Itchy Skin was the topic of a live health chat Dr. Mejia participated in today with Dr. Marta Rendon on the Sun Sentinel Health Chat . It was simultaneously in all the Tribune Co. papers: The Sun-Sentinel, LA Times, Chicago Tribune, Orlando Sentinel, Baltimore Sun, Hartford Courant.
Some definitions of the different types of skin conditions and diseases for itchy skin are:
Psoriasis (sore-EYE-ah-sis) is a chronic (long-lasting) disease. It develops when a person’s immune system sends faulty signals that tell skin cells to grow too quickly. New skin cells form in days rather than weeks. The body does not shed these excess skin cells. The skin cells pile up on the surface of the skin, causing patches of psoriasis to appear.
Contact eczema: a localized reaction that includes redness, itching, and burning where the skin has come into contact with an allergen (an allergy-causing substance) or with an irritant such as an irritating acid, a cleaning agent, or other chemical
Allergic contact eczema: a red, itchy, weepy reaction where the skin has come into contact with a substance that the immune system recognizes as foreign, such as poison ivy or certain preservatives in creams and lotions like Neosporin or Bacitracin
Seborrheic eczema (also called seborrheic dermatitis or seborrhea): is a very common form of mild skin inflammation of unknown cause that presents as yellowish, oily, scaly patches of skin on the scalp, face, ears, and occasionally other parts of the body. Often this is also called dandruff in adults or “cradle cap” in infants.
Nummular eczema: coin-shaped (round), isolated patches of irritated skin — most commonly on the arms, back, buttocks, and lower legs — that may be crusted, scaling, and extremely itchy
Neurodermatitis: a very particular type of dermatitis where the person frequently picks at their skin, causing rashes. The underling cause may be a sensitivity or irritation which sets off a cascade of repeated itching and scratching cycles. It may be seen as scratch marks and pick marks on the skin. Sometimes scaly patches of skin on the head, lower legs, wrists, or forearms caused by a localized itch (such as an insect bite) may become intensely irritated when scratched.
Stasis dermatitis: a skin irritation on the lower legs, generally related to circulatory problems and congestion of the leg veins. It may have a darker pigmentation, light-brown, or purplish-red discoloration from the congestion and back up of the blood in the leg veins. It’s sometimes seen more in legs with varicose veins.
Q & A On Sun Sentinal Health Chat
Dr. Mejia: Psoriasis is the most chronic autoimmune disease in the country, affecting up to 7.5 million Americans – or roughly 2-3 percent of the worldwide population.
The Psoriasis Foundation at www.psoriasis.org is an excellent source of information for all the up to date information research and treatments for psoriasis as well as statistics.
SunSentinel.com Health: Emailed question: Are there any new breakthroughs in the treatment of rosacea and what is the best non-prescription treatment out there? — Rich
Dr. Mejia: Rosacea can be triggered by a variety of foods such as spicy foods, red wines and certain cheeses. In many cases patients are given a list of foods to avoid.
Comment From Gabby: Do you know what causes psoriasis? I first started getting it when I was about 30 years old, mostly on my elbows. I’m now 55.
Dr. Mejia: Psoriasis is a genetic condition affecting 1% of the population.
Comment From Psoriasis Foundation: People with psoriasis are at increased risk for other serious health conditions like heart disease and diabetes. What’s the importance of maintaining overall health in people with psoriasis?
Dr. Mejia: There are several over the counter treatments such as coal tar which have worked well for my patients . Otherwise other topical treatments for itchy skin such as topical steroids are used.
Comment from Johnny: Will we ever reseach enogh to find the causes of eczema and such itchy probles that cause bad skin disorders some of the cures now can be more dangerous than the problem why is it the most effective treatments like lasers treatment so expensive when high tect equipment is really cheap to make.
Dr. Mejia: Johnny. There are many reasons for eczema. The problem is finding the cause. It may be an irritant, and allergy or atopic dermatitis.
I can’t comment on the cost of the equipment. Generally we are not utilizing expensive lasers for eczema. It is more topical therapy and trigger avoidance.
Comment from Randy: I have deep red patches on my legs that get dry and flaky. The creams they give me to get rid of it only temporarily get rid of it.
Dr. Mejia: Eczema on the lower legs can be related to stasis dermatitis or nummular eczema as above. I would also check depending on your age whether you have severe varicose veins.
Comment from Kim: My 5 year old son has excema. The only trigger seems to be our dog. We have been swimming more often recently and his excema seems to be worse; however he is spending more time with our dog. Is chlorine something that could be making it worse. Please advise any tips beyond moisturizer. We use a steroid cream to treat it and I am hesitant to use it too much. Thanks!
Dr. Mejia: Scalp itching in a young kid could be lice, psoriasis or even seborrheic dermatitis although rarer. Some children may also exhibit neurotic itching or obsessive compulsive habits. There is also a condition called trichotillomania of constant hair twirling which can lead to temporary hair loss.
Comment from Randy: It seems more like Nummular eczema primarily on my lower legs.
Dr. Mejia: Randy, unfortunately without a proper exam to diagnose your condition, I could not give you a for sure answer. However, start with good moisturization and possibly over the counter topical hydrocortisone. If things are not improving, definitely see your dermatologist for a proper diagnosis. If you are older, skin cancers can look like eczema. Nummular eczema is typically treated with steroids and moisturization. Try the greasy stuff like aquaphor for really dry skin and itchy skin.
Comment From Psoriasis Foundation: Up to 30 percent of people with psoriasis develop psoriatic arthritis, a related condition causing swelling of the joints. We recommend that people talk with their doctor if they experience joint pain, stiffness or swelling lasting more than 3 days. What symptoms should people look for?
Dr. Mejia: The symptoms of the most common form of psoriatic arthritis affects the tips of the fingers or toes. However, one in five cases of the condition can affect the spine. The least common form of psoriatic arthritis is called “psoriatic arthritis mutilans,” which targets the joints, causing severe destruction. Most patients typically have joint pain.
SunSentinel.com Health: Emailed question: My son has renal disease and horrible skin. I have seen several dermatologists and have gotten no answers. Are you aware of skin conditions associated with renal failure?
Dr. Mejia: Kyrle disease has been associated with patients with kidney problems. The cause of the disease is unknown. Some cases appear to be idiopathic (no known triggers), or inherited. What has been found is that Kyrle disease appears to occur more frequently in patients with certain systemic disorders such as Diabetes mellitus , Renal disease (chronic renal failure, albuminuria, elevated serum creatinine, abnormal creatinine clearance, polyuria) , Hepatic abnormalities (alcoholic cirrhosis) , Congestive heart failure . Treatments have included topical steroids and isotretinoin as well as antihistamines.