Tuesday, 30 September 2014

Erythromelalgia Disorder Affecting Skin of Hand and Feet

med.jhmi. edu
Erythromelalgia is a rare disorder which affects the skin of the feet or hands or the arms, legs, ears and face as well, causing visible redness with intense heat and burning sensation. The term erythromelalgia describes the syndrome erythros – redness, melo as extremity and algia as pain. Its alternative name is erythermalgia which stresses the thermos or heat that is the essential factor of the syndrome.

The symptoms could start at any age and some people with this ailment could have had it from young age while in some it could surface in their later years of adulthood. It usually affects both sides of the body though it could affect just one side.

The pain and burning could tend to be extremely severe and people with this disorder usually make a lot of adjustment in their lifestyle to reduce the pain and burning sensation. In less severe cases, normal function like standing, walking, working exercising, sleeping and socializing could be affected.

Cooling the hot areas of the body could relieve the flare ups as well as elevating the affected areas could be of much help. Besides this, the use of ice and water soaking should be avoided as ice and water submersion could damage the skin.

Flare-ups of Severe Pain

People suffering from erythromelalgia suffer from flare ups of severe pain which could last for a few minutes to several days. These flare ups begin with an itching sensation that tends to worsen to extreme burning pain with tender mottled reddish skin.

The pain could be so severe that the person may tend to have difficulty to walk, stand, or perform the normal activities which could affect their work or social life. Symptoms of this disorder usually get triggered due to an increase in body temperature.

Besides this it could also trigger off after exercising, wearing gloves, socks or tight footwear, entering a warm room, being dehydrated or on consumption of alcohol or spicy food. The cause of erythromelalgia in most cases in not known though in some cases, an underlying cause could be found, either a medical condition or it could be a faulty gene.

Causes of Erythromelalgia

Erythromelalgia could be the outcome of underlying disease like having abnormal high levels of blood cells. It could either be due to many platelets in the blood or too many red blood cells, damage to the peripheral nervous system which is the network of nerves placed on the outer area of the brain and spinal cord where the damage is called peripheral neuropathy, MS or multiple sclerosis which is a disease of the nerves in the brain and the spinal cord.

In some cases of erythromelalgia, the disorder is the result of the change in a gene which may occur spontaneously or it could have been inherited from the parent indicating that it runs in the family. Other causes could be an autoimmune problem like lupus or rheumatoid arthritis wherein the immune system tends to attack the body’s own tissues.

The genes in the body contain genetic information or instructions to proteins in the body and genetic mutation takes place when the DNA changes thereby altering the genetic instruction resulting in erythromelalgia.

Different Treatment Based on Condition

Other causes could be due to changes in the SCN9A gene which provides information for sodium channel in pain nerves and changes in these channels could result in opening which could be easy and remains open longer than usual thus increasing or amplifying the pain.

The condition of hands and feet being affected the most is not identified. Various medication have given much relieve to the symptoms experienced by the patient though no specific drug has helped and different treatment needs to be experimented under the supervision of physicians together with the combination of different medication.

The physician could then discuss the various options best suited to the person. Some treatments would also need referral to specialist centre in order to check the benefits and potential side effects.

Other Pain Relieving Drugs/Intravenous Infusion – Reduce Pain 

There are other drugs of nerve pain that could be used to reduce symptoms which includes anti-epilepsy drugs or low doses of tricyclic anti-depressants which could be effective in pain relieve that are due to increased sensitivity or damage to the nervous system.

Moreover, drugs used for high blood pressure or Raynaud’s disease could also help the blood vessels to widen and prove to be beneficial in certain cases of erythromelalgia. In some case of this disorder, when the pain has not been relieved by medication taken by mouth or orally, another option through intravenous infusion could be used wherein the medicine is given directly in the bloodstream through a drip.

A local anaesthetic drug is also given to block sodium channels which could help the nerve related pain and is administered depending on the condition of the patient, the procedure of which is explained by the physician to the person suffering from erythromelalgia.

Monday, 29 September 2014


Urticaria – Hives/Welts/Nettle Rash 

Urticaria also known as hives, welts or nettle rash is a kind of a rash which is itchy, raised rash that appears on the skin. Urticaria is a common ailment and it is estimated that 1 in 6 people could have it sometime in their lives.

Children often tend to get affected by urticaria and women between 30 and 60 years as well as people with a history of allergies may get affected by this ailment. These may cause a stinging or burning sensation and are frequently caused by allergic reactions and there are some which can be non-allergic.

The rash may be on just one area of the body or could spread across to other areas wherein the affected area may change in skin appearance within twenty four hours but it usually disappears within a few days. If the rash tends to clear within a period of six weeks it is known as acute urticarial.Chronic urticarial is when the rash persist or comes and goes for more than six weeks,often over several years, but this case is very rare.

Major cases of chronic urticarial have unknown or idiopathic cause wherein 30 to 40% cases of chronic idiopathic urticarial is caused by an autoimmune reaction. Acute viral infection is another type of common cause of acute urticarial or viral exanthema while the lesser common causes of hives are friction, pressure, exercise, temperature extremes and sunlight.

High Level of Histamine Release

Urticaria takes place when some substance causes high levels of histamine and other chemical messengers to be released in the skin and these substances could cause the blood vessels of the skin to open up in the affected area which appears to be red or pink and becomes leaky.

Histamine is a chemical which is released from specialized cells which are along the skin’s blood vessels. The extra moisture in the tissues results in itchiness and swelling. Histamine released could be due to variety of reasons such as cold or heat exposure, an allergic reaction to substance like latex, infection, or the effect of some chemicals which could be found in certain food or medicines like non-steroidal anti-inflammatory drugs – NSAIDs.

Urticaria is diagnosed on examining the rash on the skin and also checking on what could have triggered the symptoms to avoid the occurrence of it in future. If the person is suspected of allergic reaction, then the individual could be referred to an allergy clinic for an allergy test.

Identify Causes for Future Precautions

In most cases treatment is not necessary since the rash tends to get better within a few days and if the itchiness is uncomfortable, medication can be helpful. In case of severe cases of urticarial, a short course of steroid tables could be of some relief to the patient.

If urticarial persists, a skin specialist or a dermatologist should be consulted where the same could be treated with medication while identifying its cause for future precautions.

Some of the people with acute urticarial and chronic urticarial tend to develop swelling in the deeper layer of skin which is known as angioedema that can cause severe swelling in different areas of the body like the lip, eyes and genitals. In some severe cases of angioedema, steroid injection may be given which are usually given in hospitals or at clinic by an allergy or a specialist of immune system.

Thursday, 25 September 2014

Paget's Disease

Paget’s disease – Disruption of Bone Renewal/Repair of Normal Bone

Paget's disease
Paget’s disease or osteitis deformansis a chronic ailment which disrupts the normal cycle of bone renewal and repair of the normal bone remodelling process. The normal bones strikes a balance to lay down new bone and take up old bone which is known as bone remodelling which is essential in maintaining the normal calcium levels in the blood.

 Bones affected by Paget’s disease tend to get disturbed in bone remodelling and is not synchronized resulting in the bone being abnormal, enlarged and tends to get brittle and vulnerable to fracture. It mainly affects the older bone of adults.

This condition commonly causes no symptoms and is noticed when x-ray tests are done for other ailments.

Paget’s disease can cause pain in the bone which is the most common symptoms that often affects the pelvic, the thigh bone, the skull, the collarbone, the upper arm bone or spine and the pain get worse when lying down.

X-Ray/Bone Scan, MRI/CT Scan

The symptoms of this condition are based on the severity of the affected bones. Enlarged bone ten to pinch adjacent nerves resulting in numbness and tingling and may also lead to bowing of the legs. Hip or knee could lead to arthritis causing limping with pain and stiffness of the knee or hip.

When the bones of the skull get affected, headache, hearing loss and loss of vision may also occur. This condition is diagnosed depending on the x-ray, though it could also be detected with other imaging test like bone scan, CT scan and MRI scan.

Alkaline phosphatase, an enzyme which comes from bone is at times increased in the blood of people with this condition due to the abnormal bone turnover of actively re modelling bone. Besides this, the blood test is also referred to as the serum alkaline phosphatase - SAP, which is used to check the results of Paget’s treatment.

Surgery – Osteoarthritis/Bone Fracture

Bone scan is especially helpful in identifying the extent of the condition since it provides an image of the whole skeleton and the bone that is affected by this condition can be easily determined with bone scanning images.

Paget’s disease can be treated by controlling the disease activity and handle it complications. When this ailment causes no symptoms and the blood testing indicates that the level of serum alkaline phosphatase is normal, no treatment would be needed. Pain in the bone could be relieved with anti-inflammatory drugs or pain relieving medication while bone deformity would need supports like heel lifts or specialized footwear.

For damaged joints, severely deformed bones, fractures or when nerves are pinched due to enlarged bone, surgical operation would be needed. Before undergoing an operation it could be helpful to be treated with medication which could diminish the risk of complication of surgery. Surgery is often done when the disease tends to cause further problems like osteoarthritis or a bone fracture.

In some rare cases, Paget’s disease could also cause bone cancer or heart failure. It is not clear why this condition occurs, but genetic as well as environment factors are believed to be the result of this disease where around 15% of the cases runs in the family.

Monday, 22 September 2014


Red Blood Cells
Haemochromatosis – High Iron Level in the Body 

Haemochromatosis is one type of inherited disorder wherein the iron contents in the body slowly builds up over a period of time and hence it is called iron overload disorder. It is an inherited ailment caused by faulty gene known as HFE which enables a person to absorb a large content of iron from food which in normal case, the body only absorbs as much as it is needed.

The excess amount tends to build up in the body causing several problems. It is characterised by excessive iron which is stored in various organs and joints in the body especially the liver. Iron storage tends to keep rising in the person with this condition wherein the liver gets enlarged and may get damaged which may lead to serious disease known as cirrhosis.

Early haemochromatosis may have no symptoms but in later stages it may present various symptoms though not all may experience the same signs. Most of the symptoms may be the same to those that could be caused due to other illness which is the reason why this condition is very often overlooked and not treated immediately.

Recessive Gene Disorder

The condition is a recessive gene disorder which is caused by the mutations of the haemochromatosis - HFE gene and to develop a recessive gene disorder, a person needs to inherit the same from both the parents.

If the mutated HFE genes are inherited from one person only, then they tend to be the carriers and the carrier will not develop the condition but could pass the same to their children. A child has a fifty percent chance of inheriting one mutated HFE gene, if two carriers conceive, and become a carrier.

There could be one in four cases of inheriting both mutated HFE genes and be prone to this disease. To check if a person is carrying the mutated HFE genes, a simple blood test can be done for the same.

Some of these systems experienced are weight loss, liver dysfunction, joint pain normally in the joints of the second and middle fingers, feeling of weakness and lethargy, disorder of the menstrual period like early menopause, abdominal pain, loss of body hair, darkening of the skin etc.

Treatment of Venesection to Reduce Iron Level

Other related problems could also include heart disease, arthritis and diabetes for both women as well as men though women may develop the condition at a later stage in life due to regular menstrual periods which deplete the body of iron.

This condition could be diagnosed partly due to the symptoms which may be similar to those that may occur with other illnesses. Serious damage could be averted if the person with this ailment is diagnosed when the symptoms occur and the iron level is maintained at a normal range.

Haemochromatosis can be controlled with treatment which aims to remove the excess iron from the body which is a simple process known as venesection, wherein the blood is removed from the body on a regular basis just as in the case when the blood is donated with around 500 ml of blood which is taken out. This leads in the overall drop of iron level in the blood.

Saturday, 20 September 2014


Credit: ageonicsmedical
Whiplash – Sudden Movement of the Head, Damage to Ligaments/Tendons

Whiplash also called neck sprain or strain is caused by sudden movement of the head forward, backwards or sideways which could occur after sudden impact in a road accident wherein the vigorous movement tends to damage the ligaments and tendons in the neck.

Tendons are the fibrous, tough bands which connect muscles to the bone while ligaments are the fibrous connective tissue which link two bones together at a joint. In whiplash, the intervertebral joints, those which are between the vertebrae discs and ligaments, cervical muscles and the nerve roots may get damaged.

People get affected by whiplash when they experience an abrupt backward or a forwards jerking motion of the head in an accident and the symptoms may not show or could be delayed for 24 hours or more even after the trauma.

But some people may develop one or more symptoms within the first few days after injury like stiffness and neck pain, headaches, lower back pain, dizziness, pain or numb feeling in the arm or hand, difficulty in concentrating and remembering, pain in the shoulder or between the shoulder blades and irritability, fatigue and sleep interruptions.

Road Accidents/Sudden Blow/Fall or Slip – Causes 

Road traffic accidents being the main cause of whiplash, due to the sudden stopping impact of the collision results in the sudden violent head movement. With this violent impact of the forward, backwards or sideways movement, ligaments and tendons tend to get damaged resulting in this ailment.

Low speed collisions may also lead to whiplash. Besides road accidents, whiplash could also be due to sudden blow to the head especially during a boxing game, rugby or sports. A fall or a slip wherein the head tends to get affected due to a violent and sudden jolt backwards could also be the cause of whiplash, or being struck on the head by a solid and a heavy object.

No specific treatment has been scientifically proven to be effective for whiplash though pain relief medication with gentle exercises, physical therapy, massage, heat, ice, traction, injections and ultrasound could be helpful for some people

Diagnosis Based on Symptoms 

Whiplash injuries earlier were treated with immobilization in a cervical collarthough the present trend is encouragement of movement instead of immobilization. Ice is also recommended within the first 24 hours of the impact which could be followed with gentle movement.

If the neck pain is painful, it is essential to keep it mobile from the early stage which could improve its functions and quicken the recovery. It is better to move the neck by using a neck brace or collar instead of keeping it still.

Diagnosis of whiplash is often done based on the condition and injury of the ailment through a series of tests and scans like x-rays, computerised tomography –CT, or magnetic resonance imaging –MRI is done incase of a fracture or any other problem. Whiplash usually tends to get better on its own or after following some basic treatment.

Whiplash that lasts for six months or beyond is called chronic whiplash or late whiplash syndrome and the treatment plan would be based on the symptoms and if the pain tends to be severe, the physician would recommend stronger painkiller or the option of physiotherapy.

Friday, 19 September 2014

Motor Neurone Disease

Motor Neurone Disease
Motor Neurone Diseases – Group of Progressive Neurological Disorder

Motor neurone diseasesMND, is the name for a rare ailment connected with a group of progressive neurological disorder that tends to damage motor neurons, which are the cell that control the necessary voluntary muscle activity like speaking, breathing, swallowing or walking. Motor neurone disease is also known as amyotrophic lateral sclerosis – ALS, which takes place when the nerve cells in the spinal cord and the brain known as motor neurons tend to stop functioning properly affecting the muscle activities in the body. Messages from nerve cells located in the brain known as upper motor neurons tend to get transmitted to nerve cell in the brain stem and the spinal cord, called the lower motor neurons to particular muscles. From the upper motor neurons it is directed to the lower motor neurons to enable movements like walking or chewing while lower motor neurons control movements related to the arms, legs, chest throat, face and the tongue. The spinal motor neurons are also known as anterior horn cells while the upper motor neurons are called corticospinal neurons.

Disorder in Coordination between Upper/Lower Motor Neurons

When the disorder in the signals between the lowest motor neurons and the muscles takes place, the muscles fail to function properly resulting in gradual weakening and thereby develop uncontrollable twitching known as fasciculation. Disorder in the coordination between the upper motor neurons with the lower motor neurons, results in tendons reflexes like the knee and the ankle jerks getting overactive and over a period of time, the capabilities of controlling the voluntary movement could be weaken or lost. Individuals suffering from motor neurone diseases will find the normal activities difficult as the condition progress and finally may find it impossible to function normally.

Weakened Grip/Slurred Speech ……

Symptoms of this condition tends to begin gradually over weeks or months and affects only one side of the body at first and then gets worse. Early symptoms could be a weakened grip wherein the person may face difficulty in holding or picking objects, slurred speech, dragging of the leg, and weakness at the shoulder which would make lifting of the arm difficult, or a foot drop which is the result of weak ankle muscles. Though the condition is not painful, as the condition progresses, symptom may spread to the other areas of the body and eventually the person may have difficulty in movement or is unable to move. This could also affect communicating, breathing or swallowing.

Life Shortening Ailment

MND is a life shortening ailment for most of the cases and the life span could probably be three to four years when the symptoms occur, though there are few cases where some tend to live up to ten years or even longer. In most cases of MND, it could be fatal since the involvement of the breathing muscles makes the person prone to drowsiness and susceptible to chest infections. Though there is no cure for MND, treatment could be aimed at making MND patients comfortable and provide them with maximum support as well as compensate for the loss of bodily functions like communication, breathing, and mobility or swallowing.

Modern Technology Brings Better Treatment Options

Dental care
More people today have appearance goals, even when they begin to age. They recognize that quite often, appearance begins with the skin. With this in mind, those people are quickly finding that new technology makes it much easier to get the sort of skin rejuvenation that last. Yaletown Laser Centre in vancouver is just one of the facilities offering individuals a bevy of different options designed to make life just a little bit easier.

What are those companies like Yaletown Laser offering today? For one, these places offer botox treatment that can breathe new life into a person's face. The effects of age catch up with even the best person. Botox treatments provide a very easy, very affordable solution for those individuals who want to get more out of their later years.

In addition, today's laser technology can provide things like hair removal. Quite often, women run into problems with unwanted hair in all the wrong places. They might fight this for a prolonged period of time, but getting wax treatments can be cumbersome if done for long enough. Laser hair removal takes care of the problem permanently, allowing individuals to look their best without having to engage in a near-constant maintenance process.

 With new technology has come the ability to look one's best even in old age. Lasers provide individuals with new options that are easy, quick, and affordable. As more individuals have come to value the appearance of their skin, more have sought out the best laser facilities for a range of different treatments.