A Simple Guide to Ichthyosis
----------------------------------------------
What is Ichthyosis?
------------------------------------
Ichthyosis is a rare non contagious disease of the keratin of the skin where there is reduction of sweat and sebaceous secretions.
The word Ichthus means fish.
So Ichthyosis means fish like appearance of the skin.
Who is at risk of Ichthyosis?
----------------------------------------------
a family history of ichthyosis
What are the causes of Ichthyosis?
--------------------------------------------------
Most forms of ichthyosis are due to:
A.genetic conditions:
------------------------
1.Ichthyosis vulgaris 95% -autosomal dominant
2.X-linked ichthyosis -sex linked recessive
3.Ichthyosis lamellaris - autosomal recessive usually in newborns
4.Harlequins Ichthyosis -autosomal recessive
5.Bullous Ichthyosis - autosomal dominant
B.Acquired Ichthyosis
----------------------
6.Ichthyosis acquisita occur in :
leprosy,
hypothyroidism,
lymphoma,
sarcoidosis,
Hodgkin disease
7.Xeroderma - is a mild form of ichthyosis, occurs in middle aged and older patients.
What are Signs and symptoms of Ichthyosis?
---------------------------------------------
Symptoms:
1.extensor surface of limbs covered with dry scales(rarely the whole body is covered).
2.axilla and antecubal fossa (elbows,armpits,groins,back of knee)not affected
3.Usually symptoms present in childhood but improve during puberty to becoming worst again in later life.
4.Rashes can be extremely itchy in xeroderma
5.The condition is worse in colder weather.
6.Hair may be thin and dry.
7.Nails are brittle and dry.
How is the diagnosis of Ichthyosis made?
--------------------------------------------------------
1.Appearance of the skin
2.Family history of Ichthyosis
2.Skin biopsy for microscopic examination.
What are the complications of Ichthyosis?
-----------------------------------------------
1.keratisis with corneal and ocular surface disease
2.Ectropion of eyelids due to dehydration
3.Deafness in a Keratitis-Ichthyosis-Deafness (KID)Disease
What is the treatment of Ichthyosis?
------------------------------------
There is no cure for Ichthyosis.
1.Symptomatic treatment with emolient creams such as petroleum jelly my help to hydrate the skin.
2.Itch may be controlled with antihistamines
3.Hydration with propylene glycol solution will help
4.Urea in emulsion creams has also help the dry skin
5.Topical or oral retinoic acid has brought some improvement to the skin.
6.Exposure to the sun may improve or worsen the condition.
What is the prognosis of Ichthyosis ?
------------------------------------------
It is a lifelong condition and need continuous treatment.
What are the Preventive measures taken for Ichthyosis ?
--------------------------------------------------------
There is no known preventive measure for ichthyosis
Showing posts with label genetic. Show all posts
Showing posts with label genetic. Show all posts
Thursday, October 2, 2008
Monday, September 22, 2008
A Simple Guide to Polycystic kidney disease
A Simple Guide to Polycystic kidney disease
---------------------------------------------------------
What are Polycystic kidney disease ?
-----------------------------------------------
Polycystic kidney disease is a progressive genetic condition of the kidneys in which multiple cysts (polycystic)are present in both kidneys.
The disease can produce cysts in the liver, pancreas, and rarely, the heart and brain.
Who is at risk of Polycystic kidney disease formation?
------------------------------------------------------------------
Any one with a family history of polycystic kidneys.
What causes Polycystic kidney disease ?
-------------------------------------------------------
There are 2 main causes of polycystic kidney disease.
Both are determined by their genetic inheritance:
1.Autosomal dominant
----------------------
It is generally a late-onset disease with progressive cyst development.
The kidneys are bilaterally enlarged and have multiple cysts.
There may be kidney dysfunction resulting in hypertension and kidney failure by the age of 60 years.
Beside this there are also cysts in other organs such as the liver, spleen, pancreas, and arachnoid mater.
Other abnormalities includes intracranial aneurysms, dissection of the aorta, mitral valve prolapse.
2.Autosomal recessive
-----------------------------
This disease is less common than the above.
Most cases died during the pregnancy or in the first month of birth.
Early manifestations of the disease is apparent at birth or in early infancy.
What are the symptoms of Polycystic kidney disease ?
------------------------------------------------------------
Many Polycystic kidney patients do not have any symptoms.
In some cases there may be:
1.hypertension,
2.Abdominal colic due to urinary stones
3.back or flank pain
4.urinary tract infections with hematuria and proteinuria
5.Palpable large kidneys
6.Abdominal swelling
7.fatigue
The condition eventually ends in chronic renal failure with loss of kidney function.
How are Polycystic kidney disease diagnosed?
---------------------------------------------------------------
1.X-rays of the kidneys on routine checkup
2.Ultrasound of the kidneys
3.MRI of the kidneys
4.genetic testing
Genetic counseling may help families at risk for polycystic kidney disease.
How are Polycystic kidney disease treated?
--------------------------------------------------------
There is no cure for Polycystic kidney disease.
Although a cure for Polycystic kidney disease is not possible, treatment can ease the symptoms and prolong life.
1.Back Pain:
Mild pain killers such as paracetamol can relieve pain.
2.Urinary tract infections:
urinary tract infections can be treated with antibiotics.
Any urinary infection can spread from the urinary tract to the kidney cysts so early treatment is important.
Once the infection enter the cyst, treatment is difficult because many antibiotics cannot enter the walls of the cysts.
3.High blood pressure:
All hypertension cases due to Polycystic kidney disease must be kept under control with medications and lifestyle changes such as exercise, distressing, low salt and fats
4.Renal disease:
Eventually in all cases the kidney function will fail and chronic real failure develop.
Treatment will then be by dialysis or kidney transplant.
5.Surgery:
Surgery is rarely needed except to remove large cysts. Even then the kidney disease is progressive and will still end in chronic renal failure.
What is the prognosis of Polycystic kidney disease?
----------------------------------------------------------
Generally poor after the age of 60 when renal disease may set in.
How to prevent Polycystic kidney disease ?
-----------------------------------------------------------------
There is no prevention for Polycystic kidney disease.
---------------------------------------------------------
What are Polycystic kidney disease ?
-----------------------------------------------
Polycystic kidney disease is a progressive genetic condition of the kidneys in which multiple cysts (polycystic)are present in both kidneys.
The disease can produce cysts in the liver, pancreas, and rarely, the heart and brain.
Who is at risk of Polycystic kidney disease formation?
------------------------------------------------------------------
Any one with a family history of polycystic kidneys.
What causes Polycystic kidney disease ?
-------------------------------------------------------
There are 2 main causes of polycystic kidney disease.
Both are determined by their genetic inheritance:
1.Autosomal dominant
----------------------
It is generally a late-onset disease with progressive cyst development.
The kidneys are bilaterally enlarged and have multiple cysts.
There may be kidney dysfunction resulting in hypertension and kidney failure by the age of 60 years.
Beside this there are also cysts in other organs such as the liver, spleen, pancreas, and arachnoid mater.
Other abnormalities includes intracranial aneurysms, dissection of the aorta, mitral valve prolapse.
2.Autosomal recessive
-----------------------------
This disease is less common than the above.
Most cases died during the pregnancy or in the first month of birth.
Early manifestations of the disease is apparent at birth or in early infancy.
What are the symptoms of Polycystic kidney disease ?
------------------------------------------------------------
Many Polycystic kidney patients do not have any symptoms.
In some cases there may be:
1.hypertension,
2.Abdominal colic due to urinary stones
3.back or flank pain
4.urinary tract infections with hematuria and proteinuria
5.Palpable large kidneys
6.Abdominal swelling
7.fatigue
The condition eventually ends in chronic renal failure with loss of kidney function.
How are Polycystic kidney disease diagnosed?
---------------------------------------------------------------
1.X-rays of the kidneys on routine checkup
2.Ultrasound of the kidneys
3.MRI of the kidneys
4.genetic testing
Genetic counseling may help families at risk for polycystic kidney disease.
How are Polycystic kidney disease treated?
--------------------------------------------------------
There is no cure for Polycystic kidney disease.
Although a cure for Polycystic kidney disease is not possible, treatment can ease the symptoms and prolong life.
1.Back Pain:
Mild pain killers such as paracetamol can relieve pain.
2.Urinary tract infections:
urinary tract infections can be treated with antibiotics.
Any urinary infection can spread from the urinary tract to the kidney cysts so early treatment is important.
Once the infection enter the cyst, treatment is difficult because many antibiotics cannot enter the walls of the cysts.
3.High blood pressure:
All hypertension cases due to Polycystic kidney disease must be kept under control with medications and lifestyle changes such as exercise, distressing, low salt and fats
4.Renal disease:
Eventually in all cases the kidney function will fail and chronic real failure develop.
Treatment will then be by dialysis or kidney transplant.
5.Surgery:
Surgery is rarely needed except to remove large cysts. Even then the kidney disease is progressive and will still end in chronic renal failure.
What is the prognosis of Polycystic kidney disease?
----------------------------------------------------------
Generally poor after the age of 60 when renal disease may set in.
How to prevent Polycystic kidney disease ?
-----------------------------------------------------------------
There is no prevention for Polycystic kidney disease.
Sunday, September 14, 2008
A Simple Guide to Retinitis pigmentosa
A Simple Guide to Retinitis pigmentosa
----------------------------------------------
What is Retinitis pigmentosa?
---------------------------------------
Retinitis pigmentosa is a slow degenerative disease of the retina.
Who is affected by Retinitis pigmentosa?
------------------------------------------------
Retinitis pigmentosa is a genetically determined disease in which abnormal photoreceptors (rods and cones) or the Retinitis pigment epithelium of the retina cause progressive loss of vision.
Initially there is night blindness due to the abnormal photoreceptors.
This is followed by the loss of peripheral visual field known as tunnel
vision which may persist for some years.
Finally the macular region is affected with loss of central vision in the later stages.
In rare cases blindness may occur in childhood.
What is the cause of Retinitis pigmentosa?
------------------------------------------------
The cause is usually in the genes and of the recessive trait.
There is a mild form of dominant trait.
Rarely it is sex linked and can be severe.
What are symptoms and signs of Retinitis pigmentosa?
---------------------------------------------------------
Symptoms:
--------------
1.loss of night vision even in childhood
2.tunnel vision occurs at age of 40-50 for several years or decades
3.loss of central vision usually at 50-60 years of age
Signs:
-----------------
1. In early stage, direct opthalmoscopy show small spidery black spots
2. vessels are sheathed with pigments in some areas
3. Retinal vessels become attenuated (thinned)
4. Optic atrophy(cellophane maculopathy) sets in
5. posterior subcapsular cataracts form at late stage.
How is Retinitis pigmentosa diagnosed?
---------------------------------------------
1. electroretinography (ERG) show progressive loss of photoreceptor function
2.Visual field testing show loss of peripheral vision
3.Flourescin angiography may show dark pigments to establish the presence of Retinitis pigmentosa.
What are the complications of Retinitis pigmentosa?
-------------------------------------------------------
Partial to complete loss of vision.
What is the treatment for Retinitis pigmentosa?
-------------------------------------------------
Retinitis pigmentosa has no cure.
Several methods of treatment aimed at slowing down the progression of loss of vision have been tried:
1.daily intake of 15000 IU of vitamin A palmitate.
2.Retinitis transplants,
3 artificial Retinitis implants,
4.gene therapy,
5.stem cells,
How is Retinitis pigmentosa monitored?
-----------------------------------------
1.regular follow up with the eye doctor.
2.examining the retina for further damage
3.analyzing the visual fields.
What is the prognosis of Retinitis pigmentosa?
----------------------------------------------------
The prognosis is very poor as progression to blindness is the rule.
How can Retinitis pigmentosa be prevented?
-----------------------------------------------
There is no prevention for Retinitis pigmentosa.
The following may help:
1.Genetic counselling
2.Examination of family members for signs of loss of vision
----------------------------------------------
What is Retinitis pigmentosa?
---------------------------------------
Retinitis pigmentosa is a slow degenerative disease of the retina.
Who is affected by Retinitis pigmentosa?
------------------------------------------------
Retinitis pigmentosa is a genetically determined disease in which abnormal photoreceptors (rods and cones) or the Retinitis pigment epithelium of the retina cause progressive loss of vision.
Initially there is night blindness due to the abnormal photoreceptors.
This is followed by the loss of peripheral visual field known as tunnel
vision which may persist for some years.
Finally the macular region is affected with loss of central vision in the later stages.
In rare cases blindness may occur in childhood.
What is the cause of Retinitis pigmentosa?
------------------------------------------------
The cause is usually in the genes and of the recessive trait.
There is a mild form of dominant trait.
Rarely it is sex linked and can be severe.
What are symptoms and signs of Retinitis pigmentosa?
---------------------------------------------------------
Symptoms:
--------------
1.loss of night vision even in childhood
2.tunnel vision occurs at age of 40-50 for several years or decades
3.loss of central vision usually at 50-60 years of age
Signs:
-----------------
1. In early stage, direct opthalmoscopy show small spidery black spots
2. vessels are sheathed with pigments in some areas
3. Retinal vessels become attenuated (thinned)
4. Optic atrophy(cellophane maculopathy) sets in
5. posterior subcapsular cataracts form at late stage.
How is Retinitis pigmentosa diagnosed?
---------------------------------------------
1. electroretinography (ERG) show progressive loss of photoreceptor function
2.Visual field testing show loss of peripheral vision
3.Flourescin angiography may show dark pigments to establish the presence of Retinitis pigmentosa.
What are the complications of Retinitis pigmentosa?
-------------------------------------------------------
Partial to complete loss of vision.
What is the treatment for Retinitis pigmentosa?
-------------------------------------------------
Retinitis pigmentosa has no cure.
Several methods of treatment aimed at slowing down the progression of loss of vision have been tried:
1.daily intake of 15000 IU of vitamin A palmitate.
2.Retinitis transplants,
3 artificial Retinitis implants,
4.gene therapy,
5.stem cells,
How is Retinitis pigmentosa monitored?
-----------------------------------------
1.regular follow up with the eye doctor.
2.examining the retina for further damage
3.analyzing the visual fields.
What is the prognosis of Retinitis pigmentosa?
----------------------------------------------------
The prognosis is very poor as progression to blindness is the rule.
How can Retinitis pigmentosa be prevented?
-----------------------------------------------
There is no prevention for Retinitis pigmentosa.
The following may help:
1.Genetic counselling
2.Examination of family members for signs of loss of vision
Friday, July 18, 2008
A Simple Guide to Hyperhidrosis
A Simple Guide to Hyperhidrosis
---------------------------------
What is Hyperhidrosis?
----------------------
Hyperhidrosis is the condition when a person suffers from excessive perspiration due to overactivity of the sweat glands.
This may cause a social problem in people who need to shake hands or write with sweaty palms.
Excess perspiration with foul odor may also be offensive to people around the patient
What are the causes of Hyperhidrosis?
---------------------------------------
The cause of Hyperhidrosis is usually unknown.
It has been linked to :
1.excessive sweat glands
2.psychogenic excess production of sweats under stress and nervous conditions
3.Endocrine disorder such as hyperthyroidism
4.Skin diseases with increased hydration of skin such as in weeping eczema
5.Genetic - inherited as an autosomal dominant trait. Family has a history of Hyperhidrosis
6.diseases of the nervous system
7.Tuberculosis-night sweats are a typical feature of tuberculosis
8.diabetes mellitus and pituitary disorders
9.Certain medicines such as aspirin, paracetamol may provoke excess sweating
10.alcohol, caffiene, and certain food(spices) may stimulate the sweat glands
What are the symptoms and signs of Hyperhidrosis?
-------------------------------------------------------
Persons who has Hyperhidrosis has the following:
Symptoms:
1.Genralised sweating
2.localised sweating of palms, soles, axilla and groins
3.Foul smell from the excess sweat is caused by the decomposition of skin cells by bacteria and yeast infection
Signs:
1.Skin may become thickened, fissured or scaly
2.Nail deformities may occur
3.Secondary bacterial and fungal infections may be present
How do you diagnose Hyperhidrosis?
-------------------------------------------
Diagnosis can usually be made by :
1.Sweaty palms or soles
2.thickened, fissured skin with nail deformities
What is the treatment of Hyperhidrosis?
------------------------------------------------
1.Treat the underlying cause such as hyperthyroidism, diabetes
2.Clean involved skin frequently with baths etc. Use talcum powder to dry skin.
3.Wear cotton socks and underwear and change daily.
4.Local application of aluminium chloride, hexahydrate, glutaradehyde and even tannic acid from tea.
Some side effects may be allergic dermatitis or staining of skin
5.Anticholinergic drugs can reduce the sweating but has side effects such as dryness of mouth and flushing
6.Surgery in severe cases may be required such as sympathectomy (for palms).
Sweat glands suction by removing some of the sweat glands has been shown to reduce sweating
7.Iontophoresis: may help but may be painful
8.Botox injection may disable the sympathetic nerves to the sweat glands amy lasts for 6-9 months
9.Hypnosis, relaxation and meditation has help to certain extent
10.Radiotherapy has been known to be effective but not used because of the danger of bone cancer.
What is the prognosis of Hyperhidrosis?
----------------------------------------
Prognosis is usually palliative as the sweat glands and nerve cells may grow back.
Recurrence is quite common.
---------------------------------
What is Hyperhidrosis?
----------------------
Hyperhidrosis is the condition when a person suffers from excessive perspiration due to overactivity of the sweat glands.
This may cause a social problem in people who need to shake hands or write with sweaty palms.
Excess perspiration with foul odor may also be offensive to people around the patient
What are the causes of Hyperhidrosis?
---------------------------------------
The cause of Hyperhidrosis is usually unknown.
It has been linked to :
1.excessive sweat glands
2.psychogenic excess production of sweats under stress and nervous conditions
3.Endocrine disorder such as hyperthyroidism
4.Skin diseases with increased hydration of skin such as in weeping eczema
5.Genetic - inherited as an autosomal dominant trait. Family has a history of Hyperhidrosis
6.diseases of the nervous system
7.Tuberculosis-night sweats are a typical feature of tuberculosis
8.diabetes mellitus and pituitary disorders
9.Certain medicines such as aspirin, paracetamol may provoke excess sweating
10.alcohol, caffiene, and certain food(spices) may stimulate the sweat glands
What are the symptoms and signs of Hyperhidrosis?
-------------------------------------------------------
Persons who has Hyperhidrosis has the following:
Symptoms:
1.Genralised sweating
2.localised sweating of palms, soles, axilla and groins
3.Foul smell from the excess sweat is caused by the decomposition of skin cells by bacteria and yeast infection
Signs:
1.Skin may become thickened, fissured or scaly
2.Nail deformities may occur
3.Secondary bacterial and fungal infections may be present
How do you diagnose Hyperhidrosis?
-------------------------------------------
Diagnosis can usually be made by :
1.Sweaty palms or soles
2.thickened, fissured skin with nail deformities
What is the treatment of Hyperhidrosis?
------------------------------------------------
1.Treat the underlying cause such as hyperthyroidism, diabetes
2.Clean involved skin frequently with baths etc. Use talcum powder to dry skin.
3.Wear cotton socks and underwear and change daily.
4.Local application of aluminium chloride, hexahydrate, glutaradehyde and even tannic acid from tea.
Some side effects may be allergic dermatitis or staining of skin
5.Anticholinergic drugs can reduce the sweating but has side effects such as dryness of mouth and flushing
6.Surgery in severe cases may be required such as sympathectomy (for palms).
Sweat glands suction by removing some of the sweat glands has been shown to reduce sweating
7.Iontophoresis: may help but may be painful
8.Botox injection may disable the sympathetic nerves to the sweat glands amy lasts for 6-9 months
9.Hypnosis, relaxation and meditation has help to certain extent
10.Radiotherapy has been known to be effective but not used because of the danger of bone cancer.
What is the prognosis of Hyperhidrosis?
----------------------------------------
Prognosis is usually palliative as the sweat glands and nerve cells may grow back.
Recurrence is quite common.
Thursday, July 3, 2008
A Simple Guide to Amenorrhea
A Simple Guide to Amenorrhea
---------------------------------
What is Amenorrhea?
--------------------------
Amenorrhea is a symptom defined as absence of menstruation.
What are the types of Amenorrhea?
------------------------------------
1.Primary Amenorrhea
----------------------
is defined as the absence of onset of menstruation (menarche) in a girl who has reached the age of 18 years.
2.Secondary Amenorrhea
-----------------------
is defined as the absence of menstruation for a peroid of at least 6 months in a girl who has previously experienced normal menstruation and is not pregnant.
What are the causes of Amenorrhea?
-------------------------------------
1.Physiological(hormonal):
------------------------------
pregnancy hormones - pregnancy is the still the most common cause of secondary amenorrhea.
Growth hormone deficiency
Abnormal production of testosterone
2.Genetic Causes:
------------------
abnormal formation of genital tract causing cryptomenorrhea -obstruction to the flow of menstrual blood such as imperforate hymen
Chromosonal abnormalities:
Turner syndrome
Ovarian agenesis
3.Uterine Pathology:
------------------------
adhesions from previous operation
endometriosis
tuberculosis infection
radiation
4.Ovarian:
------------------
Agenesis(no ovaries)
Abnormal ovaries(again congenital)
Polycystic Ovaries
Granulosa-thca tumours of ovaries
radiation of ovaries
5.Pituitary:
----------------
Pituitary tumours
Hypopituitarism
Hypothalamic abnormalities
6.Psychological:
------------------
Depression
Anorexia nervosa,
starvation
7.Systemic Diseases:
------------------------
Hypothyoidism
Cushing syndrome
8.Medical causes:
----------------------
Chemotherapy
oral cotraceptive
corticosteroids
hypotensive drugs
How to establish a diagnosis of Amenorrhea
-------------------------------------------
History:
1.Primary Amenorrhea
------------------------
Genetic disorders:
failure to develop female sex characteristics
anatomic abnormalities due to chromosonal defects such as Turner syndrome
hirsutism-excessive male hormones
2.Secondary Amenorrhea
--------------------------
Metabolic disorders:
symptoms of hypothyroidism
symptoms of polycystic ovarian syndrome
Obesity
Pyschologic disorders:
depression
anorexia nervosa
Pelvic examination:
---------------------
vulval and vaginal examination for cryptomenorrhea,
bimanual palpation for ovarian masses like polystic ovaries
abnormal uterus or ovaries
Investigations:
--------------------
Pregnancy test
blood for follicle stimulating hormones, luteinising hormones, prolactin
Progesterone withdrawal bleeding test
Luteinizing hormone releasing tests
Serum testesterone and androsterones
Transvaginal ultrasound to check on the uterus and ovaries
X-ray Skull, Brain CAT or MRI scans to exclude pituitary tumours
What is the Treatment of Amenorrhea?
----------------------------------------------
Medications:
-------------
Specific treatment for amenorrhea depends on:
1.age,
2.overall health,
3.cause of the condition (primary or secondary)
4.the preference of the patient
Treatment for amenorrhea may include:
1.Pregnancy - no treatment if the patient wish to continue with pregnancy. Usually a referral to an obstetrician may be necessary
2.hormonal replacement(oestrogen and progesterone supplements ) in genetic cases and androgen producing tumours.
3.Cyproterone acetate is an anti-androgen which counters the effects of male hormones. It is usually given with a small dose of oestrogen.
4.Hyperprolactinaemia -treatment with bromocriptine which acts by stimulating the prolactin Inhibiting factor in the hypothalamus.
5.Polycystic ovary Disease -clomiphene and gonadatrophins may be given to improve menstruation and help fertility
6.Adrenal dysfunction due to deficiency of the enzyme 21-hydroxylase (androgegenital syndrome) results in excess ACTH and excessive production of androgens-treatment is with corticosteroids such as prednisolone
Other Treatments:
----------------------
1.Treatment of underlying systemic disease like thyroxine for hypothyroidism,
2.dietary changes to include increased caloric and fat intake especially in cases of low fat due to self induced dieting, anorexia nervosa
3.Pyschiatric treatment for women with depression, anorexia nervosa, or genetic dysfunction.
4.Healthy lifestyle for those who are obese
---------------------------------
What is Amenorrhea?
--------------------------
Amenorrhea is a symptom defined as absence of menstruation.
What are the types of Amenorrhea?
------------------------------------
1.Primary Amenorrhea
----------------------
is defined as the absence of onset of menstruation (menarche) in a girl who has reached the age of 18 years.
2.Secondary Amenorrhea
-----------------------
is defined as the absence of menstruation for a peroid of at least 6 months in a girl who has previously experienced normal menstruation and is not pregnant.
What are the causes of Amenorrhea?
-------------------------------------
1.Physiological(hormonal):
------------------------------
pregnancy hormones - pregnancy is the still the most common cause of secondary amenorrhea.
Growth hormone deficiency
Abnormal production of testosterone
2.Genetic Causes:
------------------
abnormal formation of genital tract causing cryptomenorrhea -obstruction to the flow of menstrual blood such as imperforate hymen
Chromosonal abnormalities:
Turner syndrome
Ovarian agenesis
3.Uterine Pathology:
------------------------
adhesions from previous operation
endometriosis
tuberculosis infection
radiation
4.Ovarian:
------------------
Agenesis(no ovaries)
Abnormal ovaries(again congenital)
Polycystic Ovaries
Granulosa-thca tumours of ovaries
radiation of ovaries
5.Pituitary:
----------------
Pituitary tumours
Hypopituitarism
Hypothalamic abnormalities
6.Psychological:
------------------
Depression
Anorexia nervosa,
starvation
7.Systemic Diseases:
------------------------
Hypothyoidism
Cushing syndrome
8.Medical causes:
----------------------
Chemotherapy
oral cotraceptive
corticosteroids
hypotensive drugs
How to establish a diagnosis of Amenorrhea
-------------------------------------------
History:
1.Primary Amenorrhea
------------------------
Genetic disorders:
failure to develop female sex characteristics
anatomic abnormalities due to chromosonal defects such as Turner syndrome
hirsutism-excessive male hormones
2.Secondary Amenorrhea
--------------------------
Metabolic disorders:
symptoms of hypothyroidism
symptoms of polycystic ovarian syndrome
Obesity
Pyschologic disorders:
depression
anorexia nervosa
Pelvic examination:
---------------------
vulval and vaginal examination for cryptomenorrhea,
bimanual palpation for ovarian masses like polystic ovaries
abnormal uterus or ovaries
Investigations:
--------------------
Pregnancy test
blood for follicle stimulating hormones, luteinising hormones, prolactin
Progesterone withdrawal bleeding test
Luteinizing hormone releasing tests
Serum testesterone and androsterones
Transvaginal ultrasound to check on the uterus and ovaries
X-ray Skull, Brain CAT or MRI scans to exclude pituitary tumours
What is the Treatment of Amenorrhea?
----------------------------------------------
Medications:
-------------
Specific treatment for amenorrhea depends on:
1.age,
2.overall health,
3.cause of the condition (primary or secondary)
4.the preference of the patient
Treatment for amenorrhea may include:
1.Pregnancy - no treatment if the patient wish to continue with pregnancy. Usually a referral to an obstetrician may be necessary
2.hormonal replacement(oestrogen and progesterone supplements ) in genetic cases and androgen producing tumours.
3.Cyproterone acetate is an anti-androgen which counters the effects of male hormones. It is usually given with a small dose of oestrogen.
4.Hyperprolactinaemia -treatment with bromocriptine which acts by stimulating the prolactin Inhibiting factor in the hypothalamus.
5.Polycystic ovary Disease -clomiphene and gonadatrophins may be given to improve menstruation and help fertility
6.Adrenal dysfunction due to deficiency of the enzyme 21-hydroxylase (androgegenital syndrome) results in excess ACTH and excessive production of androgens-treatment is with corticosteroids such as prednisolone
Other Treatments:
----------------------
1.Treatment of underlying systemic disease like thyroxine for hypothyroidism,
2.dietary changes to include increased caloric and fat intake especially in cases of low fat due to self induced dieting, anorexia nervosa
3.Pyschiatric treatment for women with depression, anorexia nervosa, or genetic dysfunction.
4.Healthy lifestyle for those who are obese
Saturday, September 29, 2007
A Simple Guide to Blood Cancer
A Simple Guide to Blood Cancer
--------------------------------------
What are Blood Cancer?
----------------------------
Blood cancer consists of mainly lymphoma, leukaemia and multiple myeloma.
These cancers developed either in the bone marrow or the lymphatic tissues of the body. These three types of blood cancers all involve an uncontrolled growth of abnormal cells within the blood and bone marrow.
Who is at risk of getting Blood Cancers?
-----------------------------------------------
The risk of developing blood cancers increases with age.
Adults therefore are more prone to blood cancer than children.
The acute leukemia tends to affect children.
The chronic leukemia is more common in adults.
However children and adults can develop any kind of leukaemia.
In Multiple myeloma, the average onset is at age 60.
Lymphoma
-------------
(refer to my blog on A Simple Guide to Lymphoma)
Lymphoma is a cancer of the lymphoid tissues which are composed of several types of immune-system cells that work together to fight infections.
Lymphoma usually begins in a lymph node as a primary cancer.
It can also begin in the stomach, intestines, skin or any other organ that contains lymphoid tissue.
Leukaemia
--------------
Leukaemia is a cancer that affects the blood-forming system of the body which include the bone marrow and the lymphatic system.
Leukaemia can be classified as either acute or chronic.
The acute leukemia tends to affect children while the chronic leukemia is more common in adults.
Acute leukaemia
--------------------
In acute leukaemia, immature blood cells reproduce quickly in the bone marrow, slowly killing the normal cells.
These abnormal cells can also spread to other organs, ultimately leading to disruption and distortion of these organ functions.
Acute leukaemia can be further divided into two types according to the predominant type of cells affected:
1.Lymphoblasts are immature cells that normally develop into lymphocytes, a type of white blood cell
2.myeloblasts are immature cells that normally develop into other cells such as neutrophils, another type of white blood cell.
1. Acute lymphoid leukaemia (ALL) -
here the lymphoblasts reproduce without developing into normal blood cells.
These immature lymphoblasts block out the healthy blood cells and frequently congregate in the lymph nodes, causing a swelling in that area.
2. Acute myeloid leukaemia (AML) -
here the myeloblasts reproduce without developing into normal blood cells.
The immature blast cells gather in the bone marrow and upset the production of healthy normal cells.
Anaemia results due to lack of sufficient red blood cells.
Frequent infections occurs due to the low levels of white blood cells which fight infections.
Chronic leukaemia
-----------------------
Chronic leukaemia occurs when there is over-production of blood cells that appear to be mature. Unfortunately these cells actually lack the normal functions of mature blood cells.
Chronic leukaemia usually has a slower, less dramatic course than acute leukaemia.
Chronic leukaemia can also be broken into two groups:
(a) Chronic lymphoid leukaemia (CLL) -
Here there is production of too many apparently mature lymphocytes in the bone marrow. The abnormal cells appear to be fully developed lymphocytes, but cannot fight infections as well as normal lymphocytes.
(b) Chronic myeloid leukaemia (CML) -
here the over-production of apparently mature but defective myeloid cells, reach a point where almost no healthy cells remain.
Multiple Myeloma
----------------------
(refer to my blog on A Simple Guide to Multiple Myeloma)
Multiple myeloma is cancer of the bone marrow which occurs from the uncontrolled growth of plasma cells, a form of immune-protective white blood cells.
Normally plasma cells make antibodies to fight infections.
In multiple myeloma, there is a malignant proliferation of plasma cells.
What are the Symptoms of Blood Cancer?
-------------------------------------------------
All three blood cancers have similar symptoms.
Among the common warning signs are:
1.weight loss,
2.constant infections such as flu and diarrhoea,
3.bleeding of gums or nose and slow healing cuts or frequent bruises
In addition to the above,
4.severe kidney problems,
5.general numbness of the skin
6.pain in the bones
may indicate the existence of multiple myeloma and leukemia as the disease progresses.
The pain can radiate to the back, ribs and arms of the victims. The pain is a result of an increase in the number of myeloma cells where the bone marrow is being damaged.
7.swelling of lymph nodes in the neck, the armpits or in the groin may indicate more likely a diagnosis of lymphoma
8.Persistent fever
9.loss of appetite
10.generalised weakness and pallour
What are the Causes of Blood Cancer?
--------------------------------------------
1.Exposure to excessive radiation
2.hazardous chemicals like benzene, asbestos, herbicides and pesticides are known to be the primary causes of blood cancer. Avoid these harmful materials as much as possible.
3.certain genetic abnormalities, such as Down Syndrome and the inheritance of a particular chromosome called the Philadelphia chromosome, have also been linked to the development of specific forms of leukaemia. This is controversial.
How do you diagnose Blood Cancer?
------------------------------------------
1.a full medical history and full examination especially for signs of:
anaemia,
enlarged liver and spleen,
bleeding tendencies in the skin such as petechie and ecchymoses
enlarged lymph nodes
2.a full blood and urine test should be done to examine the blood cells under the microscope for cancer cells as well as to assess the patient's kidney, liver functions and the severity of anaemia.
3.A bone marrow aspirate using a syringe and needle can be examined for further evidence of blood and bone marrow cell abnormailties.
The presence of the Philadelphia chromosome may suggest evidence of leukemia.
What is the Treatment of Blood Cancer?
------------------------------------------------
Before any cancer treatment is done, because of the patients's anaemia and bleeding tendency, blood transfusions are usually given to improve the general health and resistance of the patient.
Chemotherapy and radiation therapy have always been used to treat blood cancer effectively.
Besides these treatments, stem cells infusion and bone-marrow transplants also give patients and their families another source for a cure.
Unlike chemotherapy and radiation therapy that are used to treat all the three kinds of blood cancer, bone-marrow transplants are more frequently used to cure lymphoma and leukaemia only .
It is also more successful for younger patients and when the disease is in the early stage.
Patients shuold know that dangers and side effects of bone-marrow transplants exist.
In extreme cases when the transplant fail, death may occur.
What are the Prevention measures for Blood Cancer?
--------------------------------------------------------------
1.When exposed to dangerous chemicals and radiation, take extra precautions by wearing protective and appropriate clothing.
2.The threat of contracting lymphoma can be reduced by avoiding the risk of HIV. Patients infected with HIV are known to have a higher rate of lymphoma because of their low immune-system cells to fight infections.
3.Any family member of a leukemia patient should go for genetic testing and regular check-ups to spot the symptoms early.
--------------------------------------
What are Blood Cancer?
----------------------------
Blood cancer consists of mainly lymphoma, leukaemia and multiple myeloma.
These cancers developed either in the bone marrow or the lymphatic tissues of the body. These three types of blood cancers all involve an uncontrolled growth of abnormal cells within the blood and bone marrow.
Who is at risk of getting Blood Cancers?
-----------------------------------------------
The risk of developing blood cancers increases with age.
Adults therefore are more prone to blood cancer than children.
The acute leukemia tends to affect children.
The chronic leukemia is more common in adults.
However children and adults can develop any kind of leukaemia.
In Multiple myeloma, the average onset is at age 60.
Lymphoma
-------------
(refer to my blog on A Simple Guide to Lymphoma)
Lymphoma is a cancer of the lymphoid tissues which are composed of several types of immune-system cells that work together to fight infections.
Lymphoma usually begins in a lymph node as a primary cancer.
It can also begin in the stomach, intestines, skin or any other organ that contains lymphoid tissue.
Leukaemia
--------------
Leukaemia is a cancer that affects the blood-forming system of the body which include the bone marrow and the lymphatic system.
Leukaemia can be classified as either acute or chronic.
The acute leukemia tends to affect children while the chronic leukemia is more common in adults.
Acute leukaemia
--------------------
In acute leukaemia, immature blood cells reproduce quickly in the bone marrow, slowly killing the normal cells.
These abnormal cells can also spread to other organs, ultimately leading to disruption and distortion of these organ functions.
Acute leukaemia can be further divided into two types according to the predominant type of cells affected:
1.Lymphoblasts are immature cells that normally develop into lymphocytes, a type of white blood cell
2.myeloblasts are immature cells that normally develop into other cells such as neutrophils, another type of white blood cell.
1. Acute lymphoid leukaemia (ALL) -
here the lymphoblasts reproduce without developing into normal blood cells.
These immature lymphoblasts block out the healthy blood cells and frequently congregate in the lymph nodes, causing a swelling in that area.
2. Acute myeloid leukaemia (AML) -
here the myeloblasts reproduce without developing into normal blood cells.
The immature blast cells gather in the bone marrow and upset the production of healthy normal cells.
Anaemia results due to lack of sufficient red blood cells.
Frequent infections occurs due to the low levels of white blood cells which fight infections.
Chronic leukaemia
-----------------------
Chronic leukaemia occurs when there is over-production of blood cells that appear to be mature. Unfortunately these cells actually lack the normal functions of mature blood cells.
Chronic leukaemia usually has a slower, less dramatic course than acute leukaemia.
Chronic leukaemia can also be broken into two groups:
(a) Chronic lymphoid leukaemia (CLL) -
Here there is production of too many apparently mature lymphocytes in the bone marrow. The abnormal cells appear to be fully developed lymphocytes, but cannot fight infections as well as normal lymphocytes.
(b) Chronic myeloid leukaemia (CML) -
here the over-production of apparently mature but defective myeloid cells, reach a point where almost no healthy cells remain.
Multiple Myeloma
----------------------
(refer to my blog on A Simple Guide to Multiple Myeloma)
Multiple myeloma is cancer of the bone marrow which occurs from the uncontrolled growth of plasma cells, a form of immune-protective white blood cells.
Normally plasma cells make antibodies to fight infections.
In multiple myeloma, there is a malignant proliferation of plasma cells.
What are the Symptoms of Blood Cancer?
-------------------------------------------------
All three blood cancers have similar symptoms.
Among the common warning signs are:
1.weight loss,
2.constant infections such as flu and diarrhoea,
3.bleeding of gums or nose and slow healing cuts or frequent bruises
In addition to the above,
4.severe kidney problems,
5.general numbness of the skin
6.pain in the bones
may indicate the existence of multiple myeloma and leukemia as the disease progresses.
The pain can radiate to the back, ribs and arms of the victims. The pain is a result of an increase in the number of myeloma cells where the bone marrow is being damaged.
7.swelling of lymph nodes in the neck, the armpits or in the groin may indicate more likely a diagnosis of lymphoma
8.Persistent fever
9.loss of appetite
10.generalised weakness and pallour
What are the Causes of Blood Cancer?
--------------------------------------------
1.Exposure to excessive radiation
2.hazardous chemicals like benzene, asbestos, herbicides and pesticides are known to be the primary causes of blood cancer. Avoid these harmful materials as much as possible.
3.certain genetic abnormalities, such as Down Syndrome and the inheritance of a particular chromosome called the Philadelphia chromosome, have also been linked to the development of specific forms of leukaemia. This is controversial.
How do you diagnose Blood Cancer?
------------------------------------------
1.a full medical history and full examination especially for signs of:
anaemia,
enlarged liver and spleen,
bleeding tendencies in the skin such as petechie and ecchymoses
enlarged lymph nodes
2.a full blood and urine test should be done to examine the blood cells under the microscope for cancer cells as well as to assess the patient's kidney, liver functions and the severity of anaemia.
3.A bone marrow aspirate using a syringe and needle can be examined for further evidence of blood and bone marrow cell abnormailties.
The presence of the Philadelphia chromosome may suggest evidence of leukemia.
What is the Treatment of Blood Cancer?
------------------------------------------------
Before any cancer treatment is done, because of the patients's anaemia and bleeding tendency, blood transfusions are usually given to improve the general health and resistance of the patient.
Chemotherapy and radiation therapy have always been used to treat blood cancer effectively.
Besides these treatments, stem cells infusion and bone-marrow transplants also give patients and their families another source for a cure.
Unlike chemotherapy and radiation therapy that are used to treat all the three kinds of blood cancer, bone-marrow transplants are more frequently used to cure lymphoma and leukaemia only .
It is also more successful for younger patients and when the disease is in the early stage.
Patients shuold know that dangers and side effects of bone-marrow transplants exist.
In extreme cases when the transplant fail, death may occur.
What are the Prevention measures for Blood Cancer?
--------------------------------------------------------------
1.When exposed to dangerous chemicals and radiation, take extra precautions by wearing protective and appropriate clothing.
2.The threat of contracting lymphoma can be reduced by avoiding the risk of HIV. Patients infected with HIV are known to have a higher rate of lymphoma because of their low immune-system cells to fight infections.
3.Any family member of a leukemia patient should go for genetic testing and regular check-ups to spot the symptoms early.
Monday, September 10, 2007
A Simple Guide to Alopecia(Hair Loss)
A Simple Guide to Alopecia(Hair Loss)
------------------------------------
What is Alopecia(Hair Loss)?
-----------------------------------
Alopecia or Hair Loss is the partial or complete loss of hair in the scalp, armpit or other areas of the body to the extent that skin is evident and sparse amount of hair is present or completely absent. Hair loss usually develops gradually and may be patchy or diffuse (all over)
Who get Alopecia?
-----------------------
Hair loss is experienced by both men and women, young or old.
------------------------------------
What is Alopecia(Hair Loss)?
-----------------------------------
Alopecia or Hair Loss is the partial or complete loss of hair in the scalp, armpit or other areas of the body to the extent that skin is evident and sparse amount of hair is present or completely absent. Hair loss usually develops gradually and may be patchy or diffuse (all over)
Who get Alopecia?
-----------------------
Hair loss is experienced by both men and women, young or old.
The most common type of hair loss is called
1.male pattern baldness or androgenetic alopecia.
Its causes have been linked to genes, hormones and age.
Other types of hair loss are:
2. an auto-immune condition known as patchy hair loss (alopecia areata),
3.temporary hair loss (telogen effluvium),
4.compulsive hair pulling (trichotillomania) and
5.traction alopecia.
What is the cause of Alopecia?
-------------------------------------
The hair is made up of keratin, the same protein that is found in nails and the outer layer of our skin. The average adult has more than 100,000 strands of hair on his scalp.
What is the cause of Alopecia?
-------------------------------------
The hair is made up of keratin, the same protein that is found in nails and the outer layer of our skin. The average adult has more than 100,000 strands of hair on his scalp.
It is normal to lose about 50 to 100 strands every day.
Old strands of hair are shed so that new ones can grow out of the hair follicles.
However, various factors can lead to sudden or excessive shedding such as:
1.genes(Male pattern baldness, Congenital),
1.genes(Male pattern baldness, Congenital),
Genetic baldness is caused by the body's failure to produce new hairs and not by excessive hair loss.
Some women also develop a particular pattern of hair loss due to genetics, age, and male hormones that tend to increase in women after menopause.
The pattern is different from that of men. Female pattern baldness involves a thinning throughout the scalp while the frontal hairline generally remains intact.
Congenital Alopecia occurs in a new born who does not develop any more hairs.
2.hormones(excessive DHT or dihydrotestosterone)
Androgens appear to play a role in male pattern baldness. These very same hormones trigger the growth of hair in the pubic, underarm and facial areas at puberty. People with male pattern baldness may have the same male hormone levels as normal people, but these hormones seem to accumulate in certain areas of their scalp and cause the hair follicles there to regress.
Women are protected from male pattern baldness because they produce less androgens, and because their female hormones, estrogen can counter the effect of their male hormones. However, women who produce excess androgens may have male pattern baldness.
Women are protected from male pattern baldness because they produce less androgens, and because their female hormones, estrogen can counter the effect of their male hormones. However, women who produce excess androgens may have male pattern baldness.
Other hormones, such as those from your thyroid glands, can also affect your hair.
Too much or too little hormones from your thyroid gland can cause hair loss.
3.stress,
Sudden emotional stress can also trigger patchy baldness (alopecia areata) or temporary hair loss (telogen effluvium). Temporary hair loss may also be triggered by the stress of giving birth or losing a loved one.
4. Medical conditions
Some medicines, such as blood thinners (anti-coagulants), birth control pills, anti-depressants, anti-thyroid drugs or drugs used in chemotherapy, may cause hair loss.
5.Improper hair care
Having a hairstyle that exerts too much pull(traction) on the scalp can cause your hair to turn brittle and break. Hair breakage can also be caused by over-shampooing and the excessive use of chemical treatments such as dyes, tints, bleaches, and permanent waves.
6.Burns - Excessive heat damages the cells of the skin including the hair roots.
7.Infectious diseases such as syphilis and fungal infection can cause damage to the hair roots.
What are the Signs and Symptoms of Alopecia?
-------------------------------------------------------
Male pattern baldness (or androgenetic alopecia) accounts for the majority of all hair losses. This is the most common type of baldness in men, especially older men.
-------------------------------------------------------
Male pattern baldness (or androgenetic alopecia) accounts for the majority of all hair losses. This is the most common type of baldness in men, especially older men.
It can also occur in some women, though the instances are rare.
Hair loss is usually gradual.
The hair loss pattern differs between the sexes.
In men, the hair loss usually starts with a receding hairline.
In women, there is a diffuse thinning of the crown.
Male pattern baldness in women is usually not as severe.
Besides male pattern baldness, there are various other types of hair loss.
Patchy baldness (alopecia areata): Here a few bald patches suddenly appear.
Emotional stress(eg examinations) appears to be a triggering factor.
This condition can progress to more serious forms in which all the scalp and body hair may be lost (alopecia totalis).
Temporary hair loss (telogen effluvium): Here clumps of hair begin to fall out suddenly over a few days. It can be caused by severe stress, childbirth, severe illnesses, surgery and some medications. As its name implies, its effect is usually temporary.
Recovery though may take a year or longer depending on the cause.
Compulsive hair pulling (trichotillomania): This causes hair breakage and usually leaves the scalp undamaged. It usually affects children and women and has been linked to a psychological cause.
Traction alopecia: This is hair loss caused by certain hairstyles such as ponytails, buns or braids that pull excessively on the hair.
What tests can be done in Alopecia?
-------------------------------------------
1.Microscopic examination of a plucked hair
-------------------------------------------
1.Microscopic examination of a plucked hair
2.Skin biopsy (if skin changes are present)
Ringworm on the scalp may require the use of an oral drug, such as griseofulvin, because creams and lotions applied to the affected area may not get into the hair follicles to kill the fungus.
What is the Treatment and Prevention of Alopecia?
--------------------------------------------------------------
It is important to determine the underlying cause before treatment.
What is the Treatment and Prevention of Alopecia?
--------------------------------------------------------------
It is important to determine the underlying cause before treatment.
Most of the conditions are temporary and can be resolved once the underlying cause such as stress is removed.
However, male pattern baldness may have a permanent effect.
There has been some medical progress in helping these people regain their hair.
Two medications Finasteride and Minoxidil work by stimulating the regrowth of hair in hair follicles.
1.Finasteride counteracts the effects of the male hormone testosterone. It is available only by prescription and is taken orally. It is approved for use only in men and is not recommended in women because of its link to birth defects. Finasteride takes a few months to show its effect.
2.Minoxidil is available over the counter. . It is applied on the scalp and works by reversing the regression of hair follicles caused by hormones.It takes a few months before any effect can be seen.
2.Minoxidil is available over the counter. . It is applied on the scalp and works by reversing the regression of hair follicles caused by hormones.It takes a few months before any effect can be seen.
Alopecia areata is sometimes treated by steroid injections into the affected scalp areas while any underlying scalp problems such as tinea capitis (fungal infection) should be treated accordingly.
Causes of telogen effluvium should be addressed and given professional guidance by psychiatrist if necessary. Those due to childbirth should recover spontaneously within a year.
Hair loss from menopause or childbirth often returns to normal 6 months to 2 years later.
Hair loss from menopause or childbirth often returns to normal 6 months to 2 years later.
For hair loss caused by illness (such as fever), radiation therapy, or medication use, no treatment is necessary. The hair will usually grow back when the illness has ended or the therapy is finished. A wig, hat, or other covering may be desired until the hair grows back.
For hair loss due to heredity, age, and hormones, the topical medication minoxidil can be helpful for both male and female pattern baldness. You may need to wait 6 months before you see results.
The oral medication Propecia (finasteride) is effective in some men. This medicine can decrease sex drive.
When either medication is stopped, the former baldness pattern returns.
Hair transplants performed by a physician is a surgical approach to transferring growing hair from one part of the head to another. It is somewhat painful and expensive, but usually permanent.
Hair weaves, hair pieces, or changes of hair style may disguise hair loss. This is generally the least expensive and safest approach to hair loss. Hair pieces should not be sutured to the scalp because of the risk of scars and infection.
Thursday, August 30, 2007
A Simple Guide to Psoriasis
A Simple Guide to Psoriasis
---------------------------------
What is Psoriasis?
---------------------
Psoriasis is a disorder of the skin which typically consists of red patches covered by silvery-white scales especially around the trunk, elbows, knees and scalp.
What are the types of Psoriasis?
--------------------------------------
There are five types, each with unique signs and symptoms.
1.Plaque psoriasis is the most common type of psoriasis.
About 80% of people who develop psoriasis have plaque psoriasis, which appears as patches of raised, reddish skin covered by silvery-white scale.
These patches, or plaques, frequently form on the elbows, knees, lower back,and scalp.
2.guttate psoriasis (small, red spots on the skin),
3.pustular psoriasis (white pustules surrounded by red skin),
4.inverse psoriasis (smooth, red lesions form in skin folds)
5.erythrodermic psoriasis (widespread redness, severe itching, and pain).
Who Gets Psoriasis?
-----------------------
Psoriasis occurs about equally in males and females.
Recent studies show that there may be an ethnic link.
It seems that psoriasis is most common in Caucasians and slightly less common in African Americans.
Worldwide, psoriasis is most common in Scandinavia and other parts of northern Europe.
It appears to be far less common among Asians and is rare in Native Americans.
There also is a genetic component associated with psoriasis.
About one-third of people who develop psoriasis have at least one family member with the condition.
Research shows that the signs and symptoms of psoriasis usually appear between 15 and 35 years of age.
About 75% develop psoriasis before age 40.
However, it is possible to develop psoriasis at any age. After age 40, a peak onset period occurs between 50 and 60 years of age.
About 1 in 10 people develop psoriasis during childhood, and psoriasis can begin in infancy.
The earlier the psoriasis appears, the more likely it is to be widespread and recurrent.
What causes Psoriasis?
---------------------------
Its exact cause is unknown but the result is skin which grows about seven times more quickly and thicker than usual.
It is thought to be due, at least in part, to an abnormal immune reaction against some component of the skin.
Genetic factors play a part.
About half those affected know of someone else in the family with it.
The rash often seems to start after some sort of trigger. This may be emotional stress, skin injury (cuts and scratches for example), a streptococcal sore throat, hormones (it often occurs at puberty), or rarely, certain medications.
Psoriasis is not contagious.
What are the symptoms of Psoriasis?
--------------------------------------------
Itchy, raised patches of dark pink skin.
White scales on the scalp, knees, elbows and upper body.
Pitting, discolouring and thickening of the fingernails and toenails.
Red, scaly and cracked skin on the palms of the hands or on the soles of the feet.
There may be fluid oozing out of the cracks and movement may become very painful. The itching and discomfort may keep a person awake at night, and the pain can make everyday tasks difficult.
How does Psoriasis affects the Patient?
-----------------------------------------
All types of psoriasis, ranging from mild to severe, can affect a person’s quality of life.
Living with this lifelong condition can be physically and emotionally challenging.
Itching, soreness, and cracked and bleeding skin are common.
Nail psoriasis can be painful.
Even the simple act of squeezing a tube of toothpaste can hurt.
Several studies have shown that people often feel frustrated.
In some cases, psoriasis limits activities and makes it difficult to perform job responsibilities.
Studies also have shown that stress, anxiety, loneliness, and low self-esteem are part of daily life for people living with psoriasis.
It has been that thoughts of suicide are three times higher for psoriatics than the normal person.
Embarrassment is another common feeling.
What if you extended your hand to someone and the person recoiled?
How would you feel if you spent most of your life trying to hide your skin?
What is the Treatment of Psoriasis?
------------------------------------------
Psoriasis is a chronic, meaning lifelong, condition because there is currently no cure. People often experience flares and remissions throughout their life.
Controlling the signs and symptoms typically requires lifelong therapy.
Treatment depends on the severity and type of psoriasis.
Some psoriasis is so mild that the person is unaware of the condition.
A few develop such severe psoriasis that lesions cover most of the body and hospitalization is required. These represent the extremes. Most cases of psoriasis fall somewhere in between.
Topical medications (such as steroid and tar lotions, ointments, creams, and shampoo)
Photo therapy (either ultraviolet B, or UV, radiation or psoralen with ultraviolet A, or PU VA, radiation)
Systemic therapy (oral drugs that affect the whole body system, not just the skin e.g. cyclosporins, methotrexate)
Combinations are often used. These treatments are often given in the order described -- from least to most potent -- as necessary, although the physician may choose a more powerful therapy or use combinations first if the patient's initial condition is severe.
With the emergence of several new therapies, including the biologic agents, more people are experiencing substantial improvements and reporting a greatly improved quality of life.
---------------------------------
What is Psoriasis?
---------------------
Psoriasis is a disorder of the skin which typically consists of red patches covered by silvery-white scales especially around the trunk, elbows, knees and scalp.
What are the types of Psoriasis?
--------------------------------------
There are five types, each with unique signs and symptoms.
1.Plaque psoriasis is the most common type of psoriasis.
About 80% of people who develop psoriasis have plaque psoriasis, which appears as patches of raised, reddish skin covered by silvery-white scale.
These patches, or plaques, frequently form on the elbows, knees, lower back,and scalp.
2.guttate psoriasis (small, red spots on the skin),
3.pustular psoriasis (white pustules surrounded by red skin),
4.inverse psoriasis (smooth, red lesions form in skin folds)
5.erythrodermic psoriasis (widespread redness, severe itching, and pain).
Who Gets Psoriasis?
-----------------------
Psoriasis occurs about equally in males and females.
Recent studies show that there may be an ethnic link.
It seems that psoriasis is most common in Caucasians and slightly less common in African Americans.
Worldwide, psoriasis is most common in Scandinavia and other parts of northern Europe.
It appears to be far less common among Asians and is rare in Native Americans.
There also is a genetic component associated with psoriasis.
About one-third of people who develop psoriasis have at least one family member with the condition.
Research shows that the signs and symptoms of psoriasis usually appear between 15 and 35 years of age.
About 75% develop psoriasis before age 40.
However, it is possible to develop psoriasis at any age. After age 40, a peak onset period occurs between 50 and 60 years of age.
About 1 in 10 people develop psoriasis during childhood, and psoriasis can begin in infancy.
The earlier the psoriasis appears, the more likely it is to be widespread and recurrent.
What causes Psoriasis?
---------------------------
Its exact cause is unknown but the result is skin which grows about seven times more quickly and thicker than usual.
It is thought to be due, at least in part, to an abnormal immune reaction against some component of the skin.
Genetic factors play a part.
About half those affected know of someone else in the family with it.
The rash often seems to start after some sort of trigger. This may be emotional stress, skin injury (cuts and scratches for example), a streptococcal sore throat, hormones (it often occurs at puberty), or rarely, certain medications.
Psoriasis is not contagious.
What are the symptoms of Psoriasis?
--------------------------------------------
Itchy, raised patches of dark pink skin.
White scales on the scalp, knees, elbows and upper body.
Pitting, discolouring and thickening of the fingernails and toenails.
Red, scaly and cracked skin on the palms of the hands or on the soles of the feet.
There may be fluid oozing out of the cracks and movement may become very painful. The itching and discomfort may keep a person awake at night, and the pain can make everyday tasks difficult.
How does Psoriasis affects the Patient?
-----------------------------------------
All types of psoriasis, ranging from mild to severe, can affect a person’s quality of life.
Living with this lifelong condition can be physically and emotionally challenging.
Itching, soreness, and cracked and bleeding skin are common.
Nail psoriasis can be painful.
Even the simple act of squeezing a tube of toothpaste can hurt.
Several studies have shown that people often feel frustrated.
In some cases, psoriasis limits activities and makes it difficult to perform job responsibilities.
Studies also have shown that stress, anxiety, loneliness, and low self-esteem are part of daily life for people living with psoriasis.
It has been that thoughts of suicide are three times higher for psoriatics than the normal person.
Embarrassment is another common feeling.
What if you extended your hand to someone and the person recoiled?
How would you feel if you spent most of your life trying to hide your skin?
What is the Treatment of Psoriasis?
------------------------------------------
Psoriasis is a chronic, meaning lifelong, condition because there is currently no cure. People often experience flares and remissions throughout their life.
Controlling the signs and symptoms typically requires lifelong therapy.
Treatment depends on the severity and type of psoriasis.
Some psoriasis is so mild that the person is unaware of the condition.
A few develop such severe psoriasis that lesions cover most of the body and hospitalization is required. These represent the extremes. Most cases of psoriasis fall somewhere in between.
Topical medications (such as steroid and tar lotions, ointments, creams, and shampoo)
Photo therapy (either ultraviolet B, or UV, radiation or psoralen with ultraviolet A, or PU VA, radiation)
Systemic therapy (oral drugs that affect the whole body system, not just the skin e.g. cyclosporins, methotrexate)
Combinations are often used. These treatments are often given in the order described -- from least to most potent -- as necessary, although the physician may choose a more powerful therapy or use combinations first if the patient's initial condition is severe.
With the emergence of several new therapies, including the biologic agents, more people are experiencing substantial improvements and reporting a greatly improved quality of life.
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