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Other skin conditions outside of AD

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2. Other skin conditions outside of AD

a) Urticaria (hives)

This can happen to AD patients sometimes. Wheals usually appear when people get out of a bath and are identified by bubbled up or protuberant skin. Although it can itch severely, this itch usually only lasts for about 1 to 2 hours and until morning at worst.
This type of hives is called cholinergic urticria, and is related to acetylcholine, which comes out of the skin’s peripheral nerves. Acetylcholine is generally thought to exert an effect on mast cells so that it aids the production of substances that causes itchiness such as histamines and leukotriene, although the exact mechanisms are not yet clear. Many patients who rush into my clinic, thinking that their AD symptoms are getting worse, relax when they realize that all they have is hives. Although hydroxyzine hydrochloride (Atarax etc.) is effective at treating cholinergic urticaria, people still wonder what they should do since it happens every day when they finish bathing. Treating this is similar to treating AD, so you should take lots of Vitamin B (3 times what you would normally take) and Vitamin C (10 grams a day). Although it is not clear how this works, many people notice a significant improvement. Try using these if your hives persist.

b) Tinea

Tinea rashes are initially circular or oval in shape, and will eventually fill up in the middle. Thinking that this is AD-related and using steroid ointments will not help. Patients with diabetes, of patients with a relative who has diabetes should be cautious. Diabetes patients have skin that is vulnerable to dermatophytes. There are, however, lotions and ointments that are effective at treating tinea.

However, athlete’s foot is, in reality, very hard to cure. Extracts from mugworts and houttuynia cordata can be effective.

c) Scabies

This is caused by sarcoptesw scabiei, and is sometimes misdiagnosed as AD. Patients come into my clinic when the itch of the rice grain to azuki bean sized papules that spread over their bodies becomes unbearable. Patients who used to have AD tend to think that their AD is reappearing. The textbook procedure is to find the scabies burrow, made when mites make burrow  or tunnel-shaped holes under the skin’s horny layer to lay eggs, but these “burrow” are often mistaken as thin scratch marks and are undiagnosed. When this happens and patients are given steroidal ointments, under the assumption that they have AD, they come back, saying that their skin condition didn’t improve. After further examination, they start to realize that they could have scabies once they say that they used to work at a institution for senior citizens or that other family members had the same skin condition. One similarity between AD and scabies is that the itchiness intensifies at night. Also, scabies are not commonly seen on the fact, which can be said about many AD patients. This is how a simple diagnosis can be critical. If you are properly diagnosed to have scabies, there is a cure, so don’t worry. The problem is when you get a diagnosis, your doctor might not think of scabies as a possibility. What is important is for you to ask whether you could have scabies to your doctor. It’s a shame how unreliable doctors are these days!

d) Herpes

Many AD patients additionally get herpes. It is most common to find smarting blisters around you mouth. One characteristic is that the rashes have a little navel-like hole in the middle at its early stages. This appears especially when people are stressed. The culprit is Herpes simplex virus type 1, which is highly contagious so that in addition to direct contact, you could also contract this disease from sharing towels and cups with this virus. Once this infects you, even if your body develops immunity against it, it will repeatedly relapse. Herpes labialis, commonly seen around the mouths of adults, is an example of a relapse, and some even relapse 3 to 4 times a year. You can use antiviral drugs (that can also be in ointment form) such as aciclovir (product name: Zovirax) or vidarabine (product name: Arasena-A) to treat this without worrying about serious side effects. However, since this disease is so contagious, do not touch your eyes if you’ve touched inflicted areas. It is extremely dangerous if your cornea contacts herpes viruses. Also, do not break the vesicles. If you treat it properly, herpes can disappear within 2 weeks. However, using antiviral drugs every you relapse is not recommended. If you try the things mentioned below, the frequency of your relapse will dramatically decrease.

First, avoiding taking white sugar as much as possible. Take folate(3mg to 5mg), Vitamin B5(500mg), Vitamin B12(2mg), zinc(30mg), selenium (50μg), and Vitamin C(5g) supplements. Also, take 6 to 8 grams of lysine, an amino acid, while you eat. Lysine countervails arginine, which gets eaten by herpes viruses. Lysine can be easily purchased on the Internet. Lysine can also be found in soba (buckwheat noodles), so if you don’t have soba allergies, have light AD symptoms, and are prone to herpes relapses, you should eat lots of soba. Also, avoid eating nuts, such as peanuts and almonds, since they contain lots of arginine. Silver colloids are also effective for treating herpes. If you just have herpes on around your mouth, you do not need to go through nearly any treatment (although it may hurt!) and naturally recover after two weeks. However, if you get Kaposi’s varicelliform eruption, things get complicated. Some AD patients with severe symptoms get this. Many times, it spreads across the face, but in some bad cases, it will spread all over the body. You should be treated at a hospital for a couple of days. Although rare, some people don’t realize that they have Kaposi’s varicelliform eruption, and even though unlike usual it has a stinging pain, they think that their AD symptoms are just getting worse and use steroid ointment. This will only worsen their condition. Itchiness is a principle symptom of AD, and not pain. If your rashes hurt, please immediately go to the doctor.

e) Molluscum contagiosum

This is where there are small pearl-like papules and bumps on the skin caused by molluscum contagiosum virus (MCV). This, too, is seen among many AD patients. It is neither painful nor itchy, and will eventually disappear after 1 to 2 years. Therefore, you can leave it as it is, but if there are a large number of the papules, some mothers worry of their child’s appearance. Also, they can stay for nearly 3 years. In this case, I can take it off with tweezers, but children complain about the pain and mothers do not want to see their child suffer, so this can be put off for quite a while. However, now anesthesia tape can be used to take out molluscum contagiosum so that patients don’t feel any pain. If patients still refuse to do that, they could use a topical cream, ZymaDerm, designed especially for molluscum contagiosum. The main constituents include iodine, echinaces, and thjua, and are safe enough for even a 9-month old baby. Just look up “ZymaDerm” on the Internet.

f) Pruritus cutaneus senilis

Sometimes, there are patients in their 50s who come to my clinic due to perrsistent itchiness. These patients have pruritis cutaneus senilis, a symptom name rather than an actual disease name (since this translates to a condition where an elderly person has itchy skin). Some patients say that they were diagnosed as a type of AD particular to the elderly. Either way, the causes for this condition are not clear, so there needs to be a reasonable name for this condition. A major similarity between this condition and AD is that it inflicts intense itchiness, and that it is hard to cure even if you use steroid ointments. Also, people who get this disease don’t show signs of AD, including asthma, hay fever, and food allergies. Many of them do not use agrichemicals since their hobbies include gardening, they haven’t moved to a new house, and they haven’t encountered a particularly stressful event; they have suddenly gotten incredibly itchy rashes wtihtout having any idea what caused it.

These cases may be a prodrome to mycosis fungoides, a type of skin cancer, or can implicate how there is cancer somewhere in the body. It should be treated as a premonitory symptom of a cancer that will appear a couple years later. First, go to a university hospital and get an examination from a specialist. If it turns out that it isn’t skin cancer, check whether you have tumors using blood tests, and request the use of CT and PET scans to check whether there is cancer somewhere in your body. If you don’t find anything malignant, you are lucky, and should improve your lifestyle thoroughly before your body develops cancer. You should stop smoking, stop eating meat, go through some detox treatment, take multi-vitamin minerals, and live a stress-free life as much as possible. There is already an abnormality in the body, and the body is using the skin as a warning signal. The abnormality, in this case, is in the immune system, and with the elderly, this could easily lead to cancer. There is no way you would get rashes as a prodrome to cardiovascular diseases such as angina, a coronary, brain infarction, or bruising of the brain. Even with diabetes, the rashes are typically as athlete’s foot, not pruritus cutaneus senilis. Also, you should be especially cautious if you experience frequent herpes relapses. This shows how your immune system is getting weaker and that those kinds of viral diseases can happen easily. There is nothing wrong with changing your lifestyle to a healthy one even if your pruritus cutaneus senilis did not have anything to do with cancer and your frequent herpes had no bigger problem behind it. Family members should be aware of this as well.

Although different from pruritus cutaneus senilis, middle-aged (or older) people can get Verruca sensilis, a type of wart. When this spreads over the body and starts to itch within half a year, they have Leser-Trelat. In this case, patients can also have malignant tumors in their organs such as stomach cancer, bladder cancer, or lung cancer. Even if a patient doesn’t have these common symptoms, if he or she is elderly and has itchy rashes or many warts, the possibility of these abnormalities being malignant should be at the forefront of a dermatologist’s mind. Since many branches of medicine are getting too specialized these days, there is disjointedness between detmatology and internal medicine that causes the doctors to be too near-signted. When I administered a urine test for two men with pruritus cutaneus senilis, they both had positive occult blood test results, and one patient even had abnormal BFP levels (BFP is used to check for bladder cancer). Although I recommended for them to get an examination, they have not been able to get one so far.


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