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How to remove a tick and prevent future bites

SCHAUMBURG, Ill.

As tick populations grow and spread across the country, their prevalence is increasing the public’s risk for some troubling diseases. Of these diseases, say dermatologists from the American Academy of Dermatology, Lyme disease, Rocky Mountain spotted fever, Powassan virus and alpha-gal syndrome—a mysterious red meat allergy—are among the most serious.

“Although most ticks do not carry disease, it’s important to be mindful of these risks and keep an eye out while you’re outdoors,” said board-certified dermatologist Lindsay Strowd, MD, FAAD, an assistant professor of dermatology at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina. “If you notice a tick crawling on you or attached to your skin, remove it immediately to prevent any potential infection.”

To remove a tick that is attached to your skin, Dr. Strowd recommends the following tips:

  1. Use tweezers to remove the tick. Sterilize the tip of the tweezers using rubbing alcohol and grasp the tick as close to the skin’s surface as possible.
  2. Pull upward with steady, even pressure. Avoid twisting, squeezing or crushing the tick, as this can cause its head or mouth to break off and remain in your skin. If this happens, use tweezers to remove the remaining parts. If you cannot remove the rest of the tick, see a board-certified dermatologist.
  3. Dispose of the tick. Place it in a sealed bag or container; submerse the tick in alcohol; or wrap it tightly in tape. You may also want to save the tick in a sealed jar. That way, if you develop any symptoms after the bite, the tick can be tested for disease.
  4. Clean the bite area with soap and water.

“Although ticks can bite at any time, they’re most active in April through September,” said Dr. Strowd. “Fortunately, there are many things people can do to protect themselves and their families against ticks.”

To prevent tick bites, Dr. Strowd recommends the following tips:

  1. Walk in the center of trails. Avoid walking through heavily wooded and brushy areas with tall grass.
  2. If you must walk through heavily wooded areas, wear long pants and long sleeves. Pull your socks up over your pants, and tuck your shirt into your pants to prevent ticks from crawling up your body. It’s also a good idea to wear light-colored clothes so that ticks can be spotted easily.
  3. Use insect repellent that contains 20 to 30 percent DEET on exposed skin and clothing. Make sure to follow the product instructions. Parents should apply this product to their children, making sure to avoid the hands, eyes and mouth.
  4. Examine your skin after spending time in heavily wooded or brushy areas. Conduct a full-body tick check to make sure that no ticks are crawling on you. Since ticks prefer warm, moist areas, be sure to check your armpits, groin and hair. You should also check your children and pets, as well as any gear you used outside.

“If you develop any symptoms within a few weeks after a tick bite, such as a rash, fever or body aches, see a board-certified dermatologist,” said Dr. Strowd. “Make sure you tell the doctor about your recent tick bite, when the bite occurred and where you most likely acquired the tick.”

Source : American Academy of Dermatology 

 

Study: Most melanomas don’t arise from existing moles

SCHAUMBURG, Ill. (Aug. 29, 2017) — Additional research indicates that less than half of sunscreen buyers look for broad-spectrum protection

As the summer draws to a close, it’s time to start putting away flip-flops, bathing suits and beach bags. But as the seasonal supplies disappear into the back of the closet, sunscreen should stay within arm’s reach for year-round protection against the sun’s ultraviolet rays.

Because exposure to those harmful UV rays can increase one’s risk of skin cancer — and people spend a lot of time in the sun during the summer — the end of the season is also a good time to perform a skin self-exam. While it’s important to look for any suspicious spots on the skin, research published today in the Journal of the American Academy of Dermatology indicates that it’s vital to check for new growths in order to detect melanoma, the deadliest form of skin cancer.

After reviewing 38 published studies comprising 20,126 melanomas, researchers found that less than one-third of melanomas (29 percent) arose from an existing mole, while the vast majority (71 percent) appeared on the skin as new spots. Moreover, melanomas that arose from existing moles were thinner than other melanomas, indicating that patients whose melanoma was associated with an established mole had a better prognosis than others.

“These results could indicate that patients who monitor their existing moles for suspicious changes could detect melanoma in its early stages, when it’s most treatable,” says study author Caterina Longo, MD, PhD, a dermatologist at the University of Modena and Reggio Emilia in Italy. “Because the disease is more likely to appear as a new growth, however, it’s important for everyone to familiarize themselves with all the moles on their skin and look for not only changes to those moles, but also any new spots that may appear.”

The American Academy of Dermatology encourages everyone to perform regular skin self-exams, asking a partner to help them check hard-to-see areas like the back. Any new or suspicious spots warrant a trip to a board-certified dermatologist, as does anything changing, itching or bleeding.

The AAD also recommends that everyone protect themselves from the sun’s harmful UV rays by seeking shade, wearing protective clothing and applying a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher. According to additional research published in JAAD today, however, only 39 percent of consumers consider broad-spectrum protection as a factor in choosing a sunscreen.

“People may think SPF is the only important element of sunscreen selection, but that’s not the case,” says study author Roopal V. Kundu, MD, FAAD, an associate professor of dermatology at Northwestern University Feinberg School of Medicine in Chicago. “SPF only tells you how much protection a sunscreen provides against UVB rays. To be protected against both UVA and UVB rays, both of which can cause skin cancer, you need to use a broad-spectrum sunscreen.”

Source: American Academy of Dermatology 

To detect skin cancer early, be alert for any suspicious spots

NEW YORK (July 27, 2017) — Although melanoma is the deadliest form of skin cancer, it’s not the only form of skin cancer that can be deadly. Squamous cell carcinoma, a type of nonmelanoma skin cancer, is not only potentially fatal, but also more common than melanoma — in fact, recent research indicates that SCC incidence has risen by more than 250 percent.

“While other skin cancers may be more lethal, they’re less common than SCC,” says board-certified dermatologist M. Laurin Council, MD, FAAD, an assistant professor of dermatology at Washington University in St. Louis. “SCC is highly treatable when detected early, so it’s important for people to know the signs of this disease and keep a close eye on their skin.”

SCC may appear as a pink or white bump; a rough, scaly patch; or a sore that won’t heal. Dr. Council advises everyone who notices any suspicious spots on their skin to see a board-certified dermatologist for diagnosis and, if necessary, treatment.

“The ABCDE warning signs of melanoma don’t usually apply to SCC, so it’s important to keep an eye out for any and all suspicious spots,” Dr. Council says. “Moles are not the only skin lesions that may indicate skin cancer. Any skin growth that is new, changing or won’t go away warrants a visit to the dermatologist.”

The vast majority of SCCs can be successfully treated with surgical or destructive methods, Dr. Council says. Without treatment, however, the cancer may grow larger, which could lead to disfigurement; in rare cases, SCC may metastasize and spread, making it more difficult to treat.

According to Dr. Council, current treatment options for advanced SCC, which include traditional chemotherapy and radiation, do not have high success rates and may cause negative side effects. She says doctors may be able to provide improved treatment by utilizing targeted therapies, drugs that hone in on patients’ specific tumors, allowing for more effective treatment with fewer side effects. While these types of medications have not yet received U.S. Food and Drug Administration approval for treatment of cutaneous SCC, they have been approved for treatment of other cancers.

“Targeted therapies have shown a lot of promise for SCC patients,” Dr. Council says. “A board-certified dermatologist can explain your treatment options and help determine the best possible treatment for you.”

Dermatologists also can identify patients who are at an increased risk for recurrent and advanced SCC and suggest preventive measures, Dr. Council says. Because unprotected exposure to natural and artificial ultraviolet light is a risk factor for all types of skin cancer, she advises everyone to stay out of tanning beds and protect themselves from the sun’s harmful UV rays. The American Academy of Dermatology recommends a comprehensive sun protection plan that includes seeking shade, wearing protective clothing and using a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher.

“Prevention and early detection are both vital in the fight against skin cancer,” Dr. Council says. “Make sure you take steps to protect yourself, watch for changes on your skin, and see a board-certified dermatologist if you notice any suspicious spots.”

Source: American Academy of Dermatology

Actinic keratosis: Pictures, causes, and prevention

By Jenna Fletcher – Last reviewed Wed 19 July 2017 by Daniel Murrell, MD

Actinic keratosis is a precancerous growth on the skin caused by long-term exposure to ultraviolet light. It is also known as solar keratosis.
Actinic keratosis often appears in groups of several growths. The condition surfaces most often on areas of the body that are exposed to sunlight regularly.
Precancerous means that the condition can progress to cancer if it is not treated. As a result, actinic keratosis should be monitored and treated if appropriate.

What is actinic keratosis?
Actinic keratosis is a rough and often bumpy patch or lesion that forms on the skin. Typically, actinic keratosis is found on the scalp, back of the hands, the face, ears, back of the forearms, the neck, and the shoulders.

The size of actinic keratosis varies from tiny to an inch or more in diameter. Similarly, color variations range from light to dark with variations throughout the patches.

Actinic keratosis develops over a number of years. In most cases, people who develop actinic keratosis are in their 40s or older. The patches often grow over time.

Symptoms are usually limited to the patch of scaly, crusty skin that forms. In most cases, there are no other signs of symptoms. Even under the care of a doctor, many people will experience recurring patches for the rest of their lives.

Developing actinic keratosis increases someone’s risk of skin cancer. If left untreated, actinic keratosis may develop into squamous cell carcinoma, which is a type of skin cancer.

Appearance

Knowing what to look for can help a person spot actinic keratosis early so they can bring it to their doctor’s attention.

No two cases of actinic keratosis will look the same, but they may share the following similar features:

  • red scales
  • raised patches
  • crusty patches
  • sandpaper texture

Causes
Actinic keratosis is referred to regularly as solar keratosis. This name describes the cause of the skin lesions, which is overexposure to or damage caused by ultraviolet (UV) light.

Unlike sunburn, which is an immediate reaction to prolonged exposure to UV light, actinic keratosis takes years of regular sun exposure for the lesions to develop.

Risk factors

Anyone can develop actinic keratosis over time. However, there are risk factors that make people more likely to develop actinic keratosis.

These factors include:

  • age with people 40 and over at the highest risk
  • a long history of sunburn or extreme exposure to sun
  • living in a sunny environment
  • using tanning beds
  • having a history of developing actinic keratosis
  • having lighter color hair or eyes
  • having a tendency to burn in the sun

Diagnosis
In many cases, a person will notice the small patch of skin that develops with this condition. As with all skin changes or newly discovered bumps, a person should see their doctor, as soon as possible, to help catch any problems early.

A doctor or dermatologist is likely to be able to diagnose actinic keratosis with a simple visual examination. If in any doubt, a skin biopsy may be done where a small sample of the affected skin is examined in a lab.

The sample is often taken during the same doctor or dermatologist’s visit as the visual examination and requires only a numbing injection.

Prevention

The main methods of prevention of actinic keratosis are through lifestyle changes and a person being aware of their exposure to UV rays.

A person should take proper precautions when outside, such as wearing hats, loose-fitting clothes that cover most areas of the body, and sunscreen.

They may want to avoid being in the sun for prolonged periods of time, as well.

People should avoid excessive exposure to UV light from tanning either indoors or outdoors.

It is important to remember that this condition may occur from any source of UV light, including indoor tanning beds

Treatment

While some cases of actinic keratosis may resolve naturally on their own, a person is highly recommended to seek medical treatments. Action is needed, as the condition is considered to be precancerous.

There are several different potential treatment options, which may include a combination of the following:

  • medication
  • surgery
  • photodynamic therapy, using drugs and light to kill cancer cells

Medication

Treatment for more advanced or widespread cases of actinic keratosis includes medication in the form of various creams and gels. Some medicated creams include:

  • diclofenac gel
  • imiquimod cream
  • fluorouracil cream
  • ingenol mebutate gel

These creams and gels are applied directly to affected areas of the skin. They may produce side effects in some people who may experience rashes, redness, and swelling at the site of application.

Surgery

In cases where a person only has a few spots or patches, a doctor may recommend removing the affected area through minor surgery. Two of the more common surgery options are curettage and cryotherapy.

Scraping, which is referred to as curettage, involves a device called a curette, to scrape off the damaged skin cells. In some cases, electrosurgery is used immediately after scraping. Electrosurgery involves a doctor using a pen-shaped instrument, to destroy and cut away the affected tissue with an electric current.

Both procedures require a local anesthetic. Some people experience side effects, including scarring, discoloration, and infection.

Freezing, referred to as cryotherapy, removes the lesions by freezing them with liquid nitrogen. A doctor applies the liquid nitrogen to the skin when the extreme cold causes the affected area to blister and peel. As the skin heals, the lesions fall off, allowing new, undamaged skin to appear.

Cryotherapy is the most common treatment for actinic keratosis. This is partly because it can be done in the doctor’s office and takes only a few minutes. Side effects may include:

  • changes to skin texture
  • blisters
  • infection
  • scarring
  • discoloration of the skin at the site of treatment

Photodynamic therapy

Photodynamic therapy involves the application of a chemical to the affected areas of skin. The doctor then shines an artificial light on the chemical, which, in turn, kills the damaged cells and removes the actinic keratosis.

Side effects may include redness, swelling, and burning, which may be felt during the procedure.

A person and their doctor will work together to decide the best option or options. In some cases, a person may have regular treatment for recurring patches.

Outlook

Actinic keratosis is a marker of severe skin changes and damage to the skin, as a result of UV exposure. These changes put a person with actinic keratosis at high risk for developing skin cancer.

People who catch actinic keratosis early tend to have a good chance of removing the risk of developing cancer. However, if left untreated, actinic keratosis may develop into skin cancer.

Once treated for actinic keratosis, a person will probably need to schedule yearly dermatologist appointments, to screen for recurrence and check for other signs of skin cancer.

Source : Medical News Today

FDA Approves New Ointment for Eczema

Patients aged 2 and older have a new option for treating their mild to moderate eczema (atopic dermatitis). AD, often called eczema, is a chronic condition impacting nearly 18 million children and adults in the United States.  Approximately 90 percent of people living with AD have the mild to moderate form of the condition.

The FDA recently approved Eucrisa, a Pfizer product, the first non-steroidal topical monotherapy that is a phosphodiesterase 4 (PDE-4) inhibitor. The exact mechanism of how Eucrisa works is not fully defined, but crisaborole, the active ingredient in Eucrisa, may inhibit PDE-4 in target cells. This reduces the production of pro-inflammatory cytokines thought to cause the signs and symptoms of atopic dermatitis.

Two placebo-controlled trials were conducted to determine the safety and efficacy of Eucrisa. 1,522 participants ranging in age from two years of age to 79 years of age, with mild to moderate atopic dermatitis, were part of the trial. The results showed that participants receiving Eucrisa achieved greater response with clear or almost clear skin after 28 days of treatment; some saw improvement in as little as eight days.

Mild side effects including application site pain, burning or stinging were reported. Patients who have had a hypersensitivity reaction to crisaborole should not use the product.

Source: Pfizer and FDA