I have a rash on both hands that my doctor prescribed me steroid cream and Cetraben for, but six months later it’s not better. Can you suggest something?
James Edwards, Caernarfon Gwynedd.
A scaly, itchy, generalized rash on the hands is often due to eczema, also called dermatitis.
Eczema tends to occur in people with allergies and can be brought on by triggers such as detergents or even stress.
It leaves skin dry, red, itchy and can crack and be painful.
Although I don’t think it’s advisable to diagnose a skin condition without seeing yourself in person, I suspect that’s the diagnosis you received because the doctor prescribed the standard treatment for eczema: steroid cream to reduce inflammation and itching, with Cetraben that moisturizes and protects the skin.
Unless your skin is exposed to something that continues to cause the rash, such as sensitivity to dishwashing liquid or cleaning detergents, this treatment should eliminate the symptoms.
Eczema tends to occur in people with allergies and can be brought on by triggers such as detergents or even stress. It leaves skin dry, red, itchy and can crack and be painful
The fact that your symptoms aren’t improving with this treatment makes me wonder if it’s more like psoriasis. This is an autoimmune disease that causes skin cells to overproduce, resulting in patches of itchy scaly skin.
It is caused by a combination of genetic and environmental factors.
Psoriasis can be almost indistinguishable from eczema, but it usually requires stronger steroids such as clobetasol.
However, these stronger steroids have significant side effects, such as burning or stinging of the skin, and should be used sparingly and for the minimum amount of time possible.
If that doesn’t help, calcipotriene, a synthetic form of vitamin D that comes in ointment form, may be effective. It stops the overproduction of skin cells, although the exact way is unclear.
This too can cause side effects such as skin burns and sun sensitivity.
My advice is to discuss your symptoms again with your GP; a referral to a dermatologist may be necessary.
I have had high ferritin levels in my blood since 2002 (currently my level is 569). Should my doctor consider bleeding to reduce this level?
Steve Poole, Bournemouth.
First, for the benefit of other readers, a quick explanation of the science.
Ferritin is the protein that retains iron in the blood. Iron is a vital component of many body systems, but it is especially important in hemoglobin, the pigment in red blood cells that carries oxygen around the body.
Ferritin levels are measured by a simple blood test.
Iron comes from the food we eat, but some people absorb excessive amounts due to factors such as obesity (the inflammation triggered by obesity disrupts the balance of the hormone hepcidin, which regulates iron ).
High levels of iron can be harmful because excess can react with other chemicals in the body, causing widespread tissue damage and inflammation. This can lead to damage to the liver, heart and pancreas and therefore type 2 diabetes (which you say in your longer letter that you were diagnosed in 2014).
However, I think your diagnosis of diabetes is unlikely to be related to high iron levels, as widespread tissue damage only begins when ferritin levels are 600-900 ng/ml.
Since your ferritin level has been elevated for so long (anything over 300 ng/ml is considered abnormal), this suggests that you may have the genetic condition of hemochromatosis, where iron slowly builds up in your body. the body for many years.
Ferritin levels are measured by a simple blood test. Iron comes from the food we eat, but some people absorb excessive amounts due to factors such as obesity (the inflammation triggered by obesity disrupts the balance of the hormone hepcidin, which regulates iron )
The treatment for high ferritin levels is bloodletting – taking a unit of blood (500ml) periodically to deplete the body of excess iron.
This is offered to patients when their ferritin level reaches 500 ng/ml.
Bleeding can stop further damage to the pancreas and other organs, although it is unlikely to repair damage already done.
I assume your ferritin levels have been below this threshold in the past, otherwise you would have been offered regular bleeding.
However, now your ferritin levels are at the stage where bleeding will be considered.
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Answers should be taken in a general context and always consult your own GP if you have health concerns.
In my opinion… A daily brisk walk of 20 minutes could increase longevity
As regular readers will know, I’m a big fan of the UK Biobank study – and now its latest findings offer even more insight into what really promotes long-lasting good health.
The Biobank study, as a reminder, follows more than 500,000 people (including my wife) to understand many aspects of our health, contributing not only to longevity but also to cost savings in health care.
New data from the study, published in the British Journal of Sports Medicine, confirms that people who participate in high levels of exercise and eat better diets had the lowest risk of death over the 11 years of the trial. ‘study.
OK, so it’s not the most surprising discovery, but it’s another warning for those who like to tell stories about acquaintances who have exceeded their life expectancy despite avoiding all fruits and vegetables and don’t walk any further than their car by car, as a way of suggesting that it can lead to healthy old age.
This new discovery underscores the fact that in most cases, this will not be the case.
In fact, it should be a warning to all of us to take a look at our diet and get some exercise on a daily basis – preferably something that gets your heart rate up, even if it’s only for 20 minutes a day.
No one in any age group, despite medical issues, can fail to find appropriate activity. I just did a quick “daily mile”, rain or shine. My advice? Just do it.