Daily Archives: November 23, 2019

Eczema facts

What is eczema?

Rather than a specific health condition, eczema is a reaction pattern that the skin produces in a number of diseases. It begins as red, raised tiny blisters containing a clear fluid atop red, elevated plaques. When the blisters break, the affected skin will weep and ooze. In older eczema, chronic eczema, the blisters are less prominent and the skin is thickened, elevated, and scaling. Eczema almost always is very itchy.

Are there different types of eczema? What causes and risk factors of eczema?

There are at least 11 distinct types of skin conditions that produce eczema. In order to develop a rational treatment plan, it is important to distinguish them. This is often not easy.

Eczema is a nonspecific term for many types of skin inflammation (dermatitis). There are different categories of eczema, which include allergic, contact, irritant, and nummular eczema, which can be difficult to distinguish from atopic dermatitis. These types of eczema are listed and briefly described below. Atopy is a medical syndrome that includes three associated conditions that tend to occur in the same individual: atopic dermatitis, inhalant allergies, and asthma. All three components need not be present in the same individual simultaneously.

What are eczema symptoms and signs?

Almost all patients with eczema complain of itching. Since the appearance of most types of eczema is similar, elevated plaques of red, bumpy skin, the distribution of the eruption can be of great help in distinguishing one type from another. For example, stasis dermatitis occurs most often on the lower leg while atopic dermatitis occurs in the front of the elbow and behind the knee.

What specialists treat eczema?

Eczema often is treated by family physicians, but since there are many causes of eczema, it may be necessary to seek help from a health specialist if things are not improving. Most dermatologists specialize in the diagnosis and treatment of all forms of eczema.

How do health care professionals diagnose eczema?

An accurate diagnosis requires an examination of the entire skin surface and a careful health history. It is important for a doctor to rule out curable conditions caused by infectious organisms. Occasionally, a sample of skin (biopsy) may be sent for examination in a laboratory.

What is the treatment for eczema?

The treatment of acute eczema where there is significant weeping and oozing requires repeated cycles of application of dilute solutions of vinegar or tap water often in the form of a compress followed by evaporation. This is most often conveniently performed by placing the affected body part in front of a fan after the compress. Once the acute weeping has diminished, then topical steroid (such as triamcinolone cream) applications can be an effective treatment. In extensive disease, systemic steroids may need to be utilized either orally or by an injection (shot).

What are home remedies for eczema?

Mild eczema may respond to compresses composed of tepid water followed by room air evaporation. Chronic eczema can be improved by applying water followed by an emollient (moisturizing cream or lotion). Mild eczema can be effectively treated with nonprescription 1% hydrocortisone cream.

Does diet affect eczema?

The role of diet in atopic dermatitis is controversial. There is little compelling evidence that diet plays a significant role for majority of people who have eczema, no matter which type they have.

Is there a cure for eczema?

Each type of eczema requires a specific sort of therapy. The easiest eczemas to cure permanently are those caused by fungi and scabies. Allergic contact eczema can be cured if a specific allergenic substance can be identified and avoided.

Is eczema contagious?

Eczema caused by fungi and scabies is transmissible to others. None of the other types of eczema are contagious.

What is the prognosis of eczema?

Most of the patients with eczema do quite well under the care of a dermatologist who has made an accurate diagnosis. Occasionally, eczema can become infected by microorganisms, such a staphylococci or herpes simplex virus. This is because the normal barrier function of the skin has been damaged by the inflammatory condition. In this situation, the infection could be contagious and require antibiotics treatment. An important signal would be the development of fever and pustules, plus pain at the site of the rash.

Is it possible to prevent eczema?

The judicious use of moisturizing creams or ointments can be an effective treatment for many people in preventing certain types of eczema.

Medically Reviewed on 3/15/2018

References

Wold, Lindsey, Jennifer K. Chen, and Heather P. Lampel. "Hand Dermatitis: An Allergist's Nightmare." Curr Allergy Asthma Rep 14.474 (2014): 1-9.

See the rest here:
Eczema Types, Treatment, Home Remedies & Symptoms

MIAMI (CBSMiami) Its not often television news anchors become the story, but after developing a skin condition called perioral dermatitis earlier this year and hiding it for months, CBS4s Frances Wang decided to share what was happening on social media hoping to spread awareness.

She also wanted to share it because she knew many people deal with the physical and emotional pain of skin conditions, and wanted people to know theyre not alone.

The response she received was overwhelming in the best way, she said. The more national outlets picked up her story, the more people from all over the world reached out to connect, vent, or just talk.

(Courtesy: Frances Wang)

She says sharing her story was freeing and instrumental in her healing both physically and emotionally.

Frances took some time off in October and is now happy to be back at CBS Miami.

Thanks to a support group on Facebook, she was able to connect in-person with three incredible women right here in South Florida who are undergoing similar situations.

Andi Cisneros, 28, of Kendall works in insurance. Jenny Santiago, 36, of Pembroke Pines works in the cruise line industry and has 3 children. Alona DiPaolo works for the Broward County government and has a 10-year-old son.

These three South Florida women dont know each other, but theyre all connected through the skin condition called perioral dermatitis.

In Alonas case, its her son who is suffering.

Dr. Robert Kirsner, chair of the University of Miamis Phillip Frost Department of Dermatology, calls perioral dermatitis a cousin of rosacea. The condition presents itself differently, depending on the person, but board-certified dermatologists should be able to recognize it right away.

Examples of perioral dermatitis (CBS4)

You usually get a rash. Sometimes its red bumps, sometimes its a scaly rash around the openings of the face, explained Dr. Kirsner. Its called perioral because its usually around the mouth. It can also be around the nose or the eyes and it can go on other parts of the face as well, but it usually starts [around the mouth.]

Perioral dermatitis can be caused by anything from allergies to hormones. Even household items like fluoride toothpaste have been blamed as the culprit.

The most common cause of perioral dermatitis is steroids.

Most people would link [perioral dermatitis] to steroid usage of some sort, often topical, said Dr. Kirsner. Youre giving topical steroids, which initially help, but then perpetuates the condition and makes it worse.

WATCH THE ENTIRE UNEDITED INTERVIEW WITH DR. KIRSNER

Thats exactly what happened with Alonas 10-year-old-son. Topical steroids prescribed for his eczema triggered perioral dermatitis.

In Andis case, she believes her condition was stress-induced, but does worry that Flonase, a steroid nasal spray, contributed to the problem.

I never had skin problems [growing up], but then it was rosacea, adult acne, and now this thing that wouldnt go away. I was extremely self-conscious. It just sucked, said Andi. I had a couple of weddings. Id look at myself in the mirror [and] seeing everything was really hard. I think when your face is clear, you feel prettier, you feel more productive in all aspects of your life.

Dermatologists will typically prescribe an antibiotic and some sort of topical for perioral dermatitis. For Andi, that solution worked in about 3 weeks.

I am paranoid. I dont want it to come back and if it does, I feel itll come back ten times worse, said Andi. Id rather have rosacea and acne, theyll go away [but] I feel this just wouldnt leave.

For Jenny, treatment wasnt as easy. It took a lot of trial and error, and the condition came during her pregnancy.

Anything I thought I could fix or cover it with because I was so self-conscious, thinking everyones looking at me, said Jenny. Here I was in a very healthy pregnancy with [my 3rd baby] that we wanted, and I was crying because I had spots all over my face.

Many people who suffer from perioral dermatitis estimate they spend thousands on tests and treatments, a lot of which may not be covered by insurance.

Examples of perioral dermatitis (CBS4)

Everyones I guess treatment looks different because I tried I feel like everything. I was ordering things online that [people] were recommending that they didnt sell in the states, said Jenny. I spent my maternity leave trying to get samples of what would fix it.

After Jenny had her baby, the condition went away. However, her baby boy is now suffering from eczema, and she worries she passed that along to him.

For Alona, even finding a dermatologist for her son is hard. She is about to see her sixth.

I still havent found [a dermatologist] I can trust. Im at the point where I understand why people are skeptical about the medical industry and dermatologists in South Florida, said Alona. As a parent, you want to make sure people are seeing your child for who they are and not whats wrong with his face. Its frustrating, but at the same time I know it can be something [more] terrible.

Dr. Loretta Ciraldo, a board-certified dermatologist in Aventura with more than 40 years of experience, is empathetic to Alonas frustrations.

Frankly, there are many physicians where theres more of a priority on putting in [Botox], fillers, lasering people and the medical aspect of dermatology is sometimes a little more difficult to have addressed by your doctor, said Dr. Ciraldo.

Dr. Ciraldo adds that especially with social media and the high standard of beauty in South Florida, skin disease can have a great emotional impact on people.

We can really be traumatized by it, said Dr. Ciraldo. Stress is a very big factor. The more stressed out we are by our appearance, the more delayed our clearing.

WATCH THE UNEDITED INTERVIEW WITH DR. CIRALDO

Dr. Kirsner believes the reason many people arent aware of perioral dermatitis is because its not as talked about or easily recognized as acne.

Its not as common as acne, but dermatologists see it routinely, said Dr. Kirsner. It affects peoples appearance, and they dont want to talk about it, they hide it, put makeup on, try to do a thousand different treatments.

Dr. Kirsner adds that there is still a lot more that needs to be learned about this condition.

We dont know what always causes it, said Dr. Kirsner.

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CBS4s Frances Wang Brings Awareness To Skin Condition In Order To Help Others - CBS Miami

If you walk through the aisles of any beauty retailer, like Sephora or Ulta, youll see hundreds of different products highlighting different skin care ingredients that promise to give you the smooth complexion of a baby and the radiance of a mythical goddess. There is vitamin C for brightening, CBD for calming, retinol for anti-aging, and now, theres cica for, well, almost everything.

For over 3,000 years cica has been used by herbalists and tigers to treat wounds, and in more recent years its been studied as an effective skin care ingredient to treat an array of skin conditions, such as acne and eczema, which is why its been popping up in so many skin care products. If youre still hung up on the tigers bit we just mentioned, listen up. Its been reported that tigers roll around in the natural ingredient to help treat their wounds after a fight, hence its modern nametiger grass.

To further understand what cica is and what it should be used for, we consulted a board-certified dermatologist to break it down for us.

Cica, short for Centenella asiatica, is a green plant thats been used as a medicinal herb for thousands of years, explains Dendy Engelman, M.D., a celebrity dermatologist based in New York City. Its now used as an active ingredient in cosmetic products to help target an array of skin concerns, and its suitable for even the most sensitive skin.

Studies show that with continued use, cica helps with soothing psoriasis, eczema, acne, and the effects of aging, as well as the treatment of wounds, including infections, burns, and scars. Its most well-known for its healing and antibacterial properties, making it great for skin thats more sensitive or prone to dryness, adds Dr. Engelman.

Because cica is anti-inflammatory and anti-microbial, its a great option for acne-prone skin types to keep blemishes at bay, explains Dr. Engelman. Its also a powerful ingredient for those who are recovering from acne scarring or usage of harsh acne-targeting skin products.In fact, studies show that after six months of continued use, cica helped to reduce the thickness of scars, so not only does it help to prevent acne, but it can help to heal skin thats already been affected by it.But thats not allDr. Engelman adds that because of cicas powerful properties, it also serves as a shield for the skin to help keep it moisturized and prevent aging.

We all know that certain ingredients work best on certain types of skinfor example, people with very sensitive skin dont typically react well to retinol, so they use bakuchiol insteadbut other products, like hyaluronic acid and cica, are suited for all skin types. Cica is safe for all skin types, and everyone can benefit from using it. In many ways its a universal ingredient to make the skin look more supple, glowing and moisturized, slowing the skins aging process by keeping moisture levels within the skin regulated, explains Dr. Engelman.

Below, some of our favorite skin care products with cica:

Courtesy of L'Oral Paris

If youre looking for quick results, this is the cica product for you. It takes only two weeks to see the appearance of fine lines and wrinkles improve with everyday use, and will also make skin feel plump and soft, raves Dr. Engelman. It strengthens the skin barrier by regulating moisture levels and defending skin against free radicals and other environmental agents.

Courtesy of Dr. Dennis Gross

This is a daily peel that gently exfoliates skin without stripping it of its natural oils, since as we know, stripping the skin with over-drying ingredients can make breakouts worse, says Dr. Engelman. All acne starts with a clogged pore, and this peel usesAHAswhich remove debris and dead skin that can lead to clogged poresand cica to soothe and repair irritated skin.

If youre looking for an overnight treatment that will work to calm sensitive skin, this could be the product for you. For best results, use at night two-to-three times per week, and at least five minutes after applying your favorite serums (you want to let them absorb into the skin).

Courtesy of Dr. Jart+

One of the many perks of cica is that it helps combat skin redness, and thats what this tinted treatment is formulated to do. Apply a thin layer of this green-to-beige formula to counteract redness caused by inflammation and sensitivity, but do take into account that its not a color-corrector. For a more intense result youll need to use a color-correcting concealer and/or foundation. What we love about this product is that it works as a first layer to help mask redness while treating the skin, and it has the added benefit of having an SPF 30.

Using a booster is an easy way to incorporate a new ingredient to your skincare routine without having to swap out all your products. To use, simply add a few drops into your favorite facial cream or mask, or mix it with your daily serum for extra benefits.

Formulated with vitamin B3 (known for helping skin retain moisture), madecassoside (a compound extracted from Centella asiatica), and glycerin (an effective moisturizer), this is the perfect heavy-duty facial cream for when your skin needs a little extra TLC, like during the winter when skin gets drier. Apply as needed to dry, clean skin.

Dont forget that your body needs skincare too! This cream is especially good for those with psoriasis and eczema looking for a body product. Slather it on day and night for best results.

Excerpt from:
What is cica? Everything a dermatologist wants you to know about this buzzy ingredient - Yahoo Lifestyle

Patients with moderate-to-severe atopic dermatitis may have a 20% increased risk of atrial fibrillation, suggests a study published in the Journal of the American Academy of Dermatology.1

Atrial fibrillation is common affecting 4% of individuals 60 years or older and carries with it an increased risk of stroke.2 Research has shown that inflammation is significant risk factor for developing atrial fibrillation, as patients with inflammatory disease such as rheumatoid arthritis, psoriasis or individuals with inflammatory biomarkers have been shown to be have an increased risk of atrial fibrillation.3,4

RELATED:More evidence of cardiovascular disease in atopic eczema

The authors of the study speculated that patients with atopic dermatitis might also have an increased risk for atrial fibrillation because of the presence of low-grade inflammation due to the disease and the increased prevalence of cardiovascular risk factors, such as obesity, hypertension and diabetes, among this group.5,6

To test their hypothesis, they conducted a nationwide population-based 35-year cohort study to examine whether patients in Denmark with hospital-diagnosed moderate-to-severe atopic dermatitis were at long-term increased risk of atrial fibrillation.

Using the Danish National Patient Registry (DNPR) they identified patients born in Denmark between January 1, 1947 and January 1, 1983 who had received a hospital diagnosis of atopic dermatitis from January 1, 1977 until January 1 2013 and matched each with ten individuals of the same sex and birth year. Patients were followed up until death, emigration, atrial fibrillation diagnosis or until 2013.

References:

1. Schmidt SAJ, Olsen M, Schmidt M, et al. Atopic dermatitis and risk of atrial fibrillation or flutter: a 35-year follow-up study.Journal of the American Academy of Dermatology (2019);

2. Page RL. Clinical practice. Newly diagnosed atrial fibrillation. N Engl J Med. 2004;351(23):24082416.

3. Lazzerini PE, Capecchi PL, Laghi-Pasini F. Systemic inflammation and arrhythmic risk: lessons from rheumatoid arthritis. Eur Heart J. 2017;38(22):17171727.

4. Upala S, Shahnawaz A, Sanguankeo A. Psoriasis increases risk of new-onset atrial fibrillation: a systematic review and meta-analysis of prospective observational studies. J Dermatolog Treat. 2017;28(5):406410.

5. Silverberg JI, Becker L, Kwasny M et al. Central obesity and high blood pressure in pediatric patients with atopic dermatitis. JAMA Dermatol. 2015;151(2):144152.

6. Silverberg JI, Greenland P. Eczema and cardiovascular risk factors in 2 US adult population studies. J Allergy Clin Immunol. 2015;135(3):7218.e726.

Excerpt from:
Atopic dermatitis linked to increased risk of atrial fibrillation - Dermatology Times

A new study in the headlines this week has renewed claims that fish oil pills might be helpful for Attention Deficit Hyperactivity Disorder (ADHD) in children, but a deeper look at the research says it's too early to say anything for sure.

The double-blind, randomised trial found thata high dose of omega-3 fatty acid EPA (or eicosapentaenoic acid) might work better than a placebo, but only for kids who have ADHD andan omega-3 deficiency.

"The omega-3 supplements only worked in children that had lower levels of EPA in their blood, as if the intervention was replenishing a lack of this important nutrient," explains biological psychiatrist Carmine Pariante from King's College, London.

Fish oil supplements have been explored as a treatment for ADHD in the past - with mixed results. So much so, that they are not currently approved by the US Food and Drug Administration (FDA) as a way to manage ADHD.

ADHD is a disorder marked by ongoing inattention, hyperactivity or impulsivity.Such behaviour is thought to reflect differences in brain development and activity, and fish oil has often been linked to improved cognitive function.

Furthermore, children with ADHD are sometimesknown to haveinsufficient fatty acid levels, presenting with dry skin, eczema and dry eyes. Recentstudies on animals have also connected omega-3 fatty acids in the brain's frontal cortex with hyperactivity.

Fish oil is one of themost popular sources of polyunsaturated fatty acids, and both EPA and docosahexaenoic acid (DHA) appear to be lower than normal in children with ADHD.

But while some studies have noted improvements in ADHD symptoms when this supplement was taken, others have not. In fact, some researcherssuspect it might even make things worse.Differences in dosages and the ratio of fatty acids only makes comparing these results all the more difficult.

In a 2013 systematic review of 10 randomised, placebo-controlled trials, only two showed a statistically significant benefit; while 6 showed no benefit at all, and 2 more showed benefits on only some ADHD rating scales.

A laterreviewon fish oil pills in 2017 showed greater promise. Of the 16 studies examined, 13 showed modest benefits in ADHD symptoms, including hyperactivity, impulsivity, attention, visual learning, word reading, and memory.

Yet even in cases where results appear positive, the effects are often modest and can sometimes take high dosages for months on end to kick in.

The latest research took place over a mere 12 weeks, and involved 92 children with ADHD aged 6 to 18. After being given a small daily dose of EPA, the participants with omega-3 deficiencies were found to have a few mild cognitive benefits, while those who already had normal levels of the fatty acid showed no benefits whatsoever.

"On the other hand, it is possible to have too much of a good thing," sayschild psychiatrist Jane Chang from China Medical University. For those kids with high levels of omega-3 already, any additional dosage may actually have detrimental effects, and Chang urges parents to consult with their child's physician before they try anything new - even a supplement.

Meanwhile, areviewin 2018 warned that health care providers should notreinforce the idea that fatty acids can replace treatments that have far more robust evidence.

The authors argue that while fish oil supplements may have small beneficial effects on children with ADHD, further high-quality research is needed before we can suggest them as an additional treatment - let alone a substitute for more serious approaches.

The study was published in Translational Psychiatry.

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Here's The Real Truth About Treating ADHD With Omega-3 Fish Oil Pills - ScienceAlert