ASK THE GP: what can I do about my unbearable itch? Dr. Martin Scurr answers your health issues
For six months I had an itchy rash all over my body that started on my lower leg. I was told that it is Grover's disease. Steroid ointments and body treatments prescribed by my doctor did not help, although antibiotics I used for another condition did. It affects my sleep – is there anything you can imagine?
Andrew Sinclair, Stenhousemuir, Falkirk.
Grover's disease, technically called acantholytic dermatosis, is a rare and mysterious skin condition that primarily affects middle-aged or older men.
The cause is unknown and there are conflicting reports about whether this is due to increased sweating (it can be caused by a period of bed rest) or exposure to cold, dry air (a study reported that it becomes much more frequent in winter diagnosed than in the summer).
Did you know? Grover's disease, technically called acantholytic dermatosis, is a rare and mysterious skin condition that primarily affects middle-aged or older men
Usually there is a rash of red, raised, blister-like spots and the trunk is the most common place of what can be almost unbearable itching. The limbs can also be affected, but the face, palms and soles of the feet are usually spared.
The only way to confidently diagnose the condition is to have samples from two or three locations examined by a pathologist.
Most dermatologists recommend using moisturizers twice a day, along with powerful steroid creams or ointments. Antihistamine pills are also said to help calm the itch.
Less commonly prescribed treatment that some patients have found effective is calcipotriol ointment, which is derived from vitamin D and is generally used in the treatment of psoriasis. A prescription is necessary and it may be worth asking your doctor to think about it.
I can't think why your symptoms improved with antibiotics. This could have been a fluke. The good news is that the condition is normally temporary and disappears within six to twelve months.
My daughter has had tough periods most of her life. Eventually endometriosis was discovered and she had a hysterectomy (she had already had a daughter, now ten years old, via caesarean section). Since then she has been in pain, sometimes unbearable, from the caesarean scar region. Why could this be?
Anne Logan, Longfield, Kent.
Endometriosis occurs when endometrium – the mucous tissue of the womb – is found elsewhere in the body, usually the pelvic area, but also on the intestine, diaphragm and even in the chest cavity.
The tissue is subject to hormonal variations of the menstrual cycle – so it will bleed and cause inflammation.
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Always consult your own doctor with any health problems.
It mainly results in pelvic pain, in particular dysmenorrhea (menstrual pains). Infertility and pain during sexual intercourse are also common. Dysmenorrhea often occurs a day or two before a menstrual period and may continue after bleeding.
In your longer letter you say that your daughter had a laparoscopy – a keyhole surgery – in which surgeons found such advanced endometriosis that it was decided that a hysterectomy was the best option. Her ovaries may have been removed at the same time, pushing your daughter into the menopause.
After the menopause, the symptoms of endometriosis cease because the lack of estrogen means that endometrial tissue is no longer formed and that the present tissue no longer bleeds.
However, a caesarean section can lead to the spread of tissue from the uterus elsewhere. Endometrial tissues may be at the location of the emperor's scar and this may cause pain that may not follow the menstrual cycle and may be constant.
This seems to be the most likely option in the case of your daughter, because the pain can persist even without estrogen.
An ultrasound scan can help with a diagnosis, so your daughter should discuss this with her doctor.
If this appears to be the case, effective treatments are available, such as surgery.
IN MY OPINION: a & # 39; of course & # 39; agent can also be harmful …
I am still surprised that people may be wary of taking medication that has been rigorously tested, yet relaxed about using products that have not been thoroughly investigated, purely because they are & # 39; of course & # 39; to be.
An example of this is medicinal cannabis oil, which became known with the story of Billy Caldwell. As you may recall, his mother was stopped at the British border after trying to get a cannabis product from Canada to help with Billy & # 39; s severe epilepsy.
It led to a change in the law whereby specialized doctors – not general practitioners – could prescribe cannabis oil (very different from the less powerful CBD products in the main street) in specific circumstances.
Now more and more patients are demanding that their doctors prescribe cannabis oil for pain relief (which they cannot).
Given the lack of evidence we have about the benefits of cannabis oil in this regard, I am surprised that many would like to try it. If it was a drug from a pharmacist, I doubt they would be that enthusiastic.
It may prove to be beneficial, but there are 60 or more active ingredients in the plant and we know very little about it.
This is what we do know: although there are indications that cannabis oil provides pain relief under certain circumstances, such as the painful muscle spasms of multiple sclerosis, you have to treat 20 people to get 30% pain in one person.
In addition, you only need to treat six people to cause harm in the form of side effects such as dizziness, dry mouth, nausea, tiredness and confusion.
So most doctors – still in the dark and waiting for better information and lighting – wisely adhere to the old principle: first, do no harm.
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