Definition:

Psoriasis is an autoimmune disease that causes a chronic skin condition where cells grow too quickly.  The rapid growth of cells causes patches of plaque on areas of the skin. These patches appear as red raised areas on the skin, and most often occur on the elbows, knees, and scalp, however the patches can appear on any area of the body.  Many individuals with psoriasis report these areas can be itchy and tender.

Symptoms:

Symptoms of Psoriasis vary from mild to severe.  Mild Psoriasis can appear on the body as a small rash.  Moderate Psoriasis can appear as raised red areas with loose, silvery, scaling.  These areas can be small or as large as an individual’s entire back.  Finger and toe nails can also be affected with pitting, color changes, and separation from the nail bed.  Joint pain and inflammation can be symptom of psoriasis.  This condition is called psoriatic arthritis.

Causes: 

Autoimmune response is when the body’s immune system recognizes normal cells as a threat, and attacks them.  In the case of psoriasis immune response is attacking the skin.  Although causes of psoriasis and autoimmune is unknown, much research is connecting the body’s immune response to the health of the gut.  Research has linked gut permeability with autoimmune disorders.  This research has found that the gut’s natural permeability has been compromised, allowing particles that should remain in the intestine to escape into the blood stream, thus causing an immune response. These cells mimic other cells in the body, causing the immune system to attack normal cells, thus causing the autoimmune disease.

Common triggers of psoriasis are widely recognized.  These triggers include cold, dry weather, stress, alcohol consumption, smoking, and certain medication.  Food sensitivity and allergy may also be a culprit in triggering psoriasis, as well as common environmental allergens may trigger an episode of psoriasis.  Certain fungal infections may also contribute to triggering psoriasis.

Diagnostic tools:

• Autoimmune Panel
• Food IgG 90/120
• CDSA
• ALT/ALS (CMP)

Treatment:

• LDN
• Stone Age Diet / Rotation Diet
• Guided Imagery/Stress reduction
• Adding Fermented foods to the diet
• Yeast Eradication

 Products and Services:

Nutritional Supplements:

• Galactomune powder or capsules
• Probiotic:
  • Therbiotic Complete
  • Culturelle
  • LactoPrime
  • Vital 10
  • Biotagen
  • Saccharomyces Boulardii

Allergy Extracts/Signal Therapies:

• Allergy Testing to foods
• Allergy Extract
• Interferon Alpha B
• M2
• M4
• BCG II

Preparing for your appointment:

Prior to your appointment with a doctor at the Center for Occupational and Environmental Medicine it is important for you to review the new patient information sent to you by our new patient coordinator.  This packet includes specific information about preparing for you visit as well as an in depth medical history form.  Please take some time to fill out the form to the best of your ability.  This form will take some time, and may require reaching out to family members for additional medical history.  Please also complete all registration forms prior to arriving at the center for your appointment.  If you have completed any recent blood work or laboratory tests please bring copies with you to your appointment.  Your clinician and doctor will review this information as part of your medical history.  Plan on being with us at the center for a full day on the first day of your appointment.  Some of your recommendations may include allergy testing, and this process will take some time.

Sites:

National Psoriasis Foundation.org

WebMD, Psoriasis

Mayoclinic.org

Experiencing Life, when your body turns on you

Postherpetic neuralgia (PHN) can be an unfortunate result of herpes zoster infection (shingles). It is defined broadly as any pain that remains after healing of herpes zoster lesions or rash, usually after a three month period.

Shingles (also known as herpes zoster) is a skin rash that can be very painful. It is a viral infection of the nerves, and the nerves affected by shingles can occasionally continue to cause severe pain after the shingles have cleared. Shingles appear as a rash, patch, or a line of painful blisters which arise on the skin over a nerve in the shape of a band. This band follows the distribution of a specific nerve where the virus has been living before its spread to the skin. Shingles affects both men and women equally. This disease is caused by the same virus that causes chicken pox (varicella zoster). Chicken pox usually affects young children, and its symptoms involve itchy blisters all over the body. Once these symptoms go away, the varicella zoster virus stays in the nerves near the spine. It is almost as if the virus “goes to sleep”. It will “wake up”, however, when the body’s immune system is

If the pain caused by shingles continues after the shingles is over – within two to four weeks – it is known as post-herpetic neuralgia. It is estimated that about one-in-five patients with shingles will go on to have post-herpetic neuralgia. Post-herpetic neuralgia (PHN) is more common as people get older – it is uncommon in children weakened. The virus then grows in the nerves, causing pain. When the virus reaches the skin, it causes the shingles rash.

Each year approximately 1,000,000 people in the U.S. develop shingles or herpes zoster. Of these, it is estimated approximately 10-20% (about 200,000) will go on to develop PHN.

The risk of developing PHN increases with age and can affect at least 40% of all herpes zoster patients over age 50 and 75% of herpes zoster patients over age 75. PHN is the single most common neurologic condition in elderly patients

Causes

The nerve damage caused by shingles disrupts the proper functioning of the nerve. The faulty nerve becomes confused and sends random, chaotic (uncontrolled) pain signals to the brain, which the patient feels as a throbbing, burning pain along the nerve.

Experts believe that shingles results in scar tissue forming next to nerves and pressing on them, causing them to send inaccurate signals, many of which are pain signals to the brain. However, nobody is really sure why some shingles patients go on to develop postherpetic neuralgia.

Symptoms

Symptoms are usually limited to the area of skin where the shingles outbreak first occurred. Symptoms may include:

• Occasional sharp burning, shooting, jabbing pain
• Constant burning, throbbing, or aching pain
• Extreme sensitivity to touch
• Extreme sensitivity to temperature change
• Itching
• Numbness
• Headaches

In rare cases, if the nerve also controls muscle movement, the patient may experience muscle weakness or paralysis.

Some patients may find the symptoms interfere with their ability to carry out some daily activities, such as bathing or dressing. Postherpetic neuralgia may also cause fatigue and sleeping difficulties.

Treatment

Treatment will depend on the type of pain, as well as some aspects of the patient’s physical, neurological and mental health.

Antidepressants – These help patients with postherpetic neuralgia not because the patient is depressed, but because they affect key brain chemicals, such as serotonin and norepinephrine, which influence not only depression, but also how the body interprets pain. Dosages for postherpetic neuralgia will tend to be lower than for depression, unless the patient has both depression and postherpetic neuralgia. Examples of drugs that inhibit the reuptake of serotonin or norepinephrine are tricyclic antidepressants, such as amitriptyline, desipramine (Norpramin), nortriptyline (Pamelor) and duloxetine (Cymbalta). They will not get rid of the pain, but are said to make it more bearable.

Anticonvulsants – As with trigeminal neuralgia pain, postherpetic pain can be lessened with anticonvulsants, because they are effective calming down nerve impulses and stabilize abnormal electrical activity in the nervous system caused by injured nerves. Gabapentin (Neurontin), pregabalin (Lyrica) are examples of commonly prescribed anticonvulsants for this type of pain.

Steroids – A corticosteroid medication is injected into the area around the spinal cord. Injected steroids are effective for postherpetic neuralgia patients with chronic pain (persistent long-term pain). The patient should not receive this medication until the shingles pustular skin rash has completely disappeared.

Painkillers – This may include tramadol (Ultram) or oxycodone (OxyContin). There is a small risk of dependency.

TENS (transcutaneous electrical nerve stimulation) – Electrodes are placed over the areas where pain occurs. Small electrical impulses are emitted. The patient turns the TENS device on and off as required. Some patients obtain significant pain relief from TENS, while others don’t. Experts are not sure why the electrical impulses relieve pain. Some say that TENS stimulates endorphin release – endorphins are the body’s natural painkillers; some people call them natural “feel good” chemicals.

Spinal cord or peripheral nerve stimulation – Similar to TENS, but here the devices are implanted under the skin, along the course of peripheral nerves. These devices are a safe, efficient, and effective way to relieve many types of neuropathic pain conditions, including trigeminal neuralgia.

Alternative Treatment

Proteolytic Enzymes – Proteolytic enzymes are enzymes that are produced naturally by the pancreas to help digest protein we eat. They help in pain relief and skin improvement.

Capsaicin Cream – Although people may not have heard of capsaicin before, if you’ve ever eaten a chili pepper and felt the mouth burn. Capsaicin is the active ingredient in chili peppers and is sometimes used for postherpetic neuralgia.

Colloidal silver is an extremely effective pathogen destroyer which can be taken internally as well as applied topically. Colloidal silver attaches itself to viruses and prevents them from replicating and there are specific silver receptors on human nerve tissue – the location where the shingles virus “hides out”.

Reference –

http://www.centerforhomeopathy.com/shingles-post-herpetic-neuralgia/

http://emedicine.medscape.com/article/1143066-treatment

http://www.nhs.uk/Conditions/postherpetic-neuralgia/Pages/Treatment.aspx

http://www.healingchronicpain.org/neuralgia/frequency

http://www.med.or.jp/english/pdf/2004_11/529_536.pdf

http://patient.info/health/postherpetic-neuralgia-leaflet

http://www.medicalnewstoday.com/articles/160253.php

http://www.nhs.uk/conditions/postherpetic-neuralgia/Pages/Introduction.aspx

http://emedicine.medscape.com/article/1143066-overview

Morphea is a form of Scleroderma that literally means “hard skin”. Morphea usually affects only the uppermost layers of your skin, but in some cases may involve fatty or connective tissue below your skin. Morphea is usually chronic or recurrent.

Approximately 300,000 people in the United States have scleroderma. Women are affected three times as often as men. Although the disease can develop at any age, it most frequently begins past middle age. It is most frequently a chronic and often progressive illness.

Morphea is usually a benign skin condition of one or two colored skin plaques which affect only the skin and that gradually fade in three to five years, even without any treatment. It normally occurs by itself and not in conjunction with any other symptoms or illnesses, and generally speaking, the cause of most cases of morphea is still unknown.

Morphea makes patches called “plaques” or “lesions” appear on the skin. It usually begins with a whitish patch with a purple border. It often has the appearance of a bruise. However, it can look very different from patient to patient. It is more common in children and adolescents than it is in adults. When morphea affects the face, other tissues may be affected.

Types –

There are several types of morphea and each type looks a little different –

• Plaque morphea is usually an oval shape with a yellow or ivory colour in the centre and purple at the edges. It may feel thick, firm, and waxy, and may look shiny.
• Generalized morphea begins as many plaques on the body that may get bigger or join together.
• Linear morphea appears in a line. It is usually on the arm or leg, and may also occur on the face.

As morphea progresses, the affected skin may change. The veins under the skin may show more clearly. The affected skin may look thinner, and may look raised or sunken compared to the skin around it.

Causes

The cause of morphea is unknown at this time.  We know that patients with family histories of autoimmune diseases are more likely to get morphea, so there is probably a genetic link.  Morphea has been reported to occur after injuries and radiation therapy, which may play a role as a disease trigger.

It appears to start off with damage to small blood vessels and the release of cytokines (chemical messenger proteins) that promote fibrosis (scarring).

Morphoea can sometimes follow –

• Localised injury, including injections and radiotherapy
• Tick bites – it has been associated with Lyme disease due to Borrelia burgdorferi infection
• Pregnancy
• Measles and other viral infections
• Autoimmune diseases including vitiligo, diabetes, thyroid disease, lichen sclerosus and lichen planus
• Medications including bleomycin and penicillamine.

Risk Factors

Certain factors may affect the risk of developing morphea, including

• Sex and Age – Females are more likely to develop morphea than are males. The condition can affect people at any age. It usually appears between the ages of 2 and 14 or in the mid-40s.
• Race – Morphea is more prevalent among Caucasians.

Symptoms

Some children and adults with morphoea complain of muscle and joint pains as well as fatigue. Seizures, headaches, vascular malformation, ocular defects and other neurological symptoms may be associated with morphoea, especially in those with en coup de sabre or progressive facial hemiatrophy.

• Hardening of the skin
• Thickening of the skin
• Discoloration of the affected skin to look lighter or darker than the surrounding area. Most people develop one or two oval-shaped patches that start out red, purple (lilac-colored) or yellowish and gradually develop a whitish center. Over time, the patches may turn brownish in color and eventually white.

The Morphea looks like –

• Ivory-colored plaque with varying degrees of inflammation about its borders
• It generally starts as a reddened area that appears swollen
• The center gradually becomes white or yellow in color
• There can be a lack of hair noted in these lesions
• Sweating may be reduced depending on how advanced the lesion has become

Complications

Morphea can cause a number of complications, including –

Self-esteem issues – Morphea can have a negative effect on your self-esteem and body image, particularly if discolored patches of skin appear on the arms, legs or face.

Movement problems – Morphea that affects the arms or legs can impair joint mobility.

Widespread areas of hardened, discolored skin – Numerous new patches of hard, discolored skin may seem to join together, a condition known as generalized morphea.

Eye damage – Children with head and neck morphea may experience unnoticeable, permanent eye damage.

Treatment

The best treatment for morphoea is uncertain and current treatments often fail to help

Benefit has been reported in some cases from the following treatments –

• Topical calcipotriol
• Topical tacrolimus
• Potent topical steroids
• Imiquimod cream
• Photochemotherapy or phototherapy with NBUVB or UVA1
• Methotrexate
• Systemic steroids
• Mycophenolate
• Pentoxifylline
• Penicillamine
• Diphenylhydantoin (phenytoin)
• Physiotherapy is often recommended to prevent joint contractures when morphoea affects the limbs.
• Light therapy – A special treatment that uses ultraviolet light (phototherapy) may improve your skin’s appearance, especially when used soon after skin changes appear.

Alternative Treatment

Omega 3 Fatty Acids – Omega-3 fatty acids help improve blood flow, and a few studies suggest they may reduce symptoms of Morphea.

Bromelain – Although it is not a specific treatment for scleroderma, bromelain helps reduce pain and inflammation.

Probiotic supplement – These “friendly” bacteria help maintain gastrointestinal health. One study found that probiotics helped reduce bloating in people with scleroderma that affected their digestive systems.

Vitamin D insufficiency and deficiency rates were very high among people with the disorder. The study’s authors note that common vitamin D supplementation does not appear to correct the deficiency in scleroderma patients, and that a higher dose is most likely needed for such individuals.

Turmeric – Turmeric reduces inflammation. It may also help relieve pain, although more studies are needed to tell whether it works for scleroderma. It is often combined with bromelain.

Gotu kola for blood vessel health and circulation. Some purified extracts of gotu kola seem to reduce symptoms of scleroderma. More research is needed.

Acupuncture– A few studies suggest that acupuncture may improve blood flow in the hands and fingers, help heal fingertip ulcers, and may reduce the formation of fibrous tissue. It may also relieve pain.

Massage and Physical Therapy – Research suggests that massage may help improve circulation. More research is needed to know whether massage works for scleroderma.

Mind-Body Medicine – Biofeedback may help some people with scleroderma better control the temperature in their hands and feet, although studies are mixed. Other mind-body techniques such as counseling, meditation, and emotional freedom technique (EFT) may also help.

Reference –

http://www.dermnet.com/images/Morphea

http://www.healthcentral.com/encyclopedia/hc/morphea-scleroderma-3168904/

http://www.medpagetoday.com/Rheumatology/GeneralRheumatology/47360

http://www.healthhype.com/morphea-hardened-skin-patches.html

http://patient.info/doctor/morphoea

http://www.aboutkidshealth.ca/en/healthaz/conditionsanddiseases/inflammatoryconditions/pages/morphea.aspx

http://www.mayoclinic.org/diseases-conditions/morphea/basics/definition/con-20028397

Molluscum contagiosum is a viral skin infection that causes either single or multiple raised, pearl-like bumps (papules) on the skin. It is a chronic infection, so lesions may persist from a few months to a few years. However, most cases resolve in six to nine months. It produces harmless, noncancerous growths in the skin’s top layers. The disease is spread by direct contact with the skin of an infected person or sharing towels with someone who has the disease. Outbreaks have occasionally been reported in child care centers.

Molluscum is a common skin problem with small, harmless raised spots. The spots can stay on the body for a few weeks, several months or more than a year. It is caused by the Molluscum Contagiosum Virus (MCV). This virus only lives in humans.

The lesions, known as Mollusca, are small, raised, and usually white, pink, or flesh-colored with a dimple or pit in the center. They often have a pearly appearance. They’re usually smooth and firm. In most people, the lesions range from about the size of a pinhead to as large as a pencil eraser (2 to 5 millimeters in diameter). They may become itchy, sore, red, and/or swollen.

Molluscum is contagious and can be spread from person to person or to different areas in the same person. It can also be spread by children sharing baths or pools through bath toys and towels. Usually it does not need any treatment. Good personal hygiene can help prevent it spreading.

Causes

Molluscum contagiosum is caused by a virus that is a member of the poxvirus family. You can get the infection in different ways.

This is a common infection in children and occurs when a child comes into direct contact with a lesion or an object that has the virus on it. The infection is most often seen on the face, neck, armpit, arms, and hands. But it may occur anywhere on the body, except the palms and soles.

The virus can spread through contact with contaminated objects, such as towels, clothing, or toys.

The virus also spreads by sexual contact. Early lesions on the genitals may be mistaken for herpes or warts. But unlike herpes, these lesions are painless.

Persons with a weakened immune system (due to conditions such as HIV/AIDS) may have a rapidly spreading case of molluscum contagiosum.

Risk Factors

Molluscum contagiosum is common enough that you should not be surprised if you see someone with it or if someone in your family becomes infected. Although not limited to children, it is most common in children 1 to 10 years of age.

People at increased risk for getting the disease include –

• People with weakened immune systems (i.e., HIV-infected persons or persons being treated for cancer) are at higher risk for getting molluscum contagiosum. Their growths may look different, be larger, and be more difficult to treat.
• Atopic dermatitis may also be a risk factor for getting molluscum contagiosum due to frequent breaks in the skin. People with this condition also may be more likely to spread molluscum contagiousm to other parts of their body for the same reason.
• People who live in warm, humid climates where living conditions are crowded.

In addition, there is evidence that molluscum infections have been on the rise in the United States since 1966, but these infections are not routinely monitored because they are seldom serious and routinely disappear without treatment.

Symptoms

Bumps on the skin can be  the only sign that a person has molluscum contagiosum. These bumps often appear about 7 weeks after being exposed to the virus that causes molluscum. Sometimes, the bumps do not appear for many months.

When the bumps appear on the skin, they often –

• Begin as small, firm, dome-shaped growths.
• Have a surface that feels smooth, waxy, or pearly.
• Are flesh-colored or pink.
• Have a dimple in the center. The dimple may be filled with a thick, white substance that is cheesy or waxy.
• Are painless, but some bumps itch.
• Turn red as the person’s immune system fights the virus.
• Appear on other areas of the body after a person scratches or picks the bumps. Scratching or picking can spread the virus.

In adults, the bumps often appear on the face, neck, armpits, arms, and hands. Other common places for bumps to appear are the genitals, abdomen, and inner thighs. Adults often get molluscum contagiosum through sexual contact.

If a person has a disease that weakens the immune system, such as AIDS, the bumps can grow very large. A person may have 100 or more bumps on the face alone.

Complications

Problems that can occur include any of the following –

• Persistence, spread, or recurrence of lesions
• Secondary bacterial skin infections

Treatment

Treatment for molluscum is usually recommended if lesions are in the genital area (on or near the penis, vulva, vagina, or anus). If lesions are found in this area it is a good idea to visit your healthcare provider as there is a possibility that you may have another disease spread by sexual contact.

Oral therapy – Gradual removal of lesions may be achieved by oral therapy. This technique is often desirable for pediatric patients because it is generally less painful and may be performed by parents at home in a less threatening environment.

Podophyllotoxin cream (0.5%) is reliable as a home therapy for men but is not recommended for pregnant women because of presumed toxicity to the fetus.

Therapy for immunocompromised persons – Most therapies are effective in immunocompetent patients; however, patients with HIV/AIDS or other immunosuppressing conditions often do not respond to traditional treatments. In addition, these treatments are largely ineffective in achieving long-term control in HIV patients.

Physical removal of lesions may include cryotherapy (freezing the lesion with liquid nitrogen), curettage (the piercing of the core and scraping of caseous or cheesy material), and laser therapy. These options are rapid and require a trained health care provider, may require local anesthesia, and can result in post-procedural pain, irritation, and scarring.

Laser therapy – Pulsed dye laser therapy is the treatment of choice when there are multiple lesions. Any surgical treatment requires to be repeated each time, new crops of lesions appear.

Cryotherapy – It involves killing infected cells by “freezing” them with a pressurized liquid spray, usually liquid nitrogen or nitrous oxide. The procedure is relatively painless and can be performed by any health professional. The infected cells may fall off immediately or fade over several days.

Alternative Treatment

Zell Oxygen is an incredible remedy to activate and strengthen the immune system and will speed a successful outcome over chronic (long term) and acute (short term) infections is most likely.

Collodial Silver  has been found to attack all known harmful virus and bacteria.

Olive Leaf Extract is rapidly being recognised as a natural alternative to antibiotics. Extremely beneficial for people with viral and fungal infections and a non-toxic way to strengthen the immune system. Scientific research has shown that the active ingredient in olive leaf extract, oleuropein, has powerful healing properties and can fight bacteria, viruses, fungi and parasites that cause infection and disease.

Vitamin Oils – Specific combinations of different vitamin oils to get rid of the papules caused by Molluscum Contagiosum.

Garlic – Molluscum is viral and caused by a pox virus, according to the Centers for Disease Control. Eating raw garlic might help the body’s immune system fight off the underlying virus, helping the eruptions to disappear more rapidly than ordinarily. Garlic has anti-viral and anti-fungal properties in its active ingredient allicin, which work to destroy viruses both internally and on the skin.

Turmeric, with its potent active ingredient curcumin, has properties that are reported to be anti-viral, anti-microbial and anti-inflammatory, making it an excellent natural remedy to boost the immune system, and one that might have potent effects on the mollusucm virus, hastening its demise in the body. Because turmeric has strong anti-inflammatory properties, it can not only be taken orally but the powered turmeric applied to the skin as a poltice

Reference –

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/molluscum-contagiosum

http://www.hopkinsmedicine.org/healthlibrary/conditions/dermatology/molluscum_contagiosum_85,P00299/

http://www.mayoclinic.org/diseases-conditions/molluscum-contagiosum/basics/definition/con-20026391

http://www.cdc.gov/poxvirus/molluscum-contagiosum/risk.html

https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/molluscum-contagiosum

http://www.dermnetnz.org/viral/molluscum-contagiosum.html

http://kidshealth.org/en/parents/molluscum-contagiosum.html

http://www.emedicinehealth.com/molluscum_contagiosum/article_em.htm

Lichen planus is an inflammatory skin condition, characterized by an itchy, non-infectious rash of small, polygonal (many sided) flat-topped pink or purple lesions (bumps) on the arms and legs. Other parts of the body may also be affected, including the mouth, nails, scalp, vulva, vagina, and penis. Involvement in the scalp can result in hair loss – sometimes permanent.

Doctors use the word ‘lichen’ to mean small bumps on the skin. ‘Planus’ means ‘flat’, and tells us that the small itchy bumps that make up the rash of lichen planus have shiny flat tops. These bumps have a reddish-purplish color with a shiny cast due to a very fine scale. The disease can occur anywhere on the skin, but often favors the inside of the wrists and ankles, the lower legs, back, and neck. The mouth, genital region, hair and nails are affected in some individuals. Thick patches may occur, especially on the shins. Blisters may rarely occur. Bumps may appear in areas of trauma on some individuals. About 20 percent of the time lichen planus of the skin causes minimal symptoms and needs no treatment. However, in many cases the itching can be constant and intense.

This disease occurs most often in men and women between the ages of 30 and 70 years. It is uncommon in the very young and elderly. All racial groups seem susceptible to lichen planus.

Lichen planus is not contagious. Lichen planus is not a type of cancer.

Causes

What causes most cases of lichen planus remains unclear. One theory is that lichen planus is an autoimmune disease. This means the person’s immune system reacts as though the skin and other parts of the body are foreign. When this happens, the body starts to attack itself. To find out whether lichen planus is an autoimmune disease.

Others –

• Some medicines can cause a rash that looks like lichen planus. These medicines include diuretics (treatment for high blood pressure and heart disease) and medicine taken to prevent malaria.
• In the mouth, a metal filling may be the cause. This is rare, but it can happen. If this is the cause, replacing the metal filling with a non-metal filling will get rid of the lichen planus.
• A rare type of lichen planus, familial bullous lichen planus, runs in families. Other forms of lichen planus do not seem to run in families.
• There may be a link between lichen planus and infection with the hepatitis C virus. Many people with hepatitis C also have lichen planus.

Risk Factors

About one in 100 people will get lichen planus at some time. It is not caused by an infection, and people can’t pass it on to others. Lichen planus usually affects men and women in middle age. Equal numbers of men and women get lichen planus of the skin, but women are twice as likely to get oral (inside the mouth) lichen planus. The disease is rare in people who are very young or very old.

Symptoms

Mouth sores are one symptom of lichen planus. They –

• May be tender or painful (mild cases may not cause pain)
• Are located on the sides of the tongue, inside of the cheek, or on the gums
• Look like bluish-white spots or pimples
• Form lines in a lacy network
• Gradually increase in size
• Sometimes form painful ulcers

Skin sores are another symptom of lichen planus. They –

• Usually appear on the inner wrist, legs, torso, or genitals
• Are itchy
• Have even sides (symmetrical) and sharp borders
• Occur alone or in clusters, often at the site of a skin injury
• May be covered with thin white streaks or scratch marks
• Are shiny or scaly looking
• Have a dark, reddish-purple color
• May develop blisters or ulcers

Other symptoms of lichen planus are –

• Dry mouth
• Hair loss
• Metallic taste in the mouth
• Ridges in the nails

Complications

After the rash has gone there may be permanent brown or grey marks on the skin – the darker the patient’s skin is the more noticeable they will be.

Persistent skin lesions and mouth ulcers may slightly raise the risk of developing cancer (rare).

Treatment

The goal of treatment is to reduce symptoms and speed healing. If your symptoms are mild, patients may not need treatment.

Treatments may include –

• Antihistamines
• Medicines that calm down the immune system (in severe cases)
• Lidocaine mouthwashes to numb the area and make eating more comfortable (for mouth sores)
• Topical corticosteroids or oral corticosteroids to reduce swelling and lower immune responses
• Corticosteroid shots into a sore
• Vitamin A as a cream or taken by mouth
• Other medicines that are applied to the skin
• Dressings placed over your skin with medicines to keep you from scratching
• Ultraviolet light therapy

Alternative Treatment

Purported alternative treatments for lichen planus of the skin include:

• Aloe vera gel
• Lavender oil
• Tea tree oil
• Sulphur mineral baths
• Vitamin supplements
• A diet rich in fruit and vegetables
• Oral and topical herbal medications
• Cod liver oil supplements, a source of vitamins A and D

Reference –

http://www.hopkinsmedicine.org/healthlibrary/conditions/dermatology/lichen_planus_134,220/

http://familydoctor.org/familydoctor/en/diseases-conditions/lichen-planus.html

http://www.britishskinfoundation.org.uk/SkinInformation/AtoZofSkindisease/LichenPlanus.aspx

http://www.medicalnewstoday.com/articles/184866.php

http://www.medicinenet.com/lichen_planus/article.htm

http://www.dermnetnz.org/scaly/lichen-planus.html

http://www.mayoclinic.org/diseases-conditions/lichen-planus/basics/risk-factors/con-20026040

http://www.skincell.org/community/index.php?topic=7066.0

http://www.americanskin.org/resource/lichen.php

http://rarediseases.org/rare-diseases/lichen-planus/

Lichen nitidus is a relatively rare, chronic skin eruption. Lichen nitidus is characterized clinically by asymptomatic, flat-topped, skin-colored micropapules. Lichen nitidus may affect anyone, but typically develops in children and young adults. Lichen nitidus is a benign disease with no associated mortality or complications. The cause of lichen nitidus is unknown. It consists of tiny, skin-colored bumps (papules) that often appear in clusters on the surface of the skin, especially on the arms and legs.

Even without treatment, lichen nitidus usually disappears over time. The papule of lichen nitidus consists of a lymphohistiocytic inflammatory cell infiltrate that lies in close proximity to the epidermis and is associated with basal cell hydropic degeneration.

Certain parts of the body are more affected like trunk, arms, and genitals. Sometimes it can be seen in palms, soles or inside the mouth. Lesions are often found on the forearms, and trunk. It usually does not respond to topical steroids and resolves without treatment over a period of months, but the duration of lesions is variable.

Lichen nitidus is a rare skin condition that the frequency of its incidence internationally remains vague. No mortality or morbidity is being associated as lichen nitidus is generally a benign condition and causes no complications. The skin condition is known to affect both boys and girls although it has found to have a slight prevalence among girls. It can affect people worldwide without racial predilection. The disease is prevalent among pre-school and school aged children including young adults but can also occur in older adults.

Lichen nitidus is not a life-threatening disease that resolves on its own without the need for treatment. The incidence is not potential for skin cancer and seldom causes discomfort while it leaves without long-term or lifelong effect on the skin. Lichen nitidus was once associated with lichen planus believed to be a variant but is now deemed a separate disease.

Causes

The exact cause of lichen nitidus has yet to be identified. At the moment, it is known that skin cells present an abnormal inflammatory activity, controlled by the white blood cells that are also known as lymphocytes. The papules that appear are the result of inflammation controlled by white blood cells called T lymphocytes. Normally, these cells work to heal disease or injury, such as a cut on the finger.

However, there are certain risk factors that the medical literature presents, as lichen nitidus may be associated with the following diseases:

• Lichen planus – at some point, it was believed that lichen nitidus is a variant of lichen planus. However, today, these are two separate entities and it seems that the existence of lichen planus is one of the risk factors involved in the appearance of lichen nitidus
• Atopic dermatitis – this is also an inflammatory skin condition, believed to favor the appearance of the skin-colored micropapules from lichen nitidus
• Crohn’s disease – this is also an inflammatory condition, affecting the interior lining of the digestive tract. As lichen nitidus can affect the mucous membranes from inside the body, people can certainly understand the connection between the two
• Juvenile rheumatoid arthritis – another inflammatory disease, affecting the joints of the body and predisposing to lichen nitidus
• Tuberculosis – infectious disease suppressing the immune system and favoring the appearance of other medical problems, including this inflammatory skin condition
• HIV infection – it has to do with a suppressed immune system as well
• Down syndrome – people with this genetic disorder present an increased risk for various skin conditions, including this one.

Symptoms

Lichen nitidus is hallmarked by the development of the tiny glistering papules that is skin-toned or may be hypopigmented in the individuals with dark skin. The affected area of the skin may also be noticed with slight scaling. Lichen nitidus is often asymptomatic although may get itchy. It is usually localized and seldom develops as generalized.

The tiny papules of lichen nitidus is referred to as lichen eruption and has various clinical variants such as –

• Generalized lichen nitidus rarely occurs in children and is an even rarer variant
• Hemorrhagic or purpuric lichen nitidus is characterized by an unusual eruption replicating a pigment purpuric papules and initially develop on top of the feet and around the ankle before it progresses to the legs until it become generalized
• Vesicular lichen nitidus is the blistering variant that is similar to a pompholyx and usually involves the palm of the hands
• Linear lichen nitidus is a variant of lichen nitidus that is arranged in line
• Keratodermic lichen nitidus involves the palms of the hands and soles of the feet and appears similar to fissuring in chronic eczema
• Perforated lichen nitidus is presented by umbilicated papules that usually develops in the forearms and hands
• Actinic lichen nitidus develops in the areas of the skin that are in constant exposure to the sun and is common among dark skinned individuals and the eruption of lesion is seasonal usually during the summer months

The papules or lesions of lichen nitidus is characterized by the following –

• The size of the papule is about 1mm to 2mm in diameter or similar to the size of a pinhead
• The shape of the lesion is round to polygonal
• The color of the papule is skin-tone and rarely yellowish or brownish while it may appear as hypopigmentation or hyperpigmentation in people with dark skin
• The top of the lesion is flat and the lesion appears shiny
• The lesion appears in clustered groups which may later merge to form a plaque
• The development of the lesion is usually localized and seldom occur as generalized

Lichen nitidus may also develop in the mouth and the papules are described as tiny and flat papules in gray-white color appearing inside the buccal mucosa. It develops on the tongue as white and hard plaques and resembles the appearance of lichen planus.

Lichen nitidus may also be seen with Koebner phenomenon which is not unusual. The lesion is rather arranged in linear down the scratch marks. The lesion of lichen nitidus may also involve the palm of the hand and sole of the foot which may develop in unilateral or bilateral or may occur as localized or in combination with other usual site of lichen nitidus.

Complications

Lichen nitidus is a harmless condition that doesn’t result in long-term skin problems or medical complications. However, the appearance of lichen nitidus may cause a person to be self-conscious or embarrassed.

Treatment

Corticosteroids may reduce inflammation associated with lichen nitidus. The side effects vary depending on whether it’s used as an ointment applied directly to the skin (topical) or taken as a pill (oral). Long-term use of topical corticosteroids can cause thinning of the skin, a lessening of the treatment effect and other skin problems. Long-term use of oral corticosteroids can cause weakening of the bones (osteoporosis), diabetes, high blood pressure and high cholesterol levels.

Retinoid is a synthetic version of vitamin A that can be a topical or oral treatment. The topical treatment doesn’t cause the side effects associated with corticosteroids, but it may irritate the skin. Because retinoid can cause birth defects, it shouldn’t be used by women who are pregnant or who might become pregnant.

Other topical medications – A topical drug called tacrolimus (Protopic) helps to suppress the immune response and may be helpful for lichen nitidus. Possible side effects include stinging, burning and itching at the site where the medication is applied. This medication can’t be used in conjunction with phototherapy. Limit sun exposure while using tacrolimus and don’t use tanning beds during treatment.

Antihistamines act against a protein called histamine that is involved in inflammatory activity. An oral or topical antihistamine may relieve itching associated with lichen nitidus.

Phototherapy, a type of light therapy, may help clear up lichen nitidus. One type uses ultraviolet A (UVA) light, which penetrates deep into the skin. This therapy is usually used in combination with a drug that makes the skin more sensitive to UVA light.

Alternative Treatment

Vitamin A supplement helps skin stay healthy and boosts the immune system.

Omega-3 fatty acid supplement help reduce inflammation.

Zinc helps the immune system fight off bacteria and viruses. The lesions that develop are caused by inflammation from white blood cells called T-lymphocytes that are usually activated near the site of disease.

Vitamin C supplement strengthen the immune system and it is also important in promoting healthy skin.

Reference –

http://escholarship.org/uc/item/65p7c1s7

http://www.dermnet.com/images/Lichen-Nitidus

http://www.drugs.com/mcd/lichen-nitidus

http://emedicine.medscape.com/article/1123127-overview

http://www.dermnetnz.org/scaly/lichen-nitidus.html

http://www.fpnotebook.com/derm/hyperplasia/LchnNtds.htm

http://www.ijdvl.com/article.asp?issn=0378-6323;year=2013;volume=79;issue=4;spage=554;epage=554;aulast=Topal

http://www.fortishealthcare.com/india/diseases/lichen-nitidus-665

http://healthh.com/lichen-nitidus/

Keratosis Pilaris (KP) is a very common skin disorder seen in all kinds of people and all ages. It is a benign condition which appears as numerous small, rough red or tan bumps primarily around hair follicles on the upper arms, legs, buttocks, and sometimes cheeks. Keratosis Pilaris creates a “goose bumps”,” gooseflesh”, or “chicken skin” appearance on the skin. Although it is commonly a skin condition of children and adolescents, it is also seen in many adults. A majority of people with KP may be unaware that the skin condition has a designated medical term or that it is treatable. In general, KP is often cosmetically displeasing but medically completely harmless. Keratosis Pilaris is frequently noted in otherwise healthy, asymptomatic patients visiting physicians for other skin conditions.

Often mistaken for acne, keratosis pilaris is a chronic skin condition that forms white or red bumps when hair follicles are plugged with keratin buildup. It usually appears on the cheeks, upper arms, thighs, outer legs, buttocks and back.

It usually starts in childhood or young adulthood, and usually lasts into later life. It is often found in patients with “sensitive skin,” allergies, or asthma, and often runs in families. It can not be spread from one person to another by touching it, nor can one person spread it from one place to another on their own body. It is not a result of inadequate cleaning or other skin care regimens. People with this condition just have the tendency for their skin to form plugs in some regions.

Causes

Keratosis pilaris results from the buildup of keratin — a hard protein that protects skin from harmful substances and infection. The keratin forms a scaly plug that blocks the opening of the hair follicle. Usually many plugs form, causing patches of rough, bumpy skin.

No one knows exactly why keratin builds up. But it may occur in association with genetic diseases or with other skin conditions, such as atopic dermatitis. Dry skin tends to worsen this condition.

Risk Factors

Keratosis pilaris affects up to half of normal children and up to three quarters of children with ichthyosis vulgaris (a dry skin condition due to filaggrin gene mutations). It is also common in children with atopic eczema.

Although most prominent during teenage years, and least common in the elderly, it may occur in children and adults of all ages.

Symptoms

Symptoms include –

• Small bumps that look like “goose bumps” on the back of the upper arms and thighs
• Bumps feel like very rough sandpaper
• Skin-colored bumps are the size of a grain of sand
• Slight pinkness may be seen around some bumps
• Bumps may appear on the face and be mistaken for acne

Complications

Keratosis pilaris may fade slowly with age.

Treatment

• Non-soap cleansers (soap may exacerbate dryness)
• Rubbing with a pumice stone or exfoliating sponge in the shower or bath
• Moisturising cream containing urea, salicylic acid or alphahydroxy acids
• Topical retinoids,
• Pulse dye laser treatment or intense pulsed light (IPL) – this may reduce the redness (at least temporarily), but not the roughness
• Laser assisted hair removal

Alternative Treatment

Omega-3 Fatty Acids – Fish oil supplements have been a successful cure.  Other sources of omega-3 fatty acids are sprouted chia and flax seeds and black cumin seeds and oils.  Borage is very good for the skin in general; it has omega-6 fatty acids and is included with fish oil in some supplements.

Vitamin A contains retinol, a derivative that promotes cell turnover and prevents hair follicle plugging.

Alpha hydroxy acids are mild, natural acids. Lactic acid, found in milk and yogurt, gently exfoliates skin to remove KP. Glycolic acid, made of fruit acids, is also a popular skin care product.

Yogurt – The presence of lactic acid in yogurt decreases the dryness of the skin and provides respite from the excess deposition of keratin.

Beta-carotene is very helpful in preventing the excess production of keratin. Consume 2 to 3 carrots on a daily basis.

Ammonium Lactate Lotion – It has been believed by a lot of people that lotions made from ammonium lactate works wonders for keratosis pilaris. Being inexpensive, these lotions are easily available and extremely useful in treating various skin problems.

Witch hazel is known for curing several skin problems, including keratosis pilaris. Due to its cooling properties, it is very useful, especially for bumps caused due to hair removal or dry skin.

Tea tree oil is useful in clearing all the bumps that are caused as a result of the skin diseases. Simply massage some oil on the lesion.

Exfoliation smooths and eliminates bumps, eliminating acne and improving overall appearance. Make a paste of baking soda, water, salt, lactic acid (milk, yogurt, buttermilk), mild acids (lemon juice, apple cider vinegar) and apply it to the affected area.

Reference –

http://www.dermadoctor.com/conditions/keratosis-pilaris

http://patient.info/doctor/keratosis-pilaris-pro

http://lagunaskincenter.com/articles/keratosis-pilaris/

http://www.bad.org.uk/for-the-public/patient-information-leaflets/keratosis-pilaris/?showmore=1&returnlink=http%3A%2F%2Fwww.bad.org.uk%2Ffor-the-public%2Fpatient-information-leaflets#.Vroh8Vh97IU

https://www.msdmanuals.com/home/skin-disorders/hypersensitivity-and-inflammatory-skin-disorders/keratosis-pilaris

https://www.nlm.nih.gov/medlineplus/ency/article/001462.htm

http://www.nhs.uk/conditions/keratosis-pilaris/Pages/Introduction.aspx

http://amlactin.com/keratosis-pilaris

Ichthyosis vulgaris, also known as common ichthyosis or fish scale disease, is the most common form of ichthyosis. It is a skin condition, which is commonly inherited, and is characterized by accumulation of dead skin cells resulting in thick and dry scales on the skin. Its name is derived from the Greek word meaning “fish.

Ichthyosis vulgaris slows down the natural shedding of the skin cells. This results in accumulation of the keratin in the topmost layer of the skin. Due to the presence of the scales in ichthyosis vulgaris, it is sometimes called as fish skin disease or fish scale disease. The scales can be present at birth; however, they initially appear in early childhood. In some cases, ichthyosis vulgaris is not diagnosed at all, as people mistake them for extremely dry skin. There are very rare cases of severe ichthyosis vulgaris with the majority of them being mild. Sometimes ichthyosis vulgaris is associated with other skin conditions, such as eczema.

The disorder is not present at birth, but usually develops during the first year of life with an improvement often seen during summer and with age. The symmetrical scaling of the skin is most prominent on the extensor surfaces of the extremities and spares the flexural folds varying from barely visible roughness and dryness to marked scaling.

Causes

Ichthyosis vul­garis is the most com­mon type of ichthyosis and is es­ti­mat­ed to af­fect around 1 in 250 individuals.

Inheritence – Ichthyosis Vulgaris or Fish Skin Disease or Fish Scale Disease is an inherited condition occurring due to a genetic mutation, which is passed on by one or both the parents. Children who have inherited the defective gene from only one parent will have ichthyosis vulgaris which is milder; whereas children who have inherited defective genes from both the parents will have a severe type of ichthyosis vulgaris. Children who have inherited this condition commonly will have normal skin at the time of birth; however, later on, in the initial years of their life, their skin will develop roughness and scaling.

Genetic – If this condition is not inherited or is not the result of gene mutations, then it is known as acquired ichthyosis. This is a rare type and commonly starts during adulthood; and it also is associated with other medical conditions, such as thyroid disease, HIV/AIDS or cancer.

Risk Factors            

Ichthyosis vulgaris is found in people of all races and of both sexes. Hereditary ichthyosis vulgaris is fairly common. As many as 1 in 250 children may have hereditary ichthyosis vulgaris. On the other hand, acquired ichthyosis vulgaris is rare and is found almost exclusively in adults.

Symptoms

The most common locations for ichthyosis vulgaris include –

• Fronts (extensor surfaces) of the legs
• Backs (extensor surfaces) of the arms
• Scalp
• Back
• Forehead and cheeks, especially in younger children

The scales of ichthyosis vulgaris range in size from 1–10 mm and in color from white to gray to brown, with darker-skinned people often having darker scales. The legs are usually affected more than the arms. The creases on the palms of the hands and the soles of the feet are prominent and often crack during dry or cold weather. However, the scaling tends to improve in more humid or warmer weather.

The following areas tend to NOT be affected –

• Face
• Front of the neck
• Abdomen
• Folds in front of the elbows (flexural surfaces of the arms)
• Folds behind the knees (flexural surfaces of the legs)

Hereditary ichthyosis and acquired ichthyosis look similar, and both are usually itchy. However, the acquired form occurs in people with many internal conditions, including –

• Poor nutrition
• Infections, such as leprosy or HIV/AIDS
• Glandular diseases, such as thyroid or parathyroid problems
• Sarcoidosis
• Cancer, such as lymphoma or multiple myeloma
• Use of certain medications, such as nicotinic acid, cimetidine, and clofazimine

Complications

Some people with ichthyosis may experience –

• Overheating – In rare cases, the skin thickness and scales of ichthyosis can interfere with sweating. This can inhibit cooling. In some people, excess sweating (hyperhidrosis) can occur.
• Secondary infection – Skin splitting and cracking may lead to infections.

Treatment

Medication

• Alpha hydroxy acids (lactic acid, glycolic acid) in prescription ointments /creams help in controlling the scaling and increasing the moisture in the skin.
• Retinoids are vitamin A-derived drugs and are given in severe Ichthyosis Vulgaris. They work by cutting down the skin cells production. Side effects include: Inflammation of the eyes and lips, hair loss and bone spurs. Retinoids are contraindicated in pregnancy, as they can cause birth defects.

To get the best results, use moisture-retaining creams or ointments after a bath or shower, so that moisture is maintained within the skin surface. Petrolatum, lanolin or urea-containing preparations are very helpful in maintaining skin moisture.

Alternative Treatment

Natural oils – almond, avocado, bitter orange, lemon and lime – are good for treating dry skin. Crisco vegetable shortening can be used to treat dry skin.

Vitamins and mineral supplements can assist in curing dry skin

• Gotu Kola
• Green tea
• Honey
• Hyaluronic Acid
• Trypsin

A milk bath is also a common home remedy to moisturize skin.

Holistic herbs for curing Fish skin disease include these:

• Borage
• Calendula flower
• Chamomille tea
• Coltsfoot
• Comfrey plant
• Dandelion tea
• Geranium
• Fennel
• Hyssop
• Lavendar oil
• Oat extract
• Patchouli
• Peppermint tea
• Rose
• Sandlewood

Reference –

http://www.dermis.net/dermisroot/en/39957/diagnosep.htm

http://www.ichthyose.de/europa/pages/ichthyosis.php

http://onlinelibrary.wiley.com/doi/10.1002/psb.368/pdf

https://umm.edu/health/medical/ency/articles/ichthyosis-vulgaris

http://www.merckmanuals.com/professional/dermatologic-disorders/cornification-disorders/ichthyosis

http://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=EN&Expert=462

https://results.gentlelabs.com/ichthyosis-vulgaris

http://www.drugs.com/health-guide/ichthyosis.html

Hyperhidrosis is a disorder that defines individuals who sweat more than the body would normally need to maintain optimal temperature.

Hyperhidrosis affects work productivity, confidence, social comfort, emotional well being and wardrobe choices. Studies show that hyperhidrosis impacts quality of life similar to or even greater than other well-known dermatological conditions, such as severe acne or psoriasis. It has also been shown that only 38% of hyperhidrosis sufferers talk to a health care professional about their condition. People rarely seek help because many are unaware that excessive sweating is a treatable medical disorder.

Hyperhidrosis, or excessive sweating, is a relatively rare, non-life-threatening medical condition that occurs in the –

• Hands (palmar hyperhidrosis);
• Armpits (axillary hyperhidrosis); or
• Feet (plantar hyperhidrosis)

Regardless of where it occurs, hyperhidrosis affects a person’s quality of life.

Hyperhidrosis is not a temporary condition. Many people who suffer from it have suffered for many years, often from childhood or sometimes from adolescence. Hot or cold, the sweating is constant, and the impact of hyperhidrosis can be severe. Wetness and staining of clothes, clammy hands and sodden smelly shoes, inability to grip objects such as pens, cold and wet handshake, damage to keyboards and difficulty dealing with paper and metals, can make a miserable existence. People may constantly worry about changing clothes, freshening up, using absorbent pads or sticking with loose black or white clothes, and may avoid making friends or interacting with people at work. Patients report that they are even embarrassed to hold the hands of those they love. Loneliness, depression and decreased confidence can result.

Excessive sweating can also cause irritating or painful skin conditions.

Types

There are 2 categories of hyperhidrosis – primary and secondary.

• Primary hyperhidrosis – In primary hyperhidrosis, the most common type, the cause of the excessive sweating is not known. It often starts in childhood or adolescence and tends to affect the palms, soles, armpits and sometimes the face and scalp. Rarely, primary hyperhidrosis may affect the whole body.
• Secondary hyperhidrosis – Secondary hyperhidrosis occurs when the excessive sweating is due to an underlying medical condition. It may affect the whole body.

Causes

Primary hyperhidrosis appears to be due to overactivity of the hypothalamic thermoregulatory centre in the brain, and is transmitted via the sympathetic nervous system to the eccrine sweat gland.

Triggers to attacks of sweating may include –

• Hot weather
• Exercise
• Fever
• Anxiety
• Spicy food

Causes of secondary localised hyperhidrosis include –

• Stroke
• Spinal nerve damage
• Peripheral nerve damage
• Surgical sympathectomy
• Neuropathy
• Brain tumour
• Chronic anxiety disorder

Causes of secondary generalised hyperhidrosis include –

• Obesity
• Diabetes
• Menopause
• Overactive thyroid
• Cardiovascular disorders
• Respiratory failure
• Other endocrine tumours, eg phaeochromocytoma
• Parkinson disease
• Hodgkin disease
• Drugs – caffeine, corticosteroids, cholinesterase inhibitors, tricyclic antidepressants, selective serotonin reuptake inhibitors, nicotinamide and opioids

Symptoms

Most people sweat when they exercise or exert themselves, are in a hot environment, or are nervous, anxious or under stress. The excessive sweating experienced with hyperhidrosis far exceeds such normal sweating.

Hyperhidrosis is embarrassing and interferes with many daily activities.

Axillary hyperhidrosis –

• Clothing becomes damp, stained and must be changed several times a day
• Wet skin folds are prone to chafing, irritant dermatitis and infection

Palmar hyperhidrosis –

• Slippery hands lead to avoidance of hand shaking
• Marks left on paper and fabrics
• Difficulty in writing neatly
• Malfunction of electronic equipment such as keypads and trackpads
• Prone to blistering type of hand dermatitis (pompholyx)

Plantar hyperhidrosis –

• Affects soles of the feet
• Unpleasant smell
• Ruined footwear
• Prone to blistering type of dermatitis (pompholyx)
• Prone to secondary infection (tinea pedis, pitted keratolysis)

Complications

Complications of hyperhidrosis include –

• Infections – People who sweat profusely are more prone to skin infections.
• Social and emotional effects – Having clammy or dripping hands and perspiration-soaked clothes can be embarrassing.

Treatment

Antiperspirants – Excessive sweating may be controlled with strong anti-perspirants, which plug the sweat ducts. Products containing 10% to 20% aluminum chloride hexahydrate are the first line of treatment for underarm sweating. Some patients may be be prescribed a product containing a higher dose of aluminum chloride, which is applied nightly onto the affected areas. Antiperspirants can cause skin irritation, and large doses of aluminum chloride can damage clothing.

Medication – Medicines may prevent stimulation of sweat glands. These are prescribed for certain types pf hyperhidrosis such as excessive sweating of the face. Medicines have side effects and are not right for everyone.

Iontophoresis – This procedure uses electricity to temporarily turn off the sweat gland. It is most effective for sweating of the hands and feet. The hands or feet are placed into water, and then a gentle current of electricity is passed through it. The electricity is gradually increased until the patient feels a light tingling sensation. The therapy lasts about 10 to 20 minutes and requires several sessions. Side effects include skin cracking and blisters, although rare.

Botox – Botulinum toxin type A (Botox) is used to treat severe underarm sweating. This condition is called primary axillary hyperhidrosis. Botulinum toxin injected into the underarm temporarily block the nerves that stimulate sweating. Side effects include injection-site pain and flu-like symptoms. Botox used for sweating of the palms can cause mild, but temporary weakness and intense pain.

Endoscopic thoracic sympathectomy (ETS) – In severe cases, a minimally-invasive surgical procedure called sympathectomy may be recommended when other treatments do not work. The procedure turns off the signal that tells the body to sweat excessively. It is usually done on patients whose palms sweat much more heavily than normal. It may also be used to treat extreme sweating of the face. ETS does not work as well for those with excessive armpit sweating.

Underarmsurgery – This is surgery to remove the sweat glands in the armpits. Methods used include laser, curettage (scraping), excision (cutting), or liposuction. These procedures are done using local anesthesia.

Hypnosis – Individuals who have tried hypnosis for palmar hyperhidrosis have reported little improvement.

Lasertherapy – Some desperate patients have tried this technique. This technique involves direct irradiation of the palms which results in 3rd degree burns of the hands without any improvement in sweating.

Radiotherapy – High-dose radiation to treat axillary hyperhidrosis. Serious dermatitis and skin retraction develops.

Psychotherapy – Psychological problems commonly develop as a consequence of hyperhidrosis, not the other way around. Psychiatric or psychopharmacologic therapy may help an individual to cope with hyperhidrosis condition, but certainly won’t treat the disorder.

Complementary Treatment

Axillary Sweat Gland Removal – Z-plasty excision of the axillary sweat glands. Hypertrophic and/or constrictive scars may sometimes form restricting shoulder motion.

Acupuncture regulates organ functioning and promotes harmony between the internal and external body so as to arrest excessive sweating.

Supplements

Magnesium – Sweating is also caused due to the deficiency of magnesium in the body. However excessive sweating can also lead to magnesium deficiency in the body.

Gamma-aminobutyric or GABA is an amino acid produced naturally in the brain. Decreased levels of GABA in the body are correlated with anxiety, which is a main trigger of hyperhidrosis.

B-complex vitamins serve a crucial function in the maintenance and regulation of the nervous system. A deficiency in B vitamins will inhibit the body ability to handle stress, the main trigger of primary hyperhidrosis. B vitamins are also important to help stabilize the body’s lactate levels, which are responsible for preventing anxiety attack, another key trigger of sweating.

Calcium is secreted from your body when people sweat; therefore patients with hyperhidrosis are at an increased risk of calcium deficiency.

Vitamin C is an essential nutrient in helping your body cope with stress, which will have the secondary effect of helping reduce the sweating. Vitamin C also plays an important role as an antioxidant which counteracts hyperthyroidism, one of the leading causes of secondary hyperhidrosis.

Vitamin E and Selenium are both powerful antioxidants as well. They work together to protect cells from oxidative damage caused by hyperthyroid ism, which causes excessive sweating due to an overactive thyroid gland. Selenium strengthens the capillary walls and decreases their dilation which will reduce perspiration. Vitamin E has been shown to be especially effective in reducing hot flashes and night sweats in women going through menopause.

Herbal Treatment

Witch Hazel – The bark and leaves of the witch hazel plant are extracted into a powerful astringent which can be applied in liquid form to the skin.

Burdock – this herb safely manages excessive sweating by eliminating excessive fluids through other means rather than the sweat pores. It redirects sweating fluids through the lymph nodes, kidneys and bowels instead.

Astragalus – This herb, native to northeast China, has mild diuretic properties and plays a role in balancing your sweat response.

Tea Tree Oil – this one is exceptionally effective for foot sweating.

Passion Flower reduces the symptoms of general anxiety disorder and over-activity in the brain which are two major contributing factors of hyperhidrosis. In addition, the antispasmodic action of passion flower relaxes spasms and tensions in muscles. This leads to calmer nerves and a reduction in perspiration. Passion flower also sooths the sympathetic nervous system and improves blood circulation.

Chamomile has been listed as an alternative treatment for hyperhidrosis by the International Hyperhidrosis Society and the American Institute for Hyperhidrosis. It is a calming herb that reduces stress and anxiety by soothing the nerves.

Reference –

http://www.medbroadcast.com/condition/getcondition/Hyperhidrosis

http://patient.info/health/excessive-sweating-hyperhidrosis

http://www.parsec.it/summit/hyper1e.htm

https://www.nice.org.uk/guidance/ipg487

https://www.nice.org.uk/guidance/ipg487

http://my.clevelandclinic.org/services/heart/disorders/hyperhidrosis

http://www.dermnetnz.org/hair-nails-sweat/hyperhidrosis.html

http://www.hyperhidrosis.ca/

http://www.nhs.uk/Conditions/Hyperhidrosis/Pages/Treatment.aspx

http://www.mayoclinic.org/diseases-conditions/hyperhidrosis/basics/definition/con-20030728

http://www.sweathelp.org/hyperhidrosis-treatments/treatment-overview.html

http://www.webmd.com/skin-problems-and-treatments/hyperhidrosis2

https://www.nlm.nih.gov/medlineplus/ency/article/007259.htm

https://www.aad.org/public/diseases/dry-sweaty-skin/hyperhidrosis