Dermatology services

What is sun allergy?
We say that there is a sun allergy or polymorphic sun rash when an outbreak of red lesions appears in photo-exposed areas of the skin after exposure to the sun. The time it takes for the lesions to appear is variable, from half an hour to 24 hours later, and they usually last a few hours or a few days.

Injuries often cause intense itching and discomfort, more commonly affecting the face, earlobes, neckline, and back of the hands.

Causes of sun allergy
We know that it is an abnormal reaction of the skin to sun exposure but the exact mechanism by which it occurs is unknown.

There are some autoimmune diseases that can produce lesions similar to polymorphous solar eruption such as cutaneous lupus.

Sun allergy care and treatment
Sun allergy sufferers should prepare their skin one to two months before sun exposure. This is done by means of certain food supplements that contain antioxidant substances with a protective effect against cell damage caused by ultraviolet radiation.

The time of sun exposure should be very gradual starting with a few minutes a day to accustom the skin and avoid the outbreak of skin lesions. Sun exposure is not recommended during the central hours of the day (12-16h).

Photoprotection is another key factor to avoid the disease, advising the use of topical sunscreens, hats, sunglasses, clothing and umbrellas.

Topical corticosteroid creams and oral antihistamines can be used for the outbreak of lesions.

What is acne?

Acne is an inflammatory skin disease that can appear at any time of life, although it is more frequent in adolescence and in women of childbearing age.

It is usually located on the face but is also frequent on the décolleté and back. There is a variety of acne that appears in the groin, armpits or buttocks.

The lesions that help us identify acne are: red pimples, pimples with pus, blackheads and tiny white cysts. In addition, acne scars of various types appear over time: red, brown, sunken, cysts….

Causes of acne

The causes of acne are genetic and hormonal but we know that there are factors that can precipitate an outbreak or worsen it such as stress, excessive consumption of skimmed milk or a diet high in industrial fats and sugars.

Acne care and treatment

It is important to know that acne is not always associated with oily skin, sometimes it can appear on dry or sensitive skin. For this reason, the daily cosmetic care of skin with acne is not the same for everyone. It is necessary to identify the skin type in addition to the type of acne and its degree of severity.

There are very effective treatments for acne, both topical and oral.
Most topical acne treatments cause dryness or irritation to the skin and are therefore not suitable for all skin types. If topical treatment is not enough to control the acne outbreak, different oral treatments are used: oral contraceptives, oral antibiotics or oral isotretinoin, always under medical supervision.

Dermatologist’s advice: consult your dermatologist at the first signs of acne. There are medical treatments that prevent the dreaded acne scars.

What are canker sores? Canker sores are painful ulcerations of the mucosa that appear most frequently in the mouth and sometimes in the genital region. They generally appear in healthy people and more frequently in women than in men. The most frequent age of onset is from 10 to 20 years of age with persistence during adulthood.

Causes of aphthous ul cers The causes of aphthous ulcers are unknown although there may be associated genetic factors that predispose to outbreak after local mucosal trauma. Rarely, aphthous ulcers are a manifestation of certain systemic autoimmune or infectious diseases, so dermatological assessment of the lesions is necessary at the time of lesion activity.

Care and treatment It is essential to avoid any type of local trauma to prevent disease outbreaks. Once canker sores have broken out, it is advisable to maintain proper hygiene and rinse with mild mouthwashes specific for canker sores. In some cases, topical cortisone and local anesthetics may be used to relieve pain and shorten the duration of canker sores.

Links of interest

https://www.cun.es/enfermedades-tratamientos/cuidados-casa/aftas-bucales

https://www.nlm.nih.gov/medlineplus/spanish/ency/article/000998.htm

What is androgenic or androgenetic alopecia? This is a common progressive baldness that appears with great frequency over the years, mainly in men, although it also affects women. A gradual decrease in hair density and thickness is observed. In the male, a receding anterior hairline is observed, especially in the parietal regions. Subsequently, another bald spot appears on the crown of the head. In women there is a diffuse lightening of the hair, more intense in the central area. Causes of androgenetic alopecia It is caused by the combined effect of a genetic predisposition and the action of androgens on the hair follicles of the scalp. In the white or Caucasian race, androgenetic alopecia is more frequent than in other races.

Care and treatment of androgenetic alopecia Daily hair care for people with androgenetic alopecia should be the same as for any person: hygiene and moisturizing, if necessary, depending on the type of hair and skin. It is not true that the number of hair washes influences the evolution of androgenetic alopecia. The main medical treatments for androgenetic alopecia are oral finasteride and topical minoxidil 2% to 5%. Both should be used under medical supervision. There are food supplements that can be useful to strengthen hair and prevent other types of concomitant alopecia such as telogen effluvium.

Links of interest

https://www.nlm.nih.gov/medlineplus/spanish/ency/article/001177.htm

https://www.nlm.nih.gov/medlineplus/spanish/ency/article/001173.htm

What is alopecia areata?

It is localized hair loss in round or oval areas with no visible signs of inflammation in the skin. The most frequent location is the scalp but it can affect any part of the body. In most cases, alopecia areata produces only a few small patches of alopecia on the scalp that remit over the months with treatment. However, the evolution is unpredictable towards cure or worsening. Alopecia totalis is the loss of all hair on the scalp and eyebrows. Alopecia universalis represents a complete loss of all body hair. It is more frequent in young adults with similar incidence in both sexes.

Causes of alopecia areata It is an autoimmune disease of unknown origin although there are related genetic factors. It is common for disease outbreaks to coincide with periods of high stress. Although alopecia areata is not a sign of systemic disease, it is sometimes associated with other autoimmune disorders such as vitiligo or thyroid disease. There are other diseases that produce similar alopecia that should be ruled out when alopecia areata is suspected, such as trichotillomania, traction alopecia, androgenetic alopecia or initial cutaneous lupus erythematosus.

Alopecia areata care and treatment Treatments can be topical or systemic depending on the severity of the situation. Topical treatments usually consist of corticosteroids and vasodilating and irritating substances that improve the blood supply to the hair follicle. In more severe cases, systemic corticosteroids or other immunosuppressants are used. The anxiety generated by alopecia areata is very negative for its evolution. In many cases, the psychological support of the family, dermatologist or psychologist has a very positive influence on the evolution of the disease.

Links of interest

https://www.niams.nih.gov/portal_en_espanol/informacion_de_salud/Alopecia_areata/default.asp

https://www.nlm.nih.gov/medlineplus/spanish/ency/article/001450.htm

What is adult angioma or senile hemangioma?

Adult angiomas, also called capillary hemangiomas, are extremely common, asymptomatic vascular lesions that appear as bright red to purplish domes or tiny red spots. The region of the body where they appear most frequently is the trunk. They usually begin to appear around the age of 30 and increase in number with age. The only significance of angiomas of this type is the aesthetic impact.

Causes of adult angiomas

The causes are completely unknown, although it is possible that there is an associated genetic factor. Care and treatment of adult angiomas Senile hemangiomas do not require any special care. Moreover, there is nothing we can do to prevent its occurrence. There are good treatment options for angioma removal such as vascular laser or surgery.

Links of interest

https://www.efesalud.com/noticias/puntos-rojos-en-la-piel/

What is an infantile angioma?

Infantile angioma or hemangioma is a benign, flat or raised, bright red or purple lesion that appears at birth or shortly thereafter in any region of the body. In the first year of life, and especially in the first months, an angioma may grow rapidly, but then it slowly regresses and disappears spontaneously before the age of 7 years. Most often it disappears without leaving any residual lesion but sometimes an area of red color or thinner skin remains.

Causes of infantile angiomas

There is no known causal relationship with infantile angiomas. They are lesions that appear spontaneously with no known hereditary or environmental components. Care and treatment Each infantile angioma must be assessed individually to decide whether or not to treat it and, if so, to choose the most appropriate treatment. There are some very effective oral medical treatments and there is also the option of laser and surgery for the most severe cases.

Links of interest

https://www.aeped.es/sites/default/files/documentos/angiomas.pdf

https://www.menarini.es/images/dermatopatologia/Derma063.pdf

What are condylomas?

Condylomas are flat or raised warty lesions that appear on the oral or genital mucosa. They can be single or multiple lesions and can vary in size and volume.

Causes of condyloma

It is an infectious disease caused by the human papillomavirus (HPV) and is the most common sexually transmitted disease. The lifetime risk of infection in sexually active young adults is 80%. In the vast majority of couples in which one partner is infected with HPV, the other partner is usually infected as well.

The risk of transmission is unknown. A large proportion of genital HPV infection is latent or subclinical and is responsible for the majority of infections and recurrences following treatment. In most people HPV infection is transient and without sequelae but in a small proportion the infection persists and may progress to cancer.

HPV infection is closely related to cancer of the cervix, penis, anus, vulvovaginal area and tongue, especially in cases of HPV infection type 16 and 18, which are considered very high risk. The exact reason for this carcinogenic effect is unknown but we know that smoking and a depressed immune status increase this effect.

Condyloma care and treatment

There are different topical and surgical treatments for condyloma removal that can be used under medical supervision. Latent or subclinical infection is very difficult to control. There are HPV detection techniques by PCR that are performed in situations where the physician deems necessary. The use of condoms is recommended during infection and for 12 to 24 months afterwards.

Links of interest

https://www.cdc.gov/std/spanish/vph/stdfact-hpv-s.htm http://www.cancer.gov/espanol/cancer/causas-prevencion/riesgo/germenes-infecciosos/hoja-informativa-vph

What is atopic dermatitis?

Dermatitis is an inflammation of the different layers of the skin (dermis and epidermis) that can appear at any time of life. It manifests as an area of reddened and scaly skin that sometimes produces an itching that can become very intense. Atopic dermatitis has a characteristic skin presentation pattern and is sometimes associated with the so-called “atopic condition” with cutaneous manifestations such as dry skin, skin itching, double folding of the lower eyelid or dry lips and general clinical manifestations of allergic type such as rhinitis or bronchial asthma.

In children, atopic dermatitis most often appears on the face and flexural areas such as the back of the knees and elbows. In adults it is more frequent on the hands, extension areas, face and eyelids. The prevalence of atopic dermatitis has doubled in the last 20 years, currently affecting 10-15% of the population.

Causes of atopic dermatitis

The cause of atopic dermatitis is mainly genetic and familial although there are some factors that worsen it such as stress, pollution or dry and cold weather as well as some individual foods.

Care and treatment of atopic dermatitis

Daily care of skin with atopic dermatitis is essential to avoid flare-ups. There are 3 basic recommendations: Apply moisturizing substances daily after bathing (cream, oil, etc.).

Avoid using synthetic clothing (100% cotton is best) Avoid stress as much as possible.

It is advisable for children to do physical exercise activities where they can unload part of their energy and for adults to do meditation, yoga or Pilates. Treatment of atopic dermatitis outbreaks should be supervised by a dermatologist.

Various topical corticosteroid or immunomodulatory drugs and, in severe cases, oral medications are used to control the outbreak.

Links of interest

What is seborrheic dermatitis?

Dermatitis is an inflammation of the different layers of the skin (dermis and epidermis) that can appear at any time of life. It manifests as an area of reddened and scaly skin that sometimes itches. Seborrheic dermatitis appears very frequently in babies on the scalp producing the so-called “cradle cap”. In adults it usually manifests itself in the nasal groove, eyebrows and scalp, producing dandruff in the most severe cases. The course is chronic and relapsing with periods of worsening and improvement.

Causes of seborrheic dermatitis

The cause is genetic and outbreaks are usually precipitated by stress or seasonal changes, being more frequent in autumn and winter.

Care and treatment of seborrheic dermatitis

During outbreaks of seborrheic dermatitis, topical treatment with cortisone combined or not with antifungal active ingredients in the form of creams, lotions or shampoos is indicated. The use of topical corticosteroids should not be extended in time due to their side effects.

In general, treatment should be supervised by a dermatologist. Although seborrheic dermatitis is treated only at the time of the outbreak, we recommend the daily use of specific cosmetics for sensitive skin or skin prone to seborrheic dermatitis to avoid skin irritation and new outbreaks of the disease.

Links of interest

https://www.nlm.nih.gov/medlineplus/spanish/ency/article/000963.htm

What is telogen effluvium?

Telogen effluvium is an early and exaggerated loss of normal hairs from normal scalp follicles without inflammation of the underlying skin. Before a decrease in hair density is perceived, an intense hair loss is noticed.

The normal daily average of hair loss in an individual is influenced by age, sex, race and other genetic factors. It is estimated that the total number of hairs on the scalp is about 100,000, of which about 100-150 are lost daily. In telogen effluvium, between 150 and 400 hairs are lost per day.

Causes of telogen effluvium

Telogen effluvium appears because a high percentage of hair follicles pass from the hair growth phase (anagen) to the hair loss phases (catagen and telogen) producing a diffuse and transitory decrease in hair density. The causes of the appearance of telogen effluvium are diverse: Postpartum effluvium: begins 4 months after childbirth and can last up to 1 year Effluvium due to medication.
Low-calorie diets Anemia or lack of iron, folic acid or vitamin B12 Intense exercise Stress Seasonal changes (spring and fall)

Telogen effluvium care and treatment

In many cases telogen effluvium resolves spontaneously after a few months and the hair grows back. The prognosis is good especially if a specific causal event is identified. A healthy and balanced diet is recommended as well as the use of food supplements rich in zinc, selenium, cystine, methionine and B vitamins.

Links of interest

What are stretch marks?

Stretch marks, also called atrophic or distension stretch marks, are lines or bands of reddish skin that later become whitish, shiny, smooth and depressed. They are frequent in children and adolescents during growth, appearing mainly on the breasts, buttocks, inner and outer surface of the upper thighs, back and knees. They can also appear during pregnancy in the abdomen and breasts and in people who gain a lot of weight abruptly.

Causes of stretch marks

They are mainly genetic although abrupt changes in growth or body weight favor their appearance. Some creams or medications such as corticosteroids favor the appearance of stretch marks.

Care and treatment of stretch marks

When stretch marks are reddish in color, it means that they are of recent appearance. At this time it may be beneficial to use a vascular type laser to reduce discoloration and stimulate the creation of new collagen. Retinoic acid in cream with different concentrations has been shown to improve recent stretch marks but has the disadvantages of irritating the skin and is contraindicated in pregnant women and during lactation. Moisturizing and the use of specific cosmetics for stretch marks can improve the texture of the skin helping to improve its aesthetic appearance. In general, stretch marks improve over the years.

Links of interest

https://www.dermis.net/dermisroot/es/34736/diagnose.htm

What is herpes simplex?

Herpes simplex labialis or cutaneous herpes simplex, also called fever blisters, is a red lesion with vesicles that rupture easily producing a wound that tends to heal spontaneously with scabs in about 5-10 days. It is accompanied by pain and sometimes general malaise, fever and swollen lymph nodes in nearby regions, such as the mandibular or retroauricular region.

Genital herpes simplex, produces similar lesions with a red background on which small ulcerations appear due to the rapid rupture of the vesicles. It is also accompanied by pain and swollen nodes in the groin. Causes of herpes simplex This is an infection of the skin by the herpes simplex virus (HSV). It is one of the most prevalent virus infections in the world. HSV type 1 infection causes the typical orolabial and cutaneous herpes infection and HSV type 2 causes genital herpes. Eighty-five percent of adults worldwide have been in contact with HSV type 1 at some point in their lives. Outbreaks of orolabial or cutaneous herpes simplex usually coincide with periods of stress, sun exposure, menstruation or general systemic infections. Genital herpes is a sexually transmitted disease and with some frequency becomes recurrent with herpes simplex lesions recurring from time to time, sometimes coinciding with periods of stress or after sexual intercourse.

Care and treatment of herpes simplex

Herpes simplex tends to heal spontaneously, so it is only indicated to treat it in the first days of the outbreak. If it is a mild herpes simplex, it can be treated topically with astringent and antiseptic solutions to avoid bacterial superinfection. If the lesions are moderate or severe, treatment with specific oral antiviral drugs is recommended. In the case of recurrent herpes (labial or genital), prophylactic drug treatment may be indicated for 6 months.

Links of interest

https://www.who.int/mediacentre/factsheets/fs400/es/

https://www.nlm.nih.gov/medlineplus/spanish/herpessimplex.html

What is shingles?

Herpes zoster, also called shingles, is a skin rash that initially appears as clustered raised red lesions that spread on one side of the body in a linear fashion.

As the days pass, vesicles or blisters appear on the surface of the lesions, which rupture and produce wounds that tend to heal spontaneously through the formation of scabs. If the lesions are very intense or become superinfected, residual lesions may remain on the skin. The skin areas most frequently affected are the dorsal region and the head.

It is common that the days before the onset of shingles, discomfort or pain appear in the affected skin area that can last for the duration of the lesions and sometimes even long after, producing the so-called postherpetic neuralgia.

Causes of shingles

It is a reactivation of the varicella zoster virus. After natural infection or immunization, the virus remains latent in the root cells of the dorsal sensory ganglia. The virus begins to replicate some time later, traveling through the sensory nerves within the skin producing the typical herpes zoster lesions. Immunosuppressed states, advanced age or stress may precipitate an outbreak of herpes zoster.

Shingles care and treatment

Shingles tends to heal spontaneously so it is only indicated to treat it in the first days of the outbreak, especially in elderly patients to reduce the risk of postherpetic neuralgia. If it is a mild herpes zoster, it can be treated topically with astringent and antiseptic solutions to avoid bacterial superinfection. If the lesions are moderate or severe, treatment with specific oral antiviral drugs and analgesics for pain is recommended. In the case of recurrent herpes zoster, prophylactic drug treatment may be indicated for 6 months.

Links of interest

https://www.nlm.nih.gov/medlineplus/spanish/ency/article/000858.htm

What is hyperhidrosis?

Hyperhidrosis is excessive sweating localized in one or several areas of the body. The most frequently affected areas are the armpits, palms, soles and forehead. It mainly affects young people and, although it is not a serious problem, it can have a great impact on the individual’s quality of life by interfering with their interpersonal relationships and professional environment. Hyperhidrosis usually improves spontaneously over the years.

Causes of hyperhidrosis

Hyperhidrosis is due to an overstimulation of the eccrine glands, those whose normal function is to regulate body temperature. The origin of this eccrine hyperfunctionality is unknown but we know that there is a genetic and familial component. Stress and anxiety worsen hyperhidrosis, which in turn increases anxiety and leads to a vicious circle that is difficult to solve. Sometimes hyperhidrosis is generalized throughout the body and in this case a pharmacological, infectious, tumor, hormonal or neurological causative process should be suspected.

Care and treatment of hyperhidrosis

Aluminum salts are the most commonly used agents for hyperhidrosis. Aluminum chloride 20-25% is the most effective, although it has the disadvantage of frequently irritating the skin. Iontophoresis with tap water is an alternative in individuals in whom topical treatment fails.

The injection of botulinum toxin type A or Botox is the most effective and safe treatment for localized hyperhidrosis although it is an expensive treatment and its effect is temporary with an approximate duration of 6 to 12 months. In more complicated cases, systemic drugs of different types or surgery based on upper thoracic sympathectomy can be used.

Links of interest

https://www.nlm.nih.gov/medlineplus/spanish/ency/article/007259.htm

What are molluscum contagiosum?

Molluscum contagiosum are rounded, smooth, whitish lesions with a central depression. They may be single or multiple and grouped on areas of dry skin or dermatitis. Sometimes they become inflamed or superinfected and appear larger and redder. Molluscs are very frequent in children and their appearance is related to public swimming pools and direct skin contact. They have no medical significance and disappear spontaneously with time. When mollusks appear in the genital region of adults, it is considered a sexually transmitted disease and should be treated to prevent the spread of mollusks even though they do not present any clinical complications.

Causes of mollusks

Molluscum contagiosum is caused by a virus of the poxvirus type. It most frequently affects children who go to heated swimming pools, although skin-to-skin transmission also occurs.

Care and treatment of mollusks

The treatment of molluscum is variable depending on the number of existing lesions, the area where they appear and the possible associated dermatitis. In many occasions the attitude is conservative, waiting for the spontaneous resolution of the mollusks with the only precaution of keeping the area very hydrated to avoid the extension of the lesions. In cases of dermatitis associated with mollusks, treatment of the dermatitis will be necessary for the mollusks to disappear. In some cases, the mollusks are removed directly at the dermatologist’s office.

Links of interest

https://www.nlm.nih.gov/medlineplus/spanish/ency/article/000826.htm

What is psoriasis?

Psoriasis is an inflammatory skin disease that can appear at any time of life. These are red, scaly plaques that sometimes cause intense itching. If left untreated, over time the plaques increase in thickness and the scales become thicker and more difficult to remove. Cutaneous psoriasis appears most frequently on the elbows, knees, scalp and nails. It sometimes affects skin folds such as the armpits, groin or intergluteal folds.

Psoriasis is a disease that not only affects the skin. Between 20 and 50% of people with psoriasis skin lesions may have associated problems in other organs of the body such as the joints, liver, kidney or blood vessels. In addition, psoriasis is associated with obesity, hypertension, high cholesterol and depression. For these reasons, when psoriasis is diagnosed, it is necessary to perform a complete clinical study to rule out involvement at other levels.

Causes of psoriasis

The causes of psoriasis are genetic but we know that there are external factors that can precipitate an outbreak or worsen it such as stress, smoking and alcohol.

Psoriasis care and treatment

Daily moisturizing after bathing is essential to avoid psoriasis outbreaks. In addition, moderate physical exercise and activities such as relaxation, yoga or meditation are highly recommended. Topical and systemic medical treatments for skin psoriasis outbreaks are available with high efficacy. The choice of treatment will depend on the condition of the skin and other organs that may be affected by psoriasis.

Links of interest

https://www.accionpsoriasis.org

What are viral warts or papillomas?

Viral warts, also called papillomas, are one of the main reasons for consulting dermatologists and pediatricians. These are the typical small, scratchy, rounded lesions that appear most frequently on the hands or soles of the feet, where they are also commonly referred to as “papillomas”. They can also appear on the face, elbows, knees and the rest of the body.

Causes of warts

These warts are caused by a virus known as human papillomavirus (HPV), which is very common in human skin flora. The HPV serotypes associated with body warts are different from those that cause genital warts or condylomas. It is possible that there are genetic determinants that predispose to the development of viral warts.

Care and treatment of warts

Treatment of viral warts on the body may differ depending on the type of wart and location. Sometimes they can be treated at home by daily application of specific wart products. Another safe option is to be patient and wait, as most viral warts resolve spontaneously over time. If the warts cause cosmetic or functional discomfort, they can be treated at the dermatologist’s office by freezing with liquid nitrogen. Genital warts are considered a sexually transmitted disease and should always be treated because of their close relationship to cervical cancer in women and penile cancer in men. See condyloma.

Links of interest

https://www.nlm.nih.gov/medlineplus/spanish/ency/article/000885.htm