Keratosis

Thickening of the skin can be termed as keratosis. It resembles an overgrowth restricted to a particular area on the upper layer of the skin resembling a wart or callus.

Actinic keratosis / solar keratosis: Thick brittle and scaly patches in the skin that indicate pre malignancy, actinic keratosis indicates the progress of skin cancer. This condition is commonly referred to as precancerous condition. This condition is common among white skinned people and in people aged above 30. People diagnosed with this condition should visit the doctor on a regular basis to keep a track on these bumps. Constant exposure to sun can cause this condition. It is common in the exposed areas of the body such as chest, forearms, ears, neck, backs of hands, face, scalp and lips. Symptoms include scaly patches, rashes that don't itch or pain and reddish-brown skin. Actinic keratosis is treated through surgery. If the bumps are large, laser surgery is performed, for smaller bumps cryotherapy is performed.

Seborrheic keratosis: Small pink and brown warts represent seborrheic keratosis, this type of keratosis is benign. They resemble age spots and appear with aging. The exact cause for this condition is clearly not known. The growth occurs in areas that are more often exposed to the sun. Genetic reasons could also cause this condition. It is characterized by yellow-brown warts or papules. Seborrheic keratosis requires no treatment as it is harmless but picking at the spot might lead to an infection. In case the person affected by the condition prefers removal of these growths, they can be removed through cryotherapy, electrocautery (burning the growth with electric current) and curettage (scraping off the surface of the skin using specialized instruments).

Keratosis pilaris: Red bumps on the skin indicate keratosis pilaris, the skin surface also gets rough and bumpy. It is commonly referred to as chicken skin. This type of keratosis is usually mistaken for pimples. Keratosis pilaris is more common in children and settles down on its own as they grow up. Excessive keratin produced in the human body causes this condition. This condition is also believed to be hereditary. This condition appears like rough bumps on the skin that might get itchy. There is no treatment for keratosis pilaris. Exfoliation and moisturizing the affected area can make the skin soft and smooth.

Physiotherapy

Physical therapy also known as physiotherapy, includes evaluating, diagnosing and treating numerous disorders and disabilities through the physical way. This branch of medicine helps people restore, retain and maximize their strength, function, movement and overall well-being.

People who practice this branch of therapy are called physiotherapists. Diagnosis, treatment and rehabilitation of patients are their main areas of work. They primarily work with physical disorders and disabilities. Physiotherapy helps a person

• Become flexible
  
• Improve mobility
  
• Reduce pain
  
• Stay active
  
• Prevent injury
  
• Recover from injury

Physiotherapy helps the human body to remain functional. Physiotherapy is recommended when the human body suffers some physiological trauma. During physiotherapy the patient is examined physically and if required imaging studies are carried out so as to decide the right type of therapy. It is recommended in the following conditions:

• Post injury rehabilitation like fracture recovery, post surgical recovery.
  
• Spine problems like spina bifida, sciatica.
  
• Neck problems
  
• Muscular problems
  
• Joint disorders like osteoarthritis
  
• Neurological disorders like stroke, multiple sclerosis
  
• Backaches
  
• Headaches
  
• Urinary problems like urinary incontinence
  
• Lung and heart disease like chronic obstructive pulmonary disease

Heat therapy: Heat therapy improves the blood flow to the injured area thus speeding up healing. Heat therapy also loosens the tight tissues thereby relieving pain. Various heat treatments include ultrasound, hot pack, infrared heat, Paraffin wax bath, Diathermy

Cryotherapy: Cold therapy helps in minimizing the swelling and pain. It is very useful in acute injuries. Various treatments include ice massage and ice pack application

Strengthening exercises with Physical Therapy: Certain conditions may have caused the muscles to weaken, there are certain types of exercises aimed at strengthening the muscles thereby helping rehabilitation and improving performance.

Range Of Motion exercises: ROM exercises help in improving and maintaining the flexibility of joints. They also help in reducing the stiffness of the joints. Various exercises include:

Passive Range of Motion exercises: (PROM)

Active Range of Motion exercises: (AROM)

Active Assistive Range of Motion exercises: (AAROM)

Soft tissue mobilization/Therapeutic massage:This relaxes the tight muscles thus relieving pain and reducing swelling

Electrical stimulation: This method is used to prevent muscle atrophy in people with paralysis. Electrodes are placed on the surface of the skin thus causing the muscle to shorten.

TENS: Transcutaneous Electrical Nerve Stimulation is a type of never stimulation wherein a low degree electrical current is passed through the surface of the skin to the affected part. This process helps in relieving pain momentarily.

Other types of physical therapy treatment include taping, bandaging, joint mobilization, ergonomic training, postural training, balance exercise, traction, fitting of orthosis, etc. Physiotherapy has various specializations like geriatric, pediatric, orthopedic, neurological, sports, cardiovascular and pulmonary.

Pyogenic Granuloma

Pyogenic granulomas are common skin lesions that appear as tiny red bumps. These lesions have moist, shiny and smooth surface and are prone to bleeding quite often. They tend to bleed frequently as they contain large number of blood vessels at the site. These bumps are usually attached to the skin with stalk. The diameter of the stalk always measures lesser compared to the tumor. Pyogenic granulomas most often occur in children and young adults. It is also common in pregnant women and hormonal changes that take place during pregnancy is said to be the reason for developing Pyogenic granulomas during such period.

Causes and Symptoms

The exact cause for pyogenic granuloma is not known. However it normally occurs at the site of injured or damaged skin. This condition is neither hereditary nor is it contagious.

• A small red raised bump on the skin that bleeds frequently.
  
• They are benign and tend to erupt and grow at a rapid pace.
  
• Usually occurs on hands, arms, and face. In rare cases, they can grow on the cornea of the eye. However pregnant women often develop them on the oral mucosa.
  
• The lesion can measure from few millimeters to several centimeters and there could be single lesion or tiny multiple bumps clustered around the same area.

Pyogenic granulomas is normally diagnosed on mere observation during the clinical examination. A biopsy may be performed to confirm the diagnosis.

Treatment

Pyogenic granulomas may shrink, dry up and fall off on their own over a period of time. Yet the condition most often requires medical attention and treatment much before that; as the wait may be painful and distressing. Pregnant women need not opt for any treatment as the lesions disappear after delivery. In normal cases the following methods are usually followed to treat Pyogenic granulomas.

Curettage: Curettage is always known to be the first line treatment for Pyogenic granulomas. Curettage involves scraping of the lesion with a curette, a spoon like instrument with sharp edges. Once the lesion is removed, Electro cauterization is performed to avoid regrowth and prevent infection.

Cryotherapy: Cryotherapy involves freezing the lesion using liquid nitrogen. This method is effective in treating small lesions. Cryotherapy does not leave a deep scar. However it may change the color of the skin at the site.

Silver nitrate: Cauterization using silver nitrate is also a commonly followed method in treating Pyogenic granulomas.

Laser surgery: Laser treatment has been gaining popularity in treating Pyogenic granulomas. It is an outpatient procedure and results in better cosmetic appearance with little or no scarring.

Excision: There are high chances of recurrence even after timely treatment in Pyogenic granuloma. In such cases, the most effective method of treatment is to completely remove affected area through surgical excision and then close it with sutures.