itchy skin

Pruritus refers to an unpleasant sensation that causes the need to scratch, commonly called itching by most people. Itching may be localized to a certain area of the body, or can be all over, or generalized. When there is a rash that goes along with the pruritus, the cause is usually easily determined and treated. However, the most difficult cases of pruritus are those without an associated rash.

What Causes Pruritus?

Pruritus and pain are closely related sensations, since the same nerves transmit both signals to the brain. When the area of skin is scratched, that same area may become even itchier, leading to more scratching. This is called the itch-scratch cycle. In general, pruritus can be related to a problem with the skin or another underlying disease of the body (systemic disease). When itching is localized to a particular area of skin, it usually is not caused by a systemic disease.

Localized Pruritus

Areas of itching that are only on one part of the body are more likely caused by a problem of the skin. The area of the body that itches may give a clue as to the cause of the itch.

Child eczema

Children who live within 50 yards of a busy road are more likely to develop asthma, eczema and hay fever, a major new study has shown.

Researchers have found a strong link between exposure to traffic fumes in the first few years of life and a host of childhood allergies.

They say youngsters living alongside the busiest roads are 50 per cent more likely to be susceptible to allergies than those living in quieter streets.

The study suggests that Britain's allergy epidemic could be partly caused by the steep rise in cars and lorries on British roads in the last few decades.

The number of people with allergies has trebled in the last 20 years. One in three people now suffer at some point in their lives.

The rise has been blamed on the modern obsession with hygiene and children's indoor lifestyles. Doctors say exposure to dirt is essential for a healthy immune system.

But the new German study suggests that the rise of traffic pollution is also playing a role.

Scientists tested nearly 2,900 children at the age of four and more than 3,000 aged six for asthma, wheezing, eczema and sneezing.

Their parents were asked about their health and their exposure to traffic pollutants was calculated by looking at the distance of their homes to major roads at birth, and aged two, three and six years of age.

The scientists also tested the children at six for food allergies, and took air samples around the youngster's homes.

After taking into account the parent's own history of allergies, the number of pets in the home and the number of brothers and sisters - all factors which can cause allergies - they found a strong link between the distance to the nearest major road and hay fever, eczema and bronchitis brought on by asthma.

Children living closest to heavy traffic were 50 per cent more likely to be susceptible to allergies than those living a long way away, they report in the American Journal of Respiratory and Critical Care Medicine.

Dr Joachim Heinrich, who led the study at the Institute of Epidemiology, Munich, said:

"We consistently found strong associations between the distance tot he nearest main road and the allergic disease outcomes," Dr Heinrich wrote in the

"Children living closer than 50 meters to a busy street had the highest probability of getting allergic symptoms, compared to children living further away."

The study is particularly powerful because it is prospective - selecting a group of children first before seeing how the environment goes on to affect their health.

Retrospective studies, which take a sample of children and look back in time to see what could have caused their conditions, are more open to bias.

Past studies have found a link between traffic fumes and allergies. However the studies were was confused by other factors. In many cities, for instance, people who live next to major roads tend to be poorer.

The Germans say their study is different because in Munich just as many wealthy families as poor ones live near busy roads.

Many doctors believe that traffic fumes do not just trigger allergic reactions, they cause underlying allergies.

Busy roads release a wide range of pollutants - from dust and tyre particles, to microscopic particles called PM10s from diesel engines which could damage the body's immune system, increasing risks of allergies. Diesel fumes can also cause harmful changes to blood vessels and damage lungs.

"Children living very close to a major road are likely to be exposed not only to a higher amount of traffic-derived particles and gases, but also to a more freshly emitted aerosols which may be more toxic," said Dr Heinrich.

"Our findings provide strong evidence for traffic related air pollutants on atopic diseases as well as on allergic sensitisation."

The rise in allergies in the West is usually linked to the "hygiene hypothesis" - the idea that the body's immune system over-reacts to pollen, dust and traffic fumes because we are all raised in homes that are too clean.

Doctors say that babies' immune systems need dirt, animal hairs and dust to develop healthily.

Skin Rashes

I have a problem that has been plagueing me for nearly five weeks now... I seem to be getting this kind of rash that I'm not sure about. From the pictures below, you can see parts of my face and how this rash looks like.
It's going in a frustrating cycle. I have noticed that it will start itching, then gets worse, and then calms down. When it does calm down, my face becomes clear, but dry. Flaking occurs, and when I use my cleanser (Neutrogena Extra Gentle cleanser), it seems to get drier. With that, I am starting to believe that my rash is caused by the dryness. Before that, I get hives, and I normally associate them as harmless. Unfortunately, that is not the case, as some of the hives started growing up into liquid filled capsules.



My doctor (I went into a children's doctor, and that might've affected what type of treatment I am getting) says that I might have contact dermatitis. With my knowledge, it is also called eczema. I am currently using the Neutrogena cleanser and this hydrocortisone lotion called "Praxoline," don't remember if it is the correct spelling. I have an over the counter cream with aloe vera that I avoided using after my rash started lichenifying, but that was four weeks ago.

My condition improved during spring break, but now it started up again, and I am running out of ideas. Can someone confirm that my rash is indeed dermatitis? Should I attempt to use the OTC hydrocortisone cream? Please note that the pictures are about a week old, and my face right now is not as serious as the pictures above.

Sinusitis treatment

Pain in the forehead or between the eyes? Upper teeth ache? Face feeling full, nose stuffy and congested? The number one reason for visits to a doctor's office: sinus problems and sinus-related symptoms.

Sinuses: Air Spaces in Your Head

Sinuses are air spaces in your skull lined with mucous membranes. You have four sets of nasal sinuses:

• two frontal sinuses in the forehead above the eyes
• two maxillary sinuses, one inside each cheek bone (dark triangles seen in this CAT scan)
• ethmoid sinuses: a beehive of 18 to 22 cavities behind the bridge of the nose (also shown here)
• sphenoid sinuses, behind the nose and underneath the brain

Sinuses are like fingerprints; everybody's are different.

What Is Sinusitis?

Tiny, hair-like structures called cilia (magnified here) help move mucus across sinus membranes and toward an exit. All of your sinus cavities connect to your nose to allow a free exchange of air and mucus. Infections or allergies make sinus tissues inflamed, red, and swollen. That's called sinusitis.

Just a Cold … at First

Sinusitis usually starts with inflammation triggered by a cold, allergy attack, or irritant. But it may not end there. Colds, allergies, and irritants make sinus tissues swell.

Stuffy, Puffy, and Sore

Sinusitis causes many symptoms. Most people have a stuffy nose and pain or pressure in several locations around the face or teeth. There's usually a nasal discharge that may be yellow, green, or clear. Other symptoms may include fatigue, decreased sense of smell and/or taste, cough, sore throat, bad breath, headache, pain on bending forward, and fever.

Chronic Sinusitis

The blue areas in this color-enhanced MRI show thickened mucosal surfaces on both maxillary sinuses. Inflammation of the sinus cavity that lasts for more than three months is chronic sinusitis. It affects about 32 million Americans. Although bacteria often colonize obstructed sinuses, it's not clear that bacterial infections are the true cause of chronic sinusitis. Anatomy, allergies, polyps, immune deficiencies, and dental diseases may also cause chronic sinus problems.

Nasal Polyps

When sinuses remain inflamed, sinus membranes may thicken and swell. The swelling can be brisk enough to cause grape-like masses called polyps (shown here). Polyps may protrude from the sinus into the nasal passage and partially or completely block the nasal airway.

Nasal Decongestants: Relief, at a Cost

These sprays open swollen nasal passages and allow your sinuses to drain. That can be helpful, especially during the worst days of a cold or during air travel. But you should use these drugs only for a few days. After that, there's a kick-back effect, making your nasal passages swell shut again. Decongestants are not indicated for chronic use. Oral decongestants may help, but also have side effects. Better solutions for acute sinus symptoms: nasal steroid sprays or saline sprays or washes. If symptoms persist, see your doctor. Chronic sinus symptoms may be caused by a deviated septum or another treatable condition.

Antibiotics Usually Not Needed

Neutrogena, which is owned by Johnson & Johnson, knows how to baby kids' skin, Buchness says, speaking of Neutrogena Waterguard Kids SPF 70 ($9.99) spray. She also noted that it absorbs quickly, making it good for keeping fussy ones from getting cranky. The whole panel appreciated the gentle yet effective combination of ingredients.

Shown here is a magnified, color-enhanced image of a rhinovirus pathogen responsible for the common cold.

Treating Allergy-Related Sinusitis

What can help allergy-related sinus symptoms is irrigation with saline solution, either with a neti pot or squeeze bottle -- if your nasal passages aren't blocked. Although there's no evidence they help with sinus infections, nasal steroid sprays may help some people suffering sinus symptoms from allergies. Antihistamines may help, too, especially for symptoms of sneezing and runny nose.

When to See the Doctor

About 80% of the time, yellow or green mucus means a bacterial infection. Even then, acute bacterial sinusitis usually clears up in 7 to 14 days -- without antibiotic treatment. But if you keep feeling worse and symptoms are persistent and severe, or if you get a fever, it's time to see a doctor.

Chronic Sinusitis Treatment Still a Puzzle

Chronic sinusitis is very difficult to treat. A first step is controlling predisposing factors such as eliminating environmental irritants. For symptom relief, doctors often prescribe nasal steroid sprays or antibiotics, but neither is proven to work in comprehensive studies. Surgery -- functional endoscopic sinus surgery or FESS -- offers at least moderate relief to 80% to 90% of patients -- but this is not intended as first-line treatment for chronic sinusitis.

Sinusitis Complications: Worst-Case Scenarios

Only a layer of bone separates your sinuses from your brain. If a sinus infection passes through the bone, it can infect the lining of the brain -- meningitis -- or even the brain itself. Both problems are life threatening. A sinus infection can also spread into the orbit of the eye, possibly causing blindness. And, sinus infections can lead to potentially fatal aneurysms or infected blood clots. These complications are rare. Less severe complications include asthma attacks and loss of smell or taste.

Preventing Sinusitis

There's no sure way to avoid either acute or chronic sinusitis. But here are some things that can help:

• Keep sinuses moist -- use saline sprays or nasal irrigation often.
• Avoid very dry indoor environments.
• Avoid exposure to irritants, such as cigarette smoke or strong chemical odors.

Enterovirus Rash Pictures

Enteroviruses are a large family of viruses responsible for many infections in children. These viruses live in the intestinal tract, but can cause a wide variety of illnesses. There are more than 70 different strains, which include the group A and group B coxsackieviruses, the echoviruses, the polioviruses, Hepatitis A virus, and several strains that just go by the name enterovirus. Even though there are many strains, most illness is caused by about a dozen of them. Most children develop immunity to them and don’t get a strain more than once.

These viruses can live for days at room temperature. Refrigerating and freezing does not inactivate them. They are, however, easy to kill with heat and with disinfectants.

Who gets it?
Non-polio enterovirus infections are very common, especially in young children and in households with young children. Summer camps and day care centers are also common places for these infections.

Enterovirus infections can happen any time of the year, but summer and early fall are the main enterovirus seasons.

Severe infections are more common among the immunocompromised.

What are the symptoms?
The most common illness associated with enteroviruses is “non-specific febrile illness.” Children with this type of illness have a fever and feel under the weather for around 3 days. Sometimes they have a fever for a couple of days, feel better, and then have another fever for a couple of days. Sometimes the fever is quite high. There may be loose stools, tummy aches, sore throats, headaches, muscle aches, vomiting – or nothing but a fever.

During enterovirus season, these viruses are the main cause of rash-illnesses in children.

Enteroviruses can also cause respiratory infections, including the common cold, sore throats, and pneumonia.

Enteroviruses can cause GI infections, including nausea, vomiting, abdominal pain, and hepatitis.

Enteroviruses can cause neurologic infections, including meningitis, encephalitis, and illnesses that cause paralysis. A recent study showed that some children who contracted a certain kind of central nervous system enterovirus infection were at higher risk for the development of ADHD.

Skin Rashes in Children

Bacterial and Viral Rashes

Many childhood diseases have bacterial or viral causes and include a rash of some type. As additional vaccines become available, these diseases become less of a threat to your child's long-term health. A rash of any kind should be taken seriously, however, and may require a trip to the doctor's office for evaluation. Examples of bacterial and viral rashes include several common childhood illnesses.

Chickenpox (varicella)

A virus called varicella-zoster causes this very contagious disease. The disease is not harmful to most children. The symptoms generally last two weeks and can make the child very uncomfortable. In addition, chickenpox can be a serious illness in people with weak immune systems such as newborns, people on chemotherapy for cancer, people taking steroids, pregnant women, or those with HIV/AIDS. A safe and effective vaccine is now available to children aged 1 year or older to prevent chickenpox. The symptoms generally appear 10-21 days after exposure.

• Symptoms



• The earliest symptoms of chickenpox are fever, sore throat, and feeling tired. This is followed, usually within a day, by the appearance of the classic, intensely itchy rash which typically begins on the scalp, armpits, or groin area.



• The rash begins as an area of redness with a small, superficial blister in the center. The blister eventually ruptures, and the lesion will form a crust.



• Children with chickenpox will have both new and older lesions present at the same time.



• Treatment



• The virus is spread primarily from the nose and mouth of the child, but the rash itself is also contagious. The child remains contagious and cannot go to school or day care until the last lesion to appear has fully crusted over.



• There is no "cure" for chickenpox once it has begun, but there is a vaccine that is very effective in preventing the disease. Once a child has chickenpox, a physician can prescribe treatments to help control the itching and make your child more comfortable.



• The chickenpox vaccine, called the "varicella vaccine" was added to the routine childhood immunizations in 1995. It is given in two doses. The first dose is given at 12 to 15 months of age. The second dose is recommended between ages 4 and 6. The vaccine is both safe and effective. The vaccine can cause mild tenderness and redness at the site for a few days. While most children will be protected by the vaccine, some children who are later exposed to chickenpox can develop a mild chickenpox case usually without fever and with very few lesions. A new tetravalent vaccine against measles, mumps, rubella and chickenpox was introduced in 2005. It has been shown to work as well as the separate MMR and chickenpox vaccines.



• Never give aspirin to a child with chickenpox. A deadly disease called Reye syndrome has been associated with children taking aspirin, especially if they have chickenpox. Be sure to check any other over-the-counter medications for the ingredients aspirin or salicylates because these are often found mixed with over-the-counter cold medications.



• Chickenpox can occasionally affect the cornea, the clear front portion of the eye. If your child develops chickenpox on the tip of the nose or in the eyes, or if the child develops a red, irritated eye, you should see your doctor immediately.

Measles

A Paramyxovirus causes the measles. A safe and effective vaccine is available to prevent this disease, but outbreaks in people who have not been fully vaccinated still occur.

• Symptoms



• The disease usually begins with nasal congestion, eye redness, cough, and fever.



• The child will generally look sick, with decreased appetite and activity level.



• On the third or fourth day of the illness, the child will develop a brown rash on the face, which spreads down the body and lasts more than three days.



• Treatment



• Once the disease begins, no medication is available to treat measles.



• Children who have measles appear quite ill and are miserable, but the illness usually gets better without lasting ill effects.

You can prevent your child from getting measles by making sure they receive the recommended vaccines. The measles vaccine is part of the MMR (measles-mumps-rubella) vaccine given at age 12-15 months and repeated at age 4-6 or 11-12 years. In the past, some parents would elect to skip this vaccine because of concerns of association between vaccines and autism. Multiple recent studies have shown the vaccine to be safe and definitely not associated with autism or any other behavioral abnormality. The safety concerns focused on the vaccine preservative, thimerosal, which contains mercury. The studies on thimerosal have shown it to be safe, and its use is still endorsed by the World Health Organization (WHO). The MMR vaccine and the DTaP vaccines in the United States have been thimerosal-free since 1995. Since 2001, with the exception of some influenza (flu) vaccines, thimerosal has not been used as a preservative in routinely recommended childhood vaccines in the U.S.

Child Rash

A rash is a reaction of the skin. It can be caused by many things, such as a drug reaction, an infection, or an allergic reaction. Many different agents can cause similar rashes because the skin has a limited number of possible responses. Very often the associated symptoms in addition to the rash help make the diagnosis, such as a history of tick bites, exposure to other ill children or adults, recent antibiotic use, environmental exposures, or prior immunizations.

Most rashes caused by viruses do not harm your child and go away over time without any treatment. However, some childhood rashes have serious or even life-threatening causes. As a parent, you should be familiar with these rashes. Many rashes can look the same, making it difficult to know the exact diagnosis. Whenever you have a concern, see your doctor immediately.