Psoriasis: Symptoms and Treatment

Psoriasis is a common immune-mediated systemic disease that is prone to relapse. Psoriasis is characterized by skin lesions, red, scaly patches, plaques and papules that tend to be quite itchy. The severity varies and may include only minor and localized patches or cover the complete body.

Psoriasis types and symptoms:

Psoriasis can be divided into five main types:

  • Plaque
  • Erythrodermic
  • Pustular
  • Inverse
  • Guttate

Psoriasis symptoms vary depending on the type, but all types of psoriasis share the following symptoms:

  • itching
  • rash
  • inflamed areas of the skin, often raised and with a layer of silvery scales
  • large patches that join together (in severe cases)

Plaque psoriasis is the most typical form and it manifests as white and red scaly patches on the top layer of the skin. The skin cells accumulate quickly at these locations and create a silvery appearance. It appears most often on the elbows, knees, scalp, palms of hands or soles of feet, even genital area, but any part of the body is susceptible to it.

Erythrodermic psoriasis is closely connected to plaque psoriasis and involves a widespread inflammation of the skin, often covering the whole body. It can be accompanied by swelling, severe itching and pain. It may follow plaque psoriasis after an abrupt withdrawal of glucocorticoids and it can become life threatening as the body loses its ability to control temperature and act as a barrier.

Pustular psoriasis appears in the form of raised bumps that are filled with non-infectious pus, with the skin under and around these pustules becoming red and tender. The most common occurrence areas are hands and feet, but it can appear on any part of the body. A rare form of this type, known as generalized pustular psoriasis, often appears during pregnancy but may be triggered by abrupt withdrawal of topical corticosteroid treatment, medications or hypocalcemia. It’s often accompanied by fever, nausea, muscle aches and elevated blood cell count, and requires hospitalization.

Inverse psoriasis takes on the form of smooth and inflamed patches of skin, that most often affect skin folds (armpits, genital area, or any other skin folds). It is believed that it’s triggered by infection, heat and trauma.

Guttate psoriasis is characterized by small, red or pink and scaly lesions, often resembling droplets. The most commonly affected areas include the torso, but the limbs and scalp may also be affected. The most common trigger is a streptococcal infection.

Psoriasis often affects fingernails and toenails too, and almost 30% of individuals affected by psoriasis also suffer from inflammation of the joints, which is known as psoriatic arthritis.

Causes of Psoriasis

The exact cause of psoriasis remains unknown. Some scientists think that it can be inherited, because it has been determined that it tends to run in families. It is believed that the immune system becomes alerted after being triggered and begins to attack the skin cells. Environmental factors are believed to be a trigger.

Treatment and Management Options

Unfortunately, psoriasis can’t be cured, but there are various treatment options that help alleviate the symptoms. Psoriasis has a high recurrence rate, which makes it difficult to treat the symptoms and live with it. Mild psoriasis is usually treated with topical agents, and phototherapy is often added for moderate psoriasis. Severe cases require systemic agents, and sometimes even surgery.

Individuals who suffer from psoriasis notice that it gets worse at times, especially in cold and dry climate or when they are under stress. Other things that affect flare-ups include infections, skin injury, taking certain medications (NSAIDs, beta blockers, lithium), sunlight overexposure, alcohol and smoking.

Carpal Tunnel Syndrome

The carpal tunnel syndrome (CTS) is a condition where the median nerve is compressed in the carpal tunnel. The carpal tunnel is a narrow and rigid passage of bones and ligament, located at the base of the hand. When the median nerve becomes pinched or impinged, it will cause pain, tingling, weakness and numbness in the part of the hand that receives signals from it (mostly hand and fingers, but it might radiate into the forearm). The reason why a median nerve becomes compressed is the swelling of the tendons or the nerve in the wrist.

History of Carpal Tunnel Syndrome

The incidents of carpal tunnel syndrome appeared in the surgical literature during the mid 19th century, with the first compression of the median nerve being mentioned in 1854 by Sir James Paget. The term “carpal tunnel syndrome” was first used in the year 1939 and its incidence started being more commonplace after World War II. The pathology was identified by Dr. George S. Phalen after working with patients in the 1950s and 1960s.

Symptoms

The symptoms start gradually, and include the following:

  • Frequent tingling, burning or itching numbness of the palm and the fingers (especially thumb, index and middle finger)
  • Swelling
  • Symptoms often appear during the night first, and may affect one or both hands
  • Decreased grip strength
  • Difficulty to form a fist or grasp small objects
  • Muscle dystrophy in severe and/or untreated cases

Causes of carpal tunnel syndrome

There is no single cause that triggers carpal tunnel syndrome; it is most often triggered by a combination of factors that increase the pressure on the tendons of the carpal tunnel and the median nerve. The most common causes include:

  • A congenital disposition – individuals who have a smaller carpal tunnel are more susceptible to the condition.
  • Trauma and injury to the wrist that cause swelling, such as a sprain or a fracture
  • Work stress – repeated use of vibrating hand tools
  • Fluid retention – during pregnancy or menopause
  • Development of a cyst/tumour in the canal
  • Rheumatoid arthritis
  • Diabetes

Treatment options

Carpal tunnel syndrome might resolve on its own without utilizing any treatment, but most of times, this isn’t the case. Treatment should begin as early as possible, under a constant doctor’s supervision. Initial treatment involves resting and avoiding activities that worsen the symptoms. Further damage is avoided by immobilization, and inflammation is treated with cold packs,

Various drugs can ease the pain and swelling. Nonsteroidal anti-inflammatory drugs (NSAIDs) are often used as pain relievers, and diuretics can reduce swelling. Corticosteroid injections are administered directly to the wrist and provide immediate (but temporary) relief to individuals who display mild or intermittent symptoms. Exercise and stretching has beneficial effects, but it should be done under the supervision of a physical therapist. Acupuncture and chiropractic care have been beneficial in some cases, but their effectiveness varies from person to person.

Should the symptoms last for more than six months, a surgery may be the only choice left. To reduce the pressure on the median nerve, a band of tissue around the wrist is severed. The surgery is done under local anaesthesia. The symptoms often disappear immediately after surgery, but full recovery might take months.

 

Gout: Symptoms, Causes and Treatment Options

Gout is a condition characterized by recurring attacks of acute inflammatory arthritis, where a joint becomes tender, red, hot and swollen. The reason behind this is accumulation of uric acid crystals in the joint, which is triggered by high uric acid levels in the blood. Approximately 50% of gout cases affect the joint at the base of the big toe, but gout can also be present in the form of kidney stones, urate nephropathy and tophi. Gout is becoming increasingly common, with factors such as diet changes, metabolic syndrome and overall life expectancy playing a role in its occurrence.

History of Gout

Gout has been known as a “rich man’s disease” or “disease of kings”, and it has been known since ancient times, its first mention dating back to around 1200 A.D. The first documented case dates back to ancient Egypt in 2600 B.C. Although the condition has been known for so long, it was only in 1848 that the cause of gout (excess of uric acid in the blood) has been identified. The English physician Alfred Baring Garrod was the one to identify the cause.

Symptoms of Gout

There are a number of different ways gout can manifest, but the most usual symptoms include:

  • Attacks of acute inflammatory arthritis (red, hot, tender, swollen joint)
  • The pain begins over 2 to 4 hours and during the night; the lower body temperature during the night is the reason behind it
  • Fatigue and high fever (rarely)

Should the uric acid levels be elevated over longer periods of time, additional symptoms may arise. One of those symptoms includes tophi, which are hard and painless deposits of uric acid crystals. Although they are painless, they might lead to chronic arthritis because of bone erosion. Crystals can also form in the kidneys and lead to urate nephropathy.

Causes of Gout

The crystallization of uric acid due to its high levels in the blood is the cause of gout. Higher levels of uric acid in the blood may be caused by multiple factors, some of which include diet, genetic predisposition, salts of uric acid or under-excretion of urate. More than 90% of cases are caused by under-excretion of uric acid by the kidneys. Overproduction accounts for only 10% of all cases.

A diet rich in alcohol, fructose sweetened drinks, seafood and meat contributes to the development of the condition as well. The risk decreases by consumption of vitamin C, coffee and dairy products.

Genetics also plays an important role: some individuals are genetically predisposed to its development. Gout often accompanies other medical conditions, some of which include metabolic syndrome, lead poisoning, psoriasis, polycythemia, renal failure and organ transplants. Obesity contributes to gout as well, so having a body mass index higher than 35 contributes to risk as well. Some types of medication increase the risk of gout, diuretics being one of them. Other medication includes aspirin and immunosuppressive drugs.

Diagnosis and Treatment

Gout is diagnosed by performing blood tests to check uric acid levels, but these tests have limited use as some individuals with high uric acid levels never develop gout, while others with normal levels develop it. To be completely sure and rule out other conditions, the synovial fluid has to be examined. It is indeed gout if there are monosodium urate crystals or a tophus present in the fluid.

Gout is treated by using nonsteroidal anti-inflammatory drugs, steroids or colchicine to ease the pain. Changes in lifestyle also contribute to alleviating issues and lowering uric acid levels, which can cure gout completely. Cutting down on fatty fish, shellfish, alcohol, spinach, organ meats, red meats and dried beans helps, as well as drinking liquids and losing weight.

Clinical Depression Causes, Triggers, Symptoms and Treatment

Clinical depression, also known as major depressive disorder (MDD) is a mental disorder that is characterized by persistent low mood and accompanied by low self-esteem and loss of pleasure and interest in normally enjoyable activities. Sense of despair and hopelessness accompany individuals affected by this disorder, and it is often difficult for them to do everyday activities like working, studying, eating, sleeping, enjoying friends and activities. Some individuals may be affected only once, while others may be affected several times during their lifetime. The disorder seems to occur from one generation to the next in some families, but it can affect individuals with no family history of clinical depression.

Symptoms

Clinical depression affects the individual’s personal relationships and everyday activities, and its impact on well-being and functioning is similar to that of chronic medical condition like diabetes. Symptoms of clinical depression are numerous and the most common ones include:

  • Loss of energy and fatigue on an everyday basis
  • Feelings of guilt or worthlessness
  • Indecisiveness and lack of focus
  • Insomnia, hypersomnia
  • Diminished interest in everyday activities
  • Restlessness, feeling slowed down
  • Anger, irritability
  • Weight loss or gain (5% or more of body weight within a month)
  • Drug/alcohol abuse
  • Recurring thoughts of suicide or death

Causes and Triggers of Clinical Depression

Three types of factors play a role in clinical depression development: biological, psychological and social factors. A pre-existing vulnerability is often triggered by various life events. The vulnerability can be genetic as well. One other cause of depression is direct damage to the cerebellum. Physical, emotional and sexual abuse, as well as social isolation, major life changes and grief from losing a loved one due to divorce, separation and death are all known triggers of depression.

Risk factors

Some individuals are more at risk of clinical depression. The disorder affects about 6.7% of the U.S. population over the age of 18. Between 20% and 25% of individuals suffer from an episode of major depression at some point during their lifetime. Older adults, teens and children are also affected, but it often goes unnoticed in these populations. The number of women affected by clinical depression is twice as high, the reason behind it being hormonal changes during puberty, menstruation, pregnancy, menopause and miscarriage.

There are some other factors that boost the risk, like increased stress at home or work. Women who raise a child on their own are often more susceptible to depression as well. Clinical depression in men is underreported because they are less likely to seek professional help.

Diagnosis

Major depression is diagnosed by a health professional – either a primary care doctor or a psychiatrist – after performing a major medical evaluation. The evaluation includes:

  • Personal and family psychiatric history
  • Depression screening test
  • Blood work may be done to exclude medical issues that have similar symptoms

Treatment Options

Clinical depression is treatable and treatment varies depending on the severity of symptoms. Psychotherapy, talk therapy and antidepressant medication are the most common way to treat clinical depression. Other medication may be added to antidepressants to boost their effectiveness. It might take some time to find the right type of medication and dose for each patient, as they all react differently.

Shock therapy is another option, if drugs prove to be ineffective or if the symptoms are severe. Taking the necessary precautions, such as reporting any symptoms to your doctor as soon as they appear, reduces the risk of development.

 

All You Need to Know about Workplace Hearing Loss

Prolonged exposure to noise at work could cause damage to the ears causing occupational deafness and what is sometimes referred to as acoustic shock. According to research, this is the most common job related injury. Shockingly, many employees do not realize they have the defect until the effects have become adverse. Early detection of hearing loss makes treatment a lot easier.

Due to the alarming number of victims, regulations that protects employees from suffering from high noise levels in their working levels have been put in place. Not only is noise harmful to the ears, but also contributes to higher chances of accident happening at work. An employee may be shouting for help but noise inhibits the coworkers from hearing.

According to the regulation noise above 80dB is regarded as harmful. This rule does not exclude any profession despite some work environments like mining, construction and engineering having inevitable noise generation.

All employers are supposed to provide efficient ear protection and train their employees about risks imposed to them by noise. They should also find measures to lower noise above 80dB. They are otherwise held liable for any damages caused. Employees ought to follow procedures to avoid posing liabilities to their employer.

It is always easier for the individual to take caution since controlling the noise is at times impossible. Using hearing protection equipment is therefore recommended. You could see an audiologist for professional advice. In most cases, you will take a hearing test. As per the results, the best equipment will be administered. Usually, ear-muffs and earplugs are given to protect your ear drums. Be sure to see your audiologist regularly for checkups.

Always look out for signs like migraines, high blood pressure, tinnitus and heart disease aggravation that could be an effect of loud noise.

The employer could also consider some preventive measures where possible. For instance:

  • They could enclose noisy working machinery within a sound proof enclosure.
  • Noisy machinery can be placed or moved away from workers.
  • Before purchasing machinery, obtain the noise data. The level of noise should be relevant.
  • Enhancing job rotation to avoid exposure to specific individuals.
  • Exhaust systems could be fitted with silencers.

In case the employer fails to meet their responsibility and as a result an employee suffers, the employee is entitled to make an occupational deafness claim. The employer should compensate for the losses incurred as a result of their negligence. You could get guidance from a lawyer on how to make an injury at work claim.