skin hyperpigmentation .. does it mean some thing ?

Hyperpigmentation is a common, usually harmless condition in which patches of skin become darker in color than the normal surrounding skin .

Hyperpigmentation may be caused by sun damage, inflammation, or other skin injuries, including those related to acne vulgaris^. People with darker Asian, Mediterranean or African skin tones are also more prone to hyperpigmentation, especially if they have excess sun exposure.

Hyperpigmentation is associated with a number of diseases or conditions, including :

• Addison's disease and other sources of adrenal insufficiency, in which hormones that stimulate melanin synthesis, such as melanocyte-stimulating hormone (MSH), are frequently elevated.
• Cushing's disease or other excessive adrenocorticotropic hormone (ACTH) production, because MSH production is a byproduct of ACTH synthesis from proopiomelanocortin (POMC).
• Acanthosis nigricans – hyperpigmentation of intertriginous areas associated with insulin resistance.
• Melasma, also known as chloasma – patchy hyperpigmentation often found in pregnant women.
• Linea nigra – a hyperpigmented line found on the abdomen during pregnancy.
• Peutz-Jeghers syndrome – an autosomal dominant disorder characterized by hyperpigmented macules on the lips and oral mucosa and gastrointestinal polyps.
• Exposure to certain chemicals such as salicylic acid, bleomycin, and cisplatin.
• Smoker's melanosis
• Celiac disease
• Cronkite-Canada syndrome
• Porphyria
• Tinea fungal infections such as ringworm
• Haemochromatosis - a common but debilitating genetic disorder characterized by the chronic accumulation of iron in the body.
• Mercury poisoning - particularly cases of cutaneous exposure resulting from the topical application of mercurial ointments or skin-whitening creams.
• Aromatase deficiency
• Nelson's syndrome

treatment of hyperpigmentation may include hydroquinone,  tretinoin (Retinol), topical glucocorticoids, and licorice extract , and treating the main cause if there is any .

References: formulamedical ,aocd ,wikipedia

Before taking any medication ..

A drug eruption is an adverse drug reaction of the skin. Most drug-induced cutaneous reactions are mild and disappear when the offending drug is withdrawn. Drugs can also cause hair and nail changes, affect the mucous membranes, or cause itching without outward skin changes
Although most drug eruptions are exanthematous, different types of drug eruptions are described ...

diagnosed mainly from the medical history and clinical examination. However, they can mimic a wide range of other conditions, thus delaying diagnosis (for example, in drug-induced lupus erythematosus, or the acne-like rash caused by erlotinib). A skin biopsy, blood tests or immunological tests can also be useful. If the causative agent can not be withdrawn, the symptoms should be relieved as much as possible.

Rates of reactions to commonly used drugs are as follows:

• Amoxicillin - 5.1%
• Trimethoprim sulfamethoxazole - 4.7%
• Ampicillin - 4.2%
• Semisynthetic penicillin - 2.9%
• Blood (whole human) - 2.8%
• Penicillin G - 1.6%
• Cephalosporins - 1.3%
• Quinidine - 1.2%
• Gentamicin sulfate - 1%
• Packed red blood cells - 0.8%
• Mercurial diuretics - 0.9%
• Heparin - 0.7%

Cutaneous reaction rates in patients with HIV infection are as follows :

• Sulfasalazine - 20%
• Trimethoprim-sulfamethoxazole - 14.9%
• Dapsone - 3.1%
• Aminopenicillins - 9.3%
• Penicillins - 3.8%
• Anticonvulsants - 3.4%
• Penicillinase-resistant penicillins - 2.9%
• Cephalosporins - 2.7%
• Quinolones - 2.1%
• Ketoconazole - 2%
• Clindamycin - 1.8%
• Primaquine - 1.8%
• Tetracycline - 1.2%
• Pentamidine - 1%
• NSAIDs - 0.9%
• Erythromycin - 0.6%
• Zidovudine - 0.3%

Drugs that commonly cause serious reactions are as follows:

• Allopurinol
• Anticonvulsants
• NSAIDs
• Sulfa drugs
• Bumetanide
• Captopril
• Furosemide
• Penicillamine
• Piroxicam
• Thiazide diuretics

Drugs unlikely to cause skin reactions are as follows:

• Digoxin
• Meperidine
• Acetaminophen
• Diphenhydramine hydrochloride
• Aspirin
• Aminophylline
• Prochlorperazine
• Ferrous sulfate
• Prednisone
• Codeine
• Tetracycline
• Morphine
• Regular insulin
• Warfarin
• Folic acid
• Methyldopa
• Chlorpromazine
• Serotonin-specific reuptake inhibitors
• Topical gels (eg, 4% tetracaine gel may cause serious cutaneous adverse reactions)

^{source : emedicine , wikipedia}

Too much skin ! part 2

Here is a continuation for the previouse blog ( Too much skin ! part 1)

 these are a list of conditions that I joined togather because they have one thing in commen .. too much skin .. and below each condition a video related to the condition .

c) Diffuse hereditary palmoplantar keratodermas 

        is an autosomal dominant disorder in which hyperkeratosis is confined to the palms and soles, usually evident at birth or in the first few months of life.the they present in early childhood with redness of the palms and soles. The palms and soles gradually become thicker and develop a yellowish, waxy appearance. There is a clear cut-off between affected and unaffected skin and the edge of the thickening is often red. This is usually obvious by the age of 3 to 4

here is a shocking viedo on a man possibly having this condition .

Shocking story of Half Man Half Tree .. http://www.youtube.com/watch?v=eJLG85gn0bc

D) plaque psoriasis

skin rapidly accumulates at these sites, which gives it a silvery-white appearance. Plaques frequently occur on the skin of the elbows  and knee , but can affect any area, including the scalp palms of hands and soles of feet, and genitals .Psoriasis is not contagious and can be inherited. Environmental factors such as smoking, sun exposure, alcoholism , and HIV infection  may affect how often the psoriasis occurs and how long the flare-ups last

here is a video showing the suffering of psoriasis patients

http://www.youtube.com/watch?v=5fVVRvtoUyU

I wish for all the people world-wide to be healthy and happy

my references : wikipedia ,dermNet,webmd,emedicine

Too much skin ! part 1

these are a list of conditions that I joined togather because they have one thing in commen .. too much skin .. and below each condition a video related to the condition 

Here's a list of this conditions with a small comment on each : 

a)  Harlequin type ichthyosis

is the most severe form of congenital ichthyosis, characterized by a thickening of the keratin layer in fetal  human skin. In sufferers of the disease, the skin contains massive, diamond-shaped scales, and tends to have a reddish color. In addition, the eye , ears , penis , and the appendages may be abnormally contracted. The scaly keratin greatly limits the child's movement. Because of resultant cracked skin in locations where normal skin would fold, it is easily pregnable by bacteria and other contaminates, resulting in serious risk of fatal infection.

• Interesting real life story on this condition on youtube :

Extraordinary People - The Girls With Too Much Skin http://www.youtube.com/watch?v=hGHDjiinh80

B) Ehlers–Danlos syndrome - Dermatosparaxis

very rare, with about 10 cases reported. The dermatosparaxis type is characterised by extremely fragile and sagging skin. The skin sags and wrinkles, and extra (redundant) folds of skin may be present as children get older. Joints are very loose, which can delay the development of motor skills such as sitting, standing, and walking. Infants with the condition are born with a hernia around the belly-button. Other symptoms include a small chin, a blue tinge to the sclera, and mild overgrowth of body hair.

Could this gentleman have dermatosparaxis type of Ehles-danlos syndrome ( he stretched his skin up to 14.2 cm away from his body!) :

Stretchiest skin - Guinness World Record

http://www.youtube.com/watch?v=f46SpiboAew&NR=1&feature=fvwp

Diabetes and Your Skin

Diabetes affects many organs in the body, including the skin. People with diabetes are more prone to skin problems, including dry skin, injection-related scarring that affects insulin absorption in the body, and vaginal infection. Because diabetes increases the risk for infection, even a minor skin condition can develop into a more serious problem.
  

Diabetes skin conditions generally fall into three categories :

• Skin conditions that happen mostly to people with diabetes
• Common skin infections made worse by having high blood sugar
• Skin problems that occur from injecting insulin ( hypertropy or atrophy of the skin )

causes of diabetes-related skin conditions vary. Many are harmless, but it's helpful to recognize them and know when to see your doctor for treatment.

Diabetic dermopathy. this skin condition develops as a result of changes to the blood vessels that supply the skin. Dermopathy appears as a shiny round or oval lesion of thin skin over the front lower parts of the lower legs.
Necrobiosis Lipoidica Diabeticorum : Another disease that may be caused by changes in the blood vessels is necrobiosis lipoidica diabeticorum (NLD). NLD causes spots similar to diabetic dermopathy, but they are fewer, larger, and deeper
Disseminated granuloma annulare. This causes red, red-brown, or skin-colored raised rings or arcs on the skin. It usually occurs on the fingers, ears, or lower legs

Digital sclerosis. About one-third of people with type 1 diabetes have this condition, which can make the skin on the back of the hands become thick, waxy, and tight

Acanthosis nigricans. With this condition, the skin on the neck, armpits, or groin thickens and becomes brown or tan

Eruptive xanthomatosis. Young men with type 1 diabetes who also have high levels of cholesterol and fat in the blood often develop this condition
Vitiligo: Vitiligo, a skin problem more commonly associated with type 1 diabetes than type 2 diabetes, affects skin coloration

Diabetes and Skin Infections
Bacterial skin infections are pretty common with diabetes such as : boil , folliculitis , or infection of the nail bed, Styes

Fungal infections are pretty common too, according to Hatipoglu. People with diabetes are likely to develop fungal infections in areas that get hot and sweaty, including:

• Under the breasts
• Between fingers and toes
• In the armpits
• In the groin area
• men genital area

Keeping your diabetes under control is the most important factor in preventing these skin problems

References :medscape , wikipedia ,diabetes.org , webmd

Mycosis fungoides

 The disease, is not a fungal infection but rather a type of non-Hodgkin's lymphoma. It was so named because Alibert ( who first described mycosis fungoides in 1806 ) described the skin tumors of a severe case as having a mushroom-like appearance

The cause of mycosis fungoides is unknown .It is rare for the disease to appear before age 20, and it appears to be noticeably more common in males than females, especially over the age of 50 . The average age of onset is between 45 and 55 years of age for patients with patch and plaque disease only, but is over  for patients who present with tumours, erythroderma (red skin) or a leukemic form (the Sézary syndrome).

Typical visible symptoms include rash like patches, tumors, or lesions. Itching  is common, perhaps in 20% of patients, and is not universal.

Diagnosis is sometimes difficult because the early phases of the disease often resemble eczema or even psoriasis.

If treatment is successful the disease can go into a non-progressing state with clinically clear examination and various tests .Common treatments include simple sunlight, ultraviolet light, topical steroids, topical and systemic chemotherapies, local superficial radiotherapy, the histone deacetylase inhibitor vorinostat, total skin electron beam radiation, photopheresis and systemic therapies (e.g. interferons, retinoids, rexinoids) or biological therapies. Treatments are often used in combination

Encourage the use of supportive treatments in patients with mycosis fungoides to decrease pruritus and to lubricate the skin. Nonspecific antipruritic treatments used to control symptoms are useful and often necessary adjuncts to more specific therapies. Patients should avoid sun exposure and remain in a cool environment.

References :wikipedia , emedicine