Does type 2 diabetes cause itching,how to manage type 2 diabetes in pregnancy uptodate,type 2 diabetes case study examples uk 2014 - Try Out


Diabetes is a chronic ailment that develops when the pancreas becomes unable to create sufficient insulin in the body or the healthy cells turn resistant to insulin and leads to abnormally increased levels of sugar in the blood. Some of the health problems that can be caused due to diabetes include blood pressure, heart diseases, eye nerve damage, and skin diseases. Many times, eczema is considered to be one of the diseases that are causes due to diabetes. Diabetes causes the natural body fat to break down on its own when the body begins to lose its energy.
You must not ignore it and seek medical assistance because many times, when this condition is ignored, it can lead to severe complications such as yeast infection causing eczema like skin rashes and itchy scaly patches or even gangrene.
An impeded flow of blood and lowered immunity form the fundamental changes which make diabetics prone to various skin ailments (as compared to non-diabetics). This comprehensive article covers the possible skin conditions that may stem from diabetes so that you are able to spot them at the earliest. Damage to the nerves as a result of diabetes may negatively affect the working of the sweat glands, leading to dry skin, mainly on the lower legs or feet. This problem is fortunately easy to control via daily moisturization of the skin, proper use of sunscreen protection and by drinking adequate amounts of water that allow the skin to stay moist for long. Individuals dealing with diabetes are highly vulnerable to attacks caused by fungal species, especially those initiated by Candida Albicans.
Such infections are found most commonly in moist areas of the body; for example, the small area between toes or fingers, in the vaginal, groin or armpit area.
There are a variety of bacterial infections that can be repeatedly seen in patients with diabetes. Acanthosis nigricans is most frequently associated with insulin resistance (type 2 diabetes), resulting in an escalated amount of insulin in the blood circulation. Mostly, the creases and folds in the body, as seen in the elbows, knees, armpits, under the breast etc, show such changes.
Necrobiosis lipoidica diabeticorum is a rare diabetic complication (affects roughly 0.3% of diabetics) which has a strong predilection for adult women. Pathologic degenerative changes that take place in collagen and fat reserves below the skin result in this inflammatory skin disorder. Bullosis diabeticorum, also known as diabetic blister is an infrequent skin condition wherein an individual with diabetes may experience blister formation.
The good news is that such blisters subside on their own in a matter of few weeks (2-3 weeks). It appears as a yellow coloured, small sized bump (not more than the size of a pea) and is lined by an erythematous halo.
In Disseminated Granuloma Annulare, the diabetic sufferer notices formation of distinct elevated areas on the skin, with an arch or ring form. Atherosclerosis refers to arterial thickening that may result in skin changes (mainly the skin on legs).
Diabetes coupled with neuropathy results in the leg and foot injuries which are not noticed by the patient due to lack of pressure or temperature sensation.
Conditions that cause vomiting or acid reflux, such as the eating disorder bulimia, can damage tooth enamel. Gingivitis, also generally called gum disease or periodontal disease, describes the events that begin with bacterial growth in your mouth and may end -- if not properly treated -- with tooth loss due to destruction of the tissue that surrounds your teeth. Tooth decay occurs when foods containing carbohydrates (sugars and starches) are left on the teeth. Dental bonding is a procedure in which a tooth-colored resin is applied and hardened with a special light, ultimately "bonding" the material to the tooth to improve a person's smile. Veneers (sometimes called porcelain laminates) are wafer-thin, custom-made shells that cover the front surface of teeth, changing their color, shape, size or length.
Recontouring or reshaping is a procedure in which small amounts of tooth enamel are removed or shaped to change a tooth's length, shape, or surface. Braces can correct crooked teeth or a misaligned bite, and can improve the health and appearance of anyone's smile, adult or child.
Many teeth-whitening systems are available, including whitening toothpastes, over-the-counter gels, rinses, strips, and trays, and whitening agents obtained from a dentist.
Amalgam tattoos occur when a tiny piece of amalgam filling embeds in your cheek or gum during or after dental work.
Also called aphthous ulcers, canker sores can show up on your tongue, cheek, and even your gums. Strep infection often produces a distinct pattern of white patches in the throat and on the tonsils, as well as red swollen tonsils. Small amounts of the candida fungus are present in the mouth, digestive tract, and skin of most healthy people and are normally kept in check by other bacteria and microorganisms in the body. Tonsil stones (also called tonsilloliths) form when bacteria and mucus get trapped and calcify in your tonsils’ nooks and crannies, leaving a hard piece of matter and a bad taste in your throat.
Cold sores (fever blisters) are caused by the herpes simplex virus (HSV), passed on through contact with infected skin or body fluid. You can't cure HSV or a cold sore, but you can alleviate the pain it causes by avoiding spicy or acidic foods, applying ice, and using over-the-counter remedies.
The Warning Signs of Skin CancerSkin cancers -- including melanoma, basal cell carcinoma, and squamous cell carcinoma -- often start as changes to your skin.
Areas of the foot that have already had an ulcer may need more protection after healing, to prevent an ulcer from forming there again. NOTICE: This health information was not created by the University of Michigan Health System (UMHS) and may not necessarily reflect specific UMHS practices. If the moisture content of the skin varies significantly from normal values it can result either in dryness and cracking, or excoriation and the development of infection.
The term maceration is commonly used to describe changes to the skin resulting from prolonged exposure to water or moisture from sweat, urine or faeces. Unlike 'maceration' the proposed new term can also apply to adverse changes caused by insufficient moisture within a wound or areas of vulnerable tissue. Local treatment of moisture-related skin damage generally involves the use of dressings with significant fluid handling properties to remove excess fluid from the wound and to provide protection to periwound skin. This article describes the importance of controlling the moisture content of wounds and areas of vulnerable tissue, with particular emphasis on the use of dressings that provide protection to periwound skin, which may be damaged by proteolytic enzymes present in exudate from chronic wounds.
The article also proposes a new definition for the 'ideal dressing' in the light of recent developments in the wound management field, which takes account of the requirement to protect vulnerable tissue from secondary damage caused either by insufficient or excessive moisture. It is suggested that the correct application and frequent replacement of appropriate dressings, combined with the use of skin protectants or barrier creams where appropriate, will help prevent periwound damage, reduce the risk of infection and improve patient quality of life.
In a clinical context, 'maceration' is commonly used to describe changes in the appearance of the skin, resulting from prolonged exposure to moisture or wound exudate, the causes and treatment of which have been described comprehensively in a series of articles [1] [2] [3] [4] [5] [6]. In the present article it is argued that the widespread use of the term 'maceration' can be misleading, and that it is sometimes applied incorrectly, potentially leading to inappropriate treatment in some instances. The skin, the largest organ in the human body with an area of approximately 1.8m?, plays an important role in fluid regulation. Moisture loss by evaporation (determined by intercellular lipids, which form a barrier to transepidermal water loss (TEWL)). This, in turn, is governed by the presence of intracellular water-soluble hygroscopic substances formed within the corneocytes by degradation of the histidine-rich protein known as filaggrin [9]. According to Verdier-S?vrain and Bont? [11], glycerol, a well-known cosmetic ingredient, has been discovered in the stratum corneum as a natural endogenous humectant. The NMF can be readily released or extracted from the cells of the stratum corneum with water after first treating it with solvents or detergents to extract protective polar lipids such as sphingolipids, which exist in the intercellular spaces [12].
If the fluid regulating ability of the skin is adversely affected, it makes it susceptible to dryness and scaling, particularly if the moisture content of the stratum corneum falls below about 10%.
Most people are familiar with the skin changes that occur after spending too much time immersed in a hot bath. Similar changes can also result from simple occlusion, for example by the extended use of rubber or plastic disposable gloves. In fact it is probable that the skin changes that occur from prolonged immersion in a bath result not just from absorption of water by the outer layers of the stratum corneum, but also by the accumulation of moisture in the deeper layers of the epidermis caused by the skin's inability to transpire excess water away in the form of sweat.
These two simple examples clearly illustrate that major changes in the water content of the skin can be influenced by both endogenous and exogenous moisture.
Irrespective of the cause, in the two simple examples cited above, the obvious change in the thickness and appearance of the skin is reversible and therefore does not normally represent any serious threat to the individual concerned. However, in the treatment of certain dermatological conditions associated with the formation of dry or cracked skin, such an effect may be clinically desirable. The skin changes described thus far are very different from those often observed around the margin of chronic wounds such as leg ulcers. In such situations a barrier cream or a dressing that provides an effective seal to the periwound skin is probably indicated to provide a protective function.
A third commonly encountered cause of superficial skin damage is the presence of urine or faeces on the skin surface, the irritant nature of which can also lead to superficial damage (see Figure 3). Obese or neglected children and adults are further subject to intertrigo - chafing or excoriation between moist skin folds or adjacent surfaces.
Where skin is at risk, it is possible to apply topical agents such as zinc paste or modern proprietary skin protectants [21] that are easier and quicker to apply and remove [22] and which have the additional advantage of being transparent. Although the presence of liquid (be it urine, sweat or wound exudate) is undoubtedly a major contributory factor in all of these conditions, the skin does not have to be completely macerated in order for the damage to occur, which is why the term 'moisture-related skin changes' may be preferred. In direct contrast, conditions that lead to a depletion of the moisture content of the skin can also produce visible changes of varying severity.
If the moisture content of the skin is seriously depleted, to below about 10%, it can result in dryness [23], leading to chapping or cracking, particularly on the fingertips or knuckles (see Figure 4). If the integrity of the epidermis is seriously compromised by trauma or some metabolic or physiological disorder, the healing rate of the resulting wound will be influenced by the moisture content of the surrounding skin and the local environment. In addition to facilitating healing, a product that maintains a moist environment can also help to prevent secondary damage to a vulnerable area of tissue that occurs as a result of dehydration.
Work on burns reviewed by Lawrence [26] showed that the application of an occlusive dressing will salvage not only dermal tissue but also certain epithelial elements in the zone of stasis surrounding the original injury. In the intervening period, developments in the wound management field coupled with an increased understanding of the wound healing process, have been such that the list of functions that a dressing may be required to perform have been revisited. These are summarised in Table 1, where they are divided into primary and secondary requirements.
Even a cursory review of the performance requirements identified in Table 1 will indicate that it is unlikely that a single dressing or dressing system will possess all of these attributes. A dressing that is ideally suited to the early stages of the treatment of infected, malodorous or necrotic wounds may not be appropriate for the later stages of healing. It will be seen that this definition applies equally to products designed to achieve debridement, combat odour or infection, or promote granulation or epithelialisation. In the list of dressing functions identified previously, the primary performance requirements that are influenced by the condition of the wound are directly or indirectly related to the management of exudate or TEWL - the principal causes of maceration.
In clinical practice, although some dressings such as hydrogels are used to rehydrate eschar in order to promote autolytic debridement, the majority are applied to remove excess wound fluid (exudate) from the immediate vicinity of the wound. With the exception of the vacuum assisted closure technique (VAC? Therapy), in which fluid is actively withdrawn from the vicinity of the wound before it has time to spread onto the surrounding skin, exudate control with many advanced and traditional types of dressings is commonly achieved by one or more different mechanisms.
The presence of materials with high absorption retention greatly improves the ability of a dressing to retain liquid under pressure as the fluid is 'locked away' within its structure. It is self-evident that the absorbent capacity of any dressing is finite, limited by size (area) and volume, and although in theory it is possible to increase the absorbent capacity by simply increasing dressing thickness, this impacts negatively upon conformability and patient comfort. A third fluid handling mechanism is therefore often employed, which involves the incorporation of a semipermeable film or foam backing layer into the dressing's structure. A further important component included in many dressings is a wound contact layer that is designed to reduce the possibility of adherence of the dressing to the surface of a drying wound.
Many dressings, as they take up fluid, transport this laterally throughout the absorbent layer, including the inner surface that is in direct contact with the skin. The presence of a suitable wound contact layer can reduce although not eliminate this effect entirely as it forms an interface layer that physically separates the moist dressing surface from the periwound skin.
In the case of a chronic wound that contains high concentrations of proteolytic enzymes, this may lead to excoriation of the skin with consequent enlargement of the wound itself. An alternative method of preventing this problem involves the use of a dressing that forms an adhesive bond or seal with the skin right up to the margin of the wound. A similar sealing effect is achieved in products coated with soft silicone technology in which an absorbent layer of foam, backed with a polyurethane membrane, is coated with a layer of soft silicone that forms a gentle bond or seal between the dressing and the wound in order to ensure that fluid is taken up by the dressing and does not escape on to the surface of the skin. Such products differ from dressings in which an absorbent pad is located in the centre of a sheet of foam or film coated with adhesive to form an island dressing. A soft silicone dressing was compared with an island dressing in a clinical study involving 38 patients. It is vital, however, that all dressings used in this way are either sufficiently permeable to moisture vapour or have sufficient fluid affinity to cope with TEWL through the intact skin. Hard data on the effect of moisture-related skin changes on treatment costs are hard to find, and the author is unaware of any dressing studies specifically focused on this area. Given the multiplicity of dressings available and the clinical and financial implications of significant maceration, it might be supposed that the medical literature would contain a wealth of information on the treatment of this condition. The authors also considered the evidence for the use of honey, topical negative pressure therapy, compression therapy and the use of a skin protectant. In the absence of hard evidence from controlled studies, best practice standards based on expert opinion supported by laboratory or other experimental data (where relevant) must be used to guide clinical practice. For example, despite the lack of published data, many clinicians would accept that the use of compression, which reduces oedema and exudate production, will almost inevitably impact upon maceration.
In most instances it is likely that periwound skin damage, regardless of its primary cause, may be prevented by the adoption of simple measures including the application and frequent replacement of appropriate dressings, and the use of skin protectants or barrier creams combined with good nursing practice.
Historically, the selection of a dressing was determined by a number of factors, the majority of which were related to the position and nature of the wound, with particular attention paid to the presence of infection, odour and the amount of exudate present. AcknowledgementThis article was sponsored by an unrestricted educational grant from M?lnlycke Health Care.
Warning Signs of Eye TroubleBlurry vision, spots, glare at night -- these are common eye complaints that can be harmless annoyances or an early sign of disease.
Many times, some of the skin diseases are mistaken as eczema, which is originally caused due to some skin irritants and not due to insulin abnormalities or disrupted levels of blood sugar. When the glucose level increases in the blood stream, kidneys intend to flush out the extra sugar content from the body. When you observe that you are frequently going to the toilet more than usual, then you must check with your physician to find out if you are suffering from diabetes or not. You may realize this only when you carefully notice that even small wounds are taking a very long time to heal.
The kidney attempts to flush out the extra glucose content from the blood stream in the form of urine.
Diabetes can cause severe eye problems such as blurry vision, strain, eye pain and headaches. Early detection and prompt treatment prevent many skin problems from getting out of control. The yeast like fungal skin infection results in an inflamed, itchy rash, usually encircled by small blisters or scales. Other common fungal problems associated with diabetes cover Athlete’s foot, ringworm and jock itch.
Some of them take up the form of boils, nail infection, carbuncles or folliculitis (infection involving the hair follicles). This type of diabetic skin complication does not resolve entirely, but losing excess weight certainly improves the condition. This necrotizing type of skin condition is marked by irregularly formed hard lesions which are raised above the skin surface. The sites where necrobiosis lipoidica diabeticorum is usually seen range from legs, hands, trunk or upper arms. The tender skin is prone to ulceration on slightest of trauma.
This particular skin complication is characterized by thick, tight skin on the dorsal surface of both hands and results due to raised levels of blood glucose.
Such blisters typically surface on the feet, legs, arms (extending below the elbow to the wrist), hands or dorsal aspect of fingers. The sole mode of treatment for diabetic blister is to bring the blood sugar within normal limits. Unlike Necrobiosis Lipoidica Diabeticorum, Eruptive xanthomatosis affects young males who have both, abnormally high triglycerides, as well as cholesterol levels.


It is essentially a red or skin coloured rash which targets those parts of the body which are farther away from the trunk.
As the blood supply to the leg muscles diminishes, in case of any injury or infection, the healing process remains sluggish.
This semi-translucent, hard, outer layer of the teeth has an important job: protecting teeth from the daily wear and tear of biting and chewing, as well as temperature extremes from hot or cold foods and drinks. Over time, the constant clenching and friction can damage teeth and other health complications can arise.  Bruxism is often worst when you sleep -- that's when you can't control it.
Among the easiest and least expensive of cosmetic dental procedures, bonding can repair chipped or cracked teeth, close gaps, change the shape of teeth, or be used as a cosmetic alternative to silver amalgam fillings.
The procedure is usually done to improve appearance by creating more harmony or balance in the look of the smile.
The crown, when cemented into place, fully encases the entire visible portion of a tooth that lies at and above the gum line. Otherwise your tooth could be damaged further or become infected, possibly causing you to end up losing the tooth. Many people use this opportunity to replace silver amalgam fillings with tooth-colored composites. Implants provide a strong foundation for fixed (permanent) or removable replacement teeth that are made to match your natural teeth. Braces work by applying continuous pressure over a period of time to slowly move teeth in a specific direction. Brackets -- the parts that attach to each tooth -- can be clear, tooth-colored, or multi-colored. Porcelain veneers and crowns can correct crooked teeth, an uneven gum line, and other chipped, worn, and discolored dentistry.
Teeth whitening is ideal for people who have healthy, unrestored teeth (no fillings) and gums. The silver in the amalgam leaches into your mouth's soft tissue, resulting in a blue-gray "stain" that looks a bit like a tiny tattoo.
However, certain illnesses, stress, or medications can disturb the delicate balance, causing the fungus candida to grow out of control, causing thrush. They are not as common, but cold sores can appear anywhere on the face, including on the cheek, chin, or nose.
They can be new growths or precancerous lesions -- changes that are not cancer but could become cancer over time.
It is intended for general informational purposes only and does not address individual circumstances. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information.
Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
However, the widespread use of the term maceration can be misleading and may potentially lead to inappropriate treatments.
This encompasses skin changes such as superficial damage including nappy rash and intertrigo, as well as severe excoriation caused by the efflux of proteolytic enzymes from chronic wounds such as leg ulcers. Sometimes, however, dressings are applied to donate or conserve moisture in order to prevent desiccation and tissue death. It also discusses the importance of preventing excessive moisture loss from certain wound types and describes the way in which dressings can donate or conserve moisture in such situations.
The total volume of fluid held in the skin of a 70kg man is about 7 litres, but the moisture content varies throughout its structure.
Together these comprise around 30% of the stratum corneum and are known as natural moisturising factor (NMF), consisting of 40% free amino acids, 12% prolidine carboxylic acid, 12% lactate and 7% urea, together with minerals, electrolytes and sugars. Hyaluronan, which is regarded principally as a dermal component, is also present in the epidermis, where it helps to maintain the structure and epidermal barrier function. It has also been demonstrated that repeated exposure to water can adversely affect the fluid control mechanisms of the skin by depletion of NMF even without prior solvent extraction [13]. These are characterised by pronounced softening, swelling and wrinkling of the epidermis, which certainly may be described as maceration according to the strict definition of the term. The relatively impermeable nature of these materials prevents normal TEWL, which in turn leads to the accumulation of moisture within the skin and, ultimately, the same softening and wrinkling as described above.
In a hot bath, the situation is actually exacerbated by the fact that the capillaries within the skin are dilated as the body attempts to produce increased sweat as part of its normal temperature-regulating process. However, while in this condition the skin is more susceptible to physical damage, and its protective barrier properties to chemicals and micro-organisms are impaired. In such situations, oily emollients added to the bath, which form a film on the surface of the water, are transferred to the skin as the person rises out of the water. While these skin changes may be partly due to maceration, which predisposes the affected area to traumatic injury (which may also be caused by some types of adhesive dressings), a second and potentially more important factor is the presence within chronic wound fluid of proteolytic enzymes. In one clinical study it was reported that maceration occurred in 55% of ulcers under investigation [15].
Every year pharmaceutical and cosmetic companies spend millions of pounds in developing and promoting products designed to improve the moisture content of the skin and reduce the appearance of lines and wrinkles. In extreme cases, total dehydration caused by death of the underlying dermal structures will lead to the formation of a dry black leathery eschar, commonly associated with pressure ulcers (see Figure 5). Too dry and epithelialisation will be delayed, too wet and there is a risk of maceration and infection [24]. The capacity of deep partial thickness wounds to undergo spontaneous healing depends upon the survival of epidermal cells in hair follicles and sweat glands in the base of the wound; if these are allowed to become dehydrated and devitalised the wound may actually increase in size and convert from a partial-thickness to a full-thickness injury. The use of traditional dry dressings in these situations can result in progressive dehydration of the threatened zone followed by devitalisation and necrosis, with the result that this zone becomes indistinguishable from the original lesion. Primary requirements are those that are common to most wound management materials; secondary requirements relate to specific types of wounds or wounds in a particular condition or stage in the healing process. For example, sterile maggots represent arguably the most rapid and cost-effective non-surgical method for achieving a clean wound bed, but few would suggest that they should be applied to all types of wounds throughout the entire healing process.
It follows, therefore, that for some wounds, but by no means all, optimal wound management may involve the sequential application of a number of 'ideal dressings' that are selected according to the condition of the wound as it progresses towards healing.
Most products possess some absorptive capacity that may be provided by means of absorbent fibres or foam that rapidly take up fluid from the wound surface. This can be particularly important in the case of products made from foam which, although capable of taking up significant volumes of fluid, do not necessarily retain this well under compression.
Such layers permit the loss of fluid by evaporation through the back of the dressing while preventing the ingress or egress of liquid or micro-organisms. Available in many forms, including perforated plastic films or nets, these layers are most commonly used in dressings that have an absorbent layer made from foam or cellulose fibre. This can increase the moisture content at the skin surface, which in turn may lead to maceration or other moisture-related effects described previously. If the wound is heavily exuding and the absorbent capacity of the dressing is insufficient to cope with all the fluids produced, exudate may accumulate in the defect and then gradually spread across the surface of the skin beneath the wound contact layer.
An early example of such a product is the hydrocolloid dressing, which has one surface that is uniformly coated with an adhesive gel-forming mass. In clinical studies such dressings have been shown to facilitate vertical wicking and reduce periwound maceration and pain [28] [29]. When selecting such a dressing its island area must be larger than the wound itself so that it covers the wound area by some distance and overlaps the surrounding skin. Although healing rates were similar in the two treatment groups, as might be predicted, the incidence of maceration and local skin damage was significantly greater in the group treated with the island dressing [28]. It is not unreasonable to assume, however, that secondary damage caused in this way will delay healing and extend treatment times - with obvious financial implications for dressing usage, nursing time and, potentially, extended periods of hospitalisation. In fact, in 2007 a systematic review of the literature relating to the management of maceration of the periwound skin [6] identified nine relevant articles and in only six of these was maceration cited as a primary or secondary outcome variable. While there was reasonably strong evidence to support the use of skin protectants, the authors found no supporting evidence for the other treatment modalities [6]. It must also be remembered that absence of evidence of effectiveness is not the same as evidence of ineffectiveness. Similarly the application of topical negative pressure, which continuously removes exudate from the immediate vicinity of a wound, will reduce the possibility of skin damage caused by the spread of irritant wound fluid over the periwound skin.
These simple measures should impact favourably on the patient's quality of life by reducing the pain and some of the inconvenience associated with a heavily exuding wound. Relatively little attention was given to the management of periwound skin or the effect that the choice of dressing system might have on this potentially vulnerable area.
The situation has been further improved by the advent of effective skin-friendly adhesive systems which form an effective seal between the dressing and the skin around the wound margin, and which also permit replacement of dressings without the production of the pain or trauma sometimes encountered with traditional adhesive materials [29].
In diabetes, where excessive thirst and hunger are the main symptoms, eczema does not show any of these symptoms. But, when this condition is left untreated for a long time, it can cause severe complications affecting the entire body. Suddenly, you may observe that your appetite has increased manifolds and you wish to eat a lot.
According to the American Diabetes Association, roughly 33 percent of the entire diabetic population has or is currently living with skin complications induced by diabetes.
The affected skin becomes hyper pigmented (it turns dark), hyperplastic (that is, it begins to show incremental growth), and is thick and velvet-like in texture.
Other than the hands, joints such as those of the knees or elbows are also targeted, resulting in limited movement of the digits or joints. The common sites affected by eruptive xanthomatosis include the buttocks, arms or even the facial region.
However, this type of rash is easy to handle with certain medicines (mostly a steroid for topical application). This common skin trouble takes the appearance of brown coloured, scaly patches with a circular shape. Purging can also trigger swelling in the mouth, throat, and salivary glands as well as bad breath. The same goes for any condition that causes frequent vomiting, from gastrointestinal problems to eating disorders.
The bacteria, acid, food debris, and saliva combine to form plaque, which clings to the teeth.
Veneers offer a conservative approach to changing a tooth's color or shape compared to crowns, but the process is not reversible.
Instead of individual crowns, some patients may have attachments on their implant that support a removable denture. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain. Cosmetic dentists can make a dramatic difference in a person's smile and overall oral health, but the work must be carefully planned. Amalgam tattoos pose no harm, but it's not likely an amalgam tattoo if the blue-gray spot grows or changes color. Triggers include hypersensitivity, infection, hormones, stress, and not getting enough of some vitamins. A weakened immune system, antibiotics, diabetes, or certain medications such as inhaled corticosteroids can give candida a chance to grow wild.
An estimated 40% to 50% of fair-skinned people who live to be 65 will develop at least one skin cancer.
It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health.
The dermis contains about 80% water and the stratum corneum about 30%, which is non-uniformly distributed, varying from around 40% in the inner layers to around 10-15% in the outermost horny layer [7]. For a more comprehensive review of the fluid control mechanisms of the skin, see Agache and Black [10]. A water-transporting protein, aquaporin-3, has additionally been discovered in the viable epidermis. These effects are generally assumed to be caused by absorption of the bath water by the outer layer of the skin.
Occluded (macerated) skin has also been shown experimentally to be more sensitive to irritants [14].
This thin oily layer helps to conserve any additional moisture taken up in the stratum corneum during bathing.
These can chemically degrade exposed skin, resulting in a red, weeping surface (see Figure 1).
Maceration is a particular problem in diabetic ulcers [16], which in common with heavily exuding ulcers of all types, require frequent re-dressing to avoid or reduce damage to the surrounding skin [17] [18] (see Figure 2).
When the occlusive effects of a nappy are not matched by its absorbency, hyperhydration of the stratum corneum occurs that progresses to maceration, increasing the coefficient of friction of the skin and predisposing to epidermal damage caused by rubbing.
The prevention of dehydration by the application of a suitable occlusive or semipermeable dressing may limit or prevent these secondary effects. In both groups, the performance requirements have been divided into those which are determined principally by the design and construction of the dressing, over which the clinician has little or no influence, and those in which the ability of the product to perform in the required fashion is also influenced to a significant extent by the nature and condition of the wound. Similarly, a dressing that promotes angiogenesis and the production of granulation tissue may not be equally suitable for the final epithelialisation stage of wound closure. Depending on the design of the dressing, this is then distributed throughout the body of the absorbent layer, spreading both laterally and vertically towards the outer surface. Unlike the finite absorption capacity, the ability of the dressing to cope with exudate by evaporation is relatively unlimited, and is determined only by the permeability of the membrane relative to the rate of exudate production by the wound. The moist layer forms a pathway along which micro-organisms can migrate, either into or out of the wound. Provided that the seal remains intact, such a dressing is able to form a very effective protective covering to the healthy skin while absorbing (gelling) exudate in the immediate vicinity of the wound. However, when using this technique, it is important to consider the moisture vapour permeability of the film component of the dressing system for if this is too low it could actually cause maceration of the periwound skin by preventing TEWL. It was often tacitly accepted that wound fluid would inevitably escape from a heavily exuding leg ulcer on to the surrounding skin under the effects of gravity and there was relatively little that could be done to prevent this, other than to apply large quantities of bulky padding in an attempt to absorb the excess fluid. Prevention and treatment of moisture-associated skin damage (maceration) in the periwound skin. Effect of soaking and natural moisturizing factor on stratum corneum water-handling properties. The silver-releasing foam dressing, Contreet Foam, promotes faster healing of critically colonised venous leg ulcers: a randomised, controlled trial. Comparison of two periwound skin protectants in venous leg ulcers: a randomised controlled trial.
Formation of the scab and the rate of epithelization of superficial wounds in the skin of the young domestic pig. A note on wound healing under dressings with special reference to perforated-film dressings. A study to compare a new self-adherent soft silicone dressing with a self-adherent polymer dressing in stage II pressure ulcers. So be sure to visit an eye doctor promptly about any changes or concerns about your vision. But, diabetes causes skin infections and bacterial manifestations that can look similar to eczema. The skin may become dry and thick with certain areas showing hair loss and color disruptions. Skin dryness, sluggish blood circulation or development of a yeast infection form some of the prominent causes responsible for itchy skin.
Of all the bacterial strains, Staphylococcus is the main culprit behind the development of many skin infections. This type of skin condition mostly affects those who are overweight or diagnosed with diabetes. Mostly noticed in the front aspect of lower legs, diabetic dermopathy remains asymptomatic.
Anorexia, bulimia, and other eating disorders can also cause serious nutritional shortfalls that can affect the health of your teeth.
The American Dental Association asserts that the mercury in amalgam combines with other metals to render it safe for use in filling teeth.


There are even "invisible" braces that use a series of clear, plastic molds to gradually move the teeth into alignment.
Persistent, severe canker sores can be treated with numbing creams or prescription treatments. HSV-1 damages the skin as it reproduces itself, creating cold sores that last about a week. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. This figure can increase to around 60% when the skin is immersed or exposed to a very wet environment [8].
All these findings have brought new insights into the mechanisms of skin water distribution and barrier function.
The water then permeates the intercellular spaces, crosses cell membranes and swells the corneocytes [10].
When exposed to a warm dry environment the skin returns to normal in minutes and no further treatment is indicated or required. Faecal enzymes (urease, proteases and lipases) also can have a deleterious effect on the skin [19].
And a film dressing that may provide ideal conditions for the final stages in the healing process of an epithelialising wound, will not be suitable for a slough-filled heavily exuding infected leg ulcer. At this point a second mechanism of action may come into play in which the absorbed fluid comes into contact with gel-forming agents located within or behind the absorbent layer. The relative importance of these fluid handling mechanisms is determined by the structure, composition and physical characteristics of the various components from which the dressing or dressing system is constructed. If the adhesive seal fails around the wound margin, however, exudate contained within the vicinity of the wound will escape and flood over the skin, leading to maceration or excoriation by the mechanisms described previously. If the skin changes also contribute to the development of infection, there may be additional costs for systemic antimicrobial therapy. Products made from alginate or carboxymethylcellulose fibre are particularly prone to this problem, especially if they are not used with appropriate secondary dressings [30]. In elderly or immobile patients, maceration secondary to incontinence of urine or faeces is sometimes regarded as a precursor to skin damage caused by pressure and shearing effects, leading to pressure ulcer formation or extension [20].
These gel formers may be derivatives of starch, or superabsorbent polymers that possess a remarkable affinity for liquid. As in many areas of clinical practice, prevention of moisture-related skin changes is better (and cheaper) than cure. Actinic Keratosis (Solar Keratosis)These small, scaly patches are caused by too much sun, and commonly occur on the head, neck, or hands, but can be found elsewhere. Sometimes, as in the case of dressings made from alginate, the absorbent and gel-forming layers are one and the same. They can be an early warning sign of skin cancer, but it’s hard to tell whether a particular patch will continue to change over time and become cancerous. Most do not, but doctors recommend early treatment to prevent the development of squamous cell skin cancer. Actinic Cheilitis (Farmer's Lip)Related to actinic keratosis, actinic cheilitis is a precancerous condition that usually appears on the lower lips.
Less common symptoms include swelling of the lip, loss of the sharp border between the lip and skin, and prominent lip lines. Cutaneous HornsThe cutaneous horn appears as a funnel-shaped growth that extends from a red base on the skin. Farsightedness (Hyperopia)Most people are born with mild farsightedness and outgrow it in childhood.
The size and shape of the growth can vary considerably, but most are a few millimeters in length. When it persists, you may see distant objects well, but books, knitting, and other close objects are a blur. It usually occurs in fair-skinned elderly adults with a history of significant sun exposure. When Is a Mole a Problem?A mole (nevus) is a benign growth of melanocytes, cells that gives skin its color.
Although very few moles become cancer, abnormal or atypical moles can develop into melanoma over time.
Moles that may have changed into skin cancer are often irregularly shaped, contain many colors, and are larger than the size of a pencil eraser. The eyes' lenses become less flexible and can't change shape to focus on objects at reading distance. The solution: Wear reading glasses or bifocals, which correct both near and distance vision.
Atypical moles may be larger (one-quarter inch across or larger) and more irregular in shape, with notched or fading borders. This sensitive membrane lines the back of the eye (seen in yellow) and sends signals to the brain through the optic nerve. Know Your ABCDEsMost moles on a person's body look similar to one another. A mole or freckle that looks different from the others or that has any characteristics of the ABCDEs of melanoma should be checked by a dermatologist.
Nearsightedness often develops in school-age children and teens, who need to change glasses or contacts frequently as they grow. It usually stabilizes by the early 20s. The ABCDEs are important characteristics to consider when examining your moles or other skin growths, so learn them in the slides to come.
Know Your ABCDEs: 'A' is for AsymmetryAsymmetry means one half of a mole does not match the other half. When checking your moles or freckles, draw an imaginary line through the middle and compare the two halves. Children with significant hyperopia are more likely to have crossed eyes (strabismus) or lazy eye (amblyopia) and may have trouble reading. Know Your ABCDEs: 'B' is for BorderIf the border or edges of the mole are ragged, blurred, or irregular, have it checked by a dermatologist. AstigmatismIf you have astigmatism in one or both eyes, your vision may be out of focus at any distance.
It happens when the cornea, the clear “window” that covers the front of the eye, is misshapen.
Know Your ABCDEs: 'C' is for ColorA mole that does not have the same color throughout or that has shades of tan, brown, black, blue, white, or red is suspicious. Light rays can scatter to different points on the retina, rather than focus on a single point.
Know Your ABCDEs: 'D' is for DiameterA mole is suspicious if the diameter is larger than the eraser of a pencil. Know Your ABCDEs: 'E' is for EvolvingA mole that is evolving – shrinking, growing larger, changing color, begins to itch or bleed – should be checked. If a portion of the mole appears newly elevated, or raised from the skin, have it looked at by a doctor. Surgery to reshape your cornea can correct nearsightedness, farsightedness, or astigmatism. Melanoma lesions often grow in size or change in height rapidly.  Tips for Screening Moles for CancerExamine your skin on a regular basis. Surgery may not be right for you if you have severe dry eye, thin or abnormally shaped corneas, or severe vision problems.
Glaucoma: ViewYou can't feel it, but glaucoma can steal your sight by harming your optic nerve. Check the "hidden" areas: between fingers and toes, the groin, soles of the feet, the backs of the knees.
You may not have symptoms until you lose your central vision, after losing your peripheral vision. Pay special attention to moles if you're a teen, pregnant, or going through menopause, times when your hormones may be surging. How Are Moles Evaluated?If you find a mole or spot that has any ABCDE's of melanoma -- or one that's tender, itching, oozing, scaly, doesn't heal or has redness or swelling beyond the mole -- see a doctor.
This buildup raises pressure and damages the optic nerve at the back, where the bundle of 1 million nerve fibers carry information to your brain. Without treatment, glaucoma can cause total blindness.The bright yellow circle shows an optic nerve head that is damaged by glaucoma.
If found to be cancerous, the entire mole and a rim of normal skin around it will be removed and the wound stitched closed. Macular Degeneration: ViewAge-related macular degeneration (AMD) damages and then destroys your central vision, making it hard to read or drive. A Primer on Skin CancerMalignant melanoma, especially in the later stages, is serious and treatment is difficult. You're more likely to have it if you are older than 60, smoke, have high blood pressure, are obese, are female, or have a family history of the condition.
People who've had skin cancer once are at risk for getting it again; they should get a checkup at least once a year. MelanomaMelanoma is not as common as other types of skin cancer, but it's the most serious and potentially deadly. Consult a doctor if a mole changes in size, shape, or color, has irregular edges, is more than one color, is asymmetrical, or itches, oozes, or bleeds. Squamous Cell CarcinomaThis nonmelanoma skin cancer may appear as a firm red nodule, a scaly growth that bleeds or develops a crust, or a sore that doesn't heal. It most often occurs on the nose, forehead, ears, lower lip, hands, and other sun-exposed areas of the body. Macular Degeneration: TestCover one eye and stare at the center dot in this Amsler grid, from a distance of 12 to 15 inches.
Bowen DiseaseBowen disease is also called squamous cell carcinoma "in situ." It is a type of skin cancer that spreads outward on the surface of the skin. By contrast, "invasive" squamous cell carcinomas can grow inward and spread to the interior of the body. Bowen disease looks like scaly, reddish patches that may be crusted; it may be mistaken for rashes, eczema, fungus, or psoriasis.
Basal Cell CarcinomaBasal cell carcinoma is the most common and easiest-to-treat skin cancer. Macular Degeneration: SignsAs seen here, the Amsler grid can look quite distorted to someone with significant macular degeneration and may include a central dark spot.
Basal cell tumors can take on many forms, including a pearly white or waxy bump, often with visible blood vessels, on the ears, neck, or face.
Straight lines that appear wavy are also cause for concern, as they can be an early symptom of "wet" AMD, the more serious and fast-moving type of macular degeneration. Tumors can also appear as a flat, scaly, flesh-colored or brown patch on the back or chest, or more rarely, a white, waxy scar.
Diabetic Retinopathy: ViewType 1 and type 2 diabetes can cause partial vision loss (seen here) and lead to blindness. But it doesn't explain skin cancers that develop on skin not ordinarily exposed to sunlight. By the time they happen -- blurry vision, spots, shadows, or pain -- the disease may be severe. People with diabetes need annual eye exams, sometimes even more often if they already have diabetic eye changes. While outdoors, liberally apply a broad spectrum sunscreen with an SPF of 30 or higher (don't forget the lips and ears!), wear a hat and sunglasses, and cover up with clothing. Diabetic Retinopathy: What HappensHigh blood sugar levels can damage the tiny blood vessels that support the retina. And remember, if you notice changes to your skin such as a new growth, a mole changing appearance, or a sore that won't heal, see a doctor right way. These processes gradually damage the retina, causing blurred vision, blind spots, or blindness. Vision gradually gets foggy and makes it hard to read, drive, and see at night.  Diabetes, smoking, or too much time in the sun raise that risk.
Cataracts: What HappensA healthy lens focuses light into a sharp, clear image on the retina, which captures the image like film in a camera.
That scatters rays of light on the retina, instead of focusing it for one sharp, clear image. Very advanced cataracts are noticeable, such as the muddy-colored circle at the center of this picture. Next comes a gradual loss of side vision, which develops into tunnel vision, and finally, in some cases, blindness. But you should see a doctor before taking supplements because too much vitamin A can be toxic.
Retinitis Pigmentosa: What HappensIn people with RP, the light-sensitive tissue of the retina slowly dies over many years. Early cataracts can also happen, as well as a swelling of the retina, called macular edema (the central orange mass seen here). Floaters and SpecksBlurry spots or specks in your vision that move may be floaters, which are debris in the eye's vitreous gel. Persistent white or black spots and a sudden shadow or loss of peripheral vision need immediate medical attention.
Amblyopia (Lazy Eye)As a child, if one of your eyes can't see well, your brain sometimes favors your other eye. This condition, called amblyopia, may happen because of an alignment problem of the eyes (strabismus or crossed eyes) or poorer vision in one eye.
A patch or drops that blur the vision in the "good" eye can prod the brain to use the other eye. Eye Care: Object in the EyeMany nerve endings are just beneath the surface or your cornea, so a tiny speck can be painful. If that doesn't dislodge the object, call a doctor who can remove it and give you antibiotic drops to protect your cornea from infection. When not enough flow, perhaps due to dry air, aging, or other health conditions, your eyes can become painful and irritated. For people with mild cases of dry eye, occasionally using eyedrops labeled artificial tears may do the trick. Pinkeye (Conjunctivitis)This eye problem is inflammation caused by a virus, bacteria, irritant, or allergy. Your eye is red and you might feel itching or burning and have a discharge from that eye, too. Both bacterial and viral conjunctivitis are very contagious, so wash your hands often while you wait for it to clear up. StyeA stye is a tender, red bump that looks like a pimple on or near the edge of the eyelid.
Don’t wear contact lenses or eye makeup until it's healed.  AllergiesAllergies can give you watery, itchy eyes. Keep Up With Your Eye ExamsYou need regular eye exams all through your life, especially if eye problems run in your family or if you have other risk factors. Bulging eyes are a sign of thyroid disease, and a yellow tint of the whites of the eyes can be a sign of liver problems.
If you're suddenly more sensitive to light than usual, see your eye doctor, since that can be a sign of an eye problem. Protect Your EyesGrease splatters from a pan, yard debris flies up from the lawn mower, cleaning solution splashes in a bucket. So are spinach, nuts, oranges, beef, fish, whole grains, and many other foods in a healthy diet.



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