The biggest pain that a Christian worker has is not from attacks from outside the church. Attacks from within the church are always more painful than serious persecution. After all we have sacrificed for others for such meager material rewards, we are misunderstood, slandered, and ignored in our time of need. That we will experience this is as sure as the sunrise in the morning. We’d better be prepared to face it!
Ajith Fernando

Hair Loss diaper rash dry s

Hair Loss diaper rash dry s

MISCELLANEOUS

Vitiligo (Pigment loss)
Pityriasis Rosea
Hair Loss
Diaper Rash
Dry Skin

Vitiligo

A common cause of loss of pigment is vitiligo. This is an autoimmune disease where, for unknown reasons, the body attacks its own pigment cells (melanocytes). It tends to occur in adulthood, is familial, and progressive. The damage is purely cosmetic, though there is a statistical association with other autoimmune diseases such as thyroid problems, pernicious anemia, and diabetes.

Diagnosis

The appearance of irregular areas of loss of coloring in the skin is characteristic; dark skinned individuals have the most obvious lesions, but anyone can be affected. Sun exposure accentuates the contrast with normally tanned surrounding skin. Friction points are involved early, but any skin surface may be involved; if hair is located in the area, it too loses pigment.

The most important diagnostic test is to do a simple scraping to rule out tinea versicolor, a fungus which can also cause skin lightening.

Treatment

Treatments range from cosmetic cover-up creams to drugs called psoralens which sensitize skin to tanning, in th hopes of “over tanning” the areas involved; severe burning can result, and the skin may be more susceptible to skin cancer after treatment. It may be best in most cases to stick to the cosmetic choices.

Where more skin is involved than half the surface area, the uninvolved skin may be bleached with special chemicals to reduce the apparent contrast with the vitiligo.

Dermatologists are the primary resource for treatment.

Pityriasis Rosea

A common disorder of skin possibly due to a virus, this condition typically begins as a large slightly raised red area, with a somewhat fine, wrinkled appearance, several centimeters in diameter, often on the trunk. One or two weeks later, numerous other areas appear, somewhat smaller and aligning themselves in a peculiar orientation along the skin lines of the trunk, wider across than up and down.

The rash is somewhat itchy, but rarely causes severe symptoms. It subsides spontaneously without scarring after 6 to 8 weeks. Treatment should be simple, and aimed at control of severe itching with antihistamines and similar agents. If there is any possibility of syphilis exposure a blood test should be done, as the rash of secondary syphilis may be identical.

Alopecia Areata

Alopecia areata is characterized by otherwise unexplained patches of total hair loss, without any other signs of rash, inflammation, or infection. The patches are irregular and often involve the scalp, although any hair-bearing area may be affected.

Children and young adults are the commonest sufferers, and up to 20% of victims have another family member who has had the disease. Regrowth of hair is unpredictable, and may occur for up to 5 years following the onset. A particularly severe form may involve all of the hair on the body, including eyebrows, lashes, and body hair (alopecia universalis).

Causes

The best recent theory is that this disease is an autoimmune disease, in which the body’s immune system, for reasons unknown, suddenly recognizes the hair follicles as a foreign substance, and subsequently attacks and destroys those structures. As mentioned, the strong familial component has been recognized, but little else is known about the underlying mechanisms of causation.

Diagnosis
Diagnosis is by the typical appearance. The most important test is to rule out ringworm of the scalp, which can also cause hair loss, since that disease is easily treated.

Treatment

One third of patients have total regrowth spontaneously, one third have partial regrowth, and one third have none. Thus the effectiveness of a treatment must be carefully distinguished from spontaneous improvement.

Injection of cortisone directly into the plaques can be used for small areas, with about 60% effectiveness, often lasting only months. Oral steroids may be useful, but the risks almost always outweigh the benefits.

An exciting new treatment still in the experimental phase, but soon to be released, is the use of topical minoxidil. This drug was originally developed for high blood pressure, but was found to cause hair growth as a side effect. Topically, it helped a very high percentage of alopecia sufferers. Its effects were not permanent, but the toxicity seemed acceptable in preliminary studies. This possibility should be inquired about of the dermatologist, if other treatments have not been effective.

Diaper Rash

The combination of constant moisture exposure, irritation from the chemicals present in urine and stool, and the friction of a snug diaper give rise to the red, raw, and even blistering rash familiar to so many parents.

When areas outside the diaper region appear, it is important to rule out yeast infections, eczema, psoriasis, and other problems, but usually the diagnosis can be readily made on examination.

Fever, pus, and digestive symptoms are NOT caused by simple diaper rash, and should prompt evaluation for other problems.

Although certain non- irritating ointments such as zinc oxide, “A & D,” and others may be helpful, the primary effort should be at prevention, since the rash will resolve rapidly once the causative factors are removed.

Useful measures include air exposure (risks being all to familiar to many mothers and fathers caught in the line of fire), frequent and prompt changing of wet diapers, and avoidance or reduction in the use of occlusive rubber pants over the diaper.

Fortunately, most babies have few problems after 6 months of age, and ultimately toilet training triumphs.

Dry Skin

Water is an important component of skin, and it is well designed to retain its natural moisture through the protective outer layer, oil secretion, and replenishment from the blood stream. However, under some conditions in some people, these mechanisms can be overcome– artificially heated and dried winter air, winds, rubbing, harsh soaps and chemicals are some examples of such conditions.

The primary symptoms of dry skin are whitish scaling and cracking, and itching. Onset in early winter is common in northern climates. The lower legs and hands are often involved, and the dryness may occur in round patches or more diffusely. The elderly are more susceptible due to a lower baseline moisture content in the first place.

Occasionally an underactive thyroid can cause dry skin. This should be considered, particularly if other symptoms are also present. Treatment Preventive: keeping heating temperature settings as low as

possible, humidifying the winter air indoors, avoiding undue exposure to wind and cold, wearing gloves when necessary, avoidance of water immersion such as dishwashing without gloves, bathing at only moderate intervals, no more often then every 2 days.

Therapeutic: The application of water-attracting oils and lotions can be very useful, especially when done immediately after soaking and before evaporative drying has occurred. Petrolatum, lanolin and urea are examples of such substances. Used regularly such treatments can resolve or prevent most cases.