Scleredema

The skin gets thick and hard and becomes red in color. Scleredema or Buschke disease is very rare and can affect people belonging to any age group. The condition varies from individual to individual. Scleredema is classified into three types:

Type I: Sets in due to a streptococcal infection in the throat.

Type II: Sets in due to unusual levels of immunoglobulin. This type of Scleredema does not occur due to an infection but starts gradually and remains for a longer period.

Type III : Scleredema adultorum of Buschke, is also referred to as 'Scleredema diabeticorum', and is more common in diabetics. It is more common in men than in women.

The exact cause for Scleredema is not known. This condition is often related to diabetes, though this condition might occur after a streptococcal throat infection or viral illness. When the condition is induced due to diabetes, men are affected more than women and when the condition is induced due to an infection, women are more affected than men. Thickening and hardening of the skin are the most common symptoms of scleredema. Other commonly reported symptoms include reddishness of the skin and difficulty in opening the eyes and the mouth. In very rare cases the liver, spleen, heart and throat might get affected. The skin resembles the skin of an orange.

Scleredema can be diagnosed by a doctor after a close examination of the patient. A sample of the skin is sent for biopsy to confirm the condition. Throat culture is performed to detect any streptococcal infection in the throat. The patient's blood glucose level is analyzed for diabetes. Medications are prescribed based on the condition that induces this condition. In case of diabetes, medications are prescribed to control the blood glucose levels, a strict diet and exercise schedule has to be followed to control diabetes. Scleredema induced due to an infection persists for a short span, the symptoms settle down within a period of 6 months to 2 years if the condition is induced due to an infection. If the condition is induced due to diabetes, it takes a longer time for the symptoms to settle down. In case of restricted movements, physical therapy is used to manage the condition.

Obsessive compulsive disorder

The exact cause of obsessive compulsive behavior is yet to be established. On the basis of some studies and research carried so far, possible causes include any one or a combination of two.

Genetics (family history): Multiple genes passed on through generations are likely to affect the sufferer whose close relative is diagnosed with OCD as well. The genetic connection proves to be higher if the onset of OCD is before age 14. Identical twins have a 70% chance of sharing the disorder.

Illness: If the person is suffering from other anxiety disorder like depression, , substance abuse disorder, a personality disorder, attention deficit disorder, he or she is most likely to experience a high level of anxiety. Certain auto immune diseases such as Sydenham's chorea, rheumatic fever, pediatric streptococcal infection may also cause obsessive compulsive disorder.

Serotonin Hypothesis: People diagnosed with OCD are believed to have abnormally low levels of brain chemical, the serotonin which helps carry messages from one nerve cell to another. This imbalance may interfere with the normal biological processes including mood, sleep, appetite, impulse control, aggression and pain.

Structural brain differences: Abnormalities in several parts of the brains including the thalamus, caudate nucleus, orbital cortex and cingulated gyrus may also be a cause for OCD.

OCD traits

The disorder is clearly visible right from early childhood. Check for one or more of the following traits which are generally associated with time, dirt, relationship and money. Unless and until the individual has trouble leading a normal life due to any or all of these traits, it is not diagnosed as a disorder.

• Keeping home perfectly organized.
  
  
• Extreme attention to details, rules, lists, orderliness even if it results in waste of time and doesn't result in completion of proposed activity.
  
  
• Exhibiting over perfectionism which interferes with task completion.
  
  
• Is a workaholic, overly devoted to work and productivity.
  
  
• Unwilling to delegate work as
  
  
• Highly rigid and stubborn.
  
  
• Leading a miserly spending style, self and others. Hoards money fearing future catastrophes.
  

Treating OCD

If left unattended, OCD can have devastating effects both in personal life and at the workplace. Normal life can be completely marred. Most importantly, individuals with OCD are close to acknowledging the need for help as compared to those affected with OCPD who do not conceive it as a problem, hence do not seek help until or unless someone forces the issue.

Antidepressant medications and behavior therapy are effectively used in treating OCD. Medication other than certain antidepressants is rarely prescribed. Instead individual psychotherapy or counseling helps treat OCPD. With family support and an empathetic attitude by those in contact, improvement is evident within few weeks of professional assistance.

Erythema Nodosum

Inflammation of the skin that shows up as painful reddish tender lumps is called Erythema nodosum. This inflammation is usually located in a part of the fatty layer of skin (subcutaneous fat). The size of the lump could vary in size from 1 to 5 cm. The inflammation causes nodular swelling. The inflammation remains for about a week and then becomes flat leaving behind a bruised appearance. They usually show up on the shins (front portion of the legs, just below the knee). Erythema nodosum is a type of panniculitis, i.e. inflammation that can cause nodules below the surface of the skin. The condition is more common among youngsters aged between 12-20 years.

Erythema nodosum settles down on its own after a period of three to six weeks. It may leave behind a temporary bruised appearance or a chronic indentation in the part where the fatty layer has been injured. Though the condition is annoying and painful, the condition does not cause any damage to the internal organs of our body. In adults, the condition is more often seen in women than in men. In kids, it affects boys and girls equally. In a few people the trigger can be identified and in yet a few it cannot be identified. However identifying the trigger becomes very important as it needs to be treated.

Erythema nodosum causes

Erythema nodosum may show up on its own or may occur in association with other conditions. In about 30-50% of cases, the cause is unknown. However the common triggers that may cause Erythema nodosum include:

• Step throat (streptococcal infection) in adults and kids
  
• Fungal diseases
  
• Tuberculosis
  
• Cat scratch disease
  
• Few medications like penicillin, oral contraceptive, Hepatitis B vaccination, etc
  
• Sarcoidosis
  
• Inflammatory bowel diseases
  
• Behcet's disease
  
• Pregnancy
  
• Certain types of cancers like lymphoma, leukemia, etc

Erythema nodosum symptoms

• Painful nodules are commonly seen on the shin and sometimes on the arms, thighs and trunk of the body. The nodule when it first appears is red, hot and firm to touch and becomes flat over a few days. It appears as bruise that is blue in color and later turns yellowish as it fades. A person may develop just a couple of nodules or much more.
  
• Flu-like feeling before the appearance of lumps.
  
• Aching joints and legs before the appearance of lumps. Ankle, knee and wrist joints are the most affected.
  
• Loss of weight.
  
• Symptoms may vary depending on the underlying trigger that caused the condition.

Erythema nodosum diagnosis

• By means of physical examination
  
• Biopsy of the affected area
  
• Blood test to identify the trigger
  
• Chest X-ray in case of TB or sarcoidosis induced condition
  
• Throat swab

Erythema nodosum treatment

• Cortisone injection
  
• Oral cortisone
  
• Anti-inflammatory drugs
  
• Bed rest
  
• Compression bandages
  
• Cool wet compresses