Psoriasis & Skin Clinic

Acne

Wed, 12 Mar 2008 00:00:00 +1300

Acne is common in adolescents and young adults. It usually occurs in early adolescence and decreases after the age of 25. However, some people, particularly women, develop acne for the first time in their late twenties or thirties. Severe acne tends to run in families and is presents more often in males.

Acne may also develop in people who suffer from any of several endocrine disorders. In particular, acne may develop in people who have abnormalities in circulating androgens. Some drugs can also cause or make acne worse.

Acne is a chronic inflammatory disease of the sebaceous (oil) glands and hair follicles.The scattered lesions caused by acne can manifest as single or multiple bumps generally called nodules or papules. Acne generally appears on the face ( ...

Eczema & Dermatitis

Tue, 11 Mar 2008 00:00:00 +1300

Eczema originates from the Greek word “Ekzein”, which means “to boil”. Eczema is a common, non-infectious skin disease, that is exacerbated by internal or external factors.

Dermatitis (derm-, derma-, dermo-, dermat(o)- Prefix denoting the skin)- is a much broader term used to describe “inflammation of the skin”, in general.

The terms eczema & dermatitis are used interchangeably. Demarcation between the conditions is difficult at times, however similar treatment protocols are used for both conditions. In the interest of the reader or patient, it has been considered best to address them both in the same section.

There are many forms or subtypes of dermatitis/eczema. These include atopic eczema/dermatitis, sebo ...

Fungal Infections

Mon, 10 Mar 2008 00:00:00 +1300

Fungi are basically "simple" plants. Although widespread in nature, there are only a few that can affect the human body.

These fall into two groups:-

Dermatophytes

and
Yeasts

Dermatophytes are responsible for the majority of fungal infections that affect the body. They survive on dead keratin (a protein found in the nails, hair and the outermost layer of skin). When immunosuppression is involved the dermatophyte infection can penetrate into deeper layers of skin and in extremely severe cases can affect the body systemically.

There are three types of dermatophytes:

Trichophyton – infecting the hair, nails & skin
Microsporum ...

Granuloma Annulare

Sun, 09 Mar 2008 00:00:00 +1300

This condition normally affects the back of the hands, the top of the foot, elbows and knees. It can also spread out along the arms and up the legs and even to the buttocks.

Twice as many women are affected and it usually presents in childhood or in young adults.

This condition is a benign, uncommon, slow progressing skin condition of unknown causes. It initially presents as small red or purple papule or papules that slowly develop into an irregular “ring” of firm papules that can be 0.5 to 5 cm in diameter.

Granuloma annulare is often misdiagnosed as tinea (ring worm) because of the round pattern. It is important to note that unlike tinea, where the border usually presents with scaling, the border of granuloma annulare does not presen ...

Miliaria - Prickly Heat or Heat Rash

Sat, 08 Mar 2008 00:00:00 +1300

This condition presents as a direct result of profuse sweating from exposure to hot and humid weather conditions, especially in the tropics.

Blockage of the sweat glands causes the ducts to rupture and a superficial inflammatory reaction around the sweat glands occurs.

It is more likely to occur during scorching hot or extremely humid, summer conditions.

It usually affects children or obese people.
Rarely affecting the palms or soles, it is more likely to occur in the areas of the body that are covered by clothing and the areas that are prone to sweating.
The lesions present as papules or small, thin-walled superficial pinpoint vesicles often surrounded by a red “halo”. The lesions are slightly shiny and erup ...

Herpes Simplex Virus (Cold Sores)

Fri, 07 Mar 2008 00:00:00 +1300

The Herpes Simplex Virus (HSV) is a highly contagious infection.

Upon infection the person will develop an initial site infection – vesicle formation and local inflammation. The virus invades the sensory nerve cells where it will remain dormant. Upon reactivation, recurrences of the HSV will result.

When HSV is reactivated its presence is indicated by a burning, itching and tingling sensation prior to any vesicle formation. These vesicles may evolve into pustules. As they evolve erosion occurs and the skin layer is shed. The erosions often develop into ulcerations, either crusted or moist. The lesions may take between 2-4 weeks to fully heal and often result in post-inflammatory hypo or hyper pigmentation. The areas most likely to be affected are around th ...

Human Pappiloma Virus (Warts)

Thu, 06 Mar 2008 00:00:00 +1300

PAPILLOMARVIRUS INFECTIONS - HPV (Verruca/Warts)

These are benign growths on the skin.

VERRUCA VULGARIS – Common warts account for 70% of all cutaneous warts. Approximately 20% of all school-aged children will present with an infection of warts.

They usually occur of the hands, fingers and knees. They can be as small as 1mm and up to 10mm, but rarely larger.

VERRUCA PLANTARIS (Plantar/Palmar Warts)

Affecting normally the soles but can also appear on the palms, this form is more common in older children and adults.

In the early stages a wart presents as a small, shiny, clearly defined papule. It progresses to a thickened surface studded with brownish black spots. Te ...

Ichthyosis

Wed, 05 Mar 2008 00:00:00 +1300

From the Greek root “Ichthy” for fish. We know that the family of “Ichthyoses” are a group of genetic skin diseases that are characterized by dry, thickened and “scaling” skin.

In an Ichthyosis sufferer, the normal shedding process is inhibited or “slowed down” and in extreme cases the production of the skin cells can also be at a more rapid rate than normal. In some cases the condition is very mild to mild. However, at its worst it can be an extremely cosmetically disfiguring condition. Sufferers in this category also have to cope with many systemic infections due to the constant splitting of the skin and fissures that are often difficult to heal. The sufferer's immune system is impaired and they find it hard to fight off infec ...

Itching/Pruritis

Tue, 04 Mar 2008 00:00:00 +1300

Generalized Itching/Pruritis/Prurigo

Often the cause of itchy skin is not known or is unclear as itching is characterisitc of many skin conditions and systemic diseases.

Pruritis

Pruritis may be generalized (that may involve large areas of the body) or localized (restricted to a specific area).

Generalized pruritis also indicates "itching" that cannot be readily associated with a detectable primary skin condition such as eczema. Secondary features often involve severe excoriation (bloody scratches) that affect all sites except for the mid-back as this area cannot be reached by the patient. This pattern is called the "butterfly" sign. Most patients generally appear to have fine, dry and scaly skin and th ...

Melasma/Chloasma

Mon, 03 Mar 2008 00:00:00 +1300

CONDITIONS EFFECTING PIGMENTATION OF THE SKIN

VITILIGO

A skin condition of unknown causes resulting in the progressive loss of pigmentation (melanocytes) from the skin. Onset may be at any age but is more common in adolescence and young adulthood.

A genetic predisposition to the condition is likely. Approximately 30% of patients have a family history with either a parent, sibling or child having the condition. An auto-immune link also plays a role in Vitiligo development and an association has been observed with auto-immune disorders including diabetes mellitus and thyroid conditions.

It is a chronic condition with a rapid onset, which is then followed by a relative period of stability or a slowed progression.

Nail Infections

Sun, 02 Mar 2008 00:00:00 +1300

ONYCHOLYSIS

The detachment of the nail plate from its bed, is often associated with psoriasis, fungal infections, lichen planus, trauma, chemical exposure and other systemic disorders.

As the nail plate lifts, the space between the plate and the bed collects dirt and keratinous debris. The colour of the affected nails may vary from greyish-white, yellow, brown, greenish or even black.

ACUTE PARONYCHIA

This condition is an inflammation of the nail fold, resulting in redness, swelling and throbbing pain. In severe cases pus will drain from the area surrounding the nail.

ONYCHOMYCOSIS

A chronic, progressive infection of the nail, that is caused by dermatophytes, candida and some moulds. It is often the result of a se ...

Para Psoriasis en Plaques

Sat, 01 Mar 2008 00:00:00 +1300

PARAPSORIASIS EN PLAQUES or Chronic Superficial Dermatitis

There are two types:-

Small Plaque ( Digitative Dermatosis)

Lesions < 5cm in diameter. Yellowish or light tan in colour. The patches or plaques are clearly defined and covered with a fine layer of scale. The lesions are small and finger shaped.

Large Plaque

Lesions > 10cm in diameter. Salmon pink or light red-brown in colour. They are large and tend to be round or oval in shape. Unlike plaque psoriasis or psoriasis annularis there is little or no flaking or thickening of the skin. The lesion is also flatter.

The condition is most commonly referred to as chronic superficial dermatitis.

It affect ...

Psoriatic Arthritis

Fri, 29 Feb 2008 00:00:00 +1300

It can affect between 10%-30% of psoriatics and is more frequent in patients with psoriatic nails or pustular psoriasis.

Characteristic symptoms include joint pain with or without swelling, stiffness, throbbing, redness of joints and heat within the joints, swelling with "sausage-like" appearance of the fingers and toes, tenderness of joints and the surrounding tissue, morning stiffness, reduced movement and functioning. Eye pain and redness, similar to those symptoms of conjuctiveitis, may also be present.

In 85% of patients who suffer from psoriatic arthritis, their skin symptoms preceded the joint disease on average by about 10 years. Most patients typically develop psoriatic arthritis between the ages of 30-50 years.

Although, as yet, ...

Psoriasis

Thu, 28 Feb 2008 00:00:00 +1300

Psoriasis is a skin condition that affects about 3.8% of the population and is the cause of great discomfort. For some, it may even result in hospitalization.

The cause of psoriasis is unknown, although it is well accepted that there is an underlying genetic component which, when triggered, causes the immune system to produce an excessive number of skin cells. As such it has been termed an auto-immune skin disorder. At present there is no cure.

There are four Primary triggers that start or activate the condition. They include:

Koebner Phenomenon - injury or trauma to the skin i.e. operations, Bites, cuts, abrasions etc;

Systemic Infections - Tonsilitis, Shingles and some viral and bact ...

Porphyrias

Wed, 27 Feb 2008 00:00:00 +1300

The porphyrias are a group of genetic disorders that result from an inherited abnormal *heme biosynthesis pathway. Patients with porphyria have a reduced level of porphyrin synthesizing enzymes. This causes a reduction of normal enzyme activity and an accumulation of toxic metabolites in the system. This accumulation is responsible for many of the symptoms experienced by people who have porphyria.

The malfunction in enzyme activity that occurs in porphyria is exacerbated by ingestion of certain drugs – both pharmaceutical and recreational. These include alcohol, sulfonamides, barbiturates, phenytoin, estrogens and chloroquine. Exposure to chemicals such as hexachlorobenzene (a fungicide) can also affect porphyria and may be responsible for triggering the condition in so ...