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HEALTH:

EL NIÑO AND OUR SKIN: DRY SKIN IS MORE ALARMING THAN YOU THINK, HERE's WHY


Local and international weather stations have reported that the Philippines is about to experience its worst El Niño in recent history. The phenomenon is anticipated to take place later this year. The intense heat and heightened storm activity associated with El Niño may put Filipinos at a higher risk for various skin concerns such as skin dryness, which if left untreated may eventually lead to a skin conditioned called, xerosis.
Xerosis is characterized by the inflammation of the skin when not enough moisture is present in its layers. Typically, xerosis results in rough and flaky patches on the skin’s surface, causing it to lose elasticity. In more extreme cases, it causes deep cracks and fissures that are both painful and itchy. Xerosis is usually localized in the arms, legs, and hands, as well as friction areas like the elbows, knees, and ankles. But El Niño is not the only cause of dry skin. Various factors and habits also contribute to the occurrence of dry skin. As people age, metabolic and hormonal changes take place. This contributes to dry skin and the subsequent loss of elasticity. Prolonged exposure to the sun, air-conditioning, over-scrubbing, frequent use of antibacterial soaps and sanitizers, long showers, and dehydration may also lead to dry skin. To check if you have dry skin, perform a scratch test on your arm by dragging your fingernail lightly across your skin. If a white mark appears on the area, your skin is dry and needs to be taken care of right away. You may also check your elbows, knees, and heels for any signs of dryness as these are the hot spots where skin dryness is most noticeable. READ MORE...

ALSO: About Xerosis Cutis


Xerosis of the shins. Part 1 of 6: Overview What Is Xerosis Cutis?
Xerosis cutis is the medical term for abnormally dry skin. This name comes from the Greek word “xero,” which means dry.Dry skin is common, especially in the elderly. It is usually a minor and temporary problem, but may cause discomfort. Your skin needs moisture to stay smooth. As you age, retaining moisture in the skin becomes more difficult. Your skin may become dry and rough as it loses water and oils. Dry skin is more common during the cold winter months. Modifying your daily routine by taking shorter showers with lukewarm water and by using moisturizers can help prevent xerosis cutis.
Part 2 of 6: Causes What Causes Xerosis Cutis? Dry skin is linked to a decrease in the oils on the surface of the skin. It is usually triggered by environmental factors. The following activities or conditions may lead to dry skin: • over-cleansing or over-scrubbing the skin • taking baths or showers using excessively hot water • bathing too frequently • vigorous towel-drying • living in areas of low humidity • living in areas with cold, dry winters • using central heating in your home or workplace • not drinking enough water (dehydration) • extended sun exposure Part 3 of 6: Risk Factors Who Is at Risk for Xerosis Cutis? CONTINUE READING...

ALSO: Atopic dermatitis (Eczema), Psoriasis, Psoriatic arthritis


Though most cases of dry skin (xerosis) have an environmental cause, certain diseases also can significantly affect your skin. Potential causes of dry skin include: Weather. In general, your skin is driest in winter, when temperatures and humidity levels plummet. But the reverse may be true if you live in desert regions, where temperatures can soar, but humidity levels remain low. Heat. Central heating, wood-burning stoves, space heaters and fireplaces all reduce humidity and dry your skin. Hot baths and showers. Taking long, hot showers or baths can dry your skin. So can frequent swimming, particularly in heavily chlorinated pools. Harsh soaps and detergents. Many popular soaps and detergents strip moisture from your skin. Deodorant and antibacterial soaps are usually the most damaging. Many shampoos may dry your scalp. Sun exposure. Sun dries your skin, and its ultraviolet (UV) radiation penetrates far beyond the top layer of skin. The most significant damage occurs deeper, leading to deep wrinkles and loose, sagging skin. Other skin conditions. People with skin conditions like atopic dermatitis (eczema) or a skin condition marked by a rapid buildup of rough, dry, dead skin cells that form thick scales (psoriasis) are prone to dry skin. Risk factors By Mayo Clinic Staff Although anyone can develop dry skin, you may be more likely to develop the condition if you: • Are older than age 40 • Live in dry, cold or low-humidity climates • Have a job that requires you to immerse your skin in water, such as nurses and hairstylists • Swim frequently in chlorinated pools Complications By Mayo Clinic Staff In some people who have a tendency toward eczema, dry skin that's not cared for can lead to: CONTINUE READING...

ALSO: THE BIOLOGY BEHIND ECZEMA AND PSORIASIS


Eczema and psoriasis are some of the most challenging skin conditions encountered by skin care professionals. Often, there will simply be a little red rash on the skin and you may be left scratching your own head trying to figure out how it came to be. Up to 20% of the world’s children suffer from eczema (1, 2) and up to 3% of adults suffer from either eczema or psoriasis (3). Given that the world population just reached the 7 billion mark, that’s a lot of people. Eczema, along with asthma and allergies, are on the rise; in fact, eczema is much more common today than it was 30 years ago, especially in children. This rapid spike in apparent incidence is cause for concern, and may be due to many factors, such as inadequate diet, pollution and other environmental stressors. The truth is, it isn’t known exactly what causes eczema or psoriasis. The good news is, more and more is being learned about these inflammatory skin diseases and strategies are being developed to effectively manage their symptoms. 
It is significant to note that neither condition is contagious, nor are they infections; and they aren’t transmitted by external contact or exposure. The origins of eczema and psoriasis are genetic; however, the triggers that cause their distressing and visible symptoms may include stress and environmental factors. READ MORE...

ALSO: Diseases and Conditions Psoriatic arthritis


Psoriatic arthritis can lead to a reduced range of motion as a result of stiffness and pain in joints, as well as swelling and tenderness in tendons. Your own range of motion will depend on the severity of your other symptoms. It also will depend on how many joints are affected. - Psoriatic arthritis is a form of arthritis that affects some people who have psoriasis — a condition that features red patches of skin topped with silvery scales. Most people develop psoriasis first and are later diagnosed with psoriatic arthritis, but the joint problems can sometimes begin before skin lesions appear.  Joint pain, stiffness and swelling are the main symptoms of psoriatic arthritis. They can affect any part of your body, including your fingertips and spine, and can range from relatively mild to severe. In both psoriasis and psoriatic arthritis, disease flares may alternate with periods of remission. No cure for psoriatic arthritis exists, so the focus is on controlling symptoms and preventing damage to your joints. Without treatment, psoriatic arthritis may be disabling. Symptoms Both psoriatic arthritis and psoriasis are chronic diseases that get worse over time, but you may have periods when your symptoms improve or go into remission alternating with times when symptoms become worse. Psoriatic arthritis can affect joints on just one side or on both sides of your body. The signs and symptoms of psoriatic arthritis often resemble those of rheumatoid arthritis. Both diseases cause joints to become painful, swollen and warm to the touch. However, psoriatic arthritis is more likely to also cause: • Swollen fingers and toes. Psoriatic arthritis can cause a painful, sausage-like swelling of your fingers and toes. You may also develop swelling and deformities in your hands and feet before having significant joint symptoms. • Foot pain. Psoriatic arthritis can also cause pain at the points where tendons and ligaments attach to your bones — especially at the back of your heel (Achilles tendinitis) or in the sole of your foot (plantar fasciitis). • Lower back pain. Some people develop a condition called spondylitis as a result of psoriatic arthritis. Spondylitis mainly causes inflammation of the joints between the vertebrae of your spine and in the joints between your spine and pelvis (sacroiliitis).  When to see a doctor If you have psoriasis, be sure to tell your doctor if you develop joint pain. Psoriatic arthritis can come on suddenly or develop slowly, but in either case it can severely damage your joints if left untreated. Causes Psoriatic arthritis occurs when your body's immune system begins to attack healthy cells and tissue. The abnormal immune response causes inflammation in your joints as well as overproduction of skin cells. It's not entirely clear why the immune system turns on healthy tissue, but it seems likely that both genetic and environmental factors play a role. Many people with psoriatic arthritis have a family history of either psoriasis or psoriatic arthritis. Researchers have discovered certain genetic markers that appear to be associated with psoriatic arthritis. READ MORE...


READ FULL MEDIA REPORTS HERE:

El Niño and our skin: Dry skin is more alarming than you think: here’s why


Vaseline-Strip-Ad-Powered by VASELINE

MANILA, MAY 2, 2016 (INQUIRER) By: Clarisse Esmile, Lucille Tungol @inquirerdotnet 02:52 PM March 17th, 2016 -Local and international weather stations have reported that the Philippines is about to experience its worst El Niño in recent history.

The phenomenon is anticipated to take place later this year. The intense heat and heightened storm activity associated with El Niño may put Filipinos at a higher risk for various skin concerns such as skin dryness, which if left untreated may eventually lead to a skin conditioned called, xerosis.

Xerosis is characterized by the inflammation of the skin when not enough moisture is present in its layers. Typically, xerosis results in rough and flaky patches on the skin’s surface, causing it to lose elasticity. In more extreme cases, it causes deep cracks and fissures that are both painful and itchy. Xerosis is usually localized in the arms, legs, and hands, as well as friction areas like the elbows, knees, and ankles.

But El Niño is not the only cause of dry skin. Various factors and habits also contribute to the occurrence of dry skin. As people age, metabolic and hormonal changes take place. This contributes to dry skin and the subsequent loss of elasticity. Prolonged exposure to the sun, air-conditioning, over-scrubbing, frequent use of antibacterial soaps and sanitizers, long showers, and dehydration may also lead to dry skin.

To check if you have dry skin, perform a scratch test on your arm by dragging your fingernail lightly across your skin. If a white mark appears on the area, your skin is dry and needs to be taken care of right away. You may also check your elbows, knees, and heels for any signs of dryness as these are the hot spots where skin dryness is most noticeable.

READ MORE...

There are several ways you can bring your skin back to its former glory. One is by meeting the minimum water intake requirement of 8-10 glasses daily to stay hydrated. Another is by avoiding alcoholic beverages and fried food as these hamper the body’s ability to absorb fluids, leading to dehydration. Limiting baths to once or twice a day is also helpful in keeping the skin’s moisture content; excessive showering actually breaks down your skin’s natural barriers. Wearing soft cotton clothing is also recommended as it is kinder on the skin than other fabrics.

However, healing dry skin with the use of a moisturizing body lotion with petroleum jelly is still the best solution for xerosis. It should go deep within your skin’s surface to heal its natural lipid barrier and bring moisture back to your skin.

Dermatologists recommend Vaseline Lotion, now with micro-droplets of Vaseline Petroleum Jelly, which replenishes lost moisture and heal your skin from the inside.

1. For targeted areas like elbows, heels and knees: Heal dry skin with Vaseline Petroleum Jelly, the original wonder jelly.

3 (1)2. For everyday use: Heal dry skin from within with the new Vaseline Deep Restore Lotion, now with micro-droplets of Vaseline petroleum jelly.

3. For whitening: Heal dry skin and get 4x instantly fairer skin with the Vaseline Instant Fair Lotion.

VAS TEETH KV

Experience the healing power of Vaseline Lotion. Visit www.vaseline.ph  to know more about how you can heal dry skin. ADVT


HEALTHLINE

Xerosis Cutis SHARE
 


Xerosis of the shins.

Part 1 of 6: Overview

What Is Xerosis Cutis?

Xerosis cutis is the medical term for abnormally dry skin. This name comes from the Greek word “xero,” which means dry.

Dry skin is common, especially in the elderly. It is usually a minor and temporary problem, but may cause discomfort. Your skin needs moisture to stay smooth. As you age, retaining moisture in the skin becomes more difficult. Your skin may become dry and rough as it loses water and oils.

Dry skin is more common during the cold winter months. Modifying your daily routine by taking shorter showers with lukewarm water and by using moisturizers can help prevent xerosis cutis.

Part 2 of 6: Causes

What Causes Xerosis Cutis?

Dry skin is linked to a decrease in the oils on the surface of the skin. It is usually triggered by environmental factors. The following activities or conditions may lead to dry skin:

• over-cleansing or over-scrubbing the skin

• taking baths or showers using excessively hot water

• bathing too frequently

• vigorous towel-drying

• living in areas of low humidity

• living in areas with cold, dry winters

• using central heating in your home or workplace

• not drinking enough water (dehydration)

• extended sun exposure

Part 3 of 6: Risk Factors

Who Is at Risk for Xerosis Cutis?

CONTINUE READING...

Xerosis cutis is worse during the cold winter months when the air is very dry (low humidity).

Older people are more susceptible to developing the condition than younger people.

Part 4 of 6: Symptoms

What Are the Symptoms of Xerosis Cutis?

Symptoms of xerosis cutis include:

• skin that is dry, itchy, and scaly, especially on the arms and legs

• skin that feels tight, especially after bathing

• white, flaky skin

• red or pink irritated skin

• fine cracks on the skin

Part 5 of 6: Treatment

How Is Xerosis Cutis Treated?

At-Home Care:

Treatment is aimed at relieving your symptoms. Treating dry skin at home includes regularly using moisturizers on the skin. Usually, an oil-based cream is more effective at holding in moisture than a water-based cream.

Look for creams that contain the ingredients lactic acid or lactic acid and urea. A topical steroid medication, such as hydrocortisone one percent cream, can also be used if the skin is very itchy. Ask a pharmacist to recommend a moisturizing cream or product that will work for you.

When to See a Doctor

If your skin is oozing, has large areas that are peeling, has a ring-shaped rash, does not improve within a few weeks, or gets much worse despite treatment, see a dermatologist.

A dermatologist is a doctor who specializes in disorders of the skin. You may have a fungal or bacterial infection, an allergy, or another skin condition. Excessive scratching of dry skin can also lead to an infection.

Dry skin in younger people may be caused by a condition called atopic dermatitis, commonly known as eczema. Eczema is characterized by extremely dry, itchy skin. Blisters and hard, scaly skin is common in those with this condition. A dermatologist can help determine if you or your child has eczema.

Part 6 of 6: Prevention

How Can Xerosis Cutis Be Prevented?

Dry skin cannot always be prevented, especially as you age. However, you can help avoid or reduce the symptoms of xerosis cutis by simply modifying your daily routine.

• Avoid bath or shower water that is too hot; try using lukewarm water.

• Take shorter baths or showers.

• Avoid excessive water exposure; do not spend extended amounts of time in a hot tub or pool.

• Use gentle cleansers without any dyes, fragrances, or alcohol.

• Pat the skin dry after a shower with a towel instead of rubbing the towel on your body.

• Stay hydrated by drinking plenty of water.

• Limit the use of soap on dry areas of skin and choose mild soaps with oil added.

• Avoid scratching the affected area.

• Use oil-based moisturizing lotions frequently, especially in the winter, and directly following a bath or shower. Eucerin and Cetaphil are two recommended brands.

• Use a sunscreen when going outdoors.

• Use a humidifier to increase the moisture of the air in your home.


MAYO CLINIC WEBSITE

Atopic dermatitis, Psoriasis, Psoriatic arthritis By Mayo Clinic Staff



Though most cases of dry skin (xerosis) have an environmental cause, certain diseases also can significantly affect your skin. Potential causes of dry skin include:

Weather.

In general, your skin is driest in winter, when temperatures and humidity levels plummet. But the reverse may be true if you live in desert regions, where temperatures can soar, but humidity levels remain low.

Heat. Central heating, wood-burning stoves, space heaters and fireplaces all reduce humidity and dry your skin.

Hot baths and showers. Taking long, hot showers or baths can dry your skin. So can frequent swimming, particularly in heavily chlorinated pools.

Harsh soaps and detergents. Many popular soaps and detergents strip moisture from your skin. Deodorant and antibacterial soaps are usually the most damaging. Many shampoos may dry your scalp.

Sun exposure. Sun dries your skin, and its ultraviolet (UV) radiation penetrates far beyond the top layer of skin. The most significant damage occurs deeper, leading to deep wrinkles and loose, sagging skin.

Other skin conditions. People with skin conditions like atopic dermatitis (eczema) or a skin condition marked by a rapid buildup of rough, dry, dead skin cells that form thick scales (psoriasis) are prone to dry skin.

Risk factors
By Mayo Clinic Staff

Although anyone can develop dry skin, you may be more likely to develop the condition if you:

• Are older than age 40

• Live in dry, cold or low-humidity climates

• Have a job that requires you to immerse your skin in water, such as nurses and hairstylists

• Swim frequently in chlorinated pools

Complications
By Mayo Clinic Staff

In some people who have a tendency toward eczema, dry skin that's not cared for can lead to:

CONTINUE READING...

• Atopic dermatitis (eczema).

If you're prone to develop this condition, excessive dryness can lead to activation of the disease, causing redness, cracking and inflammation.

• Infections.

Dry skin may crack, allowing bacteria to enter, causing infections.

These complications are most likely to occur when your skin's normal protective mechanisms are severely compromised. For example, severely dry skin can cause deep cracks or fissures, which can open and bleed, providing an avenue for invading bacteria.

Preparing for your appointment
By Mayo Clinic Staff

You're likely to start by seeing your family doctor. However, in some cases, you may be referred directly to a specialist in skin diseases (dermatologist).

Here's some information to help you get ready for your appointment and know what to expect from your doctor.

What you can do

Preparing a list of questions will help you make the most of your time with your doctor. For dry skin, some basic questions to ask include:

• What is likely causing the dry skin?

• What are other possible causes for my symptoms?

• Do I need tests?

• Is it likely the condition will clear up on its own?

• What skin care routines do you recommend?

• Don't hesitate to ask any other questions you have.

What to expect from your doctor

Your doctor is likely to ask you several questions, such as:

• Do you have other symptoms?

• Have your symptoms been continuous or occasional?

• What, if anything, makes your skin better?

• What, if anything, makes your skin worse?

• What medications are you taking?

• How often do you bathe or shower? Do you use hot water? What soaps and shampoos do you use?

• Do you use moisturizing creams? If so, which ones, and how often do you use them?

Tests and diagnosis
By Mayo Clinic Staff

Physical exam and medical history

Your doctor is likely to conduct a physical exam and ask about your medical history, including when your dry skin started, what factors make it better or worse, your bathing habits, your diet, and how you care for your skin.

You may have certain diagnostic tests if your doctor suspects that your dry skin is the result of an underlying medical condition, such as an underactive thyroid (hypothyroidism).

Treatments and drugs
By Mayo Clinic Staff

In most cases, dry skin responds well to lifestyle measures, such as using moisturizers and avoiding long, hot showers and baths. If you have very dry and scaly skin, your doctor may recommend you use an over-the-counter (nonprescription) cream that contains lactic acid or lactic acid and urea.

If you have a more serious skin disease, such as atopic dermatitis, ichthyosis or psoriasis, your doctor may prescribe prescription creams and ointments or other treatments in addition to home care.

Sometimes dry skin leads to dermatitis, which causes red, itchy skin. In these cases, treatment may include hydrocortisone-containing lotions. If your skin cracks open, your doctor may prescribe wet dressings to help prevent infection.

Lifestyle and home remedies
By Mayo Clinic Staff

The following measures can help keep your skin moist and healthy:

Moisturize.

Moisturizers provide a seal over your skin to keep water from escaping. Apply moisturizer several times a day. Thicker moisturizers work best, such as over-the-counter brands Eucerin and Cetaphil.

You may also want to use cosmetics that contain moisturizers. If your skin is extremely dry, you may want to apply an oil, such as baby oil, while your skin is still moist. Oil has more staying power than moisturizers do and prevents the evaporation of water from the surface of your skin.

Another possibility is ointments that contain petroleum jelly (Vaseline, Aquaphor). However, these may feel greasy, so you might use them only at night.

Use warm water and limit bath time.

Long showers or baths and hot water remove oils from your skin. Limit your bath or shower to five to 10 minutes and use warm, not hot, water.

Avoid harsh, drying soaps.

It's best to use cleansing creams or gentle skin cleansers and bath or shower gels with added moisturizers. Choose mild soaps that have added oils and fats. Avoid deodorant and antibacterial detergents, fragrance, and alcohol.

Apply moisturizers immediately after bathing.

Gently pat your skin dry with a towel so that some moisture remains. Immediately moisturize your skin with an oil or cream to help trap water in the surface cells.

Use a humidifier.
Hot, dry, indoor air can parch sensitive skin and worsen itching and flaking. A portable home humidifier or one attached to your furnace adds moisture to the air inside your home. Be sure to keep your humidifier clean to ward off bacteria and fungi.

Choose fabrics that are kind to your skin.

Natural fibers, such as cotton and silk, allow your skin to breathe. But wool, although natural, can irritate even normal skin. Wash your clothes with detergents without dyes or perfumes, both of which can irritate your skin.

If dry skin causes itching, apply cool compresses to the area. To reduce inflammation, use a nonprescription hydrocortisone cream or ointment, containing at least 1 percent hydrocortisone.

If these measures don't relieve your symptoms or if your symptoms worsen, see your doctor or consult a dermatologist.


Published in Skin Inc Magazine, July 2012

THE BIOLOGY BEHIND ECZEMA AND PSORIASIS

Eczema and psoriasis are some of the most challenging skin conditions encountered by skin care professionals. Often, there will simply be a little red rash on the skin and you may be left scratching your own head trying to figure out how it came to be. Up to 20% of the world’s children suffer from eczema (1, 2) and up to 3% of adults suffer from either eczema or psoriasis (3). Given that the world population just reached the 7 billion mark, that’s a lot of people.

Eczema, along with asthma and allergies, are on the rise; in fact, eczema is much more common today than it was 30 years ago, especially in children. This rapid spike in apparent incidence is cause for concern, and may be due to many factors, such as inadequate diet, pollution and other environmental stressors.

The truth is, it isn’t known exactly what causes eczema or psoriasis. The good news is, more and more is being learned about these inflammatory skin diseases and strategies are being developed to effectively manage their symptoms.

It is significant to note that neither condition is contagious, nor are they infections; and they aren’t transmitted by external contact or exposure. The origins of eczema and psoriasis are genetic; however, the triggers that cause their distressing and visible symptoms may include stress and environmental factors.

READ MORE...

ECZEMA

A rash by any other name is still a rash. The terms “eczema” or “dermatitis” are very broad and can mean a whole family of skin conditions, ranging from dandruff, to contact dermatitis to atopic dermatitis.

This can lead to many a confused client and skin care professional. In dermatology and skin care, the word “eczema” typically refers to atopic dermatitis (AD), a chronic inflammatory skin disease. It causes dry, itchy, irritated skin that requires daily care. Genetic defects in eczema result in abnormal skin cell differentiation.

During differentiation, keratinocytes move from the basal cell layer of the epidermis through the granular layer to a group of flattened dead cells in the stratum corneum. This process of epidermal differentiation, or keratinization, involves a variety of proteins responsible for different functions at each stage.

One of these proteins, filaggrin, plays a major role in epidermal homeostasis; it has two main functions. First, it stacks the keratin filaments into dense bundles, allowing for easy desquamation. Imagine how much easier it is to move flattened boxes than propped-open boxes.

It is then converted into the skin’s natural moisturizing factor (NMF) along with other byproducts. So if filaggrin does not work very well, it can have adverse effects, not only on the process of epidermal differentiation, but also on the skin’s natural moisture levels and protective lipid barrier. This seems to be the biological basis of dry skin.

In the past five years, researchers have established the link between filaggrin mutations and developing ichthyosis vulgarism (4), atopic eczema (5) and, most recently, peanut allergies (6). Ichthyosis is another skin disease characterized by very dry skin.

The word itself is Greek for “fish,” suggesting the scaly nature of the lesions. Indeed, scientists are getting closer to understanding the genetic connection between allergic diseases, bringing hope for a future therapy not only for eczema clients, but also for those with allergies and ichthyosis.

There’s another type of eczema that shows up as the same itchy rash, but does not involve allergic responses. This is known as nonatopic eczema, and it affects millions of adults. Although most—about 90%—develop atopic dermatitis before age 5, nonatopic dermatitis develops in adolescence or adulthood, typically by age 15 (7, 8).

These people don’t have heightened allergic responses or specific allergies, but still get dry, itchy skin. Keep in mind that even if a client is classified as atopic or nonatopic, the end result is the same itchy patch of skin, which must be cared for in the same manner.

PSORIASIS

Psoriasis has been confused with eczema, lupus, boils, vitiligo and leprosy. Because of the confusing connection with leprosy in ancient times, psoriasis sufferers were even made to wear special suits and carry a rattle or bell, like lepers, announcing their presence.

Only in the 19th century was a distinction made between psoriasis and leprosy, alleviating some of the psychosocial impact of this highly visible and distressing skin disease.9 As with eczema, it presents as itchy, red skin and involves altered immunity. However, its complexities reach far beyond the surface of the skin.

 People with psoriasis have an increased risk of cardiovascular disease, metabolic syndrome, obesity and other immune-related inflammatory diseases—even cancer. The mysteries behind this complicated and debilitating skin disease are only beginning to be unraveled. Psoriasis is a chronic, inflammatory multisystem disease affecting 1–3% of the world’s population.

Whereas the rashes on eczematous skin can have irregular edges and texture, psoriatic lesions tend to be more uniform and distinct. Red or pink areas of thickened, raised and dry skin typically present on the elbows, knees and scalp.

This presentation tends to be more common in areas of trauma, abrasions or repeated rubbing and use, although any area may be affected. Unlike eczema, psoriasis comes in five different forms: plaque, guttate, pustular, inverse and erythrodermic.

Plaque psoriasis affects about 80% of those who suffer from psoriasis, making it the most common type. You’re likely to encounter this type in a skin care facility, so it’s important to know how to identify and understand it to help you better manage your client’s needs.

It may initially appear as small red bumps that can then enlarge and form scales. The hallmarks of this type are raised, thickened patches of red skin covered in silvery scales. The other types are less common and present inflamed skin with red bumps; pustules; cracked, dry skin; and even burned-looking skin. Clients will most likely be under a physician’s care, who will diagnose the type of psoriasis present.

As of today, psoriasis has no cure. A single cause of the disease has yet to be uncovered, but it is known that developing the disease involves the immune system, genetics and environmental factors. In psoriasis, aberrant immune activity causes inflammatory signals to go haywire in the epidermis, causing a buildup of cells on the surface of the skin.

While normal skin takes 28–30 days to mature, psoriatic skin takes only 3–4 days to mature and, instead of shedding off, the cells pile up on the surface of the skin, forming plaques and lesions.

The underlying reason may be due to the hyperactivity of T-cells, which end up on the skin and trigger inflammation and keratinocyte overproduction. Although it is not known why this happens, it is known that the end result is a cycle of skin cells growing too fast, dead cell-debris accumulation and resulting inflammation.

MANAGING THE SYMPTOMS

Although there is no cure for eczema or psoriasis, there are ways to manage symptoms, and gaining this knowledge will lead to more satisfied and educated clients.

Although eczema and psoriasis are clinically distinct from one another, they do share some common features that may be addressed in the treatment room. Both eczema and psoriasis clients have impaired barrier function and increased inflammation, so your goal will be to protect and repair.

Remember to always check first with your client’s physician for contraindications to medications and therapies, because some ingredients may counteract each other. For example, salicylic acid may seem a likely choice for exfoliating psoriatic skin, but could, in fact, inactivate a common topical treatment for psoriasis.

Once a full consultation with the client and possibly her physician is completed, proceed with a treatment using minimal products and procedures. A good way to compensate for minimal skin treatment time is to add on stress-relieving techniques, because there is a psychological component to eczema and psoriasis. Complementary therapies, such as aromatherapy, acupressure, reflexology, massage and inhalation techniques can be coupled with skin treatments to lower stress hormones and control inflammation.

Gentle cleansing and exfoliation is crucial to allow the penetration of rich, emollient moisturizers used on dry, sensitive skin. Avoid harsh exfoliants and detergents, and look for ingredients, such as lactic acid. Use anti-inflammatory ingredients, such as red hogweed, ginger, oats and chamomile, coupled with barrier-repairing oils, including evening primrose, borage, argan and sea buckthorn.

Finishing a treatment with a physical sunscreen, such as zinc oxide or titanium dioxide will ensure that harmful UV rays do not cause further damage.

Coaching the client on home care is also an integral part of skin health maintenance.

Not only will they need to comply with their prescribed skin care regimen; they will also need to have realistic expectations in terms of time, and expect to see the extended benefits of their treatments long after they are performed. Because these are chronic inflammatory skin conditions, these clients can be a valuable business opportunity, with an increased likelihood of return bookings.

Both eczema and psoriasis present highly visible symptoms, and because of this, clients are motivated to help skin improve. Skin health management is a top-of-mind priority for this client’s lifestyle, distinguishing your services from occasional treatments.

Don’t be afraid to tackle these skin diseases in the treatment room; the reward could be greatly beneficial to you and your clients.

REFERENCES

1. L Maintz and N Novak, Getting more and more complex: the pathophysiology of atopic eczema, Eur J Dermatol, 17 4 267–283 (2007)

2. HW Walling and BL Swick, Update on the management of chronic eczema: new approaches and emerging treatment options, Clinical, Cosmetic and Investigational Dermatology 3 99–117 (2010)

3. AM Bowcock and W Cookson, The genetics of psoriasis, psoriatic arthritis and atopic dermatitis, Human Molecular Genetics 13 R43–R55 (2004)

4. FJ Smith, et al, Loss-of-function mutations in the gene encoding filaggrin cause ichthyosis vulgaris, Nat Genet 38 337–342 (2006)

5. CN Palmer, et al, Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis, Nat Genet 38 441–446 (2006)

6. SJ Brown, et al, Loss-of-function variants in the filaggrin gene are a significant risk factor for peanut allergy, J Allergy Clin Immunol 127 661–667 (2011)

7. www.niams.nih.gov/health_info/atopic_dermatitis/default.asp#b (Accessed May 3, 2012)

8. S Jacob, M Miller and EM Herro, Atopic Dermatitis—A historical review, Skin & Aging 19 (Suppl) 1–11 (2011)

9. A Cowden and A Van Voorhees, Treatment of Psoriasis (1–9), Switzerland, Birkhäuser Verlag (2008)


MAYO CLINIC

Diseases and Conditions Psoriatic arthritis

Definition
By Mayo Clinic Staff


Psoriatic arthritis can lead to a reduced range of motion as a result of stiffness and pain in joints, as well as swelling and tenderness in tendons. Your own range of motion will depend on the severity of your other symptoms. It also will depend on how many joints are affected. -

Psoriatic arthritis is a form of arthritis that affects some people who have psoriasis — a condition that features red patches of skin topped with silvery scales. Most people develop psoriasis first and are later diagnosed with psoriatic arthritis, but the joint problems can sometimes begin before skin lesions appear.

Joint pain, stiffness and swelling are the main symptoms of psoriatic arthritis. They can affect any part of your body, including your fingertips and spine, and can range from relatively mild to severe. In both psoriasis and psoriatic arthritis, disease flares may alternate with periods of remission.

No cure for psoriatic arthritis exists, so the focus is on controlling symptoms and preventing damage to your joints. Without treatment, psoriatic arthritis may be disabling.

Symptoms
By Mayo Clinic Staff

Both psoriatic arthritis and psoriasis are chronic diseases that get worse over time, but you may have periods when your symptoms improve or go into remission alternating with times when symptoms become worse.

Psoriatic arthritis can affect joints on just one side or on both sides of your body. The signs and symptoms of psoriatic arthritis often resemble those of rheumatoid arthritis. Both diseases cause joints to become painful, swollen and warm to the touch.

However, psoriatic arthritis is more likely to also cause:

• Swollen fingers and toes. Psoriatic arthritis can cause a painful, sausage-like swelling of your fingers and toes. You may also develop swelling and deformities in your hands and feet before having significant joint symptoms.

• Foot pain. Psoriatic arthritis can also cause pain at the points where tendons and ligaments attach to your bones — especially at the back of your heel (Achilles tendinitis) or in the sole of your foot (plantar fasciitis).

• Lower back pain. Some people develop a condition called spondylitis as a result of psoriatic arthritis. Spondylitis mainly causes inflammation of the joints between the vertebrae of your spine and in the joints between your spine and pelvis (sacroiliitis).

When to see a doctor

If you have psoriasis, be sure to tell your doctor if you develop joint pain. Psoriatic arthritis can come on suddenly or develop slowly, but in either case it can severely damage your joints if left untreated.

Causes
By Mayo Clinic Staff

Psoriatic arthritis occurs when your body's immune system begins to attack healthy cells and tissue. The abnormal immune response causes inflammation in your joints as well as overproduction of skin cells.

It's not entirely clear why the immune system turns on healthy tissue, but it seems likely that both genetic and environmental factors play a role. Many people with psoriatic arthritis have a family history of either psoriasis or psoriatic arthritis. Researchers have discovered certain genetic markers that appear to be associated with psoriatic arthritis.

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Physical trauma or something in the environment — such as a viral or bacterial infection — may trigger psoriatic arthritis in people with an inherited tendency.

Risk factors
By Mayo Clinic Staff


Photograph of psoriasis on elbow


Photograph of thumbnails affected by psoriasis Psoriasis on the nails

Several factors can increase your risk of psoriatic arthritis, including:

Psoriasis.
Having psoriasis is the single greatest risk factor for developing psoriatic arthritis. People who have psoriasis lesions on their nails are especially likely to develop psoriatic arthritis.

Your family history.
Many people with psoriatic arthritis have a parent or a sibling with the disease.

Your age.
Although anyone can develop psoriatic arthritis, it occurs most often in adults between the ages of 30 and 50.

Complications
By Mayo Clinic Staff

A small percentage of people with psoriatic arthritis develop arthritis mutilans — a severe, painful and disabling form of the disease. Over time, arthritis mutilans destroys the small bones in your hands, especially the fingers, leading to permanent deformity and disability.

Preparing for your appointment
By Mayo Clinic Staff

You're likely to first discuss your signs and symptoms with your family doctor. He or she may refer you to a doctor specializing in the treatment of arthritis and related disorders (rheumatologist).

What you can do

Before your appointment, you may want to write a list of answers to the following questions:

• What types of symptoms are you having? When did they begin?

• Do you or any of your close family members have psoriasis?

• Has anyone in your immediate family ever had psoriatic arthritis?

• What medications and supplements do you take?

You may want to bring a friend or family member with you to your appointment. It's hard to remember everything about a complicated condition, and another person may remember information that you miss.


Psoriatic arthritis can cause many nail problems and changes. These include “pitting”—which means depressions in your fingernails or toenails—or separation from your nail bed.

What to expect from your doctor

Your doctor might ask some of the following questions:

• What joints are affected?

• Are there any activities or positions that make your symptoms better or worse?

• What treatments have you already tried? Have any of them helped?

Tests and diagnosis
By Mayo Clinic Staff

• Closely examine your joints for signs of swelling or tenderness

• Check your fingernails for pitting, flaking and other abnormalities

• Press on the soles of your feet and around your heels to find tender areas

No single test can confirm a diagnosis of psoriatic arthritis. But some types of tests can rule out other causes of joint pain, such as rheumatoid arthritis or gout.

Imaging tests

• X-rays. Plain X-rays can help pinpoint changes in the joints that occur in psoriatic arthritis but not in other arthritic conditions.

• Magnetic resonance imaging (MRI). MRI utilizes radio waves and a strong magnetic field to produce very detailed images of both hard and soft tissues in your body. This type of imaging test may be used to check for problems with the tendons and ligaments in your feet and lower back.

Laboratory tests

• Rheumatoid factor (RF). RF is an antibody that's often present in the blood of people with rheumatoid arthritis, but it's not usually in the blood of people with psoriatic arthritis. For that reason, this test can help your doctor distinguish between the two conditions.

• Joint fluid test. Using a long needle, your doctor can remove a small sample of fluid from one of your affected joints — often the knee. Uric acid crystals in your joint fluid may indicate that you have gout rather than psoriatic arthritis.


Both rheumatoid arthritis and psoriatic arthritis can cause you to feel stiff and inflexible in the morning. This stiffness might make it difficult to move joints on either or both sides of your body.

Treatments and drugs
By Mayo Clinic Staff

Medications

Drugs used to treat psoriatic arthritis include:

NSAIDs.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). Stronger NSAIDs are available by prescription. Side effects may include stomach irritation, heart problems, and liver and kidney damage.

Disease-modifying antirheumatic drugs (DMARDs).

These drugs can slow the progression of psoriatic arthritis and save the joints and other tissues from permanent damage. Common DMARDs include methotrexate (Trexall), leflunomide (Arava), and sulfasalazine (Azulfidine). Side effects vary but may include liver damage, bone marrow suppression and severe lung infections.

Immunosuppressants.

These medications act to tame your immune system, which is out of control in psoriatic arthritis. Examples include azathioprine (Imuran, Azasan) and cyclosporine (Gengraf, Neoral, Sandimmune). These medications can increase your susceptibility to infection.

TNF-alpha inhibitors.

Tumor necrosis factor-alpha (TNF-alpha) is an inflammatory substance produced by your body. TNF-alpha inhibitors can help reduce pain, morning stiffness, and tender or swollen joints. Examples include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), golimumab (Simponi) and certolizumab (Cimzia). Potential side effects include nausea, diarrhea, hair loss and an increased risk of serious infections.

Surgical and other procedures

Steroid injections.

This type of medication reduces inflammation quickly and is sometimes injected into an affected joint.

Joint replacement surgery.

Joints that have been severely damaged by psoriatic arthritis can be replaced with artificial prostheses made of metal and plastic.

Lifestyle and home remedies
By Mayo Clinic Staff

Protect your joints. Changing the way you carry out everyday tasks can make a tremendous difference in how you feel. For example, you can avoid straining your finger joints by using gadgets such as jar openers to twist the lids from jars, by lifting heavy pans or other objects with both hands, and by pushing doors open with your whole body instead of just your fingers.

Maintain a healthy weight.

Maintaining a healthy weight places less strain on your joints, leading to reduced pain and increased energy and mobility. The best way to increase nutrients while limiting calories is to eat more plant-based foods — fruits, vegetables and whole grains.

Exercise regularly.

Exercise can help keep your joints flexible and your muscles strong. Types of exercises that are less stressful on joints include biking, swimming and walking.
Use cold and hot packs. Because cold has a numbing effect, it can dull the sensation of pain. You can apply cold several times a day for 20 or 30 minutes at a time. Heat can help relax tense muscles and relieve pain.

Pace yourself.

Battling pain and inflammation can leave you feeling exhausted. In addition, some arthritis medications can cause fatigue. The key isn't to stop being active entirely, but to rest before you become too tired. Divide exercise or work activities into short segments. Find time to relax several times throughout the day.

Coping and support
By Mayo Clinic Staff

Psoriatic arthritis can be particularly discouraging because the emotional pain that psoriasis can cause is compounded by joint pain and, in some cases, disability.

The support of friends and family can make a tremendous difference when you're facing the physical and psychological challenges of psoriatic arthritis. Just having someone to talk to can give you strength. For some people, support groups can offer the same benefits — this may be especially important if you're worried about burdening your loved ones.

A counselor or therapist can help you devise coping strategies to reduce your stress levels. The chemicals your body releases when you're under stress can aggravate both psoriasis and psoriatic arthritis.


Chief News Editor: Sol Jose Vanzi
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