Skin, Our largest organ.

Skin is the outer covering of the body and in fact is the largest organ of the body covering about 20 square feet. It is composed of two layers the epidermis and the dermis. Not only is the skin the largest organ of the body; but it is your body’s first layer of defense from outside the outside environment.
The outer layer, the epidermis, is comprised of four layers, which are responsible for keeping water in, keeping infection out and helping to regulate body temperature – among other vital functions. The inner layer, the dermis, is composed mainly of connective tissue that provides the strength and elasticity your skin needs to resist stressors. Both layers are vital in understanding and treating nearly all skin conditions and concerns.

Lupis

What is Lupus?

Lupus is a chronic (long-term) disease that can cause inflammation and pain in any part of your body. It’s an autoimmune disease, which means that your immune system — the body system that usually fights infections — attacks healthy tissue instead.

What are the types of lupus?

When people talk about lupus, they’re usually talking about systemic lupus. But there are four kinds of lupus:

Systemic lupus erythematosus (SLE), the most common form of lupus
Cutaneous lupus, a form of lupus that is limited to the skin
Drug-induced lupus, a lupus-like disease caused by certain prescription drugs
Neonatal lupus, a rare condition that affects infants of women who have lupus

Lupus and the skin

Lupus affects different people in different ways. Most people with lupus have skin problems, like rashes or sores. Sometimes lupus affects only the skin, and sometimes it affects other parts of the body, too.

How does lupus affect the skin?

People with lupus can have many different skin problems.

Cutaneous lupus

Skin problems that only happen to people who have lupus are called cutaneous lupus.

There are 3 main types:

Chronic cutaneous lupus (also called discoid lupus) causes round, disc-shaped sores, usually on the face and scalp. The sores can cause scars or changes in skin color.
Subacute cutaneous lupus causes a red scaly rash or red ring-shaped sores. It usually happens on skin that gets sunlight, like the neck and arms.
Acute cutaneous lupus causes a butterfly-shaped rash on the cheeks and nose that looks like a sunburn (called malar rash). Sometimes it affects other body parts, like the arms and legs.

PCOS

What is PCOS & how does it affect skin?

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.

PCOS is the most common reproductive endocrine condition among women who are of childbearing age. As many as 10 percent of teens and young women are living with PCOS.

Although conversations about PCOS often focus on the noncancerous growths that it causes, hormonal imbalance is at the heart of the condition.

Your body depends on signals from your pituitary gland to produce the right amounts of estrogen, progesterone, and testosterone. PCOS disrupts these signals.

Without the right signals from the pituitary gland, your estrogen and progesterone levels drop, and your testosterone levels increase.

This can prevent ovulation and lead to symptoms like:

irregular menstruation
acne
hair growth on your face, chest, or back (hirsutism)
patches of dark skin on the back of your neck or other areas (acanthosis nigricans)

Psoriasis

Psoriasis is a skin disease that causes red, itchy scaly patches, most commonly on the knees, elbows, trunk and scalp.

Psoriasis is a common, long-term (chronic) disease with no cure. It tends to go through cycles, flaring for a few weeks or months, then subsiding for a while or going into remission. Treatments are available to help you manage symptoms. And you can incorporate lifestyle habits and coping strategies to help you live better with psoriasis.

Psoriasis signs and symptoms can vary from person to person.

Common signs and symptoms include:

Red patches of skin covered with thick, silvery scales

Small scaling spots (commonly seen in children)

Dry, cracked skin that may bleed or itch

Itching, burning or soreness

Thickened, pitted or ridged nails

Swollen and stiff joints

Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas. The most commonly affected areas are the lower back, elbows, knees, legs, soles of the feet, scalp, face and palms.

Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into remission.

There are several types of psoriasis, including:

Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin patches (lesions) covered with silvery scales. The plaques might be itchy or tender, and there may be few or many. They usually appear on elbows, knees, lower back and scalp.

Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails might loosen and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble.

Guttate psoriasis. This type primarily affects young adults and children. It's usually triggered by a bacterial infection such as strep throat. It's marked by small, drop-shaped, scaling lesions on the trunk, arms or legs.

Inverse psoriasis. This mainly affects the skin folds of the groin, buttocks and breasts. Inverse psoriasis causes smooth patches of red skin that worsen with friction and sweating. Fungal infections may trigger this type of psoriasis.

Pustular psoriasis. This rare form of psoriasis causes clearly defined pus-filled lesions that occur in widespread patches (generalized pustular psoriasis) or in smaller areas on the palms of the hands or the soles of the feet.

Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely.

Psoriatic arthritis. Psoriatic arthritis causes swollen, painful joints that are typical of arthritis. Sometimes the joint symptoms are the first or only symptom or sign of psoriasis. And at times only nail changes are seen. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. It can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent joint damage.

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Melasma

What is Melasma?

Melasma is a skin condition characterized by brown or blue-gray patches or freckle-like spots. It’s often called the “mask of pregnancy.” Melasma happens because of overproduction of the cells that make the color of your skin. It is common, harmless and some treatments may help. Melasma usually fades after a few months.

What causes melasma?

There are two main causes of melasma: radiation, whether ultraviolet, visible light, or infrared (heat) light; and hormones.

Ultraviolet and infrared radiation from the sun are key in making melasma worse. Other possible causes of melasma include:

·Contraceptive therapy (birth control): Melasma has been observed in individuals who use oral contraceptive pills that contain estrogen and progesterone.
Estrogen/Diethylstilbestrol: Diethylstilbestrol is a synthetic (man-made) form of the hormone estrogen. It’s often used in treatments for prostate cancer. Again, there’s a pattern between increased estrogen and melasma.
Genetics: About 33% to 50% of people with melasma have reported that someone else in the family has it. The majority of identical twins both have melasma.
Hypothyroidism: A condition where your thyroid is underactive.
LED Screens: Melasma may be caused by the LED lights from your television, laptop, cell phone and tablet.
Pregnancy: It is unclear why “the mask of pregnancy” happens to pregnant women. However, experts theorize that the increased levels of estrogen, progesterone and the melanocyte-stimulating hormones during the third trimester of pregnancy play a role.
Hormones: Hormones like estrogen and progesterone may play a role in some people. Postmenopausal women are sometimes given progesterone, and have been observed developing melasma. If you aren’t pregnant, you likely have elevated levels of estrogen receptors found in your melasma lesions.
Makeup (cosmetics): Some cosmetics can cause what’s called a phototoxic reaction.
Phototoxic drugs (medicines that make you sensitive to sunlight): These include some antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), diuretics, retinoids, hypoglycaemics, antipsychotics, targeted therapies and some other drugs.
Skin care products: A product that irritates your skin in general will likely make your melasma worse.
Soaps: Some scented soaps are thought to cause or worse melasma.
Tanning beds: The UV light produced by tanning beds damages your skin just as bad as the UV light from the sun, and sometimes worse.

Hypopigmentation & Hyperpigmentation

What are they?

Hypopigmentation and Skin

Hypopigmentation in skin is the result of a reduction in melanin production. Examples of hypopigmentation include:

Vitiligo: Vitiligo causes smooth, white patches on the skin. In some people, these patches can appear all over the body. It is an autoimmune disorder in which the pigment-producing cells are damaged. There is no cure for vitiligo, but there are several treatments, including cosmetic cover-ups, corticosteroid creams, calcineurin inhibitors (Elidel cream, Protopic ointment) or ultraviolet light treatments. New topical treatments using Janus Kinase inhibitors are being investigated.
Albinism: Albinism is a rare inherited disorder caused by the absence of an enzyme that produces melanin. This results in a complete lack of pigmentation in skin, hair, and eyes. Albinos have an abnormal gene that restricts the body from producing melanin. There is no cure for albinism. People with albinism should use a sunscreen at all times because they are much more likely to get sun damage and skin cancer. This disorder can occur in any race, but is most common among whites.
Pigmentation loss as a result of skin damage: If you've had a skin infection, blisters, burns, or other trauma to your skin, you may have a loss of pigmentation in the affected area. The good news with this type of pigment loss is that it's frequently not permanent, but it may take a long time to re-pigment. Cosmetics can be used to cover the area, while the body regenerates the pigment.

Hyperpigmentation and Skin

Hyperpigmentation in skin is caused by an increase in melanin, the substance in the body that is responsible for color (pigment). Certain conditions, such as pregnancy or Addison's disease (decreased function of the adrenal gland), may cause a greater production of melanin and hyperpigmentation. Exposure to sunlight is a major cause of hyperpigmentation, and will darken already hyperpigmented areas.

Hyperpigmentation can also be caused by various drugs, including some antibiotics, antiarrhythmics, and antimalarial drugs.

Photoaging

What is Photoaging?

Photoaging or photoageing (also known as "dermatoheliosis") is a term used for the characteristic changes to skin induced by chronic UVA and UVB exposure. Tretinoin is the best studied retinoid in the treatment of photoaging.

The deterioration of biological functions and ability to manage metabolic stress is one of the major consequences of the aging process. Aging is a complex, progressive process that leads to functional and aesthetic changes in the skin. This process can result from both intrinsic (i.e., genetically determined) as well as extrinsic processes (i.e., environmental factors). Photoaging is attributed to continuous, long-term exposure to ultraviolet (UV) radiation of approximately 300–400 nm, either natural or synthetic, on an intrinsically aged skin.

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