Archive for December, 2019

Stay Healthy This Winter

Thursday, December 19th, 2019

The much-awaited winter season is finally here. The pleasant and sometimes chilly winds are making their presence felt. Are you enjoying the wintery evenings? Winter brings along seasonal changes and temperature changes leading to many diseases. Viral fever, common cold, flu, and cough are the common diseases of this season. Winter also brings dullness and may cause feelings of depression. Winter may also weaken your immune system making you more susceptible to diseases.

Cover yourself well this winter, especially if you are travelling to places of colder climate. Use a scarf, cap, or a sweater if needed. It is important to keep infants and the elderly warm in this season. Certain dietary measures help ensure that the body stays warm from inside in winters.

Winter health tips

Here are some health tips to stay healthy during this winter:

1. Cook with Spices

Onions, garlic, turmeric, and ginger are the perfect items to add flavour to your dishes. Not only do they make food taste great, but they’re also shown to help improve immune function. Turmeric helps to combat many conditions including inflammation and heart disease, and it acts as a powerful antioxidant.

2. Add Omega 3 Fatty Acids

Omega 3 fatty acids are a healthy type of fat that is naturally found in many food types including fish, plant seeds and nuts. Omega 3 fatty acids are great for reducing joint pain and stiffness as they are a natural anti-inflammatory. Studies have also shown that omega 3 fatty acids help lower levels of depression, which people commonly feel during the shorter days of winter.

3. Cook in desi ghee

Ghee is a winter essential that can be used to keep warm naturally. Ghee is rich in unsaturated fat, which is responsible for keeping the body warm and also supplying it with energy, dispelling the sluggishness that is brought on by winters.

4. Snack On Dried Fruits:

Figs, or anjeer, is a great example of dried fruits that can help you stay warm during winters. Another excellent dried fruit to consume during winters is date. Figs and dates are rich in calcium and iron and are both help keep your body warm.

5. Get sunlight

Get outdoor and soak in the warm sun, your body requires vitamin D – which is essential for maintaining health and immunity, vitamin D is also required to regulate mood.

6. Green tea

Green tea is a powerful antioxidant and has strong antiviral and antibacterial properties. Drinking approximately three to five cups of green tea a day keeps your immune system in check.

7. Honey

It is known to be the safest and easiest way to cure cold and fever during winter. Honey is known for its antibacterial properties that help fight bacteria and virus. You can have honey every night before going to bed, or mix it in a cup of warm milk.

8. Leafy greens

Methi, Palak, Sarson are all available in abundance and are a good source of beta-carotene and Vitamin C – both powerful antioxidants that help fight disease and build immunity. Others in this category are coriander, amaranth, celery, radish greens, etc.

9. Wash your hands

Washing your hands after coming from outside helps prevent the spread of germs. Wash your hands thoroughly with soap and water to reduce the spread of viral infections like cold and cough.

10. Stay active

Maintain a healthy lifestyle by continuing your fitness regime in winters too. Running, jogging, going to a gym, playing a sport, choose an activity you enjoy the most.

Enjoy the winters by eating seasonal and taking the above health precautions. This helps boost your immune system. Have a healthy winter!

Diagnosis & Treatment

Thursday, December 19th, 2019
For temporary relief of itching, one may try these self-care measures:
  • Avoid items or situations that cause you to itch.
  • Perhaps the most important self care is to avoid scratching whenever possible.
  • Moisturize daily.
  • Use creams, lotions or gels that soothe and cool the skin with wet compresses.
  • Use moisturising soap without dyes or perfume.
  • Take a lukewarm water bath or shower.
  • Stay hydrated with at least 3-4 litres of water everyday.
  • Reduce stress.
  • Try over-the-counter allergy medicine.
  • Use a humidifier.

Short-term use of non prescription corticosteroid cream may temporarily relieve an itch accompanied by red, inflamed skin. Long term relief requires identifying and treating the cause of itching.

When to consult your skin doctor
  • If dry, itchy skin doesn’t get better within 2 weeks.
  • If its severe and affects your routine and disturbs sleep
  • If it affects your whole body
  • If it is accompanied by other symptoms like fever, change in urinary or bowel habits, tiredness and weight loss.
Diagnosis

Tracking down the cause of your itch can take time and involve a consult with a dermatologist with physical examination and questions about ones medical history. If the doctor thinks your itchy skin is the result of a medical condition, you might have tests, including:

Blood test. A complete blood count can provide evidence of an internal condition causing your itch, such as iron deficiency.

Tests of thyroid, liver and kidney function. Chest X-rays. A chest X-ray can show if you have enlarged lymph nodes, which can go along with diagnosis of blood cancers.

Treatment

Itchy skin treatment focuses on finding the cause of the itch and removing it. If home remedies don’t ease the itchy skin, your doctor may recommend prescription medications or other treatments. Topical options include: Moisturising creams, emollients, corticosteroid creams. Other treatments that may be recommended to your skin include calcineurin inhibitors, such as tacrolimus and pimecrolimus. Or you may find some relief with topical anesthetics, capsaicin and doxepin.

Oral medications include antihistaminic and steroids. Antidepressants called selective serotonin reuptake inhibitors, such as fluoxetine and sertraline may be helpful in easing some types of chronic itch. Antidepressants, Anticonvulsants, immunosuppressants and biologic agents are used in certain cases.

Light therapy (phototherapy). Phototherapy involves exposing your skin to a specific type of light. Multiple sessions are usually scheduled until the itching is under control.

Written by Dr. Jawahar Mansukhani.

For more details click here – This will go to Dermatology Department.

Causes of Itchy Skin

Thursday, December 19th, 2019

Itch is the most common presenting symptom to a dermatologist. It is an uncomfortable, irritating sensation that creates an urge to scratch that can involve any part of the body.

Common causes of this symptom

Itching can have external causes that aren’t due to underlying disease. Examples include hair regrowth, sunburns, insect bites, skin infections, contact allergic dermatitis, dry skin or healing wounds.

Itchy skin can be a symptom of an underlying illness.

  • These include liver disease, kidney failure, iron deficiency anemia, thyroid problems and certain cancers, including multiple myeloma and lymphoma.
  • Urticaria, Atopic and Seborrheic dermatitis
  • Psoriasis, Dermatitis herpetiformis
  • Drug reactions
  • Nerve disorders, as in after shingles or meralgia parasthetica are other reasons.
  • Stress and anxiety can affect your nervous system and cause sensory symptoms like burning or itching of the skin, with or without visible signs. Psychiatric illnesses like depression or obsessive compulsive disorder too can cause itchy skin.
  • Itching, occasionally, can be seen in later stage of pregnancy.

Some of the major causes:

Hair Regrowth

After removal of hair from genital area and near folds, the growing stub of hair may cause a lot of itching and discomfort.

Soothing lotions and moisturising the area helps to tide over this phase of re-growth.

Sunburns

Prolonged sun exposure especially on beaches or high altitude often leads to itching and burning on directly exposed parts of the skin on face, neck, shoulders and forearms.

Antihistaminics, analgesics and soothing creams are recommended.

Prevention with sunscreens is ideal.

Dry Skin

Itching can be without a rash, especially as we get older due to dry skin or underlying conditions like hypothyroidism, menopausal skin changes and sjogrens disease. Anything that further dries your skin – such as overuse of soaps, antiperspirants, perfumes, or hot baths – will make the problem worse. Dehydration, sun exposure, smoking, and stress also may cause dry skin. Dry skin itches because it is irritated easily.

Skin Infections – are common in children, in those with poor hygiene, in diabetics and in immune-suppressed adults

  • Fungal – commonly seen during humid months and mainly afflicting folds of the skin in those with poor hygiene,

Various dermatophytes or candida are common causes,

Presents as annular scaly or reddish patches. Clinically dermatophyosis are classified according to the site involved.

Fungal infections apart from clinical features are diagnosed with help of Woods lamp and microscopic examination of skin scales in 10-20% KOH preparation and or culturing in sabourads dextrose agar.

Patient with itch showing above signs should see a doctor immediately. Self medication especially with steroid containing creams should be avoided. Needs oral and topical antifungal treatment for at least a month,

Maintaining good hygiene and wearing appropriate clothing and footwear can prevent recurrences.

  • Bacterial – Pyoderma is caused by pus producing organisms like Stapyloccus aureus or Streptococcus group A. A pus filled eruption with or without discharge and crusting is the basic lesion in pyodermas.

Following are various types of pyoderma

  • Impetigo – small blisters with pus filled fluid spreads and ruptures to leave erosions and crusts,
  • Ecthyma – ulcerated lesions with thick adherent crust which on removal bleeds,
  • Erythrasma – well circumscribed superficial dry brownish patches with scaling near folds,
  • Folliculitis – multiple superficial pus filled lesions on legs or elsewhere,
  • Furuncle – Deep hair root infection with nodulo-pustular presentation,
  • Carbuncle – this is a large indurated nodular lesion with multiple openings, often an indicator of poorly controlled diabetes or Being on long term steroid medications,
  • Sycosis barbae – multiple pustules in beard area,
  • Cellulitis – a warm tender swelling usually on one of the legs and accompanied by marked constitutional symptoms,
  • Paronychia – painful and itchy swelling of nail folds, and
  • Hideradenitis Suppurativa – firm nodular and ulcerated lesions with pus discharging openings

The last three are more painful and may not be very itchy.

Pyodermas may be secondary to other skin conditions like injury, eczemas, burns, etc.

While impetigo can be treated with topical anti-bacterial agents, carbuncles and hideradenitis suppurativa may need invasive and prolonged systemic treatment. For secondary pyodermas, treatment of predisposing condition is essential.

  • Viral Infections Chicken pox, and other viral exanthema eruptioms may be associated with itching in initial stage. They are accompanied with fever and other constitutional symptoms.
  • Mite – It is commonly transferred from contact with affected person or animals.

It presents with generalised nocturnal itch below neck with more than one family member affected in scabetic infestation.

The skin eruption in scabies is typical and classical lesions can be seen in finger webs, folds and genital areas.

It responds well to topical anti-scabetic application.

  • Lice – Afflicted children in school and those with poor hygiene are a common source of this infestation,

Identifying the louse on the skin surface confirms the diagnosis

There are three types

Head louse is commonest in children and their close contacts and nits and louse can be observed on their scalp

Body louse affects those with poor hygiene and bed ridden with itching all over

Pubic louse cause itch below waist area and may be sexually transmitted

Perianal itching can be related to hookworm or pinworm infestation. Generalised itching can also be related to parasites such as threadworms infestation, insects such as bedbugs and mosquitoes.

Allergies

Allergy is an altered response by the human body to a variety of agents

  • External reasons include irritation with chemicals, soaps, clothing, insect bites, contact with certain plants like parthenium, etc. The site of involvement usually helps to point the incriminator.
  • Hives may be due to various reasons and may need prolonged treatment. Transient red and swollen patches may rarely present with mucous membrane involvement with swollen lips and breathlessness. Acute allergy to food, pollens, house dust and mites, cotton, pet animals, drugs, etc. can be identified with allergy tests. Specific triggers do not cause chronic urticaria, which can make allergy tests unhelpful. Hives can cause uncomfortable itching and be painful, but they are not contagious.
  • Drug allergy usually shows up immediately after certain drugs. It may show up as localised blisters or symmetrical rash all over the body. Allergic rash to certain medicines may show up even after four weeks.
  • Atopic dermatitis may be seen in more than one family member and its onset in early life and typical distribution of lesions assist in diagnosing. There may be associated asthama or allergic sneezing and rhinitis is self or in other family members.
  • Seborrheic dermatitis seen after puberty age has itchy lesions in seborrheic areas.
Other causes

Uremia is a broad syndrome that occurs when the kidneys are severely damaged and cannot filter toxins from the body. With uremia, itching tends to be worse at night. It most commonly affects the back, arms, and abdomen. Psoriasis lesions are mildly pruritic and the classical scaly patches help in diagnosing and treating specifically. Shingles with a dermatomal distribution of grouped tiny blisters should be treated early with anti-virals to prevent complications.

Psychological

People may experience an itching feeling that has no physical cause. Some mental health conditions can make a person feel as if their skin is crawling, which creates an urge to scratch. Neither skin lesion, nor a crawling insect can be detected on examination. Excessive scratching though, can lead to skin damage.

Written by Dr. Jawahar Mansukhani.

For more details, click here – This will go to Dermatology Department.