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Home , Sickle cell disease

April 2012

National Institutes of Health • Department of Health and Services • newsinhealth.nih.gov

Inside News: 3 Sickle Cell Disease... 4 Colonoscopies Cut Cancer Deaths... Diabetes Test... Brain Basics Red, Itchy Rash? Get the Skinny on Dermatitis You’ve probably had a rash at some thing that directly touches the skin. point or another, whether from Other times, the poison ivy or the chickenpox or flares in the skin because of a whole- something more unusual. Why does body infection or illness. your skin break out in red blotches The symptoms of these like that? More important, is there different types of rashes anything you can do about it? often overlap. “Itching is We often think of the skin as a bar- a common symptom for rier—it keeps the insides of our bod- all these problems,” says ies in, and it keeps the outside world Dr. Stephen I. Katz, out. But our skin is also filled with director of NIH’s special cells of the immune system. National These cells protect the skin and body Institute of against viruses, bacteria and other Arthritis and threats. Whenever these cells detect Musculoskel- a suspicious substance, they begin a etal and Skin chain reaction in the skin that leads Diseases. to inflammation. The medical name Many rashes are for this reaction is dermatitis. But it’s red, painful, more commonly known as a rash. and irritated. There are many different types of Some types of dermatitis, and each has a distinct rash can also set of treatments. Sometimes the lead to blisters or skin’s immune cells react to some- patches of raw skin. While most rashes clear up Definitions fairly quickly, others are long lasting involved in maintaining the skin and need to be cared for over long barrier. People with certain versions Immune System periods of time. of these genes are more likely to get The system that protects your body Eczema, or atopic dermatitis, is a atopic dermatitis. from invading viruses, bacteria and dry, red, itchy rash that affects up to “The skin is the outermost sentinel other microscopic threats. 1 in 5 infants and young children. It for fighting off bacteria and noxious often improves over time, although it agents,” says Katz. “If the barrier is Inflammation can last into adulthood or start later broken somehow, you can become Heat, swelling and redness caused in life. In this condition, the water- more allergic to things.” by the body’s protective response tight barrier between skin cells gets continued on page 2 to injury or infection. weak, which lets moisture out and Genes other things in. That’s why people Stretches of DNA, a substance with atopic dermatitis have to mois- you inherit from your parents, turize their skin, and they’re more @ that define characteristics such as susceptible to skin infections. Subscribe Researchers have recently how likely you are to get certain newsinhealth.nih.gov diseases. identified specificgenes that are 2 April 2012 http://newsinhealth.nih.gov/issue/Apr2012 continued from page 1 A skin , or allergic contact Other common causes of allergic Web Links dermatitis, produces a red, itchy rash dermatitis are poison oak and poison that sometimes comes with small ivy. The stems and leaves of these For more information about blisters or bumps. The rash arises plants produce a chemical that’s dermatitis, see our links online: when the skin comes in contact likely to cause . If you touch http://newsinhealth.nih.gov/issue/Apr2012/Feature1 with an allergen, a usually harmless one of them, wash your skin as soon substance that the immune system as possible. The chemical can also attacks. Allergens trigger allergic remain in clothing for a long time, so first time you take it. It could show reactions. Allergens can come from it’s important to wash any clothes or up after several uses. Not all drug certain soaps, creams and even pets. shoes—or even pets—that come into rashes are due to an allergy, howev- Your immune system might not contact with these plants. er. If you break out in itchy spots af- react the first time you encounter an Mild cases of allergic contact der- ter starting a new drug prescription, allergen. But over time, your immune matitis usually disappear after a few contact your doctor right away. system can become sensitive to the days or weeks. But if the rash persists, While most rashes get better substance. As a result, your next is extremely uncomfortable or occurs with time, some can last a lifetime. contact may lead to inflammation on the face, it’s important to see a Psoriasis, a condition where skin and an allergic rash. . A doctor can prescribe cells build up into thick red patches, “The most common form of der- medications that will tone down the tends to run in families. “It’s a com- matitis that is seen anywhere is an immune reaction in the skin. This plex genetic disease, in that there’s allergic contact dermatitis to nickel,” eases swelling and itching and will not one gene that causes psoriasis says Katz. “Why? Because of ear protect your eyes and face. but many,” says Katz. Even though piercing.” Many inexpensive earrings The immune cells of the skin can none of these genes alone has a are made of nickel, and over time, also produce rashes when they react great effect on the disease, know- wearing nickel earrings can cause an to invading germs—like bacteria, ing which genes are involved can allergic reaction to the metal. fungi and viruses. Bacterial and viral help researchers design potential infections within your body can new treatments. Other long-term cause your skin to break out in spots diseases that can produce rashes Wise Choices as well. The chickenpox virus, for include autoimmune diseases, such Call Your Doctor If… example, can cause itchy spots in as lupus, and some forms of cancer. children. Years later, in older adults, If you notice an itchy or painful n Your rash is so uncomfortable the same virus may reappear as rash on your skin, think twice before or painful it interferes with daily shingles, bringing a painful rash and going to the drugstore and getting activities or sleep. high fever. Vaccines can prevent sev- some cream if you don’t know the n The rash is on your face. eral rash-causing diseases, including cause. “The creams that you buy can chickenpox, shingles and measles. produce problems that make your n Your rash looks worrisome or Certain drugs, including original problem even worse,” Katz seems infected. like , may also cause itchy says. Because rashes can be caused n You break out in a rash after skin rashes. If you’re allergic to a drug, by many different things—bacteria, taking a new medication. a rash can be the first sign of a serious viruses, drugs, allergies, genetic n Your rash lasts for several days. reaction. As with other allergies, a disorders, and even light—it’s im- reaction to a drug may not occur the portant to figure out what kind of dermatitis you have. “If you have any significant rash, NIH News in Health (ISSN 1556-3898) you should see a dermatologist,” National Institutes of Health Managing Editor Harrison Wein, Ph.D. says Katz. A dermatologist, or skin Office of Communications Editor Vicki Contie doctor, is specially trained to figure & Public Liaison Contributors Vicki Contie, Alan Defibaugh out what’s causing a rash and help Building 31, Room 5B64 (illustrations), Lesley Earl, Belle Waring and you get the right treatment. Bethesda, MD 20892-2094 Harrison Wein Your skin is your protection. It’s [email protected] not just the covering that keeps Tel: 301-435-7489 Fax: 301-496-0019 newsinhealth.nih.gov your body in; it’s also your first Attention Editors Reprint our articles and line of defense against germs illustrations in your own publication. Our material For more health information from NIH, visit and chemicals. Take care of is not copyrighted. Please acknowledge NIH News your skin so your skin can take in Health as the source and send us a copy. http://health.nih.gov care of you. n http://newsinhealth.nih.gov/issue/Apr2012 April 2012 3 When Blood Cells Bend Understanding Sickle Cell Disease For people who don’t suspect they well as in , , South carry the sickle cell gene, having America and other regions.” a baby with sickle cell disease can The sickle cell gene has an even be heartbreaking. The illness is broader reach. More than 2 mil- inherited and lasts a lifetime. Fifty lion Americans—including 1 in 12 years ago, half of children born with African Americans—carry 1 copy sickle cell disease died by age 10. of the abnormal gene. They’re said Now they’re living into their 40s and to have . While they 50s, thanks to developed don’t have sickle cell disease, they with NIH support. Researchers are can still pass the flawed gene to now working on promising new their children. treatments. Sickle cell disease arises when Sickle cell disease is a serious you inherit 2 abnormal genes, 1 disorder in which the body makes from each parent. The genes make red blood cells that have a sickle a defective form of , shape—like the letter C. These stiff, the -carrying protein in red misshaped cells can lead to painful blood cells. Affected cells collapse episodes, serious infections, organ into a sickle shape. The sickled cells damage and long-term . bunch together and reduce blood By some estimates, 70,000 to flow through your blood vessels. 100,000 Americans have sickle cell That can cause severe and sudden disease. Most are African Americans, throughout the body and lead although the disease also occurs in to or organ damage from are more new treatments now under Hispanic Americans and others. lack of oxygen. This medical emer- investigation than in any time in his- “It’s a rare disease in the U.S.,” says gency, called a sickle cell crisis, can tory,” says Kato. “All clinical drug trials Dr. Gregory Kato, a sickle cell disease be treated with pain medication and are always speculative. Most don’t expert at NIH. “But sickle cell disease blood transfusions. work out, but some do. Biomedical affects millions of people in , as A can show if you have scientists like us are working towards sickle cell disease or the trait. All the future.” states now test newborns as part of If you have sickle cell disease, take their screening programs, so treat- steps to prevent and control its com- Wise Choices ment can begin early. Living with Sickle plications by maintaining a healthy Severe sickle cell disease can lifestyle. If you’re at high risk of Cell Disease be treated with a called having a child with sickle cell anemia n See a sickle cell disease expert hydroxyurea. It helps to prevent red and are planning to have children, regularly. blood cells from sickling. Hydroxy- ask your health care professional urea doesn’t cure sickle cell disease, n n about . Visit your eye doctor to check but it can make it milder. And it was for eye damage. recently shown to be safe and effec- n Work with your doctor to find tive for very young children. Definitions ways to manage pain. “Although the treatment of sickle n Make sure babies and young cell disease pain crisis hasn’t changed much since the discovery of the Gene children get needed antibiot- A stretch of DNA, a substance you ics and routine to disease a hundred years ago, there inherit from your parents, that prevent infections. defines characteristics such as your n Seek specialized prenatal care if Web Links risk for certain diseases. you have sickle cell disease and are pregnant or planning to Anemia For more information about sickle cell become pregnant. A condition caused by low levels of disease, see our links online: red blood cells or hemoglobin in the n Join a patient support group. http://newsinhealth.nih.gov/issue/Apr2012/Feature2 blood. It can cause fatigue, dizziness and headaches. 4 April 2012 http://newsinhealth.nih.gov/issue/Apr2012

For links to more information, see these stories online: Health Capsules http://newsinhealth.nih.gov/issue/Apr2012/Capsule1 Colonoscopies Cut Colon Cancer Deaths Removing polyps during colonos- a colonoscopy, doctors use a long, could reduce the risk of dying from copy can prevent colorectal cancer lighted, flexible tube to examine colorectal cancer by up to one half. and reduce deaths from the disease inside the rectum and colon. Many “Our findings provide strong reas- for years, a new study finds. growths they see, including polyps, surance that there is a long-term Colorectal cancer is one of the can be removed during the proce- benefit to removing these polyps and most common cancers in both men dure. Most polyps are benign, but support continued recommendations and women nationwide. The disease some (called adenomas) can of screening for colorectal cancer in is expected to kill more than 52,000 become cancer. people over age 50,” says the study’s Americans this year alone. To see if polyp removal during lead author, Dr. Ann Zauber of the Screening tests like colonoscopies colonoscopy might decrease deaths Memorial Sloan-Kettering Cancer can detect early-stage colorectal from colorectal cancer, a team of Center. Ongoing clinical trials will cancer before symptoms appear. In NIH-funded scientists examined data gather additional evidence to con- from over 2,600 patients who had firm whether colonoscopy screening adenomas removed. can also reduce these deaths in the Definitions During an average 16 years of general population. n follow-up, more than 1,200 deaths Polyps occurred in the group. But only 12 Growths on the inside lining of the of the deaths were due to colorectal Featured Website colon or rectum. cancer. Among the general popula- Brain Basics tion, over 25 patients in a compa- Colorectal Cancer rable group would have been ex- Cancer of the colon or rectum, both pected to die from colorectal cancer. www.nimh.nih.gov/brainbasics/index.html part of the large intestine. This suggests that adenoma removal Simple and straight-forward videos give you the basics of brain biology. Get an Fact Sheet Highlights Diabetes Blood Test overview of how the brain works and About 7 million Americans today test can also help patients with type 1 how mental illness is linked to brain have diabetes but don’t realize it. and type 2 diabetes to monitor their function. Learn about brain regions, This puts them at risk for the serious blood sugar (glucose) levels. neurotransmitters, gene studies, brain complications that can arise when The new fact sheet covers a wide imaging and more. diabetes is left untreated. range of details about the A1C test, A new fact sheet from NIH de- including how the test works, other scribes a blood test called A1C, blood tests for type 2 diabetes and which can diagnose type 2 diabetes prediabetes, the accuracy of blood and even prediabetes. Prediabetes tests and more. raises your risk for developing The A1C Test and Diabetes fact type 2 diabetes. sheet is available at www.diabetes.niddk. You don’t need to fast before tak- nih.gov/dm/pubs/A1CTest. Or contact NIH’s ing the A1C test, so it’s more conve- National Diabetes Information Clear- nient than other glucose tests often inghouse at 1-800–860–8747or email: used to diagnose diabetes. The A1C [email protected]. n How to get NIH News in Health Read it online. Get it by email. Get it in print. Visit newsinhealth.nih.gov Click the “Subscribe” button on Contact us (see page 2) to get free our home page to sign up for print copies for display in offices, email updates when new issues libraries or clinics within the U.S. are posted online. Subscribe NIH . . . Turning Discovery Into Health