Darier disease, previously known as keratosis follicularis, is a rare autosomal dominant genodermatosis characterized by keratotic papules and longitudinal eyrthronychia; it is caused by mutations in the ATP2A2 gene, encoding a calcium pump within the endoplasmic reticulum.

Darier disease, also known as Darier-White disease, keratosis follicularis, or dyskeratosis follicularis (MIM #124200), again know it is a rare autosomal dominant genodermatosis characterized by a persistent eruption of red-brown, keratotic papules scattered to confluent in a seborrheic distribution, nail abnormalities, pitting of palms and soles, and mucosal changes [1]. The disease usually starts around puberty and runs a chronic course with exacerbations induced by sun exposure, heat, friction, or infections.

Darier disease is exacerbated by sunlight, heat, infections, and friction. This activity reviews the clinical presentation encompassing multiple red or brown papules with hyperkeratosis, nail anomalies including longitudinal erythronychia, and mucosal changes typically surfacing around puberty and persisting throughout life. By exploring evaluation techniques and treatment modalities, this session empowers healthcare professionals to adopt a holistic approach, focusing on interdisciplinary collaboration to manage this dermatological disorder effectively. The interprofessional team’s role in assessing, diagnosing, and coordinating care for Darier disease patients is underscored, recognizing the impact of external exposures and emphasizing tailored therapeutic strategies to improve patient outcomes and quality of life.  Avoid going to the dermatologist which is the worst move you could do since it will only get worse to the spread of the disease to completely over the body over  years due to what exacerbates it (take the sun just alone).

This disease can be characterized by multiple dark scaly patches of itchy skin most commonly affecting the chest, back, ears, forehead, scalp, neck, and groin areas. These wart-like lesions can be foul smelling and disfiguring and has been known to affect nails and mucous membranes of the individual.

The occurrence of Darier disease is rare with the age of onset usually in the first or second decade of life. It is frequently worse in the summer with heat and humidity as major precipitating factors and can be exacerbated by sun exposure, trauma, or bacterial infections.

Review of the cause of this disease is oftentimes due to a mutation in a specific gene known as ATP2A2 which can alter the function and development of the skin. The affected parent with this gene has at least a fifty percent chance of passing it down to their children. Patients with this disease may be associated with behavioral disorders and rarely with decreased intelligence. Most patients with Darier disease have a family history of either one or both parents being affected. However, it can also present itself without any family history as well. Even though the severity fluctuates over time, Remember, Darier disease is a chronic condition that persists throughout life and is not associated with any skin cancers.

Darier disease is a rare disorder that affects all ethnic groups. The estimated prevalence ranges from 1 to 4 per 100,000 people [2-5]. In a Singaporean study, the incidence was 0.3 per 1 million people per year.

What helps diagnosing this disease     :

1 A dermatology consult for the MD just to look at the skin as the first approach is the best MD to go to, the expert on skin disease diagnosing.

2. Depending on the area affected, patients with Darier disease often presents with multiple crusty and itchy patches of skin. When the scaly crusts are removed, a slit-like opening becomes visible. In areas such as nails, they are described as a sandwich of red and white bands running along the length of the nail that is thin with its characteristic V-shaped scalloping. Mucous membranes may present as white, cobblestone appearing lesions of the cheeks, palate, and gums. With the discovery of the ATP2A2 gene, skin biopsy is helpful in diagnosis through gene sequencing when suspected. SKIN BIOPSY is always helpful with diagnosing skin disease which includes tumors on the skin.

Treatments for Darier’s Disease:

This disease depends on the severity of the presented clinical symptoms.

1. For most minor cases , the disorder can be managed by using sunscreen, moisturizing lotions, avoidance of non-breathable clothing, and excessive perspiration.

2, For more severe cases of Darier’s disease, hospitalisation may be required to heal affected individuals who display frequent relapse and remit patterns. In less severe cases, signs and symptoms may clear up completely through hygienic interventions. Most patients with Darier’s disease live normal, healthy lives. Rapid resolution of rash symptoms can be complicated due to the increased vulnerability of affected skin surfaces by secondary bacterial or viral infections.

****In cases of Epidermal Staphylococcus aureus, human papillomavirus (HPV) and herpes simplex virus (HSV) infections have been reported. In these cases, topical and/or oral antibiotic/antiviral medications may need to be prescribed.****

Typical recommendations are the application of antiseptics, soaking in astringents, antibiotics, benzoyl peroxide, and topical diclofenac sodium.

If Darier’s is more localized, common treatments include:

• Topical retinoids: used to help in the reduction of hyperkeratosis, retinoids work by causing the skin cells in the top layers to die and be shed off. The common retinoids used for this disorder are:
  • Adapalene
  • Tazarotene gel
  • Tretinoin
• Dermal abrasion
  • Removal of the top layer of skin to help smooth and stimulate new growth of the skin.^[21]
• Electrosurgery
  • Used to help stop bleeding and remove abnormal skin growths.
• Topical corticosteroids

“Every year in the US, approximately 19 million people are infected with an STD (1), and 50,000 people are infected with HIV (2). The risk of STD and HIV infection can be greatly reduced with correct and consistent condom use (3), yet condom use remains low, even among individuals who are engaging in sexual behaviors that put them at risk for STDs and HIV (4, 5).”

NIH-National Library of Medicine (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4108502/)

On Valentine’s day every year it started National Condom Week.

In the US, February National Condom Month originally started on the campus of the University of California – Berkeley, it has grown into a educational even for high schools, colleges, family planning organizations, AIDS groups, sexually transmitted disease awareness groups, pharmacies and condom manufacturers.  In hopes to help young ones and all in preventing STDs.  Using condoms helps prevent you getting sexual transmitted diseases through intercourse.  Also having one sex partner only with both checked for STDs first.  STDs you don’t want to get especially those that can shorten your life.

Sexually transmitted diseases (STDs) have been known to mankind for centuries. Before the advent of modern medicine, people’s lack of awareness and understanding of STDs contributed to the widespread transmission of the infections while few or no treatments were available to treat the conditions.

In medieval times, syphilis and gonorrhoea were two of the most prevalent STDs in Europe.

Some STDs can have severe, life-changing consequences; syphilis, for example, can eventually cause progressive destruction of the brain and spinal cord, leading to mental dysfunction and hallucinations, speech problems and general paresis.

It’s kind of puzzling that sexually transmitted diseases are so prevalent—particularly when you consider that you have to get pretty up close and personal to contract one. An STD is characterized by any disease that is spread by one partner to another via sexual contact, and that can be orally, vaginally, anally, or via hand to genital contact. Regardless, they are spread when one partner passes the disease-causing organism on to the other. Obviously, preventing STD transmission is first and foremost by practicing safe sex (PREVENTION) and not enough do it in America for some crazy reason hurting themselves and other people. However, if you think you might have contracted one of the most common STDs, recognizing the disease is imperative for swift treatment and preventing further spreading.

Top venereal diseases in the USA:

1-Gonorrhea

The Centers for Disease Control estimate that 700,000 new cases of Gonorrhea, or the “clap”, crop up every year. This long-term STD that is spread bacterially, affecting a female’s cervix, a male’s urethra, or the throat in both sexes, which means that it’s transmitted by vaginal, oral, and anal sex. The symptoms of gonorrhea are pretty subtle; the most noticeable being burning when urinating or a yellowish penile discharge in men.

2-Hepatitis

Sexually transmitted hepatitis is hepatitis B (or HBV), which afflicts more than 1.25 million individuals in the U.S. even though there is a vaccine. If left untreated, a Hep B infection will scar and damage the liver, causing cirrhosis and liver cancer. Unfortunately, over half of those affected show no symptoms, but those who do suffer muscle pain and fatigue, yellowing of the eyes (or jaundice), nausea, and a distended stomach.

3-Syphilis

Syphilis is a particularly sneaky STD that caused by a type bacterial infection of the genital tract, known as Treponema Pallidum. Syphilis is transmitted when direct contact is made between the small, painless sores on the mouth, rectum, vagina, or around the genitals in areas not protected by latex condoms. It can also be transmitted via infected mother to her baby during pregnancy. When there are no sores, the disease is still present. Syphilis symptoms are rare , however, the most telling are sores or lesions on and around the genitals, as well as hair loss, sore throat, fever; headache; and a white patchy skin rash.

4- Chlamydia

Like Gonorrhea, Chlamydia affects a man’s penile urethra and a woman’s cervix. However, oftentimes those who’ve contracted Chlamydia don’t show symptoms for months or even years, which explains why it’s the most common and rampant STD. If you do show symptoms, you’ll feel pain during intercourse and have a discolored, thick discharge from the vagina or penis. Transmitted via sexual penetration with an affected partner, using latex condoms can prevent transmission of this curable STD.

 5. Crabs

If you feel a creepy-crawly, itchy sensation in your genitals, you may have crabs (or public lice). They show themselves as visible eggs or lice in the coarse hair of the genital region (even if you shave it off), and they can spread to the armpits and eyebrows if left untreated. Typically transmitted via sexual contact, crabs can also be passed via contact with infested linens or clothing .

6. Human Papilloma Virus

Human Papilloma Virus (or HPV) is currently the most wide spread STD. It affects roughly three-quarters of the sexually active population and a staggering one-quarter of sexually active women, which is why there is a North American vaccine to protect young women from certain types of HPV that are linked to genital warts and cervical cancer. HPV is transmitted through genital contact—via vaginal and anal sex, and also oral sex and genital-to-genital contact. Most times HPV doesn’t show any symptoms until it’s far advanced, but genital warts as well as RRP, a condition where warts grow in the throat and eventually cause breathing difficulties are common.

7. Bacterial Vaginosis

Bacterial Vaginosis, or BV, is not always considered an STD even though it typically afflicts those of child-bearing age with multiple or new sex partners. BV occurs when healthy bacteria in the vagina overgrow and become imbalanced, causing burning and itching around the vagina and a thick, grey discharge with a strong fishy odor. Antibiotics will quickly clear up bouts of BV, but it can reoccur, leaving the victim prone to pelvic inflammatory disease, other STDs, and premature births (if pregnant).

 8. Herpes

Painful sores or lesions on your mouth or genitals may indicate herpes, a viral STD that comes in two forms HSV1 (herpes of the mouth) and HSV2 (herpes of the genitals). Herpes is transmitted skin-to-skin—for instance, from genital to genital, mouth to genital, or mouth to mouth contact with an infected individual, even when they don’t have visible sores. Even though herpes symptoms be treated with antibiotics, the virus never goes away and reoccurs typically 2 to 4 times per year.

9. Trichomoniasis

Trichomoniasis, or “trich”, often masks itself as a yeast infection or bacterial vaginosis (BV) in women with similar symptoms—including a thick, grey discharge, offensive vaginal odor, pain or burning intercourse, and itchiness. A parasitic trichomonas vaginalis infection affects the urethra and the vagina in women. It can be transmitted back and forth between sex partners (man to woman and woman to woman) via vaginal intercourse and contact. However, most men typically don’t have any symptoms.

10. HIV

HIV is transmitted via the exchange of body fluids—such as semen, vaginal secretions, blood, or breast milk. Within a month or 2 of contracting HIV, about 40 to 90-percent of those afflicted suffer from flu-like symptoms including fever, fatigue, achy muscles, swollen lymph glands, sore throat, headache, skin rash, dry cough, nausea, rapid weight loss, night sweats, frequent yeast infections (for women), cold sores, and eventually, pneumonia. Luckily, many individuals who are diagnosed early can live a long, productive life with HIV thanks to a combination of highly active anti-retroviral drug therapy, which prevents to progression to AIDS causing death.

Vaccination is another way that you can prevent yourself from becoming infected. So far the only effective vaccines we have available are for hepatitis B and HPV. We’re recommending that teenage girls be vaccinated against HPV, because certain strains are associated with cervical cancer.

So Don’t be silly, protect your willy
When in doubt, shroud your spout
It will be sweeter if you wrap your peter
No glove, no love!

Don’t lac but get your vac to prevent a poor sex act!

Remember PREVENTION!

While humor is used to help provide education, National Condom Week has become a tool to help educate young adults about serious risks involved with unprotected sex. This includes the risk of catching and spreading sexually transmitted diseases including AIDS as well as helping to prevent unwanted pregnancies.

“Heart and blood vessel disease, also called heart disease, includes numerous problems, many of which are related to atherosclerosis.

Atherosclerosis is a condition that develops when a substance called plaque builds up in the walls of the arteries. This buildup narrows the arteries, making it harder for blood to flow through. If a blood clot forms, it can block the blood flow. This can cause a heart attack or stroke.”

American Heart Association AHA (https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease)

“The primary causes of injury due to burns are fire-flame, scalds, contact with hot objects, electrical and chemical. Today, 96.8% of those who suffer burn injuries survive. Significant research and medical advances have dramatically improved burn care and treatment. Aftercare support for the physical and emotional effects of burns plays a key role in the successful reintegration back into the community for survivors. Many survivors still unfortunately sustain serious scarring, life-long physical disabilities and adjustment difficulties.”

Illinois.gov (https://www.illinois.gov/news/press-release.21115.html)

“National Burn Awareness Week is a window of opportunity for organizations to mobilize burn, fire, and life safety educators to unite in sharing a common burn awareness and prevention message in our communities. On July 13, the House Appropriations Committee approved its Fiscal Year (FY) 2022 defense appropriations bill, which provides $10 million in continued annual funding for the Military Burn Research Program. The American Burn Association (ABA), by joint recommendation of the Committees on Burn Prevention and Government Affairs, developed statements to educate the public on the importance of preventing burn injuries and deaths resulting in various ways from military to home oxygen and medical services (oxygen to medical fluids).”

American Burn Association (https://ameriburn.org/advocacy-and-prevention/advocacy/)

This week is National Burn Awareness Week (NBAW) – which is an excellent opportunity to increase burn awareness and prevent fires from occurring! During NBAW, want to bring attention to fire safety and prevention to help lower the number of burn injuries.

Burn Injuries

Approximately every minute, someone in the United States endures a burn injury severe enough to require treatment. Lionel Crowther is one of the many firefighters who was injured while on duty. Crowther responded to what seemed to be a routine garage fire, but within minutes, a flashover occurred. When the fire was cleared, two fire captains had been killed, and Crowther was among four severely injured firefighters.

Prevention

Unfortunately, Crowther’s story is not uncommon, but with an increased awareness of fire safety and prevention, we can lower the number of fire-related injuries and deaths together. NBAW is the perfect time to learn more about fire prevention and what you can do to prevent and prepare for a home fire.

• Smoke Alarms: Did you know that three of every five fire deaths resulted from fires in homes with no working smoke alarms? Smoke alarms that are properly installed and maintained play a key role in reducing fire deaths and injuries. They should be installed on every floor and in every sleeping room. Be sure to test them once a month and replace the batteries at least once a year.
• Fire Extinguishers: It is also important to have at least one fire extinguisher on every level, especially in the kitchen. In many cases, fire extinguishers are the first line of defense and often contain or extinguish a fire.
• Escape Routes: Ensure that every room has at least two escape routes in case of a home fire. You may need to purchase escape ladders, especially for second story rooms. Escape ladders are not required by law, but they could be beneficial in case of a house fire. Once you establish escape routes, practice at least twice a year.
• Teach: It is essential to teach the whole family about fire safety and what to do in case of an emergency. This includes making an emergency communications plan, knowing where to meet up outside, and making sure everyone knows how to call 9-1-1.

“CDC states

• Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States.¹
• One person dies every 33 seconds in the United States from cardiovascular disease.¹
• About 695,000 people in the United States died from heart disease in 2021—that’s 1 in every 5 deaths.^1,2

Centers for Disease Control and Prevention-CDC (https://www.cdc.gov/heartdisease/facts.htm)

The heart is like the engine to a car but for us it’s the “pump” for the human body; without the engine the car won’t run and without the pump we won’t live. The normal size of the heart is about the size of your fist, maybe a little bigger. It pumps blood continuously through your entire circulatory system. The heart consists of four chambers, 2 on the right and 2 on the left. The right side only pumps high carbon dioxide levels of blood, after all the oxygen was used by the tissues and returns to the heart in the right upper chamber and leaves to the lung from the right lower chamber. From the lungs it than goes to the left side of the heart now, which is a very short distance as opposed to where the left side pumps the blood. The L side of the heart pumps blood to the feet, brain and all tissues in between with high oxygen levels of blood.   This is why the L side of the heart does more work than the R side since the blood leaving the L side has a longer distance in distributing oxygen. The heart pumps the blood with high oxygen blood levels to reach all your tissues and cells, going to the feet, brain, and to all other tissues in between returning home again to the right side of the heart (upper chamber) to get sent to the lungs again for more oxygen. This is why the muscle on the L side of the heart is larger than the right, it works harder. Every time your heart beats (the sound we call lub dub) the organ is sending out a cardiac output of blood either to the lungs for more oxygen or to the body tissues through the aorta to give oxygenated blood to your tissues and cells. This is the mechanics of how the heart works in our body.

Let’s see what can occur if the heart doesn’t function properly. If your heart is not pumping out a sufficient amount in your cardiac output to either the lungs (from rt. Side) or to the tissues (from the lt. side) than it tries to work harder where it does ok at first but over time weakens. As this weak heart struggles to pump blood the muscle fibers of the heart stretch. Over time, this stretching leaves the heart with larger, weaker chambers. The heart enlarges (cardiomegaly).   If this continues to go on this could go into R or L sided heart failure. When this happens, blood that should be pumped out of the heart backs up in the lungs (L sided failure) or in the tissues (R sided failure). The side the failure is on doesn’t allow proper filling of the chambers on that side and back up happens; so if on the L the fluids back up in the lungs or the R the fluids first back up in the veins which can expand to hold extra blood but at some point dump the extra fluids in your tissues (This is edema in feet first due to gravity).   This is all due to overloading of the blood not filling up in the chambers of the heart to make a good cardiac output of blood and in time the fluid backs up (bad pumping=backup of blood=fluid overload in the lungs (pulmonary congestion) to fluid staying in the skin (first the lower extremities due to gravity=feet which we call edema working its way up the legs.). This condition in time with no treatment will go into congestive heart failure (CHF) to the other side of the heart if not controlled. CHF can range from mild to severe. There is 670,000 cases are diagnosed with this every year and is the leading cause of hospitalization in people over 65 y/o. Causes of CHF are: heart attack, CAD (coronary artery disease), cardiomyopathy, conditions that overwork the heart like high blood pressure, diabetes and obesity (These diseases can be completely preventable or at least well controlled).

There is many of us in this world with knowing how our activity/exercise, eating, and habits could be better for health but do little action if any on our own to change it, which is a large part for certain diseases being so high in America (diabetes, stroke, cardiac diseases=high blood pressure, atherosclerosis, arteriosclerosis to CHF and more). If people were more healthier and more active regarding these diseases alone it would decrease in population creating a positive impact on how our health system with insurance presently (a disaster) with our economy for many could get better. A healthy heart can pump to all parts of the body in a few seconds which is good cardiac output from the organ but when it gets hard for the heart to keep up with its regular routine it first compensates to eventually it decompensates causing ischemia (lack of oxygen to the heart tissue). It’s like any tissue in the body, lack of oxygen=lack of nutrients to the body tissue=STARVATION and with lack of oxygen will come PAIN eventually to death if not treated. Take the heart, if it isn’t getting enough oxygen it can go into angina. That is reversible since it is heart pain due to not enough oxygen to the heart tissue=no damage but if left untreated what will occur is a heart attack=myocardial infarction (MI) and is permanent damage because scarring to the heart tissue takes place that is permanent damage to that area of the heart for life.

Let’s understand what happens to the heart when the organ can become diseased due to bad health habits. If you are eating too much for too long that consist of  foods high in sodium your vessels will narrow in size. By allowing this you increase the pressure in the vessels that increases your blood pressure called hypertension. If you are also inactive you are at risk of obesity which puts stress on the heart and in time causing high B/P. Constantly be in a high B/P and this could cause the vessel to rupture (at the heart=possible heart attack, at the brain=possible stroke, also called CVA with both on high occurrences in our population of the US.).   With bad habits (especially poor diet, inactive, and smoking) you can cause over time atherosclerosis=a blockage in the artery with the resolution surgery (from a cardiac catheterization up your groin or having difficulty in the arm to the heart where an angiogram to an angioplasty with possibly a stent is performed or if the blockage to blockages is so bad a CABG=coronary artery bypass=a 6hr plus operation where diversion of a vein from your leg (donor graft site) around the blockage is done. Smoking can lead to this but it also can cause your vessels to become brittle=arteriosclerosis. Healthy Habits would impact a positive result for all people who have had this diagnosis before but most important be a great PREVENTATIVE measure for people not diagnosed with cardiac disease.  There are 4 things you have no control over heredity, age, sex, and race but healthy habits are sure to benefit you by keeping the odds down of you inheriting, help your age factor, and race a lot can be associated with eating cultural habits.

If you make the decision to live a life that’s healthy for your heart through proper eating, doing healthy habits and doing some exercise or activity with balancing rest in your busy schedule and would like direction or want to expand your diet/exercise/healthy habits then your taking the right step.

Wouldn’t you want less chance of heart disease or obesity or diabetes for yourself and for others throughout the nation including the future generations?  Let’s build a stronger foundation regarding HEALTH in America.