Skin Disorders
kin disorders may be genetic or have an underlying cause; they may be painless or painful, temporary or permanent. It presents with different symptoms. Often, skin conditions can cause some changes to the appearance of the skin and even cause rashes. Read More
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Skin Disorders
Table of contents
Overview
The skin, being the largest organ of the body, serves many essential functions, which include:
- The sensation of pleasant and painful stimuli
- Maintaining a balance of water and electrolyte
- Body temperature regulation
- Vitamin D synthesis participation
- Prevents harmful substances from gaining entry into the body
- Acts as a shield to prevent the adverse effects of the ultraviolet rays emitted by the sun.
Although most of the diseases that affect the skin are limited to the skin, however, sometimes it could provide a clue to a problem affecting the entire body. Skin disorders may be genetic or have an underlying cause; they may be painless or painful, temporary or permanent. It presents with different symptoms. Often, skin conditions can cause some changes to the appearance of the skin and even cause rashes.
Skin infections are among the major contributors to the morbidity of diseases in the world. As reported by The 2013 Global Burden of Disease (GBD) Morbidity and Mortality report, skin diseases were the fourth leading cause of global disability-adjusted life years (DALYs).
Skin picking
Skin picking, also called dermatillomania or excoriation disorder, is a disorder whereby an individual finds it challenging to stop picking the skin. It is not a common skin condition. Some individuals pick at the skin without realizing what they are doing, like on impulse. For others, they are conscious of what they are doing but find it difficult to stop themselves. Most times, the focus is on rough places on the face, like picking at a pimple or scratches.
One may be said to have a picking disorder if the person exhibits the following
- finds it difficult to stop picking
- if due to picking one gets acute, bruise or is bleeding
- tries to smoothen the face by picking at moles, scars, spots, pimples
- when stress or tension pushes one to pick
- is not conscious of the fact the individual is picking the skin.
Compulsion is one of the major symptoms of dermatillomania; that is an impossible or difficult urge to resist the urge to pick one’s skin. Biting with the teeth and using fingernails and fingertips are used for picking the skin. Skin picking disorder can be triggered by boredom, stress or anxiety, negative emotions, and genetics. Habit reversal training is a method employed in skin-picking disorders. In this case, triggers for picking are identified, and the therapist then finds things to help your hands, like using stressor balls.
Skin Pigmentation Disorders
Melanin is a pigment in the body produced by some special cells called melanocytes, which give the skin its color. The amount of melanin is dependent on exposure to the sun and race. Melanin production is affected by changes in hormones and sun exposure. Melanin production is increased with exposure to the sun, thereby conferring protection to the skin from ultraviolet rays.
Depending on the quantity of melanin production by the body will affect the tone of your skin color. Very dark-skinned individuals tend to produce the most melanin, moderate melanin production is by those who are dark-skinned, and those who are fair-skinned produce little melanin. Production of melanin is affected when these cells are damaged or negatively affected.
Skin pigmentation diseases usually affect the color of the skin. While some will affect the whole body, others will affect patches of the skin.
Pigment disorders can either be localized or widespread on the skin. The changes that occur include:
Depigmentation: in this case, the skin is white due to complete loss of pigment.
Hypopigmentation: the skin color is lighter due to an abnormally reduced amount of melanin. It can be caused by rare hereditary conditions, inflammatory conditions that have been healed, and injury on the skin that has happened before, like burns.
Hyperpigmentation: In hyperpigmentation, the skin’s color is sometimes different from normal, and the skin is usually darker. Besides an abnormally high amount of melanin being the cause, sometimes, deposition of other pigmented articles not normally present in the skin can cause it. Certain drugs and disorders that cause inflammation and sunlight exposure can cause hyperpigmentation.
Some of the skin pigmentation disorders include;
Albinism:
There is little or no melanin production in people with this disorder in the skin, hair, and eyes. It occurs in people all over the world, irrespective of race. People with albinism, as they are called, usually should wear sunscreen, hats, or glasses in the sun to avoid sun damage and reduce skin cancer of the skin. There is no cure for albinism as it is a rare hereditary disorder. People with albinism usually have pale skin, white hair, and eyes that are blue, pink, or pale blue, and some may have issues with their vision. It causes decreased vision and involuntary eye movements and makes the eyes not to be in alignment.
Melasma:
Overproduction of melanin is the most likely cause of melasma. It is usually characterized by dark brown to gray-brown patches, which are irregular on areas of the skin exposed to the sun, usually the face. Melasma doesn’t itch and rarely appears on the forearm. It is usually in the center of the face and on the cheeks, forehead, temples, upper lip, and nose. Melasma is commonly seen during pregnancy, also known as the mask of pregnancy. The risk of melasma increases in people who spend a lot of time in the sun. It is usually common among people with dark skin. Some of the causes include Sun exposure, hormones, and contraceptive pills.
Worsening of melisma can be achieved by the use of sunscreen and avoidance of exposure to the sun. Prescription creams containing hydroquinone and tretinoin can be used to lighten the patches.
Vitiligo:
Even though the cause of this disorder is unknown, it is believed to be an autoimmune disorder. It is a skin disorder whereby the melanocytes, the cells that produce the melanin, are attacked by the immune system, causing a loss of the melanocytes. Vitiligo causes the patches of the skin affected to become white, and it tends to run in the family. It affects up to 2 percent of individuals. It is uncommon to see vitiligo affect most of the skin’s surface. For some individuals, one or two well-defined patches of vitiligo may be seen; for others, patches may be seen over a large part of the body. The most affected parts include the face, fingers and toes, wrists, elbows, knees, hands, shins, ankles, armpits, anus and genital area, navel, and nipples. The white patches are highly prone to sunburn.
There is no cure for vitiligo. Treatment entails using sun protection, a cream containing a corticosteroid and calcipotriene, Phototherapy, and psoralens. There is a need to protect all affected areas of the skin with clothing and sunscreen from the sun to reduce the risk of severe sunburn.
Autoimmune disorders
The different types of skin-related autoimmune disorders include scleroderma, psoriasis, dermatomyositis, epidermolysis bullosa, and bullous pemphigoid.
Scleroderma:
Scleroderma is an autoimmune disorder that affects not only the skin but also other body parts. The symptoms can be felt in blood vessels, muscles, and organs. It can be localized, resulting in patches of thickened skin, or systemic, which usually has more impact on the individual.
There are two types of systemic Scleroderma, namely progressive systemic sclerosis (PSS), which can be called systemic sclerosis (SS), in which the individual may have symptoms in the esophagus, intestines, lungs, heart, and kidneys, and CREST syndrome gets its name from its symptoms. Calcinosis (accumulation of calcium under the skin), Raynaud phenomenon (where the fingers and toes are red or blue), esophageal dysfunction, sclerodactyly (the skin that surrounds the toes and fingers gets thicker and tight), and telangiectasia (the dilated blood vessel will cause red skin blotches).
Some of the risk factors include Occupational exposure to silica dust and polyvinyl chloride.
Psoriasis:
It is an autoimmune disorder that is chronic and is characterized by redness of the skin and irritation. Among the five types of psoriasis that exist, including guttate, plaque, inverse, erythrodermic, and pustular, plaque psoriasis is the most common scale, which is flaky, silver-white patches of dead skin covering patches of the skin which is red and raised. Certain research believes it is an inherited disorder. The triggers include sun exposure, medications, alcohol, infections, and skin injuries. Those whose immune systems are compromised or undergoing chemotherapy have increased risk.
Dermatomyositis:
Even though it is majorly muscular, it also affects the skin. People with this may experience shortness of breath and difficulty when swallowing. Dermatomyositis has similar symptoms to polymyositis but differs from it in the skin rashes on the upper body, and skin in many areas is usually tightened and thickened. The eyelid color of most people with this disorder is usually purple. This is more common in women. The symptoms of this disorder in children are different from those in adults.
Bullous pemphigoid:
This disorder is common in the elderly though it can be seen in all age groups. Skin blisters of various severity characterize this chronic disorder. Those with this disorder have blisters in their arms, legs, torso, and mouth (in about one-third of the cases). While some individuals may experience mild irritation of the skin, others may have blisters that are much and can form ulcerations. Itching and bleeding of the gums may be seen in some of the patients.
FAQ
Skin picking, also called dermatillomania or excoriation disorder, is a disorder whereby an individual finds it challenging to stop picking the skin. Some individuals pick at the skin without realizing what they are doing, like on impulse. For others, they are conscious of what they are doing but find it difficult to stop themselves.
Skin picking disorder is not very common. Some people have it and it is usually triggered by stress.
Skin picking disorder is called dermatillomania or excoriation disorder.
References
- https://my.clevelandclinic.org/health/diseases/21573-skin-diseases
- Karimkhani C, Dellavalle RP, Coffeng LE, et al. Global Skin Disease Morbidity and Mortality: An Update From the Global Burden of Disease Study 2013. JAMA Dermatol. 2017;153(5):406-412.
- https://my.clevelandclinic.org/health/diseases/22706-dermatillomania-skin-picking#:~:text=Dermatillomania%20is%20a%20mental%20health,%2Dcompulsive%20disorders%20(OCDs).
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/skin-pigment-disorders
- https://medlineplus.gov/skinpigmentationdisorders.html
- https://www.everydayhealth.com/autoimmune-disorders/autoimmune-skin-disorders.aspx#:~:text=There%20are%20many%20different%20types,Scleroderma.