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PSORIASIS Psoriasis is a chronic skin disease that in its most common form is characterized by inflamed skin lesions topped with silvery white scales. Psoriasis lesions can be painful and itchy and can crack and bleed. Normal skin cells mature in about 28 to 30 days but a Psoriatic cell matures in only two to three days. These cells "heap up" to form scaly lesions. The exact cause of psoriasis is still unknown although most scientists believe some type of stimuli activates the immune system to trigger the abnormally fast growth of skin cells. Scientists also believe that heredity plays a role in who develops psoriasis, but even people without a family history have developed this skin disease. There is no true test to diagnose psoriasis, but a dermatologist can usually determine whether a patient has psoriasis by examining the skin. Occasionally, it is necessary to do a skin biopsy. Unfortunately, there is no cure for psoriasis. There are many treatments which provide relief for extended periods of time and some people have been known to go into spontaneous remission. Dermatologists must often experiment with different drug combinations to find a treatment plan for each individual patient. RASHES Eczema/Atopic Dermatitis often starts as red, blistering or oozing skin, turning later to brownish, scaly or thickened skin. Eczema almost always itches intensely. Allergies can be one of the triggers of this inflammation. It is often seen in that "allergic" group of diseases labeled atopic – which includes hay fever, asthma, and atopic dermatitis. The itchy symptom of eczema is the major feature of atopic dermatitis. Characteristically, the intense scratching of that itch brings out the eczema – "the itch that rashes." 40 to 60 percent of eczema patients also have respiratory allergies. While some allergens, such as dust mites, pollen, and pet dander can trigger eczema flare-ups, they do not actually cause it. Rarely, in maybe 10 percent of the cases, certain foods have been thought to actually cause eczema in infants and young children, but eliminating those foods seldom cures the condition or even brings about lasting improvement. Ninety percent of patients develop eczema before age 5, but it is not uncommon in adolescence and adulthood. Many infants with eczema improve by age 2, and about 40 percent of patients outgrow the disorder by the time they are young adults. However, about 50 percent of patients are affected throughout life, although not as severely as during early childhood. Eczema is difficult to treat and often requires cooperation with your dermatologist to find the causes of the reaction. See your dermatologist for advice on avoiding irritating factors in lotions, tight, rough or woolen clothes, activity that causes sweating, and proper bathing and moisturizing. Internal medicines like antihistamines can sometimes help patients with the itch of eczema. Your dermatologist can often prescribe external medications such as cortisone creams or lotions to soothe the itching. There is a new class of drugs called immunomodulators (TIMs)that are showing promise in treating moderately severe eczema. Ultraviolet light treatments can also be prescribed by your dermatologists for severe cases of eczema. Seborrheic Dermatitis is a common skin disorder characterized by a red, scaly, itchy rash in various locations on the body. The most common sites are the scalp, sides of the nose, eyebrows, eyelids and the skin behind the ears and the middle of the chest. Seborrheic dermatitis can also affect the groin and buttocks, skin folds under the arms and the navel. Seborrheic dermatitis is similar to dandruff except along with itchy, scaling, flaking skin, it is also accompanied by a noticeable redness of the skin. Seborrheic dermatitis is often seen in conjunction with other illnesses such as Parkinson's disease or patients recovering from stressful medical conditions such as heart attack or stroke. People living in nursing homes or with immune disorders appear to be more likely to attract this disorder. There is no known cure for Seborrheic dermatitis, however it can be effectively treated by your dermatologist with prescription shampoos and low strength costeriod cream or lotion. Herpes Simplex Virus (HSV) can cause blisters and sores almost anywhere on the body. These blisters occur mostly around the mouth or nose, the genitals and buttocks. There are two types of HSV, Type 1 and Type 2. Type 1 infections are characterized by cold sores usually around the mouth, lips, nose, cheeks or chin. Most people with Type 1 are infected in childhood by close contact with a friend or relative with the infection. It can be transferred from person to person by kissing, sharing eating utensils or beverage containers or by sharing towels. Type 2 virus causes blisters and painful sores in the genital area. Sexual contact with an infected person is the primary way to get Type 2 virus. 20 percent of sexually active persons have Type 2 herpes. Type 1 is often referred to as cold sores or fever blisters. They are tiny, fluid filled blisters on the lips and skin. These sores usually appear two to 20 days from infection and heal completely, rarely leaving a scar. However, the virus that caused the infection remains in the body moving to nerve cells where it stays in a resting state. Type 2 viral infection usually results in sores on the vagina, cervix, penis or buttocks. These sores usually have a primary attack within two to 20 days after sexual contact with an infected person. Repeated attacks, as well as the primary attack are characterized by itching, fever, aching muscles, a minor rash or a burning sensation while urinating. Type 2 and Type 1 viral outbreaks can vary in both location and frequency. After the initial attack the virus moves to rest in nerve cells until it is set off again by such irritants as sun exposure, menstrual period, fever, stress or something else. Somewhere between 200,000 and 500,000 people are infected yearly with Type 2 herpes. There is no known cure for either Type 1 or Type 2 virus, however there are various clinical trials experimenting with reducing or eliminating outbreaks. Your dermatologist can prescribe oral antiviral medications such as acyclovir or valocyclovir to treat an outbreak or to suppress an outbreak. Low doses can be helpful in reducing the number of reoccurrences in people who suffer from frequent attacks. Herpes Zoster (Shingles)is a viral infection caused by the same virus that causes chicken pox. People with a weakened immune system are more likely to develop Herpes Zoster. The first symptom of this virus is burning pain, followed within three days by a red rash that soon turns to blisters. These blisters often resemble chicken pox, except they are generally limited to one side of the body. These blisters often start out looking like clear blisters but often turn a dark blood color or to pus before scabbing over and disappearing. Severe pain accompanies these blisters and is sometimes present even without the blisters, sometimes for months after the blisters are healed. These blisters most often occur on the trunk and buttocks area and are only contagious to those who were never infected with chicken pox. There are many oral and external treatments for this viral infection if diagnosed early. Consult your dermatologist immediately upon finding the first symptom to avoid unnecessary suffering and pain. Scabies are tiny mites that cause an allergic reaction in humans creating intense itching. The adult female mite burrows into the skin laying its eggs and leaving some bodily secretions. Sometimes it takes up to a month from infection for the reaction and the itching to begin. The first symptoms of scabies are small red bumps like hives that show up usually at night. As the conditions advances, these bumps can become scaly or crusty. Secondary bacterial infection can also accompany scabies as the itching sometimes causes lesions that become infected. Scabies are now easily treatable with a variety of methods prescribed for you by your dermatologist, however it is necessary to treat everyone who has come in contact whether they show symptoms or not. It is equally important to wash or treat all personal items to completely eradicate mite infestation. Pityriasis Rosea is a rash that lasts from several weeks to several months. It often begins as a large pink patch somewhere on the torso. This "mother" or "herald" patch may be scaly and look similar to ring worm. Within weeks of the mother patch, many more pink patches develop occur including patches on the arms and legs. Many patients experience itching especially when they are overheated. Sometimes tiredness and aching accompany the initial rash. This disease does not appear to be contagious, although no one is really sure of how it is transmitted. Treatment includes both internal and external medications for itching and for more severe cases sometimes ultraviolet light treatments are prescribed. Lichen Planus is a common skin disease that affects about one percent of the population at large. It is an inflammatory disease that most commonly affects the skin or the mouth and sometimes both. The cause of this disease is not known, however it is not an infectious disease and cannot be transmitted from person to person. Most cases go away within two years, however they can be very itchy and uncomfortable. Even though there is no known cure, dermatologists are able to provide relief from both the itching and the appearance of these small flat topped red bumps. Oral Lichen Planus is more difficult to treat and lasts longer than lichen planus of the skin. It is characterized by sores or ulcers in the mouth and on the tongue. Symptoms are treatable with both oral and topical medications prescribed by your dermatologist. HIVES Hives are pink swellings called "wheals" occurring in groups on any part of the body. These wheals generally last a few hours and leave no evidence as they fade away. However, new areas will often reappear as the old ones fade. Hives are most often itchy, but they can also sting or burn. Hives are formed when blood plasma leaks through tiny gaps between cells that line the small blood vessels in the skin. Histamine, a natural chemical is released causing these reactions, however it's not always possible to find the reason for the release of histamine and the formation of hives. The most common causes of hives are foods, drugs or infections. Hives can also be caused by physical stimuli such as pressure, sunlight, cold or heat. Other causes are insect bites or internal disease. The most common foods causing histamine reactions leading to hives are nuts, milk, chocolate, tomatoes, fish, eggs, and fresh berries. People can have allergic reactions to almost every prescription drug or over the counter medications. Antibiotics (especially Penicillin), pain medications, sedatives, tranquilizers, and diuretics are likely to cause hives in some individuals. Hives can be treated in most cases with a simple antihistamine, however it is most important to find the cause of the hives. No one histamine works for every patient so your doctor may need to try several before finding one or a combination that works best for you. In severe cases, your dermatologist will prescribe an injection of epinephrine (adrenalin) or a cortisone preparation.