Thursday, December 23, 2004

How Lupus Factors into the Rosacea Picture

Lupus can cause a reddish skin rash that spreads across the bridge of the nose and face, often in a butterfly pattern, it can appear similar to rosacea. However, while both rashes can be smooth in texture, the presence of bumps and pimples, which rarely occur in a lupus flare, may help to distinguish the two conditions. In addition, lupus is almost always accompanied by other symptoms not associated with rosacea, such as fever, arthritis and signs of renal, lung or heart involvement. A dermatologist can usually quickly tell the difference between a butterfly rash of lupus and rosacea.

Moreover, unlike lupus, as many as 50 percent of rosacea patients may also have ocular signs. Visually, an eye affected by rosacea often appears watery or bloodshot. Sufferers may feel a gritty or foreign body sensation in the eye, or have a dry, burning or stinging sensation.

Tuesday, December 14, 2004

Picture of Rosacea or.. Dioxin?

Fateful dinner party that brought disfigurement in its wake...

Nick Paton Walsh in Moscow
Monday December 13, 2004
The Guardian

It was no routine dinner party, its guests as distinguished as its agenda was questionable. On the night of September 5, the leader of the Ukrainian opposition, Viktor Yushchenko, met Igor Smeshko, the head of the Ukrainian security service, the SBU, and his deputy, Volodymyr Stasiuk, reportedly a confidant of the outgoing president, Leonid Kuchma.

The opposition had requested the meeting to discuss how the SBU, the successor to the KGB, would act during the forthcoming electoral campaign. Mr Yushchenko was ahead in most of the polls, and presumably sought assurances that the SBU would stay neutral.

At Mr Smeshko's luxurious dacha outside Kiev, they ate and drank until the small hours. But it was not until Mr Yushchenko returned home that the first traces came to light of the poisoning that was to nearly take his life.

Kateryna, his wife, told ABC on Friday: "I thought there was something different about my husband when he came home that night - because he has never taken any medicine, he's a very healthy man. And I tasted some medicine on his breath, on his lips. And I asked him about it, he brushed it away, saying there is nothing."

It was a typical reaction from a man whose tanned, square-jawed face had helped catapult him from being a former national bank chief to presidential contender in four years. A healthy, vigorous man at 50, he listed skiing and basketball among his hobbies.

So when that night the illness first struck, he shrugged it off as bad food poisoning. Yet the abdominal pains grew in intensity, interrupting his heavy campaigning. By September 10, local doctors had recommended he seek expert treatment abroad.

When he arrived at the private Rudolfinerhaus clinic in Vienna, his body was in an almost total state of collapse. He was groggy, and had the same chronic abdominal pain, and his organs appeared close to collapse.

His blood tests showed severe abnormalities. His face and upper chest were covered in unusual lesions. His digestive tract and stomach were speckled with ulcers and bleeding abrasions. Eight days of intensive tests followed, yet the doctors, led by the director of the clinic, Michael Zimpfer, could not pin down the cause of his illness. They said at the time that he had arrived too late after falling ill for any poison he had ingested to still be in his bloodstream.

Without Mr Yushchenko, the opposition's campaign was faltering, so he opted for a plan to allow him to get back on the election trail. Doctors inserted a drip into his spine so he could receive constant painkillers.

Three days after checking himself out of the Vienna clinic, he stood before parliament and accused the government of trying to kill him. "Look at my face," he said. "Note my articulation. This is one-hundredth of the problems that I've had. I want to know the names of the assassins very much. But even without any investigation the answer is simple - the killer is the regime. I survived because my guardian angels were not asleep at the time. Every one of you is next, however."

On September 28, he returned to Vienna for further tests. The doctors were no nearer establishing the cause. They suspected foul play, but had no evidence of poison, instead suggesting various rare diseases, such as the condition rosacea, might be to blame for his facial disfigurement.

He pressed on with campaigning, but the disfigurement remained the unanswered question behind his election campaign and the 16-day crisis that followed.

Days after parliament passed constitutional changes, the proof that doctors at the Rudolfinerhaus had sought for weeks finally emerged. "We could do a diagnosis and check his symptoms," said Dr Zimpfer.

"But we had no experience in advanced chemical weapons or biological weapons. We made an international call to several experts in Europe and the US."

He said they had been able to pinpoint that the poison was based on dioxin. The doctors said on Saturday he had arrived in Vienna with levels of dioxin in his blood a thousand times above normal.

The Yushchenko campaign refuses to name any suspects for the poisoning. "Mr Yushchenko does not want revenge," said spokeswoman Irina Gerashenko, who said the prosecutor general's renewed investigation should make conclusions alone. She added: "Then the courts can decide."

Wednesday, December 08, 2004

ROSACEA'S ROSY PICTURE

On a daily basis, someone walks through Dr. William Applegarth's doors and asks him if there's anything he can do with the red, sometimes painful patches on their face, the little blood vessels popping to the surface, or all the bumps and pimples.

What he tells all these rosacea sufferers is that it's highly treatable, both by avoiding what triggers the condition and through the use of a variety of medications.

"Everybody's triggers are different," he said, rattling off a list of common culprits, like heat, sun, wind, caffeine, alcohol and spicy foods.

And, because some people have dry skin, oily skin or sensitive skin -- and because rosacea manifests itself differently in people -- he doesn't use the same treatment for everybody. Among the products he prescribes is the new rosacea treatment AVAR-e Green, a cream that treats the symptoms and offers a color corrective tint to neutralize the redness.

If left untreated, sufferers can develop increasing effects, including the enlarged "W.C. Fields" nose, said Valparaiso dermatologist Applegarth.

"That can be the end result for untreated people," he said.

"The vast majority of people can have good results with treatment."

He said those with mild symptoms are usually treated with topical treatments, while those with moderate or severe symptoms might be given topical treatments and oral antibiotics. Patients usually are clear or have significant improvement within six weeks.

Rosacea can affect not only the skin, but also the eyes. Sufferers complain of irritation, dryness or a gritty feeling. Applegarth often refers patients to an eye doctor.

Winter is tough on skin

Applegarth said rosacea is common in every season. But, in winter, there are other skin conditions for which people need to watch out.

The drops in temperature and humidity, combined with indoor heating, can cause dryness and even cracking of the skin. New York-based dermatologist Dr. Mark Kaufmann recommends buying humidifiers for key rooms in the home. Kaufmann, in a news brief provided to The Times, said people might want long, hot baths in the winter, but they actually strip skin of moisture. A short, lukewarm shower no more than once a day protects dry skin or skin suffering from eczema or psoriasis.

Those longing for a warm bath can add some bath oil -- but they should use caution because the tub can become slippery.

Other tips include:

* Use a cleanser such as Cetaphil Gentle Skin Cleanser to prevent stripping the skin's natural oils.

* To avoid dryness, avoid alcohol-containing products like astringents, toners or aftershaves.

* Exfoliate skins with a washcloth or gentle scrub.

* Apply moisturizer immediately after showering, while the skin is still damp, to seal in moisture.

* Apply sunscreen and a lip balm with sun protection, even in the winter months.

* Use a hand cream, like Cetaphil Therapeutic Hand Cream, especially after washing. Adding a biotin supplement to the diet is a good idea if you have brittle, splitting nails.