Author Archives: Dr. Vaidya Karanvir Singh

Periorificial dermatitis is an inflammatory rash involving the skin around the mouth and nose.

The rash may be spread  up to the nose or even the eyes.

Perioral dermatitis usually looks as red or scaly bumpy rash. There may be a clear fluid discharge. Slight itching and burning can also occur.

The condition is most common in women, but it can be seen in all ages, races, and ethnicities. It can occur in children of any age.

Perioral dermatitis may be disaapear without proper treatment, but it may reappear after sometime.

CAUSE

The cause of perioral dermatitis is unknown.   Some other causes of perioral dermatitis include:

bacteria getting into the hair follicles

• an allergic reaction
• irritation resulting due to a using skin care product 
• hormonal changes
• taking a birth control pill
• strong winds
• UV light

SYMPTOMS

• Bumps (1-2 mm)
• Red
• Pus-filled
• Dry patches
• Mild scaling (in some cases)
• Pruritus (in some cases)
• Mild stinging & burning

TYPES

Common forms of eyelid dermatitis include:

• Allergic contact dermatitis develops because of an allergic reaction that causes inflammation of the skin, such as pollen in a person with hay fever. Some cosmetic products  are common causes of allergic skin reactions.
• Irritant contact dermatitis is caused by the eyelid coming into direct contact with a substance that damages the outer layer of the skin, such as certain types of makeup, soaps, and detergents.
• Atopic dermatitis is a form of eczema that can affect the eyelids.
• Seborrheic dermatitis it is a condition in which  the skin to become inflamed and flakey also whitish in color. It also occurs on the scalp but can also affect oily areas of skin, such as the eyelids.
• RISK FACTOR:- The skin around the eyes is thin and delicate, and so the eyes are especially sensitive to irritation.
• While it is hard to predict who will develop eyelid dermatitis, certain factors may increase the likelihood of the condition developing. These include:
• Age. Childerns are more prone to certain types of dermatitis  such as seborrheic dermatitis, also called cradle cap.
• Genetics. Skin conditions often run in families.
• Poor personal hygiene. If body is not clean it can lead to this condition.
• Certain professions. These include  frequent exposure to disease causing agent , such as construction, envoirmental , cosmetic, and beauty workers.
• Certain medications. Some medicine like neomycin or beta-blockers can cause the dermatitis.

COMPLICATION

Some complications that may occur with eyelid dermatitis include:

• Skin infections. Scratching or rubbing the eyes can lead the skin  infections.
• Difficulty sleeping. If eyelid get infected it can cause discomfort during sleeping.
• Other skin conditions. In case of eyelid dermatitis to occur before skin inflammation on other areas of the body.
• Neurodermatitis.  Chronic scratching can cause the skin to become discolored and leathery
• Medical conditions. Some disease are more prone to dermatitis like Hay fever, asthma or other skin conditions.

DIAGNOSIS

It is possible to self-diagnose eyelid dermatitis if the cause is obvious. 

• A doctor can often diagnose the form of dermatitis through a physical examination. 
• When an allergic reaction is suspected as the cause, a doctor may perscribed a patch test. 
• The doctor or dermatologist may also perform a skin culture test to find out the possible infection
• If an irritant is the suspected cause, a repeated open application test( ROAT) can be used.
• It can be more difficult to determine a specific irritant compared with an allergen.

PREVENTION

It may not be possible to prevent all cases but  you should follow all these steps. 

• The best prevention is avoid the use of any steroids around your mouth.  
• Washing your skin daily with good quality cleansers can help keep your skin free of irritants and acne. 
• Light moisturizers can also stop your skin from drying out and roughned.

AYURVEDIC VIEW FOR THE CAUSE OF  PERIORIFICAL DERMATITIS

According to ayurveda dermatitis result due to it wrong diet and lifestyle, which disturbs the digestion and trigger pitta dosha. Pitta menifests in the skin and causes the heating, toxins known as Ama get accumulated and then these toxins accumulate in body tissues ,infecting them at a deep level and causing dermatitis.

AYURVEDIC HERBS USED IN PERIORIFICIAL DERMATITIS

• Nirgundi
• Turmeric
• Aloevera
• Manjishtha
• Neem
• Gandhak Rasayan
• Guduchi
• Triphala

AYURVEDIC  TREATMENT FOR PERIORIFICIAL DERMATITIS

According to ayurveda each person has three energies and called in ayurveda is dosha. These doshas include vata, pitta, and kapha energies. Each dosha controls specific bodily functions. According to Ayurvedic medicine, the doshas should be in balance and to maintain good health.  Thus, the aim of Ayurveda is to balance them by natural treatments. It also aims to purify the body, which is said to remove toxins of the body. In case of skin disease the ayurvedic treatment include combination of therapies and medications. During this treatment patient will also need to make  some dietary changes depending on the Dosha . Medications help in reducing the skin irritation, reducing itching, and remove the root cause of the problem.During the treatment patient has need to change in diet and lifestyle. In Panchakarma treatment procedure  like lepam (face packs with medicinal herbs), dhoopanam(medicated fumigation), and . Medications help in reducing the skin irritation, reducing itching, and remove the root cause of the problem.During the treatment patient has need to change in diet and lifestyle. In Panchakarma treatment procedure  like lepam (face packs with medicinal herbs), dhoopanam(medicated fumigation), and udhwarthanam(massage with dry herbal powders), Virechana, Dhara, Snehana, etc. are used as per the patient’s condition. It is concluded that a panchkarma treatment is very useful in all skin disorder.

• Plaque psoriasis is a chronic autoimmune condition. It appears on the skin is thick patches and reddish scaly skin.
• Plaques typically appear  red patches covered with a silvery white  scale. 
• In this the plaques may appear darker and thicker and more of a purple or grayish color or darker brown.
• Plaques can appear anywhere on the body appear on the knee, elbows, scalp.
• Plaques usually appear symmetrically on  the body.

SYMPTOMS

Common signs and symptoms include:

• Red patches of skin covered with thick, silvery scales
• Small scaling spots (commonly seen in children)
• Dry, cracked skin sometime it may bleed
• Itching, burning or soreness
• Thickened, pitted or ridged nails
• Swollen and stiff joints

CAUSE

Psoriasis has no exact cause. 

• There are multiple proposed risk factors for psoriasis although genetic predisposition is thought to be the main contributor. 
• Environmental and behavioral factors may also play roles . In particular, increased rates of smoking, alcohol, and obesity are typically found among patients with psoriasis. 
• Some medications and infections have also been identified as possible triggering  factors for psoriasis.
• The following have been shown to trigger the development of psoriasis:
• High stress
• Infections (strep throat)
• Medications (malaria drugs, lithium)
• Heavy alcohol consumption
• A severe sunburn
• Reduced immunity
• Psoriasis tends to run in families, but it may be skip generations. 

CLASSIFICATION

The severity of plaque psoriasis is determined based on the amount of the body covered in plaques:

• Mild Psoriasis: Less than 2 percent
• Moderate Psoriasis: 3-10 percent
• Severe Psoriasis: 10 percent or more

DIAGNOSIS

Plaque psoriasis can be identified during a visual examination. 

• As psoriasis has a strong genetic association family history can aid in the diagnosis. 
• You should also obtain your patients medical history and information about their specific sympt 

RISK FACTORS

These factors can increase your risk:

• Family history. The condition runs in families. If psoriasis occurs in one parent then increases the risk of getting the disease. 
• Stress. If patient suffer from stress it impact  immune system, high stress levels may increase  risk of psoriasis.
• Smoking. Smoking can increases  risk of psoriasis but also may increase the severity of the disease. Smoking  also play a  key-role in the occurance of the disease.

HOW PLAQUE PSORIASIS ASSESED

Patients with chronic plaque psoriasis should be assessed by a dermatologist. Factors  may include the following:

• Age of onset of psoriasis
• Current age and sex
• Sites affected by psoriasis
• Symptoms (itch, soreness)
• The classification of psoriasis (localised or generalised, large plaque or small plaque)
• Extent and severity of psoriasis (often by PASI scoring)
• Functional impairment or disability due to skin disease (often using DLQI or Dermatology Life Quality Index scoring)
• Health problems including blood pressure, weight and body mass index .
• Smoking status and alcohol also play major role
• Current medications for psoriasis and other conditions
• Previous treatments and their effect
• Skin phototype
• Suitability of systemic therapy.

DIFFERENTIAL DIAGNOSIS

• LICHEN PLANUS
• BROWN DISEASE
• ERYTHEMA ANNULARE
• PARAPSORIASIS
• PITYRIASIS ROSEA 
• SEBORRHEIC DERMATITIS

TAKE CARE OF SKIN

•  A good moisturizer can keep plaques soft and make you less itchy.
•  Avoid harsh soaps.
• Use CAC Twak Tail for softens the plaque.
• Uses aloevera gel twice or thrice  a day.
• Apply medicated lotion,cream or ointment.
• Try using medicated shampoo for scales on your scalp. Learn about more skin care tips for psoriasis.

 AYURVEDIC VIEW OF PLAQUE PSORIASIS

• Ayurvedic says that psoriasis accur due to an imbalance of dosha and also called energy. These dosha is vata, pitta, kapha.
• Vata is responsible for controlling bodily functions and also help in movement  ,contribute to the dryness and skin scaling of psoriasis. Kapha is responsible for growth and provide the mositure to the body.
• The imbalance between these dosha can lead the skin disease .Ayurvedic treatments  in psoriasis  play a very important role.when apply herbal medication it help to detoxify the skin and remove the toxins.In psoriasis  diet and lifestyle changes also play a major role.

AYURVEDIC HERBS USED IN PLAQUE PSORIASIS

• NEEM
• KESAR
• CHANDAN
• HALDI
• ALOEVERA
• MANJISHTHA
• ELAYACHI

HOME REMEDIES USED IN PLAQUE PSORIASIS

• Use a petroleum jelly or thick mosturizer
• Mosturize the skin daily.
• Consuming a healthy diet high in vegetables.
• Use apple cidar vinegar for scalp.
• Tea – tree oil also apply on affected area.

OTHER ALTERNATIVES THERAPIES

Other home remedies that people have tried include:-

• Accupressure
•  Acupuncture
• Massage
• Yoga

DIET IN PLAQUE PSORIASIS

• Ayurvedic practices typically revolve around a vegetarian diet. 
• Take gluten free diet.
• Avoid dairy product.
• Use  omega-3 fatty acid it help to reduce inflammation.
• Avoid dairy product.
• Take fruits and leafy vegetables in high amount.
• Avoid junk food
• Avoid citrus eatables
• Take proper sunlight
• Foods to avoid include high-carbohydrate ingredients and products that contain large amounts of sugar.
• Avoid excessive salty and spicy food

Pediculosis is an infestation of lice (blood-feeding)Ectoparacitic paracites of the order Phthiraptera. The crawlling stages of this insect feed on human blood, which might result in severe itching.  Although pediculosis in humans may properly visit to lice infestation of any a part of the body, the term is typically used loosely to refer to  pediculosis capitis. Head lice are usually located on the scalp, ears and neck .

CLASSIFICATION

Pediculosis is divided into the following types-

• Pediculosis capitis (Head lice infestation)
• Pediculosis corporis (Pediculosis vestimenti, Vagabond’s disease)
• Pediculosis pubis (Crabs)

CLINICAL PRESENTATION

Persons with pediculosis typically present with pruritus. Pruritus related to lice could be a delayed hypersensitivity reaction. It may take two to six weeks to develop after the primary exposure, with future episodes leading to pruritus within 1 to 2 days of exposure. Intense itching leads to scratching, infection and secondary cellulitis. In longstanding infestation, the skin may become whitish and hyperpigmented, particularly on the trunk.  Pubic lice  Can cause  other sexually transmitted infections.

CAUSE-   Head lice can easily be caused by active infestation from another person with head lice. In case of children they ‘re affected as they  come in contact while playing or at school. Pediculosis capitis may also be caused by indirect infestation through: Brushes and combs.

SYMPTOMS

Common symptoms are-

• Itching. The quite common symptom of a lice infestation is itching on the neck,scalp and ears. This is often an hypersenstivity reaction to louse bites. 
• Lice on scalp. Lice may be visible but are difficult to identify because they’re very small, avoid light and move very fast.
• Sores on the scalp, neck and shoulders. Due to scratching can lead to small, red bumps many time  they get infected with bacteria.

DIAGNOSE

To diagnose infestation, the whole scalp should be combed thoroughly with a louse comb and also the teeth of the comb should be examined for the presence of living lice after every time the comb passes by  hair. The use of a louse comb is the most easiest way to find living lice.

The most characteristic symptom of infestation is itching on the head which normally high in to 3 to 4 weeks . The bite of lice is very small and it can be rarely seen between the hairs. On the infested areas if do excessive scratching can cause blister, which may become dangerous.

RISK FACTOR

Anyone who comes in close contact of head-to-head contact with someone who already has head lice is at greatest risk.

– Head lice also acquired from contact like hats, scarves, and coats, towels, brushes, combs, hair bands, bad sheet, pillows, blankets that belong to an infected person.Lice infestation are not related to hygiene either personal and enviormental.

HERBS USED IN PEDICULOSIS

Reetha, Neem, Dhatura, Lashun.

AYURVEDIC TREATMENT

Ayurveda has super effective remedy to deal with head lice that works very well and give fast

• Application of the paste of bitter almonds is also good if you are unable to procure the Indian hemp.
• The ointment made of the powder of the bark of Celastrus paniculata (Malakanguni) with mustard oil is another good remedy for head lice.
• Apply the paste made of the finely powdered seeds of custard apple (Seetaa-phal) with water at bedtime and cover the head with a cloth. During applying this paste save the eyes.
• Soak the hair well with tobacco paste and canopy with a cloth for two to three hours. Then wash the hair with shampu. 
• Phitkari is the non-herbal ayurvedic remedy for lice. phitkari is one of the most commomly used in head lice.

If the primary application of the louse killing agent is properly done, then destroys all the live bugs but does not kill all of the eggs . It is usual to determines small lice the day after treatment. It means that new ones have hatched out. That is why a second treatment, 7-10 days after the primary to destroy all the new lice that have hatched out since the first treatment and to kill them before they grow old enough to lay nits, is important.

PREVENTION

Using machines to wash and dry bedding, clothing, and other fabrics that a person with lice has used in the 2 days before treatment.

• Soaking combs, brushes, and other hair care items in hot water for 5–10 minutes.
• Vacuuming the furniture, floor, and other surfaces that will contain lice and their eggs.
• Avoiding sharing brushes or combs.
• Discouraging children from twiddling with one +-another’s hair, sharing pillowcases, or rubbing their heads together, especially if there has been a recent lice outbreak at their school.

SUMMARY

Lice are highly contagious, and anyone can get them. 

Lice are not typically dangerous, but if it’s not taking seriously it will be dangerous.

A doctor or another health expert can help to guide treatments . An individual with a weak immune system, a history of significant skin reactions, or previous experience with treatment-resistant lice should counsult to a doctor before treating a lice infestation.