WARTS

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Warts

Overview

  • Non-cancerous growths by human papilloma virus (HPV) that infect skin and mucuous membranes.
  • There are over 150 distinct HPV subtypes that exists.
  • Occurs most commonly in children and young adults.
  • Increased risk for infection in patients with atopic dermatitis and immunosuppresion
  • Transmission via skin to skin contact

Kinds of Warts

  • Common Warts (Verruca Vulgaris)
  • Plantar Warts (Verruca Plantaris)
  • Flat Warts (Verruca Plana)

Course:

  • Most warts eventually spontaneously resolve and therefore treatment is not always necessary/mandatory.
  • Reasons for treatment:
  • Associated with pain and discomfort
  • Cosmetic acceptability
  • Immunosuppresion

Treatment

  • Topical Solutions
  • Electrocautery
  • Liquid nitrogen (cryotherapy)
  • Laser therapy and Surgery

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SCARS

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scars

Scars

Overview

Marks on the skin from the result from normal healing of wounds caused by injuries, diseases or surgeries.
Generally classified into two types: hypertrophic scars and keloids.

  • Hypertrophic: large, raised scars that form from excess of scar tissue.
  • Keloids: tough, irregularly shaped that grows larger that size of the wound.

Characteristic of a scar:

  • May appear red and somewhat thick then later may slowly fade to a light pink or white.
  • May end up raised or depressed and darker or lighter than surrounding skin.
  • May take months for a scar to fade.

Goals of treatment

  • Accelerating the time to maturation of a hypertrophic scar.
  • Improving final end point predicted by conventional management.

Treatment a dermatologist can offer to a scar:

  • Triamcinolone Injections
  • Laser Resurfacing
  • Cryosurgery
  • Chemical Peels

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SEBORRHEIC DERMATITIS

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Seborrheic Dermatitis

I. DEFINITION

Seborrheic dermatitis is a common chronic skin disease characterized by redness and scaling

It occurs in regions where the sebaceous glands are most active such as face, scalp , presternal area and in body folds .

II. Who gets Seborrheic dermatitis?

  • People of all color and age can get Seborrheic dermatitis.
  • People in these two age groups are most susceptible
  • Infants 3 months and younger
  • Adults between 30-60 years of age

Your risk increases if you have any of these medical conditions

  • HIV, Acne , Rosacea or psoriasis
  • Parkinson’s disease, epilepsy
  • Stroke or heart attack ( recovering from)
  • Alcoholism
  • Depression
  • Eating disorder

Diagnosis

A dermatologist diagnose Seborrheic dermatitis by reviewing the patient’s medical history and looking closely at the rash

Malassezia furfur is said to play a role in the pathogenesis of Seborrheic dermatitis

 

III. TREATMENT

  • Initial topical therapy

Adults

  • Effective over the counter shampoos containing selenium sulfide  and zinc pyrithione are helpful
  • Low potency glucocorticoids solution,lotions or gels following a medicated shampoo (ketoconazole or tar) for more severe cases
  • Infants
  • For cradle cap
  • 1-2% hydrocortisone cream
  • 2% ketoconazole shampoo

Seborrheic Dermatitis can be stubborn . More often, it lasts for years . It tends to clear and flare without warning . Most patients will need the expertise of a Dermatologist to control the disease .

 

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ATOPIC DERMATITIS (AD)

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  • Atopic Dermatitis (AD) is a common recurrent itchy skin condition that is common in children but can also affect adults
  • Can also be called “skin asthma”
  • Caused by a defect in skin causing increased dryness of the skin and sensitivity.
  • It may improve as one advances in age but there are cases when it is lifelong and therefore proper guidance and management by a qualified Dermatologist is paramount.

AD2

WHAT CAUSES ATOPIC DERMATITIS?

  • The exact cause is not known, but medical researchers have found that:
  • It is usually hereditary
  • Patients with AD usually have relatives with Bronchial Asthma, Hay fever, or AD
  • It is not caused by infection
  • Foods do not cause AD, but food allergies can make it worse.

Flaring or attacks may be triggered by:

  • Dry and low humidity
  • Heat and perspiration
  • Dust and smoke
  • Chemicals like detergents, soaps, and perfumes
  • Infection

DIAGNOSIS

No lab test is needed to identify atopic dermatitis. The doctor will likely make a diagnosis by examining skin and reviewing your medical history.

WHAT TREATMENTS ARE USED?

Many treatments can help control eczema. Treatments may include:

Moisturizer or Emollient:

These products help to decrease dryness and scaling, so the skin feels more comfortable. Applying one of these after bathing and frequently throughout the day can help. Harsh soaps should be avoided. Your dermatologist can recommend products to use or avoid.

Corticosteroid:

Applied to the skin, this medicine helps to calm the skin and relieve itching. However, since there can be side effects from using too much medicine or using it too often, it is best to see what your dermatologist recommends. Some patients need a prescription-strength corticosteroid.

Antihistamine:

This medicine may be prescribed when eczema causes itching. Constant itching can cause many sleepless nights. Sedating antihistamines can help patients get the sleep they need.

Wet wraps:

This therapy consists of soaking and sealing the itchy skin with warm, damp, clothing. This can help the skin absorb medication and keep the skin hydrated. Your dermatologist can help you create a wet wrap routine best for your skin.

Calcineurin Inhibitor

This prescription medicine is applied to the skin to reduce inflammation and other symptoms

Antibiotic

If your child develops an infection, an antibiotic, either taken by mouth or applied to the skin, can kill bacteria causing the infection

Phototherapy

This is light therapy and may be added to a treatment plan when stronger treatment is needed

Systemic Immunimodulatory Agents

When a patient has not responded to other treatments, dermatologists may consider other medicines. These medicines are very strong and your dermatologist will explain the risks and benefits

Important Tips:

  • Avoid possible triggers
  • Use mild fragrance free cleansers
  • Bathe in warm, not hot water
  • Avoid long bath time or prolonged exposure to water
  • Apply moisturizers regularly, at least 2x a day
  • Keep fingernails short
  • For washing clothes, use detergents made for sensitive skin and avoid scented fabric softeners
  • Wash new clothes before wearing
  • See your Dermatologist to guide you in the proper management of AD especially if it is problematic.

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