Latest news with #dermatologist
Medscape
2 days ago
- Health
- Medscape
Ice Relieves Itch? Think Beyond the Skin
Intense itching of the upper arms following sun exposure is often dismissed as a harmless skin reaction. However, this may indicate a neuropathic condition. Brachioradial pruritus (BRP) is a rare and frequently overlooked cause of pruritus, typically localised to the arms and triggered by ultraviolet (UV) radiation in patients with underlying radiculopathy. BRP is a subtype of neuropathic pruritus that occurs most often in fair-skinned women. The Patient and His History A 41-year-old White woman with a past medical history of generalised anxiety disorder and sunburns presented to her general physician (GP) with complaints of sunburn to the bilateral arms, pins and needles, and extreme itching sensation in the bilateral upper arms. The patient reported that the rash worsened with heat and improved with ice. She also endorsed changes in colour to the rash, hot to touch, tender, mild swelling, and significant nighttime awakening related to the pain associated with the rash. Earlier treatments with lotions, over-the-counter cortisone cream, and oral Benadryl failed. Only ice application provided brief relief. Findings and Diagnosis The patient's vital signs were stable. Physical examination revealed dark erythema on the sunburned areas of the bilateral upper arms and an atypical skin rash. She was referred for both dermatological and neurologic evaluations. The dermatologist performed a punch biopsy and allergy test, which showed a nickel allergy. The biopsy report showed sparse lymphohistiocytic, superficial, perivascular inflammatory cell infiltrates; features were non-specific, with suggestions that they may be seen in some drug or viral exanthems, gyrate erythema, urticaria, tumid lupus erythematosus, pigmented purpuric dermatosis, and post-inflammatory pigmentary alteration. The neurologist recommended an MRI of the cervical spine that was normal. The patient was diagnosed with abnormal skin changes and sensory disturbance in the right lateral upper arm with a C5 dermatomal distribution, with recommendations to have dermatology refill topical pain medication (gabapentin 6%, ketamine 4%, and lidocaine 3% cream) and have the GP titrate up the gabapentin dose. Based on the overall clinical picture and through exclusion of other causes, the GP diagnosed BRP. The treatment involved a topical formulation containing gabapentin, ketamine, and lidocaine, with oral gabapentin for neuropathic pain. Within 1 month of initiating therapy, the patient experienced marked improvement in both the rash and associated symptoms. Discussion The aetiology of BRP is unknown. It has been attributed to prolonged solar radiation exposure in the summer months, exacerbating underlying cervical spine issues, and is associated with cervical nerve root injury in the setting of osteoarthritis or trauma, resulting in the compression of the nerve root. Multiple studies have found that BRP is associated with cervical radiculopathy in approximately 57% of patients. The itch and rash associated with BRP are mostly located on the dorsolateral aspect of sun-exposed forearms and are exacerbated by sun exposure. In 75% of cases, both arms were involved. Other neuropathic conditions, such as notalgia paresthetica, similarly involve spinal abnormalities with dermatomal localisation of itching. One theory proposes that UV radiation damages peripheral nerve endings and may also lead to neuropathic BRP in individuals predisposed to cervical spinal disease. Most patients describe itch as picking, prickling, burning, or plain itch involving the unilateral or bilateral dorsolateral forearms, which are neuropathic features, suggesting that BRP can be associated with a neurogenic origin. Patients with BRP report that the application of ice packs provides relief from itching. This is called the ice-pack sign, a key diagnostic indicator of BRP, which is pathognomonic for BRP. This sign was evident in the present case, with itching worsening upon exposure to sunlight and being relieved when ice packs were placed on her forearms bilaterally. Treatment for BRP has been difficult, but some reported treatments include oral gabapentin, topical capsaicin, oral carbamazepine, cervical spine manipulation, neck traction, physiotherapy, anti-inflammatory medications, surgical resection of the cervical ribs, and sunlight avoidance. In this patient, symptoms improved significantly within 1 month following treatment with oral gabapentin and a topical containing gabapentin, ketamine, and lidocaine. Early recognition and diagnosis of BRP by taking a thorough history and physical examination and the utilisation of the ice-pack test are critical for prompt management and avoiding unnecessary workup. Thorough history taking, focused physical examination, and use of the ice-pack test are critical diagnostic steps. In patients presenting with sunburn to the bilateral arms, pins and needle sensation, extreme itching sensation in the bilateral upper arms, neuropathic dysesthesia of the dorsolateral upper extremities, a visible rash, and stating improvement of pruritus with cold compresses, BRP should be considered as a top differential.
Health Line
2 days ago
- Health
- Health Line
What's the Difference Between Seborrheic Keratosis and Actinic Keratosis?
Actinic keratosis and seborrheic keratosis are two skin conditions that often show up around middle age. Since actinic keratosis lesions can become cancerous, it's best to get prompt treatment. Keratosis refers to an overgrowth of the protein keratin in the skin. This excess keratin can appear in skin lesions that resemble patches, warts, or moles. These two conditions may have similar names, but there's one major difference between the two: Actinic keratosis can become cancerous, while seborrheic keratosis cannot. This makes it important to know how to tell these lesions apart. If you have a hard time recognizing the difference between the two, here's a quick rundown: Actinic keratosis lesions often appear as rough, scaly patches that may show up in clusters. You'll often notice these patches in areas that get a lot of sun exposure, like your arms, hands, or face. Seborrheic keratosis tends to show up as a single lesion. These growths tend to be small, oval, thick, and raised. They can have a mole- or wart-like appearance. Learn more about these two conditions, along with a few key signs you may want to connect with a dermatologist for diagnosis and treatment. Actinic keratosis Since actinic keratosis is considered precancerous, it's important to identify and treat it. Signs and symptoms Actinic keratosis lesions: may appear as thick, rough, or crusty patches; sometimes, you might feel the change in skin texture rather than see it are usually smaller than 2 centimeters (cm) often appear on body parts that get a lot of sun (like your face, neck, scalp, arms, or hands) often appear as the same color as surrounding skin, if you have darker skin may appear pink on lighter skin, or have a tan, brown or gray hue might burn or itch may show up as a horn-like growth can appear as scaly or colorless patches on your lips Causes Actinic keratosis usually develops as a result of sun exposure over time. Your chances of developing this skin condition increase if you: are 50 or older have light skin and eyes tend to sunburn easily have a history of frequent sun exposure or tanning bed use have a weakened immune system Treatment options In the early stages, actinic keratosis is very treatable. Your options for treatment include: Electrocauterization: Electrocauterization involves burning the lesion with an electric current, which kills the affected skin cells. Cryotherapy: Also called cryosurgery, this treatment involves applying a solution like liquid nitrogen to the affected area. This process freezes and kills the cells so the lesion scabs and falls off. Curettage: This procedure involves scraping off the growth with a curette (a specialized surgical instrument). A dermatologist may recommend this in combination with electrosurgery. Chemical peels: A dermatologist may apply a medical-grade chemical peel in-office to help remove the top layers of affected skin. Topical medical therapy: Treatments like 5-fluorouracil can inflame and destroy the lesions. Photodynamic therapy: This treatment involves the application of a photosensitive prescription medication solution (such as aminolevulinic acid) to the affected area. A dermatologist will then direct a red or blue laser light over the treated area to help destroy the actinic keratosis cells. Seborrheic keratosis These skin lesions are the most common form of benign lesion. If you notice them on your body, you might think they're just another mole or wart. In some cases, though, they can resemble precancerous or cancerous growths, such as melanoma. Here's how to recognize this type of skin growth. Signs and symptoms Seborrheic keratosis lesions: may appear as round or oval-shaped, slightly raised growths may seem 'stuck on' to your skin often have a waxy or scale-like texture generally show up on the face, chest, back, stomach, or shoulders typically won't appear on the palms of your hands or the soles of your feet often grow larger and thicker over time and can reach about 1 inch in diameter often appear brown, black, white, or tan on light or dark skin may cause itchiness or irritation, though these lesions usually aren't painful Causes Researchers still don't know exactly what causes seborrheic keratoses. The lesions don't seem to be viral, bacterial, or contagious. That said, the following risk factors may increase your chances of developing these growths: Age: Seborrheic keratosis is uncommon in people under age 20. It often shows up in middle age, and more lesions may appear as you get older. Family history: They seems to run in families — the more relatives you have with these lesions, the more likely you may develop them yourself. Pregnancy or hormone therapy: Seborrheic keratoses may appear during pregnancy or estrogen replacement therapy. Frequent sun exposure: Some evidence suggests these lesions may appear more often on sun-exposed skin, but they can also develop on skin not regularly exposed to sun. Lighter skin: These lesions more commonly affect people with lighter skin, but it's possible to still get them if you have darker skin. Treatment options Seborrheic keratosis often doesn't require treatment. But if you dislike the way your lesion looks or feels, you can always speak with a dermatologist or other doctor about removal. If your lesion is actually a precancerous or cancerous growth, you'll need to have it removed. Your healthcare professional may recommend one of these procedures: Cryosurgery Electrosurgery and curettage Shave excision: Your dermatologist may shave off a sample of the growth to send it to a lab for analysis. Ablation: This procedure involves using a specialized laser to vaporize the growth. Nitric acid-zinc solution: This treatment involves using a topical solution called nitrizinc complex. Emerging evidence suggests this treatment can safely shrink or totally eliminate the lesion, often within about 6 months. When to get medical help Any time your skin changes unexpectedly or you're concerned about a lesion, a good next step involves getting an assessment from a dermatologist or other medical professional. Since actinic keratosis can sometimes turn into skin cancer, being vigilant about check-ups can help you lower your risk of skin cancer. And even though seborrheic keratosis may not pose any danger to your health, it never hurts to have a professional confirm that your skin growth isn't cancerous. As a general rule, you'll want to have a healthcare professional inspect your skin if: You have a new growth. The appearance of an existing growth changes. A growth appears purple, blue or reddish or changes colors. A growth has blurred or irregular borders. A growth irritates you, bleeds, or causes pain. Prevention tips Frequent sun exposure can increase your chances of skin cancer, but these tips can help lower your risk: Wear sunscreen every day — rain or shine, indoors or out. Opt for sunscreen that has a SPF rating of at least 30, with broad spectrum protection to block both UVA and UVB rays. Avoid tanning beds. Avoid spending time outside between 10 a.m. and 4 p.m. UV rays are strongest in the middle of the day. Protect your skin from UV rays by wearing hats, long sleeves, and pants. Bottom line Both actinic keratosis and seborrheic keratosis are skin conditions that show up as growths. Since actinic keratosis lesions can potentially become cancerous, it helps to know how to tell the difference between the two. Seborrheic keratosis are raised lesions that tend to have a round or oval shape, while actinic keratosis typically shows up as dry patches in areas of skin that get frequent sun exposure.
Yahoo
4 days ago
- Climate
- Yahoo
6 hot weather health mistakes a doctor wants you to stop making
When the sunshine makes a rare appearance in our typically grey country, there's no better feeling than heading out into the heat to bask in the glorious weather. But with parts of the UK set to enjoy a mini heatwave this week, with some regions reaching a toasty 29 degrees, it's never been more important to stay sun safe. From applying your SPF haphazardly to going too hard with your training, there's a plethora of hot weather mistakes Brits commonly make in the summer months. Keen to avoid them? Here's what a doctor wants you to know ahead of this weekend's mini heatwave. When you've got plans to throw a towel down in the park, it's tempting to rush out of the house and apply your sunscreen once you've snagged a prime picnic spot. But Doctify-rated dermatologist Dr Sweta Rai warns against this strategy. "The most common heatwave mistake I see people making is putting sunscreen on once they're out in the sun," she notes. Sunburn can occur in less than 15 minutes when you're exposed to the sun's rays, but as the tell-tale red inflammation can take hours to develop, many people don't realise their skin is at risk. "I always recommend applying suncream an hour before you leave the house and carrying a bottle in your bag so you can reapply regularly," Rai adds. Speaking of re-application, Rai says that hot weather perspiration can quickly wash away a protective layer of suncream. "If you can feel sweat forming in areas like the elbows and back, wipe the moisture away with a tissue or towel, and reapply your suncream immediately," she advises. The same goes if you're planning to swim. "If you're in water, be mindful of the fact that your suncream will only last for around 40 minutes," she adds. "You could set a timer on your phone if you're heading into the pool for a swim, and reapply your cream once the alarm goes off." If you're currently in the midst of a marathon training plan, you don't need to ditch your training sessions entirely. However, it's important to time them correctly. "You want to avoid doing outdoor exercise between 11 to 3pm when the sun is at its hottest, and the UV is at its highest," stresses Rai. Not only will this keep you safe from a potentially nasty sunburn, but exercising in the blistering sun can increase your risk of heat exhaustion too. "Most smart watches and phones have a feature that records the UV index," Rai continues. "If the meter is showing a moderate or high recording, you might want to consider taking your workout indoors, or at the very least, liberally applying a good layer of suncream." When it comes to SPF, there are some seriously exposed spots on our bodies that we often tend to forget, like our ears, eyelids and hair parting. "Many of these delicate areas project from the body, which means they're getting a lot of sun exposure when we're out and about," warns Rai."During the summer, I see lots of patients coming in with painful red burns on the tips of their ears and the backs of their necks, so it's always important to pay special attention to these areas when you're applying your suncream." Regardless of whether you're planning to hit the gym this weekend, stocking the fridge with a few sports drinks can help you to avoid dehydration when the mercury rises - which can cause headaches and nausea. These 'isotonic' drinks contain similar concentrations of salt and sugar as in the human body, helping you to replenish the electrolytes you lose in your sweat. "If you're you're outdoors in the heat and sweating a lot, then rehydrating with something more than just water might be helpful," adds Rai. Finally, it's a myth that you should be reaching for your lightest and breeziest clothing on hot days. "Wearing loose clothing is always a good idea for air flow, but when it comes to fabrics, its best to opt for those that are a slightly thicker, as these don't let the UV light filter through," explains Rai. "Denim is a surprisingly good fabric to wear in the sun as it has a thicker weave and darker colour which provides more protection from UV." Rai's bonus heatwave tip? "If you hold your clothing up against the window and can see tiny holes with light filtering through the fabric, it's probably not going to give you decent protection from sun damage," she notes. "If you want to be extra careful, some companies now produce UPF clothing that's specially designed to block out UV light. "This can be especially useful if you know you're going to be spending long periods of time in the sun and don't want to put yourself at higher risk of summer health issues." Read more about health: Will the hot weather make hay fever worse? (Yahoo Life UK, 5-min read) Four ways to stay hydrated in high temperatures, according to science (Yahoo News UK, 4-min read) The 4 most important things to check on your sunscreen, according to a dermatologist (Yahoo Life UK, 5-min read)
Yahoo
5 days ago
- Health
- Yahoo
How to make your legs summer ready, according to a dermatologist
With the warmer weather comes blue skies, sunny days, vibrant blooms — and, of course, showing more skin. While summer style is all about light layers and bare skin, for those of us with dry, pasty, discolored or uneven skin (i.e. all of us?), shedding layers can bring a level of self-consciousness, if not downright panic. A first outing in shorts or a skirt can be especially daunting this time of year, as it means displaying a lot of leg. Even the most glamorous gams require at least a little extra TLC before the summer solstice arrives and, more likely, a full glow up. "Concerns that occur most commonly on legs are dry skin, eczema, psoriasis, keratosis pilaris [small, red bumps], ingrown hairs and varicose veins," says Dr. Dara Spearman, a board-certified dermatologist and the founder of Radiant Dermatology Associates. "Generally, the best way to care for leg skin is by exfoliating to get rid of dead skin and prevent ingrown hairs, [and] also using hydrating body wash and moisturizer to keep the legs looking soft and shiny." Of course, long-term leg care is not simply a surface-level affair. "[For the best-looking legs] I recommend trying to be active daily — like walking more — plus staying hydrated and protecting the skin from environmental factors like the sun," Spearman explains. "For other concerns like varicose and spider veins, elevating your legs can help prevent them from forming, and laser treatments can diminish their appearance." Read on for Spearman's top solutions for all your most pressing leg-skin concerns, but don't be afraid to strut your stuff even if your pins are not camera-ready. My advice: Give yourself a close shave, slather on some inexpensive anti-bump cream, throw on a pretty dress and enjoy the ever-fleeting joy of a warm breeze on your bare, just-fine-as-it-is skin. No one likes the look of flaky, rough-textured knees and legs, but the good news is, with consistent use, quality products can treat these issues — and treat them fast. Though these formulas are gentle, as with any new topical treatment, consult with a doctor first if you have sensitive skin, particularly if your dermatological issues are severe. The bad news is: If you want to diminish the appearance of varicose or spider veins, you'll need to head to a doctor's office. Depending on the type and severity, these can be treated with surgery or, potentially, less invasive procedures like sclerotherapy and laser ablation. However, if you're prone to varicose and spider veins, Spearman says wearing compression socks and regularly elevating your legs can help prevent future outbreaks. If you want to disguise your leg veins, high-quality self tanners can aid in blurring the blue-purple hue and make the condition look less severe. If you have Amazon Prime, you'll get free shipping, of course. Not yet a member? No problem. You can sign up for your free 30-day trial here. (And by the way, those without Prime still get free shipping on orders of $35 or more.)
News.com.au
6 days ago
- Health
- News.com.au
Winter is flaring up eczema for about a third of Aussies who suffer from the irritating skin condition
An irritating skin condition is flaring up for a third of Australians trying to keep warm this winter, made worse by heaters, woollen jumpers and long, hot showers. Eczema is a dry, itchy and inflammatory skin disease that usually begins in childhood and affects one in five children and one in 10 adults that suffer redness, scales, bumps, skin cracks, oozing fluid and crusts. Children are more likely to experience eczema because their immune system has not matured. People with a family history or from East or South Asian countries or others who suffer from hay fever or food allergies are also affected. The condition can be deadly when it is left uncontrolled and extremely inflamed, although rare. People can get serious infections from the disease, or the body can divert all of its blood away from vital organs to the skin. Dermatologist Deshan Sebaratnam told NewWire that a lot of people would notice eczema flare-ups due to the cold change in weather. 'When it is cold, there's often less humidity in the air, so your skin loses water to the air easily,' he said. 'There's also less sunlight, and sunlight dampens down the activity of the immune system in the skin and because it's cold, people aren't using their creams and moisturisers as much as they should. 'Wearing long clothes and things like wool can also be irritating on the skin, so now's a common time for eczema to flare up for a lot of Australians.' Dry air, heaters and long. hot showers that strip the body of natural oils can flare up eczema. The best way to avoid the condition is to use thick and greasy moisturisers that contain glycerine and ceramides to trap water in the skin and avoid products with fragrances, perfumes or food. 'You shouldn't be spending lots of money on your moisturisers,' Dr Sebaratnam said. 'Products from the QV ceramide range are really good or QV intensive as well. 'Funnily enough, people can use a cream their whole life, or a moisturiser or make-up, then suddenly develop allergies to a product. 'No one really knows why, but one day your immune system just decides it doesn't like it, then every time you put it on you get eczema. 'That's called contact dermatitis, and that can also make eczema worse.' Dr Sebaratnam said people with concerns about their skin should see a GP or dermatologist, a medical specialist in skin disease and health. 'No one understands your skin like a dermatologist, and they can help you know with eczema,' he said. 'It is a really itchy and uncomfortable condition that affects your sleep and has a cosmetic impact in terms of people's confidence if it is on their face. 'It can affect children's schooling, and even adults. If you're constantly scratching you can't focus at work, it affects every facet of your life.' Dr Sebaratnam said there were lots of myths about eczema. He said food rarely caused problems with the condition and steroids were a safe treatment option when supervised by a doctor.
