Poison Ivy!

Spring has finally arrived in Chicago!  So has this plant……

I placed this blog in my “preventive medicine” category.  This “Disease of the Week” is VERY PREVENTABLE- as long as you stay away from this plant.  What’s your guess?

Let’s learn about shingles. It is also known as zoster or herpes zoster. It is caused by a reactivation of the varicella virus (chickenpox). Check out the photo on the previous post (Disease of the Week- # 11).

10% to 30% of people will develop shingles in their lifetime. It generally occurs as we get older because our immunity to the virus decreases as we age. Around 50% of people who live past the age of 85 will have shingles at some point in their life.

About 20% of people with shingles develop a complication caused postherpetic neuralgia (PHN). This syndrome is characterized by chronic pain and discomfort in the area involved.

The goal of the vaccine is to prevent shingles and postherpetic neuralgia (PHN).

The Shingles Prevention Study was a very good study published in the New England Journal of Medicine in 2005. The Zoster vaccination reduced the incidence of shingles by 51% and the incidence of PHN by 66%.

The vaccination, Zostavax, is the only vaccine available. It is licensed by Merck. It does not contain thimerosal (a mercury-based preservative). There are some people who should NOT receive this vaccine, so ask your doctor if it’s right for you.

The answer is Herpes Zoster! More commonly known as SHINGLES.

Herpes Zoster (Shingles) is an acute (short-term) infection associated with the reactivation of varicella-zoster virus (VZV) or Chickenpox. It characteristically starts with unilateral pain (on one side of the body). It progresses to vesicular eruption (like little blisters) in the area of a dermatome (a single spinal nerve). The skin lesions may be pruritic (itchy) but not painful. 20% of people who get shingles are at risk for developing the chronic stage- postherpetic neuralgia. Postherpetic neuralgia (PHN) can persist for months or even years after the original skin lesions have resolved.

Herpes Zoster (Shingles) usually occurs in older adults (older than 55 years of age). There is a vaccine to prevent shingles. It is recommended for people older than 60 years of age. More about that on my next post!

This 45 year old man came to the office complaining of this localized rash for the past 4 days (see photo). It was not painful, but felt “prickly”. It did itch and was sensitive to touch. He had no other medical illnesses and took no prescribed medications. He is happily married, does not smoke and occasionally drinks alcohol on the weekends. There has been no changes in the laundry detergent or exposure to any poison-ivy or poison-oak. He has never had anything like this before.

Feel free to post your guesses in the comments section.

Wandering through the small streets of Diamante in Italy, I came across this “advertisement” for the peperoncino. 

ITALIAN TRANSLATION: The “Viagra” for the poor. 

 Here’s a great simple recipe.  Eat at your own risk!

How does your doctor diagnose acne? Usually,  your doctor can diagnose acne just by examining the affected areas.  There are, however, some very important things you should mention to your doctor if it applies to you. Tell your doctor if your have:

1.  sensitive skin or a history of atopic eczema.
2. a history of kidney or liver problems.
3. an allergy to anything.
4. ever used anabolic steroids.
5. a problem with mood disorders, depression or suicidal thoughts.
6. irregular menses or use contraception.
7. a current or past pregnancy, weight gain, diabetes, loss of scalp hair, infertility, hirsutism or breast feeding.

Today’s blog was posted in an outdoor cafe in Assisi, Italy.  Thanks to all the staff at Caffe’ Duomo in the Piazza San Rufino.  This picture was taken with Photo Booth on my MacBook.

Acne affects 85% of the adolescents in the United States!  Skin-care products, doctor visits, and prescription drugs cost Americans over 2.2 billion dollars annually.

 PREVENTION:

By far, most cases of acne are inherited!   Having a first-degree relative affected by acne is the greatest risk factor.  There are no high-quality studies showing that skin-care products or diet can prevent acne.  However if chocolate or greasy foods seem to make it worse, then it would be wise to avoid those foods.  Also, good personal hygiene is also advised.  For example, washing acne-prone areas twice a day and using only oil-free (non-poreclogging) skin-care products.

A friend of mine recently returned from India. She was concerned about some red itchy “pimples” on her waist. She asked me if she had gotten bitten by bed bugs. (ugh)The Harvard School of Public Health has a wealth of information on many things- including bed bugs.I ran across a blog devoted to bed bugs- bedbugger.com. This is an amazing resource if you are unfortunate enough to have this problem. The photos are great and the advice and tips are extremely informative.WedMD also has an article called “Don’t Lose Sleep Over Bed Bugs“. Check out the bed bug slide show.Not something you want to read about before bedtime!