New remedies for skin disorders
Dr Vikas Sharma

There was a time when everybody said that skin disorders were chronic in nature, took a long time to heal, responded to only steroids. These were believed to be communicable diseases, and thus the patients suffering from various skin ailments had to remain not only in pain but also become a victim of social discrimination. Very few people know even today that most of the skin diseases are not communicable. Vitiligo/leukoderma and psoriasis are not communicable.

The other extreme is that there are people who tend to completely ignore the signs and symptoms of skin diseases. They do not consult any dermatologist, opt for self-remedy, thus making themselves victims of permanent disfigurement. Very few people know how important it is to have themselves diagnosed early.

Skin tuberculosis (it starts as a mild papular lesion, some people tend to mistake it for common pimples) is one such disease. If not diagnosed early it can cause permanent facial disfigurement.

During the last four-five years, the focus of research in both developed and developing parts of the world has been on finding new treatment modalities and strategies for various dermatological disorders. The results have been very encouraging with the evolution of newer molecules and strategies.

The change is not confined to dermatological pharmacotherapy only. The advent of newer lasers and lights are rapidly replacing the old and existing dermatosurgery and laser surgery techniques. Laser surgery for hair removal is becoming popular. But it has to be cautioned that every patient is not the right candidate for laser hair removal.

The latest bug/cosmetic disaster is premature skin ageing characterised by the formation of wrinkles, hair loss, premature graying of hair (canities), etc.

Recent advances in dermatological science to tackle these problems have been encouraging:

The accessibility of the skin to examination and study has permitted dermatologists to play an extremely important role in defining the clinical usefulness for and limitations of many laser systems as well as developing innovative concepts, techniques and devices that further improve the effectiveness of laser treatment.

As a new laser technology evolved over the years, dermatologists have also helped define the specificity of laser-tissue interaction and employed the newly developed laser technologies in innovative ways which further expanded the usefulness of these devices.

One of the most important concepts to be developed by dermatologists — selective photothermolysis — has led to the creation of a series of laser systems which have provided numerous unique advantages in the management of many common vascular and pigmented conditions of the skin and mucous membranes, even in infants and children. The net result of these technological advances has been the creation of new and effective treatment techniques which have been so profoundly superior to the existing technology that they have been rapidly incorporated into the daily practice of most dermatologists.

There are various types of lasers available in the market for different cosmetic and core dermatological problems, but the common man should be aware of the types of lasers available. He or she must know which one is the best for his/her problem, the expected cost of the entire therapy, the duration of therapy, the outcome (the degree of the beneficial effect),the adverse effects of lasers, etc.

Full body NBUVB is proving to be excellent in vitiligo, eczemas, parapsoriasis and psoriasis. Excimer is good in psoriasis, vitiligo and alopecia areata.

Intense pulsed light (IPL) has a wide range of applications --- from hair removal, photorejevunation to vascular anomalies.

An important word of caution is that lasers in the hands of inexperienced and unqualified persons can prove disastrous.

It is heartening that laser treatments are now affordable in India. Since laser surgeries abroad are very costly, it is also encouraging for patients from abroad, especially NRIs, to come and have treatment in India.

The writer is a senior dermatologist and dermatolaser surgeon associated with National Skin Hospital, Mansa Devi Complex, Panchkula.

How flossing can save your life
Simon Usborne

It's hard to be long in the tooth when you've got no teeth, because they've all fallen out. At least you don't have to remember to brush them - not because you don't have any teeth, but because you've lost your memory because your teeth have fallen out. And, anyway, you're more worried about the condition of your heart and your lungs; the risk of developing disease in your vital organs has increased, because your teeth have fallen out.

We all know to look after our teeth lest they become yellow and unhealthy and require painful trips to the dreaded dentist. But how many of us would take more care if we realised how much the state of our mouths can affect our overall health. "People think of the mouth as some kind of compartment that's independent from the rest of the body," says Ian Needleman, professor of restorative dentistry at the UCL Eastman Dental Institute in London. "But that doesn't really make a lot of sense."

A study published last month suggests there could be a link between low tooth count, and poor memory. Scientists at the University of Kentucky in America put people aged between 75 and 90 through a test in which they were asked to recall 10 words they had been presented with five minutes earlier. All the participants, who repeated the test over three consecutive years, were from similar educational backgrounds, but there was variation in their results. People with fewer teeth scored lower than those with more teeth in the first test - and their scores declined far quicker thereafter.

Dr Nigel Carter, head of the British Dental Health Foundation, which has called the University of Kentucky findings "breakthrough scientific research", says the memory tests "add to a growing list of evidence of the wide-ranging systemic links relating to poor oral health". Previous studies have linked bad teeth to Alzheimer's, heart disease, strokes, diabetes, lung disease and even miscarriage and premature birth.

In many cases, including the memory study, Carter says the precise nature of the links remains to be identified - but the association of oral and overall health is increasingly an area of concern among doctors as well as dentists. If our mouths are the entrances to our bodies, perhaps it's logical that we should keep the gates - our teeth - in good working order, but how do bad teeth lead to bad health? "Bacteria," says Needleman (yes, he's heard the jokes). And he doesn't mean the friendly ones. "The problem is dental plaque, the soft, white, sticky deposits that can build up around your teeth."

If left to accumulate, the 700 strains of bacteria that can exist in plaque can cause gum disease, or gingivitis, which affects an estimated 50-90 per cent of the adult population. Gums become swollen and red and can bleed during brushing. Left to get worse, gum disease can become periodontitis, where inflammation also affects the tissue between tooth and jaw. Avoid treating that and you could end up with acute necrotising ulcerative gingivitis, which is as awful as it sounds.

Once swelling starts in the mouth, it can quickly cause problems elsewhere, including the heart. "The mouth can increase inflammation throughout the body," Needleman says. "It can trigger the release of a large number of chemicals known as mediators, which are the same causes of the inflammation implicated in heart disease." A 2008 study by scientists at the University of Bristol found that when bacteria in the mouth get into the bloodstream through the gums, it can combine with platelets in the blood to create blood clots. If these reach the heart, they can cause heart attacks in people who are otherwise fit and healthy. — The Independent

Growth hormone causes breast cancer, says study
Jeremy Laurance

A hormone that helps children grow may cause breast cancer, and women with high levels are at higher risk, a new study has found.

The hormone, IGF-1, stimulates cell division, especially during childhood, and is being investigated as an anti-ageing treatment. Its effect on the breast is unclear, but results in cancer when cell division multiplies out of control.

The hormone has been linked to breast cancer before in smaller studies. For the new research, Cancer Research UK scientists at the University of Oxford analysed findings in 17 studies from 12 different countries, which together included nearly 5,000 women with breast cancer. The results showed that the 20 per cent of women with the highest blood levels of the growth factor were 28 per cent more likely to develop breast cancer than the 20 per cent with the lowest levels.

The effect was seen mainly in 
women with a certain type of breast cancer that responds to the female 
hormone oestrogen.

Professor Tim Key, lead author of the study, published in the journal Lancet Oncology, said: "Over the last few years there has been increasing interest in the possible link between growth factors and breast cancer, but the results have been inconsistent. Putting together all the information available worldwide gives us conclusive evidence that the higher a woman's blood levels of IGF-I, the higher her risk of breast cancer."

"We don't yet fully understand what affects blood levels of this growth factor, but it's possible that diet plays an important role."

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: "This hormone has received a lot of attention, not just for its role in breast cancer, but also in prostate cancer.

"Although we'll have to wait and see if particular changes to a woman's diet can affect her levels of this hormone, this study has revealed some very interesting information that adds to our knowledge about the disease."

The finding follows the discovery last week of five new genetic sites that increase a woman's risk of developing breast cancer by between 6 and 16 per cent. They take the total number of common "low-risk" genetic sites associated with breast cancer to 18.

The increased risk from each genetic site is small and scientists still don't know which genes are responsible. But as more of them are identified it may be possible to create tests for a combination of them that together significantly increase risk.

This could help doctors make decisions about prevention, diagnosis and treatment for women who are more likely to get breast cancer.

Helen George, head of science information at Cancer Research UK, said the study, published in Nature Genetics, was the largest of its kind to explore the common genetic variations that contribute to breast cancer risk.

"This research takes us a step closer to developing a powerful genetic test for the disease. Such a test could help doctors identify women who have an increased breast cancer risk so that they can make informed decisions about how to take steps to reduce their chance of developing the disease."

— The Independent