Sensitive Skin and Noneczematous Dermatoses
Golara Honari, Rosa M. Andersen, Howard Maibach in Sensitive Skin Syndrome, 2017
Dry skin (xerosis), from any cause, is irritable and sensitive. Skin may be dry for a variety of reasons including genetic, that is, ichthyosis; environmental, that is, low humidity; or indeed from excessive washing (46,47). General health issues such as thyroid disease or certain medications may also contribute to the problem. Dry skin tends to be itchy, especially if overheated (environmental or endogenous). Patients are advised to use regular emollients to improve skin barrier function and relieve symptoms of pruritus. Emollients act by filling spaces around desquamating but attached skin cells, sealing moisture into the skin through the production of an occlusive barrier (48). The net effect is softening of the skin. Ingredients in emollients include mineral oils (e.g., liquid paraffin, petrolatum), waxes (e.g., lanolin, beeswax, and carnauba), long-chain esters, fatty acids, and mono-, di-, and triglycerides.
Assessment of the patient with neuropathic pain
Peter R Wilson, Paul J Watson, Jennifer A Haythornthwaite, Troels S Jensen in Clinical Pain Management, 2008
Sympathetic hyperactivity may be present in some peripheral neuropathic pain states as part of complex regional pain syndrome (CRPS; formerly known as causalgia or reflex sympathetic dystrophy; see Chapter 27, Complex regional pain syndromes). The clinical aspects of sympathetic hyperactivity include a perception of burning-type pain soon (hours or days) after injury together with the demonstration of swelling, smooth glossy skin, and vasomotor instability. A characteristic localized osteoporosis may be observed in the extremities (Sudeck’s atrophy) later on. These features may exist alone or in combination. Sweating may be affected, producing either wet or dry skin. Similarly, the skin may be cooler or warmer, depending on the degree of cutaneous vasoconstriction. In patients suspected of sympathetic dysfunction, tests can be useful to document the degree of sympathetic involvement. These include sweat testing, galvanic skin resistance, plethysmography, skin blood flow measurement (laser Doppler test, thermography), and cutaneous histamine response. Diagnostic sympathetic blocks may also be used to determine the possible involvement of the sympathetic nervous system in a particular pain condition.77 There is at present no single test that can be used to exclude sympathetically maintained pain and there are no known symptoms that predict it.74
Skin at risk of ulceration
Wesley C. Finegan, Angela McGurk, Wilma O’Donnell, Jan Pederson, Elizabeth Rogerson in Care of the Cancer Patient, 2018
Dry skin should be moisturised.Moist skin (due to urine, faeces or discharges) should be cleaned, dried and protected.Remove restraints and bed rails where possible to prevent injury.Reposition the patient frequently and check the skin each time.Tilting above 30° should be avoided if possible.
Patient and caregiver preferences on treatment attributes for atopic dermatitis
Published in Journal of Dermatological Treatment, 2022
Claire Ervin, Rebecca Crawford, Emily Evans, Steven R. Feldman, Joshua Zeichner, Michael A. Zielinski, Joseph C. Cappelleri, Marco DiBonaventura, Liza Takiya, Daniela E. Myers
Efficacy attributes were the most frequently reported attributes across the different subgroups (Table 3). Specifically, the resolution (alone) and the rapid resolution of all symptoms (n = 78 (75.7%); n = 80 (77.7%), respectively) followed by the resolution of itch specifically (n = 57 (55.3%)) were the most frequently reported efficacy-related treatment attributes. The concept of ‘all symptoms’ depended on the participant, but these commonly included itching, redness, bumpy, cracking, bleeding, or dry skin. Other frequently reported efficacy attributes included how long the effects of the medication lasted (n = 48 (46.6%)), how well the treatment moisturized and/or soften skin (n = 42 (40.8%)), and flare reduction and/or prevention (n = 29 (28.2%)).
Dry eye and dry skin - is there a connection?
Published in Ophthalmic Epidemiology, 2023
Igor Petriček, Sania Vidas Pauk, Martina Tomić, Tomislav Bulum
Despite bringing crucial new insight, there are limitations to this study. First of all, the authors used the Schein questionnaire, which does not evaluate the impact of dry eye symptoms on patients’ vision, everyday activities, and quality of life. There are no established cut-off values for DED compared to OSDI and DEQ-5. Schein questionnaire was chosen for this study because authors use it routinely in their clinical work and are more familiar. Also, the questionnaire is validated for use in Croatian. Second, since the pathophysiology of dry skin is unclear by now, and it is still not recognized as a disease, there are no recommendations on how to diagnose it accurately, neither which questionnaire nor diagnostic test to use to evaluate the condition. The authors used skin self-reported dry eye type similar to those used in several more studies.28,29,33,48 Laufer and Dikstein and de Melo and Maia Campos found a positive correlation between sebum secretion measured by sebumeter and skin dryness, so the authors used the same sebumeter to assess sebaceous gland function and skin dryness.9,45 At the end, in this study, we found a significant connection between ocular and skin dryness; however, the exact mechanism of that connection is still unknown. It is suggested that it may be on the hormonal level. Indeed, more investigations on genetic and molecular levels are needed to confirm and clarify that connection.
Atopic dermatitis: new insight into the etiology, pathogenesis, diagnosis and novel treatment strategies
Published in Immunopharmacology and Immunotoxicology, 2021
Deepa S. Mandlik, Satish K. Mandlik
Several genes have been linked to AD, mainly genes that encode epidermal structural proteins and genes that encode the main elements of the immune system. The reported strong association between AD and mutations in the filaggrin gene (a genetic risk factor for AD), located on chromosome 1 is a recent and important genetic discovery [11]. Approximately 10 percent of people from western cultures have mutations in the filaggrin gene, while about 50 percent of all patients with AD have those mutations. Mutations of the filaggrin gene cause functional impairments in the filaggrin protein and thus weaken the skin barrier. The clinical manifestation of these impairments is dry skin and an elevated risk of eczema. Not all patients with AD have these mutations, and there have also been other genetic variations incriminated. This is the cumulative action of both of these genetic variations along with AD causing environmental and developmental risk factors [12].