Epidermolysis Bullosa (EB) is a rare disease which causes the skin to be extremely fragile and vulnerable to blisters. The blisters may develop both on the outer skin and inside the body along the linings of the mouth and in other internal organs such as the esophagus, respiratory tract, stomach, intestine, and genitals. Even minor rubbing, without the victim’s knowledge, can cause these blisters to form and cause extreme pain. The disease is believed to be have a genetic basis and is caused by a mutation of the keratin gene. In severe cases, this disease can be life threatening.

Epidermolysis Bullosa affects about 2-4 out of every 100,000 people in the United States. Both men and women of all ages and races have been equally impacted by the disease. The most obvious sign of infection is blistering. Others include redness and heat around open areas of the skin, pus or yellow discharge, crusting on the wound, wounds that won’t heal, and fevers and chills.

There are three major forms of Epidermolysis Bullosa. These include EB Simplex, EB Junctional and EB Dystrophic. EB Simplex affects the epidermis or outer layer of skin. In EB Simplex, blistering normally occurs on the hands and feet, although it could develop all over the body. EB simplex is the most common form of Epidermolysis Bullosa. The Junctional and Dystrophic are the more severe but less common variants of the disease. They affect an area of the skin known as the basement membrane zone, which is where the epidermis and dermis (the inner layer of skin) meet. EB Junctional can affect the lining of the gut making swallowing difficult; infants affect by this disease do not survive past the toddler years. EB Dystrophic results in severe scarring of external skin, including the hands, feet, and face, as well as the gastrointestinal tract.

Treatment

There is no cure for EB and treatment is symptomatic. The goal is to protect the skin as much as possible to avoid the formation of blisters and prevent infections from developing. Dermatologists commonly prescribe topical and oral medications to facilitate healing. Some measures that victims should take include maintaining a cool environment and good nutrition (even if swallowing is difficult), applying lotion, wearing soft clothing, using sheepskin on furniture to reduce friction against the skin, and treating blisters as prescribed by their physicians. In severe cases such as when scarring has narrowed the esophagus and made it difficult for food to go down, surgery may be necessary.

Erysipelas (a.k.a. St. Anthony’s fire) is an acute skin infection caused by group A Streptococcus bacteria which typically affects the face, ears, and lower legs. It is a superficial form of cellulitis in that the infection is closer to the skin surface as opposed to a deeper layer of the skin. Following infection, a rash forms on the affected skin which is well demarcated and typically red, warm, painful, and swollen. It is small initially but expands quickly. The rash may also be dimpled or blistered.

The appearance of the rash is abrupt and is preceded by symptoms such as high fever, chills, vomiting, and headaches. These symptoms typically occur approximately 24 to 48 hours prior to the onset of the rash. In the past, the face was most vulnerable but it now appears more commonly on the legs.

Erysipelas is a condition which most commonly affects infants, children, and the elderly. People with immune deficiency (e.g. those infected by the HIV), skin ulceration, and fungal infections are also susceptible to infection. Other risk factors include cuts and abrasions on the skin. Dermatologists diagnose Erysipelas by examining but blood cultures may be analyzed as well to rule out sepsis. Skin biopsies are usually not helpful.

Treatment

Treatment of Erysipelas is normally through antibiotics such as penicillin, erythromycin, dicloxacillin, and cephalosporins. Treatment is normally continued for around 10-14 days and signs of illness relent within a day or two. The skin may still take a few weeks to heal. Erysipelas recurs in about one third of cases, in which case long-term treatment with antibiotics may be necessary.

Scabies (aka “the itch”) is a highly contagious and common skin disease characterized by small, red itchy bumps and rashes on the outer layer of the skin. As the name suggests, the disease causes extreme itching for sufferers, particularly at night. Scabies is caused by tiny,eight-legged female mites (formally named sarcoptes scabiei) that burrow on to skin shortly after mating and fertilization. The female mites then lay up to three eggs a day for the duration of their lifetime (approximately 1-2 months). The eggs then develop into adults in about 10-14 days. Newly infected individuals may not see symptoms for up to 4-6 weeks.

Scabies is normally spread through lengthy skin-to-skin contact between individuals such as sexual parners and household members. It can also be spread through sharing beds, clothing, towels, and other personal items. It is believed to be more common in winter because that is when people are more likely to be indoors and in close proximity to each other. Anyone can get scabies, including those who stay very clean; it is not believed to be related to personal hygiene. The worst itching, however, seems to occur in children and older adults. Children also have worse skin reactions. Scabies is particularly widespread in countries with high population densities and limited medical facilities. It is estimated that one out of 1,000 people are infected with scabies each month.

Early symptoms of scabies appear in the form tiny red bumps or pimples but in more advanced cases the skin may become crusty or scaly. Crusted scabies (aka “Norwegian Scabies) is more severe and highly contagious and is caused by thousands or even millions of mites. It is uncommon, however, and tends to affect older people or those with other ailments and weakened immune systems. Folds and crevices in the body such as in the armpits, between the fingers, under fingernails, and on the wrists and buttocks are prime locations for mites to hide. These tend to be the areas where scabies normally begins. The reason for this is that the mites prefer warmth and smell. The face and scalp are not normally affected by scabies.

Scabies is diagnosed by scraping off a small sampling of dry skin from an affected area and observing it under a microscope for signs of mites. Besides itching and burrows on the skin, other signs and symptoms of scabies include rashes in the form of tiny, itch red bumps on the limbs and trunk, lumps in the armpits and groins and along the shaft of the penis, blisters on the palms and soles in infants, and the development of secondary infections such as impetigo and cellulitis. Itches may break when scratched and itchy skin may become thick and scaly and/or crisscrossed with scratch marks.

Treatment

Scabies is treated mainly through the application of scabicides (i.e. chemical insecticides) or special creams and lotions (e.g. 5% Permethrin creams like Elimite) as prescribed by physicians. In certain cases, pills may needed to be taken as well. Care should be taken, however, as not all scabies medicines are safe for everyone and some have side effects. For this reason, it is imperative to follow a doctor’s advise precisely. All infected persons within a household should be treated at once to prevent it from spreading again. Bedsheets, clothing, towels and personal effects must all be washed thoroughly. Following treatment, itching may continue for another 2-4 weeks. If itching persists beyond four weeks, an alternative form of treatment may need to be prescribed.

Dry skin is just what it sounds like. For some reason, the moisture that is in your skin is no longer there. For most people, the body produces a number of different natural oils that keep the skin moist and soft. It does this only so that your skin is soft but so that it is less likely to be injured or to dry out. But, for some reason, your skin has reduced the amount of oils that it is producing. Or, you are washing away those oils so often that your skin is left feeling dry, itchy and even painful.

All of these conditions can be prevented. For some, medical conditions are to blame for their dry skin. When that is the case, it is even more important to seek out the help of your doctor. Often, there is help for your condition whether it is just applying lotions or taking better care of your skin in the first place.

The causes for dry skin range in severity too. While you may be just a bit uncomfortable with the itchy skin, for others it is painful. Some of the causes that you may have been exposed to is low humidity, too much washing, soap too harsh for the skin, not enough vitamin A, an illness and sunlight.

The cause of your dry skin may be something different, too. The fact is that there are many causes to this common condition. The good news is that most of the time all that is needed is prevention from these conditions or a few moisturizers to give you the relief you deserve.

There are medications on the market that can help with stopping both the itch and the dry skin. These are available as over the counter products. Look for over the counter 1 percent hydro-cortisone cream on the effected areas. If they are very bad, contact your doctor who will likely give you another prescription strength product to take.

You can also try to take a bath that mixes warm water with one cup of oatmeal in it. To do this, place about a cup of oatmeal in a cotton cloth and cook it as you normally would. Ad this to the bathtub and use it as a sponge to help relieve the dry skin and the itch. There are also a number of products on the market that can provide this same help to you.

If you have dry skin so badly that you have been scratching it heavily, you should take the time to call on a doctor to find relief. If you have scratched the skin so much so that you have broken it open and it is a painful sore, you should seek help.

Here are several cases in which you really should pick up the phone and call on your doctor for some help.

1. If your body itches and feels like there is something bothering your skin much like that of dry skin, call on your doctor. You may or may not have a rash that you can notice.

2. If you have dry skin that is itching you severely that it is interfering with your day to day function or sleep, call on your doctor.

3. If your home treatment of your dry skin has not been helping or providing any relief after several applications, call on your doctor.

There are several different medical conditions that can lead to problems like dry skin. Ichthyosis vulgaris is one of them. This condition is also known as fish scale disease as the skin has problems shedding its dead skin cells. Instead, they accumulate on the skin and cause what looks like thick scales on the skin. This happens often on the lower legs and can range in color.

Another medical condition is that of lamellar ichthyosis. This condition is one that lasts throughout your life. Infants are born with the condition which will produce scales of different sorts throughout the body. This condition is one that leads to disfiguring results and often to psychological damage as well. Another condition is that of asteatotic eczema, which is a condition that leaves the skin with dry, scaly, fissured skin. The skin is itching and may become inflamed which leads to bleeding. This condition can happen to anyone but is most common in the elderly.

Yet another condition in which dry skin plays a role is that of Psoriasis. This condition is one that results in the skin having dry scales that are usually a silvery color. Sometimes, they can look like dandruff. Those that have this condition are likely to have skin that is cracked and will bleed. Pus filled blisters are also common. Unfortunately, this is a disease that is chronic and often has flares that happen sporadically. Most patients are diagnosed with this disease in their early twentys but it can happen at any time in your life.

Dry skin is something to consider being proactive about. If you are one of the many that suffers from dry skin in the winter or even in the warmer months, it is important to do your best to take care of it now. You can start by taking time to moisturize, protection against sun and cold, do not take hot showers and eat a well balanced diet.

What is this condition?

Impetigo is a contagious, superficial skin infection marked by patches of tiny blisters that erupt, exposing the skin beneath. It can occur almost anywhere but usually appears in the area around the nose and mouth.

This disorder, which usually occurs in the late summer or early fall, spreads most easily among infants, young children, and the elderly. Certain risk factors – such as poor hygiene, anemia, malnutrition, and a warm climate – may increase the likelihood of an outbreak of this infection. Impetigo can complicate chickenpox, eczema, or other skin conditions marked by open lesions.

What causes Impetigo?

Impetigo is caused by bacterial infection. Types of bacteria that produce this disorder include Staphylococcus aureus and, less commonly, group A beta-hemolytic streptococci.

What are its symptoms?

Common nonbullous impetigo typically begins with a small red macule that turns into a pus-filled vesicle. When the vesicle breaks, a thick yellow crust forms from the discharge. Smaller lesions may appear around the original lesion. Other features include itching, burning, and swollen lymph nodes in the affected region.

A rare but serious complication of streptococcal impetigo is a kidney infection called glomerulonephritis. Infants and young children may develop impetigo in the ear or an external ear infection; the lesions usually clear without treatment in 2 to 3 weeks, unless an underlying disorder such as eczema is present.

In bullous impetigo, a thin-walled vesicle opens, and a thin, clear crust forms from the discharge. The lesion consists of a central clearing surrounded by an outer rim. It commonly appears on the face or other exposed areas.

Both forms usually produce painless itching; they may appear simultaneouslyand be clinically indistinguishable.

How is it diagnosed?

When diagnosing impetigo, the doctor looks for characteristic lesions. In the lab, microscopic examination of the causative organism usually confirms bacterial infection and justifies antibiotic therapy. Culture and sensitivity testing of fluid or denuded skin may indicate the most appropriate antibiotic. Lab studies may also reveal that the person’s white blood cell count is elevated.

How is it treated?

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Generally, the doctor will prescribe systemic antibiotics (usually penicillin, a cephalosporin, or E-Mycin) for 10 days. A topical antibiotic such as Bactroban ointment may be used for minor infections. Therapy also includes removal of the discharge by washing the lesions two or three times a day with soap and water or, for stubborn crusts, warm soaks or compresses of a salt water or diluted soap solution.

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Psoriasis is a chronic, non-contagious, inflammatory skin ailment which causes red, scaly and/or thickened patches to appear on one’s skin. It is a fairly common disorder which impacts about 2-3% of the population. Individuals impacted by this disorder exhibit an inflammatory response to an unusually rapid production of skin cells caused by hyperactive T cells (aka white blood cells). In fact, skin production is about seven times faster. The outer skin tends to be poorly formed and does not shed properly. As a result, dead cells pile up and and cause scaling.

Psoriasis can affect any part of one’s body including the knees, scalp, elbows, back, and even nails. It normally does not affect the face, however. Psoriasis is more prevalent in individuals with dry skin than those with oily or well moisturized skin, particularly after a cut or injury to the skin. The reason for this is that the infecting organism can thrive better under dry conditions than oily ones which resist infections. Both men and women in any age group are susceptible to psoriasis. In moderate to severe cases, joint problems may also develop resulting in a condition known as psoriatic arthritis. There is a genetic basis to psoriasis but its influence varies. It is believed that about 30 percent of people with this disorder also have a close family member such as a parent, child, or sibling who also suffer from this condition but the severity among family members may vary.

Various factors can trigger or worsen psoriasis. In about one-third of people affected by this disease, an injury such as cut or scrape to the skin is the triggering factor. Other factors include stress, alcohol, smoking, infections,and certain types of drugs like antimalarials, enzyme inhibitors, lithium, and non-steroidal anti-inflammatory drugs.

There are several kinds of psoriasis. The most common type manifest themselves as plaques
on the knees, elbows, back, and scalp. Flexural psoriasis occurs under armpits, groin creases, and areas with excess skin folds. Guttate psoriasis manifests itself as small, salmon pink colored drops on the skin. It normally affects children and is often caused by an infection. Exfoliative psoriasis covers 90% of the body life and impacts the temperature and hydration control mechanism of the skin. It is a rare but life threatening form of this ailment.

Treatment

The methods used to treat psoriasis vary and dermatologists often use trial and error to find the right kind of treatment for their patients. The application of topical agents, such as topical steroids, is probably the most common form of treatment. Ointment and creams containing coal tars are also very effective. Such creams include Keratolytics, Emollients, and Calcipotrienes. These creams help to reduce inflammation as well as soften and remove excess skin and plaque. Activiated Vitamin D and its associated analogues are also used to treat psoriasis as it helps to prevent skin cell growth. Sunshine is yet another effective remedy, although excessive exposure should be avoided to minimize the risk of skin cancer. For more severe cases of psoriasis, potent oral medications such as Acctane, Methotrexate, and Imuran can also be used under the care and supervision of a qualified dermatologist.