General Dermatology & Surgery
Psoriasis is a term that encompasses a group of chronic skin disorders that affect any part of the body from the scalp to the toenails, but most frequently affect the scalp, elbows, knees, hands, feet and genitals. Over seven million men and women in the U.S. of all ages have some form of psoriasis, which may be mild, moderate or severe. In addition, it may be categorized into different types: plaque, pustular, erythrodermic, guttate or inverse psoriasis. Most forms involve an itching and/or burning sensation, scaling and crusting of the skin.Type-specific symptoms include:
- Plaque psoriasis (the most common type): raised, thickened patches of red skin covered with silvery-white scales;
- Pustular psoriasis: pus-like blisters;
- Erythrodermic psoriasis: intense redness and swelling of a large part of the skin surface;
- Guttate psoriasis: small, drop-like lesions;
- Inverse psoriasis: smooth red lesions in the folds of the skin.
While the cause of psoriasis has yet to be discovered, suspected triggers include emotional stress, skin injury, systemic infections and certain medications. There is a possibility that susceptibility to psoriasis is inherited.
Normally the outer layer of skin, which consists of keratinocytes, is replaced unnoticeably, about once a month. This process is faster in people with psoriasis; keratinocytes reach the skin surface too quickly, before they can be properly incorporated into surrounding tissue or even before they are fully mature. As a result, the skin flakes off. This sped-up process is called parakeratosis.
Psoriasis cannot be cured but it can be treated successfully, sometimes for months or years and occasionally even permanently. Treatment depends on the type, severity and location of psoriasis; the patient's age, medical history and lifestyle; and the effect the disease has on the patient's general mental health. The most common treatments are topical medications, phototherapy, photochemotherapy (PUVA), and oral or injectable medication (for severe symptoms).
Rosacea is a chronic skin disease that causes redness and swelling on the face. The scalp, neck, ears, chest, back and/or eyes may also be affected. Symptoms range from red pimples, lines and visible blood vessels to dry or burning skin and a tendency to flush easily. Many people find that the emotional effects of rosacea - such as low self-confidence and avoidance of social situations - are more difficult to handle than the physical ones. Although it can affect anyone, rosacea typically appears in light-skinned, light-haired adults aged 30-50. It is not yet known what causes rosacea and the disease is not curable, although it can be treated with topical and oral medications, laser therapy or laser surgery.
Shingles is a disease caused by the varicella-zoster virus, the herpes virus responsible for chickenpox. Once an individual has been infected with chickenpox, this virus lies dormant within the body's nerve tissue. Years later, the virus may reactivate as shingles, often after another illness or during a period of great stress. Advancing age and immune deficiency disorders are also risk factors for shingles.
Shingles most commonly presents as a painful rash of fluid-filled blisters wrapping around the back and chest, typically affecting only one side of the body. It is possible, however, for patients to have shingles with only a very mild rash or even no rash at all. Early treatment for shingles may minimize symptoms and prevent complications.
Since shingles affects the nerves, patients may experience a wide variety of sensations at the affected site, including shooting pain, itching, burning and numbness. Additional symptoms of the disorder may include headache, fever, fatigue and body aches. The shingles rash usually lasts for several weeks to as much as a month. For most individuals, the pain lessens as the rash heals. Some unfortunate patients, however, experience long-term nerve pain after a case of shingles, pain which may linger for more than a year.
Normally the doctor diagnoses shingles by an examination of the rash and a discussion of the patient's symptoms. If blisters are present at the time of the examination, the doctor may take a sample of fluid for a laboratory culture. Treatment of shingles consists of the use of analgesics and antiviral medications. The former provide symptom relief and the latter may shorten the course of the illness or lessen the severity of the symptoms.
While shingles is not a life-threatening disease, it can be extremely painful and interfere greatly with normal activities and quality of life. A shingles vaccine is now available and recommended for individuals over the age of 60. While not preventative of the reactivation of the shingles virus in all cases, it has been demonstrated to greatly reduce the risk of an outbreak, as well as to lessen the severity of the disease should it occur.
Vitiligo is a skin condition involving a loss of melanin that occurs when the cells that produce this substance die or malfunction, resulting in increasing areas of depigmentation on the skin and hair. The specific cause of this condition is unknown, but is linked to immune system disorders, hereditary factors or single instances of emotional distress.
In order to diagnose vitiligo, your doctor may perform a blood test or remove a small sample (biopsy) of affected skin in order to detect any abnormalities within the area. While there is no cure for vitiligo, there are several treatment options available to slow to progression of the condition and allow patients to once again feel confident and happy about the way they look.
Patients with vitiligo often experience white patches on the skin where depigmentation as occurred, as well as premature whitening of the hair (before the age of 35), change of color in the eye and loss of color on the inside of the mouth. While depigmentation can develop in nearly any area of the body, it is most common in sun-exposed areas such as the face, hands, feet and arms, and is most noticeable in people with darker skin.
Warts are a common condition that develops on different areas of the body as a result of infection by a type of human papillomavirus (HPV). There are several different types of warts, which may have a different appearance and tend to occur in different areas. In general, warts tend to appear on warm, moist parts of the body, such as the hands, feet knees and elbows.
Although they can affect anyone, warts are most common in children and young adults, as they are passed through direct contact with an infected area. Warts often appear as small skin growths that may be flat or slightly raised, and can be brown, gray, pink or skin-colored. Your doctor can diagnose warts through a simple physical exam.
While warts are not usually considered harmful, they may be painful or embarrassing and should be thoroughly treated to relieve symptoms and prevent them from spreading to other people or other parts of the body. Most warts can be treated through conservative methods such as applying salicylic acid or cantharidin or by undergoing cryotherapy (freezing) treatments. Resistant warts may require surgical treatment through excision or laser surgery.
Your doctor will determine the most effective treatment option for you after a thorough evaluation of your condition. In most cases, treatment is permanent and warts do not return. There are certain preventive measures that can be taken to prevent warts from spreading, including avoiding sharing towels, razors and other personal items.