General Dermatology - Patients ask, Dr. Ringpfeil answers
Please feel free to use the blog below to share information about General Dermatology or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
Lupus is the shortened name for the disease "Systemic Lupus Erythematosus" (SLE). Lupus is an autoimmune disease with many variations and it affects multiple areas of the body. An autoimmune disease occurs when the body's natural immune system which fights infections from bacteria, viruses, and pathogens, begins to attack itself. The body "thinks" of itself as a harmful agent. Although lupus can affect any organ in the body the disease most commonly affects the skin, kidneys, joints, and the heart.
One in every 2,500 people may develop lupus and females, especially those who are pregnant, tend to be more affected than males. Blacks are the highest risk population. The most noted sign of lupus is a butterfly-shaped skin rash that can accompany mouth and vaginal ulcers. Many patients also report joint pain or extreme tiredness resulting from anemia (low number of blood cells). As a result of the body's natural defenses attacking itself, the symptoms are caused by increased levels of inflammation.
Extreme levels of stress, hormones, or sunlight can cause the resting disease to flare. Also, certain drugs may cause adverse reactions in patients with a long-term treated illness and promote the development of lupus. These patients commonly have a hyperactive immune system as a result of other illnesses. White blood cells may also possess genetic problems that contribute to autoimmune disfunction.
Although an extremely difficult disease to diagnose, lupus appears to have a genetic link, and analysis of a family lineage and history may reveal past relatives with the disease. Besides taking a detailed patient history and observing common physical signs such as the butterfly rash, biochemical testing is required. Doctors commonly perform an "antinuclear antibody" or an "antiphospholipid antibody" test to determine if the body exhibits the autoimmune disease characteristics of lupus.
Unfortunately, lupus is a lifetime (chronic) disease without a known cure. However, there are ways to treat the flare-ups and symptoms. To prevent the widespread inflammation of lupus, patients commonly receive steroid treatment or drugs that suppress the immune system from reacting with itself. Pain relievers for arthritis commonly caused by lupus, allow for most patients to continue performing all of their daily activities. Also, non-steroids such as Advil and Motrin help relieve fevers associated with outbreaks.
Since stress can promote outbreaks, people are encouraged to involve friends and family in the treatment of the disease. A good support structure helps with managing doctor's visits and outbreaks. Also, avoiding intense sunlight and weight loss can decrease the frequency of lupus inflammations.
Since lupus is an extremely complicated disease, doctors do not know how to prevent its development. Many genetic factors are involved and the best way to avoid outbreaks is to maximize personal health and consult with a doctor.
Since lupus is a chronic disease affecting many people, the Lupus Foundation of America (www.lupus.org) has established local chapters across the United States. These organizations provide support for everyone living with lupus. Any local doctor will know the contact information of the nearest group.
American Lupus Society
260 Maple Ct, Suite 123
Ventura, CA 93003
Tel: 800-331-1802 (Info Line); 805-339-0443; 805-339-0467 (FAX)
Lupus Foundation of America, Inc.
4 Research Place, Suite 180
Rockville, MD 20850-3226
I was recommended Accuntane to treat my acne. I have an extremely difficult time swallowing pills. Is there another way to take Accutane that does not require swallowing a pill? For example, can I chew and swallow the pill/crush it up/etc?
There is no other safe and effective way.
I would like to know if you have any experience with Fox Fordyce disease and if so. What treatment do you offer?
Fox Fordyce disease is a benign obstruction of specific sweat ducts. It is challenging to treat because no known remedy exists to date. We use CO2 laser treatment when treatment is desired. It achieves about 50% reduction of the visible bumps.
Hello, wanted to know do you accept Health Partners Plan insurance?
you will find and extensive list of insurance companies we participate with at the bottom of this page: https://www.ringpfeildermatology.com/about-us.php. Our office accepts Health Partners of Minnesota. Unfortunately, we do not participate with the Health Partners Plan that covers Medicaid, Medicare, and CHIP in Philadelphia county and its surrounding counties.
Hello, I am losing lots of hair everyday for the past 3 months. Hair doesn’t hold moisture and when I add any product (oils, moisturizers) it soaks it up like a sponge but in a few minutes the products are released and running down my face. The hair also swells when proct is added giving the illusion that I have more hair than I really do. The hair is dull, brittle, costantly breaking, splitting and falling. I have just about lost all my hair on crown of head except for a small thin patch. My hair in the back is patchy and also thinning and falling. I have some itching in scalp at times. At one point, I was experiencing a burning sensation at the nape of my neck. I had blood work done about 4 months ago for Thyroid, CBC and lupus and results were negative. I had one steroid / antibiotic scalp injection in May. I chose not to get another shot because my hair was still falling tremendously and the doctor really had no clue as to why I was losing my hair. I want to desperately save what little hair I have left and I am hopeful to find an explanation for my hair loss and a solution to regrow my hair. I am African American and need answers and hoping for a solution. Please HELP ME!
You will probably need a scalp biopsy and perhaps additional work up pending biopsy results. I recommend that you speak to your dermatologist about additional studies.If your dermatologist does not perform scalp biopsies or does not work with laboratory that is equipped to prepare the biopsy specimen per the current state of the art protocol, you may schedule an appointment at our office.
I have calcinosis due to scleroderma. For 20yrs. It has been confined to my fingers, but now ( within the last year) is affecting the soles of my feet, making it very difficult to walk; etc..what type of treatment ( if any) would be helpful
Sometimes, certain types of blood pressure medications are helpful with calcinosis cutis, but treatment is somewhat limited. I recommend that you discuss treatment with your rheumatologist or the specialist who helps you manage your scleroderma.
I have what I think is a dermatofibroma on my shoulder\back. It’s dark brown on my light brown skin. It’s also hard to the touch. It gets itchy and has grown slightly over time. Do you treat for this?
Dermatofibroma is a reaction of our skin to an insect bite or an inflamed hair follicle. It can last many years, but it can resolve on its own. In the first 6 months, it is often itchy or can grow. Itch from a dermatofibroma can be treated with liquid nitrogen, short term steroid application or steroid injection. If a dermatofibroma continues to be symptomatic, it can be excised. Excision trades the dermatofiborma for a true permanent scar. The location of the excision determines what the scar might look like. On the back, a scar can spread as the back is under a lot of movement during the healing period. Please schedule an appointment with one of our dermatologists so that you can learn about your options.
I have recently been diagnosed with having
Discoid(Chronic) Lupus Erythematosis.
I am due for a treatment of 250 units of Botox for Spasmodic Torticollis on Tuesday May 15th. I am concerned this might cause a flare up of the Lupus, therefore I am considering canceling my appointment.
Dear doctor, do you specialize in treating people with this condition? If so I would like to schedule an appointment to have you evaluate me.
I am waiting for the outcome of blood work I had done Friday May 11th.
Please respond to me. Thank you kindly.
Many procedures go along with delayed wound healing in individuals with auto-immune connective tissue disease including lupus. Botulinum toxin injections help weaken an overactive muscle, such as torti collis, and do not start a wound healing response. I have treated many patients who have lupus with cosmetic doses of botulinum toxin, which are typically smaller than those used in torti collis, and I have not yet seen exacerbation of lupus. Our practice treats many patients with discoid and systemic lupus. We specialize in skin and not only in lupus. Our patients with systemic lupus also require the involvement of rheumatology, nephrology or cardiolgy.
I believe what I want requires an ocular-plastician, however I’ll ask anyway. Do you treat malar bags with laser resurfacing? I want to avoid surgery on the upper and lower eyelids if possible. I just want the pouches that have formed under the eyelid, on top of the cheek bone, to be smoothed out. I understand that to remove those pouches can be quite tricky. Any chance that you deal with malar pouches?
You are correct, what you describe requires a surgical blepharopalsty. This is usually performed by an oculopastic or facial plastic surgeon.
Hi, Is there a cure for melasma? Does hydroquinone cause cancer?
There is treatment for melasma as well as prevention but cure does not yet exist. Hydroquinone might be associated with cancer formation and therefore it is banned in Japan, the European Union and Australia. The FDA still approves prescription and over the counter sales in the US because it does not regard the data pertaining to its danger as sufficient. Safe alternative options for for treatment and prevention are arbutin, kojic acid and many others.
Hi are does some insurances cover acne facial and what all is done during theach acne facial?
Acne surgery is the physical treatment of painful cysts or painful acne lesions. It is a bit unpleasant but not intolerable and you will have visible marks for 4-7 days after. We submit acne surgery to insurance. Most insurances cover this service. Please note that removal of blackheads cannot be charged to insurance.