Ask the Doc...
Thyroid trouble?
Name withheld:
My daughter's children, a son, 12, and a daughter, six, have severe Lamellar icthyosis of the skin.
Is there any treatment to cure/improve their condition? There are no known cases in our families or my son-in-law's family.
Dr. R. Murlidhar, Consultant Dermatologist, replies:
Icthyosis is a common condition. Lamellar icthyosis, though not very common, is well known.
The best way to confirm the diagnosis is through electron microscopy of the skin. There are other clinical signs also, but there are so many types of icthyosis, it is better to be exact.
As such, lamellar icthyosis means there is a structural defect in the way the skin is being formed. So there is no complete cure. It may change with seasons and vary with change of place. Use of external creams may help, but these are temporary.
For older children, systemic drugs like high dose Vitamin A or even drugs like retinoids may be used but even this does not provide a lasting relief.
The prognosis, therefore, is more one of management. A good dermatologist will be able to tell you how to manage the child on a daily basis.
One should not forget the need for psychosocial counselling as these children may look unsightly and so suffer psychological trauma. As for future pregnancies, it may be possible to diagnose the disease in utero. So do not despair as molecular biology has a lot to offer today.
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Skin problems
V.Rajalakshmi:
I had been suffering from leg pain, below the ankle for more than a year. Recently it was diagnosed as hypothyroidism. I am taking Eltroxin 100 mcg, Resochin 250mg, Valus 10mg. Still the swelling below the ankle and pain is not reduced. RA factor and ASO titre are normal in blood test. What more should I do? Also what type of food can I take, as I am pure vegetarian? I am 39 years old.
Dr. Usha Sriram, Endocrinologist, replies:
Hypothyroidism can cause aches and pains. When thyroid levels are made normal by treatment with Thyroxine, the aches, and swelling should go away. If they persist, there may be other reasons like being overweight, varicose veins, flat foot, bad footwear, arthritis and achilles tendinoitis.
Please consult a good general physician first and then an orthopaedic surgeon or rheumatologist if necessary and undergo a thorough examination. Please have your thyroid hormone level checked and your dosage adjusted. There are no special diets for hypothyroidism. A balanced diet with fresh fruit, vegetables, grains and dairy products should keep you healthy.
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