All about Scabies; Introduction, how to discover and effective treatment.

The main symptom of scabies is intense itching that is worse at night when the skin temperature is warmer.
The skin rash that is associated with a scabies infection is made up of tiny red insect bites or spots. If you scratch the rash, you may also develop crusty sores.

Burrow marks can be found anywhere on the body but, in adults, they often appear in the some areas as shown in the picture:


-Your GP will usually be able to diagnose scabies from the appearance of your skin, and by looking for the burrow marks that are made by the Sarcoptes scabiei mite.

-Ink test
The burrows of scabies mites can be highlighted by using an ink test. The ink is rubbed around an area of itchy skin before being wiped off with an alcohol pad. If scabies burrows are present, some of the ink will remain and will have tracked into the burrows, showing up as a dark line.

In order to confirm the diagnosis, a skin sample may be gently scraped from the affected area so that it can be examined under a microscope for evidence of scabies mites and their eggs and faeces (stools).

Treatment of Scabies:
The two most widely used treatments for scabies are:

• permethrin cream
• malathion lotion

Permethrin cream is usually recommended as the first treatment. Malathion lotion is used if the permethrin cream proves to be ineffective. Both medications contain insecticides that kill the scabies mite.

Permethrin cream should be used under medical supervision for women who are pregnant and also for young children who are between two months and two years old. You should check with your GP before using this treatment.
.It is important that all members of your household, and any close contacts

Some advices for Scabies treatment:
1-Permathrin cream or malathion lotion should be applied to cool, dry skin and not after a hot bath. If the cream or lotion is applied when the body is hot, it will be absorbed quickly into the skin and will not remain on the area where the burrows are present.
2-Apply it to the whole body from the chin and ears downwards, paying particular attention to the areas between the fingers and toes and under the nails and areas where there are skin folds. Treatment can be massaged under fingernails and toenails using an old toothbrush (which should be sealed in a bag and thrown away afterwards).
3-Adults should not apply lotion above the neck. However, in children under two years old a thick layer should be applied to the scalp, face and ears, avoiding the eyes and mouth.
4-People with a weak immune system, the very young and elderly people should apply the treatment to their whole body, including their face and scalp.
5-If you wash your hands within 8–12 hours, reapply the cream to your hands, making sure that you also put it under your nails.
6-Permethrin needs to be left on for 8–12 hours, and malathion should be left on for 24 hours.
7-Follow-up treatment after seven days is recommended in order to make sure that the treatment is successful. This will ensure that any mites that have hatched from existing eggs will be killed by the second application.

Facts About Sun Exposure

Direct sun exposure without any protection is very harmful to skin, as ultraviolet A rays are high-energy rays that can penetrate even tinted glass. Use a maximum UVA protection sunscreen on a daily basis with advice from a board-certified dermatologist in this free video on skin care.

Athlete's Foot

Also called: Tinea pedis



Athlete's foot is a common infection caused by the tinea fungus. It is not serious. Symptoms include itching, burning and cracked, scaly skin between your toes. Tinea grows best in damp, dark and warm places, which is why it often develops between your toes. It can spread to your toenails, as well, making them thick and crumbly.

You can get athlete's foot from damp surfaces, such as locker room floors. To prevent it

• Wash your feet every day
• Dry your feet well, especially between your toes
• Wear clean socks
• Don't walk barefoot in public areas
• Wear flip-flops in locker room showers

Treatments include over-the-counter antifungal creams for most cases and prescription medicines for more serious infections.

Facts About Sun Exposure

Direct sun exposure without any protection is very harmful to skin, as ultraviolet A rays are high-energy rays that can penetrate even tinted glass. Use a maximum UVA protection sunscreen on a daily basis with advice from a board-certified dermatologist in this free video on skin care.

Melanoma

Melanoma is a malignant tumor of melanocytes which are found predominantly in skin but also in the bowel and the eye (see uveal melanoma). It is one of the less common types of skin cancer but causes the majority of skin cancer related deaths. Malignant melanoma is a serious type of skin cancer. It is due to uncontrolled growth of pigment cells, called melanocytes.Despite many years of intensive laboratory and clinical research, the sole effective cure is surgical resection of the primary tumor before it achieves a Breslow thickness greater than 1 mm.

Around 160,000 new cases of melanoma are diagnosed nationally each year, and it is more frequent in males and Caucasians. It is more common in Caucasian populations living in sunny climates than in other groups. According to a WHO report about 48,000 melanoma related deaths occur worldwide per year.

Malignant melanoma accounts for 75 % of all deaths associated with skin cancer.

The treatment includes surgical removal of the tumor, adjuvant treatment, chemo- and immunotherapy, or radiation therapy.

Detection

To detect melanomas (and increase survival rates), it is recommended to learn what they look like (see “ABCD” mnemonic below), to be aware of moles and check for changes (shape, size, color, itching or bleeding) and to show any suspicious moles to a doctor with an interest and skills in skin malignancy.

A popular method for remembering the signs and symptoms of melanoma is the mnemonic “ABCDE”:

* Asymmetrical skin lesion.
* Border of the lesion is irregular.
* Color: melanomas usually have multiple colors.
* Diameter: moles greater than 6 mm are more likely to be melanomas than smaller moles.
* Enlarging: Enlarging or evolving

Facts About Freckles

Freckles are flat, circular small spots of melanin on human skin in people of fair complexion. The spots develop randomly on the skin, especially after repeated exposure to sunlight. They may vary in colour - they may be red, yellow, tan, light brown, brown, or black. They are usually more often seen in the summer, especially among lighter skinned people and people with light or red hair. Both men and women get freckles at an equal rate.

There are 2 basic types of freckles: - ephelides and lentigines. Ephelides, are flat red or light brown spots that typically appear during the summer months and fade in the winter. Lentigines, are small tan, brown, or black spots which tend to be darker than an ephelis type freckle and which do not fade in the winter.

Freckles are most commonly found on the face, although they may appear on any skin exposed to the sun. Freckles are rare on infants but are very common among children aged 5 to 15 years. They are usually less common on adults.

Causes of Freckles
- Exposure of skin to sun is one of the main causes of developing freckles. Freckles will fade when sun exposure is reduced or eliminated.
- The basic cause of freckles are special cells in the skin that produce a pigment called melanin. If you have melanin in your body accumulating at one place, then it may result in freckles age spots.
- Freckles are also influenced by genetic factors.- Hormone abnormalities can cause freckles since oestrogen over stimulates pigment producing cells, causing them to generate excess colour when exposed to sunlight.
- Fair skin is another main cause for freckles. There is less overall melanin in fair skin to absorb UV light, therefore pigment cells produce melanin at an increased rate.

Symptoms of Freckles
- There may be change in the skin colour and shape.
- Diarrhoea is another common symptom which is accompanied with freckles.
- There may be crampy abdominal pain and or weight loss.
- Skin cancer may be a possible symptom of freckles.
- Moles are often produced at the affected area of skin.
- There may be blood or mucus in the stool.

Treatments
1-Bleaching Creams - The use of hydroquinone and kojic acid are one of the beneficial treatment for freckles. They may help in lightning freckles if they are applied consistently over a period of months.
2-Cryosurgery: A light freeze with liquid nitrogen can be used to treat freckles.
3-Chemical Peels: Chemical peels are used to remove age spots, freckles, discoloration, wrinkles and fine lines. They generally help to make the skin smooth and firm and also help in curing freckles gradually.
4-Intense Pulsed Light Therapy (IPL): IPL is one of the newer forms of facial rejuvenation. IPL delivers energy to both the superficial (epidermis) and deep (dermis) layers of the skin, the epidermis is spared from damage. Thus, there is virtually no recovery time.
5-Tretinoin: Tretinoin (vitamin A acid, Retin-A) also helps to make freckles lighter when applied over a period of time.
6-Laser Treatment: Freckle removal is easily achieved with lasers. The laser light is very effective and helps in eliminating freckles safely.

skin care according to type and skin property

Normal skin
Skin care products should keep normal skin well moisturised without making it oily.
For facial skin, light oil in water-emulsions (cream containing more water than oil or lipids) are recommended during the day. During nighttime, an oil in water-emulsion containing more lipids may be beneficial.
For other body areas, oil in water-emulsions are also recommended.

Dry skin
In dry skin, moisturisers are used to increase the amount of lipids (fatty substances) in the horny layer, to reduce water loss and to soothe the skin. Water in oil-emulsions (mixtures with more oil/ lipids than water) should be preferred. The lipid film smoothes the cragged skin surface and prevents a further loss of water from the epidermis. Water-binding ingredients such as urea, lactic acid and glycerin enhance the hydrating effect of moisturisers and are recommended in dry skin.
Besides lipids, so-called lipid precursors are also recommended, as they are transformed into lipids in the skin. Lactic acid is such a lipid precursor, which is turned into ceramide (a special lipid or fatty substance of the epidermis).
Oil in water-emulsions may lead to an augmented water loss through evaporation and are therefore not recommended in this skin type, although they are often easier to apply than ointments.

Oily skin
Light oil in water-emulsions (more water than oil/ lipids) or oil-free fluids should be used. Products labeled “non-comedogenic” are recommended, as these products are less likely to cause comedones (blackheads and whiteheads) in persons with oily skin.
Water in oil-emulsions (containing more oils/ lipids than water) or rich ointments should be avoided in this skin type.

Combination skin
Combination skin demands special care, and it is often necessary to use two different moisturising products. The dry skin parts need water in oil-emulsions (more oil/ lipids than water) rich in lipids, whereas only oil in water-emulsions (more water than oil/ lipids) should be applied on the oily parts to prevent the clogging of pores and comedones.

Sensitive skin

In sensitive skin, the application of only few cosmetic products is recommended. These products should preferrably contain as few ingredients as possible. Cosmetic products containing potentially irritating or allergenic substances such as propylene glycol, derivates of cinnamon acid, formaldehyde, retinoids, salicylic acid and sodium laurylsulfate should be avoided as far as possible.

Mature skin
Most people over 60 years of age have dry skin. Persons with normal skin often develop dry skin when they reach their forties or fifties, in persons with oily skin, this shift to dry skin may occur even later.
In dry skin, moisturisers are used to increase the amount of lipids (fatty substances) in the horny layer, to reduce water loss and to soothe the skin. Water in oil-emulsions (mixtures with more oil/ lipids than water) should be preferred. The lipid film smoothes the cragged skin surface and prevents a further loss of water from the epidermis. Water-binding ingredients such as urea, lactic acid and glycerin enhance the hydrating effect of moisturisers and are recommended in dry skin.
Besides lipids, so-called lipid precursors are also recommended, as they are transformed into lipids in the skin. Lactic acid is such a lipid precursor, which is turned into ceramide (a special lipid or fatty substance of the epidermis).

Laser treatment for Acne Scar

Preventing Upper Back Acne?

What Causes Back Acne?

Back acne can be caused by sweat, dirt and residue being rinsed off the hair and an unhealthy diet, so eating better, drinking plenty of water and washing the back last in the shower will help prevent back acne. Discover more about acne that can occur on the back, sometimes without a direct cause, with helpful information from a clinical aesthetician in this free video on skin care.

A very interesting story about Multiple Skin Abscesses

A 24 year old woman presented with fever and an abscess in her left antecubital fossa. She claimed that three weeks previously she had attended a blood donor session and an attempted cannulation at the site of the abscess had been unsuccessful. General examination was otherwise unremarkable and the only admitted history was of tonsillectomy, appendicectomy, and extraction of wisdom teeth. Incision and drainage of the abscess in the left antecubital fossa was undertaken on the night of admission and a ß haemolytic streptococcus and Escherichia coli were grown from the pus evacuated.

Her fever settled with intravenous antibiotics, but four days after admission a further abscess appeared on the dorsum of the right foot. Further inquiries led to a complete denial of any other relevant history.

In view of the two abscesses, a full screening for immunodeficiency was undertaken. Immunoglobulin and complement concentrations were measured and white cell function tests were performed all had normal results. The patient was negative for HIV antibodies. Other investigations performed for metastatic abscesses included abdominal ultrasonography and cerebral computed tomography, both of which had normal results.


As no further abscesses appeared during the next week's stay on the ward the patient was discharged, but she returned three days later with fever, rigors, and a swollen abscessing area in the right antecubital fossa. Again, examination was unremarkable apart from the abscess, but some tiny scars on the wrists were noted and under pressure she admitted to a suicide attempt.

Blood cultures were performed which eventually grew E coli and Streptococcus milleri, and the abscess in the right antecubital fossa was drained. She was again treated with intravenous antibiotics but six days after her admission another abscess appeared in the left antecubital fossa, which again required drainage.

Despite repeated questioning, no further helpful history was available. She vehemently denied, on confrontation, the possibility that she could either be using injecting drugs or injecting faeces into her veins. Subsequently her father, who lived 200 miles away, attended the ward and reported that the patient had been admitted to hospital with a halothane overdose in 1989 while working as a veterinary nurse. She also had a history of anorexia and bulimia with multiple suicide attempts.

Five days later she developed a further abscess on the right foot; it required drainage and again grew S milleri and E coli. Over the next two weeks she developed abscesses in her right perianal region and the right groin, both of which grew S milleri, and she then developed a suppurating wound on her abdominal wall in the right subcostal region.

On the evening that the abscess appeared on the patient's abdominal wall her friend, who visited her every day, was confronted and was found carrying a basket containing a large rat. It then became apparent that the patient had been sleeping with the rat, which was her pet, all the time she had been in hospital; her friend brought the rat in the evening and removed it in the morning. On re-examination we were unable to find any obvious rat bite marks on the patient's fingers or toes, but she habitually bit her nails and there were several lacerations on her fingers.

The multiple abscesses were thought to be due to rat bites and the patient was denied access to the rat, which had been her pet since being discovered in the wild some years before. Subsequently no further abscesses appeared, the rat no longer slept with the patient, and both remained well.
Rat bites are an uncommon cause of multiple skin abscesses, certainly in Western societies. Rat bite fever induced by Streptobacillus moniliformis is well described and is associated with chills, arthritis, and a diffuse rash