Phototherapy involves exposing individual's skin(the whole body or the afflicted area) to measured doses of specific, artificial light in order to treat medical problems. The artificial light used in phototherapy is a man-made source of ultraviolet light generated by fluorescent lamps, LEDs or lasers and broken down to three ranges - A, B and C or referred to as UVA, UVB and UVC bands. The bands vary in terms of the level of penetration with different amounts of energy sufficient enough to both treat and/or burn the skin. Artificial light sources allow much more accurate UVB dosing than using natural sunlight.
Earlier, broadband UVB therapy was used for treatment. The PUVA system based on UVA was seen to have many side effects on patients. Narrow band UVB units work on emitting light on short-range wavelengths. This typically results in minimal sun burning of the skin. But it has not been established whether repeated use over a number of years would increase the risk of skin cancer.
UVB when carefully administered is effective in the treatment of psoriasis. UVC has no therapeutic use but is used in a variety of air and water purification and sterilization systems. UVC bulbs are used in restaurants, operating rooms and even laboratories.
Dermatologists are physicians who specialize in diagnosing and treating diseases related to the skin, nail and hair. Pediatric dermatologists are trained to cure any skin disorders in infants, children and young adults. Cosmetic dermatologists are trained specialists in beautifying the skin by removing scars and external marks on the skin either through medications or surgical procedures. Dermatologists have to complete medical school and then an internship period of one year followed by three years residency program in dermatology. After completion of the residency program, they take up training in sub-specialties of dermatology such as cosmetic dermatology, pediatric dermatology etc.
Task of a dermatologist
Dermatologists have the prime responsibility of providing care to the most exposed organ of the body, their task includes:
Latest techniques employed in the field of dermatology
With the newer techniques available for treatment in the field of dermatology it has become easier to treat skin related with ease.
Heavy menstrual bleeding may happen due to underlying conditions such as hormonal imbalance, uterine polyps and ovarian dysfunction. Menorrhagia is also an inherited disorder as it is associated with blood clotting impairments like Von willebrand's disease. In most cases, endometrial biopsies are done to determine histological overview of the conditions. Many treatment options are suggested depending upon the age, lifestyle and medical history of the patient. Among many prophylactic measures, endometrial ablation or uterus ablation is increasingly becoming the most preferred method.
The inner layer of the uterus called as the endometrium is removed using the diathermy electrode. The patient is subjected to general anesthesia during the procedure. Careful examination of the uterine wall is done to identify any underlying uterine disorders. The electrode is 4mm and it helps in cutting of the endometrium. In addition to this, the myometrium is also destroyed to eliminate the underlying endometrial basal cells.
The basal cells of the endometrium are also called basalis. They enable the multiplication and thickening of the endometrium forming the superficial layer of the endometrium which is shed out. The walls of the uterus are examined for bleeding points and then the patient is sent to the recovery room. Other modern techniques such as the administration of microwave endometrial ablation, cryoablation, diode laser phototherapy are considered.
Endometrial ablation is not advisable for patients who might be in early pregnancy, have a history of uterine cancer and menopause. Women who undergo endometrial ablation have a chance of conception; however there is a possibility of miscarriage. This happens because the uterine lining has been removed.
Endometrial ablation is also recommended as an alternative to hysterectomy. Endometrial ablation is also done on an outpatient basis with a given recovery time. The results of the endometrial ablation treatment include absence of menstrual bleeding. In some cases, there is a possibility of reduced bleeding. Consult a doctor in the case of spotting to identify the emergence of conditions such as fibroids or polyps of the uterus. Endometrial ablation procedure is widely administered among women in the age group of 30 to 45.
Endometrial Resection : The Loop Electrosurgical Excision Procedure(LEEP) is used to destroy the uterine lining. The use of LEEP is faster and provides faster recovery than any comparable surgical procedure.
Complications of Endometrial Ablation
The most significant complication is perforation caused to the uterus. In these cases laparoscopy is done. Other possibilities include perforations to organs such as the bladder, blood vessels and the organs in pelvic region.
The fluid absorption during the endometrial ablation procedure may result in the lowering of blood salt levels causing damage to the lungs and brain. In post-operative cases, vaginal bleeding is common for a few days. However, if the discharge or bleeding from the vagina is associated with foul smell, infections of the uterus are suspected. Women who have undergone the endometrial ablation procedure are generally advised to take progestogens which help in reducing the risk of uterine cancers. Sexual intercourse is advised only after two weeks to prevent vaginal bleeding or pain.
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Bibliography / Reference
Collection of Pages - Last revised Date: September 27, 2022