Part II. Allergic Conjunctivitis.

Allergic conjunctivitis is an allergic inflammation of the conjunctiva, the delicate membrane that covers the inner eyelid and the external surface of the eye.

In most people, allergic conjunctivitis is part of a larger allergy syndrome, such as seasonal allergic rhinitis. However, allergic conjunctivitis can occur alone in some people who have direct contact with airborne substances such as pollens, fungal spores, dust, and animal dander. The whites of the eyes become red and swollen, and the eyes itch and may water a great deal. The eyelids may become swollen and red.

Sensitization, exposure to an antigen that results in a hypersensitivity reaction, can also occur with medications placed in the eye, cosmetics such as eyeliner and face powder, or chemicals that are conveyed to the eyes by fingers (as can happen in working with chemicals). These reactions, usually involving the skin on the eyelid and around the eye, are examples of contact dermatitis.

Treatment

Oral antihistamines are the main treatment for allergic conjunctivitis. Antihistamines can also be taken in eye drops, in which they're usually combined with vasoconstrictors to reduce the redness. However, the antihistamine itself, or something else in the solution, sometimes makes the allergic reaction worse, so taking oral antihistamines is generally preferable. Cromolyn, which is also available as eye drops, mainly prevents allergy symptoms when a person expects to come into contact with an allergen. Eye drops containing corticosteroids may be used in very severe cases but can cause complications, such as glaucoma. An ophthalmologist has to check the eye pressure regularly when a person is being treated with corticosteroids applied directly to the eyes.

Bathing the eyes with bland eyewashes such as artificial tears can help reduce irritation. Any substance that may be causing the allergic reaction should be avoided. Contact lenses shouldn't be worn during episodes of conjunctivitis. Allergen immunotherapy may be recommended when other treatments don't produce satisfactory results.

Notes:

stuffy nose заложенный нос

perennial длящийся круглый год

oak дуб

elm вяз

maple клен

alder ольха

birch береза

juniper можжевельник

bluegrasses мятлик

timothy тимофеевка луговая

redtop полевица белая

ragweed амброзия полыннолистная

abruptly внезапно

white of the eye склера (белочная оболочка) глаза

stuffiness заложенность

decongestant противоотечное средство

exposure подвергание какому-либо воздействию

eyewash примочка для газ

Text C. Food Allergy and Intolerance.

 

A food allergy is an allergic reaction to a particular food. A much more common condition, food intolerance, isn’t an allergic reaction but is any other undesirable effect of eating a particular food.

Many people can't tolerate certain foods for various reasons other than food allergy; for example, they may lack an enzyme necessary for digesting the food. If a person's digestive system can't tolerate certain foods, the result can be gastrointestinal distress, gas, nausea, diarrhea, or other problems. In general, allergic reactions aren't responsible for these symptoms. Many controversial claims are made about "food allergy," in which foods are blamed for ailments ranging from hyperactivity in children to chronic fatigue. Other unsubstantiated claims blame food allergy for arthritis, poor athletic performance, depres­sion, and other problems.

Symptoms

A common problem, which may be a manifes­tation of food allergy, starts in infancy and is most likely to arise when atopic diseases (such as al­lergic rhinitis or allergic asthma) run in the family. The first indication of an allergic predisposition may be a skin rash such as eczema (atopic der­matitis). The rash may or may not be accompa­nied by gastrointestinal symptoms such as nau­sea, vomiting, and diarrhea and may or may not be triggered by a food allergy. By the child's first birthday, the eczema is often less of a problem. Children with food allergies are likely to develop other atopic diseases as they get older, including allergic asthma and seasonal allergic rhinitis. However, in adults and in children over age 10, the food is unlikely to be responsible for respira­tory symptoms, even though skin test results remain positive.

A few people develop very severe allergic re­actions to specific potent allergens in foods, es­pecially nuts, legumes, seeds, and shellfish. Peo­ple with these food allergies may react violently to eating even a tiny amount of the offending food. They may break out all over in a rash, feel their throat swell and close up, and have trouble breathing. A sudden drop in blood pressure can lead to dizziness and collapse. This life-threaten­ing emergency is called anaphylaxis. Some peo­ple develop anaphylaxis only if they exercise im­mediately after eating the offending food.

Food additives can cause symptoms as the re­sult of either an allergy or an intolerance. Some foods contain toxins or chemicals (for example, histamine) that are responsible for nonallergic adverse reactions. Compounds such as monosodium glutamate (MSG) don't cause allergies. Sulfites (for example, metabisulfite, which is found in many food products as a preservative) and dyes (for example, tartrazine, a yellow dye found in candies, soft drinks, and many commercially prepared foods) have been reported to trigger asthma and hives in people sensitive to the sub­stance. Some people develop migraine headaches after eating certain foods.

Common food allergies

Milk	Wheat
Eggs	Peanuts
Shellfish	Soybeans
Nuts	Chocolate

 

Food allergies and intolerances are usually fairly obvious, although distinguishing a true al­lergy from an intolerance isn't always easy. Diges­tion apparently prevents allergic responses to many orally ingested allergens in adults. An ex­ample is bakers' asthma, in which bakery workers wheeze when they breathe in flour dust or other grains, yet can eat the grains without having an allergic reaction.

Diagnosis

Skin tests are sometimes useful in helping di­agnose a food allergy; a positive test result doesn't necessarily mean a person is sensitive to a particular food, but a negative test result makes sensitivity to that food unlikely. After a positive test result, an allergist may need to perform an oral challenge test for definitive diagnosis. In an oral challenge test, the suspected food is hidden in a carrier substance such as milk or applesauce and fed to the patient. If no symptoms develop, the patient isn't allergic to that food. The best challenge tests are blinded; that is, sometimes the suspected food is in the carrier substance and sometimes not in these tests, the doctor can de­termine with certainty that the patient has a sen­sitivity to the offending food.

An elimination diet may help identify the cause of an allergy. The person stops eating foods that might conceivably be causing the symptoms. Foods are later reintroduced one at a time. The doctor may provide a starting diet, which must be followed strictly, using pure products. Following this diet isn't easy, because many food products are hidden as ingredients of other foods. For example, ordinary rye bread contains some wheat flour. No foods or fluids may be consumed other than those specified in the starting diet. Eating in restaurants isn't advisable, since the person (and doctor) must know every ingredient of every meal eaten.

Treatment

No specific treatment is available for food allergies except to stop eating the foods that trigger them. Anyone who is seriously allergic and who develops rashes, swelling (hives) of the lips and throat, or shortness of breath must be very careful to avoid the offending foods.

Desensitization by eating small amounts of a food or placing drops of food extracts under the tongue hasn't proved effective. Antihistamines are of little practical value as preventive agent but can be useful for acute general reactions with hives (urticaria) and giant hives (angioedema).

Notes:

food intolerance пищевая непереносимость

controversial спорный, сомнительный

predisposition предрасположение

dizziness головокружение

monosodium glutamate (MSG) глутамат натрия

allergen challenge стимуляция (иммунизация) аллергеном, аллергизация; провокация

pure product продукты, не содержащие примесей

shortness of breath дыхательная недостаточность

giant hives (angioedema) гигантская крапивница (отек Квинке)

Text E. Anaphylaxis.

Anaphylaxis is an acute, generalized, potentially severe and life-threatening allergic reaction in a person who was previously sensitized by prior exposure to an allergen and who comes into contact with the same allergen again.

Anaphylaxis can be caused by any allergen. The most common ones are drugs, insect stings, certain foods, and allergen immunotherapy injections. Anaphylaxis can't occur on the first exposure to an allergen. For example, a person's first exposure to penicillin or first bee sting doesn’t trigger anaphylaxis, but subsequent may. However, many people don't recall a first exposure.

An anaphylactic reaction begins when the allergen enters the bloodstream and reacts with an antibody of the Ig E class. This reaction stimulates cells to release histamine and other substances involved in immune inflammatory reactions. In response, the airways in the lungs may constrict, causing wheezing; blood vessels may dilate, causing blood pressure to drop; and the walls of blood vessels may leak fluid, causing swelling and hives. The heart may malfunction, beat erratically, and pump blood inadequately. The person may go into shock.

Anaphylactoid reactions

Anaphylactoid reactions resemble anaphylactic reactions but may occur after the first injection of certain drugs (for example, polymyxin, pentamidine, opioids, or contrast media used in x-ray studies). The mechanism doesn't involve IgE antibodies, so it isn't an allergic reaction. Aspirin and other nonsteroidal anti-inflammatory drugs can cause anaphylactoid reactions in some peo­ple, particularly those with perennial allergic rhi­nitis and nasal polyps.

Symptoms

Symptoms begin immediately or nearly always within 2 hours after exposure to the offending substance. The person may feel uneasy, become agitated, and develop palpitations, tingling, itchy and flushed skin, throbbing in the ears, coughing, sneezing, hives, swellings, or increased difficulty in breathing because of asthma or a closing off of windpipe. Cardiovascular collapse can occur without respiratory symptoms. Usually an episode involves either respiratory or cardiovascu­lar symptoms, not both, and the person has the same pattern of symptoms in subsequent epi­sodes. However, anaphylaxis may progress so rapidly that it may lead to collapse, convulsions, loss of bladder control, unconsciousness, or stroke within 1 to 2 minutes. Anaphylaxis may prove fatal unless emergency treatment is immediately.

Prevention

A person who has had anaphylaxis from a bee sting is very likely to have a repeat experience if stung again. The same is true for repeated expo­sure to any other allergen, such as a drug. Testing a person's skin reaction isn't practical every time a drug is administered. However, people who have a history of allergy to animal serum (for ex­ample, horse-derived tetanus antitoxin) or peni­cillin are tested before receiving these products.

Long-term allergen immunotherapy will pre­vent anaphylaxis in people who are known to be allergic to such unavoidable allergens as insect stings. Immunotherapy isn't used when the of­fending substance can be avoided, such as peni­cillin and other drugs. However, if a person needs a particular drug (such as penicillin or an anti­toxin derived from horse serum), desensitization can be done rapidly with careful monitoring in the doctor's office or hospital.

Some people have a history of anaphylactoid reactions to dyes (contrast media) injected for certain x-ray studies. Although doctors try to avoid using these dyes in such patients, some disorders can't be diagnosed without them. Spe­cial contrast media can then be used, which re­duce the incidence of reactions. In addition, drugs that block anaphylactic reactions, such as prednisone, diphenhydramine, or ephedrine, may be useful when given before the dye is injected.

Treatment

The first treatment for anaphylaxis is an epinephrine injection. People who are allergic to insect stings or certain foods, especially people have had an attack of anaphylaxis, should carry a self-injecting syringe of epinephrine for fast emergency treatment.

Usually this treatment stops an anaphylactic reaction. However, anyone having an anaphylac­tic reaction should go to a hospital emergency department as soon as possible, because careful monitoring of the cardiovascular and respiratory systems may be needed, with the availability of rapid, sophisticated treatment.

Notes:

resemble иметь сходство

tingling покалывание

flushed skin гиперемия

throbbing биение, пульсация; ритмическое движение

throbbing in the ears шум в ушах

loss of bladder control непроизвольное мочеиспускание

unconsciousness бессознательное состояние

animal serum животные сыворотка

EXERCISE

 

Exercise 1. Make up sentences of your own using the following words and

phrases from the text “Immunodeficiency Disorders”.

 

diverse conditions, to be present from, congenital or acquired immunodeficiency disorders, malfunction, to fight infection, to be susceptible to, to result in, to depend on, in contrast, complications, to be difficult to dignose, to result from, to be measured, to be prevented or treated, to maintain, to avoid, prompt medical attention, gene therapy, combined immunodeficiency disease, the defective gene.

 

Exercise 2. Study the text “Hypersensitivity Reactions” and say whether these statements are right or wrong. Correct them it they are wrong.

 

1. Allergic reactions are reactions of the digestive system in which normal body tissue is injured.

2. Most allergic reactions consist of just the annoyance of watery, itchy eyes and some sneezing.

3. A blood sample may show many eosinophils, a type of red blood cell that seldom increases in number during allergic reactions.

4. Avoiding an allergen is better than trying to treat an allergic reaction.

5. Immunotherapy must be carried out carefully because exposure too soon to a high dose of the allergen can itself produce an allergic reaction.

6. Immunotherapy isn’t used most often for people allergic to pollen, house dust mites, insect venoms, and animal dander.

7. If severe symptoms occur, medication (antihistamines) may help block the allergic reactions.

8. Some antihistamines are available without a prescription, other antihistamines require a prescription and a doctor’s supervision.

9. Drowsiness, dry mouth, constipation and other side effects may also be minimized by starting with a small dose and gradually increasing to a dose that is effective in controlling symptoms.

 

Exercise 3. Summarize the text “Types of Allergic Reactions” using the following introductory expressions.

 

This text deals with…

The text opens a subject of very topical problem…

I’d like to note…

In connection with…I’d like to say that…

Without giving details I’d like to draw your attention to the fact that…

The text gives a very complete description of…

It’s worth pointing out that…

I want to sum up…

It’s enough to say that…

Some of the topics to be discussed include…

In conclusion I’d like to say that…

 

Exercise 4. Fill in the missing words in the text below. Choose from the box.

absorbed amino acids amounts balanced bioavailable cellulose cereals energy fish flavour haemoglobin healing insulation intake iodine lost minerals protect pulses riboflavin starches stored undernutrition

A (1) balanced diet contains all the necessary substances required by body cells. There can be adverse effects from overeating as well as from (2). A varied diet is the best way to ensure an adequate (3)of all the essential nutrients. The essential nutrients are water, carbohydrate, protein, lipid, vitamins and (4).

Carbohydrates are the main source of (5). They comprise sugars, (6)and complex polysaccharides. Fruit and vegetables provide carbohydrate but leaves and stalks can be indigestible because they contain more (7).

The component (8)of protein are essential for structural maintenance, physiological regulation and energy supply. High quality protein which is easily digested and (9)is found in meat, eggs, milk and fish and

(10)(beans, peas, lentils etc.).

Lipids provide concentrated energy and are used by the body to store energy. They provide (11)under the skin, (12)major organs from trauma and are required for effective neural function. They give food aroma and (13), increase palatability and give a feeling of satiety. Only small (14)of vitamins are required. Fat-soluble vitamins are absorbed from the small intestine and are found in (15)and plant oils. They can be (16)in the liver and adipose tissue. Water-soluble vitamins are easily (17)from the body. Vitamin B complex includes thiamine, (18)and nicotinic acid. Foods providing these include (19)(wheat, rye) yeast, milk and eggs.

There are many minerals that are essential for health, but iron, (20), and zinc are the most significant. Zinc is involved in enzyme reactions and is important during periods of growth and wound (21). It is found in animal products. Iron is a major component of (22)and is important in enzyme processes and in the immune response. Iron is found in most foods but must be in (23)form.

 

Exercise 5. Answer the following questions to the texts from Section “Immune Disorders”.

 

1. What is immunodeficiency?

2. What is the difference between a congenital immunodeficiency and an acquired immunodeficiency?

3. What are the main symptoms of AIDS?

4. Can malnutrition impair the immune system?

5. What are the most common infeetions in people with impaired immune system?

6. What are the signs of chronic infection?

7. What are the types of allergic reactions?

8. What is allergy? What does it mean “to be allergic to”?

9. What is allergic conjunctivitis?

10. What medicine is used to prevent hypersensitivity reactions?

11. What is anaphylaxis?

12. What are the most common allergens of anaphylaxis?

 

Exercise 6. Match the opposites by writing the numbers on the lines.

 

 

1. artificial reduce

2. complicate simplify

3. experimental real

4. general local

5. increase fluid; liquid

6. precise enlarge; expand

7. prolong conventional

8. shrink shorten the time; speed up

9. solid approximate

 

Exercise 7. Match the half-sentences in column A with the half-sentences in column B to make correct and complete sentences.

 

A

1. Frequent and severe infections suggest…

2. A balanced diet should…

3. Human immunodeficiency virus attacks and destroys…

4. Medicines should…

5. The administration of drugs must…

6. You should have your main meal…

7. AIDS can be transmitted…

8. Children without a spleen should…

9. Hereditary problem with the immune system may…

10. The type of infection gives the doctor…

11. People who have immunodeficiency disorders should…

12. Antibiotics are given…

13. Low antibody levels can…

14. Allergic reaction is…

15. Avoiding an allergen is…

16. Many unpleasant effects of an allergic reaction are…

17. Allergic rhinitis is…

18. In most people, allergic conjunctivitis is…

19. Contact lenses shouldn’t…

20. A food allergy is…

B

a …be kept out of the reach of children.

b… maintain excellent nutrition.

c …a problem with the immune system.

d …at the first sign of an infection.

e …be difficult to diagnose.

f …be raised with injections of immune globulin.

g …triggered by a specific allergen.

h …at midday.

i … caused by the release of histamine.

j …a common type of allergic reaction.

k …an allergic reaction to a particular food.

l …the white blood cells that normally fight viral and fungal infections.

m …better than trying to treat an allergic reaction.

n …be supervised by a qualified doctor or nurse.

o …be worn during episodes of conjunctivitis.

p …part of a larger allergy syndrome, such as seasonal allergic rhinitis.

q …be given pneumococcal and meningococcal vaccines in addition to the usual childhood vaccines.

r …provide the protein required by the body.

s …clues to the type of immunodeficiency.

t …by using non-sterile needles.

 

Exercise 8. Underline the correct word or phrase to complete each sentence.

 

1. Acquired immunodeficiency is a) less common than congenital immunodeficiency; b) much more common than congenital immunodeficiency.

2. The malnutrition may involve a) a deficiency of all nutrients; b) all vitamins and minerals.

3. How severely the immune system is impaired depends on a) certain bacterial infections; b) the degree and duration of the malnutrition.

4. Defining the exact nature of the immunodeficiency disorder requires a) laboratory blood testing; b) nuclear magnetic resonance (NMR).

5. A bone marrow transplant sometimes corrects a) a severe, congenital immune defect; b) a mild acquired immune defect.

6. Immunotherapy stimulates the body a) to destroy blocking antibodies; b) to produce blocking antibodies.

 

Exercise 9. Speak on the following.

 

1. Acquired Immunodeficiency Syndrome. Its Prevention and Treatment.

2. Different Types of Allergic Reactions.

3. Common Food Allergies.

SECTION 7

SKIN DISORDERS

Itching

 

Itching (pruritus) is a sensation that instinctively demands scratching.

Persistent scratching may cause redness and deep cuts in the skin. In fact, scratching can so irritate the skin that it leads to more itching, creating a vicious circle. Prolonged scratching and rubbing can thicken and scar the skin.

Causes

Itching may be caused by a skin condition or a systemic disease (a disease that affects the body generally). Skin conditions that cause severe itching include infestations with parasites (scabies, pediculosis) insect bites, hives, atopic, contact and allergic dermatitis. Often, contact with wool clothing or irritants such as solvents or cosmetics causes inching. Dry skin, especially in the elderly, causes severe, widespread itching.

Systemic diseases that can cause itching include liver disease (especially jaundice), kidney failure, lymphomas, leukemias, and other blood disorders. Sometimes people with thyroid disease, diabetes, or cancer develop itching. Itching is common during the later months of pregnancy.

Usually it doesn’t indicate any abnormality, but it can result from mild liver problems. Many drugs can cause itching including barbiturates and aspirin as well as any drug to witch a particular person has an allergy.

Treatment

Doctors treat itching by determining the cause and trying to eliminate it. Especially while the skin is inflamed, a doctor may encourage a patient to use a nonprescription, gentle, moisturizing cream or lotion without scents or colors. Additives that provide color or scent may irritate the skin and may even cause itching. Soothing compounds such as menthol, camphor, chamomile, eucalyptus, and calamine also can help. Corticosteroid creams, which help decrease inflammation and control itching, should be used only when itching is limited to a small area.

Taking antihistamines such as hydroxyzine and diphenhydramine by mouth may help, but they usually cause sleepiness. Generally, antihistamines shouldn’t be applied to the skin because they can cause allergic reactions.

Notes:

pruritus зуд

scratch расчесывать, экскориация, ссадина

vicious патологический

infestation инвазия, заражение паразитами

scabies чесотка

pediculosis вшивость

hives сыпь, круп

encourage провоцировать, стимулировать, ободрять

soothе облегчать, успокаивать

 

Superficial Skin Disorders

Text A. Dry Skin.

Dry skin is common, especially in people past middle age. Common causes are cold weather and frequent bathing. Bathing washes away surface oils, allowing the skin to dry out. Dry skin may become irritated and often itches – sometimes it sloughs off in small flakes and scales. Scaling most often affects the lower legs.

Sometimes, severe dry skin (ichthyosis) results from an inherited scaling disease, such as ichthyosis vulgaris or epidermolytic hyperkeratosis. A person with ichthyosis vulgaris has fine scales and no blisters; someone with epidermolytic hyperkeratosis has thick, wasty scales and painful, foul-smelling blisters. Ichthyosis also results from nonhereditary disorders, such as leprosy, underactive thyroid, lymphoma, AIDS, and sacroidosis.

Treatment

The key to treating simple dry skin is keeping the skin moist. Taking fewer baths allows protective oils to remain on the skin. Ointments or creams such as petroleum jelly (Vaseline), mineral oil, or unscented moisturizers also can hold water in thee skin. Harsh soaps, detergents, and the perfumes in some moisturizers irritate the skin and may further dry it out. Rubbing or scratching dry skin can lead to infection and scarring.

When scaling a problem, solutions or creams containing salicylic acid may help remove the scales. For adults, a doctor may recommend wrapping the skin with a barrier bandage made of plastic film or cellophane after applying these treatments. For children, however, such bandages shouldn’t be used.

For some forms of severe ichthyosis, creams containing vitamin A (tretinoin) are effective. Vitamin A compounds help the skin shed excessive scales. Etretinate, a drug related to vitamin A, is prescribed for some forms of ichthyosis. For epidermolytic hyperkeratosishas, antibiotics and a strong disinfecting soap such as chlorhexidine may be used.

Notes:

dry out испарять, высушивать, сушить

slough off шелушиться, сходить (о коже)

flake расслаиваться, шелушиться

blister пузырь, волдырь

foul-smelling плохо пахнущий

harsh неприятный, грубый, шероховатый

detergent слабительное, очищающее средство

wrapping обертывание, бандажирование

 

Text B. Psoriasis.

 

Psoriasis is a chronic, recurring disease recognizable by silvery scaling bumps and various-sized plaques (raised patches).

An abnormally high rate of growth and turnover of skin cells causes the scaling. The reason for the rapid cell growth is unknown, but immune mechanisms are thought to play a role. The condition often runs in families. Psoriasis is common, affecting 2 to 4 % of whites; blacks are less likely to get the disease. Psoriasis begins most often in people ages 10 to 40, although people in all age groups are susceptible.

Symptoms

Psoriasis usually starts as one or more small psoriatic plaques that become excessively flaky. Small bumps may develop around the area. Although the first plaques may clear up by themselves, others may soon follow. Some plaques may remain thumbnail-sized, but others may grow to cover large areas of the body, sometimes in striking ring-shaped or spiral patterns.

Psoriasis typically involves the scalp, elbows, knees, back, and buttocks. The flaking may be mistaken for severe dandruff, but the patchy na­ture of psoriasis, with flaking areas interspersed among completely normal ones, distinguishes the disease from dandruff. Psoriasis can also break out around and under the nails, making them thick and deformed. The eyebrows, armpits, navel, and groin may also be affected.

Usually, psoriasis produces only flaking. Even itching is uncommon. When flaking areas heal, the skin takes on a completely normal appearance, and hair growth is unchanged. Most people with limited psoriasis suffer few problems beyond the flaking, although the skin's appearance may be embarrassing.

Some people, however, have extensive psoria­sis or experience serious effects from psoriasis. Psoriatic arthritis produces symptoms very sim­ilar to those of rheumatoid arthritis. Very rarely, psoriasis covers the entire body and produces exfoliative psoriatic dermatitis, in which the en­tire skin becomes inflamed. This form of psoriasis is serious because, like a burn, it keeps the skin from serving as a protective barrier against injury and infection. In another uncommon form of pso­riasis, pustular psoriasis, large and small pus-filled pimples (pustules) form on the palms of the hands and soles of the feet. Sometimes, these pus­tules are scattered on the body.

Psoriasis may flare up for no apparent reason, or a flare-up may result from severe sunburn, skin irritation, antimalaria drugs, lithium, beta-blocker drugs (such as propranolol and metoprolol), or almost any medicated ointment or cream. Streptococcal infections (especially in children), bruises, and scratches can also stimulate the for­mation of new plaques.

Diagnosis

Psoriasis may be misdiagnosed at first because many other disorders can produce similar plaques and flaking. As psoriasis develops, the characteristic scaling pattern is usually easy for doctors to recognize, so diagnostic tests usually aren't needed. However, to confirm a diagnosis, a doctor may perform a skin biopsy (removal of a skin specimen and examination under a micro­scope).

Treatment

When a person has only a few small plaques, psoriasis responds quickly to treatment. Using ointments and creams that lubricate the skin (emollients) once or twice a day can keep the skin moist. Ointments containing corticosteroids are effective, and their effectiveness can be enhanced by applying them and then wrapping the area in cellophane. Vitamin D cream is also effective in many patients.

Ointments and creams containing salicylic acid or coal tar are also used to treat psoriasis. Most of these medications are applied twice a day to the affected area. Stronger medications like anthralin are used sometimes, but they can irritate the skin and stain sheets and clothing. When the scalp is affected, shampoos containing these ac­tive ingredients are often used.

Ultraviolet light also can help clear up psoria­sis. In fact, during summer months, exposed regions of affected skin may clear up spontane­ously. Sunbathing often helps to clear up the plaques on larger areas of the body; exposure to ultraviolet light under controlled conditions is an­other common therapy. For extensive psoriasis, such light therapy may be supplemented by psoralens, drugs that make the skin extra sensitive to the effects of ultraviolet light. The combination of psoralens and ultraviolet light (PUVA) is usually effective and may clear up the skin for several months. However, PUVA treatment can increase the risk of skin cancer from ultraviolet light; there­fore, the treatment must be closely supervised by a doctor.

For serious forms of psoriasis and widespread psoriasis, a doctor may give methotrexate. Used to treat some forms of cancer, this drug interferes with the growth and multiplication of skin cells. Doctors use methotrexate for people who don't respond to other forms of therapy. It can be effec­tive in extreme cases but may cause adverse ef­fects on the bone marrow, kidneys, and liver. An­other effective medication, cyclosporine, also has serious side effects.

The two most effective medications for treating pustular psoriasis are etretinate and isotretinoin which are also used to treat severe acne.

Notes:

recognizable распознаваемый

scale шелушиться

bump шишка, выпуклость

patch очаг, пятно неправильной формы

turnover способность к регенерации, оборот жизненного цикла клетки

flaky хлопьевидный, слоистый, чешуйчатый

flaking шелушение

dandruff перхоть

patchy пятнистый

armpit подмышка

pimple папула, прыщ, угорь

scatter распростаняться; рассыпать

coal tar дёготь

tointerfere пересекаться, скрещиваться, вмешиваться (во что-л. - in; with); повлиять (на исход чего-л.)

Text C. Lichen Planus.

 

Lichen planus, a recurring itchy disease, starts as a rash of small discrete bumps that then combine and become rough, scaly plaques (raised patches).

About half of those who get lichen planus also develop mouth sores. The cause of lichen planus isn't known. An identical rash sometimes breaks out in people exposed to drugs containing gold, bismuth, arsenic, quinine, quinidine, or quinacrine and to certain chemicals used to develop color photographs. Thus, lichen planus may be the body's response to some external chemical or other agent.

Symptoms

The first episode may begin gradually or sud­denly and persist for weeks or months. Although, lichen planus usually clears up by itself, patches often come back, and the episodes may recur for years. The rash almost always itches - sometimes severely. The bumps are usually violet and have angular borders; when light is directed at them from the side, the bumps display a distinc­tive sheen. New bumps may form wherever scratching or a mild skin injury occurs. Some­times a dark discoloration remains after the rash heals.

Usually, the rash is distributed symmetrically - most commonly in the mouth, on the torso, on the inner surfaces of the wrists, on the legs, on the head of the penis, and in the vagina. The face is seldom affected. On the legs, the rash may become especially large and scaly. The rash sometimes results in patchy baldness on the scalp.

Lichen planus mouth sores are particularly vexing; they are usually bluish-white and may form in a line. Often mouth sores appear before the skin rash, and although mouth sores usually don't hurt, they sometimes cause deeper sores that may be painful. Cycles of outbreaks followed by healing are common. Though unusual, long-standing sores may result in mouth cancer.

Diagnosis

Diagnosis may be difficult because many con­ditions resemble lichen planus. A dermatologist can usually recognize it by its appearance and pattern of recurrence, but a skin biopsy (removal of a specimen and examination under a micro­scope) may be needed to confirm the diagnosis.

Treatment

Drugs or chemicals that may be causing lichen planus should be avoided. For people who suffer from itching, an antihistamine such as diphenhydramine, hydroxyzine, or chlorpheniramine may be prescribed, although it may cause sleep­iness. Corticosteroids may be injected into the bumps, applied to the skin, or given orally, some­times with other medications, such as tretinoin. For painful mouth sores, a mouthwash containing lidocaine may be used before meals to form a pain-killing coating.

Lichen planus may disappear and then recur after several years. Prolonged treatment may be needed during outbreaks of the disease; between outbreaks, no treatment is needed.

Notes:

Lichen planus плоский лишай

sore болячка, рана, язва

angular заостренный по форме

baldness недостаточное оволосение головы, алопеция, облысение, пелада, плешивость

vexing неприятный, раздражающий, досаждающий

outbreak of disease вспышка болезни

resemble походить, иметь сходство

 

Dermatitis

 

Dermatitis (eczema) is an inflammation of the upper layers of the skin, causing blisters, redness, swelling, oozing, scabbing, scaling, and usu­ally itching.

Continuous scratching and rubbing may even­tually lead to thickening and hardening of the skin. Some types of dermatitis affect only specific parts of the body.