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Dr. Perri's Blog

Entries in Dermatology Tomball (263)

Saturday
May142011

Eczema - Hand Dermatitis

Hand Dermatitis is a very common form of Eczema that I encounter on a daily basis in both my The Woodlands dermatology and Conroe dermatology offices.  Clinically, the hands develop scaly red plaques that on the fingers and palms which can ultimately become very thick and develop cracks and fissures.  Excessive hand washing worsens Hand Dermatitis as does the use of alcohol based hand sanitizers.  Hand Dermatitis is extremely common in ICU nurses who have to wash their hands over 20 times per day.  In severe cases, small water filled blisters form beneath the skin which are due to inflammation and this condition is called Pompholyx or Dyshidrosis.  Emotional stress also exacerbates Hand Dermatitis in many patients.  The nails can become dystrophic if the Eczema involves the proximal nail fold of the distal fingers.  Treatment involves minimizing hand washing and using a gentle liquid soap such as Dove.  It is very important to use a moisturizing cream or ointment after each hand washing.  Aquaphor is an excellent ointment that improves Hand Dermatitis.  I typically prescribe an ultrapotent steroid cream to be used twice a day to minimize the inflammation.  In patients with fissures and cracks, these can be sealed with superglue and filed down smooth to limit exposure to external antigens and irritants.  Some patients have Hand Dermatitis due to occupational exposure or allergens/irritants they encounter during their daily activities.

 

 

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Sunday
May082011

Eczema - Nummular Eczema

Nummular Eczema is a very common type of Eczema, which I encounter on a very frequent basis in both my The Woodlands dermatology and Conroe dermatology offices.  Nummular Eczema is most often found on the legs and arms and occasionally on the trunk.  The itching in Nummular Eczema can be severe.  Clinically, the skin lesions in Nummular Eczema appear as small round circular red scaly plaques.  Nummular Eczema is a type of Eczema most often seen in adolescents and adults and is usually not encountered in children.  The typical atopic skin care regimen of emollients and steroid creams is used to treat Nummular Eczema.

 

Nummular Eczema (http://www.healthcentral.com/common/images/2/2407_10189_5.jpg)

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Sunday
May012011

Eczema - Nipple Eczema

Nipple Eczema is a very common skin condition, which I encounter frequently in both my The Woodlands dermatology and Conroe dermatology offices.  Nipple eczema appears as scaly red plaques on the areola or nipple.  It is typically bilateral (on both sides) and is more concerning if it is unilateral (on one side only) as there is a type of breast cancer called Paget's disease that can clinically mimic Nipple Eczema.  Nipple Eczema usually responds rapidly to treatment with topical steroids.  Persistent or unilateral Nipple Eczema usually warrants a biopsy to rule out Paget's disease.

Nipple Eczema (http://www.oncoprof.net/Generale2000/g01_HistoireGenerale/Images/PagetSein.jpg)

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Saturday
Apr302011

Eczema - Ocular Manifestations

Although Eczema is mainly a disease of the skin, some atopic patients experience problems with their eyes related to this skin disease and I occasionally encounter these ocular manifestations in both my The Woodlands dermatology and Conroe dermatology offices.  Eczema predisposes patients to the development of cataracts.  The cataracts can either be either anterior or posterior subcapsular and the incidence is directly proportional to the severity of the Eczema.  Another ocular problem seen in atopic patients is the development of keratoconus.  Keratoconus occurs when the structure of the cornea breaks down so the normal curvature becomes more conical (like a cone).  This causes severe visual problems and fortunately occurs in less than 1% of patients with Eczema.

 

Cataracts (http://www.diabetesmine.com/wp-content/uploads/2012/11/Cataract-Eye.jpg)

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Monday
Apr252011

Eccrine Neoplasms - Mucinous Carcinoma

Mucinous Carcinoma is a malignant lesion that arises from the integumentary glands which I rarely encounter in both my The Woodlands dermatology and Conroe dermatology offices.  The majority of Mucinous Carcinomas arise from the eyelid in the glands of Moll.  Clinically, Mucinous Carcinomas apepar as flesh colored or red papules which may be ulcerated.  Local recurrence after excision of Mucinous Carcinomas is very common but distant metastasis is fortunately rare.  The treatment of Mucinous Carcinomas is surgical excision.

 

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