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Melanoma is a type of skin cancer that affects melanocytes, the cells that produce the skin pigment melanin. Moles form when melanocytes are grouped in clusters. Although these lesions are usually benign, malignant melanoma may develop in these locations in susceptible individuals, particularly with exposure to factors such as excessive sun exposure. Melanoma is known for its aggressive growth and tendency to metastasize to other areas of the body, but modern treatments have improved recovery rates dramatically. Patients should regularly examine their skin for new moles or changes to existing moles and visit their dermatologist if they see anything unusual.
Among causes of melanoma, sunlight exposure has been established as the strongest risk factor despite a lack of clarity regarding which wavelengths are most responsible. Although some individuals develop melanoma without having any apparent risk factors, researchers have identified a number of factors that can make people more prone to melanoma. These include:
Dysplastic moles: Also called nevi, at least a few of these are present on most people. However, having many dysplastic moles is known to raise the risk of melanoma. Individuals whose family history includes both dysplastic moles and melanoma have the highest melanoma risk.
More than 50 moles: Melanoma risk is increased in people who have a very large number of moles.
Fair skin: People who have fair skin are more likely to have freckles and become sunburned from sun exposure compared to dark-skinned individuals. Caucasians, particularly those with blue eyes and blond or red hair, are more likely to develop melanoma compared to black people for this reason.
Melanoma in family history: Individuals whose family history includes melanoma are more likely to develop it themselves. When patients have family members with melanoma, they should visit a doctor regularly to watch for signs of the disease.
Immune suppression: Individuals with reduced immune function because of cancer, HIV or immunosuppressive drugs are more likely to develop melanoma.
Very severe sunburns: Even a single blistering sunburn during childhood or adolescence raises the risk of melanoma later. This is why doctors recommend protection of children from heavy sun exposure. However, sunburns during adulthood also increase the likelihood of developing the disease.
UV radiation exposure: Researchers have repeatedly linked extensive sun exposure to melanoma risk. In fact, melanoma is more common in the sunny southern United States compared to the cloudier northern states. Exposure to tanning beds and sun lamps can also damage skin and increase melanoma risk. For this reason, both sun exposure and use of artificial UV sources should be limited.
Melanoma can present in a variety of forms classified according to location, growth pattern and prognosis. The four types to remember are:
Superficial Spreading Melanoma: Two-thirds of melanoma cases are of this type. In most cases, this is characterized by either mutations of existing moles or black or dark brown flat areas of discoloration on the skin.
Nodular Melanoma: These melanomas normally appear independently of existing moles. Often appearing in the form of a smooth blue-black bump, known as a nodule or papule, this type is known for its fast growth and more frequent metastasis to lymph nodes.
Acral-Lentiginous Melanoma: Often appearing on the soles of the feet, palms of the hands or skin beneath the nails, this type develops rapidly. This is the most common type of melanoma among people with darker skin. Moles rarely appear on the feet or hands, so an exam should be performed for any mole in these locations.
Lentigo Maligna Melanoma: This type is usually seen on areas of skin damaged by sun exposure, such as the faces of older patients.
With timely treatment, melanoma can often be cured successfully. This is particularly true when melanoma has not yet spread. A variety of factors can affect which melanoma treatment is recommended, including the location on the body, the cancer stage, the cancer thickness and overall health. The following treatments may be recommended for melanoma:
Surgery: This is the standard option for treating melanoma that has not yet spread. Depending on the level of risk associated with a particular case of melanoma, recommendations for chemotherapy, radiation or other treatments may be given afterwards.
Chemotherapy: This is a systemic treatment that addresses cancer throughout the body and may be recommended after melanoma has metastasized.
Radiation therapy: Useful for certain types of melanoma, radiation targets melanoma cells that may be present in areas already treated by surgery.
Biological therapy: Also called immunotherapy, this is often used for patients whose melanoma has metastasized to nearby lymph nodes or who have higher risks of recurrence. Biological therapy works by stimulating the entire immune system. For some tumors, specific immunotherapy may be used to directly address the cancer. Interferon alpha, used in high doses, is the most common drug used in biological therapy.
Melanoma becomes more dangerous after it has spread throughout the body. This fact highlights the importance of checking moles regularly and scheduling exams to have suspicious spots assessed. By taking these precautions, patients are more likely to have the disease caught early so that treatment can proceed for a higher chance of recovery.
The term “eczema” can actually mean one of several medical conditions, though most mean atopic dermatitis. This is a hereditary disorder, which means it runs in the family. Most often, affected individuals first discover symptoms in childhood. Doctors characterize eczema as a condition that causes itchy rashes all over the body, including the arms, legs, face and torso.
Atopic Dermatitis is the most common of all types of eczema, mostly due to the fact that it’s a hereditary condition. Canadians in particular are at risk for developing eczema; up to 17 percent of Canadians may experience atopic dermatitis during their lives.
It is common for atopic dermatitis to start as young as infancy; symptoms include inflamed skin that is itchy behind the knees, on the neck, inside the elbows, and/or on top of the hands. It is also common to develop hay fever or asthma alongside eczema. Other family members likely also experience similar symptoms.
Contact Dermatitis can be further classified into two finer categories: irritant or allergic. Irritant contact dermatitis occurs more often after repeatedly exposing the skin to chemical damage; for example, harsh cleaning products and soaps can thoroughly dry out the skin, causing itchiness from skin damage. As the protective skin layer becomes damaged, inflammation starts.
The less common of the two, allergic contact dermatitis, usually occurs 48 hours after coming into contact with a substance the patient is allergic to. The symptoms won’t begin right away; the immune system reacts on a delay. The most common cause of allergic contact dermatitis is poison ivy; in addition to the infamous plant, dyes, perfumes and metals can all trigger dermatitis.
Less Common Variations:
Regardless of the type of eczema a patient has, the condition demands a mix of treatments that work for the individual. A dermatologist can help provide expert input on which course of treatment will work best to help keep the condition under control; some methods will be less effective than others depending on the exact kind of eczema.
Antihistamines are a good starting point as they are designed to alleviate itching and induce drowsiness and sleep. Moisturizers can also improve skin dryness. These products add moisture to scaly skin and helps the area feel smooth again. Physiologic moisturizers in particular have essential oils, such as ceramide, that is absent from affected skin.
Cool compresses won’t work as functional treatment, but it does cool the skin enough to calm itching and inflammation. Coal tar is one final over-the-counter remedy to try; it comes in ointments, soaps, shampoos and bath oils.
Only a dermatologist can prescribe certain medications to help fight eczema. Antibiotics are a common choice when the patient has a secondary infection caused by eczema. The barrier of skin breaks down between the inflammation and the patient scratching, allowing bacteria to infect the area.
If a dermatologist prescribes corticosteroids, use these regularly until the inflammation is gone. This treatment is very effective regardless of the severity of the condition; these agents are made in various strengths.
For chronic conditions, a dermatologist can prescribe a topical calcineurin inhibitor, which attempts to calm the immune system within the skin. The purpose is to prevent flare-ups from recurring regularly.
Finally, phototherapy is an option in extreme cases; this treatment requires regular exposure to ultraviolet light to quell symptoms. Like with other prescribed methods, this should only be considered under the supervision of an experienced dermatologist.
Rosacea is a redness, swelling and irritation of the face. The redness and irritation that is indicative of rosacea usually begins across the central area of the face, including the eyes, nose, cheeks, and forehead. Rosacea can also affect the ears, chest, neck, scalp and upper back. Some people also experience burning, gritty eyes, a semi-permanent redness of the face called telangiectasia and small red bumps. The symptoms of rosacea often develop in people between the ages of thirty and fifty.
This skin disorder can also develop during adolescence, in part due to the fluctuating levels of hormones at that time period of an individual’s life. Rosacea can affect both men and women, but women are three times more likely to develop this skin disorder than men. Rosacea is found frequently among Caucasians; it has also been known to affect those of Asian and African descent.
There are many different environmental triggers that have been known to cause rosacea. Some of these triggers include chemical exposure, such as exposure to high levels of chlorine in a hot tub or pool, or exposure to irritants that are found in medications and some types of cosmetics. Additionally, rosacea symptoms may be triggered in some people by high levels of stress, consumption of spicy food, going from cold to hot temperatures, smoking, and drinking alcohol.
Experts suggests that individuals who are susceptible to rosacea keep a diary so that they can track their own individual lifestyle and behaviors that trigger rosacea symptoms. For example, an excess of chocolate, sunlight exposure, or even hot flashes during menopause can cause a bout of rosacea. Many people also find that quitting smoking can alleviate symptoms of rosacea. If an individual keeps a diary or journal, it can help indicate which the behaviors that trigger rosacea so he or she can avoid those behaviors.
In addition, individuals who suffer from rosacea are advised to use a gentle skin cleanser, such as Dove or Neutrogena for sensitive skin, and to wear only mineral-based cosmetics. It is also recommended that people with rosacea should stay away from harsh, alcohol-based astringents and toners. It is important for individuals with rosacea to wear a zinc oxide sunscreen when they go out in the sun and a wide-brimmed hat to further protect delicate skin. When possible, it is best to use only organic, high-quality sunscreens that are free of harsh chemicals.
If an individual suffers from acna rosacea, there are a number of topical antibiotics that can relieve symptoms. Topical antibiotics, such as erythromycin, clindamycin and metronidazole, have all been shown to be effective for some rosacea patients. If an individual with rosacea does not respond to topical antibiotics, an oral antibiotic may be necessary to get symptoms under control. It is only advisable to use retinoic acid once the symptoms of acna rosacea have subsided. At which point, an acne rosacea patient may benefit from the rejuvenating properties of retinoic acid when the symptoms have abated.
Many people with rosacea respond quite well to a course of oral antibiotics. Oral antibiotics have an anti-inflammatory effect and also help minimize eye complications and reduce redness and flushing.
Prescription strength topical antibiotics have been shown to be effective at reducing the symptoms of acna rosacea. Topical antibiotics are not effective on spider veins.
Light-based and laser therapy can help alleviate and control symptoms of rosacea and may be more effective than oral or topical antibiotic medications alone. There are a number of light-based and laser treatments available to rosacea patients today. For instance, KTP skin laser treatment helps reduce redness without bruising the skin, although there will still be some swelling for up to 3 days with this treatment.
A popular laser treatment that is highly effective at reducing the appearance of spider veins is PDL therapy, or pulsed dye laser therapy. In this treatment, a highly focused light laser targets the red pigmentation of the skin discoloration and destroys the blood vessel by a pulse of heat. Most patients experience bruising for up to ten days from this laser treatment, at which point the bruise clears up and the spider vein is either much less visible or gone completely. Up to 90% of the patients who elect to undergo the pulsed dye laser treatment experience a resolution of their symptoms in only one treatment.
Fotofacial treatments, or IPL, is appropriate for rosacea patients who experience a generalized redness that covers the face, including visible spider veins. This treatment entails up to five sessions, approximately a month apart. Many of the symptoms of rosacea are resolved in 3 to 5 sessions with the IPL treatment, including reducing the appearance of spider veins, brown spots and the general redness that often covers the face of rosacea patients. The IPL treatments are less effective for reducing or eradicating the appearance of spidar veins than the PDL treatment, but the Fotofacial treatments also cause much less bruising of delicate facial skin.