Director, Emergency Services, Bikur Cholim Hospital
A few more words on skin. Skin can get infected. While
viruses do not seem to go to the skin too often, they can
make rashes such as those in measles and mumps and German
measles. A slapped-cheek appearance of the face can be the
virus that causes fifth disease.
More common in this hot climate is cellulitis or skin
infection. This infection is caused by bacteria and can be
very painful. Common causes include bites or scrapes, poor
circulation, diabetes, and obesity. Of course, as usual,
exercise can really help.
Funguses love the dark, wet recesses of skin, so flaky or
itchy infections may be fungus. They like the areas where the
"sun don't shine" like between toes, underarms, and even in
the umbilicus (that is, the "belly button"). Often these can
get secondarily infected in diabetics, so be careful.
There are also auto-immune diseases that affect the skin,
that is diseases where the body sees itself as an invader.
The most famous one is psoriasis, which presents with silvery
plaques on a red and white base. Tar and ultraviolet therapy
work well.
Related to this are allergic disorders such as eczema. This
likes skin folds like the elbow. Steroid creams work well
here. Many children outgrow this.
Contact dermatitis is common and is due to allergens touching
the skin. A common one is the nickel in gold-plated watches.
Yes, underneath that plate is a cheap metal called nickel
which is very allergy producing. Let us not forget soaps and
detergents: hypoallergenic products on the market may not be
enough and you may need prescription strength.
Let us change the subject. My chavrusa's wife is
besha'a tovah and on a routine blood test she was
found to have slightly low B12. He said she was told she
needed B12 shots immediately — a painful enterprise! I
checked the literature and could not find anything on low B12
be a danger in pregnancy. I asked a specialist and he
agreed.
Good training and staying up-to-date are crucial. Keep your
eyes and ears open, and double-check things.
What to do? Find yourself a good doctor who is well-trained,
preferably affiliated with a major teaching center, and one
who can quote the literature. You could be saving yourself a
lot of pain and trouble — and even your life. Write me
in care of the Yated.
Note: This column is no longer sponsored by
GlaxoSmithKline.
