Monday, January 30, 2006

 

Charting Your Eczema Treatment

In the past 40 years, a number of treatments have gone a long way to managing the terrible discomfort of eczema. However, there is still no cure for eczema and no one treatment has safely or effectively worked for everyone, every time. But there is hope. And there is treatment. Recently, breakthrough advances have been made in the treatment of eczema that appears to target the origin of eczema rather than simply treating the symptoms once they have already started. These new eczema medications, called topical immunomodulators, are steroid-free, so they don't have the same potential limitations of current treatments. If you have any concerns or questions about treatments prescribed for you or your child, talk to your doctor.To help you manage your treatment and monitor your progress, keep a chart of what treatment you are using, the location of the treatment application and the dates you apply the treatment along with any reaction you may notice.

Tuesday, January 24, 2006

 

Response To FDA Black Box Warning

The American Academy of Dermatology (Academy) has issued a statement in response to the U.S. Food and Drug Administration's (FDA) announcement that a black box warning will be added to the labeling and a medication guide will be distributed for the topical calcineurin inhibitors (TCIs), pimecrolimus and tacrolimus.
These topical medications effectively reduce the inflammation and other symptoms associated with the skin disease eczema.
"The American Academy of Dermatology disagrees with this action taken by the FDA. We believe that the data does not prove that the proper topical use of pimecrolimus and tacrolimus is dangerous," said dermatologist Clay J. Cockerell, M.D., president of the American Academy of Dermatology. "Because these medications are applied to the skin, virtually none of it gets inside the body. It's not the same as taking a pill. These are valuable medications, and if used properly, they allow millions of our patients with eczema to live normal lives."
This past summer, the Academy held a conference to discuss the scientific, regulatory, clinical, and public concerns raised by this potential FDA action. The dermatologists, patients, pharmacists and immunologists participating in the conference reviewed the current literature and safety data for these medications. It was determined that the addition of a black box warning and medication guide was unwarranted and could limit access to TCIs, or limit treatment options if qualified patients decide not to use these medications based on fear of a malignancy risk.
"The health, safety and welfare of our patients being treated with these topical medications are of paramount importance to dermatologists," said Dr. Cockerell. "We are concerned that this warning will confuse and unnecessarily worry our patients. We urge patients to get the facts on how to appropriately manage their eczema from their dermatologist."

Friday, January 20, 2006

 

Elevated Concerns Over Eczema Drugs

The labels on two prescription creams to treat eczema will have to bear "black box" warnings of possible cancer risks.
The Food and Drug Administration's action Thursday follows an agency advisory committee recommendation last February that Elidel cream and Protopic ointment carry the label warnings.
The new labeling also will clarify that the two drugs are recommended for use only after other prescription topical medicines have been tried by patients, the FDA said. The agency is also issuing a guide updating patients of its concerns.
A black box warning is the most serious type of warning in prescription drug labeling. The warning will be located lower on the labels of the two drugs than is typical, although a statement higher on the labels will refer to the risk.
"This is something that is a possible risk, is a long-term possibility and is something that still needs to be researched," FDA spokeswoman Susan Cruzan said.
As of October, the FDA has received reports of 78 cases of cancers, including skin and lymphoma, in patients treated with the two drugs, said Dr. Stanka Kukich, the acting director of the FDA's dermatologic and dental drug products division.
Novartis Pharmaceuticals, which makes Elidel, said in a statement Thursday that it remained confident in the safety and efficacy of Elidel.
"While Novartis believes this action is not substantiated by scientific or clinical evidence, Novartis has agreed to make the requested changes," the company said.
Astellas Pharma Inc., formed through the merger of Protopic maker Fujisawa Healthcare Inc. and Yamanouchi Pharmaceutical Co., said in a statement that its drug "is safe and effective when used in a manner consistent with its label."
"It addresses a theoretical risk — a potential risk, not a demonstrated link," Dr. Joyce Rico, vice president for medical sciences research and development at Astellas, said of the warning.
While the two manufacturers dispute whether there is a cancer link, the FDA felt it had to convey notice of the cancer reports to doctors and patients, said Dr. Julie G. Beitz, an acting director of one of the FDA's drug evaluation offices.
Along with the small number of cancers reported in both children and adults treated with the drugs, animal tests have shown an increase in cancer associated with the drugs, the FDA said last year.
No causal link between use of the drugs and cancer has been established, Beitz said.
The long-term safety of the drugs has not been established, according to the FDA. While both companies are studying that issue, the results may not be known for years, the FDA said.
Elidel and Protopic are applied to the skin to control eczema by suppressing the immune system.
The companies estimate that roughly 10 million people combined have used the two drugs.

Thursday, January 19, 2006

 

Sweet's Syndrome

Sweet's disease was named after a Dr Sweet from Plymouth, England, who first described this condition in 1964. It is also known as acute neutrophilic dermatosis.
In Sweet's disease there is a sudden appearance of red tender lumps (plaques) on the skin usually of the limbs or neck, sometimes elsewhere. It most often occurs in middle-aged women, but men, children and the elderly may also be affected.

Sweet's is a reaction to an internal condition.
It may follow:
Upper respiratory tract infection (e.g. chest infection, streptococcal throat infection)
Vaccination
Inflammatory bowel disease (e.g. ulcerative colitis or Crohn's disease)
Rheumatoid arthritis
Blood disorders including leukaemia (most often acute myelogenous leukaemia).
Internal cancer usually of bowel, genitourinary organ or breast
Pregnancy
Drugs, including granulocyte colony stimulating factor (G-CSF), nonsteroidal anti-inflammatory medications, cotrimoxasole and several others
In some people, no underlying condition is found.

Sweet's disease generally results in the following symptoms:
High or moderate fever
Tiredness and malaise (feeling unwell)
One or more tender red papules or plaques. These enlarge and persist for several weeks. They may have blisters, pustules or ulcers. Sometimes they appear to clear in the centre.
Aching joints and headache
Sore eyes and/or mouth ulcers
Sometimes other organs are affected including bones, nervous sytem, kidneys, intestines, liver, heart, lungs, muscles and spleen.
Skin lesions may arise at the site of injury such as a needle prick, biopsy or insect bite. It some patients they arise only in sun exposed areas.
Sweet's disease is related to pyoderma gangrenosum, and is sometimes difficult to distinguish from it.
In one variant of Sweet's disease, ‘neutrophilic dermatosis of the dorsal hands’, bluish or grey abscess-like nodules arise on the backs of the hands. These nodules may ulcerate. This is sometimes known as ‘pustular vasculitis’ of the hands, because inflamed blood vessels are seen on biopsy as well as an infiltration of neutrophil white cells.

Investigations may reveal:
Raised erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP), indicating systemic inflammatory disease
Raised white cell count (neutrophil leukocytosis)
Numerous neutrophil inflammatory cells on skin biopsy associated with broken-up neutrophils (leukocytoclasia) and swelling of cells lining blood vessels (endothelial cells)

Sweets' lesions resolve eventually without leaving a mark or scar, with or without treatment.
Generally there is a single episode of Sweet's disease, but a third of patients may develop recurrent episodes. This is more likely in patients who have underlyng cancer.

Friday, January 13, 2006

 

Facial Contact Dermatitis

The irony of facial contact dermatitis is that, in search of a cause, patients often overlook what was once literally right in front of them. Since allergic reactions can take several days to develop after initial exposure, the substance responsible for the dermatitis on the face has plenty of time for a clean getaway.
Dermatologist Susan T. Nedorost, MD, Director, Contact Dermatitis Program and Patch Test Clinic, Case Western Reserve University, Cleveland, Ohio, addresses some of the common causes of facial contact dermatitis.
Dermatitis By Allergy
Contact dermatitis is characterized by redness, swelling, itching, and scaling caused by an allergic substance that makes direct contact with the skin. The condition can develop at any age, although the facial version of the disorder is most often seen in young and middle-aged adults.
"Facial contact dermatitis often stems from fragrances or preservatives in cosmetics and other personal care products; hence, more women are affected because they use a greater number of personal care products," said Dr. Nedorost. "Facial contact dermatitis is also common in patients who also have hand dermatitis, signaling that the cause is a substance the patient touches that is transferred from the hands to the face."
Allergens
Dermatologists rely on patch testing to identify contact allergens. Small concentrations of suspected allergens are applied to the skin on the back and held in place with tape for 48 hours. If small, red spots, that may also itch, appear within three to five days, this indicates that the patient is allergic to the substance.
Patch testing for facial contact dermatitis may reveal an allergen that the patient or dermatologist had not previously considered because it was not intentionally or directly applied to the face. There are a variety of sources of allergens that patients may not recognize as likely causes of dermatitis and include:
Rubber
Rubber contains several allergenic chemicals in addition to latex. "Rubber allergy may cause dermatitis where applicators used to apply eye shadow contact the skin, or where foam rubber sponges are used to apply and remove cosmetics," said Dr. Nedorost.
Metals
Metal allergy is the most common form of contact dermatitis, and nickel is the most common of all metal allergens. Nickel may be present in costume jewelry, such as earrings, and in eyelash curlers or tweezers used on the face. Gold is also a common allergen and may be transferred to the face from gold rings on the hands.
Acrylates
Acrylates are used in the application of artificial nails and in both home and salon nail repair kits. "Ironically, nail products can cause dermatitis on the face without causing it on the nail itself, as the nail plate is composed of dead tissue and cannot exhibit dermatitis," commented Dr. Nedorost. "Instead, patients may notice itching or burning of the skin following a nail salon service or the application of nail cosmetics at home." Acrylates are also found in eyeglass frames and dental resins, as well as in adhesives used in industrial work.
Pine Resin
Colophony, or pine resin, is a sticky material that may cause allergy. "In addition to being used in mascara, pine resin may also be transferred from the fingers due to exposure in hobbies such as bowling, baseball, or playing stringed instruments," stated Dr. Nedorost.
Sunscreen Ingredients
The sunscreen ingredient benzophenone, which blocks both types of harmful UV radiation, can also cause allergy. "Photo contact dermatitis is common on areas of the face and neck where sunscreen has been applied and is most often noticed after UV exposure because UV light activates the sunscreen," stated Dr. Nedorost.
Hair Products
Benzophenone can also be found in hair care products but a more common ingredient in these products that may cause facial contact dermatitis is cocoamidylpropyl betaine, which is found in baby shampoos and many adult shampoos. "Ingredients in hair care products can cause facial or neck dermatitis, even if they don't cause scalp dermatitis," said Dr. Nedorost. "The face and neck are more sensitive than the scalp and may react where hair products run off of the scalp or are not completely rinsed."
It is common for patients to self-treat facial contact dermatitis with topical corticosteroids which are available over-the-counter. "Unfortunately, long-term use of these medications on the face can cause thinning of the skin with visible blood vessels, rosacea, or even cataracts and glaucoma if used near the eye," stated Dr. Nedorost.
Individuals who suspect they may have contact dermatitis should seek evaluation and treatment from a dermatologist. "By working with the dermatologist to identify the allergens, successful treatment for even longstanding facial dermatitis is possible for patients," stated Dr. Nedorost.

Wednesday, January 11, 2006

 

Hydrating Winter Skin

Skin care companies love winter. That's because as the temperature drops and the central heating is turned up, dry, chapped and dehydrated customers hit their local supermarkets, pharmacies and malls, spending heavily on various creams and lotions in search of relief. In fact, according to Packaged Facts, a publishing division of Cleveland-based Market Research.com, in 2004, Americans spent more than $1 billion on facial moisturizers and body lotions. That same year, the entire skin care market in the U.S. rang up more than $4.56 billion in sales.

Although many of the biggest names in the fight against cracked skin are made by some of the U.S.'s largest companies--such as Oil of Olay from Procter & Gamble,
Neutrogena from Johnson & Johnson, and Lubriderm from Pfizer there is still plenty of room for smaller companies to establish a niche for themselves, especially at the high end.

Dr. Andrew S. Alexis, a director at the Department of Dermatology at St. Luke's Hospital in New York City, says consumers shouldn't feel inclined to purchase a lotion or cream just because of price. His favorite brands include Nivea, Eucerin and, in severe cases, Aquaphor--all products from German company Beiersdorf and easily purchased at a local drugstore.

Even more important, he adds, "The first step is to reduce some of the factors that aggravate dry skin symptoms, like avoiding extremely hot showers and baths and reducing the amount of time in them." There are plenty of other common sense--and inexpensive--ways to keep skin soft when it snows. Dry, dull, even chapped skin can also be attributed to the environment, harsh cleansers and even nutrition.

Cari Kamm, creator of Kammplexion skin line, says it's best to eat raw fruits and vegetables high in beta-carotene, along with food high in essential fatty acids like fish, grains, nuts and seeds. "I firmly believe we are what we eat. These simple nutritional suggestions, along with products rich in antioxidants and moisture magnets like Hyaluronic acid, will improve skin noticeably."

Of course, if you have severely dry skin called "winter eczema" or "winter itch," in which the skin is cracked or extremely itchy, a consultation with a dermatologist is recommended where you will be prescribed a steroid ointment or cream to treat the problem.

Tuesday, January 03, 2006

 

Soothing Eczema

Native Americans used to extract the oil from jojoba beans as a treatment for cuts, sores and bruises, as well as sunburn. It has been applied to both face and scalp to help prevent evaporation and provide lubrication for dry, flaky skin. It absorbs easily, is non-greasy, and is very pleasant and soothing no matter what your skin type. Many women claim that jojoba oil also has a minimizing effect on pores!Jojoba oil, like other natural oils, is considered a "natural moisturizing factor". Just like the lipids that are naturally found in your skin, it helps fight surface roughness, flaking, and fine lines. But it isn't reserved just for those who have dry skin. People with acne-prone skin, who suffer more than others from clogged pores and blackhead formation, tend to avoid oil-based products like the plague. They assume that all oil-based products will make their acne worse.
Not so! Due to the unique molecular structure of jojoba oil, not only will it mix readily with the skin's natural oils, but studies have shown that it can even inhibit the growth of certain types of bacteria associated with acne.
Jojoba oil is also soothing for skin conditions like rosacea and sebborheic dermatitis, and will not cause flare-ups. By helping to reinforce the structure of the skin's outer layer (the epidermis), jojoba oil -along with the natural oils produced by the skin- is extremely helpful in the healing process. Natural oils help prevent individual cells from losing moisture, and aid in keeping the skin smooth and supple.
Another oil that benefits the skin and has a low comedogenic (pore-clogging) factor is Almond oil, which also makes for a great massage oil. However, it hasn't been shown to have the antibacterial benefits of Jojoba oil.

This page is powered by Blogger. Isn't yours?

Blogarama - The Blog Directory Review My Site