. In most cases, pompholyx eczema involves the development of intensely itchy, watery blisters, mostly affecting the sides of the fingers, the palms of the hands and soles of the feet. Some people have pompholyx eczema on their hands and/or feet with other types of eczema elsewhere on the body. This condition can occur at any age but is usually seen in adults under 40, and is more common in women. The skin is initially very itchy with a burning sensation of heat and prickling in the palms and/or soles. Then comes a sudden crop of small blisters (vesicles), which turn into bigger weepy blisters, which can become infected, causing redness, pain, swelling and pustules. There is often subsequent peeling as the skin dries out, and then the skin can become red and dry with painful cracks (skin fissures). Pompholyx eczema can also affect the nail folds and skin around the nails, causing swelling (paronychia). What causes it? A reaction could be the result of contact with potential irritants such as soap, detergents, solvents, acids/alkalis, The exact causes of pompholyx eczema are not known, chemicals and soil, causing irritant contact dermatitis. Or although it is thought that factors such as stress, there could be an allergic reaction to a substance that is sensitivity to metal compounds (such as nickel, cobalt or not commonly regarded as an irritant, such as rubber or chromate), heat and sweating can aggravate this nickel, causing allergic contact dermatitis. -
ORIGINAL ARTICLE a Clinical and Histopathological Study of Lichenoid Eruption of Skin in Two Tertiary Care Hospitals of Dhaka
ORIGINAL ARTICLE A Clinical and Histopathological study of Lichenoid Eruption of Skin in Two Tertiary Care Hospitals of Dhaka. Khaled A1, Banu SG 2, Kamal M 3, Manzoor J 4, Nasir TA 5 Introduction studies from other countries. Skin diseases manifested by lichenoid eruption, With this background, this present study was is common in our country. Patients usually undertaken to know the clinical and attend the skin disease clinic in advanced stage histopathological pattern of lichenoid eruption, of disease because of improper treatment due to age and sex distribution of the diseases and to difficulties in differentiation of myriads of well assess the clinical diagnostic accuracy by established diseases which present as lichenoid histopathology. eruption. When we call a clinical eruption lichenoid, we Materials and Method usually mean it resembles lichen planus1, the A total of 134 cases were included in this study prototype of this group of disease. The term and these cases were collected from lichenoid used clinically to describe a flat Bangabandhu Sheikh Mujib Medical University topped, shiny papular eruption resembling 2 (Jan 2003 to Feb 2005) and Apollo Hospitals lichen planus. Histopathologically these Dhaka (Oct 2006 to May 2008), both of these are diseases show lichenoid tissue reaction. The large tertiary care hospitals in Dhaka. Biopsy lichenoid tissue reaction is characterized by specimen from patients of all age group having epidermal basal cell damage that is intimately lichenoid eruption was included in this study. associated with massive infiltration of T cells in 3 Detailed clinical history including age, sex, upper dermis. distribution of lesions, presence of itching, The spectrum of clinical diseases related to exacerbating factors, drug history, family history lichenoid tissue reaction is wider and usually and any systemic manifestation were noted. -
Atopic Dermatitis 101 for Adults
TRIGGER TRACKER Atopic Dermatitis 101 for Adults WHAT IS ATOPIC DERMATITIS? IS THERE A CURE? Atopic dermatitis (AD) is the most common type There is no cure for of eczema. It often appears as a red, itchy rash or atopic dermatitis yet, dry, scaly patches on the skin. AD usually begins but there are treatments in infancy or childhood but can develop at any available and more are on the way. point in a person’s lifetime. It commonly shows up on the face, inside of the elbows or behind the WHAT ARE MY TREATMENT OPTIONS? knees, but it can appear anywhere on the body. It is important to have a regular schedule with AD care that includes bathing with a gentle IS IT CONTAGIOUS ? cleanser and moisturizing to lock water into the You can’t catch atopic dermatitis or spread it to skin and repair the skin barrier. Moisturized skin others. helps control flares by combating dryness and keeping out irritants and allergens. WHAT CAUSED IT? Depending on severity of symptoms and age, AD While the exact cause is unknown, researchers do treatments include lifestyle changes, over-the- know that people develop atopic dermatitis counter (OTC) and natural remedies, prescription because of a combination of genes and a trigger. topical medications, which are applied to the People with AD tend to have an over-reactive immune system that when triggered by skin; biologics, given by injection; something outside or inside the body, responds immunosuppressants, usually taken by mouth in by producing inflammation. It is this inflammation the form of a pill; and phototherapy, a form of that causes red, itchy and painful skin symptoms. -
Pityriasis Alba Revisited: Perspectives on an Enigmatic Disorder of Childhood
Pediatric ddermatologyermatology Series Editor: Camila K. Janniger, MD Pityriasis Alba Revisited: Perspectives on an Enigmatic Disorder of Childhood Yuri T. Jadotte, MD; Camila K. Janniger, MD Pityriasis alba (PA) is a localized hypopigmented 80 years ago.2 Mainly seen in the pediatric popula- disorder of childhood with many existing clinical tion, it primarily affects the head and neck region, variants. It is more often detected in individuals with the face being the most commonly involved with a darker complexion but may occur in indi- site.1-3 Pityriasis alba is present in individuals with viduals of all skin types. Atopy, xerosis, and min- all skin types, though it is more noticeable in those with eral deficiencies are potential risk factors. Sun a darker complexion.1,3 This condition also is known exposure exacerbates the contrast between nor- as furfuraceous impetigo, erythema streptogenes, mal and lesional skin, making lesions more visible and pityriasis streptogenes.1 The term pityriasis alba and patients more likely to seek medical atten- remains accurate and appropriate given the etiologic tion. Poor cutaneous hydration appears to be a elusiveness of the disorder. common theme for most riskCUTIS factors and may help elucidate the pathogenesis of this disorder. The Epidemiology end result of this mechanism is inappropriate mel- Pityriasis alba primarily affects preadolescent children anosis manifesting as hypopigmentation. It must aged 3 to 16 years,4 with onset typically occurring be differentiated from other disorders of hypopig- between 6 and 12 years of age.5 Most patients are mentation, such as pityriasis versicolor alba, vitiligo, younger than 15 years,3 with up to 90% aged 6 to nevus depigmentosus, and nevus anemicus. -
Ringworm & Other Human Fungal Infections
Ringworm & Other Human Fungal Infections McKenzie Pediatrics Ringworm, medically known as Tinea Corporis, is a common skin infection of childhood, and is not caused by a worm at all, but rather by a fungus. It is usually easily treated, and should not be seen as a source of social stigma. It is just one of many types of Tinea infections that affect humans. Tinea is a widespread group of fungal infections caused by dermatophytes. It is second to acne as the most frequently reported skin disease in the United States. Infection may occur through contact with infected humans (by way of shared combs, brushes, hats, pillows, clothing, or bedding) and animals (especially dogs and cats), soil, or inanimate objects. Tinea should be suspected in any red, scaly, itchy, and enlarging rash. Tinea is a superficial infection of the skin (Tinea Corporis), scalp (Tinea Capitis), nails (Tinea Unguium), groin (Tinea Cruris), hands (Tinea Manuum) or feet (Tinea Pedis). There are three types and 27 varieties of dermatophytes that cause human Tinea: Trichophyton, Epidermophyton, and Microsporum. Tinea Corporis (Ringworm) causes smooth and bare skin, typically surrounded by a raised, red, scaly “ring”. Lesions are often solitary, though may be multiple, and even overlapping. It is not nearly as common as what it is most often mistaken for: nummular eczema, a variety of eczema that causes round or oval scaly patches but without a clear area in the center. Nummular eczema tends to be more numerous, and is often less itchy than Ringworm. Topical treatments that are available over-the-counter usually work quite well for Tinea Corporis. -
Common Dermatoses in Patients with Obsessive Compulsive Disorders Mircea Tampa Carol Davila University of Medicine and Pharmacy, Tampa [email protected]
Journal of Mind and Medical Sciences Volume 2 | Issue 2 Article 7 2015 Common Dermatoses in Patients with Obsessive Compulsive Disorders Mircea Tampa Carol Davila University of Medicine and Pharmacy, [email protected] Maria Isabela Sarbu Victor Babes Hospital for Infectious and Tropical Diseases, [email protected] Clara Matei Carol Davila University of Medicine and Pharmacy Vasile Benea Victor Babes Hospital for Infectious and Tropical Diseases Simona Roxana Georgescu Carol Davila University of Medicine and Pharmacy Follow this and additional works at: http://scholar.valpo.edu/jmms Part of the Medicine and Health Sciences Commons Recommended Citation Tampa, Mircea; Sarbu, Maria Isabela; Matei, Clara; Benea, Vasile; and Georgescu, Simona Roxana (2015) "Common Dermatoses in Patients with Obsessive Compulsive Disorders," Journal of Mind and Medical Sciences: Vol. 2 : Iss. 2 , Article 7. Available at: http://scholar.valpo.edu/jmms/vol2/iss2/7 This Review Article is brought to you for free and open access by ValpoScholar. It has been accepted for inclusion in Journal of Mind and Medical Sciences by an authorized administrator of ValpoScholar. For more information, please contact a ValpoScholar staff member at [email protected]. JMMS 2015, 2(2): 150- 158. Review Common dermatoses in patients with obsessive compulsive disorders Mircea Tampa1, Maria Isabela Sarbu2, Clara Matei1, Vasile Benea2, Simona Roxana Georgescu1 1 Carol Davila University of Medicine and Pharmacy, Department of Dermatology and Venereology 2 Victor Babes Hospital for Infectious and Tropical Diseases, Department of Dermatology and Venereology Corresponding author: Maria Isabela Sarbu, e-mail: [email protected] Running title: Dermatoses in obsessive compulsive disorders Keywords: Factitious disorders, obsessive-compulsive disorders, acne excoriee www.jmms.ro 2015, Vol. -
Diagnosis and Treatment of Tinea Versicolor Ronald Savin, MD New Haven, Connecticut
■ CLINICAL REVIEW Diagnosis and Treatment of Tinea Versicolor Ronald Savin, MD New Haven, Connecticut Tinea versicolor (pityriasis versicolor) is a common imidazole, has been used for years both orally and top superficial fungal infection of the stratum corneum. ically with great success, although it has not been Caused by the fungus Malassezia furfur, this chronical approved by the Food and Drug Administration for the ly recurring disease is most prevalent in the tropics but indication of tinea versicolor. Newer derivatives, such is also common in temperate climates. Treatments are as fluconazole and itraconazole, have recently been available and cure rates are high, although recurrences introduced. Side effects associated with these triazoles are common. Traditional topical agents such as seleni tend to be minor and low in incidence. Except for keto um sulfide are effective, but recurrence following treat conazole, oral antifungals carry a low risk of hepato- ment with these agents is likely and often rapid. toxicity. Currently, therapeutic interest is focused on synthetic Key Words: Tinea versicolor; pityriasis versicolor; anti “-azole” antifungal drugs, which interfere with the sterol fungal agents. metabolism of the infectious agent. Ketoconazole, an (J Fam Pract 1996; 43:127-132) ormal skin flora includes two morpho than formerly thought. In one study, children under logically discrete lipophilic yeasts: a age 14 represented nearly 5% of confirmed cases spherical form, Pityrosporum orbicu- of the disease.3 In many of these cases, the face lare, and an ovoid form, Pityrosporum was involved, a rare manifestation of the disease in ovale. Whether these are separate enti adults.1 The condition is most prevalent in tropical tiesN or different morphologic forms in the cell and semitropical areas, where up to 40% of some cycle of the same organism remains unclear.: In the populations are affected.