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Acrochordon

Acrochordon, also known as skin tag is an overgrowth of the skin hanging loose from the surrounding area and is connected by a stalk (peduncle). Acrochordons are normally benign growths; they are soft wrinkled protrusions and appear in flesh or light brown color. They are filled with collagen fibres and blood vessels with a thin layer of skin covering them.

They do not cause any pain and small growths may just fall off unknowingly. Slightly bigger acrochordons do not fall on their own and need to be removed using various methods. Though they can occur anywhere on the body, the areas like under arms, eyelids, upper chest, neck, and groin are more prone to develop skin tags as the skin here rubs against the clothing or with the adjoining skin. Acrochordon occurs in both men and women and the frequency of the condition increases as we age.


What causes Acrochordon?

Skin tags are caused by the constant rubbing between the skins of adjacent sites. Obesity is one of the very obvious causes that lead to acrochordon. These people tend to develop more skin tags simply because they have more skin folds on their body. Research also shows that this condition is inherited: people with close relatives having acrochordons have higher chances of developing this skin condition. Pregnant women also have a tendency to develop skin tags due to the hormonal changes taking place in their bodies. Diabetic patients are also prone to skin tags. Wart virus or human papilloma virus also cause skin tags.

Clinical examination is sufficient to diagnose the acrochordon. Yet in case of suspicion, doctor may advise skin biopsy. This procedure involves removal of small piece of skin to be examined in laboratory. This is done to rule out any malignancy of the growth.


Treatment of Acrochordon

Typically acrochordons do not require any treatment and they need not be removed. But the bearer may choose to get it removed either for cosmetic reasons or if the tags become bothersome. A word of caution here, if the skin tags are changing color or growing too quickly it is advisable to show it to your physician to rule out any further complications. Cryosurgery is used extensively, where the skin tag is removed by freezing it using the liquid nitrogen. Cauterization is one more method which involves burning of the skin tag using electrolysis (heat). Skin tags are also removed by surgical excision.

Acromegaly

Acromegaly is a hormonal disorder that usually affects middle aged adults. Acromegaly is the result of excessive production of Growth Hormone (GH) from the pituitary gland. In children it can result in Gigantism - unusual bone growth and consequent unusual height. Acromegaly is characterized by enlarged hands, feet and face (lips, tongue and nose). Acromegaly can affect heart and bones also.


Acromegaly Causes

The hands and feet are over sized when the body makes elevated amounts of growth hormone due to a benign tumor in the pituitary gland located at the base of the brain. The elevated levels cause an excess of bone and tissue growth.


Acromegaly symptoms

The most noticeable symptom is an over-sized finger necessitating the ring if worn, to be removed. Hitherto fitting shoe may seem unfitting due to an increased shoe width. Noticeable change in the face is a swollen/larger/broader lip, tongue and nose. Other symptoms may include one or a combination of the following.


  • Weight gain
  • Swollen and painful joints that restrict movement
  • Spaces appearing between teeth
  • Hoarse voice
  • Fatigue
  • Headache
  • Inability to sleep
  • Muscle weakness
  • Excessive sweating
  • Body odor due to enlargement of sweat glands
  • Enlarged sebaceous glands that make skin oily
  • Severe acne
  • Severe snoring
  • Impaired vision
  • Menstrual cycle irregularities in women
  • Abnormal breast milk production in women
  • Erectile dysfunction in men
  • Increased chest size
  • Non-cancerous thickened skin and skin tags.

Acromegaly diagnosis

The physical changes occur gradually and are often not recognized immediately. There are instances when individuals recognize symptoms after comparing old photographs. Awareness is the key to seeking medical attention. If any of the symptoms persists for more than few weeks, seek medical attention. An early diagnosis can avert severe health complications.

Doctors proceed to laboratory tests after discussing medical history followed by physical examination. Blood tests are done to confirm diagnosis. To assess the size and location of the tumor, magnetic resonance imaging (MRI) of the brain or a Computerized Tomography (CT scan) is required.

Instead of checking random levels of hormones which vary minute to minute, doctors recommend testing for protein called insulin like growth factor 1 or IGF-1 which indicate the presence of abnormal body growth.

Another definitive diagnosis method is the growth hormone suppression test. Blood levels of growth hormone before and after drinking a preparation of glucose is measured. If the test shows high GH level, it confirms Acromegaly.


Acromegaly Treatment

Medications, surgery and radiation are suggested depending on the age and health condition of the individual. The aim is to restrict the excessive production of hormones and improve problems caused by the condition. Doctors prescribe medicines for treatment after surgery or in cases where surgery cannot be performed. Surgery is performed to remove the tumor if it is not too large. In cases where medicines and surgery do not treat the condition, radiotherapy (stereotactic radio surgery or conventional radio therapy) that eventually leads to reduction in growth hormones is recommended.



Sensory Processing Disorder

Sensory processing Disorder or SPD is like a neurological 'traffic jam' that prevents certain parts of the brain from receiving information needed to interpret sensory information correctly. Since these persons find it difficult to process information received through the senses, it becomes a challenge to perform numerous tasks every day. Clumsy behavior, anxiety, depression, failure at school and other impacts may result if this disorder is not attended to effectively.


Since our senses are working together, we hear background sounds and feel our clothing, chair, floor or sky. We can see letters on the screen and can also filter out unimportant sensory input to make sense of what we are reading. But, for instance, if we feel that our shirt is itchy and is hurting us or keep sliding off the chair, or the words that you read pulsate, then we may have sensory processing dysfunction – these could be developmental delays, attention and learning problems, and autistic spectrum disorders.


What happens if a child's normal every day functioning is so severely affected by sensory preferences? The child is either hypersensitive (over-responsiveness) or hyposensitive (under-responsiveness) to sensory stimuli. He/she has trouble integrating sensory input – in other words, these children suffer from Sensory Processing Disorder, which is also called Sensory Integration Dysfunction.


If we examine the signs and symptoms of hypersensitivities to sensory input, the first thing that strikes is fear of sudden loud, or metallic noises like flushing toilets, clanking silverware or other noises that could be unoffensive to others. These children may be distracted by background noises that others do not hear and are fearful of surprise touch; they avoid hugs and cuddling even with those familiar to them. They are fearful of crowds and avoid standing in close proximity to others and do not enjoy a game of swing. They are extremely fearful of climbing or falling and have poor balance, and may fall often.


Hyposensitivities to sensory input include a constant need to touch people or textures. They exhibit clumsy and uncoordinated movements and have an extremely high tolerance for or indifference to pain. They do not understand their strength and are often fidgety and unable to sit in one place whereas they enjoy movement-based play like jumping, spinning etc. They could be thrill seekers and can be dangerous at times. Whether the child is eating a hamburger or riding a cycle or reading a book, his/her successful completion of that activity will depend upon 'Sensory integration'. Out of proportion reactions to touch, sound, sight, movement, taste or smell could be:


  • Bothered by fabrics, tags, labels
  • Dislikes messiness
  • Resists grooming
  • Squints, blinks or rubs eyes frequently
  • Bothered by light and patterns
  • Very sedentary or high with activity
  • Usually exhibits high or low pain threshold

A study by Briggs-Gowen Group in 2009 suggested that at least 1 in every 6 children experience this sensory symptom that may be significant enough to affect aspects of everyday life functions. Indeed, it could get so chronic that it can disrupt the everyday life of a child.


What could be the causes of SPD ?

The causes of SPD are both genetic and environmental. Preliminary research studies suggest that SPD is often inherited. Prenatal and birth complications have been implicated and even environmental factors are involved to cause SPD. But only with further research, it will be possible to identify the role of each.


Emotional impacts of SPD

Since the child has problems with motor skills and other abilities, success at school and childhood accomplishments could be challenging. As a result, the child often gets socially isolated and will suffer from low esteem complex. Inability to make friends or be part of a group, poor self-concept, academic failure, uncooperative, disruptive and being labeled as clumsy or 'out of control'. Parents of such children are often blamed by those who are unaware of the child's hidden handicap.


Treatment for SPD

Although effective treatment for SPD is available, far too many children are misdiagnosed with this disorder and hence not properly treated. Untreated SPD can affect the individual's ability to succeed in marriage and social environments.

Once accurately diagnosed, such children can immensely benefit from a program of occupational therapy or physical therapy with a sensory integration approach, under a well-trained clinician, with listening therapies, and other complimentary and combined effective therapies.


Such therapies takes place in a sensory-rich environment called the OT gym. The child is guided through fun activities that are subtly structured so that he/she though constantly challenged is always successful. The child is able to behave in a more functional manner. Such effective occupational therapy enables children with SPD to take part in normal childhood activities such as playing with friends, enjoying school, dressing and sleeping. Parents are involved and work with the therapists to learn more about their child's sensory challenges and methods for engaging therapeutic activities called 'sensory diet', at home or elsewhere. This way, the parents could become better advocates for their ward at school and within the community at large.


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Bibliography / Reference

Collection of Pages - Last revised Date: November 22, 2019