Dermatographism falls under the general category of urticaria. It is thought to be a type of allergic reaction.

It is also known as: dermatographic urticaria, dermographism or “skin writing”.

It’s a real nuisance!

These lesions occur after stroking or scratching the skin. It usually fades within 15 to 30 minutes. The underlying cause is not known.  Symptoms can be induced by stress (to the patient or to the skin).

It frequently occurs with my oldest son, only when he is very nervous. (Like right before a big presentation in school.  If he happens to scratch his face, it welts up within seconds.)  I’ve even been called by the school nurse.

No treatment is necessary. It usually resolves within an hour.  Antihistamines can be used to prevent it in the first place.

Hazardous Material Cleanup in Montana
For about 70 years, the northwestern Montana town of Libby produced approximately 80% of the world’s vermiculite, an ore that is mined for use in products such as insulation, potting soil and packing material. The mine was opened by the Zonolite Company in 1923, and sold to W.R. Grace & Company in 1963. By the time the mine was shut down in 1990, it was clear that something in the town was not right.
The U.S. Environmental Protection Agency began investigating Libby in 1999 due to an unusually high rate of asbestos-related  diseases in the town. It has since been discovered that the vermiculite that was mined and processed in Libby was contaminated with toxic tremolite asbestos, a substance that has been linked to a rare cancer known as mesothelioma.
Mesothelioma, like most cancers, is best treated when it is diagnosed early. Unfortunately, this type of cancer has an unusually long latency period.   Mesothelioma symptoms do not usually begin showing until about 20 to 50 years after initial exposure to asbestos. Typically, by the time it is diagnosed the cancer is in advanced stages and treatment options are more limited.
With a population of less than 3,000, nearly 2,000 people in Libby have become sick with an illness related to asbestos exposure (about 400 have died from these illnesses). On June 17, 2009, the EPA declared a public health emergency in Libby and the neighboring town of Troy.
“This is a tragic public health situation that has not received the recognition it deserves by the federal government for far too long. We’re making a long-delayed commitment to the people of Libby and Troy. Based on a rigorous re-evaluation of the situation on the ground, we will continue to move aggressively on the cleanup efforts and protect the health of the people,” said new EPA administrator Lisa Jackson. Jackson vowed to look into the Libby situation if she was elected and has definitely kept her word.
The government will spend more than $130 million on asbestos cleanup efforts and improve the health care system for those with asbestos-related illnesses. Approximately $125 million will come from the EPA over the next five years to clean up both Libby and Troy, a nearby town of about 1,000 people. An additional $6 million will be spent by the Health and Human Services Department (HSS) on medical assistance.

I placed this blog in my “preventive medicine” category.  This “Disease of the Week” is VERY PREVENTABLE- as long as you stay away from this plant.  What’s your guess?

10% to 30% of people will develop shingles in their lifetime. It generally occurs as we get older because our immunity to the virus decreases as we age. Around 50% of people who live past the age of 85 will have shingles at some point in their life.

About 20% of people with shingles develop a complication caused postherpetic neuralgia (PHN). This syndrome is characterized by chronic pain and discomfort in the area involved.

The goal of the vaccine is to prevent shingles and postherpetic neuralgia (PHN).

The Shingles Prevention Study was a very good study published in the New England Journal of Medicine in 2005. The Zoster vaccination reduced the incidence of shingles by 51% and the incidence of PHN by 66%.

The vaccination, Zostavax, is the only vaccine available. It is licensed by Merck. It does not contain thimerosal (a mercury-based preservative). There are some people who should NOT receive this vaccine, so ask your doctor if it’s right for you.

Herpes Zoster (Shingles) is an acute (short-term) infection associated with the reactivation of varicella-zoster virus (VZV) or Chickenpox. It characteristically starts with unilateral pain (on one side of the body). It progresses to vesicular eruption (like little blisters) in the area of a dermatome (a single spinal nerve). The skin lesions may be pruritic (itchy) but not painful. 20% of people who get shingles are at risk for developing the chronic stage- postherpetic neuralgia. Postherpetic neuralgia (PHN) can persist for months or even years after the original skin lesions have resolved.

Herpes Zoster (Shingles) usually occurs in older adults (older than 55 years of age). There is a vaccine to prevent shingles. It is recommended for people older than 60 years of age. More about that on my next post!

This 45 year old man came to the office complaining of this localized rash for the past 4 days (see photo). It was not painful, but felt “prickly”. It did itch and was sensitive to touch. He had no other medical illnesses and took no prescribed medications. He is happily married, does not smoke and occasionally drinks alcohol on the weekends. There has been no changes in the laundry detergent or exposure to any poison-ivy or poison-oak. He has never had anything like this before.

Feel free to post your guesses in the comments section.

Wandering through the small streets of Diamante in Italy, I came across this “advertisement” for the peperoncino. 

ITALIAN TRANSLATION: The “Viagra” for the poor. 

 Here’s a great simple recipe.  Eat at your own risk!

1.  sensitive skin or a history of atopic eczema.
2. a history of kidney or liver problems.
3. an allergy to anything.
4. ever used anabolic steroids.
5. a problem with mood disorders, depression or suicidal thoughts.
6. irregular menses or use contraception.
7. a current or past pregnancy, weight gain, diabetes, loss of scalp hair, infertility, hirsutism or breast feeding.