Treating Cancer, Keratosis, And Acne

A therapy traditionally used on esophageal cancer and lung cancer is causing a buzz in dermatology circles as a way to treat precancerous skin lesions, sun damage and acne.
Called photodynamic therapy, or PDT, it is gaining popularity with claims that it's more convenient and less painful, and that it brings fewer side effects than conventional treatments.
The Food and Drug Administration has approved PDT only for the treatment of certain tumors and actinic keratoses, which are scaly or crusty bumps that form on the skin surface from too much sun. But now the procedure also is being widely used for sun damage and acne on an "off-label" basis.
"There are exciting new and improved cosmetic indications," says Dr. Ron Berne, an Elmwood Park, Ill. dermatologist who began using PDT on his patients in March.
He explained that PDT can improve sun damage such as blotchy complexion, fine lines and telangiectasia, which are dilated superficial blood vessels such as are found with rosacea. The procedure improves the entire area treated, creating a more uniform color, texture and tone, rather than just spot treating with liquid nitrogen or other techniques.
The procedure involves applying a topical solution called 5-aminolevulinic acid (Levulan Kerastick) directly to the skin, then activating it with a light source for a specific time. The solution is absorbed by the abnormal keratin in precancerous or sun-damaged cells or oil glands, depending on what is being targeted.
A variety of light sources may be used, from lasers and intense pulsed light to blue light, which refers to the light wavelength. Therapy can be repeated several times at the same site if necessary.
PDT also can dramatically improve mild to moderate inflammatory acne when used in combination with other treatments, Berne says, eliminating the need for oral antibiotics or the controversial drug Accutane. The Levulan is absorbed into the oil glands, significantly reducing them.
Accutane has a much higher risk of side effects, such as birth defects and liver problems, according to Berne.
Kim Nguyen, 32, of Chicago, Ill., is allergic to many antibiotics and benzyl peroxide, so she is limited in her choices of acne treatment. She has had two PDT treatments.
"I can see a reduction in the acne and scars, and the redness is less intense," she says.
She has two more treatments scheduled, and her health insurance has covered a portion of the cost.
A PDT treatment typically ranges from $250 to $350.
In general, patients must avoid all sunlight and even brightly lit rooms for 36 hours or risk getting a severe burn due to heightened skin sensitivity to light.
"Plan a day and a half inside in the shadows," Berne says.
Even with that drawback, Berne prefers PDT as a treatment for actinic keratoses.
The standard treatment uses liquid nitrogen to freeze off the lesions. But doctors can't treat more than a couple at a time, so return office visits are required, according to Berne.
"For multiple actinic keratoses, conventional therapy can be painful and inconvenient," he added.
PDT targets only abnormal cells, so all lesions can be treated at one time, or repeated if necessary, according to Berne.
The use of PDT in dermatology, however, isn't universally hailed, says Dr. Gregg Menaker, director of dermatologic surgery at Evanston Northwestern Healthcare and assistant professor of dermatology at the Feinberg School of Medicine at Northwestern University, Evanston, Ill.
While director of the dermatologic surgery unit at Massachusetts General Hospital (Boston), "I saw a steady parade of people from our lab to my surgical unit for lesions that didn't go away with PDT," he says.
In patients with multiple actinic keratoses, not every lesion may be an actinic keratosis, he explains. The lesion could be a squamous cell, a common skin cancer. "There are other treatments that are faster, cheaper and more effective," he says.
As for using PDT for acne, Menaker says, "Our standard acne therapies are going to end up being the preferred way to treat acne. Acne patients are mostly kids who are in school and don't want to come to the dermatologist. From a scheduling standpoint it's difficult. And there is no long-term data to support its use."
But PDT is in use at the Texas Dermatology Research Institute, where Dr. William Abramovits, a professor of dermatology at Baylor University Medical Center in Dallas employs it to treat actinic keratoses, acne and other skin diseases.
He says, however, that because low-energy light may not be able to penetrate deep enough into thick lesions, PDT may fail to destroy squamous cell cancers or thick actinic keratoses.
"Many centers, particularly in Europe, are exploring the potential of newer sensitizers, and light of wavelengths that will penetrate deep enough to destroy thicker lesions," Abramovits says. "The results are very promising."

The International Eczema Psoriasis Foundation

The International Eczema-Psorasis Foundation is an organization whose mission is to gather in one place, available information found on the web, in books and articles concerning the often confusing terms dermatitis, eczema, and psoriasis. Our goal is to assist others in learning about these chronic conditions. The information provided by this site should not be considered medical advice, nor is it intended to replace consultation with a 'qualified physician'. The various dermatitis conditions and treatments may vary substantially from one patient to another, and treatment must be tailored for each individual case.

Nummular Eczema Common in Winter

Nummular eczema is a name given to a stubborn, sometimes itchy rash that forms coin-shaped patches on the skin. The lesions as they get older may clear in the center resembling ring worm or fungus. The condition tends to be chronic, with periods of quiescence and exacerbation.The cause is unknown although it is more common in the winter.

Nummular eczema is frequently associated with dry skin. Wool, soaps and frequent bathing (more than once a day) often worsen the condition. People with eczema have skin that is dry and easily irritated by soap, detergents, and rough wool clothing. Clothes washed or dried with liquid or sheet fabric softeners such as Cling, may also irritate the skin. Hot and cold weather often aggravates eczema. Certain allergies may worsen eczema, but they don't cause it.

The Terminology of Eczema

Dermatitis-Ltd offers consumers a free online glossary which defines commonly used eczema and dermatitis terms, including products and medications used in the treatment of eczema and dermatitis as well as other skin conditions that may co-exist with dermatitis, such as acne, rosacea, eczema, and psoriasis.

Protecting the Skin in Cooler Weather With Proper Cleansing

Astringent soaps and any astringent agents that shrink the skin pores such as witch hazel, alum, oatmeal, very cold water, and rubbing alcohol should be avoided, as they shrink pores, trapping more body oils in the skin.

Deodorant soaps would also be too drying and irritating for the skin. These soaps often cause increased itching and skin irritation.

Cetaphil® "gentle cleansing bar for dry, sensitive skin" which can be purchased at your local drug store or pharmacy, has given the best result for skin with psoriasis and eczema. Wash with Cetaphil® gentle cleansing bar as needed which would be one or two times per day for dry or normal skin, and three or four time daily for oily skin. Please do not pick the Cetaphil® Skin Cleanser in a plastic bottle containing two alcohols, the Cetaphil® anti-bacterial, nor the Cetaphil® Bar for oily skin as all three are too harsh for the psoriasis and eczema sufferer.

Protecting the Skin in Cooler Weather With Moisturizers

Moisturizers or emollients including bath oils, soap substitutes can be applied as frequently as required to relieve itching, scaling and dryness. Emollients should also be used on the unaffected skin to reduce dryness. Emollient therapy helps to restore one of the skin's most important functions, which is to form a barrier to prevent bacteria and viruses getting into the body and therefore help to prevent a rash becoming infected. Emollients are safe and rarely cause an allergic reaction. Occasionally, products with lanolin may cause a reaction. Ideally, moisturizers should be applied three to four times a day. Apply in a gentle downward motion in the direction of hair growth to prevent accumulation of cream around the hair follicle (this can cause infection of the follicle).

An excellent choice in moisturizers would be jojoba oil. The importance of jojoba oil derives from its similarity to the natural restorative oil produced by the sebaceous glands in the demal layers of the skin. Jojoba oil is non-allergenic and will not clog the pores.

Dry Skin Affects Eczema In The Colder Months

As we enter into the cooler months of fall and winter; dry skin becomes a factor in controlling one's eczema. One type of eczema often seen in the colder months is commonly known as winter itch.

Xerotic eczema, winter itch, or asteatotic eczema occurs in winter and in the elderly on the legs, arms, and hands. It is characterized by dry, cracked, fissured skin and redness. Stasis dermatitis is a rash of the lower legs which is due to poor return of blood to the heart. Usually the inner leg is more involved than the outer lower leg. Sometimes the rash breaks down into a sore resulting in a stasis ulcer. It affects people with varicose veins

Types of Eczema Keratosis

Put simply keratosis is a thickening of the skin. There are four basic
types of keratosis:

Actinic keratosis- which appears as rough, red or brown scaly patches
on the skin, is known as a precancerous condition because it sometimes
develops into squamous cell cancer. Like skin cancer, it usually appears
on sun-exposed areas but can be found elsewhere.

Seborrheic keratosis- is a thickening of the skin condition usually from
age, these areas can show a skin discoloration and may be mistaken
for malanoma.

Solar keratosis-are wart-like lumps from sun exposure. These also will
show a skin discoloration.

Keratosis pilaris-is a very common genetic follicular disease manifested
by the appearance of rough bumps on the skin. Primarily, it appears on
the back and outer sides of the upper arms, but can also occur on thighs
and buttocks or any body part except palms or soles. There are several
different types of keratosis pilaris, including keratosis pilaris rubra (red,
inflamed bumps), alba (rough, bumpy skin with no irritation), rubra faceii
(reddish rash on the cheeks) and related disorders.

Rhus Allergy Induced Eczema

Poison ivy and poison oak rashes are caused by an allergy to the resin of these plants, called Rhus plants. You don't have to come in direct contact with the leaves, roots, or branches of Rhus plants to get the rash. The plant resin can reach your skin indirectly when you touch clothing or a pet that carries the resin. Posion oak can spread through the air from the pollen.
Like other allergies, Rhus allergy is acquired; you're not born with it. While some lucky people never become allergic to Rhus plants, most persons become sensitized at some time and remain allergic. Unfortunately, there's no way to desensitize persons allergic to Rhus plants. These types of Allergies are forms of allergic contact dermatitis.

The poison ivy or poison oak rash is not contagious. The fluid in the blisters does not spread the rash. Rhus rash doesn't appear immediately after exposure to the plant resin, but only after a time called the latent period. This latent period between exposure to the plant and appearance of the rash may be as short as four hours or as long as 10 days, depending on individual sensitivity and the amount of plant contact. Sometimes, more rash appears after treatment has begun. These new patches are areas that had a longer latent period.

Rhus rashes are self-limited--sooner or later they clear up without treatment. Letting nature take its course with a mild Rhus rash is reasonable, but severe rashes need a visit to a doctor and treatment to ease the misery and disability they cause.

The best and safest treatment for Rhus rashes is with manganese sulfate solution. Manganese sulfate solution has been shown to be effective both to inactivate urushiol on the skin and to relieve itching. Manganese sulfate solution probably acts as a chelating agent for detoxification of urushiol.

The only way to prevent Rhus rash is to avoid contact with the plant resin. It's traditional advice to wash with strong soap and warm water after exposure. This does no harm, but is only effective if you wash within 15 minutes of exposure. You will need to wash clothing, pets, and tools or you may become re-exposed to the resin.

Rhus plants may cause rashes throughout the year. Roots and stems can cause a rash just as much as the leaves. If you can't recognize poison ivy or poison oak plants, have someone point them out so you can avoid them.

Dermatitis-Ltd: Controlling Eczema the Natural Way

Dermatitis-Ltd III is simple and fast to use. After you wash the affected areas, be sure to leave them wet - just glide Dermatitis-Ltd. over the area where you have skin inflammation.

The smell of Dermatitis-Ltd III is barely noticeable unlike many conditioners that are heavily fragranced or that smell "medicinal". Dermatitis-Ltd. is also practically invisible! It dissolves into the affected skin area leaving almost no trace of the product (you would have to examine your skin 'very' carefully to see it). Dermatitis-Ltd. does not leave your skin feeling greasy as most other products do. Also, it does not rub off on to clothing or bedding or stain the skin or any fabric. And it does not cause redness as steroids do.

The sodium chloride and sulfur in Dermatitis-Ltd III have been used in many ways for centuries without causing any known side effects. Dermatitis-Ltd III does not cause watery eyes, nausea, constipation, temporary redness, mild dryness, burning sensations of the skin, yeast infections, or birth anomalies. Skin subject to treatments that call for continued exposure to UV rays put an individual at increased risk for developing skin cancer. Dermatitis-Ltd III does not cause photosensitization (i.e., increased sensitivity to sunlight). Past use of steroids can often damage or thin the skin and sometimes cause scarring. Dermatitis-Ltd. helps keep skin from drying, a common problem in dermatitis sufferers and will not further irritate the skin as do many topical products. Unlike azelaic acid, which can lighten the skin, Dermatitis-Ltd III causes no hypopigmentation. However, it is strongly recommended by the American Academy of Dermatology that everyone apply sunscreen (SPF of at least 15) as part of their daily skin care regimen. Lastly, Dermatitis-Ltd III does not interact with drugs, which allows for complete freedom in treating any other medical conditions.

Dermatitis-Ltd III users gerenally see visible improvement in the appearance of their skin within several days to two weeks. Almost all notice a substantial change within 40 days, and even more improvements after several months. Dermatitis-Ltd III is formulated to avoid any reddening effect by calming the skin and minimizing the overactive blood vessels which can lead to redness. The appearance and feel of skin suffering from psoriasis, eczema, or dermatitis is improved within just a few days.