Skin Conditions

We treat a number of skin condition and allergies and only a few examples are given below: Acne Acne is the formation of comedones, papules, pustules, nodules, and/or cysts as a result of obstruction and inflammation of pilosebaceous units (hair follicles and their accompanying sebaceous gland). It most often affects adolescents, but is not uncommon in adults, particularly in women with PCOS/D. Diagnosis is by examination. Classification of Acne Severity.
Severity	Definition
Mild	< 20 comedones, or < 15 inflammatory lesions, or < 30 total lesions
Moderate	20 to 100 comedones, or 15 to 50 inflammatory lesions, or 30 to 125 total lesions
Severe	> 5 cysts, or total comedo count > 100, or total inflammatory count > 50, or > 125 total lesions Treatment is a variety of customised topical and systemic medicinal plant based extracts intended to reduce sebum production, infection, and inflammation and normalize keratinization.

ECZEMA

Eczema also called Atopic dermatitis is an immune-mediated inflammation of the skin, often with a significant genetic component. Pruritus (itching) is the primary symptom; skin lesions range from mild erythema to severe lichenification. Diagnosis is by history and examination.

Treatment is based on plant based moisturizers, systemic medicinal plant based medication and avoidance of allergic and irritant triggers. A blood allergy test may be helpful to identify the underlying causes.

Atopic dermatitis (AD) is IgE-mediated (extrinsic type, 70 to 80% of cases) or non-IgE-mediated (intrinsic type, 20 to 30% of cases). IgE-mediated disease is better characterized; non-IgE-mediated disease is non-familial and idiopathic.

Clinical Findings in Atopic Dermatitis

Common features

Chronic or chronically relapsing

Personal or family history of atopic disease

Pruritus

Typical morphology and distribution:

Facial and extensor eczema in infants and children

Flexural eczema in adults

Frequent features

Cutaneous infections

Early onset

Elevated serum IgE

Nonspecific dermatitis of hands and feet

Positive type I allergy skin tests

Xerosis

Occasional features

Cataracts (anterior subcapsular)

Facial erythema

Food intolerance

Ichthyosis

Infraorbital folds

Itching with sweating

Keratoconus

Nipple eczema

Pityriasis alba

Recurrent conjunctivitis

White dermatographism

Wool intolerance

Psoriasis

Psoriasis is an inflammatory disease that manifests most commonly as well-circumscribed, erythematous papules and plaques covered with silvery scales. Cause is unknown, but common triggers include immune related reactions, trauma, infection, and certain drugs. Symptoms are usually minimal with occasional mild itching, but cosmetic implications may be major. Some people develop severe disease with painful arthritis. Diagnosis is based on appearance and distribution of lesions.

Treatment is with medicinal plant based emollients, vitamin D analogues, retinoids (Vitamin A derivatives), tar, phototherapy as well as systemic plant based medicines.

Subtypes of Psoriasis
Subtype	Description
Guttate psoriasis	Abrupt appearance of multiple plaques 0.5 to 1.5 cm in diameter, usually on the trunk in children and young adults following streptococcal pharyngitis.
Erythrodermic psoriasis	Gradual or sudden onset of diffuse erythema, usually in patients with plaque psoriasis (though may be the first presentation); typical psoriatic plaques are less prominent or absent. Most commonly caused by inappropriate use of topical or systemic corticosteroids or light therapy.
Generalized pustular psoriasis	Explosive onset of widespread erythema and sterile pustules
Pustular psoriasis of the palms and soles	Gradual onset deep pustules on palms and soles. Flare-ups may be painful and disabling. Typical psoriatic lesions may be absent.
Inverse psoriasis	Psoriasis of inguinal, gluteal, axillary, inframammary, and retroauricular folds and of the glans of the uncircumcised penis. Cracks or fissures may form in the center or edge of involved areas.
Nail psoriasis	Pitting, stippling, fraying, discoloration (oil spot sign), and/or thickening of the nails, with or without separation of the nail plate (onycholysis). May resemble a fungal nail infection. Affects 30–50% of patients with other forms of psoriasis.
Acrodermatitis continua of Hallopeau	Pustular psoriasis confined to distal fingers or toes, sometimes just one digit; replaced by scale and crust upon resolution.

Rosacea

Rosacea (acne rosacea) is a chronic inflammatory disorder characterized by facial flushing, telangiectasias, erythema, papules, pustules, and in severe cases, rhinophyma. Diagnosis is based on characteristic appearance.

Treatment depends on severity and includes topical water based customised medicinal plant extract creams, systemic medicinal plant extract tinctures, as well as addressing life style and dietary requirements.

The etiology of rosacea is unknown, although associations with impaired facial venous drainage, an increase in hair mites (Demodex folliculorum), and Helicobacter pylori infection have been proposed. The basic disturbance seems to be one of vasomotor control. Rosacea most commonly affects patients aged 30 to 50 with fair complexions, most notably those of Irish and Northern European descent, but it affects and is probably under-recognized in darker-skinned patients. The age of onset helps distinguish rosacea from acne.

Seborrheic dermatitis

Seborrheic dermatitis (SD) is inflammation of skin with a high density of sebaceous glands (face, scalp, upper trunk). The cause is unknown, but Pityrosporum ovale, a normal skin organism, plays a role. SD occurs with increased frequency in immuno-suppressed patients and in those with certain neurologic diseases. Seborrheic dermatitis causes occasional pruritus, dandruff, and yellow, greasy scaling along the hairline and on the face. Diagnosis is clinical. Treatment is tar based shampoo and topical plant extract anti-fungals, as well as plant extract based systemic medication.

Despite the name, the composition and flow of sebum are usually normal. The incidence and severity of disease seem to be affected by genetic factors, emotional or physical stress, and climate (usually worse in cold weather). SD may precede or be associated with psoriasis (seborrhiasis). Patients with neurologic disease (especially Parkinson's disease) or HIV may have severe SD. Very rarely, the dermatitis becomes generalized.

The pathogenesis has been linked to the number of Pityrosporum yeasts present on the skin.