Q Every autumn I seem to develop an area of dry flaky skin in patches around my mouth, to the side of my nostrils and towards my chin. It’s slightly red and perhaps a bit itchy. I’ve seen my doctor, who didn’t think it was anything significant, but I’m fed up with it. What can I do?
A The condition you have described is known as seborrheic (seb-oh-REE-ick) Dermatitis (SD). It is a form of eczema and is also known as seborrheic eczema. The skin becomes inflamed, itchy, and sometimes infected. On the scalp, this causes itchy, red patches to appear usually with yellowish colored scales that can be dry or greasy. Seborrheic dermatitis may also spread to the eyebrows, the upper part of the body and also behind the ears.
It is not understood precisely why it happens but SD is a genetically determined condition, it can run in families. It may be related to hormones, because the disorder often appears in infancy and disappears and may reappear in adults from 30 to 60 years of age. Alternatively, the cause might be related to a fungus, called malassezia.
It is often aggravated by cold weather conditions stress, foods that are high in fat and sugar, and changes in temperature all seem to trigger it and make it worse for many people. The disorder affects areas with high densities of large oil glands. It can be persistent, causing embarrassment and discomfort. SD can be unpleasant and uncomfortable, and is usually unattractive.
It can disappear spontaneously and suddenly reappear, for no known reason. On the other hand, it can stubbornly linger, resisting treatment. There is no way to prevent or cure seborrheic dermatitis. However, it can be controlled with treatment. You have to see a dermatologist who shall prescribe an appropriate non-fluorinated steroid and other adjuvant therapies. Dr Badr Dhanani
OMI
Q I am about 53 years old. I have diabetes from last 10 years and I am controlling it properly without taking any medicine. I have been having prostate problem for more than one year. As per the doctor’s advice, I took ultrasound scan of the bladder and found “Normal scan of both kidneys and urinary bladder. Prostate appears enlarged indenting the base of bladder”. I am taking homeopathic medicines but not getting proper relief.
Can you please tell me the possible treatment for prostate and about the chances of success in case of surgery.
A You have not mentioned the nature and severity of the complaints that you are experiencing because of your prostate problem. You will require a detailed history and physical examination. Did you ever get urinary infection?
An ultrasound scan before and after passing urine will help to know how much urine is retained after passing urine. A uroflowmetry is a graphic representation of the voiding pattern and helps us to know how much the urine flow is altered from the normal. In view of long standing history of diabetes and young age urodynamic study (to see the behaviour and function of the bladder) may be necessary, if the clinical picture suggests the need for it.
A decision to put you on medication or surgery can then be made. Surgery done in properly selected patients is very successful. Dr Syed Raziuddin Biyabani,
Aga Khan University Hospital
Q I am 34 years old and I have two children. I have been using birth control pills ‘Nova’ for the last three years and have had no problems with it. However, remembering to take it everyday is the problem and I often forget about it due to which my circle becomes shorter.
I want to use the injections as I believe they are to be taken once in three months. Can you tell me the pros and cons of the injections and what do you recommend — the pills or the injections?
A If you are asking my recommendation, I think the birth control pill is the best method of contraception as the pill is 100 % safe when taken regularly and also results in a regular menstrual cycle. However, for a person who is forgetful the injections are extremely suitable, but they can cause irregularity in periods and may result in a lot of uncalled for mental tension. Dr Yasmin Raashid
Lahore
Identities of the questioners are being withheld on request.
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