The skin is the largest human organ and has a variety of functions. Understanding the physiological processes in the skin is important for recognizing the many diseases that affect the skin. At Noris Dermatology, we treat all skin diseases using the latest findings and the most modern methods. Some clinical pictures and their treatment are discussed here as examples.
Eczema and psoriasis
Neurodermatitis and psoriasis are common dermatological diseases that are mostly chronic. The causes are varied and require a detailed examination of those affected. Since neurodermatitis patients in particular can suffer from a large number of allergies, an allergological investigation is also useful. While neurodermatitis is usually associated with excruciating itching and is localized on the bends of the body, psoriasis leads to noticeably scaly so-called plaques, especially on the extensor sides of the body. Both diseases can usually be clearly distinguished by an experienced dermatologist.
New research shows that psoriasis is not just a skin disease, it can affect other organs as well. It has long been known that many psoriasis patients also suffer from a special form of joint inflammation, the so-called psoriatic arthritis. Psoriasis is also an important risk factor for the development of cardiovascular diseases. Psoriasis patients should therefore always be examined for possible concomitant diseases.
The treatment of neurodermatitis and psoriasis should always be tailored to the skin condition and the circumstances of the individual patient. Precise skin care recommendations and close cooperation between the patient and their dermatologist are of particular importance. In noris dermatology, a special light therapy is offered (SUP therapy), which can accelerate the healing of flare-ups. Systemic therapies are necessary in rare cases.
Acne is generally based on a cornification disorder in the hair follicle. This cornification disorder leads through intermediate stages to bacterial colonization and the formation of inflamed “pimples”, which are cosmetically disturbing and can cause discomfort through pronounced inflammatory processes. The causes of acne are many. This includes in particular hormonal changes – e.g. during puberty or due to other diseases (e.g. polycystic ovaries). Medicines and hormonal preparations (e.g. muscle building preparations) can also cause acne-like skin diseases. Therefore, the diagnosis and treatment of acne should be in the hands of experienced dermatologists. The treatment options include special creams and gels that attack the various stages of the inflammation.
There are a number of immunological diseases that can affect the skin. These include the so-called autoimmune diseases such as lupus erythematosus, dermatomyositis or scleroderma. Some autoimmune diseases are accompanied by the formation of blisters, such as pemphigus vulgaris or bullous pemphigoid.
The clinical presentation of these diseases is very large. Any acute or chronic formation of blisters, the appearance of hardening of the skin or unclear skin discoloration should be investigated for autoimmune diseases.
Treat systemically in severe forms
If topical therapy is insufficient, the acne must be treated systemically. The tetracyclines doxycycline and minocycline are used as antibiotics. The advice should point out possible undesirable effects such as gastrointestinal side effects and thrush, as well as a possible reduced effectiveness of contraceptives. Women with severe acne vulgaris who also wish to use contraception are prescribed contraceptives with the antiandrogens cyproterone acetate, chlormadinone acetate or dienogest says the best skin doctor in delhi.
Recommended care products
When advising acne patients in the pharmacy, care instructions should also be given and reference should be made to special, non-comedogenic preparations (e.g. from Neutrogena, Roche Posay and Sebamed). Syndets with a pH value of 5.5 and mild surfactants are suitable for skin cleansing. Suitable peeling substances are aluminum oxide (Brasivil ® medium) or preparations with lactic or salicylic acid. Care products should only contain non-comedogenic vehicles such as light O / W emulsions or hydrogels. Cosmetics containing titanium dioxide, iron oxide or kaolin are suitable for covering.
Excessive sweating – difficult to treat
Patients who suffer from excessive sweating in the armpits (hyperhidrosis axillaryis) are exposed to high levels of suffering. They feel stigmatized, have problems in their work and relationships, which often leads to complete social withdrawal. The therapy options are unfortunately limited. General recommendations such as wearing loose clothing, avoiding alcohol, tea, coffee and hot spices, and using special deodorants or powders do not help in severe cases.
Local therapies such as the use of aluminum hexahydrate or iontophoresis have only shown limited success. This also applies to botulinum toxin A (Botox ® ), which has been approved for the treatment of axillary hyperhidrosis for some time, but whose effects do not last long enough. Sage extract and anticholinergics can be used systemically. The preparation Sormodren® (active ingredient bornaprine), which is approved for this indication, has many side effects and therefore poor compliance.
Suction curettage successful
Surgical procedures for treating axillary hyperhidrosis are sympathectomy, sweat gland excision, and surgical suction curettage. Sympathetic ganglia are obliterated during sympathectomy, but compensatory hyperhidrosis often occurs afterwards. When the sweat gland is excised, large scars are usually left behind; this procedure is now obsolete. During surgical suction curettage, scarring rarely occurs. On the other hand, this method succeeds in permanently reducing sweat production to 25 to 50 percent of the initial level. However, the GKV does not reimburse the treatment; private health insurance companies, on the other hand, cover 95 percent of the costs.
Acne – often a case for self-medication
80 to 90 percent of all adolescents suffer from acne vulgaris, with 30 percent of them requiring dermatological treatment. Since many sufferers seek advice from a pharmacy or a beautician, knowledge of the symptoms and treatment options for acne is of great importance for pharmacists.
The appearance of acne is similar to other dermatological diseases such as B. rosacea or perioral dermatitis (“stewardess disease”), which often occurs as a side effect of cortisone therapy on the face. The decisive distinguishing feature of acne is the blackhead (comedo). It can be either open or closed. Black dots are often found in open comedones. This is melanin and not, as is often assumed, “dirt” due to insufficient cleaning of the skin. The starting point for the development of acne is the sebum follicle, where the following pathological processes take place:
- increased sebum flow (seborrhea),
- follicular hyperkeratosis (cornification disorder in which horny cells are increasingly exfoliated from the inner wall of the hair follicle epithelium),
- Symptoms of inflammation, promoted by metabolic products of Propionibacterium acnes, an anaerobic bacterium that finds particularly favorable conditions in blackheads because of the sebum plug