Tag Archives | immune system

Skin Thickening Disease on a Thicker View

Not everything that glitters is gold, and not everything that’s bigger and thicker is good. A skin that’s extraordinarily thick, which is commonly accompanied with one or more worse symptoms, is alarming.

Scleroderma – the skin thickening disease – is an autoimmune disease involving the connective tissue/s. One’s immune system behaves abnormally and overly active, that it attacks its own cells – thus, the term, autoimmune. Aside from skin thickening, the disease also features spontaneous scarring, blood vessel affectation, inflammation, and damages to internal organs such as the esophagus, kidneys and lungs. Truly, beauty is not the only thing which is skin deep, scleroderma too.

Skin Thickening Disease on a Thicker View

This skin thickening disease is classified according to the degree and location of the skin and organ involved. Currently, it has been categorized into localized scleroderma and systemic sclerosis or widespread. The latter is further divided into either limited or diffused forms based upon the extent of skin involvement. In both categories, overactive immune cells attack body cells and form scar tissue or fibrosis in the skin or on the internal organ affected. Scar tissue may form haphazardly that it leads to thickness and firmness of the involved organ.

What causes scleroderma is an FAQ. Like most autoimmune diseases, the long-awaited answer is still far unknown. But brilliant researchers have identified the potential causes, and even risk factors. Some evidence has associated the skin thickening disease with genes. A study for Choctaw Native Americans showed that this race has a high prevalence for the disease. However, environment still seems to take a major role as it contains most of our body’s stressors. When an individual becomes susceptible, his immune system is activated – but in a more intense manner – thereby damaging tiny blood vessels and injuring tissues leading to scar formation and collagen accumulation. This process continues until thickening and other worse symptoms appear!

These signs and symptoms will then be the reference for classifying the disease. Localized scleroderma includes skin changes in isolated areas. These can be morphea patches – hardened and slightly pigmented multiple skin lesions, or linear scleroderma – localized and hardened skin patches usually at the lower extremity. Sometimes, the latter is accompanied with a ‘satellite’ lesion, such as on the abdomen.

Whilst localized type involves only the skin, the diffuse form may afflict important internal body organs. It includes symmetric skin thickening of the extremities, face and trunk that can quickly proceed to hardening after the inflammatory phase. With this fast pace type, organ affectation may occur early and seriously, such as scarring of the lungs, esophagus, heart and kidneys. Elevation of blood pressure is definitely a danger sign and may lead to kidney failure.

The limited form of scleroderma is not that limited at all. There might be lesser skin involvement but remains as serious as the diffuse form. Its characteristic manifestation pattern is better known as CREST, or Calcinosis (tiny calcium deposits on the skin), Raynaud’s phenomenon (spasm of tiny arterial vessels due to heat or cold), Esophageal (weaker lower esophagus leading to acid reflux from the stomach), Sclerodactyly (localized thickening and tightness of the skin of the fingers and toes), and Telangiectasis (tiny red portions on the face, hands and mouths which blanch when pressed). Patients may have symptom variation of CREST and worse, may overlap to a diffuse form of this skin thickening disease.

Skin Thickening Disease on a Thicker View

Patients are diagnosed according to the signs and symptoms present and verified with a blood test that suggest autoimmunity and presence of antinuclear antibodies (ANA). Anticentromere antibody can be found on limited form and Anti-Sci 70 antibody for diffuse scleroderma.

Can it be treated? A universal treatment has not been identified yet, but sign/symptom – directed method has been used, especially for those life threatening manifestations. Indeed, this skin thickening disease is still a thicker and bigger challenge both for its patients and medical scientists.

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Dupuytren’s Contracture of the Hand: Facts at Hand

Oftentimes, people take our poor hands for granted, not realizing how much and how many ‘they’ can do. Being unable to grasp, grip, or hold something can be a horrible experience. And these are really true for people suffering with Dupuytren’s contracture of the hand.

Dupuytren’s disease or Dupuytren’s contracture of the hand is a fixed flexion of the hand, usually the ring and pinky fingers towards the palm. Why does it happen? Usually an autoimmune disease, immune system cells over actively behaves, attacking own cells leading to scar tissue formation or fibrosis. These scar tissues form a thickened, shortened cord that forces some of the fingers to curl inwards towards the palm, creating the hand deformity.

Dupuytren’s Contracture of the Hand: Facts at Hand

Also called a Viking Disease, legends say that Vikings spread the disease throughout Europe and Scandinavia hundreds years ago. Fact or myth, the disease really has a higher incidence rate in European countries such as Norway, Scotland, Iceland and Australia – where the Viking ancestry is predominant.

But it was until 1600 that the disease had been fully described by Swiss Doctor Felix Platter. Although this was recognized, it was still French Surgeon Baron Guillame Dupuytren who acquired the name of the disease for successfully initiating the operation for the retracted finger in 1831.

Decades have past but still the issue on what exactly causes Dupuytren’s contracture of the hand is still a big question mark. However, it is mostly associated with genes and family history. 60-70% of incidence runs in families. Men after age 40 are closely at risk, more so, those with North European/Viking ancestry. Trauma, diabetes, epilepsy and liver disease are also identified factors but still unexplainable. Meanwhile, smoking and alcoholism are sure precipitating factors as they affect blood circulation and tissue oxygenation – the less oxygen our tissues could get the higher chances of abnormal immune responses!

Most of the time, small, painless nodules in the palm are the first clinical signs. These nodules may begin to merge and become a more obvious lump on the skin. On later stages, the skin and underlying fascia contracts, including some fingers bent inwards, causing impairment of the hand and finger function. All fingers may be involved but most commonly the ring and little fingers are affected. Whilst nodules progression is rapid, the changes resulting to symptoms can be very slow. Thus, most of the time, patients would only seek consultation at its later stage, and shall be diagnosed through the table top test. Inability to place the hands, with the fingers, completely flat at the table renders a positive result.

Dupuytren’s contracture of the hand can be less painful, but it can be a nuisance in hand-involved activities. When this happens, medical treatment is initiated. The needling technique and the enzyme injection procedure both involve puncturing the cord and breaking it apart, to release the flexion. Although, these are non-invasive, recurrence is highly possible. For long term and hopefully lifetime treatment, surgery is advised. However, rehabilitation and physical therapy may also take a longer time.

Dupuytren’s contracture of the hand may be hereditary, but preventing its initiation and progression by protecting it from any kind of trauma, depends entirely at our hands!

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Fibromatosis Hand

Unusual hand curvatures and abnormal hand flexion, these can all be caused by fibromatosis. A broad medical term, fibromatosis includes a group of ‘mutated’ cells, producing a scar tissue with a distinct biologic behavior. Oftentimes, this is related to an auto-immune disorder, where the body’s own immune system destroys or damages own cells. Although considered benign or localized, the scar tissues have infiltrative growth, thus forming tumor-like lesions and have a tendency towards recurrence. What happens with fibromatosis at your hands?

Fibromatosis hand or palmar fibromatosis is medically called Dupuytren’s disease or contracture. Commonly affecting the hands of adults aged 50 and above, thick cord-like structures or lesions form at the palm of the hand causing the fingers to bend down slowly towards the palm. Definitive diagnosis for this is the table top test. With this, the patient places his hand flat on the table. If the hand cannot lie completely flat on the table with a space from the hand to table is as big as the diameter of a ballpoint pen, then the test is positive and treatment may be required.

Fibromatosis Hand

However, treatment of the disease can be delayed as symptoms occur very slowly and possible causes are not yet identified. Risk factors such as age, family history, a North European race, diabetes, smoking and alcohol use may increase chances of having it. Once positive, treatments are then based on its severity. Mild cases – those that do not impact one’s hand abilities – can do home remedies which are aimed towards avoiding or minimizing hand flexion. Meanwhile, severe cases are encouraged whether to undergo enzyme injection, needling, or surgical procedures to remove or puncture the cord-like formation.

Fibromatosis Hand

Dupuytren’s disease is fibromatosis at your hands! One’s genes might make you at risk of having it, but ‘loving’ your hands and ‘using’ it wisely, plus a healthy lifestyle, hold the definite key to avoid the disease, and even other fibromatosis!

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Dupuytren’s Contracture of the Foot Rediscovered and Redefined

Ever heard of Dupuytren’s contracture of the foot? Nah, contracture of the hand is more popular but abnormal foot flexion is seldom discussed. What it is and what actions should we take to treat, or possibly, to prevent it?

Dupuytren’s Contracture of the Foot Rediscovered and Redefined

Dupuytren’s contracture of the foot is known as Ledderhose’s disease (LD), plantar fibromas or Morbus ledderhose. Like the hand disease, it is a type of fibromatosis – scar tissues developing inside, usually under the skin. Causes are still unknown but it is closely related with autoimmune diseases. Our body’s immune system destroys our own cells and forms scar tissues and accumulates excess collagen. What a weird yet hideous way of betrayal inside our body!

As exact causes are still unknown, risk factors are identified for precautions, early detection, and treatment. A person with family history of both Dupuytren’s curvature of the foot and the hand may incur the disease, much worse, when he is a Caucasian male with over 70 years of age. A person with other health problems such as diabetes mellitus, epilepsy, liver disease, and thyroid problems poses higher threat of acquiring it. Smoking and alcohol use can stimulate cell mutation – leading to an abnormal immune response – thus, both lifestyle-related factors have been included. Foot trauma and overuse of the feet may also place you at risk, as well as punctures – wounds or tears can cause fibromas or scar tissues.

What happens with Ledderhose’s disease? Scar tissues, as above, also called plantar fibromatosis grow on the plantar surface or the sole of the foot. These are firm masses that grow slowly along the plantar fascia- which runs from the heel to the toes on the bottom of the foot- containing excess collagen or fibrotic tissue. At earlier stages, fibromas are small and do not impact foot’s ability. As they grow bigger at your sole, flexing your foot or bending the toes becomes more difficult and walking becomes painful. Early symptom includes a painful and noticeable lump in the arch, firm to touch and grows over time. Multiple fibromas may develop or they can merge to form a unified lump! As they grow in size, wearing shoes or walking barefoot might be very painful.

Dupuytren’s contracture of the foot is diagnosed by excising a part of the fibroma. Most of the time, the disease can be confirmed. But to visualize this, imaging studies are done such as MRI. MRI results shall help the doctor to determine shape, size and depth of the fibroma. In most cases, it even reaches the aponeurosis – the flat, fibrous sheet of connective tissue that attaches muscle to the bone. A thorough medical history shall also be taken to identify predisposing and precipitating factors leading to the disease.

Dupuytren’s Contracture of the Foot Rediscovered and Redefined

Once diagnosed, treatment shall proceed based on the size and location of the fibroma and the pain it causes. Small fibromas causing minimal pain shall include treatments aimed to alleviate direct pressure on it. This is done through padding, functional foot orthotics, heel lifts, night splints or arch support. Reduction of pressure does not only minimize pain but shows to shrink the lump. Verapamil gel, a calcium channel blocker, usually used for cardiac problems, is applied to the mass twice daily to ‘constrict’ the fibroma.

For larger fibromas that inflict greater pain, two invasive treatment options are available. Cortisone injections stall the progression of the disease temporarily but may also induce inflammation. Surgery can also be done but with more accuracy and care since nerves, tendons, and muscles are located in the foot.

Now that you have rediscovered and redefined Dupuytren’s curvature of the foot or Ledderhose’s disease, you might think about your chances of acquiring it and ways of preventing it. Remember, prevention by being aware and living a healthier lifestyle is still the best deal than starting a cure!

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9 Common Finger Joint Disorders

Joints are bestowed a tough function in the person’s optimum movement. They should support the weight as well as provide bones the ability to make smooth and painless movements. These functions make them one of the most worked-out parts of the body. Aside from the joints normal wearing and tearing, the joints are often times injured because of infection, overuse, misplaced immune system attach and degeneration. Among the most common joint disorders are:

Dislocation

This is one of the most common finger joint disorders. It is the luxation or dislocation of a finger joint characterized by a displaced articulating bone which most often is a result of bad landing from a fall. Aside from the finger joint, the joints of the jaw, fingers, elbows, knees and shoulders are typical sites for this kind of injury. This bone displacement produces a joint deformity, swelling, localized pain and inability to move affected bones.

Bursitis

Excessive joint use of bursa stress can cause bursitis – this is the inflammation of the bursa. The bursa, which is located in between the calcaneus or the heel bone and the popular Achilles tendon, might become inflamed when put to sudden strenuous physical activities. Aside from this, a kind of bursitis referred to as the “tennis elbow” actually affects the body’s bursa in between the skin and the olecranon process. Rest is the most efficient treatment of choice for bursitis; however, seeking for the advice of a doctor is beneficial.

Sprains

This joint disorder results from tearing or overstretching of the connective tissues, tendons and ligaments. However, this does not misplace articular bones. Forceful twisting or wrenching the ankles and/or ankles results to sprains of the ankles or wrist. For instance, excessively inverting your ankle could result to a sprain because the ligaments located on the lateral surface are being stretched. Serious injuries might pull all of these tissues from where they are loosely attached.

A joint that is sprained is swollen and painful, almost all of the time restricting movements. The first aid for sprain is taking a rest, while the more serious cases need medical attention. Nevertheless, joint immobilization for some specific time-frame could cause ligament weakness and bone resorption. Also, exercises could help in strengthening the joints.

Arthritis

This is disease condition which causes painful, swollen and inflamed joints. There are several kinds of arthritis and have affected more than 50 million citizens of US. Also, arthritis could be a member of some syndromes. The most usual forms of arthritis are:

Lyme Arthritis

Often called the Lyme disease, this is an infection caused by bacteria. The infection is passed through a tick bite which will then cause an intermittent arthritis of the body’s joints. Intermittent arthritis usually happens after the first few symptoms occur like pain, flu-like syndrome, fatigue and rashes.

This disease was first discovered in the town of Lyme, Connecticut where a woman wrote a journal about her younger neighbors’ juvenile and rare rheumatoid arthritis. This woman’s observations became the basis of Allen Steere’s research about this tick-borne infection. When antibiotic treatment is started during the appearance of the first few symptoms, other kinds of arthritis will be prevented.

There are also other kinds of bacteria which causes arthritis. These include the common Streptococcus and Staphylococcus species, Mycobacterium, and Neisseria gonorrhea. Furthermore, arthritis, a few times, is associated with acquired immune deficiency syndrome due to the fact that while the immune system of the affected person breaks down, the risk of developing the infection will increase.

Osteoarthritis

This is a degenerative disorder and is recorded as the most common kind of arthritis. This most often comes with age. However, an arthritis that is inherited may occur earlier in life. The most common initial form of symptom is an unusual joint pain. Slowly, the affected joint will deform. For instance, fingers affected with arthritis appear gnarled or the knees are bulged.

With osteoarthritis, the articular cartilage gradually disintegrates and softens, slowly roughening the surfaces of the affected parts. Joints then are unable to make full range of motion and eventually become very painful. For instance, fingers affected with arthritis might lock in place while playing an instrument or tying his shoelaces. Most often, osteoarthritis affect joints which are utilized the most like those that are found on the knees, hips, fingers and vertebral column.

Luckily, NSAIDs have the power to control the symptoms of osteoarthritis. Exercise could make joints become more flexible. If the daily exercise routine is successful, wearing gloves and tying shoelaces will become easier.

Rheumatoid Arthritis

This is an autoimmune disorder where the person’s immune system attacks healthy tissues. This kind of arthritis is the most debilitating and painful. The body’s synovial membrane located in joints thickens and becomes inflamed, forming a tissue mass referred to as the pannus. The articular cartilages then become damaged giving the fibrous tissue the chance to infiltrate it, hence, interfering with the movements of the joints. Eventually, the joints will ossify and the articulated bones fuse together. Surgery is the treatment of choice for RA especially when the joints are damaged severely.

Gout

This actually is a metabolism error acquired even before birth. This is an inherited illness where the missing or defective enzyme causes the certain bodily chemicals to build up. With gout, the crystals of the uric acid accumulate in the joints, most often in the metatarsophalangeal joint. In the past, gout was thought to have been caused by consuming rich foods. In a certain condition referred to as the pseudogout, a different kind of uric acid crystal accumulates most often in the wrist or knee joint.

9 Common Finger Joint Disorders

Dupytren’s Contracture

This condition attacks the palmar fascia – the tissue that is lying beneath the palm. This is a thickened tissue which lies just above the tendons and under the skin in the hand region. Palmar fascia is actually attached to both the structure below and the skin above. This condition causes tightening or contractures of the hand tissues. Due to the contractures, the person’s fingers could be permanently bent; thus, making the hand’s movements impaired.

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