Author Archives: Dr. Vaidya Karanvir Singh

What is granuloma annulare?

• Granuloma annulare is a skin disorder that is mostly seen in children and young adults. This is a benign skin condition 
• Granuloma annulare is a  chronic (long-lasting) skin condition  in which there is inflammation in the skin occur and  causes a raised, discolored rash or lumps under the skin. 
• In most cases, rashes appear on the hands, feet and forearms.

Who develops granuloma annulare?

• It can affect people of all ages. The more prevalence of granuloma annulare is seen in children and young adults, although it can affect people of all ages. Women are affected more often than men.

What are the types of granuloma annulare?

There are five main types that are noticed among individuals.  In some patients, more than one type of granuloma annulare can be present at the same time.

• Localized granuloma annulare: This is the most common form of granuloma annulare which is noticed in people. A circular rash appears on the skin in localized granuloma annulare that may begin as small circles that later merge together. Sometimes several small bumps are noticed on the skin before developing a rash. The areas are usually discolored. 
• Generalized granuloma annulare:  In this condition, occurrence of bumps is seen over a larger area, like the whole forearm, instead of in a smaller and rash is more concentrated. The bumps join to cover large area and cause discoloration.
• Subcutaneous granuloma annulare: In This type of granuloma annulare lump formation occur under the skin. The lumps are commonly firm and round and not painful in nature. Lumps are usually small in these cases, lumps but they grow quickly. 
• Perforating granuloma annulare: In this Painful, scaly, small bumps seen on the hands and fingers. In some cases, itchy or painful bumps are seen and they leak fluid. 
• Patch granuloma annulare: In this condition Red colored, reddish-brown, or purple flat patches of rash form on the skin. 

SYMPTOMS AND CAUSES

Causes for granuloma annulare

The exact cause of granuloma annulare is not known yet. However immune system may play a role in the development of this condition. There are some factors that can trigger the condition these include-

• Skin injuries  like insect bites or trauma
• Certain medications, like allopurinol can also play a role in cuasing this condition.
• Some immune-compromised conditions like human immunodeficiency virus (HIV) and hepatitis C.
• Environmental trigger factors also contribute to this skin condition of granuloma annulare  for eg. Exposure to the sunlight for a long time.

What are the symptoms of granuloma annulare?

 Most commonly rash, lumps are noticed in people .Type, pattern of rash and lumps depends upon the type of the granuloma annulare . Sometime inflammation, pain and itching is also noticed among individuals. 

 DIAGNOSIS OF GRANULOMA ANNULARE

• Diagnosis of granuloma annulare is made by taking proper medical history of patient and by doing visual examination of the skin. 
• A dermatologist will help to diagnose the type of rashes, lesions or damage of any other part .Medical history may hold clues to support the diagnosis.
• Skin biopsy may be helpful to confirm the diagnosis and rule out the other skin conditions.

MANAGEMENT AND TREATMENT

• In most of the cases, granuloma annulare goes away on its own without any treatment. The condition usually disappears completely within two years. In some cases reoccurrence is seen.
• In severe cases of granuloma annulare which affect the large areas of rash on your skin, or deep, large lumps under your skin then treatment is necessary. 
• The purpose of treatment is to help control the severity of the condition and to control the itching or pain. 
• Medications: Certain drugs are helpful to treat the inflammation. Medications like strong corticosteroids, isotretinoin , or tacrolimus are effectively used to treat the condition . Medications can be used for local application i.e. applied directly to your skin or can be given as an injection. Drugs that are used to treat malaria help to reduce the occurrence of rashes on your skin.
• PUVA therapy: In this therapy, a drug named psoralen, that can be taken orally or can be given as a bath or soak after that exposure to UVA light is done. Psoralen makes your skin more sensitive to light. UV light help to slow down the growth of skin cells, which stop the further growth of granuloma annulare . PUVA therapy is also known as photo chemotherapy.
• Cryotherapy: In this therapy, affected portion of the skin is freeze by using specialized equipment. This treatment tries to stop the skin patches from continuing to grow.
• Laser therapy:  A special laser is used to target and to heat the skin. This is helpful to decrease inflammation in the skin and prevent further complications.

AYURVEDIC TREATMENT OF GRANULOMA ANNULARE

• Chandigarh Ayurved centre provides effective Ayurvedic  treatment for granuloma annulare  . CAC provides combination of medications that are very effective to treat this kind of skin condition.

Description of medications

1. Detox Premium Powder

The powder is very beneficial to cure any kind of body pain as it removes excess toxins from the body and balances the aggravated pitta and vata dosha. The ingredients help in reducing swelling, redness, shrinkage of tear lining in the anus, burning sensation, etc.

2. Blood Purifier Syrup:

The herbal syrup is prepared from herbs like Khadir Chall (Acacia catechu), Manjistha (Rubia cordifolia), Neem (Azadirachta indica) etc. that acts as a natural blood purifier. This herbal syrup reduces redness, itchiness, swelling on the skin.

3. Panchtikat Ghrit Guggul:

This herbal preparation contain ingredients like Neem (Azadirachta indica), Patola (Trichosanthes dioica), Guduchi (Tinospora cordifolia), Vasa (Adhatoda vasica), Patha (Cissampelos pariera), Vidanga (Embelia ribes), etc that relieves all skin diseases. It balances Pitta & Kapha dosha in the body.

4. Twak churna:

Twak Churna balances all the three doshas of your body.  It help reduce Pigmentation of skin, MELASMA over face and Acne along with Urticaria, Cellulites and all kinds of Dermatitis. It contain ingredients like Yashtimadhu and Manjishtha that possess antioxidant, anti-fungal, anti-bacterial and anti-inflammatory properties.

5. Skin Care tablet:

Skin care tablet is herbo mineral and purely ayurvedic formulation. Skin care is a blood purifying tablet. It cools and detoxifies the blood, removes stagnant blood and dissolves obstructions in the blood flow that further increase blood circulation of the skin.

6. Twak Tailam

TWAK TAILAM is the herbal oil and is purely Ayurvedic preparation. CAC Twak Tailam provides relief from various skin problems such as pimples, blemishes, scars, ulcers, wounds, skin rashes, dry patches, itching, skin irritation, reduces redness, etc. It is composed of natural herbs that pacifies all three doshas and provides healthy skin. Twak tailam supports skin health, helps in reducing uneven pigments, delays the process of ageing, improves complexion, and helps in deep detoxification, blood purification without any side effects.

Gout is a type of arthritis in which crystals of sodium urate produced by the body can form inside the joints. Its most common symptom is sudden and severe joint pain accompanied by swelling and redness. It usually affects the big toe, but it can develop in any joint.

Symptoms can rapidly get worse over 6–24 hours and usually last 3–10 days (sometimes referred to as a gout attack). After this time, the joint will start to feel normal again and any pain or discomfort will eventually disappear completely.

Most people with gout develop further symptoms of gout in the future.

What causes gout?

Gout is caused by the accumulation of uric acid in the blood. Uric acid is a waste product that builds up in the body every day and is mainly excreted by the kidneys. It is made when the body breaks down chemicals in cells called purines.

If you produce too much uric acid or you excrete too little uric acid when you urinate, it tends to build up and small crystals can form in and around the joints.

These hard, needle-shaped crystals form slowly over many years. You wouldn’t even know it was happening.

Crystals can cause the following two problems:

Some crystals can spread on the soft lining (synovium) of the joints, which causes the pain and swelling associated with gout.

Some crystals clump together to form hard and slowly growing tophi that can gradually damage joints and nearby bone; This eventually leads to irreversible damage to the joints that causes pain and stiffness when the joints are used.

Factors that increase the risk of gout include:

Age and gender: Gout is more common as you get older and is three to four times more common in men.

• Being overweight or obese
• Having high blood pressure or diabetes
• Having gout in close relatives (gout is often familial)
• Having long-term kidney problems that reduce the elimination of uric acid
• Eating a diet rich in purines; such as eating sardines and liver frequently
• Drinking a lot of beer or spirits – these types of alcoholic beverages contain relatively high levels of purines

Treating Gout

Preventing future attacks of gout: through a combination of lifestyle changes (such as reducing your weight if you are overweight) and taking a medicine to lower uric acid levels

When medication is taken as directed with recommended lifestyle changes, such as changing your diet and drinking less alcohol, many people are able to lower their uric acid levels sufficiently over time to allow those crystals to dissolve. can cause gout.

Who is affected?

Gout is more common in men than women. This is mainly because the female hormone estrogen, which is released during the female reproductive cycle, lowers a woman’s uric acid levels by increasing the excretion of uric acid through the kidneys.

Symptoms of gout usually appear after the age of 30 in men and after the age of 60 in women. After menopause, uric acid levels rise in women and may also develop gout. The incidence of gout increases with age; It affects 1 in 14 older men and 1 in 35 older women.

Complications

Complications of gout are uncommon, but may include:

• Kidney stones – high levels of uric acid can lead to the development of stones (uric acid and calcium stones) inside the kidney
• Tophus formation – tophi are small hard lumps that are sometimes visible and easily felt under the skin
• Permanent joint damage – due to ongoing joint inflammation between acute attacks, and the formation of tophi within the joint that damages cartilage and bone; This is usually only a risk if gout is left untreated for many years.

The most common symptom of gout is sudden and severe pain in one or more joints; Usually in your big toe. Gout is extremely painful.

Its symptoms often develop at night, although they can arise at any time. Other symptoms include:

• Swelling (swelling) in and around the affected joint
• Red, shiny skin over the affected joint
• As the swelling subsides, a peeling, itchy and flaky skin on the affected joint
• The intense pain caused by gout can make it difficult to walk and move. Even the slightest pressure of a bed cover or blanket can be painful.

 What joints are affected?

Seventy percent of people with gout experience their first attack in the big toe, and most people with gout will experience pain in this joint at some point.

However, while gout is most common in the big toe, it can affect any peripheral joint  and can occur in two or more joints at the same time.

Affected joints may include:

• Midfoot
• Ankles
• Knee
• Fingers
• Wrists
• Elbows

Pattern of symptoms

It is difficult to predict when the attack will take place. Symptoms can develop rapidly over a few hours and usually last for 3-10 days. After this time, the joint will start to feel normal again and any pain or discomfort should eventually disappear completely.

More than half (62%) of all people with gout experience a re-attack within a year. You may experience symptoms every few weeks, months or years, but it is impossible to predict when that condition will recur. Some people experience only a few attacks in their lifetime.

When to seek medical advice

Always see your doctor if you suspect you have gout, especially if it has not been diagnosed before. It is important that a diagnosis be confirmed because sometimes a more serious condition, such as an infected joint, can cause similar symptoms.

You may also need treatment with prescription medication that only your doctor (or specialist) can provide.

When to seek immediate medical advice

If you have a temperature above 38C (100.4F) as well as joint pain and swelling, contact or call your doctor right away because you may have an infection inside the joint (septic arthritis).

Causes

Gout is caused by the accumulation of uric acid in the blood. Uric acid is a waste product that is created when the body breaks down chemicals in cells, known as purines.

Most uric acid is removed from the body through the kidneys. A small amount is excreted through the digestive tract.

Uric acid

Uric acid is usually dissolved in your blood and passes through your kidneys into your urine so that it can pass out of your body.

If you produce too much uric acid or excrete too little uric acid when urinating, it can build up and cause microscopic crystals to form, usually in a joint or surrounding tissue.

Crystals can spread from the cartilage of the joints to the joints where they trigger a reaction from the soft lining (synovium), which produces the intense pain and swelling associated with gout.

Risk factors

Certain things can increase the amount of uric acid in your blood, making you more likely to get gout. These risk factors fall into one of two categories:

Medical conditions known to increase uric acid levels, such as obesity, high blood pressure (hypertension), high lipid levels, and long-lasting obstruction of kidney function

lifestyle factors, such as diet or certain medications you may be taking

These risk factors are discussed in detail below.

Medicine

Certain types of medications can raise your uric acid levels and increase your risk of developing gout. These include:

Diuretics, which are used to treat high blood pressure (hypertension) or abnormal fluid accumulation in your body

niacin, which is used to treat high cholesterol

Gender

Men are more likely to develop gout than women because their uric acid levels rise during puberty. During menopause, women also experience similar increases in uric acid levels. This explains why symptoms start later in women than in men.

Diet

Foods naturally high in purines include:

• Beef
• Pork
• Pork
• Lamb
• Seafood
• Liver
• Kidney
• Alcohol

Alcoholic beverages increase the level of uric acid in the blood by increasing the production of uric acid in the liver and reducing how much of it is excreted in the urine.

Beer and spirits do this more than wine, and beer also contains significant amounts of purines. (Moderate consumption of alcohol—one or two glasses per day—should not significantly increase your risk of gout.

Sugary drinks

Research has shown a possible link between gout and certain sugary beverages.

Specifically, one study found that men who regularly drank sugary soft drinks and drinks with high levels of fructose (a sugar found naturally in many fruits) had an increased risk of gout.

Diet soft drinks were not found to increase the risk of gout.

Family history

• Studies have shown that gout often runs in families. About one in five people with gout have a close family member who has gout.
• High blood pressure (hypertension)
• Diabetes, both type 1 diabetes and type 2 diabetes
• Kidney disease
• Having high levels of fat and cholesterol in your blood
• Susceptibility

Attacks of gout most often occur in the joints of the feet and hands, possibly because the temperature in these joints is often lower than in the rest of the body, making crystals more likely to form.

It is still uncertain why some people are more susceptible to crystal formation and gout than others with equally high blood levels of uric acid. Many people with high levels of uric acid in the blood and tissues never develop gout.

Diagnosis

The most accurate way to diagnose gout is to examine your joints for the presence of crystals. However, your doctor may only need to look at your symptoms and medical history to make a diagnosis.

Many conditions can cause joint pain, swelling and irritation. Gout is just one of more than 200 different forms of arthritis (any condition that causes joint pain and problems).

Gout Care Kit

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Impetigo is a skin problem. It spreads on the skin due to bacterial infection of Staphylococcus aureus or Streptococcus pyogenes. Due to this, many types of problems and wounds can occur on the skin. Impetigo can spread to any part of the body. In many cases, this problem has been seen in the mouth, nose, hands and feet. Yellow and dark colored fluid comes out due to impetigo. Impetigo can happen to people of any age, but this bacterial infection is very common in young children i.e. 2 to 5 years old. This problem mostly spreads in such a place, where there is a cut due to some injury, insect bite or wound. However, it can also spread inside the skin. 

Symptoms of Impetigo

People of any age can have impetigo in any part of the body. But this infection is seen more on the face of children. Also, sometimes this infection is also seen on the hands and feet of children.

Blisters first start forming on the skin of people suffering from this problem. When it breaks, pus comes out and the skin becomes red. Gradually it starts spreading to other parts of the body as well. Apart from this there are some other symptoms. like-

• Suffering from itching problem due to wound.
• Red rash on the skin.
• Swelling at the site of infection.
• Feeling of pain at the infected area.

The doctor says that in severe cases, impetigo infection starts reaching deep into the skin. Due to which there is a problem related to other skin, which is called Ecthyma.

Impetigo Causes

The doctor says that impetigo is caused by bacteria. This problem can be easily passed from one person to another. Therefore, most infected person is advised to stay away from healthy person.

• Impetigo is caused by staph (staphylococcus) and bacteria-strep (streptococcus) bacteria.
• This bacteria can also spread in the body due to skin infection.
• This bacteria spreads more in the place of insect bite or irritation.
• This bacterium attacks quickly on children suffering from cold.
• In children, this bacteria can enter the body through sheets, towels and toys.
• Impetigo bacteria can attack when immunity is weak.
• In some cases, this disease can occur even if you have healthy skin.

Risk of Impetigo

• Children between the ages of 2 and 5 have a higher risk of developing impetigo.
• The problem of impetigo is more in hot places and places with moisture.
• This disease is contagious, due to which one infected person can infect another healthy person.

Treatment of Impetigo

Doctors tell that impetigo can be treated mainly through antibiotics and creams. This medicine is applied on the affected area. To apply antibiotic ointment, the affected skin is first cleaned with warm water. After this, with the help of cotton, the crust is removed from the blister area, so that this ointment can reach deep. After removing the scab, the cream is applied on the blistered area.

Prevention of Impetigo

• Take care of cleanliness at the place of infection.
• Try to stay away from the infected person.
• Follow the rules given by the doctor.
• Do not make children sit on dirty sheets.
• Keep children away from dirty toys and things.

Home Remedies of Impetigo

Use garlic

Garlic is very beneficial for us. Garlic can be used in case of impetigo. Garlic is effective in removing fungal and bacterial problems. To use garlic, crush the cloves of garlic and extract its juice. Now apply this juice on the affected area. This will remove the problem of impetigo.

Use neem

Neem can be used to overcome the problem of impetigo. Neem has the property of removing bacterial problems. To use it, rub the neem bark with a little water on the stone. You will get a paste by rubbing neem bark. Apply this paste on your affected area. In place of coating you wish. So neem oil can also be used.

Turmeric is effective in removing impetigo

Turmeric has anti-septic and anti-bacterial properties, which is effective in removing the problem of impetigo. It has anti-inflammatory properties, which helps you in reducing the inflammation of impetigo. In case of impetigo, mix turmeric powder in cold water. Now apply this paste on your affected area. This will give you relief from impetigo in a few days.

Keep in mind that for the number of days you have been given medicine, you must use the medicine given by the doctor for the same number of days. if you hurry

What is the treatment for impetigo?

Impetigo is an extremely common and contagious skin infection that causes red marks all over the face, especially around the mouth. As this infection mostly occurs in children and infants, it is also known as school sores. These sores mostly occur around the nose and mouth. Due to which the body of children breaks down, drowsiness, and over time they form a yellow-brown layer on their skin. Sometimes they can occur on the wound as well as affect the lower part of their body. Until that disease is over, the children may become lethargic and the children sleepy. Fortunately, not only is impetigo a known condition, it is also a fairly common one. This means that you do not need to worry about your child getting sick because of these sores. There are effective treatments available in the market for you to use and you can cure your child of this infection in no time. Impetigo is mainly treated with the help of antibiotics. These antibiotics come in the form of creams or ointments that have to be applied topically on the wounds. However, in case of excessive wounds, you can also administer the medicine orally as it also comes in the form of tablets.

How is impetigo treated?

Impetigo is usually diagnosed visually because the lesions tend to be very specific. Sometimes, your doctor may choose to drain some of the fluid from the sores for laboratory testing. This can help in determining which type of antibiotic to use for maximum effectiveness. However, it is an optional step in the diagnosis and treatment process and cannot be done in your case either. Once the infection is detected, it can be treated. The treatment should be very careful as even slight negligence in the treatment can be costly for the patient. Whichever medicine the patient will face a lot of problems in the future, they should be used only in the prescribed way by the doctor and while getting the treatment done to the patient, attention should be paid only to recovery. Because the recovery of the patient depends a lot on his thinking, if a patient’s thinking is good, then he can get rid of his disease quickly. And can enjoy healthy life and can think about his future life.

The main line of treatment for impetigo is through antibiotics. Antibiotics are available in the form of ointments or creams that need to be applied topically on the wounds. However, before applying the cream, you need to use a warm and wet cloth to wipe the yellowish-brown layer over the wounds. If this is not done, the cream will not be completely absorbed and it will definitely hamper its overall effect. After cleaning the wounds, you can apply the cream frequently as directed by your doctor. If you prefer oral medicines, you can give the pills to your child as well. They are equally effective and are often used in severe cases of this infection. The dosage of the pill will depend on the severity of the infection. You can keep it at home.

Who is eligible for the treatment of impetigo

If your child has been diagnosed with impetigo, you can seek treatment for the same.

Who is not eligible for the treatment?

Children are susceptible to a large number of diseases and infections and if the child is absolutely fine and does not have any kind of problem in his body then that child is not necessary for any kind of treatment. Chicken pox is one of the most common people if a child has chickenpox, then this disease usually happens, children with chickenpox are not eligible for this treatment. Do not confuse it for impetigo as chickenpox scars cannot be cured by this treatment and no matter how isolated the lesions may be, it is always better to get a diagnosis from a doctor And only the doctor will give you the right advice. Without the doctor’s advice the treatment should not be done if your child has rash or chicken pox, then he will not be eligible for this treatment.

What are the post treatment guidelines?

Maintaining cleanliness around children and keeping your child away from overcrowded areas or other children, because if you do not do this then this disease can happen again in your children who have this infection, they will again can help prevent infection.

How long does it take to recover?

It only takes a few days for the infection to clear up. If the treatment is not done properly then it may take some more time to recover if the treatment is not done properly The exact number of days which depends on the severity of the infection and the number of lesions. Always think well of the patient So that he can get well soon. And to be able to return to his routine, the patient should listen carefully to every thing told by the doctor and follow it.

1. Detox Premium Powder:

This is a herbo-mineral preparation that contains ingredients like Parwal Pishti, Giloy satv, Shukta Pishti, Kamdudha Ras, Gandhak Rasayan, etc.

Parwal Pishti: This Pishti reduces inflammation, flaking, itching of the skin. The Pishti is composed of natural coral calcium processed with rose water.

Shukta Pishti: It helps to balance the Pitta dosha in the body. All signs and symptoms related to Psoriasis patients are managed with this article.

Giloy Satv: This satv is prepared from the herb Giloy (Tinospora cordifolia). The anti-inflammatory, antioxidant, and analgesic properties of this herb deal with psoriasis easily.

Kamdudha Ras: This herbal-mineral classical preparation balances Pitta dosha in the body.

Gandhak Rasayana: This herbal preparation is used since ancient times for all types of skin disorders.

Tal Sindoor: It contains ingredients like Shuddh parad, Aloe vera, Gandhak, etc that relieve redness in psoriasis patients.

Akik Pishti: This Pishti reduces all types of Pitta related disorder hence it gives good results in psoriasis.

Recommended Dosage: Take 1 sachet twice daily with plain water.

2. Blood Purifier Syrup:

It is ayurvedic syrup that consists of various natural ingredients such as Khadir Chall (Acacia catechu), Manjistha (Rubia cordifolia), Neem (Azadirachta indica), Giloy (Tinospora cordifolia), Harad (Terminalia bellirica), Baheda (Terminalia chebula), Amla (Emblica officinalis), etc. As the syrup purifies the blood by removing excess toxins it is very beneficial in maintaining proper circulation and improves the skin naturally.

Recommended Dosage – Take 2 teaspoonful twice daily.

3. Skin Care Plus tablet:

skin care tablet is a pure ayurvedic formulation. It help to maintain the texture of your skin depending on the type of skin you have. It contains various herbs like Haridra khand, Panchnimb churna, Khadir chahal, Chirayta, Mulethi, Chopchini, Gandhak, Ajmoda that work very effectively on all skin types. Skin care is a blood purifying tablet. It cools and detoxifies the blood, increase blood circulation of the skin. It minimizes the blemishes, lighten sun tan, delay ageing of skin and heal skin problems.

Recommended Dosage: Take 1 tablet twice daily.

4. Panchatikta Ghrita Guggulu:

Panchatikta Ghrita Guggulu is an ayurvedic preparation mainly used for skin diseases. This tablet contains pure herbal ingredients such as Nimba(Azadirachta indica), Patola(Cucumis acutangulus), Guduchi(Tinospora cordifolia), Vasa(Adhatoda vasica), etc. This tablet promotes detoxification and rejuvenation. Panchatikta Ghrita Guggulu tablet is a natural source of anti – oxidant. It promotes engender vibrant and healthy skin.

Recommended Dosage–Take 1 tablets twice a day with normal water.

5. Strawberry Face Cream:

Strawberry face cream is pure herbal cream which gives you glowing complexion without any side effects. This face cream Delays ageing, eliminates dead skin cells, cleanses the skin, improves complexion, and even tones your skin. The antioxidants present in strawberries delay the signs of aging like wrinkles and sagging skin. The Vitamin C fights free radicals that cause damage to cells and collagen resulting in fine lines. Vitamin C in strawberries is essential for the production of collagen, which improves the skin’s elasticity.

Recommended Dosage– Apply to the affected area twice daily.