What is dyshidrotic eczema. How does it manifest on the skin. What triggers this condition. How is dyshidrotic eczema diagnosed. What treatment options are available for managing symptoms. How can you prevent flare-ups at home. Who is most at risk for developing this skin condition.

What is Dyshidrotic Eczema?

Dyshidrotic eczema, also known as pompholyx or vesicular eczema, is a skin condition characterized by the sudden appearance of small, itchy blisters on the palms, sides of fingers, soles of feet, and toes. This chronic condition tends to come and go in cycles, with flare-ups occurring periodically.

While there’s no cure for dyshidrotic eczema, various treatments and self-care measures can help manage symptoms and reduce the frequency of outbreaks. The condition typically affects adults between 20 and 40 years old, with women being twice as likely to develop it compared to men.

Recognizing the Symptoms of Dyshidrotic Eczema

The hallmark sign of dyshidrotic eczema is the emergence of small, itchy blisters. However, several other symptoms may accompany this primary manifestation:

• Intense itching or burning sensation before blisters appear
• Clustered blisters on fingers, toes, palms, and soles
• Redness and cracking of affected skin
• Sweating around blistered areas
• Thickening and discoloration of nails

Typically, blisters resolve within 2-3 weeks, but the underlying skin may remain red and tender for some time afterward. The severity of dyshidrotic eczema can vary significantly among individuals, ranging from mild cases to severe outbreaks that impair daily activities.

When to Seek Medical Attention

While dyshidrotic eczema is not life-threatening, it’s essential to consult a healthcare professional if you experience persistent or severe symptoms. Seek immediate medical care if you notice signs of infection, such as:

• Increased pain or swelling
• Formation of crusts over blisters
• Presence of pus in the blisters
• Fever or chills

Exploring the Causes and Risk Factors of Dyshidrotic Eczema

The exact cause of dyshidrotic eczema remains unknown, but researchers have identified several factors that may contribute to its development or trigger flare-ups:

1. Stress: Emotional or physical stress can exacerbate symptoms
2. Metal exposure: Contact with nickel, cobalt, or chromium salts, often found in costume jewelry or certain occupational settings
3. Moisture: Excessive sweating or prolonged exposure to water
4. Climate: Warm, humid weather conditions
5. Allergies: Seasonal allergies or hay fever
6. Immune system factors: HIV infection or certain immunosuppressive treatments

Individuals with a family history of dyshidrotic eczema or other forms of eczema are at higher risk of developing this condition. Additionally, about half of those with dyshidrotic eczema also experience other types of eczema, such as atopic dermatitis or contact dermatitis.

Diagnosing Dyshidrotic Eczema: What to Expect

Diagnosing dyshidrotic eczema typically involves a thorough examination by a dermatologist. While there’s no specific lab test to confirm the condition, healthcare providers can usually make a diagnosis based on the characteristic appearance of the blisters and their location on the hands and feet.

During the diagnostic process, your doctor may:

• Examine your hands, feet, and nails
• Ask about your medical history and potential triggers
• Recommend tests to rule out other conditions with similar symptoms, such as athlete’s foot
• Refer you to an allergist for patch testing to identify potential metal allergies

Patch tests involve applying small amounts of various substances to your skin to observe any allergic reactions, which could help identify triggers for your dyshidrotic eczema.

Effective Treatment Options for Managing Dyshidrotic Eczema

While there’s no cure for dyshidrotic eczema, various treatment options can help manage symptoms and reduce the frequency of flare-ups. The choice of treatment depends on the severity of your condition and may include:

Topical Treatments

• Corticosteroid ointments or creams to reduce inflammation and itching
• Calcineurin inhibitors like tacrolimus (Protopic) or pimecrolimus (Elidel) to modulate the immune response
• Moisturizers to hydrate and protect the skin

Oral Medications

• Antihistamines to relieve itching
• Oral corticosteroids for severe flare-ups
• Immunosuppressants in resistant cases

Other Therapies

• Phototherapy (light therapy) using ultraviolet light to clear the skin
• Botulinum toxin injections to reduce sweating, which can trigger blisters
• Draining of blisters by a healthcare professional (not to be attempted at home)

It’s crucial to work closely with your healthcare provider to find the most effective treatment plan for your individual case of dyshidrotic eczema.

Home Remedies and Lifestyle Changes to Manage Dyshidrotic Eczema

In addition to medical treatments, several self-care measures can help control dyshidrotic eczema and prevent flare-ups:

1. Practice good hand and foot hygiene:
   • Wash with lukewarm water and mild, fragrance-free soap
   • Gently pat skin dry after washing
   • Remove rings before washing hands to prevent moisture trapping
2. Protect your skin:
   • Wear cotton-lined gloves when hands are in water
   • Apply a thick moisturizer immediately after bathing or washing
   • Use protective creams containing dimethicone
3. Manage environmental factors:
   • Use a humidifier in dry weather to maintain skin moisture
   • Avoid known triggers, such as certain metals or allergens
4. Apply cold compresses:
   • Hold a cool, damp cloth on blisters for 15 minutes several times a day to relieve itching and discomfort

Consistently following these self-care practices can significantly improve your comfort and reduce the frequency of dyshidrotic eczema flare-ups.

Understanding the Long-Term Outlook for Dyshidrotic Eczema

Dyshidrotic eczema is a chronic condition that tends to come and go over time. While there’s no permanent cure, many individuals find that their symptoms become less severe or frequent as they enter middle age. The long-term outlook varies from person to person, with some experiencing complete remission and others dealing with periodic flare-ups throughout their lives.

Factors that can influence the long-term prognosis include:

• Adherence to treatment plans and self-care routines
• Success in identifying and avoiding triggers
• Overall health and immune system function
• Stress management and lifestyle choices

Regular follow-ups with your healthcare provider can help monitor the progression of your condition and adjust treatments as needed for optimal management.

Dyshidrotic Eczema in Children: Special Considerations

While dyshidrotic eczema primarily affects adults, it can occasionally occur in children. When it does, special considerations come into play:

Diagnosis Challenges

Diagnosing dyshidrotic eczema in children can be more challenging, as they may have difficulty articulating their symptoms or avoiding scratching, which can alter the appearance of the rash.

Treatment Modifications

Treatment approaches for children with dyshidrotic eczema may need to be adjusted:

• Lower-strength topical corticosteroids are typically prescribed to minimize side effects
• Oral medications are used more cautiously, considering potential impacts on growth and development
• Greater emphasis is placed on non-medicinal interventions and trigger avoidance

Impact on Quality of Life

Dyshidrotic eczema can significantly affect a child’s quality of life, potentially interfering with school activities, sports, and social interactions. Parents and caregivers play a crucial role in helping children manage their condition and maintain a positive outlook.

Education and Support

Educating children about their condition and involving them in their care routine can foster a sense of control and improve treatment adherence. Support groups or counseling may be beneficial for children struggling to cope with chronic symptoms.

Recent Advances in Dyshidrotic Eczema Research

Ongoing research continues to shed light on dyshidrotic eczema, paving the way for improved understanding and management of the condition:

Genetic Factors

Recent studies have identified specific genetic variations that may increase susceptibility to dyshidrotic eczema, offering potential targets for future treatments.

Microbiome Connection

Emerging research suggests that imbalances in the skin microbiome may play a role in dyshidrotic eczema development, opening avenues for probiotic-based therapies.

Novel Treatments

Investigators are exploring new treatment options, including:

• Biologics targeting specific inflammatory pathways
• Topical phosphodiesterase-4 inhibitors to reduce inflammation
• Advanced moisturizers designed to repair and maintain the skin barrier

Personalized Medicine Approaches

Researchers are working on developing personalized treatment strategies based on individual genetic profiles and biomarkers, aiming to improve treatment efficacy and minimize side effects.

These ongoing research efforts offer hope for more effective management and potentially new breakthrough treatments for dyshidrotic eczema in the future.

Dyshidrotic Eczema: Symptoms, Causes, Diagnosis, Treatment

Written by Stephanie Watson

• What Is Dyshidrotic Eczema?
• Dyshidrotic Eczema Symptoms
• Dyshidrotic Eczema Causes
• Dyshidrotic Eczema Diagnosis
• Dyshidrotic Eczema Treatment

Dyshidrotic eczema is a sudden rash of small, itchy blisters on your palms and along the sides of your fingers. This skin condition can also make blisters pop up on the soles of your feet or on your toes.

Your doctor might call it by another name, including dyshidrosis, foot-and-hand eczema, pompholyx, vesicular eczema, or palmoplantar eczema.

There’s no cure, so these blisters will come and go over time. But you can manage them with medicine, moisturizers, and good hygiene. They might start to taper off once you get into middle age. And if you have a mild case, it could go away on its own.

The small, itchy blisters are the most noticeable sign of dyshidrotic eczema. These usually pop up in clusters. You may also have: 

• Itching or a burning pain before blisters appear 

• Blisters on the edges of your fingers, toes, palms, and soles of your feet

• Red, cracked skin

• Sweaty skin around the blisters 

• Nails that thicken and change colors

The blisters often go away in 2 to 3 weeks. But the skin underneath can be red and tender for a while.

Dyshidrotic eczema can be mild or severe. If you have a severe case that affects your feet, the blisters can make it hard to walk. Blisters on your hands can make it hard to do things like cook, type, or wash dishes.

Sometimes, the blisters can get infected, especially if you scratch them a lot. Signs that you have an infection include:

• Pain

• Swelling

• Crusting

• Pus in the blisters

Doctors aren’t sure what causes dyshidrotic eczema. It mostly affects adults ages 20 to 40, and it’s twice as common in women as in men. You’re more likely to get it if you have allergies like hay fever, a family history of dyshidrotic eczema, or other forms of eczema. 

Several things can set off dyshidrotic eczema, including:

• Stress

• Contact with metals like nickel, cobalt, or chromium salts on your job, or from things like costume jewelry

• Sweaty or wet hands and feet

• Warm, humid weather

• HIV infection

• Certain treatments for a weak immune system (immunoglobulin)

• Seasonal allergies

About half of all people with dyshidrotic eczema also have other types of eczema such as contact and atopic dermatitis. This condition isn’t contagious. You can’t catch it from touching someone who has it.

No lab test can confirm that you have dyshidrotic eczema, but if you notice blisters on your hands and feet, see a dermatologist (a doctor who specializes in your skin). They’ll look at your hands and feet, as well as your nails. Your doctor could also suggest tests to rule out other conditions with similar symptoms like athlete’s foot.

You also might need to see an allergy doctor (allergist). Patch tests can show if you have an allergy to nickel or another metal. During these tests, your doctor will put patches with a small amount of different metals or other things on your skin to see whether you react to them.

Your doctor can prescribe an ointment or cream with a steroid in it to bring down swelling and help get rid of the blisters. Your skin will take in the medicine better if you put a wet compress on it after you use the cream. If you have a severe flare-up, you might need to take a steroid drug, like prednisone, in a pill.

An antihistamine like diphenhydramine (Benadryl) or loratadine (Alavert, Claritin) can help with the itch, too. Or you might hold a cold, wet compress on the blisters for 15 minutes at a time several times a day.

If these treatments don’t work well for you, you might try one of these:

• Light therapy. This uses ultraviolet (UV) light to clear up your skin. You might first get a sensitizing medication to help your skin respond better to the light.

• Botulinum toxin. These shots stop your hands and feet from sweating, which can trigger the blisters.

• Medicines that slow your immune system. Tacrolimus (Protopic) ointment or pimecrolimus (Elidel) cream can calm the swelling and irritation. These drugs can be options if you don’t want to take steroids.

• Draining the blisters. Your dermatologist can drain fluid from the blisters. Don’t try to do this yourself. You could make the eczema worse.

To control the blisters at home:

• Wash your hands and feet every day. Use lukewarm water and a mild, scent-free soap. Afterward, gently pat your skin dry.

• Take your rings off before you wash your hands. Moisture can get trapped under your rings and cause more blisters.

• Wear gloves with cotton liners whenever your hands are in water, like when you wash dishes.

• Put a thick moisturizer on your hands and feet every time you shower or wash. Rub it on while your skin is still wet to seal in water. You also might use a cream that has dimethicone to protect your skin.

• Turn on a humidifier in dry weather to keep your skin from cracking.

• If allergies set off your eczema, try to stay away from things that trigger them.

• Don’t scratch the blisters. You’ll make them worse.

If you’re sensitive to nickel or cobalt, your dermatologist might tell you not to eat foods that are high in these metals. Nickel is in foods like chocolate, broccoli, legumes, and nuts. Cobalt is in shellfish, liver, nuts, beets, cabbage, and chocolate.

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Dyshidrotic Eczema: Symptoms, Causes, Diagnosis, Treatment

Written by Stephanie Watson

• What Is Dyshidrotic Eczema?
• Dyshidrotic Eczema Symptoms
• Dyshidrotic Eczema Causes
• Dyshidrotic Eczema Diagnosis
• Dyshidrotic Eczema Treatment

Dyshidrotic eczema is a sudden rash of small, itchy blisters on your palms and along the sides of your fingers. This skin condition can also make blisters pop up on the soles of your feet or on your toes.

Your doctor might call it by another name, including dyshidrosis, foot-and-hand eczema, pompholyx, vesicular eczema, or palmoplantar eczema.

There’s no cure, so these blisters will come and go over time. But you can manage them with medicine, moisturizers, and good hygiene. They might start to taper off once you get into middle age. And if you have a mild case, it could go away on its own.

The small, itchy blisters are the most noticeable sign of dyshidrotic eczema. These usually pop up in clusters. You may also have: 

• Itching or a burning pain before blisters appear 

• Blisters on the edges of your fingers, toes, palms, and soles of your feet

• Red, cracked skin

• Sweaty skin around the blisters 

• Nails that thicken and change colors

The blisters often go away in 2 to 3 weeks. But the skin underneath can be red and tender for a while.

Dyshidrotic eczema can be mild or severe. If you have a severe case that affects your feet, the blisters can make it hard to walk. Blisters on your hands can make it hard to do things like cook, type, or wash dishes.

Sometimes, the blisters can get infected, especially if you scratch them a lot. Signs that you have an infection include:

• Pain

• Swelling

• Crusting

• Pus in the blisters

Doctors aren’t sure what causes dyshidrotic eczema. It mostly affects adults ages 20 to 40, and it’s twice as common in women as in men. You’re more likely to get it if you have allergies like hay fever, a family history of dyshidrotic eczema, or other forms of eczema. 

Several things can set off dyshidrotic eczema, including:

• Stress

• Contact with metals like nickel, cobalt, or chromium salts on your job, or from things like costume jewelry

• Sweaty or wet hands and feet

• Warm, humid weather

• HIV infection

• Certain treatments for a weak immune system (immunoglobulin)

• Seasonal allergies

About half of all people with dyshidrotic eczema also have other types of eczema such as contact and atopic dermatitis. This condition isn’t contagious. You can’t catch it from touching someone who has it.

No lab test can confirm that you have dyshidrotic eczema, but if you notice blisters on your hands and feet, see a dermatologist (a doctor who specializes in your skin). They’ll look at your hands and feet, as well as your nails. Your doctor could also suggest tests to rule out other conditions with similar symptoms like athlete’s foot.

You also might need to see an allergy doctor (allergist). Patch tests can show if you have an allergy to nickel or another metal. During these tests, your doctor will put patches with a small amount of different metals or other things on your skin to see whether you react to them.

Your doctor can prescribe an ointment or cream with a steroid in it to bring down swelling and help get rid of the blisters. Your skin will take in the medicine better if you put a wet compress on it after you use the cream. If you have a severe flare-up, you might need to take a steroid drug, like prednisone, in a pill.

An antihistamine like diphenhydramine (Benadryl) or loratadine (Alavert, Claritin) can help with the itch, too. Or you might hold a cold, wet compress on the blisters for 15 minutes at a time several times a day.

If these treatments don’t work well for you, you might try one of these:

• Light therapy. This uses ultraviolet (UV) light to clear up your skin. You might first get a sensitizing medication to help your skin respond better to the light.

• Botulinum toxin. These shots stop your hands and feet from sweating, which can trigger the blisters.

• Medicines that slow your immune system. Tacrolimus (Protopic) ointment or pimecrolimus (Elidel) cream can calm the swelling and irritation. These drugs can be options if you don’t want to take steroids.

• Draining the blisters. Your dermatologist can drain fluid from the blisters. Don’t try to do this yourself. You could make the eczema worse.

To control the blisters at home:

• Wash your hands and feet every day. Use lukewarm water and a mild, scent-free soap. Afterward, gently pat your skin dry.

• Take your rings off before you wash your hands. Moisture can get trapped under your rings and cause more blisters.

• Wear gloves with cotton liners whenever your hands are in water, like when you wash dishes.

• Put a thick moisturizer on your hands and feet every time you shower or wash. Rub it on while your skin is still wet to seal in water. You also might use a cream that has dimethicone to protect your skin.

• Turn on a humidifier in dry weather to keep your skin from cracking.

• If allergies set off your eczema, try to stay away from things that trigger them.

• Don’t scratch the blisters. You’ll make them worse.

If you’re sensitive to nickel or cobalt, your dermatologist might tell you not to eat foods that are high in these metals. Nickel is in foods like chocolate, broccoli, legumes, and nuts. Cobalt is in shellfish, liver, nuts, beets, cabbage, and chocolate.

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Rubella in children and adults: symptoms, methods of treatment

Author

Zurnadzhi Elena Vyacheslavovna

Leading physician

Pediatrician

Creation date: 2016. 03.30

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Rubella

Rubella is an acute viral disease predominantly of childhood. A typical manifestation: a pink-red rash that appears first on the face, and then spreads throughout the body within a few hours.

The susceptibility of children to rubella is high. Usually, children under the age of 6 months have innate immunity received from their mother, but if the child does not have specific antibodies, he can get sick even in the first months of life.

Rubella is most common in children aged 2 to 9 years.

Immunity after the transferred rubella is persistent, lifelong.

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Causes of rubella

Rubella is transmitted by airborne droplets. Although the virus is considered non-persistent, contact transmission of the disease (for example, through children’s toys) is also possible.

The incubation period for rubella is from 11 to 24 days (in most cases – from 16 to 20 days). The patient is contagious already a week before the rash appears. After the rash, the risk of infection persists for another 5-7 days.

Another option for transmission of infection is during pregnancy, from mother to fetus. With such congenital rubella, the virus is secreted for a long time – within 1.5-2 years after birth (with sputum, urine, feces).

Rubella risk

The main danger of the disease lies in its effect on the fetus in the early stages of pregnancy. Up to 11 weeks, the probability of infection of the fetus upon contact with the source of infection is 90%. The consequences can be serious: various pathologies and fetal death. Therefore, rubella is included in the number of ToRCH infections (a group of infections that pose a particular danger to the fetus and the health of the unborn child).

Symptoms of rubella

The main symptoms of rubella are:

Rash

Rubella is manifested primarily by a rash. The rubella rash looks like small pink-red spots of a round or oval shape.

In children, the rash lasts 2-4, occasionally 5-7 days, then disappears – without pigmentation and peeling.

More about the symptom

Swollen lymph nodes

There is enlargement of the lymph nodes, especially those located on the back of the head and back of the neck.

Catarrhal phenomena

Sometimes in children with rubella, catarrhal phenomena are observed: a slight runny nose, sore throat, dry cough.

Symptoms of rubella in adults

In adults, rubella is much more severe: headache, general weakness, fever (up to 38-39 ° C), muscles hurt. The disease can affect the joints (primarily the small joints of the hands).

Methods for diagnosing rubella

Do not assume that you or your child is already immune because you have experienced symptoms that fit the description of rubella. Other viral diseases can have similar symptoms. Absolute certainty can only be given by a blood test for specific antibodies.

Serological blood test

Serological analysis detects the presence of antibodies to the rubella virus in the blood. Such an analysis can be done separately, or you can use the “Diagnostics of ToRCH infections” profile.

More about the diagnostic method

To accurately diagnose the disease, make an appointment with the specialists of the Family Doctor network.

Rubella treatments

If symptoms appear that suggest rubella, the child should be shown to the pediatrician, and the adult should consult a general practitioner.

Symptomatic treatment

Rubella is treated with bed rest and symptomatic treatment. The patient should receive enough vitamins (in the form of vitamin preparations or in kind).

Vaccination

Vaccination is a simple and effective way to avoid the danger of getting sick already in adulthood. It is especially important to exclude the threat of rubella disease to the expectant mother. The prevention of this disease is so significant that rubella vaccination is included in the National and Regional immunization schedules.

The vaccine is administered subcutaneously or intramuscularly. Vaccination is carried out at the age of 12 months, repeated immunization (revaccination) – at 6 years. For girls who have not had rubella and have not previously been vaccinated, the vaccine is administered at the age of 18 to 25 years. Specific immunity is provided in almost 100% of cases. It develops 15-20 days after vaccination and persists for more than 20 years.

More about the treatment

Do not self-medicate. Contact our specialists who will correctly diagnose and prescribe treatment.

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Dyshidrotic eczema – Eva Art

Why do itchy blisters appear on the palms and feet?

Dyshidrotic eczema is a type of eczema (dermatitis) that is characterized by an itchy, blistering rash on the fingers, hands and feet. It occurs in children and adults and can be acute, recurrent, or chronic. In English-language literature, the term “pompholyx” is used for this condition, which means “bubble”. The clinical course of dyshidrotic eczema can vary from mild, self-limiting to severe, chronic, and debilitating, resistant to treatment. It is impossible to single out an unambiguous cause of dyshidrotic eczema. It is believed that pompholyx is a skin reaction caused by various external and internal provoking factors.

The most likely causes of dyshidrotic eczema are as follows:

1. Genetic factors. Filaggrin is a structural protein in the stratum corneum of the skin that plays an important role in its barrier function. Mutations in the filaggrin gene cause disruption of the skin barrier. This leads to increased permeability of allergens into the skin.
2. Atopy. According to some reports, about half of patients with dyshidrotic eczema have a personal or family history of atopy (atopic dermatitis, asthma, allergic rhinitis). Serum immunoglobulin E (IgE) levels are often elevated even in patients reporting no history of atopy.
3. Hypersensitivity (allergy) to nickel. Nickel contact dermatitis has been reported in 30% of patients with dyshidrotic eczema. Nickel ingestion with food can also be a cause of dyshidrotic eczema in some patients. Increased urinary nickel excretion has been reported during exacerbations of pompholyx.
Profuse sweating is thought to result in localized concentrations of metal salts that can induce a blistering reaction.
A diet low in nickel may reduce the frequency and severity of pompholyx flare-ups.
4. Hypersensitivity to cobalt. When cobalt is consumed with food, allergic dermatitis in the form of dyshidrotic eczema occurs less frequently than when nickel is taken orally. Much more common is the co-occurrence of nickel and cobalt allergy, seen in 25% of nickel-sensitive patients who develop pompholyx. In these cases, the eczema is usually more severe.
A low cobalt diet has been suggested to help patients limit their intake and keep blood levels of cobalt below the threshold for pompholyx flare-ups. In addition, this diet reduces the amount of nickel consumed.
5. Contact exposure to allergenic chemicals or metals. Dyshidrotic eczema flare-ups are sometimes associated with exposure to allergenic chemicals found in metals or cosmetics (eg, chromium, fragrances, dyes, preservatives, etc.)
Shower gel, shampoo, hair dye, etc. often act as a contact allergen.
6. Fungal infection. In some patients, pompholyx develops with a fungal infection and resolves with antifungal treatment.
7. ID reaction. This is a reaction to distant foci of a fungal or bacterial infection. For example, with a fungal infection of the feet (or bacterial interdigital diaper rash), itchy blisters may appear on the hands.
8. Emotional stress. This is a possible factor in dyshidrotic eczema. Many patients report recurrences of pompholyx during stressful periods.
9. Hyperhidrosis – excessive sweating. To date, it has been proven that hyperhidrosis of the palms and feet is not the cause of pompholyx, but is an aggravating factor in 40% of patients with dyshidrotic eczema. Reducing sweating of the palms after the introduction of botulinum toxin helps to reduce / stop itching and blisters.
10. Climatic and seasonal factors. Environmental factors (seasonal increase in temperature, high humidity) exacerbate rashes in the form of bubbles.
Although phototherapy is a known effective treatment for pompholyx, exposure to ultraviolet A rays can trigger an outbreak in some patients. The use of photoprotective agents in this case leads to a decrease in the frequency and severity of exacerbations.
11. Other factors. The results of various studies describe other possible causes of the development of pompholyx, such as taking certain drugs, foods, smoking tobacco, diseases of the internal organs.