A skin condition that causes pimples or “zits”. This includes whiteheads, blackheads, and red, inflamed patches of skin (such as cysts). Acne is extremely common and can result in psychological distress. It is a medical condition that should be treated to reduce the chance of scarring.
Adverse drug reactions are undesirable effects caused by consuming one or more drugs, and may involve the skin as well as internal organs. Adverse drug reactions of the skin may be mild or severe, and can present with a rash or blisters that may also affect the mucosal membranes. These reactions may rarely be life-threatening, hence the importance of early recognition and withdrawal of the offending drug.
Atopic dermatitis or eczema, is an itchy inflammatory skin condition that may start in infancy and continue into adulthood. It may be associated with other atopic diseases which are hypersensitivity disorders that include asthma and allergic rhinitis. Genetic factors, defective skin barrier function and environmental triggers play important roles in the development of atopic dermatitis. Allergies to food allergens such as cow’s milk, wheat, egg and peanut may aggravate the dermatitis in some children. It most frequently presents in infancy and early childhood with itchy dry, scaly and red patches, often localized to the creases of the elbows, knees, neck, as well as the ankles and wrists. The management of atopic dermatitis includes relieving itch, preventing or treating secondary infection, frequent application of moisturizers, avoidance of irritants, and appropriate topical or oral medication.
There are 3 normal phases in the hair loss and growth cycle, namely anagen (growth), catagen (resting) and telogen (shedding). There are many causes of excessive hair loss (alopecia). Sudden increase in hair fall may be the result of childbirth, illness, medication side effects or change in diet. Androgenetic alopecia, or hereditary thinning, is one of the most common forms of hair loss that affects both men and women. Alopecia areata is another common cause of hair loss that is more frequent in children and young adults.
Alopecia areata is a condition that causes round patches of hair loss, which rarely can lead to total hair loss in severe cases. Effective treatments are available to speed up recovery. Alopecia areata may occasionally be associated with autoimmune diseases such as vitiligo and thyroid disorders.
Androgenetic alopecia (AGA) affects both men and women. In men, male pattern balding can start early and usually becomes clinically obvious in patients in their twenties and thirties. In female pattern hair loss, thinning of hair usually happens around the whole scalp, and unlike in men, the hairline does not recede. Several factors are thought to be important in the development of AGA, including genetic factors and male hormones. There are effective topical and oral medications available for the control of hair loss, and some medications may also promote hair growth.
The autoimmune blistering diseases (AIBD) are characterized by the presence of autoantibodies that target certain components of the skin, resulting in loss of stickiness between skin cells and blister formation at various depths of the skin. In some cases, the mucous membranes are also affected, resulting in painful erosions. The more common forms of AIBD include bullous pemphigoid and pemphigus. Bullous pemphigoid affects mainly elderly individuals and is usually a chronic disease. The main subtypes of pemphigus include pemphigus vulgaris and pemphigus foliaceus. Blistering in pemphigus occurs at more superficial layers of skin than in pemphigoid. AIBD often require topical and oral medication for control of disease.
Bacterial skin infections can cause painful boils on the body, and occasionally blisters as well. In children, impetigo is a common condition that is highly contagious and requires effective antibiotic therapy. Some patients have recurrent bacterial infections involving the hair follicles, and this causes pimple-like bumps to appear on areas such as the scalp and buttocks.
Contact dermatitis is a condition in which the skin becomes red, sore, or inflamed after direct contact with a substance. There are two kinds of contact dermatitis: irritant or allergic. Irritant dermatitis is caused by contact with acids, alkaline materials such as soaps and detergents, fabric softeners, solvents, or other chemicals. The reaction usually looks like a burn. Allergic dermatitis is caused by exposure to a substance or material to which one becomes extra sensitive or allergic.
Superficial fungal skin infections are commonly caused by dermatophytes and yeasts. Dermatophyte infections, otherwise known as ringworm, affects people of all ages and can involve the scalp, hair, face, limbs, trunk or nails. Yeast infections include tinea/pityriasis versicolor (“white spots”) and candidal infections in warm moist body areas. There are various effective topical and oral medications that can eradicate these fungal infections.
Skin problems can also affect the genital areas, and are often a cause for concern. Many people are worried that they may represent a form of sexually transmitted infection. A rash on the genital area may not be related to any infection at all. Some of the lumps and bumps on the genital area may be normal anatomical findings. A rash on the genital area should be evaluated by a dermatologist.
Hyperhidrosis or excessive sweating is a common disorder affecting many people. Palmar hyperhidrosis or sweaty palms is the most common form of hyperhidrosis, causing excessive sweating of the hands. Hyperhidrosis can also cause excessive foot, underarm and facial sweating. It is thought that hyperhidrosis is a result of over activity of the sympathetic nervous system.
Keloids are scars that develop at the site of skin injury that result from trauma, surgery, friction, injections and previous inflammation. They represent an excess of scar tissue formation that grows beyond the boundaries of the wound. Keloids can be itchy or painful. Some people are more prone to keloid formation than others. Common sites of keloid formation are the chest, upper back, shoulders, jawline, and ears. Keloids cannot be removed, but there are some treatments aimed at alleviating the itch or pain, and assist in flattening the scars.
Moles or melanocytic naevi, are collections of melanocytes (pigment producing cells) in the skin. Moles are non-cancerous but can occasionally change, increasing suddenly in size, developing irregular borders or bleed. In such cases, one should consult a dermatologist to have the mole properly examined or biopsied.
There are several skin conditions that are specific to pregnancy that may affect some women during pregnancy or just after delivery. These include polymorphic eruption of pregnancy (pruritic urticarial papules and plaques of pregnancy), pemphigoid gestationis (a blistering eruption), prurigo of pregnancy and intrahepatic cholestasis of pregnancy. Normal hormone related changes during pregnancy include the development of stretch marks (striae gravidarum) and facial hyperpigmentation (melasma).
Psoriasis is an inflammatory disease that affects the skin, nails and occasionally the joints as well. Psoriasis presents on the skin as red plaques with dry whitish thick scales that may flake off. These plaques can occur anywhere on the body, and can be particularly thick and unsightly on the scalp. Psoriasis can result in considerable psychological distress as it is a chronic condition that is often aggravated by illness or stress. Nail changes include nail pitting, lifting off of the nail from the nail bed (onycholysis) and changes in colour of the nail plate. There are now many available treatment modalities for psoriasis, depending on the severity of disease and whether there is associated joint involvement. These include topical therapies, phototherapy, oral medications and medications injected into the skin, muscle or vein.
A number of rheumatologic diseases are associated with skin manifestations, and some of them may present predominantly with skin changes. These include rheumatoid arthritis, lupus erythematosus, scleroderma and dermatomyositis. The diagnosis of these diseases is usually made from suggestive clinical features, laboratory tests and skin biopsies. A multidisciplinary approach to management is often adopted, involving the rheumatologist, dermatologist and other specialists where necessary.
Rosacea is a chronic condition characterized by facial redness. Tiny blood vessels may also be evident, along with pimple-like bumps. In some individuals, the eyes area are also affected, resulting in swollen eyelids, tearing, irritation, redness and in severe cases, ulceration of the cornea. Avoidance of triggering factors, topical and oral medications and laser therapies assist in controlling disease symptoms.
Scabies is caused by the scabies mite, which burrows into the skin of infected individuals. Scabies is extremely itchy, and usually worse at night. The infection may be transmitted to close contacts, such as those within the same household, hospital or institution. Various topical medications have shown to be effective in eradicating the infection, and close contacts of the infected person are advised to be treated as well.
Herpes zoster, commonly known as shingles, is caused by the varicella-zoster virus, which is the same virus that causes chicken pox. Shingles represents a reactivation of the virus that continues to live within the nerves after a bout of chicken pox. Shingles presents with painful vesicles often confined to an area of the skin on one side of the body. Post-herpetic neuralgia is one complication of shingles that leads to persistent pain long after the skin has healed.
Urticaria is also known as hives. Urticaria presents as itchy red raised bumps that usually resolve within 24 hours. It is the result of histamine released by mast cells within the skin. Urticaria may be acute (appearance of hives for days to 6 weeks) or chronic (hives appearing continuously for more than 6 weeks). Triggers include allergies to medications and food, viral infections, pressure on the skin, insect bites and contact allergies. In chronic urticaria, the cause is often not known and is rarely the result of an allergy.
Vasculitis refers to a heterogeneous group of disorders that are characterized by inflammatory destruction of blood vessels in various organs. Vasculitis of the skin may or may not involve internal organs such as the nerves and kidneys. There are several different forms of vasculitis, some affecting only small blood vessels in the skin, others affecting deeper large blood vessels.
Viral warts are growths on the skin caused by the papillomavirus. They usually appear as rough bumps with tiny dark dots, and can grow on any part of the skin, including the genitals. Warts are mostly painless, unless they are located on pressure areas such as the soles. There are various modalities of destroying the warts, including cryotherapy (liquid nitrogen treatment), chemical application (salicylic acid, imiquimod), surgery and laser ablation.
Vitiligo is a condition that causes loss of pigment in the skin, resulting in white spots and patches. It occurs when melanocytes (pigment cells in the skin) are destroyed and can no longer produce melanin. Persons with vitiligo may have associated autoimmune diseases such as diabetes mellitus and thyroid disease. Therapeutic modalities include topical medication, phototherapy, laser therapy and surgical grafting. The response to treatment is however variable, and differs from person to person and site of involvement.