Cheyletiella: your pet’s walking dandruff can make you itch

Cheyletiella mite. Photo from Wikipedia user Joelmills
Cheyletiella mite. Photo from Wikipedia user Joelmills

Man/Woman’s best friends can sometimes lead to annoying & itchy skin conditions.  Take the Cheyletiella mite which can live on your dog, cat or rabbit.  This little mite can appear as a little white fleck on your pet, and it can look like your pet has “walking dandruff.”  You may notice your pet grooming itself or scratching more than usual.  Unfortunately, this mite can get on your skin as well and lead to itching and a rash.  The good thing however, is that even if these mites get on you, they can’t live on your skin for long (no more than 3 weeks really).  They don’t burrow into your skin the way other mites can (e.g.  the scabies or Sarcoptes mite). You should bring your pet to the vet though, where your vet can treat your pet with an anti-mite medication.

As if you needed another reason against the hot tub! Or wading pools.

Courtesy of wikipedia user Bromr
Courtesy of wikipedia user Bromr

It’s the first day of summer and I doubt you’ll be itchin’ to get into the hot tub but here’s yet another reason not to!  Remember our previous post on hot tub folliculitis?  Well, in addition to little bumpies around your follicles, you can also end up with painful bumpies of your hands and feet.  These kids who went to a party involving a hot tub ended up with tender bumps on the palms and soles and/or with hot tub folliculitis.  There are also previous reports of kids who got these bumps on their feet from a contaminated public wading pool. (Wading pools are a bit more summer-appropriate than hot tubs.)  So if you end up with bumps around your follicles, or painful bumps of your hands or feet and you’ve been in a hot tub or wading pool, this could be the cause.

Polypodium leucotomos: is this fern extract an oral sunscreen?

Recently, a group of us dermatologists were lamenting that fact that there is no sunscreen in pill form. Wouldn’t it great if there were an oral sunscreen out there?   You could just take it with your daily multivitamin. Or rather, it could be incorporated into your daily multivitamin.

Then we remembered the Polypodium leucotomos fern.  Polypodium leucotomos is a fern that has been used as a folk remedy for years for many different conditions due to its antioxidant properties.  The product Heliocare or Fernblock contains an extract from this fern and has been marketed to protect you “against sun-related effects and aging.”

So is this fern extract really an oral sunscreen?  Not quite.  So far, the published studies have been small.  Some of these small studies suggest that in various skin conditions, this extract may help decrease sensitivity to the sun.  For example, in a rash called polymorphous light eruption (PMLE), this extract may prevent flares of this rash in some individuals (Journal of the American Academy of Dermatology 2012; 66(1)).  In a more recent study evaluating whether this extract can be used in melasma which is strongly influenced by the sun (JAMA Dermatology, 2013; 5(1-2)), the extract didn’t help in the treatment of melasma.

So what’s the bottom line?  Keep up with sun protection by seeking the shade, sun protective clothing and sunscreen use.  The Polypodium leucotomos fern may provide extra protection but more studies are needed.

What is Neurofibromatosis?

Neurofibromas in neurofibromatosis often appear during puberty or adulthood.
Neurofibromas in neurofibromatosis often appear during puberty or adulthood.

In dermatology, we have many conditions that are caused by defects in a specific gene. In the case of Neurofibromatosis 1 (we’ll go over other Neurofibromatoses later), the defect is in Neurofibromin.  The transmission is autosomal dominant, meaning that to have the condition, you only need one of the mutated genes to be passed on from either mom or dad.

Neurofibromatosis 1 (aka Von Recklinghausen disease) is a syndrome, meaning, several different findings are seen.

These include:

cafe au lait macules which are flat tan spots of the skin and show up either at birth or early in childhood. The number and size of these spots can increase with time. The criteria for diagnosis includes having 6 or more of these spots and sets 5 mm as the minimum size in a kid, or 15 mm in those who are past puberty.

– clumps of pigment causing growths in the eyes called Lisch nodules or iris hamartomas which usually show up during childhood.

– freckling of the armpits – aka axillary freckling or Crowe’s sign. This shows up in later childhood.  Freckling can also occur in the groin area (inguinal freckling).

– soft fleshy growths on the body called neurofibromas which show up during puberty or adulthood.

– growths in the eye nerves called optic glioma(s). These growth can affect vision, potentially leading to vision loss.

– plexiform neurofibromas which are not the standard neurofibroma. These are more complex, often deeper in the skin and larger.  These have a chance of turning into a type of cancer called a malignant peripheral nerve sheath tumor.

– bone abnormalities including the bones around the eye and of the bones of the extremities..

There are other findings which may be seen as well, such as high blood pressure.

What are genital warts?

Genital warts are growths that occur on the genitals  and anus.  They may appear skin colored, pinkish, tan, or brown and are often raised and soft.  In the medical field, we often refer to them as condyloma or condyloma acuminata.  These condyloma (although colloquially referred to as genital warts), can occur on other areas as well (e.g. around the mouth/lips, inside the mouth, throat, etc.)

What causes genital warts? Genital warts are caused by the human papilloma virus (HPV).  HPV types 6 and 11 cause the vast majority of genital warts.

How do you get genital warts?  Genital warts are considered a sexually transmitted disease.  The virus is spread through close contact with an infected individual.

If you have genital warts, can you spread them to someone else? Yes, as above, the virus is spread via skin to skin contact.  Thus, you can continue to spread it to sexual partners.  Although barrier protection is not perfect, it can decrease the likelihood of transmission.

If you have genital warts, does that mean you will have cancer?  Recently, there has been a lot of buzz about HPV and cancer.  The media reported that Michael Douglas said his throat cancer was caused by the HPV virus.  There’s some controversy over what was said exactly, but recall that he talked about how oral sex could lead to transmission of HPV virus.

Anyways, just because you have genital warts does NOT mean you will get cancer.  HPV 6 and 11 which we said is linked to the majority of genital warts is less linked to  cancer.

How do you treat genital warts? There are several types of different treatments.  Cryotherapy involves freezing the wart, often with liquid nitrogen.  The lesions may also be burned or treated with a laser. Sometimes they may be cut off with a scalpel or scissors and other times they may be treated with a liquid or cream.  Injections have also been used for genital warts.  Find a physician who has experience treating genital warts.


Sunscreen helps keep your skin young

Bahamas_beachRecently published research shows that diligent use of daily sunscreen helps keep the skin young.  Researchers in Australia followed patients for 4 and a half years.  At the end of that time, they looked at the back of the patients’ hands, assessing for evidence of skin aging by making molds of the back of the patients’ hands.

They found that those who used sunscreen at least 3 to 4 days a week showed less skin aging than those that stuck to their usual habits of sunscreen use.

The researchers also studied whether beta-carotene ingestion by supplementation would make a difference in skin aging. It did not.

So what’s the take home lesson? As dermatologists have encouraged for some time, sun protection and sunscreen use is important for decreasing risk of skin cancer, but also to keep you looking young!  If you need to see a picture to convince yourself, just look at the photo here of a trucker whose left side of the face was exposed to sun while driving.