Psoriasis Linked to Obesity in Children


The possibility of a link between obesity and psoriasis in children has been revealed by a study done by Dr Amy Paller from the Northwestern University Feinberg School of Medicine and published in the Archives of Dermatology.

This study was done on more than 600 children aged between 5 and 17 years of which approximately 200 had severe psoriasis, 200 mild psoriasis and the rest served as the control group.

Dr Paller's study revealed that:
1. On average, children with psoriasis were four times more likely to be obese when compared to those without pediatric psoriasis. 

2. This tendency was noted to rise with the severity of the psoriasis since children with severe psoriasis were seven times more likely to be obese.

Dr Paller speculated that the link between these two conditions could be inflammatory mediators which contribute to both their development.
  
Holistic Dermatology
This study suggested that applying the principles of holistic dermatology is the best approach when managing children with psoriasis since the weight issues have to be addressed in concert with the skin problem.

This holistic approach is also backed by the fact that some studies imply that psoriasis goes into remission in adults with a high body mass index (BMI) who lose weight.

Therefore parents as well as children with psoriasis should be given lifestyle modifications tips like exercise and diet plans and referred to specialists to help them lose the excess weight when they are being issued with conventional medicine prescriptions for psoriasis.

To learn more about this study, click here. 

Why Patients Discontinue Treatment of Psoriasis


The reasons why patients discontinue their treatment of psoriasis have been revealed by a study done by Howa Yeung from the University of Pennsylvania Perelman School of Medicine in Philadelphia and published in the Journal of the American Academy of Dermatology.

This study, which was done on patients with plaque psoriasis of moderate to severe severity, revealed the following reasons for stopping psoriasis treatment:
1. Medications loosing their effectiveness was given as the reason by more patients who had been prescribed etanercept and adalimumab for psoriasis treatment than those who had been taking methotrexate.

2. Side effects of the medications were cited as the reason for cessation by more patients who had been put on acitretin compared to those who had been on etanercept, adalimumab, methotrexate and ultraviolet B phototherapy.

3. The cost of the treatment was given as the reason for discontinuing treatment by more patients who have been put on ultraviolet B phototherapy.

To learn more on why patients discontinue their treatment of psoriasis, click here.


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Pellagra



Pellagra uses color pictures and clear explanations to teach you about this nutritional disease which affects the skin.

Table of contents:
Chapter 1. What causes Pellagra?
Chapter 2. What are the symptoms and signs of Pellagra?
Chapter 3. What investigations are done for Pellagra?
Chapter 4. What are the differential diagnosis for Pellagra?
Chapter 5. What is the treatment for Pellagra?
Chapter 6. What are the complications of Pellagra?
Chapter 7. How can Pellagra be prevented?

BOOK EXCERPT
Chapter 1
WHAT CAUSES PELLAGRA?
Pellagra is a nutritional disease that is caused by deficiency of vitamin B3 or niacin which is a water soluble vitamin.

Pellagra can be classified in the following way:
1. Primary pellagra
Primary pellagra develops as a result of inadequate dietary niacin intake. Primary pellagra can also develop as a result of inadequate dietary tryptophan intake since this amino acid is converted to niacin in the body. The causes of primary pellagra include poverty related malnutrition, maize (corn) based diet, anorexia nervosa, chronic parenteral nutrition, fad diets and severe elimination diets.  

2. Secondary pellagra
Secondary pellagra develops despite adequate dietary niacin due to poor niacin intake, absorption, and processing by the body. Causes of secondary pellagra include:
a. Gastrointestinal diseases such as chronic diarrhea, Crohn’s disease, ulcerative colitis, regional enteritis, gastrointestinal tuberculosis, and liver cirrhosis.
b. Chronic alcoholism and chronic drug addiction
c. Anorexia nervosa
d. Chronic dialysis
e. Malignant carcinoid tumors since the tryptophan is used to form the serotonin.
f. Hartnup syndrome which is an inherited disorder of amino acid transport which results in defective absorption of tryptophan by the gastrointestinal tract and kidneys.
g. Medications such as isoniazid which competes with niacin, pyrazinamide, 5-fluorouracil, 6-mercaptopurine, azathioprine, chloramphenicol, and phenytoin.

 Click here to buy the PDF eBook Pellagra.


Poikiloderma

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Poikiloderma uses color pictures and clear explanations to teach you about this skin condition.
Table of contents:
Chapter 1. What is Poikiloderma?
Chapter 2. What causes Poikiloderma?
Chapter 3. What are the symptoms and signs of Poikiloderma?
Chapter 4. What investigations are done for Poikiloderma?
Chapter 5. What is the treatment for Poikiloderma?
Chapter 6. Poikilodermatous Mycosis Fungoides or Poikiloderma vasculare atrophicans
Chapter 7. Poikiloderma of Civatte

BOOK EXCERPT

WHAT IS POIKILODERMA?
Poikiloderma is a skin condition characterized by patches of hyperpigmentation, hypopigmentation and atrophy (thinning skin) with telangiectases (dilated capillaries).

WHAT CAUSES POIKILODERMA?
Conditions associated with prominent poikiloderma include:
1. Poikilodermatous mycosis fungoides
2. Poikiloderma of Civatte
3. Large plaque parapsoriasis
4. Connective tissue disease such as lupus erythematosus and dermatomyositis
5. Overuse of topical glucocorticoids
6. Radiation dermatitis
7. Graft versus host disease
8. Genodermatoses such as Rothmund-Thompson syndrome, Bloom syndrome, and dyskeratosis congenita.

Click here to buy the PDF eBook Poikiloderma.


Urticaria

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Urticaria uses color pictures and clear explanations to teach about this common skin disorder which can progress to life threatening angioedema and anaphylaxis.

Table of contents:
Chapter 1. What is Urticaria?
Chapter 2. What are the different types of Urticaria?
Chapter 3. What causes Urticaria?
Chapter 4. What is the pathophysiology of Urticaria?
Chapter 5. What are the symptoms and signs of Urticaria?
Chapter 6. What investigations are done for Urticaria?
Chapter 7. How is a diagnosis of Urticaria made?
Chapter 8. What are the differential diagnosis for Urticaria?
Chapter 9. What is the treatment for Urticaria?
Chapter 10. What are the complications of Urticaria?
Chapter 11. How can Urticaria be prevented?

BOOK EXCERPT

WHAT IS URTICARIA?
Urticaria, which is also known as hives or wheals, occurs in all races and affects approximately 15-20% of the general population at one time. It is the most commonly seen skin disorder in the emergency department and one that should be attended to emergently since it can progress to life threatening angioedema and anaphylaxis.


WHAT ARE THE DIFFERENT TYPES OF URTICARIA?
Urticaria can either be classified acute urticaria or chronic urticaria depending on the duration of the lesions.
1. Acute urticaria
Acute urticaria is usually a self-limiting illness since the transient lesions usually resolve within 24 hours though they may recur for up to 6 weeks. It can occur in all age groups and its incidence is equal in both men and women. 

Acute urticaria can develop because of physical contact with allergens such as latex, inhalation of allergens in molds, ingestion of allergens in shellfish and intravenous administration of allergens in radio-contrast dye.  

The cause of acute urticaria are usually identified in around 50% of patients. Most cases of acute urticaria respond well to treatment with histamine receptor blockers and patients have complete resolution of symptoms within a week.

Click here to buy the PDF eBook Urticaria.


Lamellar Ichthyosis


Lamellar Ichthyosis uses color pictures and clear explanations to teach about this inherited skin disorder. It also suggests specific products that are beneficial for moisturizing and softening the dry, scaly skin of lamellar ichthyosis.  

Table of contents:
Chapter 1. What causes Lamellar Ichthyosis?
Chapter 2. What are the symptoms of Lamellar Ichthyosis?
Chapter 3. What are the investigations for Lamellar Ichthyosis?
Chapter 4. What is the treatment for Lamellar Ichthyosis?
Chapter 5. What are the complications of Lamellar Ichthyosis?
Chapter 6. How can Lamellar Ichthyosis be prevented?

Book Excerpt
What Causes Lamellar Ichthyosis?

Lamellar ichthyosis is a keratinization disorder which is usually inherited in an autosomal recessive fashion. This means that both parents have to be carriers of the abnormal gene to pass it on to their children.

Patients with lamellar ichthyosis have a proliferative hyperkeratosis which means that the rate of production of new skin cells is faster than the rate at which the body can shed them.

What are the Symptoms of Lamellar Ichthyosis?
1. The baby is born covered with a thick collodion membrane which is a shiny, yellow film that covers the baby. This tough film later dries up and is shed in 10 to 14 days to reveal erythematous (red) skin covered with scales. 

2. 2. These scales of lamellar ichthyosis can be fine and white or large and dark. They are arranged in a mosaic pattern resembling the scales of a fish (ichthys is a Greek word which means fish). 

 Click here to buy the PDF eBook Lamellar Ichthyosis.

Ichthyosis

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Ichthyosis uses color pictures and clear explanations to teach about this skin disorder. It also gives specific products that are beneficial for moisturizing and softening the dry, scaly skin of both acquired and inherited ichthyosis.   

Table of contents:
Chapter 1. What is Ichthyosis?
Chapter 2. What causes Ichthyosis?
Chapter 3. What are the symptoms of Ichthyosis?
Chapter 4. What is the treatment for Ichthyosis?
Chapter 5. What are the complications of Ichthyosis?
Chapter 6. Ichthyosis Vulgaris
Chapter 7. Congenital Ichthyosiform Erythroderma or Non-Bullous Ichthyosiform Erythroderma
Chapter 8. Epidermolytic Hyperkeratosis Ichthyosis or Bullous Ichthyosiform Erythroderma
Chapter 9. Lamellar Ichthyosis
Chapter 10. X-Linked Ichthyosis
Chapter 11. Acquired Ichthyosis

Book Excerpt
What is Ichthyosis?
Ichthyosis is derived from the Greek word ichthys which means fish. It consists of a group of around 20 disorders of keratinization which are characterized by persistently dry skin with a fish-like scale. These disorders affect all races and occur all over the world.
The widespread dry scaling of ichthyosis can develop either as a result of:
1. The production of new skin cells at a rate that is faster than the body can shed (proliferative hyperkeratosis)
2. The production of new skin cells at a normal rate but coupled with a slower than normal rate of shedding the old skin cells (retention hyperkeratosis)   

What are the Causes of Ichthyosis?
Ichthyosis can be inherited or acquired.

The inherited ichthyosis are due to genetic mutations (changes in the genes) and include:
1. Ichthyosis vulgaris
2. Lamellar ichthyosis
3. Epidermolytic hyperkeratosis
4. Congenital ichthyosiform erythroderma
5. X-linked ichthyosis

The acquired ichthyosis develop later on in life and are associated with diseases such as of the kidney and thyroid or the use of medications such as nicotinic acid.

 Click here to buy the PDF eBook Ichthyosis.

Linear IgA Dermatosis

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Linear IgA Dermatosis uses color pictures and clear explanations to teach about this autoimmune skin disease.
Table of contents:
What is Linear IgA Dermatosis?
What causes Linear IgA Dermatosis?
What are the symptoms and signs of Linear IgA Dermatosis?
What investigations are done for Linear IgA Dermatosis?
What are the differential diagnosis for Linear IgA Dermatosis?
What is the treatment for Linear IgA Dermatosis?
What are the complications of Linear IgA Dermatosis?

Book Excerpt
What is Linear IgA Dermatosis?
Linear IgA Dermatosis (LAD) is an autoimmune disease in which the patient develops vesicles (small blisters) and bullae (large blisters). Though it was formerly known as chronic bullous disease of childhood, it affects both adults and children.

The age of onset for this immunobullous disease in children is usually around 4 years though it can range from less than a year to 10 years of age. The age of onset for adult LAD ranges from the teen years to the eighties with most developing symptoms at around 50 years.
What Causes Linear IgA Dermatosis?
Linear IgA Dermatosis can be caused by:
1. Drugs such as vancomycin which is the most commonly associated drug. The skin lesions begin to develop from 1 day to 2 weeks after the patient takes the first dose.
2. Diseases such as typhoid, brucella, and tuberculosis have also been associated with LAD.  
4. Malignancies such as Hodgkin’s disease, non-Hodgkin lymphoma, and chronic lymphocytic leukemia (CLL) have also been associated with LAD though the association has not been proven.
5. Idiopathic or cases which arise due to unknown causes.

Click here to buy the PDF eBook Linear Iga Dermatosis.




Dark Skin Dermatology Color Atlas

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Dark Skin Dermatology Color Atlas uses clear explanations and over 100 color photos of skin diseases, hair diseases, and nail diseases affecting people with skin of color or Fitzpatrick skin types IV, V, and VI.

Table of Contents
Chapter 1 Abscess
Chapter 2 Acne Vulgaris
Acne Vulgaris
Symptoms of acne vulgaris include swellings on the face and other areas with high concentrations of sebaceous or oil glands. These swellings which may be painful, range from small comedones or black heads to large nodules and cysts.  

Chapter 3 Alopecia Areata
Chapter 4 Aphthous Ulcers
Chapter 5 Atopic Dermatitis
Chapter 6 Blastomycosis
Chapter 7 Blister Beetle Dermatitis or Nairobi Fly Dermatitis
Chapter 8 Cellulitis
Chapter 9 Chronic Ulcers
Chapter 10 Confetti Hypopigmentation
Chapter 11 Cutaneous T Cell Lymphoma
Chapter 12  Cutaneous Tuberculosis
Chapter 13 Erythema Nodosum
Chapter 14 Gianotti  Crosti Syndrome
Chapter 15 Hand Dermatitis or Hand Eczema
Hand Dermatitis
Symptoms of hand dermatitis or hand eczema include itching or a burning sensation when the skin comes in contact with the irritant.

Chapter 16 Herpes Zoster
Chapter 17 Ichthyosis
Chapter 18 Ingrown Toenails
Ingrown Toenails
Symptoms of ingrown toenails include painful, red swellings on the toes which may be discharging pus if an abscess has developed.

Chapter 19 Irritant Contact Dermatitis
Chapter 20 Keloids
Chapter 21 Keratoderma Blenorrhagica
Chapter 22 Leprosy
Chapter 23 Leukonychia
Chapter 24 Lichen Planus
Chapter 25 Lichenoid Drug Eruption
Chapter 26 Linear IgA Dermatosis (LAD)
Linear IgA Dermatosis

Chapter 27 Molluscum Contagiosum
Chapter 28 Neurofibromatosis
Chapter 29 Nickel Dermatitis or Irritant Contact Dermatitis
Chapter 30 Onychomadesis
Chapter 31 Onychomycosis
Onychymycosis
Symptoms of onychomycosis include thickened and discolored toenails or fingernails.

Chapter 32 Palmoplantar Eccrine Hidradenitis
Chapter 33 Paronychia
Chapter 34 Piebaldism
Chapter 35 Pityriasis Rosea
Chapter 36 Plantar Hyperkeratosis
Chapter 37 Plantar Warts
Plantar Warts
Symptoms of plantar warts include rough swellings on the soles of the feet. These swellings are usually painless but they may become painful if they are on areas that receive much pressure when walking such as on the heel.

Chapter 38 Poikiloderma
Chapter 39 Postinflammatory Hyperpigmentation and Hypopigmentation
Chapter 40 Psoriasis
Psoriasis
Symptoms of plaque psoriasis include red patches with a non-greasy, silvery white scale.

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Chapter 41 Pyogenic Granuloma or Lobular Capillary Hemangioma
Pyogenic Granuloma
Symptoms of pyogenic granuloma include a beefy swelling which arises suddenly, grows rapidly and tends to bleed easily.

Chapter 42 Steven Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)
Chapter 43 Sunburn
Chapter 44 Tinea Capitis
Chapter 45 Tinea Pedis
Chapter 46 Tinea Versicolor
Tinea Versicolor
Symptoms of Tinea Versicolor include hyoopigmented or whitish patches on people with skin of color and salmon colored patches on people with light skin.

Chapter 47 Traction Alopecia
Traction Alopecia
Symptoms of traction alopecia include gradual and painless hair loss with bald spots usually along the hairline and above the ears.

Chapter 48 Urticaria
Chapter 49 Vasculitis
Chapter 50 Vitiligo
Vitiligo
Symptoms of vitiligo include white spots on the skin that range in size from a few millimeters to covering almost the entire skin.
 
Chapter 51 Xanthelasma
Xanthelasma
Symptoms of Xanthelasma include yellowish swellings on the eyelid which progressively increase in size.

Capecitabine Xeloda Hand Foot Syndrome

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Capecitabine (Xeloda) Hand Foot Syndrome teaches about the dermatological adverse effects of the antineoplastic drug Xeloda.
Table of Contents:
Capecitabine (Xeloda) Indications
Capecitabine (Xeloda) Contraindications
Capecitabine (Xeloda) Hand Foot Syndrome Symptoms and Treatment
Other Dermatological Capecitabine (Xeloda) Side Effects
Other Capecitabine (Xeloda) Adverse Effects
Capecitabine (Xeloda) Drug Interactions

Book Excerpt
Capecitabine Indications
Capecitabine (Xeloda) is a prodrug of 5 deoxy 5 fluorouridine which is converted to 5 fluorouracil (5 FU) in the body. This antineoplastic drug works by retarding or stopping the growth of cancer cells and decreasing the tumor size Though the Capecitabine (Xeloda) dose depends on body size and response to treatment, the common dosage is 1250 mg/ m2 twice daily for two weeks then stopped for one week. This orally administered tablet with tumor selective conversion of capecitabine to 5 FU is used to treat:
1. Metastatic colorectal cancer (cancer of the colon and rectum that has spread to other parts of the body)
2. Metastatic breast cancer (breast cancer that has spread to other parts of the body)
3. Advanced gastric cancer (stomach cancer that has spread to other parts of the body)

Capecitabine Contraindications
Capecitabine (Xeloda) should not be taken by the following patients:
1. Patients who are breastfeeding as it can pass through the breast milk and affect the baby.
2. Patients who are deficient of the enzyme dihydropyrimidine dehydrogenase (DPD)
3. Patients who are allergic to 5FU  or capecitabine

Capecitabine (Xeloda) Hand Foot Syndrome Symptoms and Treatment
Hand foot syndrome (HFS), which is also known as palmo plantar erythrodysesthesia (PPE), is seen in almost 50% of patients treated with capecitabine.

HFS usually begins with dysesthesias such as tingling or burning sensations in the soles and palms. These are usually followed by a burning pain with symmetrical erythematous (red) swelling of the hands and feet. This can progress to blistering, ulceration, and painful desquamation (peeling) of the hands and feet.

Though the lesions of HFS are not life threatening, they can interfere with activities of normal daily living such as walking and using the hands to hold and manipulate objects. 

 Click here to buy the PDF eBook Capecitabine (Xeloda) Hand and Foot Syndrome.
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