Atopic dermatitis or Eczema

 What is Atopic Dermatitis

Atopic Dermatitis(AD), commonly known as Eczema is the most common type of long-term inflammatory skin condition.

Eczema cause the breakdown of the skin barrier and its ability to hold moisture, which makes the skin dry, itchy and more sensitive to irritants and allergens. 

Eczema affects individuals of all age groups, but most commonly begins in infancy or early childhood and sometimes continues into adulthood. Some imdividuls who have AD may go on to develop asthma and or allergic rhinitis or food allergies. 

Causes of Atopic Dermatitis/Eczema

Irritants - wool or synthetic clothing, soaps, detergents, perspiration, disinfectants & chemical regents, insect dropping or feathers.

Contact allergens - certain preservatives in topical formulation, strong perfume-based products, leaves like parthenium(congress grass), metals and latex.

Foods/dietory factors - Cow's milk, eggs, peanuts, tree nuts, wheat, soya, fish, shelfish, and others such as sesame, kiwi and legumes.

Inhalant allergens(aero-allergens) -House dust mites, animal dander, cockroach, certain grass or weed pollens and moulds.

Microbial colonization or infection - Staphylococus aureus, streptococcus species, Candida albicans, Pityrosporum yeasts, herpes simplex.

Climate - Extremes of temperature and humidity

Environmental factors - hard water, cooking with gas, proximity to road traffic and environmental tobacco smoke 

Symptoms of Atopic Dermatitis and Eczema

In babies, symptoms usually affect the face, neck, scalp, elbows, and knees. In children, symptoms usually affects the skin inside the elbows, on the back of the knees, the sides of the neck, around the mouth, and on the wrists, ankles, and hands.

Symptoms can occur a bit differently in each child. They can include:

● Thickened skin 

● Small, raised bumps that may become crusty and leak fluid if scratched

● Rough bumps on the face, upper arms, and thighs

●Darkened skin of eyelids or around the eyes

●Skin changes around the mouth, eyes, or ears

●Raised, red areas(hives) 

Major symptoms of atopic dermatitis includes Dry, scaly skin, Severe itching, redness and swelling.

Management of Atopic Dermatitis and enczema

There may be times when your child has few or no synonyms. And he or she may have times when symptoms get worse. This is called a flare-up. To help prevent flare-ups, make sure your child:

●Uses moisturizer: Apply creams/lotions/ointments post bathing. Ensure you use a moisturizer designed for eczema.

●Uses the right cleanser: use soap free cleanser with no harsh chemicals like sulphates, phthalates or paraben  to avoid skin irritation

●Takes bath or showers with lukeworm water not hot water: Gently pat dry the skin afterward.

●Stays away from triggers: common triggers include irritants such as wool, soap, or chemicals; allergens such as eggs, dust mites, or pet dander and stress.

●Doesn't scratch the skin : Try to keep your child away from scratching and keep the finger nails short. As excessive scratching can cause symptoms to get worse and lead to infections.

●Wears soft clothing: Doesn't dress your child in wool or other rough fabric.

● Keeps cool: Try to keep your child as cool as possible, Getting hot and sweating can make him or her more uncomfortable.

What is the right moisturizer in eczema?

Well, when it comes to eczema, choosing the right moisturizer plays a vital role. While a moisturizer must address the skin barrier abnormalities, restore the pH, reduce itching and inflammation but at the same time should also establish a proper balance of good and bad bacteria. As in case of eczema this balance is disturbed, only the right choice of parabiotic based moisturizer will help restore this balance. 

What is the right cleanser for eczema ? 

A cleanser designed for eczema should

1. Be hypoallergenic & dermatologically tested

2. Be devoid of any harsh surfactants

3. Help stabilize the skin microbiome 

4. Protect the acid mantle - outer protective layer of the skin 

Dermatologic Disorders (Dermatitis and Psoriasis)

 The dermatologic disorder are broadly classified into Dermatitis and Pigmentation disorders. 

Dermatitis also known as eczema, is inflammation of the skin. It is characterized by  itchy, erythmatous, vesicular, weeping, and crusting patches. In general, eczema and dermatitis is synonyms, while some text books refer; dermatitis as an acute condition and eczema as a chronic condition. The cause of dermatitis is unknown, one possiblility is a dysfunctional interplay between the immune system and skin. 

Eczema include dryness and recurring skin rashes that are characterized by one or more of these symptoms: redness, skin swelling, itching and dryness, crusting, flaking, blistering, cracking, oozing, or bleeding.  

Treatment is typically with moisturizers and steroid cream. The steroid cream should generally be of mid to high strength and used for less than two weeks at a time. If these are not effective, creams based on calcineurin inhibitors may be used. 

Atopic Dermatitis 

Atopic dermatitis is an alergic disease believed to have a hereditary component, and often runs in families who members also have asthma. It is more common in infant. Itchy rashes is particularly noticeable on head and scalp, neck, inside of elbows, behind knees, and buttocks. 

Contact Dermatitis 

A condition in which skin becomes red, sore, or inflamed after direct contact with a substance.

Contact dermatitis is two types:

Irritant:(includes cement, hair dyes, Long-term exposure of wet diapers, pesticides or weed killers, rubber gloves, shampoos)

Allergic:(includes adhesives, fabric and clothing, fragrances in perfumes, soap, cosmetics and moistirizers, Nickel or other metals(found in jewellery, watch straps, metal zips), Dust mites and mold or  poison ivy and other plants)

Seborrhoeic Dermatitis 

Seborrheic dermatitis is also known as seborrhoeic eczema or simply as seborrhoea, is a chronic, relapsing and usually mild dermatitis. In infants seborrheic dermatitis is called cradle cap.

 "Dandruff is a type of seborrheic dermatitis in which inflammation is not present." Seborrheic dermatitis is a skin disorder affecting the  scalp, face and torso. Typically seborrheic dermatitis presents with scaly, fleky, itchy, and red skin. It particularly affects sebaceous-gland rich area of skin.  In adolescents and adults, seborrheic dermatitis usually presents as scalp scalling.

Pt.Jawaharlal Nehru

 

Pundit Jawaharlal Nehru

(1^st Prime Minister of India)

Birth-14 Nov 1889, Prayagraj

Death- 27 May 1964 

 Pt. Jawaharlal Nehru was the 1st Prime minister of independent India in 1947.

EARLY LIFE

The son of Motilal Nehru, a prominent lawyer and Indian nationalist. Jawaharlal Nehru was born in Allahabad, his family was originally from Kashmir. He was educated in England, at Harrow School, and then at Trinity College, Cambridge. He studied law at the Inner Temple in London. He returned to India in 1912 and practiced law for some years. However, his career in law was short-lived and he soon got extensively involved in the independence movement. In 1916, he married Kamala Kaul and the following year they had a daughter, Indira Gandhi.

Nehru's only child, Indira, served as India's prime minister from 1966 to 1977 and from 1980 to 1984 when she was assassinated. Her son, Rajiv Gandhi, was prime minister from 1984 to 1989, when he was also assassinated.

POLITICAL CAREER

In 1912, he attended the Bankipore Congress as a delegate, and became Secretary of the Home Rule League, Allahabad in 1919. In 1916 he had his first meeting with Mahatma Gandhi and felt immensely inspired by him. He organized the first Kisan March in Pratapgarh District of Uttar Pradesh in 1920. He was twice imprisoned in connection with the Non-Cooperation Movement of 1920-22.

Pt. Nehru became the General Secretary of the All India Congress Committee in September 1923. He toured Italy, Switzerland, England, Belgium, Germany and Russia in 1926. In Belgium, he attended the Congress of Oppressed Nationalities in Brussels as an official delegate of the Indian National Congress. He also attended the tenth anniversary celebrations of the October Socialist Revolution in Moscow in 1927. Earlier, in 1926, at the Madras Congress, Nehru had been instrumental in committing the Congress to the goal of Independence. While leading a procession against the Simon commission, he was lathi-charged in Lucknow in 1928. On August 29, 1928 he attended the All-Party Congress and was one of the signatories to the Nehru Report on Indian Constitutional Reform, named after his father Shri Motilal Nehru. The same year, he also founded the ‘Independence for India League’, which advocated complete severance of the British connection with India, and became its General Secretary.

In 1929, Pt. Nehru was elected President of the Lahore Session of the Indian National Congress, where complete independence for the country was adopted as the goal. He was imprisoned several times during 1930-35 in connection with the Salt Satyagraha and other movements launched by the Congress. He completed his ‘Autobiography’ in Almora Jail on February 14, 1935. After release, he flew to Switzerland to see his ailing wife and visited London in February-March, 1936. He also visited Spain in July 1938, when the country was in the throws of Civil War. Just before the court-break of the Second World War, he visited China too.

The Congress elected Nehru to assume office as independent India's first prime minister, although the question of leadership had been settled as far back as 1941, when Gandhi declared Nehru as his political heir and successor. As Prime Minister, he set out to realize his vision of India. The Constitution of India was enacted in 1950, after which he embarked on an ambitious program of economic, social and political reforms. Chiefly, he oversaw India's transition from a colony to a republic, while nurturing a plural, multi-party system. 

On 15 August 1947, Nehru became the first prime minister of independent India. He held the post until his death in 1964. He implemented moderate socialist economic reforms and committed India to a policy of industrialisation.

Nehru also served as foreign minister of India. In October 1947, he faced conflict with Pakistan over the state of Kashmir, which was disputed at independence. Nehru sent troops into the state to support India's claim. A United Nations ceasefire was negotiated, but Kashmir remains deeply unstable to this day.

Against the background of the Cold War, Nehru developed a policy of 'positive neutrality' for India. He became one of the key spokesmen for the non-aligned countries of Africa and Asia, many of which were former colonies that wanted to avoid dependence on any major power.

Despite efforts at cooperation by both countries, Indian-Chinese border disputes escalated into war in 1962 and Indian forces were decisively beaten. This had a significant impact on Nehru's declining health. He died on 27 May 1964.

Two years later Nehru's daughter, Indira Gandhi, became prime minister. With an interruption of only three years, she held the post until her assassination in 1984. Her son Rajiv was prime minister of India from 1984 to 1989, but he too was assassinated.

Baal divas (children’s day)

His birthday, November 14, is celebrated in India as Baal Divas ("Children's Day") in recognition of his lifelong passion and work on behalf of children and young people.

 

Dr. A.P.J. ABDUL KALAM

 DR A.P.J.ABDUL KALAAM
 (MISSILE MAN OF INDIA)    

Birth -15 oct 1931 Rameswaram

Death - 27 July 2015 Shillong                          

The full name of Dr. A.P.J.Abdul Kalaam was Dr. Avul Pakir Jainulabdeen Abdul Kalam. Dr. APJ Abdul Kalam was the 11th President of the Republic of India. Former President of India Dr. Avul Pakir Jainulabdeen Abdul Kalam was one of India's most successful and respected scientists. Dr. Abdul Kalam became the 11th President of India on 25th July 2002.

EARLY LIFE OF DR. APJ ABDUL KALAM

Kalam was born on 15th October 1931 in Rameswaram, Madras (Present Day- Tamilnadu, India). Kalam was brought up in a very poor joint family. His father, Jainulabdeen Marakayar, was an imam of a mosque and a boat owner.

In his school, Kalam was recognized as a bright and hardworking student. Sources say that Kalam had to sell newspapers with his cousin to add the family income. After completing his schooling at Schwartz Higher secondary, Kalam attended Saint Joseph College, Tiruchirappalli. Kalam graduated in physics in 1954. He started Aerospace engineering in 1955 at Madras Institute of Technology. He just missed his dream of becoming a fighter pilot, with one position in IAF.

CAREER AS SCIENTIST OF ABDUL KALAM

After completing his education at Madras Institute of Technology in 1960, Kalam joined the Aeronautical Development Establishment of DRDO (Defence Research and Development Organization. Kalam started his career by designing a Hovercraft. Kalam was also part of INCOSPAR committee working under Vikram Sarabhai. Kalam was moved to the ISRO (Indian Space Research Organization) in 1969. Kalam was the project director of India’s first Satellite Launch Vehicle (SLV-lll). Kalam successfully made the development of Polar Satellite Launch Vehicle (PSLV) and SLV-lll projects. Dr. Kalam played a vital role in developing the missile mission Agni, an intermediate-range ballistic missile, and Prithvi. Kalam worked as Chief Scientific Adviser to Prime Minister and Secretary of the DRDO from July 1992 to December 1999. He also played a role in the 1998 Pokhran-II tests under the leadership of Atal Bihari Vajpayee. 

PRESIDENCY OF ABDUL KALAM

A.P.J.Abdul Kalam was elected as 11th president of the Republic of India. As an NDA party candidate, Kalam participated in the presidential election and won with an electoral vote of 922,88,4, surpassing the 107,366 votes won by Lakshmi Sahgal (congress party candidate).

Kalam was the third President of India to possess been honored with a Bharat Ratna, India's highest civilian honor; before becoming the President, Dr. Sarvepalli Radhakrishnan (1954) and Zakir Hussain (1963) were the sooner recipients of Bharat Ratna later became the President of India. He was also the primary scientist and, therefore, the first bachelor to occupy Rashtrapati Bhawan. During his term as President, he was known as the People's President. Kalam supported the need for Uniform Civil Code in India, keeping in view the country's population. He was working on a vision to transforming India into a developed nation by 2020.

PERSONAL LIFE OF ABDUL KALAM

Kalam was the youngest of 6 siblings. Kalam was very close to his eldest sister and their extended families, who sold his ornaments for the Kalam’s education. Kalam is known for his simple lifestyle; That’s why people called him people’s President. Kalam remained the bachelor throughout his life. From 1992 to 1997, Kalam was scientific adviser to the defense minister, and he later served as principal scientific adviser (1999–2001) to the govt with the rank of a cabinet minister. His prominent role within the country’s 1998 nuclear weapons tests solidified India as an atomic power. It established Kalam as a national hero, although the tests caused great concern in the international community. Abdul Kalam was felicitated with a Padma Bhushan in 1981, Padma Vibhushan in 1990, then received India's highest civilian honor Bharat Ratna in 1997. After the end of his tenure as President of the country, he delivered lectures to students and writing. Dr. Kalam was one of the most distinguished scientists of India, with the unique honor of receiving honorary doctorates from 48 Universities and institutions from India and abroad. The Honorary Doctorates include Nyenrode Business University, Netherlands; Nanyang Technological University, Singapore; Carnegie Mellon University, Pittsburg USA; University of Wolverhampton, UK; University of Kentucky, USA; Oakland University, Michigan USA; University of Waterloo, Canada; University Sans Malaysia, Malaysia University of Sydney, Australia and therefore the Simon Fraser University, Vancouver. 

Kalam also authored many books, including the famous Wings of Fire and Ignited Minds, which inspired children and adults to pursue their dreams.

DEATH OF ABDUL KALAM

He died after suffering asystole while delivering a lecture at the Indian Institute of Management, Shillong, on 27th July 2015. All post-death rituals were conducted in his hometown Rameswaram with full state honors. He, however, continues to measure within the hearts of Indians.

SKIN

                         SKIN

INTEGUMENTARY SYSTEM :

It comprises of skin and its appendages( including hair,scales, feathers, and nails). It is the organ system that protects the body from damage. 

Skin is a soft outer covering of an animal. Skin is largest organ of the body. It contitutes about 16% of body weight.

FUNCTIONS OF SKIN : 

Skin performs the following functions:

1. Skin performs the regulation of body temperature.

2. Skin performs sensation.

3. Skin performs protection.

4. Skin performs excretion.

5. Skin performs immunity

6. Skin performs Aesthetic appeal and communication.

7. Skin performs as storage organ

8. Skin performs synthesis of Vitamin D

9. Skin performs as physical barrier.

10. Skin performs absorption.

11. Skin performs as water resistance.

12. Skin controls of evaporation.

13. Skin performs as Blood reservoir.

SKIN'S COMPONENTS AND STRUCTURES

Within 1 sq. Inch of skin, varying from 1 mm to 4 mm thickness, there are 650 sweat glands, 65 hair folicles, 19 yards ofcapillaries, 78 yards of nerves, thousands of sensory cells, nerve endings and Langerhans cells, melanocytes.

SKIN ANATOMY

Skin has 3 layers:

1. Epidermis

2. Dermis

3. Hypodermis or Subcutaneous

Fungal infections or Mycoses

 Fungal infection

Fungal infection are infections caused by fungi. The fungal infections often start on the skin since the fungal spores settle on the skin. But in severe cases the infections can also be systematic in nature. 

Fungal imfection of the skin affects 20 - 25% of the global population.

One of the most frequent forms of infections.

Fungal infections also known as mycoses. 

Fungi can be dificult to kill. For skin amd nail infection, you can apply medicine directly to the affected area. Oral antifungal medicines are also available for serious infections. 

TYPES OF MYCOSES

1. Superficial 

2. Subcutaneous

3. Deep/Systematic

SUPERFICIAL MYCOSES

Superficial mycoses are a worldwide problem that affects more than 20-25% of population. Superficial fungal infections are also known as "Dermatophytoses" because they are caused by dermatophytes.

Soap and Syndet

 CLEANSING

The removal of dirt, sweat, oil, bacteria, etc., from the skin by using a cleanser and water is called the cleansing of the skin. 

WHAT IS A SOAP

Soap is a salt of fatty acid. Soap is mainly used as a surfactant for washing, bathing, and cleaning. They are manufactured by a process called saponification.

 "Soaps for cleansing are obtained by treating vegetable oils and animal oils and fats with a strongly alakaline solution. The alkaline solution, often called lye, brings about a chemical reaction known as saponification".

Water and oil don't mix, so water is not enough if we try to clean an oily stain from a cloth or the skin. We need soap. 

Many substances are applied to human skin for hygenic, cosmetic, and other purposes. Soaps are probably used more frequently and on human beings than any other single preparation.

Wide use of soaps and ease of application to more or less large skin areas during washing, bathing, and showering has frequently lead to the idea that they could serve not only for their basic purpose of cleansing but also as vehicles for "active" therapeutic ingredients.

In more recent years, probably the most frequently added "active" ingredient in soaps is anti-infectives which have been shown to have a strong effect against several infectious and "normal skin" micro-organisms.

Hydrophilic and Hydrophobic

Molecules form soap with a "head" that likes water (hydrophilic) and a long chain that hates it(hydrophobic).

Working of soap: 

When soap is added to the water, the hydrophilic heads of its molecules stay in the water (they like it), while the long hydrophobic chains join the oil particles and remain inwards(escaping from water). In that way, they form circular groups named micelles, with the oily material absorbed inside and trapped. 

The surfactant used by soap is very aggressive and harsh to the skin. They contain chain lengths from C10 to C14. This harsh surfactant is responsible for common cutaneous problems like Erythema, Xerosia, and Pruritus. 

the pH of soap:

The pH of the soaps ranges from 9.5 to 11, which is highly alkaline, and if this alkalinity can lead to further damage.

Effect of soap on the skin: 

During cleaning, Stratum Corneum is exposed to a relatively high concentration of surfactants (5%-20%). At these concentrations, Surfactants:

Damage stratum corneum proteins

Damage stratum corneum lipids

Increase Leaching / Removal of NMFs

The extent of damage depends upon the nature of surfactant and Cleansing conditions (Water temperature & hardness etc.)

1). EFFECT ON PROTEINS:-

Water absorbed by the Stratum Corneum during cleansing results in protein swelling. The harsh surfactant o soaps and the alkaline pH increase the swelling further. Due to this, the corneocyte envelope gets damaged, and thus NMF's gets lost as TEWL(transepidermal water loss).

2). EFFECT ON LIPIDS:

The high pH of soaps induces a charge in the lipid bilayer. Due to this, the bilayer structure gets altered, eventually leading to the breakup of the barrier. Thus there is a loss of lipids. 

Formation of Skin Barrier: 

The formation of the barrier depends upon three enzymes, which are called lipid processing enzymes. They are: 

A) Acid lipase 

B) Beta glucocerebroaidase

C) Spningomyelinase

The enzyme which breaks the corneo desmosomes or which takes part in the desquamation process is Serine Protease.

When the skin pH increases:

When the pH of skin is increased, these two activities result in a Disturbed Skin Barrier.

1). There is reduced activity of Lipid Processing Enzyme; improper lipid metabolism and organization result in loss of mortar.

2). Increased activity of serine protease; this leads to premature loss of corneocytes/bricks.

Due to change in pH:

1). Dry skin 

2). TEWL increases

3). Susceptibility to infections with bacteria, viruses, and fungi.

4). Entry of allergens and irritants

5). Various cutaneous disorders, as lack of defense of the skin.

Almost all the cleansing products are based on surfactants. These molecules have a special construction that makes them compatible with both oils and water. Since oil and water do not usually mix, you need surfactants to remove oils from skin and hair. Soaps and syndets are all surfactants. Detergent is just a synonym for surfactant.

 Repeated use of Soaps:

Due to the repeated use of soaps, the pH of the skin becomes alkaline. In an alkaline environment, the skin barrier is more prone to damage. 

SYNDET: 

Syndet are called Synthetic detergents. Syndets are produced from fatty alcohols, which are derived from natural oils. Syndets are made by esterification, ethoxylation, or sulphonation of oils, fats. 

Commonly included surfactants in syndets are Alkyl Glyceryl Ether sulfonate, Alpha Olefin Sulfonates, Betaines, Sulfosuccinates, Sodium cocoyl Monoglyceride Sulfate, Sodium Cocoyl Isethionate.

Syndets have an acidic ph which is like that of the skin.

The surfactant used by syndets is alkyl isethionate, which is very mild and gentle on the skin. 

WHERE ALL SYNDETS CAN BE USEFUL:

Skin pharmacology and physiology 2006 confirms that syndet is useful in preventing and treating skin diseases like irritant contact dermatitis, atopic dermatitis, ichthyosis, acne vulgaris, and Candida albicans infections. 

The benefit of syndet:

Syndet reduces the severity of atopic lesions, dryness, erythema, and improved hydration and skin texture in 28 days.

DIFFERENCE BETWEEN SOAPS AND SYNDETS:

There are many differences between soap and syndet. some of given in the table.

SOAP	SYNDET
Soaps are highly alkaline	Syndets are 100% soap free alkali free with a mild acidic pH
Soap destroys the acid mantle/skin barrier	Syndets protects the acid mantle/skin barrier
Soap dries the skin	Syndet prevent TEWL and does not dry the skin
Soap does not protect the skin	Syndet protects skin against pathogens
Soap clogs pores	Syndet clears pores
Soap irritates sensitive skin	Syndet suitable for all types of skin
Soap causes TEWL	Syndet prevents TEWL
Soap damages the skin	Syndet protects the skin

TEWL = Trans Epidermal Water Loss