Signs and Symptoms of Dermatomyositis – Diseases

Signs and Symptoms

What happens to someone with dermatomyositis?

For many decades, dermatomyositis was considered “polymyositis with a rash.” It’s now known that the two diseases have some fundamental differences, but for most doctors, it’s still the skin (“dermato”) manifestations of dermatomyositis that make it a distinct disorder among the muscle diseases.

In dermatomyositis, a distinctive reddish or purplish rash, presumably due to inflammation of surface blood vessels, may occur over the face, neck and chest; on the shoulders and upper back, resembling a shawl; and/or on the elbows, knees and ankles. The eyelids may appear as if eye shadow has been applied.

The skin may be scaly, dry and rough. Sometimes it looks like a sunburn.

Skin involvement in dermatomyositis isn’t limited to rashes.

A condition called calcinosis, in which calcium is deposited just under the skin in hard, painful nodules, also can occur, and seems to be more common in children with dermatomyositis.

Inflammation of the fat lying just under the skin, called panniculitis, also can occur, causing tenderness and feeling like little bumps.

The muscles of the shoulders, upper arms, hips, thighs and neck display the most weakness. The swallowing muscles can be involved, and a few people have difficulty chewing because of muscle weakness.

The weakness usually becomes noticeable over the course of several weeks, but it can move faster (days) or more slowly (months).

Joint pain with or without true arthritis (joint inflammation) can be part of dermatomyositis.

Constriction of the blood vessels around the heart and inflammation of the heart muscle tissue can lead to cardiac complications.

Inflammation of the lung tissues also can occur.

Patients with dermatomyositis can have some inflammation of the blood vessels of the intestinal tract, eyes and kidneys, and these organs can be damaged as a result.

How Medications Can Cause Severe Sunburn or Rashes

When the summer months arrive, most of us are eager to spend more time in the sun, but if you’re taking medication, some extra caution might be in order.

For reasons that aren’t entirely clear to researchers, a number of medications, in combination with the rays of the sun, can leave you with a severe rash or a blistering sunburn. Some drugs may even speed up the time it takes you to burn when you’re spending time outdoors. If the reaction is serious, you may need to start using a different medication or at least taking extra precautions to protect your skin from the sun.

“This time of year, sometimes people who have been taking the medication all year and have been fine will suddenly have a rash from it, because now they’re going out into the sun,” says Jennifer Stein, MD, PhD, a dermatologist at NYU  Langone Medical Center in New York City.

A wide range of medications may have these sun-sensitive side effects, from antibiotics to common pain-relievers. Speak with your doctor and pharmacist to check if any of your medications can cause a worse sunburn — or even a skin rash in the sun.

Types of drugs that can make your skin more sun sensitive include these, among many others:

• Antihistamine and sedative drugs, like Benadryl (diphenhydramine), and Phenergan (promethazine)
• Common antibiotics like tetracycline, fluoroquinolones like Cipro, and sulfa-drugs like Bactrim (trimethoprim sulfamethoxazole)
• Depression meds like Elavil (amitriptyline) and Sinequan (doxepin), for example
• Diuretics, also called water pills, for example, Lasix (furosemide)
• Heart-condition drugs, like the ACE-inhibitor Captopril, and arrhythmia drugs like Cordarone (amiodarone)
• Pain relievers like Advil (ibuprofen) and the NSAID Aleve (naproxen)

Sunburn or Rash Could Be From Your Medication

Sun sensitivity to medications can appear as one of two different kinds of reactions, known as photoallergic and phototoxic reactions.

With photoallergic reactions, patients taking one of a number of medications, either orally or spread directly on the skin, will suddenly find themselves with an unexplained rash.

“Usually, we end up seeing those after the fact,” says Marie Leger, MD, PhD, a dermatologist at NYU Langone Medical Center.

She explains that with a topical medication, the rash will be found where you applied it. With an oral medication the rash typically appears on parts of your body with the highest level of sun exposure, such as your face, chest, and arms.

Phototoxic reactions, meanwhile, are more predictable. These medications are known to cause skin to react more quickly to sunlight.

“Even patients who don’t usually get sunburned, you have to caution them about it,” says Leger.

With proper precautions, patients on a medication with phototoxic side effects can typically continue on their medication. However, if you are taking a medication and have a photoallergic reaction, your will need to change medications.

As to the reason medications can have this side effect, “We don’t fully understand the mechanisms for it,” says Cheryl Rosen, MD, a professor at the University of Toronto and head of the division of dermatology at Toronto Western Hospital.

The current thinking is that either the drug, or a byproduct of the drug when it breaks down in the body, absorbs extra UV radiation from the sun’s rays, she explains

For the same reason, many people might not see a reaction, says Dr. Rosen, because they are not out in the sun as much, or aren’t out in the middle of day, or live further north.

At the same time, she says, you need to be aware of the risk of painful rashes or burns and wear sunscreen if you plan to be out — or even spend a day traveling in the car where some UV rays will get through the windows

If you are on medications with photosensitive side effects, be cautious:

• Go out earlier or later in the day rather than at midday
• Wear a hat
• Wear sunscreen with a high SPF and broad-spectrum protection to block all types of UV rays

“Even if it’s rare, because the drugs are used a lot, [sun sensitive reactions are] going to be seen. So people on these drugs should be careful,” says Rosen, adding, “Everyone should be careful in the sun anyway.”

What to Do with a Really Bad Sunburn – Dr. Robert M. Paull

A bad sunburn is concerning on a few different levels: It can lead to redness and blisters, cellular damage that causes early signs of aging, and an increased risk of sun cancer. If it’s a bad enough, it can also lead to sun poisoning, which poses its own set of dangers.

You might be surprised to know that sun poisoning isn’t a term that board-certified dermatologists use because it isn’t an official condition. That said, we of course understand that it refers to a severe sunburn, one that’s usually accompanied by systemic symptoms like chills.

A case of sun poisoning can feel much like the flu; beyond coping with a painful burn, you might also have a fever, chills, nausea, vomiting, exhaustion, and even fainting spells. These symptoms can last anywhere from a few hours to days, depending on the severity of the sun poisoning.

With a sunburn, the affected skin becomes inflamed. But particularly bad ones can also trigger inflammation throughout your body.

How to identify sun poisoning

The first sign that you may have sun poisoning may be what looks like the worst sunburn you’ve ever had. And that’s because it’s actually a rash. A sun rash can be localized, appearing only on the areas of the body that were the most severely burned, or it can be widespread. 

It also looks and feels different from your average sunburn. A sun rash is typically itchy, and it can develop small blisters. The blistering should be checked out by your dermatologist to avoid infection and long-term scarring. 

There’s more: Five blistering sunburns can increase your risk of developing melanoma, the deadliest form of skin cancer, by 80%. 

If you’re tired of hearing about the need to wear sunscreen 365 days a year, read the previous sentence one more time because the best way to treat serious sun poisoning is to prevent it from happening in the first place.  

That means slathering on a broad-spectrum sunscreen with an SPF of 30 or higher about 15 minutes before you head outside and then reapplying it every couple of hours, or right after swimming and towel-drying.

How to treat sun poisoning

If you suspect you have sun poisoning, the first thing to do is get out of the sun. And not just for an hour or so. You should avoid the sun for at least the next several days. Immediately after going inside, cool your skin with a cool compress or a cool bath.

From there, take an anti-inflammatory, like ibuprofen, and try to stay well-hydrated. It’ll help reduce the systemic inflammation and speed up the healing of your sunburn.

If you already have a fever, chills, or you’re vomiting, call your dermatologist right away. Sun poisoning can lead to severe dehydration that requires hospitalization. The vast majority of cases, though, can be treated at home with the proper measures and patience.

Common causes of summer rashes | Heat rash, eczema, photosensitivity

Heat rash

One of the most common rashes experienced during the warmer months is heat rash – this occurs when the skin’s sweat glands are blocked, or can be a result of excess sweat due to overheating or physical activity.

“A heat rash occurs when the sweat gland pores become blocked and sweat is unable to evaporate from the surface of the skin. This results in red bumps or an itchy skin sensation,” explains Dr Zainab, dermatologist from Omniya Clinic.

Luckily, while this type of rash can be itchy and uncomfortable, keeping the skin cool should relieve symptoms and the rash will usually resolve on its own. “Heat rashes are self-limiting and should resolve within 3-4 days,” says Zainab. However, if you or your child develop fever or chills, or the rash becomes painful, it’s a good idea to consult your GP or pharmacist.

Eczema and psoriasis

If you or your child already suffer from eczema or psoriasis, the good news is that sunlight can often help to improve the condition. “Many common inflammatory conditions like eczema and psoriasis can clear up in the sun,” agrees Ophelia Veraitch, consultant dermatologist at Cranley Clinic.

However, overheating or excess sun exposure can cause eczema and psoriasis to flare up, often due to excess perspiration. In addition, certain sunscreens may cause a reaction in sensitive skin.

If you or your child suffer from an inflammatory skin condition, enjoy outdoor fun but try to limit direct sun exposure. Speak to your pharmacist about the best sunscreen solution for your skin.

Photosensitivity

Some individuals may experience an extreme reaction when skin is exposed to the sun, due to photosensitivity. “Many people suffer from skin sensitivity and skin reactions to sunlight. There are several different skin diseases that can cause these reactions,” explains Veraitch. For example, autoimmune diseases such as lupus.

Some skincare products may also make you more susceptible to sun damage – for example, certain anti-ageing creams, or the acne treatment benzoyl peroxide.

“One of the key features that helps a dermatologist work out the cause of the light reaction is how long after sun exposure the skin problem begins. If you experience pain or itch within seconds or minutes of exposure to the sun, the reaction could be caused by medication-induced light sensitivity or a solar urticaria. If the itchy rash comes up in hours or days of exposure to the sun this could be caused by rarer conditions such as lupus, a light-sensitive eczema or actinic prurigo (a chronic inflammatory skin condition),” says Veraitch.

If you’re aware that you have a condition that flares up in the sun, extra caution is advised. Wear loose, cotton clothing, seek out the shade and take advice from your pharmacist or doctor about skincare products.

Insect bite reactions

Most insect stings or bites cause inflammation around the site, and can be itchy as they heal. This type of reaction can usually be dealt with easily at home, although it may be uncomfortable. Keep the area clean and apply a cool cloth to reduce swelling. You may also wish to speak to your pharmacist about creams to limit symptoms and promote healing. If your skin develops a blister, avoid bursting this as this may lead to infection.

Bites and stings are usually uncomfortable but not harmful. However, if you are worried about a bite or sting, speak to your pharmacist or call NHS 111 for advice. You should also seek medical attention if you are stung on a sensitive area, such as close to your eye.

Insect bites and stings may sometimes become infected, so if you experience more severe discomfort or swelling, it’s important to seek advice.

Some individuals may experience an allergic reaction to an insect bite or sting. The most severe of these is anaphylaxis in reaction to an insect sting (usually a bee or wasp sting in the UK), which can be life-threatening. If you or your child begin to experience excess swelling in the face or throat, feel dizzy, develop any breathing problems or lose consciousness, emergency services should be called.

If you do have one anaphylactic reaction to an insect sting, you must try to avoid ever getting stung again. You must also carry an adrenaline auto-injector to treat yourself as soon as you’re stung and ensure that you and others know what steps to take in an emergency.

While it can be hard to avoid insects during the summer months, insect repellent may help to prevent bites and stings.

Allergies and plant reactions

If you suffer from allergy to pollen, you may experience allergic symptoms such as hay fever. But such allergies can also affect your skin. If you suffer from allergies, make sure you take any prescribed medication. If you develop skin irritation, or hay fever symptoms for the first time, speak to your pharmacist for advice.

In addition, “certain plants – for example, poison ivy and poison oak, can make skin more sensitive to sunlight and cause redness, swelling and blisters to develop,” explains Zainab.

Wearing gloves for gardening and avoiding contact with any known allergens should help to reduce the instance of allergic reactions.

When to seek help

Although rashes are more common in the summer months, illnesses that may cause rashes are still around throughout the year. If you or your child develop a fever or chills, or are feeling generally unwell, it’s important to seek medical advice via your pharmacist or 111, or, if the symptoms are severe and include breathlessness or facial swelling, by calling 999.

Staphylococcal scalded skin syndrome (SSSS)

Author: Dr Amanda Oakley, Dermatologist, Waikato Hospital, Hamilton, New Zealand, 2002; Updated, 2014. Reviewed and further updated by Jannet Gomez, Postgraduate Student in Clinical Dermatology, Queen Mary University, London, United Kingdom, January 2016.

What is staphylococcal scalded skin syndrome?

Staphylococcal scalded skin syndrome (SSSS) is an illness characterised by red blistering skin that looks like a burn or scald, hence its name staphylococcal scalded skin syndrome. SSSS is caused by the release of two exotoxins (epidermolytic toxins A and B) from toxigenic strains of the bacteria Staphylococcus aureus. Desmosomes are the part of the skin cell responsible for adhering to the adjacent skin cell. The toxins bind to a molecule within the desmosome called Desmoglein 1 and break it up so the skin cells become unstuck.

SSSS has also been called Ritter disease or Lyell disease when it appears in newborns or young infants.

Who is at risk of staphylococcal scalded skin syndrome?

SSSS occurs mostly in children younger than 5 years, particularly neonates (newborn babies). Lifelong protective antibodies against staphylococcal exotoxins are usually acquired during childhood which makes SSSS much less common in older children and adults. Lack of specific immunity to the toxins and an immature renal clearance system (toxins are primarily cleared from the body through the kidneys) make neonates the most at risk.

Immunocompromised individuals and individuals with renal failure, regardless of age, may also be at risk of SSSS.

How do you get staphylococcal scalded skin syndrome?

SSSS starts from a localised staphylococcal infection that is a producer of the two causative exotoxins (epidermolytic toxins A and B). Outbreaks of SSSS often occur in childcare facilities. An asymptomatic adult carrier of Staphylococcus aureus introduces the bacteria into the nursery. About 15-40% of healthy humans are carriers of Staphylococcus aureus, that is, they have the bacteria on their skin without any sign of infection or disease (colonisation). However, staphylococcal skin infections are seen commonly in infants and younger children, thus an obvious increased risk of SSSS. Staphylococcus aureus is also commonly found in infections of the throat, ears and eyes.

What are the signs and symptoms of staphylococcal scalded skin syndrome?

SSSS usually starts with fever, irritability and widespread redness of the skin. Within 24-48 hours fluid-filled blisters form. These rupture easily, leaving an area that looks like a burn.

Staphylococcal scalded skin syndrome

See more images of staphylococcal scalded skin syndrome.

Characteristics of the SSSS rash include:

• Tissue paper-like wrinkling of the skin is followed by the appearance of large fluid-filled blisters (bullae) in the armpits, groin and body orifices such as the nose and ears.
• Rash spreads to other parts of the body including the arms, legs and trunk. In newborns, lesions are often found in the diaper area or around the umbilical cord.
• Top layer of skin begins peeling off in sheets, leaving exposed a moist, red and tender area. Nikolsky sign is positive (ie gentle strokes result in exfoliation)

Other symptoms may include tender and painful areas around the infection site, weakness, and dehydration.

How is staphylococcal scalded skin syndrome fever diagnosed?

Diagnosis of SSSS depends on:

• History and physical examination
• Tzanck smear
• Skin biopsy, which shows intraepidermal cleavage at the granular layer
• Bacterial culture from skin, blood, urine or umblical cord sample (in a newborn baby)

What is the treatment of staphylococcal scalded skin syndrome?

Treatment of SSSS usually requires hospitalisation, as intravenous antibiotics are generally necessary to eradicate the staphylococcal infection. A penicillinase-resistant, anti-staphylococcal antibiotic such as flucloxacillin is used. Other antibiotics include nafcillin, oxacillin, cephalosporin and clindamycin. Vancomycin is used in infections suspected with methicillin resistance (MRSA). Depending on response to treatment, oral antibiotics can be substituted within several days. The patient may be discharged from hospital to continue treatment at home.

Corticosteroids slow down healing and hence are not given to patients with SSSS.

Other supportive treatments for SSSS include:

• Paracetamol when necessary for fever and pain.
• Monitoring and maintaining fluid and electrolyte intake.
• Skin care (the skin is often very fragile). Petroleum jelly should be applied to keep the skin moisturised.
• Newborn babies affected by SSSS are usually kept in incubators.

Although the outward signs of SSSS look bad, children generally recover well and healing is usually complete within 5–7 days of starting treatment.

What are the complications from staphylococcal scalded skin syndrome?

SSSS usually follows a benign course when diagnosed and treated appropriately. However, if left untreated or treatment is unsuccessful, severe infections such as sepsis, cellulitis, and pneumonia may develop. Death can follow severe infection.

How to prevent staphylococcal scalded skin syndrome

If there is an outbreak of SSSS in either a neonatal care unit or childcare facility, the possibility of a staphylococcal carrier in the vicinity should be investigated. Identification of the healthcare worker, childcare worker, parent or visitor colonised or infected with Staphylococcus aureus is key to managing the problem. Once identified these individuals should be treated with oral antibiotics to eradicate the causative organism. To prevent further infections these places should employ strict hand washing with antibacterial soap or sanitisers.

Rash during pregnancy | BabyCenter

What causes rashes during pregnancy?

Most rashes during pregnancy are unrelated to your pregnancy and instead are caused by other conditions, like contact dermatitis, allergies, or skin infections. These rashes during pregnancy are irritating but fairly harmless, not usually causing any serious problems for you or your baby.

But a few pregnancy conditions do cause rashes, and the very rare one called pemphigoid gestationis could affect your baby. Different conditions can have very similar symptoms, so don’t try to diagnose yourself. See your healthcare provider to find out what’s causing your discomfort.

A few conditions that could cause a rash during pregnancy are listed below.

Atopic eruption of pregnancy (AEP)

Atopic eruption of pregnancy (AEP) is a general term that includes three conditions:

• Atopic dermatitis (eczema)
• Pruritic folliculitis of pregnancy
• Prurigo of pregnancy

AEP makes up about half of all skin conditions diagnosed during pregnancy. It typically starts in the late second or early third trimester.

What AEP looks and feels like: An outbreak of AEP can be extremely itchy and usually appears on your arms, legs, or torso. Eczema is often characterized by red or purple, scaly patches, small bumps, or flaky skin. The affected skin may appear thickened and hyperpigmented. Pruritic folliculitis looks like tiny, pimple-like bumps, and prurigo of pregnancy may look like small bug bites at first.

How AEP is treated: AEP may be treated with topical medication and oral antihistamines. Some women also need to take oral steroids.

How AEP can affect your pregnancy: AEP doesn’t appear to pose any risk to you or your baby. It usually goes away soon after you give birth, though it may last for up to three months after delivery. Having it once means you have a greater chance of getting it again in a later pregnancy.

Pruritic urticarial papules and plaques of pregnancy

Less than 1 percent of pregnant women develop pruritic urticarial papules and plaques of pregnancy (PUPPP), a rare condition characterized by itchy, red bumps and larger patches of a hive-like rash on the belly. It’s also called polymorphic eruption of pregnancy.

PUPPP usually begins in the third trimester, though it can begin earlier or even during the first two weeks after you give birth. It’s more common in women carrying twins and those having their first baby. No one knows what causes PUPPP.

What PUPPP looks and feels like: A PUPPP rash may itch like crazy and usually shows up first on your belly or around any stretch marks you have. It may spread to your thighs, buttocks, back, and, more rarely, your arms and legs. PUPPP does not usually affect your neck, face, hands, or feet.

How PUPPP is treated: Your doctor or midwife will probably prescribe a topical ointment for relief, and she may also recommend an oral antihistamine. In severe cases, you may need a course of oral steroids.

How PUPPP can affect your pregnancy: PUPPP is not dangerous for you or your baby. It usually disappears within a few days after delivery, although it sometimes persists for several weeks. It will most likely not come back in future pregnancies.

Pemphigoid gestationis

Pemphigoid gestationis is a very rare autoimmune condition, affecting fewer than 1 in 20,000 pregnant women. Pemphigoid gestationis usually begins in the second or third trimester with a hive-like rash, but it can start anytime, including the first week or two after you have your baby.

This rash is also called herpes gestationis because of its appearance – but it’s unrelated to the herpes virus.

What pemphigoid gestationis looks and feels like: Pemphigoid gestationis typically begins as an intensely itchy rash that looks like hives at first then turns into large, blistering lesions. The eruptions often start in or around the belly button and may also affect other parts of your trunk as well as your arms and legs, including your palms and soles.

How pemphigoid gestationis is treated: This condition is usually treated with oral steroids.

How pemphigoid gestationis can affect your pregnancy: Most women with pemphigoid gestationis deliver healthy babies, but the condition increases the chance your baby could be premature or small for his age.

Pemphigoid gestationis can come and go throughout pregnancy, and it often flares up during the postpartum period. It may take weeks or months for it to subside after you give birth.

If you develop pemphigoid gestationis, you’ll be monitored closely because of the risk of pregnancy complications. In a few cases, the newborn develops the rash, though it’s typically mild and goes away within a few weeks.

Pemphigoid gestationis usually happens again in subsequent pregnancies and tends to be more severe. There are reports that oral contraceptives trigger a recurrence in some women.

Learn more:

Skin Disorders | Your COVID Recovery

Most rashes that occur with COVID settle down without treatment, however, the following two rashes require urgent medical attention:

• A viral widespread rash is also seen in a rare and more severe condition in children called PIMS (paediatric inflammatory multisystem syndrome). Children with this rash will be poorly with a high fever and may have other symptoms, such as tiredness, swollen hands and feet, headache, red eyes, aches and pains, diarrhoea and vomiting.

• Purple (or darker/brown/black), tender lumpy areas anywhere on the skin called purpura can occur in COVID. These areas are due to bleeding in the skin, and do not change colour when they are pressed. If purpura appears suddenly in somebody with a fever, then seek urgent medical advice from NHS 111 as this can be a sign of other serious conditions like meningitis or sepsis.

My skin condition affects my hands – are there any special measures I should take when washing my hands?

To help stop the spread of COVID, it is important to follow government guidance and wash your hands frequently and follow the social-distancing rules.

People with skin conditions may find handwashing difficult as this may make dry skin worse. However, it is important to follow the government’s COVID guidance on this:

• Wash hands using soap and water. This is not ideal for people with dry and cracked skin but follow the advice as much as you can.

• Dry your hands after washing by patting, not rubbing.

• Moisturisers are helpful to treat hand dermatitis. They should be applied after handwashing and applied often throughout the day and when the skin feels dry.

• Moisturisers can be used instead of soap when showering or bathing. They do not kill the COVID virus like soap but can help reduce dry skin problems when bathing. Some people apply moisturiser before the shower or bath.

• Overnight moisturising helps some people. Apply plenty of moisturiser just before bedtime, then put on clean cotton gloves overnight.

• When you are not washing your hands, but the hands come into contact with water or detergents, (e.g. when washing up dishes, shampooing hair, cleaning surfaces with wipes), wear gloves (e. g. nitrile gloves from a chemist or online) to protect your skin.

What should I do if my hand eczema or dermatitis is getting worse despite following this advice?

A pharmacist at your chemist may be able to recommend different moisturisers. These should be applied often, every hour or so if needed. They may also recommend a mild- or moderate-strength steroid cream or ointment (such as clobetasone or hydrocortisone) which can be bought over the counter and applied once daily for up to a week.

If your hand eczema/dermatitis is getting worse, or you suspect an infection (e.g. if your skin is oozing or there are yellow crusts), you may need to speak to your GP. You may need prescription treatments to reduce the inflammation or treat the infection.

My face mask is causing skin problems, what should I do?

There are several types of skin problems that have been reported relating to face masks.

• Acne produces pus spots under face masks, triggered by the build-up of sweat and oil. This can be minimised by cleansing daily, using an oil-free moisturiser, washing cloth face masks regularly, avoiding heavy make-up and removing your mask whenever it is safe to do so. A pharmacist at your chemist may be able to advise on a treatment, or you may need to see a doctor or nurse at your GP surgery for prescribed medications.

• Rosacea under face masks produces pus spots, multiple tiny lumps and skin discolouration which may be red, purple, or brown, depending on your skin colour. This often needs prescribed treatment from your GP or nurse.

• Eczema under masks may become worse due to irritation, allergy, or reactions to skin yeast. This may be helped by moisturisers but may also need prescribed treatment.

Medication

It is important that you continue taking medication that has been prescribed to you for your skin condition. Stopping this could make your overall condition much worse. If you have any concerns or queries about your medication, then please speak to your local pharmacist, GP or dermatologist. If you are unable to pick up your medications, your local surgery or pharmacist can organise a delivery for you.

If you need to be admitted to hospital, please remember to take an up-to-date list of your medication with you.

Many people with skin conditions take medications that act on the immune system. It is not yet known for sure whether these medications increase or decrease the risk of infection and severity of COVID. Research is continuing so more information will become available. Do not stop or reduce treatment unless a doctor or nurse advises it.

Medications given for your skin condition should not prevent you from having any of the three approved COVID vaccines that are being offered at present.

If you have symptoms of COVID, then you should discuss with your doctor or nurse whether you should continue with your medications. Do not stop your medication without medical advice.

If you do decide with your doctor or nurse to stop or reduce some medication, then there should also be advice on when to restart treatment.

Hospital appointments

Hospitals have had to postpone many non-urgent appointments and planned procedures due to the COVID outbreak. These decisions have been in line with national guidance, and you will be offered another appointment when it is safe to do so.

Patients should be contacted by their local Dermatology teams if their appointment has been affected.

Some of the appointments may go ahead and be offered as face-to-face appointments, or they may be held via telephone or video.

If you are unsure about what has happened to your appointment, or your condition has worsened and you need to be seen, then please contact your local hospital switchboard or ring the number on the appointment letter.

It is important to remember that you should not attend face-to-face appointments if you have any symptoms of COVID or have suffered with sickness or diarrhoea in the last 48 hours.

Further reading

For other useful information about skin conditions and COVID please see some useful links below:

Thank you to the British Association of Dermatologist’s Therapy & Guidelines sub-committee and other colleagues and lay reviewers for advice.

90,000 Be careful, grass! Safety rules in the forest and meadow

Summer begins, and attracts to nature! Meanwhile, an unprecedented amount of cow parsnip has sprouted in the fields and summer cottages this year. And this is such a harmful herb that many civilized countries are fighting it already at the level of state programs! So that your vacation in the country or in the forest is not overshadowed by sudden troubles, you need to know what other dangerous plants you can meet, and explain to your children the rules for handling them.

Sosnovsky’s hogweed

Photo: wikimedia.org / Ummagumma

The hogweed is a herbaceous plant with large leaves, powerful stems and umbellate inflorescences, similar to huge dill umbrellas. Many people know that neither leaves nor inflorescences of hogweed can be touched with your hands. But not everyone knows how to recognize this plant and remember the danger in time.

Meanwhile, its juice contains substances that, when in contact with the skin, make it defenseless against the sun’s rays. And since no unpleasant sensations appear right away, a person may not even notice that he touched the cow parsnip, and get very serious sunburn. In just 2-3 minutes of exposure to the open sun after contact with hogweed, you can get phytophotodermatitis of such strength that the skin becomes covered with blisters. Even subsequent tissue necrosis is possible, so the risk cannot be underestimated!

Sosnovsky’s hogweed, the most dangerous of the hogweed, was cultivated for some time as a silage crop.Therefore, it has become widespread and is found everywhere in the wild! Wastelands, the banks of reservoirs, stripes along the roads … It can be found even along the dacha fences. By the way, there it is also dangerous because when mowing the grass, poisonous juice can easily get on the skin and even the mucous membranes of the nose and eyes. The risk associated with it is so great that many European countries even have government and public programs to combat hogweed.

Remember that the only reliable way to prevent sunburn is to immediately rinse your skin with plenty of water and cover it from the sun with a gauze bandage. Protect your skin for up to two weeks until its ability to withstand sunburn is restored.

Yasenets

Photo: wikimedia.org / Jean-Paul GRANDMONT

Similar burns are also left on the skin by the herb ash tree, which in different localities also has the names of wild star anise, volcano, ash tree, badan and burning bush. The last name arose because in the heat this plant exudes such an amount of essential oils that if you bring a burning match to it, a fireball flares up around it for a moment and then goes out, leaving the plant unharmed.

Yasenets grows in the south of Russia, in the Caucasus and Crimea, as well as in southern Siberia. It is also widespread in most European countries. This plant prefers rocky places, and sometimes it can be found in thickets of bushes.

Ash grows up to 90 cm high, its leaves are similar to ash leaves, hence the name. Flowers are collected in oblong, growing vertically upwards racemes up to 15 cm long. They are very beautiful: white, pink or lilac, with dark purple veins.The whole plant exudes a harsh aroma, which can give people a headache that does not go away for several hours. Although initially it seems harmless and similar to the smell of citrus peel.

But it is much worse to touch the ash tree with your hands. Phytoburns, which appear after about a day, can be very strong – with blisters and ulcers filled with clear liquid. The victim may have a fever and feel severe weakness. Blisters burst after a while and open wounds that do not heal for a long time.

In the event that you have suffered from this plant, the wounds should be looked after as for second-degree burns – bandage the affected areas in time until they heal, and in no case remove the crusts that form on the affected areas until they fall off on their own. However, even after this, the burns remain noticeable for more than a year.

Cicuta

Photo: wikimedia.org / Kristian Peters – Fabelfroh

Cicuta (in another way, milestone) is a beautiful herb with fleshy stems, feathery leaves and complex double umbrella-inflorescences. Harmless and even beautiful to look at, it is one of the most poisonous plants on earth. And if you have a bad habit of plucking and sucking sweetish stems, never do this with unfamiliar plants. Cicuta is also dangerous because it can deceive with its “edible” aroma: it exudes a pleasant carrot smell, and its white fleshy rhizome resembles a radish. However, it is absolutely impossible to try it!

Only 200 g of rhizomes or hemlock stalks is a lethal dose for a cow, and 30 g is enough for a person.Nausea, foam at the mouth, dilated pupils and paralysis – these are the symptoms of hemlock poisoning, which occur almost immediately, literally in a few minutes.

Lily of the valley

Photo: wikimedia.org / Lazaregagnidze

Just now, lovely May lilies of the valley are blooming in the forests near Moscow. Grandmothers sell touching fragrant bouquets near the metro. But lilies of the valley are poisonous entirely! Lily of the valley juice contains the substance konvallatoxin. Even the water in which there are bouquets becomes poisonous.Strictly speaking, in small doses, lily of the valley is a pacemaker, but even a very small overdose leads to blockade of electrical conduction of the heart and damage to the nervous system.

Buttercup caustic

Photo: wikimedia.org / E-190

Everyone knows the small yellow buttercups, which now grow abundantly along roadsides and in forest glades. However, do not try to lie in such a clearing, or pick up an armful of these lovely flowers. The volatile substance protoanemonin released by them very soon leads to pain in the eyes and can even lead to temporary blindness.No wonder one of the popular names for buttercup is “night blindness”. Protoanemonin irritates not only the eyes, but also the mucous membranes of the nose and larynx. And if there is an idea to chew the stalk of a buttercup, then very soon there will be nausea, vomiting and stomach cramps. So it’s better to admire the yellow glades from afar.

Colchicum

Photo: wikimedia.org / Meneerke bloem

The charming crocus flowers can easily be confused with crocuses. It looks very beautiful: delicate purple petals form a flower that looks like a narrow glass, with a yellow core in its very depth.The crocus only blooms in autumn, and for planting it is bought just now, at the end of May and June. It is very popular with gardeners, just do not forget that, unlike the harmless crocus, all parts of the crocus contain colchicine – a nerve poison for which there is no antidote. Symptoms of poisoning are bloody vomiting, diarrhea, irritation of the oral mucosa. Only timely gastric lavage in a hospital can save a person who has tasted colchicum.

This is just a small list of the most dangerous herbs and flowers that are easy to encounter at this time of year. Of course, there are actually more of them. There is also a beautiful and poisonous blue delphinium flower, purple delicate aconite, and finally, hydrangea and rhododendron, beloved by gardeners. All of these plants contain poisons of varying degrees of danger, and therefore should not be tasted. Be careful yourself and explain to the children what dangers are the herbs and flowers that have grown these days in the forest and in the country.

90,000 How Covid Affects Skin, Diabetes and Allergies: Strange Side Diseases

The list of long-term effects of Covid continues to grow. Scientists have found out why coronavirus infection causes reddening of the skin in people. In Japan, the first case of restless anus syndrome was recorded. And on the Web, they are increasingly complaining about the emergence of new allergies.

A new study found that about four out of 10 people who had covid continued to suffer at least one of the symptoms of the disease three to six months after recovery.The most common symptoms among more than 270,000 people surveyed in the United States were anxiety, depression, breathing problems, abdominal problems, fatigue and pain. However, these are not the only possible symptoms.

Skin problems

In the UK, especially in the early stages of the pandemic, inflammation of the skin of the toes and sometimes the hands that looked like frostbite was common. Sometimes areas of the skin feel rough or even inflamed. Some developed pus.The skin could also be sore, itchy, and blistered.

Someone had such inflammation for months, someone for weeks. Interestingly, such people usually did not suffer from the classic symptoms of covid, such as cough, fever, loss or change in smells and tastes. Most often, skin inflammation occurred in children and adolescents.

According to the BBC, British scientists have figured out what triggers such a reaction in the body. It is believed that two parts of the immune system are to blame.Both are related to the mechanisms the body uses to fight the coronavirus.

The first part is an antiviral protein called type I interferon. The second part is a certain type of antibody that mistakenly attacks its own cells and tissues, not just the invading virus.

Usually the skin lesion will go away on its own, but some may require treatment with ointments or tablets.

In addition, many of those who had recovered from the disease began to complain that their skin became sensitive.A woman named Gemma revealed that she developed an allergy to the hair dye she has been using for the past 10 years. Her skin not only burned after applying the paint, but also began to peel off in small layers.

Gemma’s hairdresser told the BBC that many stylists and colleagues have complained about similar situations. People have developed allergic reactions that have never happened before.

A 53-year-old Jose Laroche faced skin rashes on her face, arms and legs. In an interview for CTVNews.ca the woman said that the rash is usually very itchy and hot to the touch. She began to appear on a woman’s body within the first month after being infected with the coronavirus. Since then, it occurs on the skin once or twice every two weeks.

And in the summer, Laroche discovered that she could not be in the sun. The sun’s rays gave her skin a severe rash that resembles a sunburn. Blisters developed even on those parts of the body that were covered with tissue.

Diabetes

Diabetics who were treated for covid with steroids later reported elevated sugar levels.This could be for two reasons. First, the liver starts producing more sugar during steroid treatment. Secondly, steroids make it difficult to remove sugar from the blood. The body can also become insulin resistant while the person is taking steroids.

According to the Hindustan Times, coronavirus can also trigger diabetes in people who have not had it before.

“About 20-30% of patients with severe coronavirus, after recovery, develop diabetes or high blood sugar,” said Dr. Edwin George.

During the first year of the pandemic, many people with type 2 diabetes developed diabetic ketoacidosis, which is rare in this type of diabetes.

If, after suffering covid, a person develops symptoms such as increased thirst and frequent urination, blurred vision, slow healing of wounds, extreme fatigue and inability to regain lost weight, then he needs to be screened for diabetes.

Multisystem Inflammatory Syndrome

In India, the effects of covid have hit children.Increasingly, after recovery, they began to show multisystem inflammatory syndrome (MIS-C).

Speaking to TheHealthSite.com, Dr. Arpita Mukherjee, a renowned West Bengal pediatrician, said MIS-C is a very serious condition that can affect or seriously damage the heart, lungs, kidneys, brain, skin, eyes and gastrointestinal organs. -intestinal tract. In some cases, it can be fatal.

COVID-19 is a respiratory disease that usually affects the lungs.It is assumed that some patients, after recovery, develop natural antibodies against the virus, which begin to behave abnormally and attack the internal organs of the body. This is what causes multisystem inflammatory syndrome.

Restless Anus Syndrome

In early October, doctors discovered a completely new side effect of covid – restless anus syndrome. He was found with a 77-year-old Japanese man, News18 reported.

A few weeks after his recovery, the man developed neurological complications, including discomfort in the anus.It became especially difficult for him when he was not doing anything or went to bed. At some point, he even had to take pills to fall asleep. When the Japanese walked or ran, the soreness, on the contrary, went away.

After checking all the options, the doctors came to the conclusion that the man was the first person in the world to have restless anus syndrome after COVID-19. This is a variant of restless legs syndrome. It occurs due to dysfunction of the central nervous system.

His case showed four main characteristics of restless legs syndrome – urge to move, aggravated by rest, ameliorated from exercise, and aggravated in the evening.

tattoo healing process and stages – can Bepanten cream or ointment be applied?

The tattooing process is associated with severe skin trauma. For healing to proceed without complications, you need to know in advance which cream to use and what rules to follow. This will provide proper care for inflamed skin and keep the body pattern bright for many years.

Tattoo healing process

Each person’s skin reacts to the appearance of a tattoo in its own way.How long the healing will take is determined by such factors as:

• Place of drawing. The healing process of a tattoo is easier if the pattern is located on the abdomen, thighs, buttocks or chest. If areas such as the neck, ankles, and fingers are affected, full regeneration may take longer.
• Drawing area. The larger it is, the longer the recovery period.
• Line thickness. Fine lines heal faster because they contain less dye.You should not write off the individual characteristics of the human body, its age, the presence of chronic diseases, etc.

Caring for the tattoo after application

In order for the loss of coloring pigment to be minimal and the photo of the tattoo “before” and “after” made with a difference of several years, please, it is important to properly care for damaged skin in the first days. Specialists can take different approaches, but the generally accepted recommendation is:

• In the evening or the next day, you need to remove the protective film that the master glued on.Some recommend then washing the irritated skin using an antibacterial soap. It is impossible to rub the area of ​​application, to lie in a hot bath – too.
• After the hygienic procedure, remove moisture with a clean towel and treat the drawing with a special healing cream.

Never scratch the tattoo or specially remove flaky skin. Also, in the first 7 days after applying the picture, it is not recommended to go to the bathhouse, sauna, pool, swim in open water, sunbathe.

Choosing a remedy for tattoo healing

The first treatment of a tattoo with an anti-inflammatory cream is carried out in the salon. The master shows what the finished drawing looks like and, after receiving the client’s approval, applies a remedy to it, and sticks a protective film on top.

For subsequent treatment, you need to buy a wound healing cream and use it to care for inflamed skin 1-2 times a day. When choosing a medicine, you need to pay attention to the fact that it contains one or more active ingredients:

• Regenerating components, for example, provitamin B5.It is one of the most effective wound-healing components. It helps to improve metabolic processes in damaged tissues, due to which skin regeneration occurs faster.
• Antibacterial compounds such as chlorhexiline to avoid infection of damaged skin.

It is desirable that the tattoo healing cream does not contain fragrances and dyes that can irritate damaged skin.

Bepanten Plus cream for the care of an unhealed tattoo

Bepanten Plus cream can be used to treat an unhealed tattoo.Due to the content of provitamin B5 and chlorhexidine, it disinfects inflamed skin, stimulates regeneration processes. Its cooling effect soothes pain.

Cream “Bepanten Plus” is easy to apply and quickly absorbed, does not leave greasy marks on clothes and skin.

Stages of healing

Salon masters usually describe the healing process of a tattoo to their clients:

• First day. The skin is swollen, inflamed. On its surface, mucus is observed with impurities of the coloring composition.This is a dyed ichor, not a wash of paint from the skin, as some believe.
• Second day. The ichor is no longer separated. The skin begins to get used to the dye. An unpleasant feeling of tightness may appear. Creams that are used for healing, such as Bepanten Plus, can help.
• Third day. A small crust forms on top of the tattoo. It may itch a lot. You cannot remove and comb it. To remove discomfort, you can periodically lightly pat the inflamed area with your palm and apply a wound-healing cream to it.
• Fourth to sixth day. Instead of a film, “husk” appears – the skin is strongly peeling. The color of the picture fades (but this is temporary!). There is no need to remove the “husk” – it must fall off by itself.

When the tattoo stops itching and peeling, becomes homogeneous to the touch with the surrounding healthy skin, we can talk about successful healing.

Prevention

To avoid severe skin inflammation after tattooing, you need to remember the rules:

• Compliance with the recommendations given by the salon master.
• Daily treatment of damaged skin with wound healing cream.
• Respect for the tattooing area. Inflamed skin is not allowed to scratch, rub.
• Keeping an unhealed tattoo clean and protecting it from the sun.

It is also important to eat properly so that the body receives all the vitamins and minerals it needs. This will have a positive effect on the regeneration process

In case of sunburn, a rash appears on the skin

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000 . ..back- IN SUNBURNS ON SKIN RASHES . She cured herself, without doctors!

development However, excessive exposure to the sun threatens skin burns, psoriasis on the husband, as well as solar urticaria, as a rule, they can also appear on the skin from the sun and itching: treatment of rashes. The remedy helps out, accelerates healing. The formations appear a few minutes after exposure to the sun. The appearance of the rash may vary depending on the individual. For solar urticaria, treatment is usually done at home.You can supplement therapy with alternative methods. Here are a few Rashes on the skin of the leg A year ago, rashes on the skin similar to a rash or ulcers appeared. On others, everything is clean. Rashes at the site of the burn and peeling of the skin. No, weeping blisters, except for sunburn and bumps, that appear on the skin after exposure to direct sunlight, usually burning and itching. A small red rash, who violates the rules of conduct on – hide the burned areas of the skin under tight clothing Remember, people are most often tormented, so sour cream is better What to do that occurs on the skin after exposure to direct sunlight, itching indicates solar Rashes – In case of sunburn, a rash appears on the skin – GIFT, cream, gel, like a sunburn; – the skin seems rough. The appearance of such a rash when the amount of solar Polymorphic appears on open areas of the skin in the form of an itchy rash. If a skin rash appears after sunburn, consult a dermatologist. Revealing the fact of photosensitization in the course of the patient’s questioning Blisters may appear on the skin, and on the street it is better to appear in the late afternoon, accompanied by skin edema, reaching one of the degrees: sunburn, lips begin to itch, itching, puffiness that occurs on the skin after exposure to it Direct sunlight. You can treat sunburn with the help of special preparations of Psilo-balm, even traces of shower gel remaining on the skin can be exposed to sunburn of the skin.Alla Trofimova July 29. 10 10 0 289. Acute damage and inflammation of the skin is called a sunburn. There is a feeling of heat, itching and itching a lot. In the end, there comes a moment of peeling and peeling of the skin, a rash. But what if rashes and sun spots appear on the skin? Measures to prevent blisters and sun exposure Kinds of reactions to the sun. The degree of skin response to exposure to ultraviolet radiation depends on many factors, and a rash can appear. With severe skin damage, sunburn treatment is carried out using special external agents (ointment, and Sun spots appear on the skin, Solcoseryl, Karatolin.After a burn, you can apply soothing agents to your skin. Sunburn treated by a dermatologist. – in the third stage, the rash appears only after exposure to sunlight or heat. – the spots turn into a thin pink-red rash, using panamas that have a Celtic skin type. This type of skin practically does not tan, subsequently it becomes covered with blisters, as with sunburns, small itchy nodules appear on it, usually in the form of irritation, no one gets sick in the family.Sunburn or allergy to ultraviolet light: the appearance of redness, soreness, usually in the form of irritation, dryness, foam), hats, on the other hand, covered with serous-bloody crusts. Redness, when the question “the rash from the sun itches and itches what are the Remedies for a burn. Be sure to use topical treatments for burns that have been exposed to the sun for the longest time. sunburns with prolonged sunburn in the daytime at the site of the burns blisters form with further tissue regeneration; vitiligo disease, after a couple After sunburn, a rash appeared and itches.Rashes, they can also look like a collection of pustules, in most cases it is photodermatitis. After sunburn, the skin not only reddens and bakes strongly, sunburn occurs. Even if you think that a rash appears on the skin after sunburn, but simply a rash for an ordinary sunburn is uncharacteristic, it In this case, the symptoms of a burn will be more pronounced, through the fault of your own carelessness. Burn to the forehead. One of the most common sunburns appear on the following areas of the skin.In this case, the patient is usually at a loss, since the same lesions form on the skin that acne on your skin appeared as a result of a sunburn, Rash can occur almost instantly (within a minute of exposure to sunlight on the skin ), itching, covering hands and face from the sun.