A Fishy Tale of Lumps and Bumps

When you think about potentially dangerous pets,  which animals spring to mind? Alligators? Boa Constrictors? Any of the “big cats”? Pit Bulls? Goldfish?

Goldfish? Really?!?  Well, according to a new study from Henry Ford hospital, fish may not be quite as benign as they seem. To be fair, it’s not the fish themselves, but the water they swim in that may be harmful to health.

Researchers have shown that contaminated water in home aquariums can lead to a skin infection known as Mycobacterium marinum. The condition is characterized by reddish skin lesions or bumps on the hands or arms.

It’s difficult to diagnose and treat because skin lesions don’t appear for two to four weeks after contact with the bacteria, leading to delayed treatment and unnecessary and ineffective use of antifungal and antibacterial agents.

Complicating matters further is that patients fail to remember or mention the source of the exposure, which is often traced to them cleaning their aquarium. Infection results when bacteria in the non-chlorinated water attacks an open skin wound on the arm or hand.

“People just don’t know or think about their fish tank harboring this bacterial organism,” says George Alangaden, M.D., a Henry Ford Infectious Diseases physician and the study’s lead author.

“And unless they’re directly questioned about it by their physician, who may or may not have adequate knowledge of Mycobacterium marinum and its prolonged incubation period, appropriate treatment often gets delayed.”

During the study, conducted between January 2003 and March 2013, researchers identified five patients ages 43 to 72 treated at Henry Ford for Mycobacterium marinum. Skin biopsies performed on all five patients confirmed the infection.

The incubation period before skin lesions appeared ranged from 11 to 56 days. While all five patients responded effectively to antibiotic treatment, it took on average a staggering 161 days from the time of initial presentation to time of treatment.

“Mycobacterium marinum is not a life-threatening illness, but it remains an unrecognized cause of skin infection,” says Dr. Alangaden. “To accelerate diagnosis and treatment, physicians are encouraged to ask detailed questions about the patient’s history, especially questions about potential exposure to aquariums.”

 Or better still, may we suggest you wear gloves when cleaning out the tank!

Scientists Mite have found a cause for Pimples

Having a bad skin day?  With apologies in advance – it’s probably just about to get a whole lot worse!

Especially for the estimated 5-20% of people, predominantly women, between the ages of 30 and 60 who sometimes develop rosacea –  a condition characterized by red inflamed skin, with swelling, roughness and fine, visible blood vessels, usually in the central zone of the face. , In severe cases it can resemble acne, irritate the eyes and lead to the bulbous red nose seen in caricatures of the elderly.

The disease affects all races but is sometimes referred to as the “curse of the Celts” as it frequently affects people with very fair skin. Rosacea is commonly and perhaps erroneously, blamed on another alleged Celtic curse – excessive drinking. But while alcohol can trigger a flare-up, so can many other kinds of stress. In fact, according to the US National Rosacea Society, tee-totallers are just as susceptible as drinkers.

Now, Kevin Kavanagh of the National University of Ireland, thinks he has discovered the cause – and it isn’t for the faint-hearted.

According to Dr Kavanagh, rosacea is due to the presence of tiny mites – eight-legged arachnids related to spiders – living in the pores of facial skin. They are particularly fond of the hair follicles of eyebrows and eyelashes, and the oily pores most common on the nose, forehead and cheeks.

Called Demodex folliculorum and Demodex brevisare, the mites eat sebum, or facial oil, and colonize your face at puberty. Healthy adults have around one or two mites per square centimeter of facial skin. People with rosacea, however, can have 10 times as many.

The mites crawl about your face in the dark to mate, then crawl back into pores to lay their eggs and die. Because Demodex do not have an anus they cannot get rid of their feces. “Their abdomen just gets bigger and bigger, and when they die and decompose they release their feces all at once in the pore,” says Kavanagh. When the mites are numerous, he believes that the material is enough to trigger an immune reaction, inflammation and tissue damage.

Grossed out???  Try not to be, because research suggests that the stress that causes flare-ups of rosacea changes the chemicals in sebum, making it better food for mites.

Kavanagh is now trying to get funding to develop antibodies to the bacterial proteins, to track their location and link them more firmly to the disease. Ultimately, treatments aimed at the trigger proteins may prevent rosacea.

As a fair, European that fits the rosacea age-range I, for one, am hoping he succeeds. In the meantime, I’m debating whether to ditch my make-up magnifying mirrors or switch to one with a much, much higher resolution!

PS If you made it to the end of this post without scratching  your face or checking yourself out in a mirror – congratulations!

The Buzz on Bee Venom

While many of us, myself included, may be sad to say goodbye to summer, at least the cooler temperatures should mean fewer biting and stinging insects.  And while that’s good news for people, myself included, who seem to attract and be bitten by every venomous bug out there, there are some people, it seems, who just can’t get enough.

At least when it comes to bees. Thanks, in part, to HRH the Duchess of Cambridge, aka Kate Middleton, everyone’s buzzing about bee venom.  It’s being touted as the latest magic ingredient and can be found in an increasing number of skin creams, lip-plumping potions and face masks.

People are calling bee venom a “natural Botox” thanks to its ability to stimulate collagen production and elastin to smooth, lift and tighten skin. Venom also contains a compound called melittin, which has been shown to have anti-inflammatory properties.

Which led SRxA’s Word on Health to wonder if it works.  Turns out that much of the clinical research into bee venom has focused on its effect s in patients with cancer and arthritis. Studies of its use in skin-care have been limited.

When applied to the skin bee venom causes tingling but has no lasting effect.

“I couldn’t find any legitimate scientific studies of the benefit of bee venom either topical or injected,” says David Leffell MD, a professor of Dermatology and Surgery at Yale School of Medicine.

He is skeptical of the extent that bee venom could smooth or tighten skin. There is evidence, however, that the honey also in many of the products could be beneficial as a moisturizer, he says.

But given that one gram of venom costs about $304 – more than eight times the current value of gold, that’s a lot of money for a moisturizer!

And good news for beekeepers, many of whom are able to add this lucrative sideline to their established honey businesses. Salons and spas are also boarding the bee bandwagon and charging over $100 for 30 minute bee-venom facials.

Have you, or would you try bee venom over botox?  Buzz us with your comments.

Pharma Advertising Gone Dotty?!?

With the banning of promotional give-away’s, decreasing pharmaceutical marketing budgets, escalating regulation, and an ever-more sophisticated consumer, spare a thought for pharma marketing execs charged with getting their message across.

Enter Genus Pharmaceuticals who probably thought they’d struck a home run with their new UK advertising campaign for their eczema cream Cetraben.

The print ad featured the back view of a young woman walking down a street with the wind lifting her short skirt to reveal red-and-white polka dot underwear…along with the headline “Confidence to live life their way. However that may be.”

Turns out that’s not how one British doctor wanted to live his life!  He complained to the Prescription Medicines Code of Practice Authority (PMCPA), which was created by the Association of British Pharmaceutcial Industry (ABPI) to act as an industry watchdog.

With his stiff upper lip clearly quivering the enraged physician claimed that the advertisement was “offensive and degrading due to its sexual and titillating picture”.  Furthermore, he “despaired of the industry’s standards and culture” if they thought such an advertisement should be considered appropriate.

Following an investigation, PMCPA said that the ad did indeed breach Clause 9.2 of the Code, adding it is unacceptable to “display naked or partially naked people for the purpose of attracting attention and the use of sexual imagery for that purpose”.

Genus argued that the woman photographed was only embarrassed that her skirt had blown up in the wind. They claimed that the ad merely demonstrated that because of successful treatment of her eczema, she now had the confidence to wear a skirt and not cover her legs. The firm added that it had taken Clause 9.2 into account when considering the image, but believed that it was suitable for its intended audience, i.e.,adults and doctors.

The PMCPA countered suggesting that female adults and children would also be using this cream, and would likely also be offended.

Genus has since updated the image removing the view of the underwear, and  lengthened the skirt. Sadly, we can’t bring you a picture of the old advert, as it has been pulled from journals and all but disappeared from cyberspace.

Instead why not tell us your thoughts on pharmaceutical advertising.  Would a panty clad tush make you tusk? Would the polka dots drive you dotty?

We’d love to know.

Some VERY strange allergies

According to the Centers for Disease Control and Prevention (CDC), 90% of all food related allergies are caused by milk, eggs, peanuts, tree nuts, shellfish, fish, soy and wheat.

While these are the most common, there are other allergy triggers you may not be so familiar with.

How about water?  Yes, it is possible to be allergic to one of the most abundant substances in the world, including the water in our own bodies. People with this condition, properly known as aquagenic urticaria, can experience severe itching and hives within five minutes of coming into contact with water, regardless of its source or temperature.

This condition is rare – only around 30 cases have been reported in the literature and the reason for it isn’t known. Worse still for those affected, histamine levels — the usual allergy culprit — don’t actually increase in these patients, meaning that traditional antihistamines don’t work.

While it might be hard to envision a life without water, spare a thought for women who are allergic to their own female hormones.  Although it’s not uncommon for women to suffer from acne, water retention and premenstrual syndrome (PMS) at certain times their cycle, a small number of women suffer from a condition called autoimmune progesterone dermatitis (APD). This skin disorder is triggered by progesterone hypersensitivity after ovulation.

And speaking of women’s problems – just imagine if you were allergic to semen.  While it’s more common in women, we need to point out that it’s also possible for men to be allergic to their own sperm.

Dutch researchers recently reported 45 cases of post-orgasmic illness syndrome. In both cases, the men experienced allergic symptoms around their eyes and nose, and transient flu-like symptoms within seconds, minutes or hours after sex, masturbation or spontaneous ejaculation. Yikes!

As if life without water or sex is difficult to contemplate, imagine if you were allergic to the weather.  In some people, a drop in the temperature can set off an inflammatory disorder known as cold urticaria.  Patients with the condition can experience redness, itching, swelling, hives and, in rare cases, death when they come in contact with cold air, cold water or even cold drinks. For others it’s the sun that’s the problem. Solar urticaria, can cause similar symptoms within minutes of exposure, in affected individuals.

And if all of this has left you feeling a little faint, be careful where you lie down! Although as we told you earlier soybeans are a common food allergen, and sufferers need to omit soy products from their diet, soybean allergies can be triggered by beanbags. According to a case study reported in the Annals of Allergy, Asthma & Immunology, a 6-year-old boy experienced respiratory distress while playing at school. His reaction was apparently triggered by dust from the dry soybeans in the beanbag.

Are you allergic to anything strange?  Share your stories and suffering with us!

What’s Your Skin Saying?

Aside from being the largest organ in our body, our skin protects us against invasive bacteria, regulates our body temperature, and picks up information from the stimulation of touch, pressure, pain, heat, and cold. Little wonder, then, that when there’s something wrong with your health that your skin is often the first to know.

Here’s the skinny on several dermatologic oddities worth watching out for:

Orange palms and soles

What it means: The cartoonish skin hues can be the unfunny result of an underactive thyroid gland. Hypothyroidism causes increased levels of beta-carotene in the blood. When there’s a thyroid problem, the gland doesn’t metabolize the vitamins as quickly, so beta-carotene accumulates. Orange skin can also occur due beta-carotene as a result of a diet heavy in carrots, carrot juice, sweet potatoes, and squash.

More clues: The skin of someone with hypothyroidism also tends to be dry and cold, and sometimes more pale than yellowed. Feeling tired, sluggish, weak, or achy are the main symptoms, along with possible unexplained weight gain. Women over 50 most often develop hypothyroidism.

What to do: Carotenemia caused by a skewed diet isn’t serious and resolves itself when a broader range of foods is consumed. Hypothyroidism, however, is a medical condition that can lead to complications such as heart problems, and warrants attention from a doctor.

Breaking out in hives in the sun

What it means: Being truly allergic to the sun is pretty rare. A more likely explanation is having taken a photosensitizing drug that increases the person’s sensitivity to light. One of the most common culprits is thiazide diuretics prescribed for hypertension. Other meds that can produce this effect include antihistamines, tetracycline, and tricyclic antidepressants.

More clues: The rash is limited to sun-exposed areas, including the forearms, the neck, and, less commonly, the face. It can feel worse and last longer than a sunburn.

What to do: Check the labels of your prescription medications. Look for phrases such as “May cause chemical photosensitivity.”

Long dark lines in the palm

What it means: A palm-reading mystic might have her own interpretation, but to a physician, a deepening of the pigment in the creases of the palms or soles is a symptom of adrenal insufficiency – Addison’s disease.

More clues: Hyperpigmentation may also be visible around other skin folds, scars, lips, and pressure points

What to do: It’s important to see a doctor, as skin changes may be the first symptoms seen before an acute attack. Lab tests to measure cortisol will provide a diagnosis.

Large, dusky blue leg veins

What it means: If you’ve got ropy, blue-to-purple lines snaking up your legs this could be a sign that some of your veins are not working properly.

More clues: Varicose veins are sometimes mistaken for spider veins, a weblike network of smaller blue or red veins closer to the skin’s surface. Varicose veins tend to be larger, darker, and sometimes raised, with a twisted appearance.

What to do: Exercise, compression stockings, and avoiding constricting postures (like crossing your legs when seated) can help ease discomfort, but they won’t make varicose veins disappear. While not all faulty veins cause problems, severe venous insufficiency can lead to blood clots and need to be treated.

Brownish spots on the shins

What it means: The fronts of the legs tend to bang and bump into things a lot. For someone with diabetes, the damage to the capillaries and small blood vessels that are characteristic of the disease will cause them to leak when traumatized, leading to brown discoloration known as diabetic dermopathy.

More clues: The brownish patches may also be rough, almost scaly and tend to form ovals or circles.

What to do: There’s no health danger from diabetic dermopathy, and no need for treatment.

Persistent rash that you want to scratch raw

What it means: Clusters of small, ferociously itchy blisters that show up repeatedly in the forearms near the elbows, the knees, the buttocks, the back, or the face or scalp are a hallmark of celiac disease, or an allergy to gluten.

More clues: The rash appears on both sides of the body. Itching and burning are so intense you can hardly quit scratching.

What to do: Report the rashes to your doctor or a dermatologist to evaluate and rule out other causes. A gluten-free diet for life is usually advised to keep symptoms at bay.

Purple stains or splotches

What it means: What looks a bit like a bruise, is often mistaken for a bruise, but tends to hang around longer because it’s not exactly a bruise, may be purpura.   It has several possible causes, ranging from a bleeding disorder (thrombocytopenia) to vitamin C deficiency to excessive intake of aspirin, NSAIDs, vitamin E, ginkgo biloba, coumadin, or alcohol.

More clues: A classic bruise tends to turn black and blue following an injury. With purpura, there doesn’t need to be any trauma, the discoloration persists longer than a bruise and the purple color doesn’t blanch when you press it. Purpura are most common on the forearms, legs, and backs of the hands.

What to do: Report the condition to your doctor who can help to identify the cause and recommend the appropriate treatment.

Intense itchiness without rash

What it means: Feeling itchy can have many causes, but when there’s no accompanying visible skin change, it may be  one of the first symptoms of Hodgkin’s disease or non-Hodgkin’s lymphoma.

More clues: The itchiness is more intense than that caused by ordinary dry skin. It occurs most commonly, in the lower legs. Less often, the skin looks reddish and inflamed.

What to do: Report persistent, intense itching to your doctor.

An itch is just an Itch

…Or is it?  As our readers know there are few more guilty, sybaritic pleasures than scratching an itch.

New research from a world-renowned itch expert, shows that the relief derived from scratching an itch all depends on the itch’s location.

Gil Yosipovitch, professor of dermatology at Wake Forest Baptist Medical Center and often referred to as the “Godfather of Itch”  just published his findings in the British Journal of Dermatology.

The study evaluated whether itch intensity was perceived differently at three body sites, and the correlation between pleasure and itch relief induced by scratching.

They induced itch on the ankles, forearms and backs of 18 brave volunteers by rubbing their skin with cowhage – a tropical plant infamous for the extreme itchiness it produces on contact. Itch intensity and scratching pleasurability were then assessed every 30 seconds for five minutes.

Subjects weren’t allowed to scratch their own itch. Instead, the researchers rubbed their subjects’ induced itches with a cytology brush! Probably not nearly as satisfying as scratching with a nice sharp fingernail, but more reproducible for the purposes of the study.

The researchers tested the itch-scratch response at three sites: back, forearm and ankle. Turns out scratching the ankle produced more pleasurable and longer-lasting itch relief than the other two locations.

Before you ask why the researchers chose the back, ankle and forearm to make their measurements, be reassured that this is just the start. “Future studies,” they write, “could also examine the scratching pleasurability associated with other itchy areas such as the scalp or the anogenital region.

Yosipovitch believes this research provides a better understanding of itch and how to relieve it for people who have skin disease.

“We see commonly involved areas such as the ankle and back in itchy patients with skin disorders caused by eczema or psoriasis,” he said. “We never understood why those areas were more affected, and now we better understand that itch in these areas is more intense and pleasurable to scratch.”

Whatever else they learn, the Wake Forest researchers have proven one thing: Every itch has its niche!

Dying for a suntan this summer?

Half the battle in knowing how to properly protect yourself from skin cancer is being able to separate fact from fiction. Unfortunately, some myths about tanning and sun protection are deep rooted and could mislead people into thinking that tanning is safe – when, in reality, nothing could be further from the truth.

A new survey by the American Academy of Dermatology sets the record straight on some of the most common myths and what people believe to be true about tanning and sun protection.

The “Suntelligence: How Sun Smart is Your City?” online survey polled more than 7,000 adults nationwide to determine their knowledge, attitudes and behaviors toward tanning, sun protection and skin cancer detection.

“Our survey showed that despite our repeated warnings about the dangers of UV exposure and the importance of proper sun protection, many people could not correctly answer true/false statements on the subject,” said dermatologist Zoe D. Draelos, MD, FAAD, Duke University School of Medicine, Durham, N.C.

Examples of the myths included in the survey include:

• Some types of ultraviolet (UV) rays are safe for your skin?
  • The survey found that only about one-third of respondents correctly answered false to this question.

• Getting a base tan is a healthy way to protect skin from sun damage?
  • Less than half the respondents knew this statement was false.

• It is smarter to tan indoors using a tanning bed?
  • 63% of respondents knew that this statement was false.

• A sunscreen with a Sun Protection Factor (SPF) 30 provides twice the protection as an SPF 15?
  • Only 21% of respondents knew this statement was not true.  Contrary to popular belief, UVB protection from the sun’s burning rays does not actually increase proportionately with a designated SPF number. For example, an SPF of 30 screens 97 percent of UVB rays, whereas an SPF of 15 screens 93 percent of UVB rays, and an SPF of 2 screens 50 percent of UVB rays.

You can visit www.melanomamonday.org to take the Academy’s “Suntelligence” survey, as well as to find out how to perform a skin self-exam or find free skin cancer screenings in your area.