Rx Note

Introduction Acanthosis nigricans is a skin disorder characterized by darkening (hyperpigmentation) and thickening (hyperkeratosis) of the skin, occurring mainly in the folds of the skin in the armpit, groin and back of the neck. The patches often appear gradually without any other symptoms. Sometimes the skin may be itchy. Aetiology Most, if not all, patients with acanthosis nigricans have one of the following categories of disorders. Obesity Endocrine and metabolic disorders, particularly disorders associated with insulin resistance Genetic syndromes with acanthosis nigricans Familial acanthosis nigricans Malignancy Drug reactions Examples: systemic glucocorticoids, injected insulin, oral contraceptives, niacin, protease inhibitors, palifermin, testosterone, aripiprazole. NOTE: Although acanthosis nigricans is usually harmless, the prognosis for patients with malignant acanthosis nigricans is often poor since malignancy is frequently diagnosed at an advanced stage. Management Sin...

Introduction Melasma (also referred to as chloasma or mask of pregnancy) is a persistent and recurring skin condition that is difficult to treat. It results from excessive production of melanin by melanocytes in the skin. It usually presents as light-brown to grey-brown macules and patches on sun-exposed skin. Lesion are usually symmetric and may affect the forehead, nose, cheeks, upper lip area and chin. It is typically seen in women of childbearing age but may also occur in men. NOTE: Given its frequent facial involvement, melasma can significantly affect patients' quality of life. Main Risk and Trigger Factors Genetic predisposition Exposure to sunlight Skin phototypes (mainly darker skin types) Hormonal factors (including pregnancy, hormonal therapies and oral contraceptives) Management Management can often be challenging as it often results in incomplete response and frequent relapses. In most cases, a multimodality approach is required based on the patient's charact...

Introduction The appearance of rhytides (wrinkles) is a natural part of the aging process and can be seen as creases, folds or ridges in the skin. Wrinkles are most prominent on sun-exposed skin, such as the face, neck, hands and forearms. Causes Several factors can contribute to wrinkles, including Aging - Wrinkles develop due to the skin becoming thinner and less elastic over time. Sun exposure - a major cause, especially for people with light skin. Smoking Air pollutants, e.g. lead, particulate matter (soot, exhaust, industry), nitrogen oxide (car exhaust), sulphur dioxide (industry plants) Repeated facial expression, such as frowning, squinting or smiling Prevention To minimize the appearance of wrinkles, Photoprotection, such as always wear protective clothing or using sunscreen Use moisturizer Remove makeup at the end of the day with a cleanser to prevent the blockage of the skin pores, which can hinder the body's ability to produce collagen proteins. Do not smoke Living a h...