[vc_row][vc_column width=”2/3″][vc_column_text]ΣΥΝΕΝΤΕΥΞΗ στον ΓΙΩΡΓΟ ΚΙΟΥΣΗ
The most serious dermatological issues-diseases of the summer? -Where do they come from; Dermatologist-Venoresiologist Efi P., a graduate of the Medical School of Ioannina, who worked as a Rural Doctor at Kalpaki Hospital and then specialized entirely in Swedish Hospitals, obtaining the Specialty of Dermatology-Venoresiology in Sweden and Greece, speaks to us..
What is sunburn, what do we do about insect bites, what are viral infections: herpes, ringworm, terminitis, what is athlete's foot and fungus, do you know what bacterial infections and Barman's disease are?
-Sunburn:
Greek summers at sea have turned into high-cost one-day getaways for most urban dwellers. Greek men and women spend their carefree moments basking in the sun, often without the use of appropriate sunscreen. Solar exposure during midday hours hits red. There is no luxury of overnight stays and midday siesta. The result; Sunburn. Sunburn is an acute inflammatory skin damage following excessive sun exposure. The cause of sunburn is sought in the UVB spectrum of radiation (290-320nm), almost 90% is absorbed by the upper layer of the skin, while about 10% reaches deeper into the dermis (the layer of skin below the epidermis). Depending on its severity, the burn can range from simple redness of the exposed area, 2-3 hours after exposure, to severe redness with edema (swelling) of the skin, blisters filled with serum and pain. The Severity of a Burn is a function of many different parameters. Factors play an important role, such as their skin phototype (light-skinned people are more sensitive than dark-skinned ones), the time and duration of exposure to the sun, the correct or not application of protection measures, the place where we are (we will burn much more easily in a dry beach, than on a beach with sand and pine trees). Children are more sensitive to solar radiation. The redness usually subsides in a week with desquamation (peeling) of the skin. In these areas, spots, discolorations, moles (olives) may later appear, while in the future, there is an increased possibility of carcinogenesis. Treatment for sunburn consists of staying in a cool environment, light clothing and absolute avoidance of sun exposure, taking plenty of fluids and pain relievers such as indomethacin. As local care, it is recommended for large surfaces to apply preparations (mixtures) containing cortisone to deal with inflammation and intensive moisturizing with emollients. In a small area, topical creams or ointments can be applied directly. If blisters are present, mild antisepsis (eg x octenidine) and if they open, application of topical antibiotic ointments (eg x fusidic acid) is recommended. It goes without saying that further exposure to the sun should not take place for several days.
-Stings:
ON THE COAST: The sting of a bee or a wasp normally causes a small local reaction on the skin (redness, pain and mild swelling) due to the toxic effect of the venom. The normal reaction depends on the part of the sleep. For example, if someone is stung on the arm or leg, a local irritation will be created with a rash and slight swelling, pain or even itching. The sting in soft tissues (eg, lips, tongue, eyelids, etc.) , causes a stronger reaction. The damage disappears completely in two to three days with or without treatment.
However, sensitized individuals may experience a widespread reaction (eg, swelling of the whole hand even if the finger is stung), hives all over the body, or even allergic shock (universal hives, dyspnea, hoarseness, pressure drop etc.).
AT THE FLOOR OF THE SEA: sea urchin and sea urchin
In the event of a sting from a stingray in the sea, the use of ammonia topically. Ammonia neutralizes the poison that the sow has. An ammonia stick can be found at any Pharmacy. If a sea urchin is stepped on, emollients such as oil help the skin shed the spines on its own, as well as removing the spines carefully, eg with clean tweezers. However, special care is required, because very easily the thorns penetrate deeper into the skin.
OUTSIDE: SNAKES
In Greece, out of the approximately 70 species of reptiles that can be found, only 7 snakes are venomous and 5 of them are dangerous for humans. They all belong to the Echidna family (Vipers) with relatively strong venom. The venom of these snakes mainly affects the circulatory system, causes blood to clot and blocks the arteries of the lungs. Pain and local swelling are usually severe and intense, with a burning sensation. The bite site soon swells, bruises, and if untreated begins to turn black as the venom progresses and destroys the tissues at the bite site. The severity of symptoms depends on the amount of venom injected.
In the event of a snake bite, keep calm, the snake is probably not poisonous. If we see in the wound the characteristic two holes from the teeth of the snake, then we are probably dealing with a viper. We don't make any assumptions. The venom moves through the lymphatic main circulation and the bandaging, especially if it is also small (ie with accompanying occlusion of the arteries) can cause a lot of damage. We do not make incisions with knives and do not suck blood from the wound (especially by mouth!). The tissue destruction and pain thus caused is far more dangerous than the 6% of venom calculated to be removed by the above methods. Wash the wound with mild antiseptics (e.g. soap and water, oxygen, etc.). We do not apply ice and arrange for the victim to be immediately transported to the nearest medical facility, calling in advance and stating the incident and type of snake so that the appropriate anti-epileptic serum can be administered.
Viral infections: herpes, termites, terminthos infectious:
The sun aggravates many pre-existing skin diseases either through immunosuppression locally or through other mechanisms. Cold sores recur after prolonged exposure to the sun.
Warts are caused by the skin being infected by some strains of the HPV virus (Human Papilloma Virus), i.e. the virus of human papillomas. They appear on bare parts of the body, mainly on the soles and palms, usually without pain. It is noted that the strains of the family that cause warts, a venereal disease, are different. Ants are very common in children. Warts on the soles of the feet are mainly caused by strain 1, while those on the hands are caused by strains 2 and 4. Smooth warts mainly on the face are caused by strains 3 and 10. Warts have an incubation period of 2-9 months and appear on the hands as painless papules while on the soles they resemble hyperkeratosis that can be peeled off by the patient as calluses (calluses), intensely painful when walking. If left untreated they increase in size and number.
Molluscum contagiosum:
Infectious termite is a papular skin lesion caused by Infectious termite virus (IMT), of the Pox viridae family. It can appear anywhere on the body and is characterized by 3-6 mm pearly pink papules (like pimples). It has an incubation time of 2-7 weeks. It is a sexually transmitted disease in adults with the main localization being the adolescent and the external genitalia. Children with atopic dermatitis are prone to infection with the virus, and in these cases infectious terminthos may worsen the atopic dermatitis. Transmission is common through water (pool use) and increases significantly after injury. Usually 10-20 lesions are seen, but in immunocompromised individuals many more may be seen.
Infectious terminthos are diseases that heal themselves within a few months, however we treat the lesions to limit their spread to the same or other people. The treatment consists in removing the lesions and crushing them with surgical forceps or cochlear and then applying iodine tincture. Other methods are the treatment of lesions with cryotherapy, with diathermocoagulation, with imiquimod cream, or with cytostatic substances (podophyllin and podophyllotoxin).
FUNGI and athlete's foot:
There are three groups of fungi that infect humans: anthropophiles, zoophiles and geophiles. Yeast infection on the body appears as a plaque with peripheral peeling, usually pink, while there is pruritus (itching).
On the nails, the fungal lesion appears as a yellowish to black spot, usually at the tips of the nails. Onychomycosis usually affects women. It is due to excessive nail filing and cutting of the skin around them combined with open shoes.
More often in athletes and not only, the increased humidity and temperature in the summer predisposes to fungal infections in the soles and interphalangeal spaces, in feet that sweat and are not sufficiently ventilated. Hence the name of the condition as athlete's foot. In foot fungus, the interdigital spaces can be affected, especially when the space between the toes is very narrow, but also the sole partially or entirely. The skin appears whitish, may have cracks and lines, and peeling is observed. Most of the time it is accompanied by itching or bad smell. In advanced fungal infections, intense hyperkeratosis as well as blistering can be observed. Secondary infection from common microbes is not uncommon. 17% of people who frequent swimming pools have been found to suffer from what is called athlete's foot.
The identification of the responsible fungus is done by culture from skin scales of the area and is necessary in some cases that must be differentiated from other diseases of the soles (e.g. eczema, psoriasis, etc.). Treatment in the initial conditions is with topical antifungal preparations, foot baths with antiseptic substances and advice for dealing with relapses. In extensive and resistant fungal infections, antifungal pills should always be administered in combination with local measures.
Drying the soles after bathing, frequent change of socks, especially after sports and use of special protective powders are some auxiliary measures of daily use. The shoes should not be made of synthetic materials and should be sufficiently ventilated.
Another skin problem with increased frequency in the summer is Scabies. It is caused by a fungus, Malassesia Fur-Fur, that grows on the skin and scalp of all of us. This yeast is not transmitted by sand, objects or swimming pools, rather it multiplies in oily skin due to sweating and high temperature. Recurrences are common with spots in a variety of shades depending on the phototype, are lightly scaly and are located on the back, upper chest and arms.
It is treated with antifungal shampoos, creams or sprays and in extensive cases or frequent recurrences with oral pills. It is also important to maintain the local treatment 1-2 times a week during the summer months to prevent recurrences.
Bacterial Infections:
Ringworm is a skin infection most commonly caused by Staphylococcus aureus or more rarely by Streptococcus pyogenes. Most commonly, impetigo appears on the face, but it can appear anywhere on the body. Initially the lesion takes the form of a blister which spreads and turns into a scab (a hard black crust on the wound). Scabies may be absent and the lesion may be erythematous with erosions and bullae (blisters with fluid). There are cases where the skin lesions are extensive. It is common in children during the summer months. In the event that it does not subside with mild local antiseptics and spread is observed, it would be advisable for the patient to refer to a Dermatologist.
Contact Dermatitis:
Contact dermatitis is a skin condition due to the inflammatory reaction to contact with an irritant or allergic substance, usually of low molecular weight, which results in a rash or allergic reaction. Itching, redness and peeling of the skin are usually observed. In more severe cases, blisters, extensive rashes and swelling may also occur.
Skin contact with poison ivy is the most common contact dermatitis. It occurs through contact with poison ivy or poison oak outdoors, such as camping and hiking. Some flowers can also be the culprit for some other types of contact dermatitis, eg, lavender, narcissus, tulips, chamomile and chrysanthemums.
Prevention is the best treatment for this condition and performing special allergy tests (patch test, photopatch test, prick test) at the Dermatologist or Allergist.
Phytophotodermatitis and Barman's Disease:
Furocoumarins are found naturally in plants and synthetically in essential fragrance oils, as well as in medicines. Plants such as dill, celery, coriander, citrus fruits (lemon, orange, bergamot), fig, mustard and white dictum contain these phototoxic or photoallergenic substances. All these plants when they come into contact with the skin cause the so-called phytophotodermatitis. For example, in limes, the pigment furocoumarin is found in the peel and not in the juice. As it is not a fat-soluble substance, it easily passes through the skin during the preparation of drinks in the summer months, hence the name Bartender's Disease.
Therefore it would be good to make reasonable use of celery roots and exposure to light, to wash hands after cutting lemon lime and generally to limit our exposure to these plants. Perfumes should be sprayed on clothing and on sun-exposed skin areas.
Skin diseases with aggravation in the sun:
Vitiligo is a disease that also requires strong sun protection of the affected areas as they do not have melanin, they burn immediately. The aesthetic problem of vitiligo is aggravated by the hyperpigmentation of normal skin with age exposure.
- Medicated rashes flare up in the sun and those with varicose veins should avoid sunbathing because they get worse.
- Especially for the summer season, acne patients should keep the following in mind: the sun and seawater help acne temporarily most of the time, but sun exposure should be done in moderation, because overexposure can make it worse.
- Rarer skin diseases with clinical aggravation due to sun exposure are porphyrias, dermatomyositis, pemphigus foliaceus, pellagra (niacin deficiency), Darier disease, Hailey-Halley disease, Darier disease, etc. They concern a limited number of patients and in these cases the Dermatologist has given the relevant preventive information.
The most vulnerable groups:
In young children, the elderly and those with chronic illnesses, the effects of sunburn can be systemic and lead to fluid loss, electrolyte disturbances and dehydration, heatstroke, and even infections (e.g. herpes simplex and shingles flare up under the UVB exposure).
In children, the keratin layer of the skin is thinner, melanin levels less, and the ratio of body surface area to body mass higher. Preventing burns in childhood also reduces the risk of developing melanoma in adulthood. Strong scientific evidence shows that the risk of developing melanoma and other skin tumors is associated with cumulative exposure to sunlight and a history of sunburn during childhood. Considering that solar radiation is becoming more and more aggressive, due to the ozone hole, we can understand why children should avoid sun exposure between 12 and 4 in the afternoon and always "wear" sunscreen with a high protection factor (e.g. SPF50+) or clothing, when for some reason they are exposed to the sun more than normal.
A short rule of thumb to avoid: Especially on the beach:
INSTRUCTIONS
- Avoid sun exposure during midday hours. The main cause of melanoma is sun exposure, especially during childhood. Don't let children play unprotected in the midday sun. Definitely a cool t-shirt, hat and glasses.
- CHOOSE THE RIGHT SUNSCREEN that protects against both UVA and UVB, that is heat- and photo-stable, that does not come off easily with water, sweat, friction, that is quickly absorbed, that does not cause allergies, that moisturizes and is safe, fragrance free.
- Dress in appropriate clothing (cotton, light-colored and densely woven clothing).
- Avoid wearing perfumes, nail polishes, sunscreens with strong odors because they attract insects (especially wasps). They can also cause phototoxic and photoallergic reactions.
- Don't sit in a wet bathing suit on the sand and don't walk barefoot to avoid fungi and ants.
- Self-examination: Notice any changes in your skin. Look carefully at your moles at regular intervals. A Mole Mapping is indicated once a year, especially in people over 40 years of age, with a heredity for Melanoma and in people with many moles. Changes in color, shape, size, infiltration, skin surface, and symptoms such as persistent itching or bleeding of a lesion are hallmarks of malignancy.
- Any suspicious lesion should motivate the patient to consult his dermatologist. Prevention is the only, stable and effective tool we have to deal with skin cancer.
- Use a body and face moisturizer, preferably fragrance-free, after sun exposure and showering. Baby oil also provides hydration and reduces itching.
- If you are allergic and have sensitive skin, it would be a good idea to consult your Dermatologist, so that you have the appropriate medicines with you and, above all, have an adrenaline pen with you in case of need, an ID with his illness and a contact phone number in case of loss of contact with the environment.
- HEALTHY HAIR: Don't forget the sunscreen for your hair. Top tip: use sunscreen body oil on your hair to prevent it from fading with salt, pool chlorine and sun exposure. It thus protects the hair from mechanical irritations and frequent washing.
Our exposure to the sun:
Sudden intense and direct exposure to the sun should definitely be avoided, especially between 11:00 A.M. and 3:00 p.m. The aim is to avoid sunburn (e.g. skin erythema after exposure to the sun). The most dangerous burns – in terms of future risk of skin cancer – are severe burns, where blisters are seen and the pain lasts for 48 hours
Sunscreen products should have a high SPF – SPF 20+ for adults, 30+ for children – and provide protection from both ultraviolet A (UVA) and ultraviolet B (UVB). Sunscreen should be applied half an hour before going out in the sun and reapplied every two to three hours.
It should be emphasized that people sitting under an umbrella in an open environment, such as the beach, are still susceptible to sunburn from reflected UV radiation unless additional sun protection measures are applied.
Likewise, the sun's rays penetrate the clouds in significant amounts and therefore there is still a tendency for the skin to get sunburned even on cloudy spring and summer days. Ultraviolet radiation does not give us the feeling of heat on our skin, that is why, often, the presence of air can falsely give us the feeling of safe exposure to the sun.
The skin should gradually get used to solar radiation (gradual exposure). If skin tans gradually it can tolerate UV radiation up to 10 times better than untanned skin. Everyone also needs to know the specific personal protection time corresponding to their photo or else the maximum permissible time of exposure to the sun without protection.
There are certain medications that increase sensitivity to light. This is something you should discuss with your doctor or pharmacist before going out in the sun. Also, long-term immunosuppressive treatments, such as those given to transplant patients, may increase the risk of developing skin cancer.
Deodorants, cosmetics and perfumes can cause an adverse reaction to the sun or permanent pigmentation. Application of these products before sunbathing should therefore be avoided.
Artificial tanning devices
Η χρήση των συσκευών τεχνητού μαυρίσματος θα πρέπει να αποφεύγεται. Έχει υπολογιστεί ότι οι άνθρωποι που κάνουν χρήση ανάλογων συσκευών έχουν 74% περισσότερες πιθανότητες να αναπτύξουν μελάνωμα σε σύγκριση με αυτούς που δε χρησιμοποιούν ποτέ. Η υπεριώδης ακτινοβολία επιδρά στο DNA των κυττάρων του δέρματος, με αποτέλεσμα αθροιστικά να προκαλείται καρκίνος του δέρματος. Παρόλο που, συχνά, η χρήση συσκευών τεχνητού μαυρίσματος προβάλλεται ως ασφαλής και ελεγχόμενος τρόπος μαυρίσματος, είναι εξίσου ή και περισσότερο επικίνδυνη με την απευθείας έκθεση στον ήλιο. Στη Σουηδία έχει απαγορευθεί η χρήση συσκευών τεχνητού μαυρίσματος σε όλη τη χώρα, στη δε Νορβηγία για τα άτομα κάτω των 18 ετών.[/vc_column_text][/vc_column][vc_column width=”1/3″][vc_widget_sidebar sidebar_id=”apexclinic-general-sidebar”][/vc_column][/vc_row]