ASK THE DOC
Dr. R. Murlidhar, Consultant Dermatologist, Apollo Hospitals, Chennai, replies to this week’s queries:
I get rashes on the inner side of my thighs after walks. I used to put Whitefield ointment and it would heal in a day. But over the years, the skin has become dark. Can the marks be removed? Name withheld
Answer: Marks on the thigh appear after sweating, especially after a walk or some form of exercise. Sweat tends to be retained between the thighs and this leads to fungal or bacterial infections or sometimes a mixed infection. This may
result in intertrigo or inflammation in the folds. Repeated episodes of intertrigo lead to dark marks. Such problems are also common in overweight patients and when the thighs rub against each other. Use a simple talc powder every day before going for the walk. This will reduce friction and absorb sweat. As for the mark, lose weight and wait for three to four months. If there is no further inflammation, the mark should gradually fade. If the patch is itchy, you may need an anti-fungal cream. Do not use a steroid as it can damage the skin. Some over-the-counter creams contain steroids, so ask your dermatologist.
I have vitiligo for 10 years. One dermatologist prescribed antioxidant and vitamin tablets in addition to allegra 120 (one a day) and levocetrizine dihydrochloride tablet (at bedtime). If I do not take it regularly, I get itching in the thigh and scrotum. Is long-term use of medicines harmful? Mahaveer Chand
Answer: Vitiligo is a condition in which the skin loses colour. Antioxidants and vitamins may be prescribed as adjuvants or add-on drugs to the actual prescription. By themselves, they may not help you.
The problem you mention is itching in the thigh and scrotum areas. While long-term use of drugs like allegra may not be harmful, it is not indicated in this situation. Levocetrizine may help reduce the itch better here, but this is symptomatic
I would like to know why you are itching for so long here. I would look for obesity, diabetes, fungal infections, frictional dermatosis, eczemas and even psychological factors, which compulsively make you scratch. The list is long; but, once you get the cause, this is not such a big problem that you should have to take drugs all your life.
I am 66 years old and have black spots all over my body. About three years ago, one peeled off and then started growing. When it started itching, a specialist advised immediate excision and biopsy. Biopsy indicated it was squamous cell carcinoma. I underwent radiation, as margins still had a few squamous cell. Will the remaining spots turn into carcinomas? Is there some general precautions or treatment? I have about 45 years history of asthma. Also I underwent an operation on my left lower lobe, which had a non-small cell lung cancer. I also went through six rounds of chemotherapy. Lung operation was done three years back. Skin spot, which became squamous cell carcinoma, started growing around the time chemotherapy rounds were finishing. S.C.Bhargava
Answer: You have raised an important issue. The fact that you have undergone chemotherapy and radiation for lung cancer is important. When patients undergo chemotherapy for one cancer or when they have one type of cancer, they can have
a second malignancy in another organ. In your case it may be the skin.
Immunosurveillance is a mechanism by which the body’s immune system monitors the behaviour of every cell. Chemotherapy or a primary malignancy can imply the destruction of immunosurveillance. Hence, in the prone individual, second malignancies can occur.
One should therefore check your systems thoroughly, not just every spot on the skin. Please see not only a good dermatologist who has worked in oncology, but also your oncologist.
Suspicious spots may need biopsies. There are also imaging techniques, which your oncologist can advise you about.
I am 30 years old. I am suffering by dandruff, which becomes round patches if left alone. If I use nizoral then it goes but it recurs. Is there a permanent solution? Saravanavelu
Answer: Dandruff produces yellowish sticky or whitish scales, which are related to overgrowth of a yeast organism normally present on the scalp. The scalp is diffusely involved, as the entire scalp reacts to this by producing flakes.
Ketoconazole shampoos are anti-fungal in nature. At a concentration of two per cent, they work well and can certainly help you.
However if the scalp shows round patches, then you probably do not have dandruff. You might be having psoriasis, which produces well demarcated patches on the scalp.
I think you should consult a dermatologist who can counsel you properly.
I am 16. For two years I have been suffering from hair loss. One doctor tested my hair and it showed Hairs-positive for fungal elements (Exothrix). I wash my hair daily. Recently another doctor advised me to take trichoton, livogen, finax and doxt for one month and a shampoo (fontiger) but my hair continues to fall to a great extent. Is there any cure for this problem? Pavan
Answer: The incidence of hair loss in youngsters is growing. Hair loss due to fungus will produce patches with broken and powdery hairs. Trichoton and livogen contain vitamins and iron; they are used as non-specific stimulants of hair
growth. However, iron deficiency anemia is a very common cause of hair loss and, if this is so, you should investigate, document and treat optimally.
Finax is finasteride, a drug given to males to block the male hormone from damaging the hair root and thus preventing its growth. A cure can be talked about only if we have a definite diagnosis. See a good dermatologist who will examine you and investigate for systemic causes and also see the pattern of hair loss.
There are several systemic diseases which can also produce hair loss. With a clear diagnosis, treatment should not be a problem. Several safe options are available.
Send in your medical queries to Ask the doc, Magazine,
The Hindu,
859-860, Anna Salai,
Chennai 600 002 or e-mail askthedoc@thehindu.co.in
Please keep questions short and focussed. Please do not send medical reports along with the queries.
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