AtoZ Diseases

The most common disorders of the middle ear are infections and damage to the eardrum. Infections are commonly caused by bacteria or viruses, which enter the middle ear either through a perforated eardrum or along the eustachian, or auditory, tube from the back of the nasal cavity, The delicate bones that conduct sound to the inner ear are vulnerable to damage, so some conductive hearing loss is a common symptom in many middle ear disorders.

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Skin is composed of two layers. The surface layer that you see is a thin covering called the epidermis. Below the epidermis is a thicker layer, the dermis. The dermis contains many specialized structures such as hair follicles and sweat glands . Below the dermis is a layer of fat that is called subcutaneous fat.The surface skin layer, the epidermis, is a very active layer of cells. Cells at its base are continuously dividing to produce new cells, which gradually die as they fill up with a hard substance, keratin. As they die, they move up to the skin surface, to be shed or worn away by rubbing from your clothes, washing, or handling things. In fact, virtually any movement that causes friction also causes some skin cells to be rubbed away. The continuous production of cells at the base of the epidermis keeps up with the continuous loss of cells from its surface. It takes an average of one month for any single epidermal cell to complete the journey from base to surface. On parts of the body where pressure and friction are greatest, the epidermis is thicker, and the journey takes longer. A number of skin problems are caused by a fault in the constant turnover of skin cells. In psoriasis, for example, there is an abnormal build-up of surface cells because there are increased numbers of cells being produced and pushed up from the base of the epidermis.

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Normal skin contains special cells called melanocytes that produce the brown skin coloring pigment melanin. There are several conditions in which melanocytes are either abnormal or abnormally distributed. Sometimes they are fewer in number or less active than usual; this results in a pale area of skin that does not tan from the sun. Alternatively, the melanocytes may be more numerous or more active than usual. This results in a darker area of skin that tans very readily.Albinism: This is a rare inherited condition. The melanocytes are unable to make melanin, so an albino is very pale skinned and has white hair and pink or pale blue eyes. Albinos are advised to wear dark glasses and to avoid sunlight, because sun hurts their eyes and burns their skin easily.

Abnormal suntan: Certain diseases, and some drugs can provoke a “suntan” without exposure to sun. If this happens to you, see your physician.

Vitiligo: In vitiligo, pale irregular patches of skin appear, often symmetrically placed on either side of the body. The patches may grow, shrink, or stay the same size.

Pityriasis or tinea versicolor: This uncommon fungal infection causes patches of paler or darker skin to develop on the trunk. In addition, the affected skin may flake. Chloasma: Hormonal changes during pregnancy or while taking oral contraceptives cause some women to develop patches of darker skin on the face, particularly over the cheeks. The condition disappears after childbirth or when the pill is stopped.

Moles: These are small dark areas of skin composed of dense collections of elaborates. Some moles are hairy. Very occasionally, one may become malignant. If you have a mole that changes in size or shape, you should see your physician.

Seborrheic warts: These are not true warts , but round or oval patches of dark skin 1 to 3 cm (up to about 1 in) across. They are common and often develop after middle­age. They have a crusty, greasy surface.

What should be done?

Most of these conditions are harmless, but if you are concerned, especially about a mole. consult your physician.

Self-help: You can find a number of non­prescription depigmenting creams available for lightening skin, but follow the instructions carefully and do not use one for more than a few weeks at a time. The darker your skin is. the more care you should take in using these preparations. Covering the discoloration with ordinary cosmetics may help.

Professional help: There are specific treatments available for some of these conditions. Vitiligo may be improved by ultraviolet lamp treatment combined with drug therapy. Pityriasis can be cured by an antifungal ointment. Moles may be cut out. Special cosmetics can cover various blemishes.

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What do Doctors call this Condition? - Basal Cell Epithelioma

What is this Condition?

Basal cell cancer is a slow-growing destructive skin tumor. This cancer usually occurs in people over age 40. It’s more prevalent in blond, fair­skinned men. In fact, it’s the most common malignant tumor in whites.

What Causes it?

Prolonged sun exposure is the most common cause of basal cell cancer. Other possible causes include arsenic ingestion, radiation exposure, burns, immunosuppression and, rarely, vaccinations.

Although it’s not well known how basal cell cancers develop, some experts suspect they originate when, under certain conditions, undifferentiated skin basal cells become cancerous instead of differentiating into sweat glands, sebum, and hair.

What are its Symptoms?

Symptoms vary, depending on which of the three types of basal cell cancer is involved. In one type, lesions develop on the face, particularly the forehead, eyelid margins, and around the nose. The lesions are initially small, smooth, and translucent, later becoming enlarged and ulcerated. In a second type, irregularly shaped, lightly pigmented plaques with clearly defined borders develop on the chest and back. The third type forms indistinct waxy, yellow to white plaques on the head and neck.

How is it Diagnosed?

All types of basal cell cancer are diagnosed by clinical appearance, biopsy, and cell microstructure studies.

How is it Treated?

Treatment depends on the size, location, and depth of the lesion as well as the individual’s age and health. Therapy may involve one or more of the following:

• curettage and electrodesiccation, if the cancer is small
• chemotherapy, if the cancer is superficial
• microscopically controlled surgery to carefully remove layers of skin until a tumor-free layer is reached
• radiation therapy, for less accessible tumors or if the individual is older or physically unable to endure surgery
• cryotherapy, which freezes and kills cancerous cells
• chemosurgery, if lesions are persistent or recurrent.

What can a person with Basal Cell Cancer do?

If you have basal cell cancer, here are some steps you can take to ease its symptoms and help prevent a recurrence:

• If the cancer has invaded the mouth and caused eating problems, substitute egg nog, pureed foods, or liquid protein supplements for solid foods to keep up your nutrition.
• To relieve local inflammation from chemotherapy, use cool compresses or a steroid ointment prescribed by your doctor.
• If you have facial lesions, wash your face gently when ulcers and crusting occur because scrubbing too vigorously may cause bleeding.
• Avoid excessive sun exposure to prevent recurring episodes.

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Pernicious Anemia

What is this Condition?

This type of anemia is characterized by decreased ability to absorb vitamin B-12. The resulting vitamin B-12 deficiency causes serious neurologic and gastrointestinal abnormalities as well as destruction of red blood cells. Untreated pernicious anemia may lead to permanent neurologic disability and death.

Pernicious anemia primarily affects people of northern European ancestry. In the United States, it’s most common in New England and the Great Lakes regions, where many such people have settled. It’s rare in children, Blacks, and Asians. The disorder typically begins between ages 50 and 60; its incidence increases with age.

What Causes it?

The tendency of this disorder to run in families suggests a genetic predisposition. Pernicious anemia is common in people with certain immune disorders.

What are its Symptoms?

Pernicious anemia usually begins gradually but eventually causes these three symptoms: weakness, sore tongue, and numbness and tingling in the arms and legs. The lips, gums, and tongue appear bloodless. Excessive bilirubin in the blood, which is due to destruction of red blood cells, may tint the eyes yellow and cause pale to bright yellow skin. In addition, the person may become highly susceptible to infection, especially of the genitourinary tract.

Other symptoms of pernicious anemia include the following:

• Digestive tract: disturbed digestion; nausea; vomiting; loss of appetite; weight loss; gas, diarrhea, and constipation; bleeding gums and tongue inflammation.

• Nervous system: neuritis; weakness, numbness, and tingling in the arms and legs; disturbed position sense; poor coordination; ataxia; impaired fine finger movement; light-headedness; double or blurred vision; altered sense of taste; ringing in the ears; optic muscle wasting; loss of bowel and bladder control; and (in males) impotence.

• Heart and circulation: weakness, fatigue, and light-headedness due to low hemoglobin levels. The heart works faster to compensate, resulting in palpitations, wide pulse pressure, shortness of breath, difficulty breathing while lying down, faster heart rate, premature beats and, eventually, congestive heart failure.

How is it Diagnosed?

A positive family history and results of blood studies, bone marrow aspiration, gastric analysis, and the Schilling test establish the diagnosis. Lab tests must rule out other anemias with similar symptoms, such as folic acid deficiency anemia, because treatment differs. The diagnosis must also rule out vitamin B-12 deficiency due to malabsorption caused by stomach disorders, gastric surgery, radiation, or drug therapy.

How is it Treated?

The doctor can prescribe early vitamin B12 replacement to reverse pernicious anemia, minimize complications, and possibly prevent permanent nervous system damage. The vitamin is given by injection into the muscle, skin, or veins. An initial high dose of parenteral vitamin B12 causes rapid regeneration of red blood cells. Within 2 weeks, the persons condition should markedly improve. Because rapid cell regeneration increases iron and folate requirements, these compounds are given to prevent iron deficiency anemia.

After the person’s condition improves, the vitamin B-12 dosage can be decreased to maintenance levels and given monthly. Because such injections must be continued for life, the person should learn how to give himself or herself the vitamin.

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What is this Condition?

In this condition, the spleen aggressively filters the blood and removes any blood cells that are abnormal, aging, or coated with antibodies, even though some may be functionally normal. The over­active spleen may also temporarily withhold normal red blood cells and platelets from the circulation.

What Causes it?

An enlarged spleen may have no apparent cause or it may result from another disorder, such as chronic malaria, an abnormal increase in the red blood cell count, or rheumatoid arthritis.

What are its Symptoms?

Most people with an enlarged spleen have anemia (decreased hemoglobin) or too few circulating white blood cells or platelets. This causes frequent bacterial infections; easy bruising; spontaneous bleeding from the mucous membranes and the digestive or urinary tract; and sores of the mouth, legs, and feet. Fever, weakness, and palpitations are other common symptoms.

How is it Diagnosed?

To diagnose the condition, the doctor must find evidence of an enlarged spleen and must determine that the spleen is destroying or trapping red blood cells or platelets.

In the most definitive diagnostic test, the person receives an intravenous infusion of red blood cells or platelets labeled with radioactive chromium; then red blood cells in the spleen and liver are measured.

The doctor also orders a complete blood count, which typically shows decreased hemoglobin, white blood cells, platelets, and immature red blood cells. A spleen scan, spleen biopsy (removal and analysis of tissue), and X-ray studies of the spleen’s blood vessels may be useful. However, a biopsy is hazardous and should be avoided if possible.

How is it Treated?

If the person doesn’t respond to medical therapy and must depend on transfusions, all or part of the spleen is removed. Although spleen removal rarely cures the disorder, it does correct the effects of low blood cell counts. Postoperative complications may include infection and blocked blood vessels.

If spleen enlargement results from an underlying disorder, that disorder must be treated.

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