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Other Skin Diseases

Lichen Planus

Lichen planus (LP) is a disease of the skin and mucous membranes that resembles lichen. It is thought to be the result of an autoimmune process with an unknown initial trigger. There is no cure, but many different medications and procedures have been used to control only the symptoms The overall prevalence of lichen planus in the general population is about 0.1 - 4%. It generally occurs more commonly in females, in a ratio of 3:2, and most cases are diagnosed between the ages of 30 and 60, but it can occur at any age Oral lichen planus is relatively common, It is one of the most common mucosal diseases. The prevalence in the general population is about 1.27-2.0%, and it occurs more commonly in females than males

Classification:

Lichen planus lesions are so called because of their "lichen-like" appearance and can be classified by the site they involve and by their morphology.

Site classification:

Lichen planus may be categorized as affecting mucosal or cutaneous surfaces.

  • Cutaneous forms are those affecting the skin, scalp, and nails.
  • Mucosal forms are those affecting the lining of the gastrointestinal tract (mouth, pharynx, esophagus, stomach, anus), larynx, and other mucosal surfaces including the genitals, peritoneum, ears, nose, bladder and conjunctiva of the eyes.

Signs and symptoms:

Although lichen planus can present with a variety of lesions, the most common presentation is as a well-defined area of purple-coloured, itchy, flat-topped papules with interspersed lacy white lines (Wickham's striae).This description is known as the characteristic "6 P's" of lichen planus: planar (flat-topped),purple,polygonal, pruritic, papules, and plaques.

Causes:

The cause of lichen planus is unknown, but it is not contagious and does not involve any known pathogen. It is thought to be a T cell mediated autoimmune reaction (where the body's immune system targets its own tissues This autoimmune, T cell mediated process is thought to be in response to some antigenic change in the oral mucosa, but a specific antigen has not been identified.

  • Drug reactions, with the most common inducers including gold salts, beta blockers, antimalarials, thiazide diuretics, furosemide, spironolactone, Metformin and penicillamine.
  • Reactions to amalgam (metal alloys) fillings.
  • Graft-versus-host disease lesions, which chronic lichenoid lesions seen on the palms, soles, face and upper trunk after several months.
  • Hepatitis, specifically hepatitis B and hepatitis C infection, and primary biliary cirrhosis.

It has been suggested that lichen planus may respond to stress, where lesions may present during times of stress.It has also been suggested that mercury exposure may contribute to lichen planus .




Eczema

The term eczema is broadly applied to many persistent skin conditions. These include dryness and recurring skin rashes that are characterized by one or more of following symptoms:

Classification or Types::

  • Atopic dermatitis:

    an allergic disease believed to have a hereditary component and often runs in families whose members also have bronchial asthma. Itchy patches on skin are present on head and scalp, neck, inside of elbows, behind knees, and buttocks
  • Contact dermatitis:

    Most of the cases of contact eczema are of the irritant type, which is the most common occupational skin disease. Contact with substances like nickel, cement, detergents ,sunlight, some chemicals act as allergens or triggering factors. Contact eczema is curable, provided the offending substance can be avoided and its traces removed from one's environment.
  • Xerotic eczema:

    is dry skin that becomes so serious it turns into eczema. It worsens in dry winter weather. Limbs and trunk are most often affected. The itchy, tender skin converts in a dry, cracked eczema.This disorder is very common among the older population.
  • Seborrheic dermatitis:

    is a condition sometimes classified as a form of eczema that is closely related to dandruff. It causes dry or greasy peeling of the scalp, eyebrows, and face, and sometimes trunk. The condition is harmless except in severe cases of cradle cap. In newborns it causes a thick, yellow crusty scalp rash called cradle cap.
  • Venus eczema:

    Occurs in people with impaired circulation, varicose veins and edema, and is particularly common in the ankle area of people over 50. There is redness, scaling, darkening of the skin and itching. The disorder can lead to non healing foot ulcers.

Causes:

The cause of eczema is unknown but is presumed to be a combination of genetic and environmental factors.[5]

Another study identified a gene that the researchers believe to be the cause of inherited eczema and some related disorders. The gene produces the protein filaggrin , the lack of which causes dry skin and impaired skin barrier function.[66]A recent study indicated that two specific chemicals found in the blood are connected to the itching sensations associated with eczema. The chemicals are neurotrophic factor & P substance.In a genome-wide study published on Dec 25, 2011 in Nature Genetics, researchers reported discovery of three new genetic variants associated with eczema. They are OVOL1, ACTL9 and IL4-KIF3A.




Vitilgo

Vitiligo is a condition that causes depigmentation of parts of the skin. It occurs when melanocytes, the cells responsible for skin pigmentation, die or are unable to function. The cause of vitiligo is unknown, but research suggests that it may arise from autoimmune, genetic,oxidative stress, neural, or viral causes.[1] The incidence worldwide is less than 1%.[2] The most common form is non-segmental vitiligo, which tends to appear in symmetric patches, sometimes over large areas of the body.

Signs & symptoms :

The most notable symptom of vitiligo is depigmentation of patches of skin that occurs on the extremities.

Although patches are initially small, they often enlarge and change shape.When skin lesions occur, they are most prominent on the face, hands and wrists. Depigmentation is particularly noticeable around body orifices, such as the mouth, eyes, nostrils, genitalia and umbilicus. Some lesions have hyperpigmentation around the edges A Black light (also referred to as a UVA light, Wood's lamp, or simply ultraviolet light) can be used in the early phase of this disease for identification and to determine effectiveness of treatment.

Classification:

Non-segmental:

In non-segmental vitiligo (NSV), there is usually some form of symmetry in the location of the patches of depigmentation. New patches also appear over time and can be generalized over large portions of the body or localized to a particular area. Vitiligo NSV can come about at any age (unlike segmental vitiligo, which is far more prevalent in teenage years).[5]

Classes of non-segmental vitiligo include:

  • Generalized Vitiligo: the most common pattern, wide and randomly distributed areas of depigmentation[7]
  • Universal Vitiligo: depigmentation encompasses most of the body[7]
  • Focal Vitiligo: one or a few scattered macules in one area, most common in children[7]
  • Acrofacial Vitiligo: fingers and periorificial areas[7]
  • Mucosal Vitiligo: depigmentation of only the mucous membranes[7]

Segmental:

Segmental vitiligo (SV) differs in appearance, etiology and prevalence from associated illnesses. Its treatment is different from that of NSV. It tends to affect areas of skin that are associated with dorsal roots from the spine and is most often unilateral. It spreads much more rapidly than NSV and, without treatment, it is much more stable/ static in course and is not associated with auto-immune diseases. It is a very treatable condition that responds to topical treatment.




Purigo

Prurigo nodularis (PN) is a skin disease characterised by pruritic (itchy) nodules which usually appear on the arms or legs. Patients often present with multiple excoriated lesions caused by scratching .

Signs and symptoms :

Nodules are discrete, generally symmetric, hyperpigmented or purpuric, and firm. They are greater than 0.5 cm in both width and depth (as opposed to papules which are less than 0.5 cm). They can appear on any part of the body, but generally begin on the arms and legs.

  • Excoriated lesions are often flat, umbilicated, or have a crusted top.
  • Nodules may appear to begin in the hair follicles.
  • Nodule pattern may be follicular.
  • In true prurigo nodularis, a nodule forms before any itching begins. Typically, these nodules are extremely pruritic and are alleviated only by steroids.

Causes:

The cause of prurigo nodularis is unknown, although other conditions may induce PN. PN has been linked to an autoimmune condition, liver disease and T cells. Systemic pruritus has been linked to cholestasis, thyroid disease, polycythaemia rubra vera, uraemia, Hodgkins disease, HIV and other immunodeficiency diseases. Internal malignancies, liver failure, renal failure, and psychiatric illnesses may induce PN, although more recent research has refuted a psychiatric cause for PN

Diagnosis:

Diagnosis is based on visual examination and the presence of itching. A skin biopsy is often performed to exclude other diseases. Lesion biopsies will typically show a high level of eosinophils in PN




ACNE

Small Pimples coming on Face, Neck, Shoulders, Chest and sometimes at back are generally called ACNE Acne are visible at adolesence age due to hormonal changes in human body. These are physiological changes and do not need any treatment. But sometimes due to hormonal imbalance these Acne grow in bigger size & need to be treated

Sign & Symptoms :

Large swollen pimples with pus filled inside Appears on Buttocks, Groins and Armpit area Redness, swelling, Papules, Pustules, Nodules, Scarring.Oozing and bleeding with pain Black scar formation and hyper-pigmentation of badly heated Acne

Causes:

  • Adolecent age
  • Excessive heat exposure
  • Improper face care - lack of washing and cleanliness
  • Excess sweating
  • No Exercise
  • High carbohydrate and fatty diet
  • Stress
  • Genetics

These above reasons are responsibble for acne at any age. If not treated properly normal Acne converts into ACNE VULGARIS



 

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