Malignant melanoma skin cancer Stages and prognosis

Malignant melanoma is the most serious form of skin cancer as metastasis can occur early and it causes a number of deaths even in young people. As with other types of skin cancer the incidence is continuing to increase, probably because of excessive exposure to sunlight. The history of childhood sun exposure and intermittent sun exposure appears to be particularly important in the development of malignant melanoma.

Other risk factors include atypical mole syndrome, giant congenital melanocytic naevi, lentigo maligna and a positive family history of malignant melanoma. Malignant melanoma is commoner in later life but many young adults are also affected.

Diagnosis of melanoma is not always easy but the clinical signs help distinguish malignant from benign moles. Examination with epiluminescence microscopy can further help in detecting malignant lesions.

Four clinical types of Malignant melanoma exist:

Lentigo maligna melanoma is where a patch of lentigo maligna develops a papule or nodule signalling invasive tumour.
Superficial spreading malignant melanoma is a large flat irregularly pigmented lesion which grows laterally before vertical invasion develops.
Nodular malignant melanoma ( Fig. 22.33 ) is the most aggressive type. It presents as a rapidly growing pigmented nodule which bleeds or ulcerates. Rarely they are amelanotic (non-pigmented) and can mimic pyogenic granuloma.
Acral lentiginous malignant melanoma arises as pigmented lesions on the palm, sole or under the nail and it usually presents late.

Treatment of Malignant melanoma

This consists of urgent wide excision of the lesion. Histological analysis will determine the depth of invasion ('Clark's level') and the thickness of the tumour ('Breslow thickness'). These two factors help to predict prognosis and 5-year survival rates. Excision and histology interpretation should only be done by experts to ensure optimum treatment and assessment of prognosis. Metastatic disease is best managed by an oncologist and can involve surgery to lymph nodes, radiotherapy, immunotherapy and chemotherapy.

The role of governments and medical personnel in public health education to discourage sunbathing and encourage the use of sunscreens is of the utmost importance in skin cancer prevention.

Back to skin disorder section

Mastocytosis - systemeic and diffuse

What is Mastocytosis?

Mastocytosis is a disorder characterized by mast cell proliferation and accumulation within various organs, most commonly the skin. Types of cutaneous mastocytosis include solitary mastocytoma (M), diffuse erythrodermic mastocytosis, paucicellular mastocytosis, and urticaria pigmentosa . Urticaria pigmentosa is the most common form and is characterized by oval or round red-brown macules, papules, or plaques ranging in number from a few to thousands.

Most patients with mastocytosis are children (75% of cases occur during infancy or early childhood). Incidence peaks again in patients aged 30-49 years.

What are Mast Cells?

Mast cells seem to have other roles as well. Because they gather together around wounds, mast cells may play a part in wound healing. For example, the typical itching you feel around a healing scab may be caused by histamine released by mast cells. Researchers also think mast cells may have a role in the growth of blood vessels. No one with too few or no mast cells has been found, which indicates to some scientists that we may not be able to survive with too few mast cells. The presence of too many mast cells, or mastocytosis, can occur in two forms - cutaneous (skin) and systemic (involves internal body organs). Cutaneous mastocytosis (CM), the most common form, occurs when mast cells increase in the skin. It is also called urticaria pigmentosa. CM mostly affects children.

What are the causes of mastocytosis? - systemeic and diffuse

Mastocytosis probably is a hyperplastic response to an abnormal stimulus. We don't know why some people have too many mast cells. We do know some things that trigger the release of histamine from mast cells and cause the symptoms of mastocytosis. Symptoms may be triggered by cold or heat, certain medicines, emotional stress and insect bites. The triggers aren't the same in every person.

Systemic mastocytosis is caused when mast cells collect in the tissues and can affect organs such as the liver, spleen, lymph nodes, and bone marrow.

What are the symptoms of mastocytosis?

Chemicals released by mast cells cause changes in the immune system leading to typical allergy symptoms such as itching, abdominal cramping, and even anaphylaxis (dangerously low blood pressure).

The symptoms are different, depending on where the extra mast cells are. When too many mast cells exist in a person's body, the additional chemicals can cause

• Bone or muscle pain
• Abdominal discomfort
• Nausea and vomiting
• Stomach ulcers
• Diarrhea
• Skin lesions
• Episodes of very low blood pressure and faintness
• Shock

How is mastocytosis diagnosed? - systemeic and diffuse

Doctors can diagnose urticaria pigmentosa by seeing the characteristic lesions which are dark-brown and fixed. A small skin sample may help confirm the diagnosis.

By taking a tiny piece of tissue from a different organ, such as the bone marrow, the doctor can diagnose systemic mastocytosis. Using special techniques on a bone marrow sample, the doctor looks for an increase in mast cells. Another sign of this disorder is high levels of certain mast-cell chemicals and proteins in a person's blood and sometimes in the urine.

How is mastocytosis treated? -systemeic and diffuse

Therapy is conservative and aimed at symptom relief because the prognosis for most patients with mastocytosis is excellent. None of the currently available therapeutic measures induces permanent involution of cutaneous or visceral lesions. Advise patients to avoid agents that precipitate mediator release, such as aspirin, NSAIDs, codeine, morphine, alcohol, thiamine, quinine, opiates, gallamine, decamethonium, procaine, radiographic dyes, dextran, polymyxin B, scopolamine, and D-tubocurarine. Several medicines help treat the symptoms of mastocytosis.

• Antihistamines to work against mast cell chemicals
• Medicines to relieve cramping in the intestines

Medicines help treat other signs and symptoms of mastocytosis, including Itching and other skin reactions

• Ulcer-like symptoms
• Low blood pressure
• Inability to take up nutrients from food

In rare cases in which mastocytosis is cancerous or associated with a blood disorder, the patient may have to use steroids and/or chemotherapy.

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Erythema Multiforme

This reaction pattern of blood vessels in the dermis with secondary epidcrmal changes is exhibited clinically as characteristic erythematous iris-shaped papules and vesicolobullous lesions typically involving the extremities (especially the palms and soles) and till the mucous membranes. Erythema multiforme can be minor or more severe. The more severe form is also known as Stevens-Johnson syndrome. Severe reactions can involve the skin, lungs, kidneys, eyes, and other areas.

EM is relatively common problem for a dermatologist. Half the cases are in young people (under 20). It rare both under the age of 3 and over the age of

Causes of Erythema multiforme

The cause of erythema multiforme often remains unknown. Possible causes include: Viral infection (especially herpes simplex ) Mycoplasma pneumonia (a chest infection) Medicines (especially those containing sulfa) Immunizations

Signs and symptoms of Erythema multiforme

• Multiple skin lesions:
  • With sudden onset, which may recur
  • That may spread
  • Located on the legs, arms, palms, hands, or feet
  • May involve the face or lips
  • Trunk is usually not involved
  • Usually symmetrical
• Itching of the skin may be present
• Fever
• Dry eyes
• General ill feeling

On the skin, a wide variety of irregular red macular, papular and vesicular lesions may occur, either separately or in combination. A unique lesion, the target or bull's-eye lesion appears as concentric rings of affected skin interspersed with rings of clinically normal skin, often with a bullous lesion at the center.

Diagnosis

The diagnosis is primarily based on the appearance of the skin lesion and its typical symmetrical distribution, especially if there is a history of risk factors or associated diseases.

Treatment of Erythema multiforme

Treatment of Erythema multiforme begins with identification and removal of the trigger factor, however that is not always possible. EM minor is typically asymptomatic and therefore needs no treatment, as the lesions will clear up by themselves within 2-4 weeks. In herpes virus induced EM minor, Zovirax or Valtrex pills will help, but only if started in the first few days. If the EM keeps recurring, a continuous low dose of Zovirax or Valtrex will prevent it.

Corticosteroids In severely ill patients temic corticosteroids are usually given (prednisone 50 to 80 mg/d in divided doses, quickly tapered), but their effectiveness has not beeen established by controlled studies.

Most cases of erythema multiforme completely recover. There may be dark marks for a few months when the patches clear up. Sometimes, the condition recurs, particularly if the cold sore virus was the cause. If it happens several times a year, continuous aciclovir may prevent it.

Prevention of Erythema multiforme

• Good hygiene and isolation from others may be required to prevent secondary infections .
• Control of herpes simplex oral acyclovir may prevent development current erythema multiforme.

Dyshidrotic Eczema - Causes, Symptoms And Treatment

Alternative name :: Dyshidrosis, Pompholyx and Vesicular eczema

What is Dyshidrotic Eczema ?

Also called pompholyx or vesicular eczema. Dyshidrotic eczema is a form of eczema often seen on the hands and feet where tiny blisters of serum form just below the skin's surface. Dyshidrotic eczema is a recurrent disease of the palmar and or plantar skin characterised by sudden eruptions of clear, mostly pruritic vesicles. Dyshidrotic eczema may occur in both men and women. Its onset occurs usually before the age of 40. Individuals experiencing emotional stress may be more likely to develop flare-ups of this disease.

Causes of Dyshidrotic Eczema (Pompholyx)

The exact cause of Dyshidrotic Eczema is not known. Some consider it is caused by abnormal sweating. The condition may be mild with only a little peeling, or very severe with big blisters and cracks which prevent work. The first (acute) stage shows tiny blisters (vesicles) deep in the skin, associated with itching and a burning feeling. The later and more chronic stage shows more peeling, cracking, or crusting. Some patients will have mostly one stage, and some patients will have mostly the other. Some times both stages occur at the same time. Secondary infection with staphylococcal bacteria is not infrequent. The result is pain, redness, swelling and crusting or pustules.

Symptoms of Dyshidrotic Eczema (Pompholyx)

Common symptoms of Dyshidrotic Eczema are :-

• Intense itching at the site of the blistering.
• Pain may occur with larger blisters.
• Cracks or fissures on the fingers or toes.

Treatment of Dyshidrotic Eczema (Pompholyx)

Some of common treatment of Dyshidrotic Eczema are :-

• Soaks or compresses using weak solutions of Condy's crystals (potassium permanganate), aluminium acetate, or vinegar in water, are applied for 15 minutes four times a day. This will dry up blisters. Compresses are not suitable for dry eczema.
• Moisturizers with cream.
• Corticosteroid creams and ointments play an important role in the treatment of Dyshidrotic Eczema.
• Oral anti-pruritics such as Atarax or Benadryl may alleviate itching
• Antibiotics such as flucloxacillin.
• PUVA therapy.

Expectations (prognosis)

Dyshidrotic eczema normally resolves without problems. Uninhibited scratching and skin trauma may lead to thick, irritated skin which is more difficult to treat and has a longer healing time.

Dyshidrotic Eczema is contagious?

Dyshidrotic Eczema is not contagious and you cannot "catch it" from anyone. It is not a fungus infection, and it has nothing to do with sweating or the sweat glands.

When Will I Start To See Results

When Will I Start To See Results

Acne runs on a 2-3 week cycle, which means that acne that is showing on your face today actually started forming 3 weeks ago. Therefore claims that acne can be gone in a few days are not normally possible. In order to stop acne, you first need to stop this cycle.

To see an end to this cycle you should use an acne treatment for at least 2 months, doing so will ensure that you do not only stop your current break outs for future ones as well.

Within the first month of using ClearPores the wash will be ridding the skin of toxins, bacteria and dead skin cells. Typically people will see some improvements within the first 30 days, although if your acne is bad it may take longer.

In the 2nd month you will notice a considerable difference, typically by this time your skin will feel smooth and soft as well as experience far less breakouts.

Finally after 3 months your skin should be blemish free, simply continue using ClearPores to maintain your results.

If you want a fast and effective acne treatment then Buy ClearPores, it really will give you the skin that you have always wanted!

ClearPores Protection Cream

ClearPores Protection Cream

The protection cream is non oil based moisturizing cream, which has been formulated to combines both alpha and beta hydroxy acids. The alpha hydroxyl acid helps to stop the tight, dry feeling you may get with other acne treatments. It does this by drawing moisture into the exfoliated skin.

It is the Beta hydroxyl acid that prevents the pores from becoming clogged with dead skin cells, which in turn can result in future breakouts.

By using the protection cream each day you will see benefits such as;

• Anti-Inflammatory relief
• Have Soft, Smooth and Health Skin
• Protection From Clogging
• Restricts The Growth Of Acne Bacteria
• Moisturizes Your Skin

ClearPores Herbal Supplement

ClearPores Herbal Supplement

The herbal supplement uses recognized naturopathic methods to control aspects such as your hormone levels, the promotion of flushing away toxins, keep a healthy blood flow and regulating the digestion. There are a number of internal factors that can cause acne flare ups such as;

• Anxiety
• Hormone Imbalance
• Poor Liver Function
• Unhealthy Diet
• Poor Digestion
• And More

The effects of the 100% natural herbal supplement can help to restore balance with these factors and stop future acne flare ups effectively.

ClearPores – The 3 Steps to Clear Skin

ClearPores – The 3 Steps to Clear Skin

One of the reasons why ClearPores is one of the most recommended Acne Treatments is because you do get a 3 step system. Each step is vital at clearing the acne from your skin for good. With the continued use of ClearPores, you will be able to keep your skin looking and feeling healthy.
ClearPores Facial Wash

The facial wash has been formulated to remove the build up of dead cells and bacteria, as well as unclogging the skins pores. The facial wash will then exfoliate the skin, ensuring that all of the “good” oils that keep your skin healthy will remain.

The facial was has been formulated to stop break outs quickly, you will also see additional benefits such as;

• Removal Of Bacteria That Causes Acne
• Improved Skin Cell Regeneration
• Return The Skins PH Balance To A Normal Level
• Residual Sebum Is Removed
• Prevents Pores Becoming Clogged Again
• Quickly Remove Whiteheads, Blackheads, Pimples and Blemishes

Clear Pores Review

What is the ClearPores System?

ClearPores is not like most acne treatments, it uses a 3 step system to help combat acne from inside and out. In fact a massive 98% of acne treatments only combat acne on the surface of the skin, even though breakouts are normally caused by internal factors as well.

ClearPores is perfect for you if you’re looking for an acne treatment that will;

• Ease Acne Breakouts
• Reduce Redness and Swelling
• Give You Soft, Smooth Skin
• Clear Skin Quickly

Chilblain - Home Treatment For Chilblains.

A chilblain is a small, itchy blue or red swellings occur in the winter on the toes but can occur on the finger, face and the nose. Chilblain usually occur several hours after exposure to the cold in temperate humid climates. Chilblain start during the winter (when the weather gets colder) - the initial symptoms include burning and itching in the area of the developing chilblain. These symptoms are often intensified when going into a warm room.

What do chilblain look and its causes :

In chilblains, freezing causes the terminal blood vessels to shut down. This is called vasoconstriction. The local tissue metabolism being at an extremely low ebb, the requirement for oxygen is much more, due to extreme cold. Vasoconstriction decreases blood supply, which leads to tissue damage.

Chilblain appear as small itchy, red areas on the skin. Chilblain become increasingly painful as they get congested and take on a dark blue appearance. Factors that contribute to tendency to chilblain include - a familial tendency. poor circulation. anemia. hormonal changes. some connective tissue disorders and some bone marrow disorders. Damp living conditions may also increase the risk for chilblains.

They occurs due to cold that's restricts blood circulation in the extremities.To prevent the chilblain you should keep your legs and body warm, especially if you have poor circulation. If your feet do get cold, allow them to warm up slowly - do not put them straight in front of a source of heat (this gives a chance for the circulation to respond to the warming skin). Do not let the feet become exposed to any source of direct heat (like a heater), especially if the foot is very cold - this is a common factor causing chilblain.

Here are a few simple Treatment for Chilblains.

• Keeping your feet warm is an important way to prevent chilblains - wear several layers of clothing, which trap body heat more efficiently than one bulky layer. Keep your fingers warm by wearing the gloves to prevent the chilblain.
• Soak hands/feet in a warm infusion of marigold flowers to a spoonful of sea salt has been added. Helps to reduce chilblains.
• Padding and pressure relief may give some relief for the chilblain symptoms.
• The part of the body that has chilblains should be elevated. This will reduce the swelling. Stay indoors in a warm room and let the body adjust to the warm room temperature naturally. Only then start with gentle, slow massage.
• Avoid scratching, and apply the anti-itch creams, calamine lotion and keep the effective chilblains toe and fingers in warm condition.
• The best treatment is to avoid having the chilblain problem in the first place by - wearing proper protection against the cold.

Natural Home Remedies to prevent Chilblain - Natural Treatment For Chilblains.

• Onion is best for chilblain.

If you suffer from chilblain use this remedy regularly winter. Cut a raw onion . Use the cut edge all over the chilblains; let the juice soak into the skin. The severity of itching dies down almost instantly and also helps in reducing the chilblain.

• Egg and Honey can also reduce chilblain.

Take a tablespoon of honey, a little glycerin, and one egg white. and add to this a little flour . Mix in to a paste. Apply all over the chilblain. Leave it on for 6-8 hours. Wash off. Cures your chilblain very quickly.

• Potato is treatment for chilblain.

Slice a potato. Sprinkle some salt on it. Rub it all over the chilblain. Helps to soothe the itching and redness.

• Regular Massage will helps to reduce chilblains.

Regular massage of hands and feet in winter with any warmed vegetable oil, with a few drops of lemon added, improves circulation. Use the discarded halves of lemons to cup them around fingers/toes, and rub them for a while. Wash off with warm water. Helps in reducing the chilblains.

• Black peppercorns with mustard or sesame seed oil.

Grind a few black black peppercorns and fry them in a tablespoonful of hot mustard or sesame seed oil. Filter and while still warm, use this oil for massage. Make sure the skin is not abraded or bruised, or else this will cause pain and inflammation in the chilblains.

• Garlic Juice reduces the itching of the chilblain.

Fresh juice and warm oil helps in reducing itching of chilblain. Rinse out hands in warm water, or the pungent garlic smell will remain.

All above are the best treatment to cure chilblains, but prevention in this as in most cases, is better than cure. Avoid smoking, Keep warm, be adequately clothed, keep dry and keep moving.

Treatment in case of severe chilblain

In case of the severe chilblain you need professional attention. A qualified podiatrist can treat your chilblain and offer advice on prevention. If you have a pre-existing condition such as diabetes, see your doctor if your chilblain ulcerate.