Skin Health Overview

Hives, eczema, psoriasis, acne, rashes, and other irritating skin conditions can have an adverse effect on more than just your skin. These conditions can greatly affect the way you live your life, how you feel about yourself and may even stop you from doing the things you love.

Eczema

Eczema is a chronic skin condition that causes repeated episodes of itchy, red rashes and dry, sensitive skin. Eczema may be caused by a combination of genetic, environmental and immune system factors, and is often accompanied by asthma, and/or hay fever also known as “the allergic march”, comprising Eczema, Asthma, Allergies.

CAUSES
  • Skin Irritants Such as Soap, Detergent, Etc.
  • Microbes Such as Bacteria, Viruses and Fungi
  • Hot and Cold Temperatures
  • Foods Such as Dairy, Eggs, Nuts Etc.
  • Allergens Such as Pollen, Dust Mite & Pet Dander
SYMPTOMS
  • Itchy Skin
  • Red Rashes
  • Dry, Thickened, Scaly Skin
  • Fluid-Filled Bumps
  • Cracks in the Skin
  • Infections of Skin

Hives

Hives are raised red bumps or welts on the skin, triggered by an allergic reaction. They can be as small as a pencil tip, or as large as a dinner plate and can last anywhere from a few minutes to several days to weeks. Hives may often begin in one area, like the abdomen, before fading and appearing in another area of the body such as hands or chest.

CAUSES
  • Foods, Especially Milk
  • Food Additives
  • Fish or Nuts
  • Drugs Such as Aspirin, Ibuprofen, Penicillin, Sulfa Agents
  • Bug Bites
  • Auto-Immune Conditions
    Eg: Thyroid Problems, Lupus or Others
  • Hormonal Fluctuations or Stress
SYMPTOMS
  • Itchy, Red or Skin-Colored Welts
  • Dizziness
  • Wheezing
  • Swelling of the Tongue, Lips
  • Chest Tightness

Angioedema

Angioedema is swelling that develops underneath the skin of the face, hands, feet and genitalia, as well as the lining of the throat and bowel, often accompanied by hives, as a result of an allergic reaction. It may take several minutes or hours to develop and may affect only one side of the body.

Another type of Angioedema has a hereditary component that is seen in certain families caused by decreased C1 esterase protein or decreased complement protein. There are very effective medications available now for treatment of the Hereditary form of this illness such as C1-INH concentrate replacement, kallikrein inhibitor or selective bradykinin B2 receptor antagonist to treat acute Hereditary Angioedema attacks as well as for prevention of these attacks (C1-INH concentrate as well as recent monoclonal antibodies).

CAUSES
  • Insect Bites
  • Pollen
  • Hereditary Genetic Etiology
  • Poison Oak or Ivy
  • Latex
  • Animal Dander
  • Medications Such As ACE Inhibitors for Blood Pressure
  • Foods (for Example, Shrimp Allergy)
SYMPTOMS
  • Swelling for up to Three Days
  • Red, Irritated Eyes
  • Recurring Abdominal Pain
  • Nausea
  • Diarrhea
  • Dizziness
  • Fainting

Skin Health Testing and Treatment

Testing

  • Skin Testing

    Whether you suffer from a reaction to foods, chemicals or the environment, we can often diagnose the allergy with scratch or patch testing. Scratch tests assess allergies to foods, stinging insects and airborne allergens by pricking the surface of the skin with a few drops of purified allergen. Patch tests can identify allergies to skin irritants like cosmetics and chemicals by applying the allergen directly to a patch of skin. If a reaction occurs, we can recommend the best course of treatment for your allergies.

Treatment

  • Oral Drops For Allergies

    Oral drops, also known as sublingual immunotherapy, work like injections, building up immune tolerance in the body. Unlike injections, oral drops are an at-home treatment, ingested under the tongue – no weekly visits, and no waiting! However, they are not covered by health care policies; you must pay for oral drops directly on a three- to six-month payment plan.

  • Shots For Allergies

    For any allergies caused by animals, dust, mold, pollen or stinging insects, we typically administer allergy shots, injecting a minor amount of allergen under the skin, which develops antibodies to prevent allergic reactions over time. We determine the best shots for you based on your skin test results. With weekly treatments, allergies and asthma are typically under control within a few months with a 90% success rate.

  • Shots For Swelling

    Typically hereditary, angioedema-related swelling is generally caused by an allergic reaction and can be treated with one of four treatments to prevent symptoms: Firazyr®, Cinryze®, Berinert® and Kalbitor®.

Frequently Asked Questions
  • What is hereditary angioedema and its different types?

    Hereditary Angioedema is an autosomal dominant disorder in which patients are deficient in C1 inhibitor [C1INH] and angioedema in the absence of urticaria. There are 2 types of C1–INH deficiency, type I and type II. Both types have reduced C1–INH functions.

    Type I has reduced levels of C1–INH whereas Type II has normal levels of C1–INH.
    Therefore, it is important to distinguish between both by ordering C1–INH functional assay to determine which type is causing the angioedema.

    During the asymptomatic period C2 Level is normal and C4 is reduced.
    During the symptomatic period C2 is reduced and C4 is further reduced

    There is also an acquired form of the disorder in which C1 is reduced.

  • What is the basic workup of hereditary angioedema?

    Recommended tests for workup should include C1, C2, C4, C1–INH and C1–INH functional assay.

  • What is the mechanism of angioedema?

    The mechanism of angioedema involves degranulation of mast cells.  Induction and release of mediators may be a result of IgE mediated phenomenon when antigen specific IgE binds to high affinity IgE receptor, and FC epsilon R1, on the mast cell surface, such as most antibiotics causing activation and degranulation of mast cells.

    Mast cell degranulation may also be a result of non-IgE mediated phenomenon such as with vancomycin or polymyxin B, which causes direct mast cell degranulation or agents such as opiates and ionic contrast dyes.

    Another mechanism of mast cell degranulation is complement mediated as in acquired angioedema and serum sickness.

    Regardless of the inciting event, the induction pathway once initiated results in histamine release as a major mediator.

    Histamine release causes 3 major event pathways which includes erythema [capillary dilatation] an induction pathway resulting in flare [arteriolar dilatation] and induction pathway 3 resulting in the formation of wheal [exudation of fluid because of increased vascular permeability hence resulting in edema].

  • What are the latest advances in treatment of Hereditary angioedema?

    Significant advances have been made over the past 2 decades for the treatment, prevention and management of Hereditary form of angioedema. These new medications are used to prevent recurrent symptoms such as pain and edema events especially in the throat area that may be life threatening.

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