Lichen Planus

      
  

         Lichen Planus

Lichen planus is a common inflammatory disease of the skin presenting with characteristic violaceous, polygonal, pruritic papules. The disease may also affect the mucosa, hairs and  nails. Lichen planus (LP) occurs worldwide with no racial predilection. Although the aetiology is unknown, immunopathological mechanisms are implicated in the pathogenesis of the dermatosis.

The rash is made up of shiny, 3-5 mm, slightly raised purple-red spots. A close look is needed to see the irregular white streaks that lie on the flat surface of some of them. The spots arise most often on the fronts of the wrists, around the ankles and on the lower back, but can spread more widely. In addition, lichen planus sometimes comes up in lines where the skin has been scratched or cut.

Other types of lichen planus include a thickened ('hypertrophic') lichen planus, which tends to affect the shins, and a ring-shaped ('annular') lichen planus, which usually comes up in the creases such as the armpits. Lichen planus occasionally appears on the scalp where it can cause hair loss, or may damage the nails (thinning and grooving of the nail plate), though this is rare.

Lichen planus is common in the mouth and is present in about 30-70% of those who have it on their skin.

Lichen planus can affect the penis in men, causing purple-coloured or white ring-shaped patches. Unlike other patches of lichen planus, these often do not itch. Lichen planus can affect the genital area in women too, but this is less common. 

Lichen planus in most patients clear up within 18 months and usually stay clear, although some have a second episode many years later. Unfortunately some types of lichen planus, such as oral, hair or nail involvement, can last for many years. Even after the active lichen planus has cleared up, pigmented stains in the skin may persist for a long time, particularly in Asian or Afro-Caribbean skin.

Symptom

The symptoms of lichen planus of the skin are:

    * purple-red coloured bumps (papules) that are slightly raised and shiny and have a flat top

    * the papules usually measure 3-5mm in diameter

    * the papules may also have irregular white streaks (Wickham's striae)

    * thicker scaly patches can appear, usually around the ankles; this is known as hypertrophic lichen planus

    * itchy skin

Lichen planus of the skin often affects the wrists, ankles and lower back, although other parts of the body can also be affected.

Thickened (hypertrophic) lichen planus affects the shins and ring-shaped lichen planus affects creases in the skin, such as the armpits. After the lesions have cleared, the affected area of skin can sometimes become discoloured.

The symptoms of lichen planus of the mouth are:

·        a white pattern on the tongue and inner cheeks

·        white and red patches in the mouth

·        burning and discomfort in the mouth while eating or drinking

·        painful, red gums

·        recurring mouth ulcers

Mild cases of oral lichen planus do not usually cause any pain or discomfort.

The symptoms of lichen planus of the penis are:

·        purple or white ring-shaped patches on the tip of the penis (glans)

·        bumps (papules) that are flat-topped and shiny

·        the rash is often not itchy

Lichen planus of the vulva and vagina

The symptoms of lichen planus of the vulva and vagina include:

·        soreness, burning and rawness around the vulva

·        the vulva may be covered in white streaks and be a red, pink or pale white colour

·        if the vagina is affected, sexual intercourse can be painful

·        if the outer layers of skin break down, moist, red patches can form

·        scar tissue can form, which distorts the shape of the vagina

·        a sticky, yellow or green discharge can form, which may be bloodstained

·        the opening of the vagina can become narrowed

Treatment

The first line of treatment is represented by oral antihistamines and flourince dermato-corticosteroids;

A second choice therapy is the systemic corticosteroid therapy (0.25 – 0.5 mg / kg Predison) for 3-4 weeks if there are no obvious contraindications, and retinoids, 40-80 mg weekly, in intramuscular injection and triamcinolone acetonide, for 6-8 weeks;

For severe forms of lichen planus, treatment should be intensive, it starts with a topical steroid, then is choosen another treatment option (corticosteroids, cyclosporine, topical and systemic retinoids, immune suppressants).

Conjunctivitis

                                                                                
 


                  Conjunctivitis

Conjunctivitis, or pink eye, is an inflammation of the membrane covering the inside of  eyelids and the outer part of eye. It is generally not serious but can be highly contagious. Conjunctivitis often feels like something in eye that can't get rid of. The condition can be caused by bacteria or a virus, or by an allergic reaction or exposure to a chemical irritant.

Conjunctivitis is most often the result of viruses, such as those that cause the common cold. Other causes can be bacterial infections, allergies, chemicals, irritation from contact lenses, or eye injury. Viral and bacterial conjunctivitis are very contagious. Some studies suggest that the severity of the disease is significantly associated with sun exposure.

Symptom 

Conjunctivitis causes the following symptoms in one or both eyes:

• Redness and tearing
• Itching
• Swollen eyelid
• Discharge (watery or thick)
• Crust that forms overnight
• Sensitivity to light
• Gritty feeling

Treatment

Conjunctivitis commonly happen during late fall and early spring and usually attends common colds and upper respiratory tract inflections like sore throat and runny nose. Just like common colds, the condition resolves in a few days. 65% of cases subside within 2-5 days even without treatment. 

Pinkeye or conjunctivitis generally to not require hospitalization except in rare cases  of accidental chemical burns which are treated as medical emergencies that could lead to intraocular damage or severe scarring if not treated immediately. Otherwise, just like common colds, all it takes is a short visit to the doctor and a home medication regimen that simply follows your doctor’s orders that may include prescription antibiotics.

• Just like common colds caused by virus, viral conjunctivitis has no known cure and the most that you can do is to relieve the symptoms.  The most common relief is achieved though warm compress applied to the eyes. Non-prescriptive artificial tears or eye drops can also provide relief.
• Bacterial conjunctivitis also resolves without any treatment but symptomatic relief can be had with antibiotic ointment or eye drops if no improvement happens within 3-4 days.  The condition generally subsides in less than 5 days without antibiotics
• Allergy-triggered conjunctivitis are best managed with cool or cold water splashed over the face and eyes with head tilted down.  The action can constrict blood capiliaries in the eyes and wash out any chemical residue that may have caused the allergy.  Artificial tears or eye drops can sometimes provide relief in mild cases but in more server cases, the application of antihistamines or non-steroidal anti—inflammatory ointment as prescribed by your doctor has more efficacies.  Topical steroid drops can relieve persistent allergic conjunctivitis.
• Conjunctivitis caused by accidental chemical splashes is best treated with irrigating the eyes with Ringer’s lactate of saline solution.  
• You should never wear your contacts when suffering conjunctivitis.
• A swollen eye during the period may encourage you to wear eye make-up when going out, but don’t.  Cosmetics around the eyes should be avoided if you still have symptoms of conjunctivitis.  A sunglass to cover it up is better.
• Viral and bacterial conjunctivitis are highly contagious and members of your family can easily catch one.  If you are applying ointments to a child or family member, be sure to disinfect and cleanse your hands thoroughly after each session. Refrain from sharing anything with the affected member and it may be good idea to isolate him or her from the rest of the family for the period.  Handle his or her laundry separately and disinfect surfaces, sinks, doorknobs, countertops, etc to prevent contamination.
• If you plan on traveling overseas, you may not be allowed to enter some countries, or even allowed to enter some public places where people concentration is high to avoid unnecessary spread of the infection. 

Lupus

                  Lupus

Lupus is a disease that is unfamiliar to many. It's difficult to diagnose and often misunderstood.

Lupus is a chronic inflammatory disease that can target your joints, skin, kidneys, blood cells, heart and lungs. The great majority of people affected are women. For reasons that aren’t clear, lupus develops when the immune system attacks your body’s own tissues and organs.

Three main types of lupus exist — systemic lupus erythematosus (SLE), discoid lupus erythematosus and drug-induced lupus. 

Of these, SLE is the most common and serious form of the disease, frequently causing swollen, painful joints, skin rash, extreme fatigue and kidney damage.

In a normal immune system, antibodies stave off germs and viruses. With lupus, the immune system does not function properly, becoming instead an autoimmune system unable to differentiate between healthy tissue and bacteria. Autoantibodies generated by the autoimmune system attack healthy tissue, destroying it and causing pain and discomfort throughout the body.

Symptoms

The symptoms of lupus are both internal and external and imitate those of other diseases and disorders, such as fibromyalgia, Lyme disease, rheumatoid arthritis and diabetes. Because of its similarity to other diseases, additional testing, including blood and urine, are needed to aid the doctor in properly diagnosing the disease.

Symptoms may show up quickly or gradually. The length of an episode or flare can range from short to long periods and the intenseness of the effects during that period ranges from mild to severe.

Episodes fluctuate so there are times when the disease subsides and there are no adverse affects.

External Effects

External symptoms involve the skin, scalp, joints, fingers and toes. Exposure to the sun or bright light can exasperate the disease causing a rash or lesions on the skin. Joints may become swollen and stiff, fingers and toes may become discolored during bouts of cold or during a stressful episode, skin may acquire scaly, raised patches and hair loss may occur.

Internal Effects

Because the immune system is affected, infections can easily occur. Additionally, nasal and mouth sores may appear, inflammation to vital organs occurs and headaches, dizziness, anemia and bruising may be experienced.

Treatment

Doctors who treat Lupus most often are Rheumatologists. Dermatologists, Internists, Nephrologists, Neurologists, Cardiologists, and Psychiatrists may also be involved in Lupus treatment depending on which organs are affected.

A natural treatment for lupus rashes is usually avoiding direct exposure to sunlight. While this might sound easy during the cold season, it becomes incredibly hard to conform to during the summer months. This is why corticosteroids treatment is used for the rash. Corticosteroid creams can be prescribed by dermatologists or lupus specialists and they can be found in pharmacies. Applied to the affected areas, these creams reduce the pain and remove the unsightly redness of the skin.

Giving up certain pills also constitutes a simple, natural treatment of lupus. However, treating drug-induced lupus requires professional assistance; therefore it is recommended to consult your physician for clear indications on what pills you should leave out of your current treatment or which medication can be changed for a more efficient one.

Non-steroidal anti-inflammatory drugs (NSAIDs) are a frequent component of the lupus treatment. Their inhibitory features help maintaining the normal functionality of several internal organs, especially the kidneys. This aspect is very important, since kidney disease is a common symptom in male lupus patients. Ibuprofen and naproxen are probably the most popular NSAIDs used largely world-widely.

Since lupus is best described as an autoimmune condition, immuno-modulating drugs are also used in the SLE treatment. These drugs (Cellcept, Cytoxan, etc.) prevent the autoimmune behavior of the immune system. Another benefit of this treatment would be that it helps doctors reduce the use of corticosteroids in some lupus treatments.

It is important to understand that surgery is rarely recommended as one of the lupus treatment options. However, when kidney failure occurs in a lupus patient or if one of the hips is affected by avascular necrosis (a mass amount of cells die due to circulation problems caused by lupus), surgery is required. Between 5 and 10% of the lupus sufferers are listed for splenectomy. This surgical intervention consists in the partial or complete removal of the spleen and in some cases it’s the only option available to avoid further complications caused by lupus.

For now, lupus remains an autoimmune disease with unknown causes or cures. It affects one in one thousand people, most of whom are women. It is not a contagious disease and its symptoms can remain dormant for varying periods of time before manifesting again in flare-ups.

Pneumonia

             

             


       Pneumonia

Pneumonia is an infection within one or both lungs. It can be caused by a number of germs, including bacteria, viruses, or, in rare cases, fungi or parasites.

Pneumonia is a common infection. It is more common in men than women and in smokers compared to non-smokers. It is also potentially serious and even life-threatening

Causes

·        Bacterial infection - which can develop following an upper respiratory track infection like a cold, sore throat or the flu. Bacteria is the cause of 50% of pneumonias, most commonly a streptococcus bacteria known as pneumococcus

·        Virus - this tends to happen more in the winter and can be serious in people with heart or lung disease

·        Chlamydia - more common in school children. This is a different bacteria than the one that causes the sexually transmitted disease

·        Mycoplasma – a tiny bacteria which tends to spread in child care centres and schools

·        Pneumocystis carinii – which occurs in people with suppressed immune infections, such as those who are undergoing chemotherapy, have had organ transplants, people with AIDS and those being treated with corticosteroids

·        Other causes of pneumonia include fungi, parasites, chemical or physical injury to the lungs, tuberculous, lung cancer, alcohol abuse.

·        SARS (Severe Acute Respiratory Syndrome) is a particularly contagious and dangerous type of pneumonia.

Symptoms

Common symptoms of this condition can vary from mild to severe. They include:

• A cough that produces green or yellow phlegm
• Trouble breathing
• Chest pain when breathing or coughing
• A rapid heart rate and breathing rate
• Fever (temperature greater than 100.5ºF or 38ºC)
• Chills.

Symptoms may also include nausea, vomiting, or diarrhea.

Most cases of pneumonia can be treated without hospitalization. Typically, oral antibiotics, rest, fluids, and home care are sufficient for complete resolution. However, people with pneumonia who are having trouble breathing, people with other medical problems, and the elderly may need more advanced treatment. If the symptoms get worse, the pneumonia does not improve with home treatment, or complications occur, the person will often have to be hospitalized.

Bacterial pneumonia

Antibiotics are used to treat bacterial pneumonia. In contrast, antibiotics are not useful for viral pneumonia, although they sometimes are used to treat or prevent bacterial infections that can occur in lungs damaged by a viral pneumonia. The antibiotic choice depends on the nature of the pneumonia, the most common microorganisms causing pneumonia in the local geographic area, and the immune status and underlying health of the individual. Treatment for pneumonia should ideally be based on the causative microorganism and its known antibiotic sensitivity. However, a specific cause for pneumonia is identified in only 50% of people, even after extensive evaluation. Because treatment should generally not be delayed in any person with a serious pneumonia, empiric treatment is usually started well before laboratory reports are available.

Antibiotics for hospital-acquired pneumonia include third- and fourth-generation cephalosporins, carbapenems, fluoroquinolones, aminoglycosides, and vancomycin. These antibiotics are usually given intravenously. Multiple antibiotics may be administered in combination in an attempt to treat all of the possible causative microorganisms.

People who have difficulty breathing due to pneumonia may require extra oxygen. Extremely sick individuals may require intensive care, often including endotracheal intubation and artificial ventilation.

Viral pneumonia

Viral pneumonia caused by influenza A may be treated with rimantadine or amantadine, while viral pneumonia caused by influenza A or B may be treated with oseltamivir or zanamivir. These treatments are beneficial only if they are started within 48 hours of the onset of symptoms. Many strains of H5N1 influenza A, also known as avian influenza or "bird flu," have shown resistance to rimantadine and amantadine. There are no known effective treatments for viral pneumonias caused by the SARS coronavirus, adenovirus, hantavirus, or parainfluenza virus.

Aspiration pneumonia

There is no evidence to support the use of antibiotics in chemical pneumonitis without bacterial infection. If infection is present in aspiration pneumonia, the choice of antibiotic will depend on several factors, including the suspected causative organism and whether pneumonia was acquired in the community or developed in a hospital setting. Common options include clindamycin, a combination of a beta-lactam antibiotic and metronidazole, or an aminoglycoside.

Corticosteroids are commonly used in aspiration pneumonia, but there is no evidence to support their use either. Viral pneumonia may last longer, and mycoplasmal pneumonia may take four to six weeks to resolve completely. In cases where the pneumonia progresses to blood poisoning (bacteremia), just over 20% of sufferers die.

Here are some natural remedies for pneumonia that you can follow at home to treat pneumonia effectively. These home remedies are simple, easy to prepare and easy to follow.

1. Fenugreek Seeds: Having an herbal with tea with black pepper and fenugreek seeds helps to treat pneumonia symptoms in early stages. You can take up to 4 cups of this herbal tea daily which can be gradually reduced as condition improves. A little honey or lemon juice can be added to improve the flavor. This home remedy is helpful in getting rid of fever that comes with pneumonia and also eliminates the sharp pains experienced by those suffering from pneumonia.

2. Beet Juice: The soothing and healing properties of beets help to ease the pain that comes with pneumonia. Beet Juice can help clear phlegm from the lungs that could be hindering proper breathing, making it one of the best home remedies for pneumonia treatment. You can add carrot or cucumber juice with beet juice and drink twice a day for better results.

3. Sesame Seeds: Sesame seeds contains antibacterial and anti inflammatory properties making it one of the best home remedies for pneumonia treatment. A hot infusion of this herb can be prepared by steeping 15 gm of seeds in 250 ml water. Add 1 teaspoon of honey, 1 tablespoon of linseed, and a pinch of common salt in this mixture. Consume this mixture everyday. It will aid in removing phlegm from the bronchial tubes.

4. Ginger: You can consume 10 ml fresh ginger juice, or dried ginger powder 3 gm mixed with 2 teaspoons of honey twice or thrice a day for destroying bacterial infection in respiratory tract and lungs. Ginger may also help reduce fever associated with pneumonia.

5. Garlic: It is considered to be effective home remedy for pneumonia. Either fresh raw or lightly cooked garlic is most accessible for pneumonia cure. To get relief from chest pain and discomfort, take a teaspoonful of garlic juice. The curative properties found in garlic work in treating pneumonia by bringing down the high temperatures and speeding up the healing process.

6. Parsnip Juice: Parsnip juice has chlorine and phosphorus which help in clearing the bronchial system thereby getting rid of infection. A dosage of 250 ml per day is recommended. The leaves can also be steeped in water and placed onto the chest area as a way of getting rid of the pain that comes with pneumonia.

7. Carrot Juice: Carrot contains essential nutrients that aid in proper healing in cases of pneumonia. It works by getting rid of toxins thereby treating the underlying problem. The juice happens to be very strong and therefore should be mixed with other vegetable juices and taken with or after meals.

8. Turpentine Oil: This is also a great remedy for pneumonia. Massaging turpentine oil on the rib cage and keeping the area covered with warm cotton wool will help in reducing the pain of Pneumonia.

9. Dandelion: Dandelion contains anti-inflammatory and antibiotic properties making it one of the best home remedies for pneumonia. It gets rid of the pain and inflammation that comes with pneumonia thereby offering a complete cure. Take the leaves of dandelion and add in boiling water to make a decoction. The roots of the plant can also be used in the water and then taken on a daily basis as treatment for the condition. The dried root of dandelion can be ground into powder and then a paste made and applied onto the chest to offer proper treatment from the condition.

10. Holy Basil: Holy basil contains essential minerals and compounds which are helpful to get relief from pneumonia. Take the juice of few fresh leaves of holy basil. Add a pinch of ground black pepper to this juice and consume at six hourly intervals.

Drink lots of water as it will help to flush toxins. Fluids are also important because they help prevent dehydration and help loosen mucus in your lungs

Avoid alcoholic drinks and carbonated drinks as well as cold drinks which are known to make the pneumonia symptoms worse.

Avoid foods that may not be well-digested. It may aggravate pneumonia symptoms.

The patient should be kept in a clean, hot and healthy room. Make sure that sunshine enters in the patient room.

Try to keep the chest and the feet of the patient warmer than the other parts of the body.

Get plenty of rest, even if you don’t really feel like it.