Gout is a clinical disease associated with
hyperuricemia and caused by the deposition of
monosodium urate (MSU) crystals in and
around the tissues, resulting in one or more of
/the following manifestations:
I- Acute gouty arthritis
II - Tophaceous gout
III- Gouty nephropathy
IV- Uric acid stones
Uric Acid, Hyperuricemia, and Gout
• Uric acid (urate) is the end product of purine
degradation in humans
• Hyperuricemia is a serum urate concentration in
excess of urate solubility (>6.8 mg/dL)
— Results from overproduction and'or underexcretion of
uric acid
— Is a common serum abnormality but does not result in gout
without crystal deposition
• Gout is the disease state resulting from deposition of
monosodium urate crystals in tissues
Because uric acid has limited
solubility in bodily fluids,
monosodium urate crystal formation
occurs above the solubility threshold
Urate crystals are deposited
preferentially in and around
peripheral joints in the feet, knees,
hands and elbows, especially those
affected by osteoarthritis
Conditions Influencing the
Deposition of Urate Crystals
• Decreased solubility of urate
- Low temperatures
- Low pH
• Disturbances to the joint or soft tissue
- Trauma or tissue injury or altered connective tissue matrix
• Reabsorption of water resulting in supersaturation
- Lack of joint activity during sleep
> The fundamental aims of pout
treatment.
Improve outcomes by
<3>short-term suppression
4> long-term elimination of gout flares
<z> induce durable resolution of tophi
<3> identify and effectively manage
comorbidities
Tuesday, August 16, 2016
gout home remedies baking soda
Purines are natural substances found in all of the body's cells, and in virtually all foods.
The reason for their widespread occurrence is simple: purines provide part of the chemical structure of our genes and the genes of plants and animals When cells die and get recycled, the purines in their genetic material also get broken down.
Uric acid is the chemical formed when purines have been broken down completely.
Hyperuricemia
The condition when there are high
concentrations of uric acid in the blood.
Serum levels of uric acid are >7mg/dL
(Normally, 2.4-6mg/dL in females; 3.4-
7mg/dL in males)
At such a high level, uric acid tends to
aggregate and form crystals
Primary Hyperuricemia: an innate
defect in purine metabolism and/or uric
acid excretion
Secondary Hyperuricemia: high uric
acid levels due to medications/medical
conditions such as diabetic ketoacidosis,
psoriasis, chronic lead poisoning
Most uric acid dissolves in blood and travels to the kidneys, where it passes out in urine.
If your body produces too much uric acid
or doesn't remove enough if it, you can get
sick.
High levels of uric acid in the body is
called Hyperuricemia.
Uric Acid
Uric acid is the end product in purine metabolism
Excretion of uric acid removes nitrogenous wastes from
body
2/3 of uric acid made is excreted via kidneys; 1/3 via Gl
tract
Urate: protonated form of uric acid
> Uric acid can accumulate due to:
> Overproduction of purine nucleotides
^ Enhanced cell turnover (purine degradation)
^ Decreased in purine salvage pathway
> Underexcretion of uric acid
> Predisposition to many diseases
> People may live with elevated uric acid levels
without experiencing any symptoms
GOUT
Gout and gouty arthritis
• Transient attacks of acute arthritis initiated by
crystallization of urates and neutrophils, followed
by chronic gouty arthritis with tophi in joints and
urate nephropathy
• Sites: 50% have initial attack in first
metatarsophalangeal joint; also ankles, heels,
knees, wrists, fingers, elbows
Gout
> Affects less than 0.5% of the population.
> It is a common condition, presenting h. 1-4%
of adult men.
> Due to familial disposition, incidence may be
as high as 80% in families affected by
disorder.
Alcohol and Gout
Oalcohol metabolism contributes to urate retention
Osome red wines contain purines or oxypurines,
which lead to an increased purine load
Oalcohol may contribute to obesity which is
associated with under excretion of uric acid
O Patients with a history of gout are advised to
drink plenty of fluid, approximately 2 litres per
day (nonalcoholic).
GOUT
• Primary gout (90%): idiopathic with
overproduction of uric acid
• Hyperuricemia in the absence of other
disease
OAsymptomatic hyperuricemia can precede gout
• Impaired secretion by kidneys
• Secondary gout (10%): increased nucleic acid
turnover due to
• chronic renal disease,
• HGPRT deficiency^ hypoxanthine-guanine
phosphoribosyl transferase deficiency)
• Tumors
O Leukemias
O Lymphomas
O After chemotherapy
• Alcoholism
O Accelerated ATP catabolism
GOUT
• Arthritis: synovial fluid is poorer solvent for sodium
urate than plasma, so with hyperuricemia.
• Urates in joint fluid crystallize, particularly in ankle due
to lower temperature; crystals develop in synovial lining
cells, stimulate formation of antibodies, which
accelerates formation of new crystals.
• Release of crystals attracts neutrophils and complement,
(generates c3a, c5a, attracts more neutrophils),
• Releases free radicals, releases lysosomal enzymes
GOUT
^ This will eventually causes acute arthritis that last days
to weeks without treatment; repeated attacks of acute
arthritis cause
^ Renal failure, urate stones
Risk factors for gout with Hyperuricemia are:
Age > 30 years,
Male, familial history of gout,
Alcohol use,
Obesity,
Thiazide administration(reduce the clearance of uric
acid)
Pathogenesis
Enzymatic deficiencies and increased
nucleic acid turnover account for only 10%
of gout patients.
Remaining 90% are "primary gout" due to
an unknown defect limiting the ability to
excrete uric acid.
Uric acid normally dissolves in plasma
Poorly soluble in synovial fluid and
precipitates out as MSU crystals
(monosodium urate crystals )
The reason for their widespread occurrence is simple: purines provide part of the chemical structure of our genes and the genes of plants and animals When cells die and get recycled, the purines in their genetic material also get broken down.
Uric acid is the chemical formed when purines have been broken down completely.
Hyperuricemia
The condition when there are high
concentrations of uric acid in the blood.
Serum levels of uric acid are >7mg/dL
(Normally, 2.4-6mg/dL in females; 3.4-
7mg/dL in males)
At such a high level, uric acid tends to
aggregate and form crystals
Primary Hyperuricemia: an innate
defect in purine metabolism and/or uric
acid excretion
Secondary Hyperuricemia: high uric
acid levels due to medications/medical
conditions such as diabetic ketoacidosis,
psoriasis, chronic lead poisoning
Most uric acid dissolves in blood and travels to the kidneys, where it passes out in urine.
If your body produces too much uric acid
or doesn't remove enough if it, you can get
sick.
High levels of uric acid in the body is
called Hyperuricemia.
Uric Acid
Uric acid is the end product in purine metabolism
Excretion of uric acid removes nitrogenous wastes from
body
2/3 of uric acid made is excreted via kidneys; 1/3 via Gl
tract
Urate: protonated form of uric acid
> Uric acid can accumulate due to:
> Overproduction of purine nucleotides
^ Enhanced cell turnover (purine degradation)
^ Decreased in purine salvage pathway
> Underexcretion of uric acid
> Predisposition to many diseases
> People may live with elevated uric acid levels
without experiencing any symptoms
GOUT
Gout and gouty arthritis
• Transient attacks of acute arthritis initiated by
crystallization of urates and neutrophils, followed
by chronic gouty arthritis with tophi in joints and
urate nephropathy
• Sites: 50% have initial attack in first
metatarsophalangeal joint; also ankles, heels,
knees, wrists, fingers, elbows
Gout
> Affects less than 0.5% of the population.
> It is a common condition, presenting h. 1-4%
of adult men.
> Due to familial disposition, incidence may be
as high as 80% in families affected by
disorder.
Alcohol and Gout
Oalcohol metabolism contributes to urate retention
Osome red wines contain purines or oxypurines,
which lead to an increased purine load
Oalcohol may contribute to obesity which is
associated with under excretion of uric acid
O Patients with a history of gout are advised to
drink plenty of fluid, approximately 2 litres per
day (nonalcoholic).
GOUT
• Primary gout (90%): idiopathic with
overproduction of uric acid
• Hyperuricemia in the absence of other
disease
OAsymptomatic hyperuricemia can precede gout
• Impaired secretion by kidneys
• Secondary gout (10%): increased nucleic acid
turnover due to
• chronic renal disease,
• HGPRT deficiency^ hypoxanthine-guanine
phosphoribosyl transferase deficiency)
• Tumors
O Leukemias
O Lymphomas
O After chemotherapy
• Alcoholism
O Accelerated ATP catabolism
GOUT
• Arthritis: synovial fluid is poorer solvent for sodium
urate than plasma, so with hyperuricemia.
• Urates in joint fluid crystallize, particularly in ankle due
to lower temperature; crystals develop in synovial lining
cells, stimulate formation of antibodies, which
accelerates formation of new crystals.
• Release of crystals attracts neutrophils and complement,
(generates c3a, c5a, attracts more neutrophils),
• Releases free radicals, releases lysosomal enzymes
GOUT
^ This will eventually causes acute arthritis that last days
to weeks without treatment; repeated attacks of acute
arthritis cause
^ Renal failure, urate stones
Risk factors for gout with Hyperuricemia are:
Age > 30 years,
Male, familial history of gout,
Alcohol use,
Obesity,
Thiazide administration(reduce the clearance of uric
acid)
Pathogenesis
Enzymatic deficiencies and increased
nucleic acid turnover account for only 10%
of gout patients.
Remaining 90% are "primary gout" due to
an unknown defect limiting the ability to
excrete uric acid.
Uric acid normally dissolves in plasma
Poorly soluble in synovial fluid and
precipitates out as MSU crystals
(monosodium urate crystals )
gout home remedies
Gout is a disorder that manifests as a spectrum of clinical and pathologic features built on a
foundation of an excess body burden of uric acid, manifested in part by hyperuricemia, which is
variably defined as a serum urate level greater than 360umol/l (6.8mg%)
The term gout is derived from the latin word 'guta' meaning a drop, and originally may have referred to a drop of poison or evil humor.
? a group of diseases characterized by hyperuricaemia and uric acid crystal formation.
Gout is a disease in which tissue deposition of monosodium urate (MSU) crystals occurs due to hyperuricemia (MSU supersaturation of extracellular fluids) Occur at >360umol/l concentration
These clinical syndromes include Asymptomatic hvperuricaemia
Acute ooutv arthritis,
tophaceous pout,
uric acid nephrolithiasis, and
outv nephrooath
:*ln its more narrow and perhaps more commonly
used definition, gout refers to arthritis caused by
uric acid crystals.
CHARACTERISTICS OF AN ACUTE
ATTACK OF GOUT
• Early episodes of acute gouty arthritis are typically monoarticular (85%) and begin abruptly, often during the night or early morning.
• The affected joint becomes exquisitely painful, warm, red, and swollen.
• A low -grade fever may be present.
• The periarticular erythema and swelling may progress to resemble a cellulitis termed gouty
cellulitis.
Pathophysiology
uric acid is an end product of purine biosynthesis.
Hyperuricaemia is a necessary but not a
sufficient condition for the development of
gout;
and although the mechanisms of excess uric
acid accumulation are well defined, the
subsequent phases of crystal formation and
release into tissues remain less well
characterized.
purine metabolism
Purines are derived from two sources.
(1) ingested in food
(2) generated via a complex de novo synthetic pathway.
Components of the purine ring are complexed to the
donor substrate phosphoribosylpyrophosphate (
PRPP).
These are then taken through a 10-step process
culminating in purine nucleotide formation.
PRPP is also used as a substrate for pyrimidine and
pyridine synthesis. Thus, the first committed step in
purine synthesis is catalysed by the enzyme
amidophosphoribosyl transferase (amidoPRT).
ric acid metabolism
¦ Uric acid is ultimately formed from purine nucleotides
through the intermediate compounds xanthine,
hypoxanthine, and guanine by the enzyme xanthine
oxidase.
¦ It is a terminal product as no mammalian uricase
exists.
Uric acid is made primarily in the liver.
The average pool size is 1200 mg in men and 600 mg in
women.
In both men and women, about two-thirds of the total uric
Causes of secondary gout
cid, such as tumour
lysis syndrome, myeloproliferative disease,
haemolytic amaemia, and psoriasis.
All of these conditions are characterized by
increased cell turnover with a subsequent increase
in purine synthesis and catabolism.
*) Undersecretion of uric acid
> such as renal failure and many drugs
> Lead exposure is a cause of secondary gout.
Saternine gout, which is associated with heavy lead
exposures (often from the ingestion of lead-laden
whisky), is rare today.
foundation of an excess body burden of uric acid, manifested in part by hyperuricemia, which is
variably defined as a serum urate level greater than 360umol/l (6.8mg%)
The term gout is derived from the latin word 'guta' meaning a drop, and originally may have referred to a drop of poison or evil humor.
? a group of diseases characterized by hyperuricaemia and uric acid crystal formation.
Gout is a disease in which tissue deposition of monosodium urate (MSU) crystals occurs due to hyperuricemia (MSU supersaturation of extracellular fluids) Occur at >360umol/l concentration
These clinical syndromes include Asymptomatic hvperuricaemia
Acute ooutv arthritis,
tophaceous pout,
uric acid nephrolithiasis, and
outv nephrooath
:*ln its more narrow and perhaps more commonly
used definition, gout refers to arthritis caused by
uric acid crystals.
CHARACTERISTICS OF AN ACUTE
ATTACK OF GOUT
• Early episodes of acute gouty arthritis are typically monoarticular (85%) and begin abruptly, often during the night or early morning.
• The affected joint becomes exquisitely painful, warm, red, and swollen.
• A low -grade fever may be present.
• The periarticular erythema and swelling may progress to resemble a cellulitis termed gouty
cellulitis.
Pathophysiology
uric acid is an end product of purine biosynthesis.
Hyperuricaemia is a necessary but not a
sufficient condition for the development of
gout;
and although the mechanisms of excess uric
acid accumulation are well defined, the
subsequent phases of crystal formation and
release into tissues remain less well
characterized.
purine metabolism
Purines are derived from two sources.
(1) ingested in food
(2) generated via a complex de novo synthetic pathway.
Components of the purine ring are complexed to the
donor substrate phosphoribosylpyrophosphate (
PRPP).
These are then taken through a 10-step process
culminating in purine nucleotide formation.
PRPP is also used as a substrate for pyrimidine and
pyridine synthesis. Thus, the first committed step in
purine synthesis is catalysed by the enzyme
amidophosphoribosyl transferase (amidoPRT).
ric acid metabolism
¦ Uric acid is ultimately formed from purine nucleotides
through the intermediate compounds xanthine,
hypoxanthine, and guanine by the enzyme xanthine
oxidase.
¦ It is a terminal product as no mammalian uricase
exists.
Uric acid is made primarily in the liver.
The average pool size is 1200 mg in men and 600 mg in
women.
In both men and women, about two-thirds of the total uric
Causes of secondary gout
cid, such as tumour
lysis syndrome, myeloproliferative disease,
haemolytic amaemia, and psoriasis.
All of these conditions are characterized by
increased cell turnover with a subsequent increase
in purine synthesis and catabolism.
*) Undersecretion of uric acid
> such as renal failure and many drugs
> Lead exposure is a cause of secondary gout.
Saternine gout, which is associated with heavy lead
exposures (often from the ingestion of lead-laden
whisky), is rare today.
Monday, August 15, 2016
Cure Gout Naturally
Definition
Gout is an inflammatory arthritis
associated with hyperuricaemia
Acute arthritis is the most frequent early clinical
manifestation of MSU gout.
Usually only one joint is affected initially
Polyarticular acute gout is also seen in male
hypertensive patients with ethanol abuse as well as
in postmenopausal women.
The metatarso phalangeal joint of the first toe is
often involved.
Ankles, and knees are also commonly affected.
In elderly patients, finger joints may be inflamed.
Epidemiology
—o—
Prevalence of hyperuricaemia 5%
Prevalence of Gout 0.2%
M:F ratio 10:1
Hyperuricaemia is defined as >2 SD from me
umol in males and 360 umol/1 in females.
Urate production varies with the purine content of
the diet and the rates of purine biosyntesis,
degradation and salvage.
Factors associated with High Uric acid
Increasing age
Obesity
High protein diet
High alcohol consumption
Combined hyperlipidemia
Diabetes mellitus
Ischaemic heart disease
Hypertension
Uric acid is the last step in purine breakdown
Conversion of hypoxnthine to xanthine and xanthine
to Uric acid is catalysed by Xanthine Oxidase
Causes of hyperuricemia
Primary
No recognized cause
Hypoxanthine
phosphoribosyltransferase
deficiency
Increased phosphoribosyl
pyrophosphatase activity.
Secondary
Hereditary fructose
intolerance
Myeloproliferative disease
Linfoproliferative disease
Hemolitic anemia
Drugs: Low-doses salicylate,
diuretis, pyrazinamide,
ethambutol, nicotinamide, etanol
Several events may precipitate acute gouty arthritis:
o Dietary excess
0 Trauma
o Surgery
o Excessive ethanol ingestion
o Glucocorticoid withdrawal
Uric acid excretion
UA is completely filtered by glomerulus
Almost 100% is reabsorbed by proximal tubule
50% is re-excreted by distal tubule
Low dose aspirin blocks secretion
High dose aspirin blocks reabsorption
Impaired excretion
Chronic renal failure
Drugs: thiazides, low dose aspirin
Hypertenion
Lead toxicity
Pr. Hyperparathroidism
Hypothyroidism
t lactic acid production: alcohol,
sxercise, starvation
G 6 PD deficiency
Increased production
Lesch Nyhan Syndrome (HGPRT deficiency
PRPP overactivity
G6 PD deficiency
Increased purine turnover
Myeloproliferative disorders eg Polycythemia
rubra vera
Lymphoproliferative disorders like leukemia
Carcinoma esp after chemo, severe psoriasis
Acute Gout
Sudden onset of severe agonizing pain, swelling of
1st MTP joint
Too painful to touch or move
Precipitated by food, exercise, alcohol or diuretic
Usually recovers in 7 days
Typically associated with desquamation of overlying
skin
Treatment
High Dose NSAIDs
Rapid response
Naproxen 750 mg initially then soomg bid
Diclofenac 75-100 mg intially then 50 mg bid or tid
Indomemethacin 75 mg initially the 50 mg bid or qid
Alternative treatments
Colchisine looomg initially then soomg bid to qid
((DIARRHOEA))
Corticosteroids ((intramuscular or intra articular))-
depot methylpredisolone
Gout is an inflammatory arthritis
associated with hyperuricaemia
Acute arthritis is the most frequent early clinical
manifestation of MSU gout.
Usually only one joint is affected initially
Polyarticular acute gout is also seen in male
hypertensive patients with ethanol abuse as well as
in postmenopausal women.
The metatarso phalangeal joint of the first toe is
often involved.
Ankles, and knees are also commonly affected.
In elderly patients, finger joints may be inflamed.
Epidemiology
—o—
Prevalence of hyperuricaemia 5%
Prevalence of Gout 0.2%
M:F ratio 10:1
Hyperuricaemia is defined as >2 SD from me
umol in males and 360 umol/1 in females.
Urate production varies with the purine content of
the diet and the rates of purine biosyntesis,
degradation and salvage.
Factors associated with High Uric acid
Increasing age
Obesity
High protein diet
High alcohol consumption
Combined hyperlipidemia
Diabetes mellitus
Ischaemic heart disease
Hypertension
Uric acid is the last step in purine breakdown
Conversion of hypoxnthine to xanthine and xanthine
to Uric acid is catalysed by Xanthine Oxidase
Causes of hyperuricemia
Primary
No recognized cause
Hypoxanthine
phosphoribosyltransferase
deficiency
Increased phosphoribosyl
pyrophosphatase activity.
Secondary
Hereditary fructose
intolerance
Myeloproliferative disease
Linfoproliferative disease
Hemolitic anemia
Drugs: Low-doses salicylate,
diuretis, pyrazinamide,
ethambutol, nicotinamide, etanol
Several events may precipitate acute gouty arthritis:
o Dietary excess
0 Trauma
o Surgery
o Excessive ethanol ingestion
o Glucocorticoid withdrawal
Uric acid excretion
UA is completely filtered by glomerulus
Almost 100% is reabsorbed by proximal tubule
50% is re-excreted by distal tubule
Low dose aspirin blocks secretion
High dose aspirin blocks reabsorption
Impaired excretion
Chronic renal failure
Drugs: thiazides, low dose aspirin
Hypertenion
Lead toxicity
Pr. Hyperparathroidism
Hypothyroidism
t lactic acid production: alcohol,
sxercise, starvation
G 6 PD deficiency
Increased production
Lesch Nyhan Syndrome (HGPRT deficiency
PRPP overactivity
G6 PD deficiency
Increased purine turnover
Myeloproliferative disorders eg Polycythemia
rubra vera
Lymphoproliferative disorders like leukemia
Carcinoma esp after chemo, severe psoriasis
Acute Gout
Sudden onset of severe agonizing pain, swelling of
1st MTP joint
Too painful to touch or move
Precipitated by food, exercise, alcohol or diuretic
Usually recovers in 7 days
Typically associated with desquamation of overlying
skin
Treatment
High Dose NSAIDs
Rapid response
Naproxen 750 mg initially then soomg bid
Diclofenac 75-100 mg intially then 50 mg bid or tid
Indomemethacin 75 mg initially the 50 mg bid or qid
Alternative treatments
Colchisine looomg initially then soomg bid to qid
((DIARRHOEA))
Corticosteroids ((intramuscular or intra articular))-
depot methylpredisolone
Saturday, August 13, 2016
the Best Remedies to Remove Pimples
A skin problem which usually affects the teenagers is the pimples or
acne. Mainly the problem starts at early at in the teens. Pimple or acne
can be a source of high distress to youngsters and they looking
for homeopathic remedies to remove pimples. This is the age when
the teenagers are most concern about their looks. It commonly affects
the girls. When, the face is usually covered with all kinds of eruptions,
big and small, blackish, whitish or reddish in color, dry or explodes in
nature.
Homeopathic remedies will help in solving the problems of pimples or
acne in very cool and effective manner without developing any
difficulties. As the homeopathic remedies does not consists of any type
of chemicals so they treat naturally without affecting the skin or in other
words we can say that homeopathic remedies does not provide any side
effects, one can also treat this problem with the help of home remedies.
Here are the top of homeopathic remedies for acne or pimples as given below, which
are quite effective. These top remedies have been personally used to cure the pimples
or acne. By using these homeopathic remedies on regular basis will provide very
positive results.
1. Hepar sulphur:
If there is pain and more in the form of the boils or abscesses. It is one of best and
effective homeopathic remedies for acne and pimples. In this case patient who are
sensitive against the pain as well as cold. There is enhancement in the perspiration.
2. Pulsatilla:
It is very effective homeopathic remedy to eliminate the pimple or acne especially
for the girls with menstrual problems. This beneficial remedy is good for scanty
periods or postponed periods along with pimple or acne. Girls who usually found
themselves flooded with acne just before the arrival of the monthly menstrual
flow often respond very favourably to Pulsatilla.
3. Silicea:
It is better homeopathic remedy to eliminate the pimples. It is for suppuration or
pus formation in the norm. There is developing of pus in the pimples and this pus
tends to be offensive. „_
4. Antimonies crud:
It is very effective homeopathic remedy for small red pimples on the face,
right shoulder, when touched it stings and for severe thirst and white
coated tongue.
5. Calcarea carb:
This homeopathic remedy is very effective for pimple or acne which occurs
on the face and the neck. It is due to the sexual surplus, redness of the nose
because of the scanty monthly or for those who work excessive in water.
6. Sepia;
This homeopathic remedy will work on the acne which occurs on the
chin, become poor during the periods and pregnancy. Moreover it is very
effective for the pimple which occurs on the genitals, legs and on the
creases of the joints, also good for dirty skin, yellow and scurfy.
7. Natrum Mur:
This remedy is beneficial for pimple or acne, when there is excessive
secretion of sebum or oil. The face will remain oily and greasy. The
patient is usually thin and weak.
8. Belladonna to Remove Pimples:
This homeopathic remedy is effective for pimple or acne rosaceous and
moreover good for redness and paleness of skin and Dry, hot and swollen
skin.
9. Asteriasrubens:
This remedy is very effective for the deposition of pimples at adolescence
and also for red face, pimples on side of nose, chin and mouth.
10. Sulphur to Remove Pimples:
This one of the most beneficial and wonderful remedies for pimple or acne This
medicine is one of the top homeopathic remedies for acne. Moreover Sulphur
tops in all the homeopathic medicines which are good for Skin ailments. The most
effective benefits of sulphur resides in it is to build-up the ability to remove the
deep down tendency to develop the acne. Once sulphur starts acting, acne can be
gone in few months time period. Moreover, once the sulphur is suited in the case
of acne, patients complexion also leads to changes, it is also better for unhealthy
looking skin to a glowing skin. It is also beneficial in slowly removing the old scars
of Acne.
acne. Mainly the problem starts at early at in the teens. Pimple or acne
can be a source of high distress to youngsters and they looking
for homeopathic remedies to remove pimples. This is the age when
the teenagers are most concern about their looks. It commonly affects
the girls. When, the face is usually covered with all kinds of eruptions,
big and small, blackish, whitish or reddish in color, dry or explodes in
nature.
Homeopathic remedies will help in solving the problems of pimples or
acne in very cool and effective manner without developing any
difficulties. As the homeopathic remedies does not consists of any type
of chemicals so they treat naturally without affecting the skin or in other
words we can say that homeopathic remedies does not provide any side
effects, one can also treat this problem with the help of home remedies.
Here are the top of homeopathic remedies for acne or pimples as given below, which
are quite effective. These top remedies have been personally used to cure the pimples
or acne. By using these homeopathic remedies on regular basis will provide very
positive results.
1. Hepar sulphur:
If there is pain and more in the form of the boils or abscesses. It is one of best and
effective homeopathic remedies for acne and pimples. In this case patient who are
sensitive against the pain as well as cold. There is enhancement in the perspiration.
2. Pulsatilla:
It is very effective homeopathic remedy to eliminate the pimple or acne especially
for the girls with menstrual problems. This beneficial remedy is good for scanty
periods or postponed periods along with pimple or acne. Girls who usually found
themselves flooded with acne just before the arrival of the monthly menstrual
flow often respond very favourably to Pulsatilla.
3. Silicea:
It is better homeopathic remedy to eliminate the pimples. It is for suppuration or
pus formation in the norm. There is developing of pus in the pimples and this pus
tends to be offensive. „_
4. Antimonies crud:
It is very effective homeopathic remedy for small red pimples on the face,
right shoulder, when touched it stings and for severe thirst and white
coated tongue.
5. Calcarea carb:
This homeopathic remedy is very effective for pimple or acne which occurs
on the face and the neck. It is due to the sexual surplus, redness of the nose
because of the scanty monthly or for those who work excessive in water.
6. Sepia;
This homeopathic remedy will work on the acne which occurs on the
chin, become poor during the periods and pregnancy. Moreover it is very
effective for the pimple which occurs on the genitals, legs and on the
creases of the joints, also good for dirty skin, yellow and scurfy.
7. Natrum Mur:
This remedy is beneficial for pimple or acne, when there is excessive
secretion of sebum or oil. The face will remain oily and greasy. The
patient is usually thin and weak.
8. Belladonna to Remove Pimples:
This homeopathic remedy is effective for pimple or acne rosaceous and
moreover good for redness and paleness of skin and Dry, hot and swollen
skin.
9. Asteriasrubens:
This remedy is very effective for the deposition of pimples at adolescence
and also for red face, pimples on side of nose, chin and mouth.
10. Sulphur to Remove Pimples:
This one of the most beneficial and wonderful remedies for pimple or acne This
medicine is one of the top homeopathic remedies for acne. Moreover Sulphur
tops in all the homeopathic medicines which are good for Skin ailments. The most
effective benefits of sulphur resides in it is to build-up the ability to remove the
deep down tendency to develop the acne. Once sulphur starts acting, acne can be
gone in few months time period. Moreover, once the sulphur is suited in the case
of acne, patients complexion also leads to changes, it is also better for unhealthy
looking skin to a glowing skin. It is also beneficial in slowly removing the old scars
of Acne.
Natural Home Remedies to Remove Pimples and Acne
A beautiful face with pimples and acne looks very worst. Because of pimples
most of the people get irritated and they start hate from this. By removing
the pimples can provide a pain to you. Pimples are occur mainly because of
many reasons like non suitable atmosphere, quality of food intake and some
other reasons.
The best way to keep the body away from pimples and some other diseases
is to consume a plenty of water, consume fruits in the diet and stay in the
clean atmosphere which can be non polluted.
1. USE ICE to Remove Pimple:
It is very effective remedy for removing6 the redness, swelling and inflammation of the
pimples. It promotes blood circulation to the infected part and help n tightening the
skin pores. Ice also eliminates dirt and oil from your skin. You can use crushes ice or ice
2. USE LEMON:
It is also very perfect in eliminating the acne and pimples. It is enriched with rich
vitamin C which helps in eliminating the pimples very quickly. It makes the pimples dry.
Make sure use fresh lime juice.
How to apply?
Dip the cotton swab in the lemon juice and gently apply it on the pimples before going
to the bed. Mix one table spoon of lemon juice and one tablespoon of cinnamon
powder and apply it overnight and wash it with lukewarm water in the morning.
However, this method is not suitable for those people who are having sensitive skin.
cubes, whatever is suitable to you.
3. USE TOOTHPASTE:
This remedy is also good on your pimples to get rid of pimples instantly followed by
applying ice on the infected area. Make sure to avoid using gel toothpastes.
How to apply?
Simply apply some toothpaste on your pimples before going to bed and left it
overnight, then rinse your face in the morning with lukewarm water. You can also
apply it at daytime but make sure it remains on your pimples for at least half an
hour.
4. TEA TREE OIL for Pimple Dis-appearance:
It is an antibacterial which helps in fighting against the bacteria
that causes the skin problems. It also helps in giving the soothing
effect. This oil is good for removing the pimple and acne dry out
blackheads and whiteheads.
How to apply?
■Dip the cotton swab in tea tree oil and gently apply it on the
infected part. Remain it for 15-20 minutes and wash it with
lukewarm water.
■Mix one tablespoon of aloe Vera gel with few drops of tea tree
essential oil. Apply and remain it for 15 minutes and then rinse it
off.
Caution: Steer clear of tea tree essential oil, it you are having a
sensitive skin.
5. STEAM:
This remedy will help your skin to breath as it pen your skin pores. It
eliminates oil, dirt and bacteria that causes inflammation and infection. Fill a
large container with water and allow steam to come in contact with your
skin. Perform it for few minutes and then rinse your face with lukewarm
water and then apply an oil free moisturizer.
6. PAPAYA to Cure Pimples and Acne:
This fruit is good in eliminating the pimples and acne naturally at home. It is
used in many beauty products. It helps in eliminating a dead skin and also
eliminates excessive lipids from your skin surface. Papaya consists of an
enzyme pa-pain which lowers inflammation and prevents from pus
formation.
How to apply?
Rinse your face and mash the flesh of papaya over your face, until it is of
consistency that can be easily applied to your skin. Then remain it for 15
minutes and rinse it off with warm water.
7. ORANGE PEELS PASTE:
Orange fruit is enriched with vitamin c. It eliminates the dirt, oil and
bacterial from the skin and helps in the eliminating the pimples.
How to apply?
Firstly Wash your face and pat dry. Prepare a paste by using blender,
mortar and pestle by adding two orange peels and few drops of water.
Than gently apply this paste on your skin and remain it for 20-25
minutes, Mask should be firm. Wash it completely with water, pat your
face and apply a good moisturizer.
8. MINT:
It consists of methanol, which acts a pain killer and have anti inflammatory properties.
It may not treat your pimples, but will definitely lowers the redness and swelling of
your face.
How to use?
Wash your face and pat dry. Crush the leaves by using mortar and pestle or blender.
Rub the juice and crushes leaves on your face and leave it for 5-10 minutes before
rinsing with water cold. ,
9. Potato:
It is enriched in potassium, sulphur, chloride and phosphorus; all components can &
in the lowering of blemishes. It contains antioxidant property in order to nourish your
skin and promotes the healthy growth of the skin cells.
How to use?
Wash your face and pat dry, leaving it a bit damp. Grate the potato and use its pulp
juice and rub it on your face in a circular motion. Let it dry for at least 25-30 minutes
and then rinse it off completely using warm water.
most of the people get irritated and they start hate from this. By removing
the pimples can provide a pain to you. Pimples are occur mainly because of
many reasons like non suitable atmosphere, quality of food intake and some
other reasons.
The best way to keep the body away from pimples and some other diseases
is to consume a plenty of water, consume fruits in the diet and stay in the
clean atmosphere which can be non polluted.
1. USE ICE to Remove Pimple:
It is very effective remedy for removing6 the redness, swelling and inflammation of the
pimples. It promotes blood circulation to the infected part and help n tightening the
skin pores. Ice also eliminates dirt and oil from your skin. You can use crushes ice or ice
2. USE LEMON:
It is also very perfect in eliminating the acne and pimples. It is enriched with rich
vitamin C which helps in eliminating the pimples very quickly. It makes the pimples dry.
Make sure use fresh lime juice.
How to apply?
Dip the cotton swab in the lemon juice and gently apply it on the pimples before going
to the bed. Mix one table spoon of lemon juice and one tablespoon of cinnamon
powder and apply it overnight and wash it with lukewarm water in the morning.
However, this method is not suitable for those people who are having sensitive skin.
cubes, whatever is suitable to you.
3. USE TOOTHPASTE:
This remedy is also good on your pimples to get rid of pimples instantly followed by
applying ice on the infected area. Make sure to avoid using gel toothpastes.
How to apply?
Simply apply some toothpaste on your pimples before going to bed and left it
overnight, then rinse your face in the morning with lukewarm water. You can also
apply it at daytime but make sure it remains on your pimples for at least half an
hour.
4. TEA TREE OIL for Pimple Dis-appearance:
It is an antibacterial which helps in fighting against the bacteria
that causes the skin problems. It also helps in giving the soothing
effect. This oil is good for removing the pimple and acne dry out
blackheads and whiteheads.
How to apply?
■Dip the cotton swab in tea tree oil and gently apply it on the
infected part. Remain it for 15-20 minutes and wash it with
lukewarm water.
■Mix one tablespoon of aloe Vera gel with few drops of tea tree
essential oil. Apply and remain it for 15 minutes and then rinse it
off.
Caution: Steer clear of tea tree essential oil, it you are having a
sensitive skin.
5. STEAM:
This remedy will help your skin to breath as it pen your skin pores. It
eliminates oil, dirt and bacteria that causes inflammation and infection. Fill a
large container with water and allow steam to come in contact with your
skin. Perform it for few minutes and then rinse your face with lukewarm
water and then apply an oil free moisturizer.
6. PAPAYA to Cure Pimples and Acne:
This fruit is good in eliminating the pimples and acne naturally at home. It is
used in many beauty products. It helps in eliminating a dead skin and also
eliminates excessive lipids from your skin surface. Papaya consists of an
enzyme pa-pain which lowers inflammation and prevents from pus
formation.
How to apply?
Rinse your face and mash the flesh of papaya over your face, until it is of
consistency that can be easily applied to your skin. Then remain it for 15
minutes and rinse it off with warm water.
7. ORANGE PEELS PASTE:
Orange fruit is enriched with vitamin c. It eliminates the dirt, oil and
bacterial from the skin and helps in the eliminating the pimples.
How to apply?
Firstly Wash your face and pat dry. Prepare a paste by using blender,
mortar and pestle by adding two orange peels and few drops of water.
Than gently apply this paste on your skin and remain it for 20-25
minutes, Mask should be firm. Wash it completely with water, pat your
face and apply a good moisturizer.
8. MINT:
It consists of methanol, which acts a pain killer and have anti inflammatory properties.
It may not treat your pimples, but will definitely lowers the redness and swelling of
your face.
How to use?
Wash your face and pat dry. Crush the leaves by using mortar and pestle or blender.
Rub the juice and crushes leaves on your face and leave it for 5-10 minutes before
rinsing with water cold. ,
9. Potato:
It is enriched in potassium, sulphur, chloride and phosphorus; all components can &
in the lowering of blemishes. It contains antioxidant property in order to nourish your
skin and promotes the healthy growth of the skin cells.
How to use?
Wash your face and pat dry, leaving it a bit damp. Grate the potato and use its pulp
juice and rub it on your face in a circular motion. Let it dry for at least 25-30 minutes
and then rinse it off completely using warm water.
How to get RID of Acne Naturally
How to get RID of Acne Naturally - Body Acne
Treatment
When dealing with acne skin care, most of the
medical professionals commonly suggest that
people affected with acne must practice certain
acne skin care methods that will help improve the
condition of their skin.
Acne, as you may already know, is a very severe
skin disorder that affects thousands of people
from all over the world.
It not only affects the surface of the skin but also
the inner layers of the skin. Acne usually occurs
on the face, neck, chest and back, and it starts
during the adolescence period.
During the past several years, a good number of
acne experts and skin care professionals have
conducted many studies on how to prevent the
formation of acne.
And fortunately, these skin care specialists have
come out with certain acne skin care tips that can
be of great help for fighting acne.
I have selected the three simpler yet most
powerful acne skin care tips that you can follow in
order to have a healthier skin.
Acne Skin Care Tip # 1:
You Should Always Clean Your Skin Very Gently .
First of all, personal hygiene is very necessary for
fighting acne. So as what most experts usually
suggest, you should gently clean your skin with a
mild cleanser at least twice a day.
This simple acne skin care step is deemed
important for fighting acne since washing your
face or the other affected areas will wipe away the
acne-causing bacteria on the skin.
Also note that although you are sometimes told to
scrub your face, scrubbing is not a good acne skin
care move since it will just trigger the
development of acne, worsening the condition.
In addition to this acne skin care
step, it is worth noting that astringents are not
always suggested unless the skin is very oily. And,
they must only be applied on the oily spots.
Acne Skin Care # 2
You Should Refrain from Frequently
Holding Your Skin
Another helpful acne skin care tip is to avoid
frequently handling of the skin. Don't pinch, pick
or squeeze your pimple since it will only worsen
the condition. Many of the people have
considered this acne skin care step as one of the
most important acne skin care pointers knowing
that it may only cause infection and scars
formation.
As this acne skin care tip holds, you should
avoid rubbing and touching your skin lesions if
possible.
Acne Skin Care # 3:
Always Choose Cosmetics
Carefully
This last acne skin care tip holds that people who
are being treated for acne must change some of
the cosmetics they use.
Note that in order to avoid the onset or the
development of acne, the cosmetics you plan on
using like the foundation, blush, moisturizers, and
eye shadow should be oil free.
Aside from that, this acne skin care tip also holds
that you must avoid oily hair products for they
may cause closed comedones. Therefore, those
products that are labeled as noncomedogenic
should be applied.
It is a fact that many of us are very conscious of
our skin condition. And as such, we are always
wanting to have a fresh, good-looking skin as
much as possible.
Unfortunately, many of us also fail to come to the
conclusion that simple steps are the best ways to
accomplish this goal.
We often are blind enough that we don;t see
what;s really right or wrong for our skin. We often
fall in so much frustration and desperation that
make us go buy any high-priced beauty products
that in the end just turn out to be a waste of time
and money, and even worsen our acne.
Hopefully, the above mentioned acne skin care
tips will be a good start to help you enhance your
skin condition.
Treatment
When dealing with acne skin care, most of the
medical professionals commonly suggest that
people affected with acne must practice certain
acne skin care methods that will help improve the
condition of their skin.
Acne, as you may already know, is a very severe
skin disorder that affects thousands of people
from all over the world.
It not only affects the surface of the skin but also
the inner layers of the skin. Acne usually occurs
on the face, neck, chest and back, and it starts
during the adolescence period.
During the past several years, a good number of
acne experts and skin care professionals have
conducted many studies on how to prevent the
formation of acne.
And fortunately, these skin care specialists have
come out with certain acne skin care tips that can
be of great help for fighting acne.
I have selected the three simpler yet most
powerful acne skin care tips that you can follow in
order to have a healthier skin.
Acne Skin Care Tip # 1:
You Should Always Clean Your Skin Very Gently .
First of all, personal hygiene is very necessary for
fighting acne. So as what most experts usually
suggest, you should gently clean your skin with a
mild cleanser at least twice a day.
This simple acne skin care step is deemed
important for fighting acne since washing your
face or the other affected areas will wipe away the
acne-causing bacteria on the skin.
Also note that although you are sometimes told to
scrub your face, scrubbing is not a good acne skin
care move since it will just trigger the
development of acne, worsening the condition.
In addition to this acne skin care
step, it is worth noting that astringents are not
always suggested unless the skin is very oily. And,
they must only be applied on the oily spots.
Acne Skin Care # 2
You Should Refrain from Frequently
Holding Your Skin
Another helpful acne skin care tip is to avoid
frequently handling of the skin. Don't pinch, pick
or squeeze your pimple since it will only worsen
the condition. Many of the people have
considered this acne skin care step as one of the
most important acne skin care pointers knowing
that it may only cause infection and scars
formation.
As this acne skin care tip holds, you should
avoid rubbing and touching your skin lesions if
possible.
Acne Skin Care # 3:
Always Choose Cosmetics
Carefully
This last acne skin care tip holds that people who
are being treated for acne must change some of
the cosmetics they use.
Note that in order to avoid the onset or the
development of acne, the cosmetics you plan on
using like the foundation, blush, moisturizers, and
eye shadow should be oil free.
Aside from that, this acne skin care tip also holds
that you must avoid oily hair products for they
may cause closed comedones. Therefore, those
products that are labeled as noncomedogenic
should be applied.
It is a fact that many of us are very conscious of
our skin condition. And as such, we are always
wanting to have a fresh, good-looking skin as
much as possible.
Unfortunately, many of us also fail to come to the
conclusion that simple steps are the best ways to
accomplish this goal.
We often are blind enough that we don;t see
what;s really right or wrong for our skin. We often
fall in so much frustration and desperation that
make us go buy any high-priced beauty products
that in the end just turn out to be a waste of time
and money, and even worsen our acne.
Hopefully, the above mentioned acne skin care
tips will be a good start to help you enhance your
skin condition.
The Causes of ACNE
Acne is a common skin condition that
mainly appears during youfsteenage
years, when hormone levels are changing
Acne is caused by:
family/genetic history
oily cosmetics
stress
diet
hot weather
exposure to some chemicals
Vitamin A and Vitamin E deficiency
poor hygiene
use of anabolic steroids
puberty and menstrual cycles
Other Causes,.,
Our skin is covered with very small holes, called
follicles
Each follicle has a fine hair growing out of it
The follicle produces a special moisturiser for the
skin, called sebum, that flows out along the hair
Acne usually
occurs on the
face,
arms,
chest,
neck
and back
People with acne can:
have very low self esteem
feel unattractive
be bullied by their peers I
become depressed
consider suicide
Sometimes acne can be
cleared by regular
washing and special acne
treatments.
Most treatments aim to:
Help clear dead skin
Help clear blackheads
This allows sebum to move freely ag
The spots heal
mainly appears during youfsteenage
years, when hormone levels are changing
Acne is caused by:
family/genetic history
oily cosmetics
stress
diet
hot weather
exposure to some chemicals
Vitamin A and Vitamin E deficiency
poor hygiene
use of anabolic steroids
puberty and menstrual cycles
Other Causes,.,
Our skin is covered with very small holes, called
follicles
Each follicle has a fine hair growing out of it
The follicle produces a special moisturiser for the
skin, called sebum, that flows out along the hair
Acne usually
occurs on the
face,
arms,
chest,
neck
and back
People with acne can:
have very low self esteem
feel unattractive
be bullied by their peers I
become depressed
consider suicide
Sometimes acne can be
cleared by regular
washing and special acne
treatments.
Most treatments aim to:
Help clear dead skin
Help clear blackheads
This allows sebum to move freely ag
The spots heal
Acne vulgaris Alternative treatments
Acne vulgaris, more commonly referred to simply acne, is a chronic inflammatory disorder of the pilocebaceous unit.
characterized by:
■ abnormalities in sebum production
■ follicular desquamation
■ bacterial proliferation
■ inflammation
Acne vulgaris is the most common cutaneous disorder.
It affects more than 17 million Americans.
Patients can experience significant psychological morbidity
and, rarely, mortality due to suicide.
Important that physicians are familiar with Acne Vulgaris and
its treatment.
affects all races and ethnicities with equal significance.
Darker skinned patients at increased risk for developing
post-inflammatory hyper-pigmentation and keloids.
Acne is polygenic and multi-factorial. Four main pathogenetic
factors contribute to the disease:
Propionibacterium acnes and Staphylococcus epidermidis
colonisation. :
bacteria found deep in follicles and stimulate the production
of pro-inflammatory mediators and lipases.
Inflammation and immune response. Inflammatory cells and
mediators efflux into the disrupted follicle, leading to the
development of papules, pustules, nodules, and cysts.
Sebaceous gland hyperplasia and excess sebum production.
Abnormal follicular differentiation.
Propionibacterium Acn
Propionibacterium acne is a gram-positive, non-motil rods relatively
slow growing typically aerotolerant anaerobic gram positive bacterium
S. epidermidis is a very hardy microorganism, consisting of
nonmotile, Gram-positive cocci, arranged in grape-like clust-
ers.is part of human skin flora and consequently part of human
flora. Although S. epidermidis is not usually pathogenic,
patients with compromised immune systems are often at risk
for developing acne.
The initial step in the development of acne is the formation of
the microcomedo.Follicular keratinocytes that exhibit increas-
ed cohesiveness do not shed normally, leading to retention
and accumulation.
Androgens stimulate enlargement of sebaceous glands and
increased sebum production, and the abnormal keratinaceo-
us material and sebum collect in the microcomedo.
This leads to a build-up of pressure, and whorled lamellar
concretions develop. At this stage, a non-inflammatory
comedo may be seen clinically.
This micro-environment allows the proliferation of bacterium,
which is part of the normal flora of follicles. This gram-positive
rod has low virulence but is capable of metabolising
triglycerides and releasing free fatty acids.This metabolism,
as well as its ability to activate complement, produces pro-
inflammatory mediators, including neutrophil chemo-
attractants.
With increased pressure and recruitment of inflammatory
mediators, the microcomedo may rupture and release
immunogenic keratin and sebum, thus stimulating an even
greater inflammatory response
Depending on the specific inflammatory cells present,suppur-
ative pustules or inflamed papules, nodules, or cysts may
develop. If a sufficient amount of inflammation and tissue
damage results, post-inflammatory hyperpigmentation and
scarring may result.
Closed comedone (whitehead) - a clogged follicle.
Whiteheads usually appear on the skin as small, round, white
bumps.
Open comedone (blackhead) - a plugged follicle that opens
and turns dark at the surface of the skin. Blackheads do not
indicate the presence of dirt.
Papules - inflamed lesions that appear as small, pink bumps
on the skin.
Pustules (pimples) - inflamed pus filled lesions that are red at
the base.
Cvsts and nodules - large, inflamed, pus filled lesions deep
under the skin that can cause pain and scarring.
Local symptoms :
include pain
tenderness.
Systemic symptoms:
most often absent
Severe acne with associated systemic signs and symptoms
such as Fever, Psychological impact on any patient
The goals of pharmacotherapy for acne vulgaris are to reduce
morbidity and to prevent complications.
Medication: Benzoyl Peroxide Antibiotics,Topical and Oral
retinoids
Benzoyl Peroxide :
Benzoyl peroxide is a first-line treatment for mild and
moderate acne vulgaris due to its effectiveness and mild side-
Topical and systemic antibiotics used in the treatment of
acne vulgaris are directed at Propionibacterium acnes.
They also have anti-inflammatory properties.
Minocycline
Doxycycline
Tetracycline
Retinoids
These agents decrease the cohesiveness of abnormal hyperproliferative
keratinocytes, and they may reduce the potential for malignant degene-
ration. They also modulate keratinocyte differentiation.
isotretinoin
Tretinoin topical
Adapalene
Tazarotene
Alternative treatments
Phototherapy with blue and red light emitted from special
fluorescent lights, LEDs, lasers, or dichroic bulbs.
Photodynamic therapy involving intense blue or violet light,
zinc, teat tree oil, heat therapy, salt water therapy are all
used for treating acne.
Prognosis
Acne of any severity usually remits spontaneously by the
early to mid-20s,but a substantial minority of patients,
usually women, may have acne into their 40s.
characterized by:
■ abnormalities in sebum production
■ follicular desquamation
■ bacterial proliferation
■ inflammation
Acne vulgaris is the most common cutaneous disorder.
It affects more than 17 million Americans.
Patients can experience significant psychological morbidity
and, rarely, mortality due to suicide.
Important that physicians are familiar with Acne Vulgaris and
its treatment.
affects all races and ethnicities with equal significance.
Darker skinned patients at increased risk for developing
post-inflammatory hyper-pigmentation and keloids.
Acne is polygenic and multi-factorial. Four main pathogenetic
factors contribute to the disease:
Propionibacterium acnes and Staphylococcus epidermidis
colonisation. :
bacteria found deep in follicles and stimulate the production
of pro-inflammatory mediators and lipases.
Inflammation and immune response. Inflammatory cells and
mediators efflux into the disrupted follicle, leading to the
development of papules, pustules, nodules, and cysts.
Sebaceous gland hyperplasia and excess sebum production.
Abnormal follicular differentiation.
Propionibacterium Acn
Propionibacterium acne is a gram-positive, non-motil rods relatively
slow growing typically aerotolerant anaerobic gram positive bacterium
S. epidermidis is a very hardy microorganism, consisting of
nonmotile, Gram-positive cocci, arranged in grape-like clust-
ers.is part of human skin flora and consequently part of human
flora. Although S. epidermidis is not usually pathogenic,
patients with compromised immune systems are often at risk
for developing acne.
The initial step in the development of acne is the formation of
the microcomedo.Follicular keratinocytes that exhibit increas-
ed cohesiveness do not shed normally, leading to retention
and accumulation.
Androgens stimulate enlargement of sebaceous glands and
increased sebum production, and the abnormal keratinaceo-
us material and sebum collect in the microcomedo.
This leads to a build-up of pressure, and whorled lamellar
concretions develop. At this stage, a non-inflammatory
comedo may be seen clinically.
This micro-environment allows the proliferation of bacterium,
which is part of the normal flora of follicles. This gram-positive
rod has low virulence but is capable of metabolising
triglycerides and releasing free fatty acids.This metabolism,
as well as its ability to activate complement, produces pro-
inflammatory mediators, including neutrophil chemo-
attractants.
With increased pressure and recruitment of inflammatory
mediators, the microcomedo may rupture and release
immunogenic keratin and sebum, thus stimulating an even
greater inflammatory response
Depending on the specific inflammatory cells present,suppur-
ative pustules or inflamed papules, nodules, or cysts may
develop. If a sufficient amount of inflammation and tissue
damage results, post-inflammatory hyperpigmentation and
scarring may result.
Closed comedone (whitehead) - a clogged follicle.
Whiteheads usually appear on the skin as small, round, white
bumps.
Open comedone (blackhead) - a plugged follicle that opens
and turns dark at the surface of the skin. Blackheads do not
indicate the presence of dirt.
Papules - inflamed lesions that appear as small, pink bumps
on the skin.
Pustules (pimples) - inflamed pus filled lesions that are red at
the base.
Cvsts and nodules - large, inflamed, pus filled lesions deep
under the skin that can cause pain and scarring.
Local symptoms :
include pain
tenderness.
Systemic symptoms:
most often absent
Severe acne with associated systemic signs and symptoms
such as Fever, Psychological impact on any patient
The goals of pharmacotherapy for acne vulgaris are to reduce
morbidity and to prevent complications.
Medication: Benzoyl Peroxide Antibiotics,Topical and Oral
retinoids
Benzoyl Peroxide :
Benzoyl peroxide is a first-line treatment for mild and
moderate acne vulgaris due to its effectiveness and mild side-
Topical and systemic antibiotics used in the treatment of
acne vulgaris are directed at Propionibacterium acnes.
They also have anti-inflammatory properties.
Minocycline
Doxycycline
Tetracycline
Retinoids
These agents decrease the cohesiveness of abnormal hyperproliferative
keratinocytes, and they may reduce the potential for malignant degene-
ration. They also modulate keratinocyte differentiation.
isotretinoin
Tretinoin topical
Adapalene
Tazarotene
Alternative treatments
Phototherapy with blue and red light emitted from special
fluorescent lights, LEDs, lasers, or dichroic bulbs.
Photodynamic therapy involving intense blue or violet light,
zinc, teat tree oil, heat therapy, salt water therapy are all
used for treating acne.
Prognosis
Acne of any severity usually remits spontaneously by the
early to mid-20s,but a substantial minority of patients,
usually women, may have acne into their 40s.
Friday, August 12, 2016
Hereditary Breast and Ovarian Cancer Syndrome Fact Sheet for Healthcare Professionals
Hereditary Breast and Ovarian Cancer (HBOC) syndrome is associated with an
increased risk for breast, ovarian, and other cancers. HBOC is usually caused
by mutations in the BRCA1 and BRCA2 genes. BRCA mutations are responsible for approximately 3% of all breast
cancers and 10% of all ovarian cancers. Identification of individuals with BRCA mutationsis important to allow them
to take advantage of interventions that can significantly reduce their risk of
cancerandallow for early detection of cancer if it develops.
Cancer Risks Associated with BRCA1 and BRCA2 Mutations:
·
45-65% risk ofbreast cancer by age 70 for women with BRCA1orBRCA2 mutations, compared with a 12-13% risk for women in the
general population.
·
10-39% risk of ovarian cancer by age 70 for women with BRCA1orBRCA2mutations, compared witha 1-2% risk for women in the general
population
·
Increased risk for tubal, peritoneal, prostate, pancreatic, and
male breast cancers
·
Increased risk for early onset breast or ovarian cancer (before age
50)
Individuals Are More Likely to Have a BRCA1orBRCA2 Mutation if They Havea Personal or Family HealthHistory of
Any of the Following:
·
Breast cancer diagnosed at age 50 or younger in women
·
Triple negative breast cancer diagnosed at age 60 or younger in
women
·
Epithelial ovarian, fallopian tube, or primary peritoneal cancer
·
Two diagnoses of breast cancer or two types of BRCA-related cancer in the same person
·
Breast cancer at any age in men
·
Pancreatic cancer or prostate cancer with Gleason score =7
·
Breast, ovarian, pancreatic, or prostate cancer among multiple
blood relatives
·
Ashkenazi (Eastern European) Jewish ancestry
·
A known BRCA1 or BRCA2mutation in the family
Evidence-Based Clinical Recommendations for
Identifying Patients at Risk Because of Family Health History Who Should Be
Referred for Genetic Services
Recommendation for BRCA
Mutation Testing for Breast and Ovarian Cancer Susceptibility from the U.S.
Preventive Services Task Force (USPSTF) (2014)1
The
USPSTF recommends that primary care providers screen women who have family
members with breast, ovarian, tubal, or peritoneal cancer with one of several
screening tools designed to identify a family history that may be associated
with an increased risk for potentially harmful mutations in breast cancer
susceptibility genes (BRCA1 or BRCA2). These tools include the Ontario
Family History Assessment Tool, Manchester Scoring System, Referral Screening
Tool, Pedigree Assessment Tool and the FHS-7. Women with positive screening
results should receive genetic counseling and, if indicated after counseling, BRCA testing.It is important to note
that the screening results from different tools might not be consistent,because
the criteria and algorithms used vary among tools. Furthermore, some
individuals withBRCA1 or BRCA2 mutations might not be identified
using these tools.
Other recommendations
Recommendations
from the National Comprehensive Cancer Network (NCCN) and the American College
of Medical Genetics and Genomics (ACMG)/National Society of Genetic Counselors
(NSGC) include specific personal and family health history referral criteria
for BRCA genetics counseling and
testing.
Genetic Counselingand Testing for HBOC
Insurance Coverage
The
Centers for Medicare and Medicaid Services (CMS) Local Coverage Determination
(LCD) on BRCA1 and BRCA2 Genetic Testing allows for regional
coverage of BRCA genetic counseling and
testing for individuals with personal histories of breast, ovarian, and other
cancers that fit specificcriteria for increased risk for a BRCA mutation.The Recommendation for BRCA Mutation Testing for Breast and Ovarian Cancer Susceptibility
from the U.S. Preventive Services Task Force (USPSTF) (2014)1addressesBRCA genetic counseling and testing in
women who have a family health history of breast, ovarian, tubal, or peritoneal
cancer but have not had these cancers themselves.The Affordable Care Act
requires non-grandfathered health plans to cover without cost sharing preventive
services with a USPSTF rating of “B” or higher, which includes the BRCA testing recommendation.
Importantly, genetic counseling, if appropriate, is covered without cost
sharing by many health plans under the Affordable Care Act when used in
accordance with the USPSTF recommendation. And, the U.S. Department of Health
and Human Services has advised insurance companies to also cover the BRCA test without cost sharing when used
in accordance with the USPSTF recommendation.
Genetic Counseling
Genetic
counseling helps individuals better understand their risk for hereditary cancer
so that they can make informed decisions about genetic testing and follow-up
care by:
·
Reviewing an individual’s personal and family medical history
·
Determining which family member is most appropriate for initial
genetic testing in a family
·
Reviewing risk for HBOC and the chance of finding a mutation through
genetic testing
·
Interpreting genetic test results and explaining what they mean for
individuals and their relatives
·
Outlining medical management implications of a positive or a
negative test result
·
Providing referrals to medical specialists, support resources, and
research opportunities
·
Addressing concerns about the privacy and confidentiality of
personal geneticinformation
Benefits and Risks of Genetic Testing
·
Individuals with a positive test result
can take steps to reduce their cancer risk through prophylactic surgery, medications
that can prevent the onset of cancer, and/or earlier, more frequent screening
·
Genetic testing may provide a patient’s relatives
with useful information, including which mutation relatives should be tested
for.
·
A negative test result may provide a
sense of relief and will help the patient avoid unneeded screens, medications,
or surgeries.
·
Although the benefits of genetic testing
are thought to greatly outweigh the disadvantages, test results may affect a
person’s emotions, family relationships, finances, privacy,and medical choices.
·
Genetic information cannot be used to
deny someone health coverage or employment, because of a federal law called the
Genetic Information Nondiscrimination Act of 2008 (GINA). However, this law
does not cover life, disability and long-term care insurance, and only applies
to asymptomatic individuals (not
those with a personal history of HBOC-related cancer).
·
Medical treatments, such as prophylactic
surgery, are not without risk and could have serious, long‐term implications.
Medical Management of Patients with HBOC
Several management options exist but the
strength of evidence varies across types of interventions
Interventions
noted by USPSTF1 that may
reduce risk include:
·
Bilateral mastectomy results in an 85-100% reduction in breast cancer
risk
·
Oophorectomy or bilateral salpingo-oophorectomy results in a 69-100%
reduction in ovarian cancer risk and a 37-100%
reduction in breast cancer risk
·
Chemoprevention with tamoxifen or raloxifene
·
Earlier, more frequent, or more intensive cancer screening
·
In addition,
NCCN recommendations include2:
- Increased breast surveillance through yearly MRI or mammogram starting at age 25
- Clinical breast examstwice per year starting at age 25
- Pelvic exam, trans-vaginal ultrasound, and/or CA-125 every 6 months starting at age 30 years or 5-10 years before earliest age of first diagnosis of ovarian cancer in the family (not determined to decrease morbidity or mortality)
References
1.
U.S. Preventive Services Task Force. Risk Assessment, Genetic
Counseling, and Genetic Testing for BRCA-Related Cancer in Women: U.S.
Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2014;
160:271-281.
2.
National Comprehensive Cancer Network. NCCN Guidelines Version
2.2014 Genetics/Familial High-Risk Assessment: Breast and Ovarian. HBOC-A.
What is kidney cancer?
Kidney cancer occurs when abnormal cells within one
kidney grow in an uncontrolled way.
There are two kidneys in the body, located on either
side of the spine above the waist. Each kidney contains very small tubes,
called tubules, which filter and clean the blood. Waste products removed from
the blood form urine, which is taken from each kidney to the bladder through a
tube called a ureter. The bladder stores urine until it is released from the
body through the urethra.1
What are the different types of kidney cancer?
There are two main types of kidney cancer. These are
named after the cell type in which the cancer first develops.
·
The
most common type of kidney cancer starts in the lining of the tubules in the
kidney. This is called renal adenocarcinoma.1,2 Approximately 85 per
cent of cases of kidney cancer start in the lining of the tubules.2
·
Transitional
cell carcinoma of the renal pelvis or ureter starts in cells lining the renal
pelvis of the kidney or the ureter.3
What are the symptoms of kidney cancer?
There are often no symptoms of kidney cancer until the
late stages of the disease.4
The most common symptoms of kidney cancer are:
·
blood
in the urine - this is called haematuria4
·
a
lump in the abdomen1,4
·
pain
in the side that does not go away4
·
loss
of appetite
·
unexplained
weight loss
·
anaemia.
There are a number of conditions that may cause these
symptoms, not just kidney cancer. If any of these symptoms are experienced, it
is important that they are discussed with a doctor.
What are the risk factors for kidney cancer?
A risk factor is any factor that is associated with an
increased chance of developing a particular health condition such as kidney
cancer. There are different types of risk factors, some of which can be
modified and some which cannot.
It should be noted that having one or more risk
factors does not mean a person will develop kidney cancer. Many people have at
least one risk factor but will never develop kidney cancer, while others with
kidney cancer may have had no known risk factors. Even if a person with kidney
cancer has a risk factor, it is usually hard to know how much that risk factor
contributed to the development of their disease.
While the causes of kidney cancer are not fully
understood, there are a number of factors associated with the risk of
developing the disease. These factors include:
·
tobacco
smoking1,4,5
·
obesity4,5
·
high-blood
pressure - this is called hypertension4,5
·
long-term
use of certain pain medications1,4,5
·
having
certain genetic conditions such as von Hippel-Lindau (VHL) syndrome or
hereditary papillary renal cell carcinoma.1,4
How is kidney cancer diagnosed?
A number of tests will be performed to investigate
symptoms of kidney cancer and confirm a diagnosis. Some of the more common
tests include:4
·
a
physical examination
·
examination
of a blood sample
·
examination
of a urine sample
·
imaging
of the kidney and nearby organs, which may include ultrasound, X-ray, computed
tomography (CT) scans or magnetic resonance imaging (MRI)
·
taking
a sample of tissue (biopsy) from the affected kidney wall for examination under
a microscope.
Treatment options
Treatment and care of people with cancer is usually
provided by a team of health professionals - called a multidisciplinary team.
Treatment for kidney cancer depends on the stage of
the disease, the severity of symptoms and the person's general health.
Treatment options can include surgery to remove part or all of the affected
kidney, and radiotherapy, chemotherapy, or targeted therapies to destroy cancer
cells.
Research is ongoing to find new ways to diagnose and
treat different types of cancer. Some people may be offered the option of
participation in a clinical trial to test new ways of treating kidney cancer.
Finding support
People often feel overwhelmed, scared, anxious and
upset after a diagnosis of cancer. These are all normal feelings.
Having practical and emotional support during and
after diagnosis and treatment for cancer is very important. Support may be
available from family and friends, health professionals or special support
services.
In addition, State and Territory Cancer Councils
provide general information about cancer as well as information on local
resources and relevant support groups.
The Cancer Council Helpline can be accessed from
anywhere in Australia by calling 13 11 20 for the cost of a local call.
More information about finding support can be found on
the Cancer Australia website www.canceraustralia.gov.au
References
1. National Cancer Institute. Renal cell cancer
treatment (PDQ) - patient version.Available from http://www.cancer.gov/cancertopics/pdq/treatment/renalcell/Patient.[Accessed July 2012].
2. National Cancer Institute. Renal cell cancer
treatment (PDQ) - health professional version.Available from http://www.cancer.gov/cancertopics/pdq/treatment/renalcell/HealthProfessional/page2.[Accessed
July 2012].
3. National Cancer Institute. Transitional cell cancer
of the renal pelvis and ureter treatment (PDQ) - patient version.Available from
http://www.cancer.gov/cancertopics/pdq/treatment/transitionalcell/Patient.[Accessed
July 2012].
4. Ljungberg B, Cowan NC, Hanbury DC et al. EAU
Guidelines of Renal Cell Carcinoma: The 2010 update. European Urology 2010; 58:
398-406.
5. National Institute for Clinical Excellence.
Guidance on Cancer Services Improving Outcomes in Urological Cancers. London:
2002.
Subscribe to:
Comments (Atom)