Volume 11 Issue 1 Recognizing truncal acne Celiac disease of the skin Canadian The OffSkin icial Publication of the Canadian Skin Patient Alliance Living with Scleroderma Complimentary Spring 2020 Avoiding lice and scabies: A contagious itch Engaging with your pharmacist www.canadianskin.ca skinfacts Suggestions and tips for skin patients and their families... If toenails could talk Maybe it’s time for us to focus on our feet Science of greys more often (and not just during sandal Your hair follicles have pigment cells season). Toenail colour changes can signal that make melanin, a chemical that health problems. Here’s what to watch for gives your hair its colour. As you and talk to your doctor about. age, these cells start to die. Without pigment, new hair strands grow in o Black toenail: This is commonly caused lighter and take on various shades of grey, silver by a bruise under the nail, technically called a subungual and eventually white. Once a follicle stops making hematoma. Expect your black toenail to grow out in melanin, it won’t make coloured strands again. about six to nine months. But it might also be malignant melanoma, a fungal infection, a chronic ingrown nail or What’s premature gray? other health problem. Some people go grey 10 or more years earlier than average. It’s premature if you’re grey before: o Yellow or white: When toenails turn yellow or white, • 20 years if you’re white • 25 years if you’re Asian a fungus is usually to blame. If left untreated, an infection • 30 years if you’re black can worsen or spread. o Got green: This might be What causes cellulitis? green-nail syndrome Cellulitis is a life-threatening skin infection (chloronychia), which that often strikes the arms and legs, but can is caused by an infection. appear anywhere on the body. Here are the The culprit is usually basics on cellulitis and how to protect yourself: bacteria that thrive in u Cellulitis is not contagious. damp or wet conditions. u It is caused by common bacteria getting into the skin’s o Shades of blue: If you get a blue spot for no apparent deeper layers—usually Streptococcus or Staphylococcus. reason then you might have a mole beneath the nail. u Some people develop cellulitis while others never do. In very rare cases, a type of mole called a cellular blue u Keep your fingernails and toenails clean and trimmed. nevus can become cancer. u Practice proper wound cleaning—wash cuts o Brown streaks: Called melanonychia, brown usually and wounds as soon as possible, and apply an appears as a line or streak going up and down the nail. antibacterial ointment. Causes range from injury to certain medications, but u Keep skin moisturized to prevent tiny cracks in there’s a small chance it could be something serious. the epidermis. Spring 2020 n Volume 11 n Issue 1 Canadian Skin Patient Alliance: ISSN 1923-0729 111-223 Colonnade Road South, Ottawa, ON K2E 7K3 Toll Free: 1-877-505-CSPA (2772) • E-mail: [email protected] Publisher: BCS Communications Ltd. Canadian Publication Mail Sales Product Agreement No 40065546. Printed in Canada. www.bcsgroup.com Follow us on Facebook, Twitter and Instagram at: All rights reserved. ©2020. facebook.com/canadianskin • twitter.com/canadianskin Contents may not be reproduced. instagram@canadianskin. To subscribe today to this complimentary magazine, call 1-877-505-2772 or email us at [email protected] 2 canadianskin.ca Spring 2020 Ask the Expert Treatment options for palmar psoriasis, and is it dry skin or athlete’s foot? By Dr. Isabelle Delorme Learn more, live better. A Canadian health care professional answers your questions. I have psoriasis on my phototherapy and systemic hands. My doctor has medications. The latter include Q prescribed topical cortisone oral drugs, such as methotrexate, cream, but it’s not working acitretin and ciclosporin, and injected the mainstay of treatment for this very well. What other options biological agents. These are long- condition. For more severe cases, do I have? term treatments. phototherapy is recommended. Tinea pedis usually presents Hand (or palmar) psoriasis The skin between my toes with redness, scaling, cracks and can be more difficult to treat always seems to bubble maceration between the toes, A than plaque psoriasis on Q and peel, especially after especially the last two web spaces. other parts of the body. It has a big a shower or bath. Is this just dry Vesicles can occur. Itchiness is impact on quality of life, as it can skin or could it be athlete’s foot? variable. Tinea pedis is a fungal interfere with daily activities and infection that can also affect the work. There are two forms of psoriasis “Bubbling” and “peeling” toenails. Treatment is usually with that can be seen on the palms and between the toes are a topical antifungal cream. cs soles. The plaque form causes dry signs of either dyshidrotic A Dr. Isabelle Delorme is a certified and scaly plaques and the pustular eczema or tinea pedis (athlete’s foot). dermatologist working in Drummondville, form causes pustules on the hands Dyshidrotic eczema is characterized Quebec. She was the CSPA Dermatologist and feet. by firm vesicles (bubbles) on the of the Year in 2017. A few lifestyle changes can ease soles and toes and the palms and the discomfort. Avoid friction and fingers. They initially contain clear Congratulations Vanessa T. (Calgary), wet-work. Protect your hands by fluid, and resolve after several days the winner of a $25 gift card. For your using cotton gloves under vinyl by peeling (more technically known chance to win, send us your question for gloves. Moisturize regularly, as desquamation). The bubbles the expert at [email protected]. immediately after hand washing and are usually very itchy. Dyshidrotic bathing, and anytime inbetween. eczema usually appears in adults, The treatment depends on the and people with atopic dermatitis condition’s severity. Milder forms or hay fever are at higher risk of Ask may be managed by a family doctor, developing it. Blisters normally last but if you have moderate or severe for about two to four weeks and the psoriasis then you might want to may be related to seasonal allergies, Expert ask for a referral to a dermatologist. changes in humidity or stress. Got a question? Send to Topical treatment is the first-line Occasionally, dyshidrotic eczema therapy. Topical medications used may be triggered by contact to [email protected]. to treat palmar psoriasis are topical allergens such as nickel, cobalt If your question is corticosteroids (more potent ones or balsam. published you such as clobetasol propionate are Management includes avoidance will receive a $25 preferred) and calcipotriol. of triggers. Soaks or cool compresses gift card. Good luck! Treatment options for moderate- 2 to 4 times daily can help to dry to-severe palmar psoriasis include blisters. Topical corticosteroids are Spring 2020 canadianskin.ca 3 A contagious itch Lice and scabies By Matthew Ladda and Dr. Patrick Fleming Learn the difference between these conditions and how to treat them. Head lice Head lice are small insects that infest and live on the human scalp. They feed on small amounts of human blood and lay eggs close to hair shafts. After being laid, lice eggs hatch within one to two weeks. What are the symptoms? An itchy scalp is the most common symptom of a head lice infestation. Small red bumps can occasionally be seen on the scalp. However, it is pos- sible to have head lice without even noticing these symptoms. Lice are very small, but they can be seen on the scalp upon careful inspec- tion. Adult lice are no larger than a sesame seed and have a grey-coloured body that may appear redder after How are head lice spread? or pharmacist can recommend a feeding. Their eggs are small, brown It’s important to recognize that head particular product and provide you and difficult to see. However, after lice are highly contagious and spread with instructions on how to use it. hatching, the empty egg case (known easily among people, especially They include insecticide treatments as a “nit”), is white and remains at- children. Group settings such as such as permethrin, and non- tached to a person’s hair shaft, making classrooms, playgroups and camps insecticide treatments such as it easier to detect. are particularly susceptible to the silicone oil dimethicone, isopropyl spread of lice. However, head lice myristate/cyclomethicone and can only survive for one or two days benzyl alcohol lotion. People with when not on a human. head lice should repeat the same treatment one week later to ensure How do you treat head lice? any newly hatched lice are also killed. People only need to be treated for Home remedies such as applying head lice if live lice are found in their heat to the scalp or covering the hair. Because head lice are easily scalp with oil or petroleum jelly are spread from one person to another, not at all recommended. Tea tree oil it is necessary to check the hair of all is also not effective and can often family members and anyone else who cause unnecessary irritation. has been in close contact. To ensure all lice have been There are several treatments eliminated and to prevent for head lice, and your doctor reinfestation, all bed linens, towels, 4 canadianskin.ca Spring 2020 hats and clothing should be washed Everybody who lives in the same in hot water and dried on high heat. home as a person with scabies, Items that cannot be washed, such whether they have symptoms or as pillows and jackets, should not, should be treated at the be sealed in a plastic bag for same time to prevent the mites at least two weeks.