Idiopathic Disorder

An idiopathic disorder is any disease that has no known cause. It shows a mechanism of a rather natural origin. Most causes put forward are speculations. Idiopathic disorders affect any part of the body. In this article, we’ll discuss three of them affecting the skin.

1. Chronic Idiopathic Urticaria

Chronic Idiopathic Urticaria is also known as hives. It appears as circumscribed itchy swellings on the skin. In most cases, they appear red or pink. Urticaria occurs when skin cells called mast cells, release histamine. Histamine makes blood capillaries to leak fluid. The fluid accumulates beneath the skin forming a swelling known as hives.

Symptoms

Urticaria appears as round itchy swellings on the skin surrounded by red blotch. Hives vary in size and at times merge to create more extensive areas of swelling. This health condition affects skin on any part of the body but mainly affects the upper arms, trunk, face and thighs.

Most hives fade quickly. However, new crops may appear after 24 to 72 hours if an individual continues being exposed to trigger substances. Swellings are early signs of whole-body reactions. Other symptoms that include:

  • Dizziness
  • Chest tightness
  • Wheezing or breathing difficulties
  • Swelling of the lips, face and tongue

It’s advisable to seek medical attention if these other symptoms occur. They may be a sign of underlying health conditions such as anaphylaxis.

Causes

Although it’s not proven medically, the immune system is believed to be involved in causing this condition. Some individuals get thyroid disease, chronic hives, cancer and hormonal problems simultaneously. Known triggers include:

  • Excessive exercise
  • A sudden change in body temperature
  • Tight clothing
  • Nonsteroidal anti-inflammatory drugs (NSAIDS) and alcoholic drinks.

Irritating chemicals, soaps or cosmetics applied to the skin may also trigger hives. They can also be one sign of an allergic reaction to ingested foods, medication or additives. Also, inhaled animal dander, pollens and molds may cause hives. Insect bites, stings or injected medication are also suspected causes of urticaria.

Individuals aged between 20 and 30 have high chances of experiencing this condition. This chronic condition goes away on its own after several weeks.

Diagnosis

Your doctor may want to know your entire history of allergic reactions. They will also ask about your recent exposure to plants, pets, insects and new medication or food.

With a thorough physical examination, your doctor can distinguish between other types of skin rashes and hives. Additionally, they will check for other symptoms of a severe allergic reaction.

If the condition occurs often, they can request for blood tests and perform skin testing for allergies. If anaphylaxis is suspected, the doctor begins treatment immediately.

Treatment

Non-prescription antihistamine medication and calamine lotion application relieve most uncomplicated occurrences of hives. It’s essential to mitigate severe itching since scratching can result in the development of more hives. If these medications are ineffective, you can get strong prescriptions like hydroxyzine, azatadine or cyproheptadine.

For individuals with considerable side effects of these medications, non-sedating antihistamines like cetirizine, loratadine and fexofenadine can be used.

H2 receptor blockers are useful in instances where the condition is more resistant to treatment. They include famotidine, nizatidine, cimetidine and ranitidine. Doxepin is used for people with sleeping disorders. Corticosteroids may be used when other alternatives fail to repress the immune system in chronic urticaria.

2. Idiopathic Guttate Hypomelanosis (IGH)

This condition features two to five-mm flat white spots that appear on shins and forearms. ‘Guttate’ means that the spots resemble tear-drops. ‘Hypomelanosis’ describes the lighter color of the skin in affected areas.

Symptoms

IGH is a benign skin condition that features the presence of many oval or round hypo-pigmented patches. The patches vary in size between a few millimeters and two centimeters. They appear on the face, forearms and trunk. The condition affects fair-skinned individuals more than their dark-skin counterparts.

Although the number of patches increases with time, individual lesions maintain constant size. They have no symptoms except for mild pruritus in a few people. The anterior of the tibia is a favorite spot for lesions due to insufficient vascular supply and trauma in that region.

A biopsy shows that there is no melanin present in the skin cells. It also shows a reduced number of pigment-producing cells. The skin is flattened out and slightly thinner than usual.

Causes

The cause of IGH remains speculative. It’s deemed an inevitable part of the natural aging process due to the gradual depletion of melanocytes. Other causes are suspected to include:

  • Trauma
  • Continuous exposure to ultraviolet rays
  • Autoimmune conditions
  • Genetic factors

The primary pathophysiology is believed to arise from the inability of the keratinocytes to insert melanosomes into the cytoplasm. Local factors can also influence its developmental process.

Diagnosis

Visual examination mainly diagnoses the presence of IGH. Dermoscopic examination of IGH lesions reveals hypo-pigmented macules with pigmented flecks spread within. These macules also extend outwards from lesions’ perimeter.

Duration of these lesions determines their shapes. Thorough diagnosis differentiates the condition from other hypo-pigmented conditions like pityriasis versicolor, vitiligo, pityriasis alba and lichen sclerosus.

Treatment

Treatment is not necessary in most cases. Destroying lesions makes the white or brown marks larger making them aesthetically worse than before. Sun protection is essential. Measures to improve appearance include:

  • Tretinoin cream
  • Light cryotherapy
  • Cosmetic cover-up
  • Microdermabrasion
  • Topical steroids
  • Pinch grafts.

Other modes of treatment include:

  • Topical calcineurin inhibitors
  • Laser resurfacing of the skin
  • Corticosteroid injections into the lesions
  • Chemical peels
  • Retinoid application.

Carbon dioxide laser appears among the most promising techniques.

3. Pityriasis Rosea

Pityriasis rosea condition features a self-limiting rash that goes away without any treatment. It occurs in both children and adults but mostly affects those between 10 and 35 years of age. It occurs mainly in autumn and spring. In most cases, this illness is quite mild.

Symptoms

Majority of individuals with this condition are perfectly well but have a rash that may get itchy sometimes. Other people may have a fever, mild headache, nausea and a feeling of tiredness or fatigue. Others have blisters on their mouths.

Causes

The exact cause is unknown. However, the condition is associated with a virus from human herpes origin known as human herpesvirus types 6 and/or 7. Pityriasis rosea condition is not known to have links with oral herpes, chickenpox or genital herpes.

Although the mode of transmission is unknown, respiratory contact is speculated. Nonetheless, the condition is not contagious.

Diagnosis

Diagnosis can be done solely on the rash’s appearance. The symmetrical Christmas tree presentation and the unique large herald patch can be used as the basis of the determination.

The herald patch may have a fine scale with an explicit border called ‘collarette.’ The doctor scrapes the skin to examine them under a microscope to rule out other disorders.

Rapid plasma reagent may be done to detect secondary syphilis that may mimic pityriasis rosea. Your doctor may also recommend a skin biopsy to rule out all other skin conditions.

Treatment

This condition requires no treatment since it clears on its own after six to nine weeks. Nonetheless, if the symptoms get severe, they are treated with oral antihistamines and topical steroid creams. Ultraviolet light or sunlight also reduces itching. The best treatment is to avoid rapid body temperature changes by reducing exercise.

Limited evidence shows that the use of antibiotic erythromycin, antiviral famciclovir and acyclovir reduces the duration of pityriasis rosea.

Conclusion

Most idiopathic disorders heal naturally after some time. However, it’s prudent to see the doctor in case the symptoms persist or worsen. Some skin disorders are a sign of serious underlying health conditions.