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What skin disease do I have?

This is a very common question and almost all patients ask this when they visit their dermatologist. But in today’s world, many people try to diagnose their skin disorder using the internet. They will try to match the images of different diseases to their skin conditions and then GUESS what skin disease they are suffering from, based on their chosen images. Some of them even go to the extent of treating them all by themselves and as a result end up facing even more disease complications.


Let me put it into perspective for you, so you may have an idea about what you are asking.


Fact: Roughly 3000 different skin diseases are diagnosed and managed/treated by dermatologists!!

And those who opt to treat themselves using the internet try to pick just one disease image (out of the 3000 possible images) that matches their own skin condition closely.

Mathematically, what are the chances of getting this correct? Only 0.03% !!

Remember, your skin is the first organ of your body that others notice whenever you encounter them. Its really not a good idea to diagnose yourself using the internet or using an App that claims to diagnose your skin disorder.

What skin disease do i have?

The best answer to this question is: Visit a Dermatologist and s/he will guide you about your skin condition. You may also see a dermatologist online.

However, if this is not a possibility, take a look at the list of most common skin disorders and their given below and try to figure out if you have any one of them. Although this is not the perfect approach, it is likely to help you, since I have chosen the skin disorders that are most frequently encountered in our daily clinical practice in Pakistan.

Scabies

  • Very itchy skin disease caused by a mite called Sarcoptes scabiei

  • Almost never affects the skin above your neck

  • The mite forms burrows in the skin

  • Easily spreads by direct skin contact or by sharing fabrics (beds, clothings)

  • Usually more than one person of the family is involved by the time patients visit a dermatologist

  • Skin in groins and under the breasts (in women) is frequently affected

  • Patients usually give a history of contact with a person who had itchy skin

  • People living in institutions like hostels, barracks or madrassas are often affected

  • Easily treatable

Acne / Steroid induced acne

  • Frequently seen in young adults of both genders

  • Some patients may continue to have acne beyond 35 years of age

  • Common causes include: hormonal factors, Propionibacterium acnes bacteria and misuse of steroids

  • Acne mostly involves face, but other parts of body like upper chest, trunk may be affected

  • Comedones i.e. whiteheads or blackheads are visible

  • In some patients, pus-filled pimples are present

  • Milder forms of acne show little inflammation

  • In severe acne, marked inflammation is present

  • In severe acne, cysts may be felt under the skin

  • In some pregnant women, acne appears during pregnancy but disappears after pregnancy

  • In Asia, many young patients use cosmetic creams to change their skin complexion, not knowing that such creams contain steroids. Such creams give birth to acne

  • Acne is treatable in most cases

Cold Sores (Herpes Labialis)

  • Caused by a virus (HSV-1)

  • This disease is contagious i.e. it can spread from one person to another

  • If this is your first time, you may develop fever, sore throat, headache and muscle pain

  • Mostly starts with a burning or itching feeling around lips

  • About a day later, blisters appear in close groups on or around lips; swelling may be felt

  • Skin becomes red and painful

  • Later, in the next 2 or 3 days, blisters rupture and the fluid inside is released

  • Cold sores may affect you again and again; mostly affecting the same spots of skin each time

  • May clear without treatment

  • Your doctor will manage it using antiviral drugs

Melasma

  • Also called chloasma or mask of pregnancy (in pregnant women)

  • Possible causes: hormonal factors, birth control pills, pregnancy, anemia, sun exposure

  • Flat brown patches on both sides of face (forehead, nose, cheeks, lips); may affect shoulders and upper arms

  • People with dark complexion are more likely to have melasma

  • Melasma is more common in women, but men are also affected

  • Sun exposure can trigger or worsen melasma

  • Hundreds of poor quality creams are sold in Asian market, each claiming to cure melasma. Many of them contain steroids. When patients use them, their skin gets worse

  • Melasma can be managed by your dermatologist

Hives / Urticaria

  • Raised itchy skin-colored bumps that appear and mostly disappear within 24 hours

  • Can appear, disappear and reappear over short time periods

  • The skin of any part of your body may get affected

  • Itching may be severe in some patients

  • Causes: Infections, medications, some foods, blood transfusion, plants/pollen, stings etc.

  • Some Laboratory investigations may be needed to confirm the presence of infections

  • In some patients swelling of lips, eyes and mouth along with difficulty in breathing is reported

  • Sometimes, patients may need to visit hospital emergency rooms for management

  • Treatment: removal of triggering agent ( Infections, medications, some foods, blood transfusion, plants/pollen, stings) + advise by your doctor


Eczema

  • Eczema is inflammation of the skin

  • Skin may become red, scaly, itchy, cracked, thickened. Fluid may ooze and your skin my show blistering.

  • Causes: certain “irritants” & “allergens” my trigger eczema

  • Common irritants: metals, jewellary, soaps, shampoos, fragrances, cosmetic products, chemicals, latex, dry skin, woolen clothes etc

  • Common allergens: pollen, dust mites, cow milk, eggs, pets, peanuts, fish, gluten etc

  • Prolonged eczema may spread to distant sites of skin

  • Treatment is usually not difficult, but recurrence is common

  • Identification and removal of the triggering agent (irritant or allergen) is very helpful in treatment; although quite difficult to achieve

Psoriasis

  • Skin appears dry, red and raised, covered with scales that are silver-colored

  • Affected skin sites may become tender and itchy

  • The skin of scalp, elbows, lower back and knees is most commonly affected

  • Nails, tongue and joints may also become affected

  • Sometimes the whole skin becomes inflammed (erythrodermic psoriasis)

  • Cause: Immune system problem. Skin starts to regerate at a much higher rate than normal. As a result, dead cells start to accumulate over the skin forming scales and plaques

  • Genetics: 14% chance of acquiring this condition if one parent has the disease; 41% chance if both parents have psoriasis

  • Treatment: mild cases are easily managed by topical preperations. Severe cases demand expert opinion by dermatologists.

Keratosis Pilaris

  • Skin appears dry with rough patches and tiny bumps (skin-colored or red)

  • Mostly affects individuals of younger age

  • More commonly seen in winters

  • The skin of cheeks, upper arms (outer aspects), buttocks and thighs is most commonly affected

  • Cause: Abnormal keratinisation causes the scale to fill the lining of hair follicle, instead of exfoliating

  • Usually a harmless condition

  • The condition can be managed by certain topical preperations and laser hair removal; no cure available so far.


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