H
Haemangiomas |Hailey
Hailey disease | Hairloss (go to alopecia)
| Hand eczema or hand
dermatitis | Hand
Foot and Mouth disease | Hang
nails or torn cuticles | Herpes
simplex virus infection | Herpes zoster (go to zoster)
| Hidradenitis suppurativa
| Hirsutism | Histiocytoma (go to dermatofibroma) | Hives (go
to urticaria) | Hyperhidrosis
HAEMANGIOMAS
Haemangiomas are harmless
overgrowths of the blood vessels in the skin. Most develop at
or soon after birth (see below):-
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HAILEY HAILEY DISEASE
Hailey-Hailey disease
or familial benign chronic pemphigus, is rare genetic skin disorder
characterised by blistering and crusting of the neck, armpits,
groin, and scalp.
Cause
- Inherited as an autosomal
dominant trait which means that only one parent need be infected
and the offsprings have a 50% chance of inheriting the disorder.
- In a small number
of cases, there does not appear to be a family history and these
are thought to be cause by spontaneous mutation in the gene.
Symptoms
- Redness, blistering
and crusting on the neck, armpits, groin and sometimes on the
scalp.
- Itching and soreness.
- Malodour.
- Hailey-Hailey disease
usually runs for years with alternating periods of activity and
relative inactivity.
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Hailey hailey disease.
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Complications
- Secondary infection
by bacteria or Candida albicans.
What you can do
- You should consult
a doctor.
- Avoid heat, sweating
and friction which makes the condition worse.
- Use cold water compresses.
What the doctor
may do
- Prescribe steroid
creams to relieve symptoms.
- Prescribe oral and
topical antibiotics for secondary bacterial infection.
- Prescribe antifungal
creams for candidiasis.
- Surgical removal followed
by skin grafting may be considered in some patients.
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HAND ECZEMA OR HAND DERMATITIS
Hand eczema refers
to an eczema that primarily affects the hands.
Causes
- Irritant contact
dermatitis
which may develop after brief contact with highly irritating
substances such as acids, alkalis and solvents or after repeated
exposure to mild irritants such as soaps, detergents, solvents,
abrasive dusts and water. The latter variety is known as cumulative
insult dermatitis and is best exemplified by "housewife's
dermatitis" and "bartender's hands". Persons with
a history of atopy, that is, asthma, allergic rhinitis and atopic
dermatitis are more susceptible to this type of hand dermatitis.
- Allergic contact
dermatitis
which is due to allergy to substances handled such as metals,
cement, epoxy resins and soldering flux.
- Endogenous hand
eczema which
is believed to be due to inborn sensitivity. It may represent
atopic dermatitis affecting
the hands or pompholyx.
-
- Symptoms
- During the acute stage,
there may be redness, swelling, small blisters and pusheads and
weeping.
- As the eczema becomes
chronic, the skin becomes scaly and cracked.
- Very often, there
is a combination of the two, for example, dryness and scaling
accompanied by small blisters. This stage is sometimes referred
to as subacute eczema.
- Itching.
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Hand eczema.
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Key points
- Psoriasis confined to the hands is sometimes
difficult to distinguish from hand eczema and the diagnosis may
not be apparent until symptoms of psoriasis appear on other parts
of the body. However, distinguishing them on the hands is not
crucial because the treatment is similar.
- Pompholyx is a special variety of endogenous
eczema that affects the hands. It is characterised by deep seated
blisters that look like sago-grains or frog spawn.
Complications
- Secondary bacterial
infection.
What you can do
- You should consult
a doctor to determine the cause, if any and for treatment.
- Minimise contact with
water.
- Wear gloves whenever
you perform wet chores, especially when it involves exposure
to known irritants such as soaps, detergents and household cleansers.
Gloves with cotton liners are ideal as they help to absorb sweat.
Alternatively, cotton gloves may be worn inside impervious gloves.
All gloves should be changed if their insides get wet through
water seepage or sweating.
- Use a mild non-drying
soap for bathing and washing the hands.
- Wear gloves to shampoo
the hair.
- Apply moisturisers
regularly.
- Take antihistamines
to relieve itching.
What the doctor
may do
- Determine the cause,
using patch tests if
necessary.
- Prescribe antihistamines.
- Prescribe topical
steroids or tar
preparations.
- Treat severe acute
cases with a short course of systemic steroids.
- Treat very chronic
and resistant cases with PUVA.
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HAND, FOOT AND MOUTH DISEASE
This is a contagious
viral infection of the skin in young children. It is spread by
droplet infection and tends to occur in small epidemics, especially
in the summer. The incubation period is 3 - 5 days.
Cause
- Coxsackie A16.
- Enterovirus 71.
Symptoms
- Small slightly oval
shaped blisters surrounded by a red border on the palms and soles.
- Painful ulcers inside
the mouth.
- Mild fever may be
present.
What you can do
- You should consult
a doctor.
- Use antiseptic mouth
gargles.
- Take simple painkillers
such as paracetemol.
What the doctor
may do
- Prescribe anaesthetic
gels to reduce discomfort during meals.
- Specific treatment
is not necessary because the blisters and sores heal after about
one week.
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HANGNAILS OR TORN CUTICLES
These are splits in
the skin along the sides and base of the nails.
Causes
- Dryness.
- Paper cuts.
- Picking of the skin
and cuticle around the nails.
- Improper manicuring.
Symptoms
- Pain and bleeding
if the slivers of skin are pulled.
Complications
- Secondary bacterial
infection, leading to acute paronychia.
What you can do
- Cut off the slivers
of skin with a sharp pair of scissors. Do not pull the skin as
this causes bleeding and pain.
- Moisturise the skin.
- Minimise contact with
water and known irritants (see hand
eczema).
What the doctor
may do
- Prescribe antibiotics
if there is infection.
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HERPES SIMPLEX VIRUS INFECTION
Herpes simplex virus
(HSV) infections are classified into primary or recurrent infections.
After a primary infection, the virus remains dormant in the cells.
The virus may become active from time to time and cause a recurrent
infection. There are a number of triggers
that can provoke a recurrence. HSV infection on or around the
lips is known as herpes labialis and that on the genitals
is known as herpes genitalis.
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HIDRADENITIS SUPPURATIVA
Hidradenitis suppurativa
is a chronic inflammation of the hair follicles in the armpits,
pubic area and around the nipples and anus.
Cause
- Inflammation of the
upper part of the hair follicle into which the apocrine glands
(the special sweat glands found in the armpits, pubic area and
around the nipples and anus) open, leading to obstruction and
rupture.
Symptoms
- Inflamed swellings
and abscesses.
- Pus discharging through
openings of the abscess or through sinuses (blind tracts).
- Bridge-like scars
develop as old abscesses heal.
- Pain.
- Fever.
- Often associated with
obesity and severe cystic acne (aee acne
vulgaris).
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Hidradenitis suppurative.
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Complications
- Scarring.
- Recurrent attacks
of pain, inflammation and discharging pus.
What you can do
- Early treatment is
necessary and more effective. You should consult a doctor.
- Wash the affected
areas with an antiseptic soap to reduce the number of bacteria
in the area.
- Consider reducing
friction by wearing loose clothing.
- Reduce the weight
if obese.
What the doctor
may do
- Take swabs for culture
and sensitivity to determine which is the best antibiotics to
use.
- Prescribe longterm
oral antibiotics.
- Give intralesional
steroids injections.
- Prescribe oral isotretinoin.
- Prescribe oral contraceptive
pills such as Diane 35 with or without cyproterone acetate in
female patients.
- Drain abscesses that
are very painful.
- Excise persistent
swellings.
- Remove the entire
hair-bearing area and replace with a skin graft.
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HIRSUTISM
Hirsutism refers to
excessive growth of coarse dark hair of a male pattern in females.
Causes
- Genetic or racial
hirsutism may be observed in some families and among certain
races, especially among Mediterranean, Middle Eastern and Semitic
people. Their hair follicles are, for some reason, more sensitive
to normal levels of male hormones.
- Hormonal hirsutism
is due to increased levels of circulating androgens for example,
in polycystic ovary syndrome, adrenogenital syndrome and Cushing's
syndrome.
- Menopause due to an
increased influence of androgens as a result of lower levels
of oestrogens (female hormones).
- Drugs such as androgens
(which may be abused by athlete's), steroids
and minoxidil and cyclosporin
(an immunosuppressive
drugs).
- Porphyria
cutanea tarda.
Symptoms
- Dark coarse hair in
a male sexual distribution such as on the upper lip, chin, sideburns,
chest, abdomen, arms and legs.
- In hormonal hirsutism,
these changes are accompanied by signs of virilisation
such as deepening of the voice, increased muscle bulk, severe
acne vulgaris, androgenetic
alopecia, sterility and menstrual disturbances.
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Hirsutism.
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What you can do
- You should consult
a doctor to determine the cause.
- Consider cosmetic
measures (see below).
-
- Cosmetic procedures
- Shaving, plucking
and waxing. However, these treatments do not permanently remove
hair and folliculitis is a common complication.
- Bleaching to make
the hairs less visible. However, irritation may occur.
- Use depilatory creams
to chemically remove the unwanted hairs. Care as these products
can irritate the skin.
- Electrolysis can permanently
remove hair. However, the procedure is slow as it involves inserting
an electrode into each hair follicle and is painful. Multiple
treatments are necessary and scarring may occur if electrolysis
is not done by properly electrologists.
What the doctor
may do
- Order blood tests
to detect abnormal levels of male hormones.
- Perform ultrasound
examinations to detect polycystic ovaries.
- Prescribe drugs to
suppress androgen production. The drug treatments used include
a combination of spironolactone (a drug used to treat water retention)
and a birth control pill or the birth control pill Diane-35 with
or without cyproterone acetate (an anti-androgen).
- Surgery to remove
androgen producing tumours, if any.
- Remove the hairs with
lasers.This method, known as laser hair removal is fast
and relatively painless. However, two or more treatments are
usually necessary and treatment reduces hair rather than completetely
remove hair. Preliminary results show that this treatment has
some promise.
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HYPERHIDROSIS
Hyperhidrosis refers
to inappropriate and excessive sweating. It may affect the palms
(palmar hyperhidrosis), soles (plantar hyperhidrosis) or the
armpits (axillary hyperhidrosis). The problem usually occurs
after puberty and is worse under stress.
Causes
- Idiopathic (of unknown
cause).
- Overactive thyroid
gland.
Symptoms
- Excessive sweating
usually of the palms, feet and armpits.
Complications
- Socially embarrassing.
- Interferes with ability
to grip.
- Causes writing to
smudge.
- May give an unpleasant
odour when there is bactarial decomposition of the sweat, especially
when it affects the armpits and feet.
- Damages shoes.
- Predisposes to pitted keratolysis.
What you can do
- Nothing as it improves
with age.
- Use antiperspirants
for axillary hyperhidrosis.
- Wear lightweight cotton
clothes.
- Wear shoes made of
natural materials.
- You should consult
a doctor if it is distressing.
What the doctor
may do
- Prescribe formaldehyde,
glutaraldehyde soaks for hyperhidrosis affecting the palms and
soles. Prescribe
aluminium chloride solution for hyperhidrosis affecting the armpits.
- Iontophoresis which
involves soaking the palms or soles in a solution of tap water
or isoprotium bromide and passing a small direct current through
the solution. A modification of this method has also been used
to treat axillary hyperhidrosis. A battery powered iontophoresis
machine is also available.
- Surgery - Excision
of the sweat glands in the armpits in cases of axillary hyperhidrosis
and thoracic sympathectomy (cutting the nerves that control sweating)
in severe cases of hyperhidrosis of the palms.
- Prescribe drugs to
reduce sweating. These drugs may cause some unpleasant side effects
such as dry mouths and blurred vision.
- Prescribe transquilisers
before stressful events.
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