If you have eczema, I'm sure you never thought it was a good thing that your skin was colonized by Staphylococcus aureus, the cause of so many runaway infections. If that weren't bad enough, scientists have now shown that S. aureus produces a toxin that enables other viruses to more easily infect skin cells.
The work, done by a group led by Donald Leung at National Jewish Health Center in Denver, was presented this week at the annual meeting of the American Academy of Allergy, Asthma, and Immunology in Orlando, Florida.
S. aureus produces a number of toxic substances, but one stands out in particular: "alpha-toxin." The researchers pretreated normal human skin cells with a variety of toxins, and then incubated the cells with two viruses: vaccinia and herpes simplex. Only alpha-toxin increased the amount of virus infecting the cells, compared to a control experiment. Alpha-toxin increased viral load of herpes in the skin cells by threefold, and that of vaccinia tenfold.
This may explain, the authors say, why patients with eczema are much more susceptible in general to viral skin infections than "normal" people. Eczema patients, for whatever reason, host a semi-permanent population of S. aureus, which is pumping out alpha-toxin and opening the door for its viral relatives.
[added later] It's well-known that people with eczema are more likely to develop warts, which are caused by viruses. Maybe if there were a way to neutralize S. aureus alpha-toxin, we could cut down on the number of times we get viral skin outbreaks and warts too.
Thursday, March 8, 2012
Wednesday, March 7, 2012
My daughter is not a smaller version of me. She has asthma
One of the subtle but surprising things I’ve learned as a father is that our children are not little copies of us. Their personality differences shine through from the beginning but become more apparent as they grow up. My son looks like me; he likes dinosaurs and Kraft noodles, as I did; he refuses to learn anything from a teacher, as I did; but he doesn’t “get” Lego, he has no interest in music; he’s got his own opinions, likes, dislikes, and outlook on the world.
Also, he doesn’t have eczema, thank god.
My daughter does, but not as severely as I did. I can see myself in the way she deals with the itch and indignity. My own experience with eczema meant that I knew what it was from the get-go, and I knew what to do to treat it, in the limited way that medicine permits. When my wife doesn’t know what an inflamed patch of skin is, or whether something is infected badly enough that we have to worry about it, I have an answer.
This makes me feel that I am a little bit in control. But here’s the danger: my daughter is developing asthma, which I know nothing about. She hasn’t had a serious attack yet, but when she gets a cold, she wheezes and breathes quickly and shallowly, and the doctors have had us put her on an inhaler—with Albuterol, a bronchodilator, plus a vaporized steroid for more severe incidences.
Because I don’t have asthma (and possibly because I am a dad), I worry less than I should about my daughter’s breathing difficulties. I don’t know what it means. I just assume she’s a small version of me and she’s got a stuffy nose. But she’s not. She’s got a well-defined medical condition that I need to take seriously.
My own father thought of my eczema as something trivial, something I needed to grow up and leave behind. (If only that were possible!) When I was 20, he told me to stop scratching—that adults were able to control themselves. He should have known better, because his own father had had eczema, but he didn’t. He assumed that I was just a younger version of himself who could benefit from some advice.
My daughter is not a smaller, younger me. So I’d better get informed about asthma: how it develops, what causes an attack, what to have on hand. It could be a matter of life or death.
Also, he doesn’t have eczema, thank god.
My daughter does, but not as severely as I did. I can see myself in the way she deals with the itch and indignity. My own experience with eczema meant that I knew what it was from the get-go, and I knew what to do to treat it, in the limited way that medicine permits. When my wife doesn’t know what an inflamed patch of skin is, or whether something is infected badly enough that we have to worry about it, I have an answer.
This makes me feel that I am a little bit in control. But here’s the danger: my daughter is developing asthma, which I know nothing about. She hasn’t had a serious attack yet, but when she gets a cold, she wheezes and breathes quickly and shallowly, and the doctors have had us put her on an inhaler—with Albuterol, a bronchodilator, plus a vaporized steroid for more severe incidences.
Because I don’t have asthma (and possibly because I am a dad), I worry less than I should about my daughter’s breathing difficulties. I don’t know what it means. I just assume she’s a small version of me and she’s got a stuffy nose. But she’s not. She’s got a well-defined medical condition that I need to take seriously.
My own father thought of my eczema as something trivial, something I needed to grow up and leave behind. (If only that were possible!) When I was 20, he told me to stop scratching—that adults were able to control themselves. He should have known better, because his own father had had eczema, but he didn’t. He assumed that I was just a younger version of himself who could benefit from some advice.
My daughter is not a smaller, younger me. So I’d better get informed about asthma: how it develops, what causes an attack, what to have on hand. It could be a matter of life or death.
Friday, March 2, 2012
Why I blog about eczema anonymously
The ability for internet users to be anonymous has made possible a virtual world where courtesy and tact are notably absent. Trolls and flame wars abound; insults and knee-jerk reactions are the norm. To be online as your true identity immediately makes you kinder and more civil. It also makes you more credible.
So why do I write this blog anonymously?
I've been thinking about this and the answer is that I am not ready for eczema to be a part of the public me. Ha, you may say, it already is; it's written on the backs of your hands, the insides of your elbows, the backs of your knees in the eternal cycle of inflammation, sores, scabs, and scratch marks. It's there on your face for all to see in the red, itchy patches you get because of a pollen allergy.
But to see my eczema for yourself, you have to see me in person. And I don't make it easy--I wear long-sleeved shirts and trousers and rarely visit the pool or beach.
These days, however, your personality and public appearance do not consist merely of what you act like and look like on any given day. They're augmented and almost supplanted by your online persona in emails, websites, Twitter, LinkedIn, and Facebook. And you relinquish control to anything you put online. It's immediately recorded and archived and made searchable to everyone for eternity.
Searchable.
Any of my Facebook "friends," any business contact, any future employer, any government agency potentially has the ability to see my entire online personality. (Oh, sure, you think you've put some restrictions on those images and updates, but a sudden glitch can make the private public, as I found out the other day when I Googled myself and saw a photo of my son at one year old--a photo that was supposedly part of a private Picasa archive.)
If you have any degree of internet savvy, you know that you're always curating your own personal brand in anything you put online. You're choosing what to present. And eczema is an unsightly, embarrassing affliction that I choose not to include in my true personal brand at the moment.
Just think: how many celebrities do you know of who have eczema? How many celebrity spokespeople are there? I know of only one: Sasha Vujacic of the LA Lakers. He's adopted eczema as a cause because of a connection with Eric Kageyama, whose son Jarrett suffers from severe eczema.
I think it's a lot easier for parents of children with eczema to go public than it is for adults who have the condition. You're not embarrassed about putting yourself out there for your child. You have little to lose. The adult with eczema, however, has something to lose: social standing. It's unfortunate but there it is. In this way, although one is blameless for being afflicted, having eczema is like being an alcoholic or a sex addict--something you're only ready to reveal to fellow sufferers.
So that's why I blog anonymously.
[added later] I think the same phenomenon prevents many of us from connecting via social media. If you've got an established online personality, you probably don't want other people to know that you're finding tweets or blog posts about eczema interesting--so you don't "like" them or otherwise pass them along, unless you create an avatar, a separate anonymous identity, for yourself.
So why do I write this blog anonymously?
I've been thinking about this and the answer is that I am not ready for eczema to be a part of the public me. Ha, you may say, it already is; it's written on the backs of your hands, the insides of your elbows, the backs of your knees in the eternal cycle of inflammation, sores, scabs, and scratch marks. It's there on your face for all to see in the red, itchy patches you get because of a pollen allergy.
But to see my eczema for yourself, you have to see me in person. And I don't make it easy--I wear long-sleeved shirts and trousers and rarely visit the pool or beach.
These days, however, your personality and public appearance do not consist merely of what you act like and look like on any given day. They're augmented and almost supplanted by your online persona in emails, websites, Twitter, LinkedIn, and Facebook. And you relinquish control to anything you put online. It's immediately recorded and archived and made searchable to everyone for eternity.
Searchable.
Any of my Facebook "friends," any business contact, any future employer, any government agency potentially has the ability to see my entire online personality. (Oh, sure, you think you've put some restrictions on those images and updates, but a sudden glitch can make the private public, as I found out the other day when I Googled myself and saw a photo of my son at one year old--a photo that was supposedly part of a private Picasa archive.)
If you have any degree of internet savvy, you know that you're always curating your own personal brand in anything you put online. You're choosing what to present. And eczema is an unsightly, embarrassing affliction that I choose not to include in my true personal brand at the moment.
Just think: how many celebrities do you know of who have eczema? How many celebrity spokespeople are there? I know of only one: Sasha Vujacic of the LA Lakers. He's adopted eczema as a cause because of a connection with Eric Kageyama, whose son Jarrett suffers from severe eczema.
I think it's a lot easier for parents of children with eczema to go public than it is for adults who have the condition. You're not embarrassed about putting yourself out there for your child. You have little to lose. The adult with eczema, however, has something to lose: social standing. It's unfortunate but there it is. In this way, although one is blameless for being afflicted, having eczema is like being an alcoholic or a sex addict--something you're only ready to reveal to fellow sufferers.
So that's why I blog anonymously.
[added later] I think the same phenomenon prevents many of us from connecting via social media. If you've got an established online personality, you probably don't want other people to know that you're finding tweets or blog posts about eczema interesting--so you don't "like" them or otherwise pass them along, unless you create an avatar, a separate anonymous identity, for yourself.
Monday, February 27, 2012
New path discovered by which vitamin D reduces inflammation
Scientists have identified a new path by which vitamin D reduces inflammation.
According to a group led by Elena Goleva at National Jewish Health Center in Denver, vitamin D binds to a receptor in monocytes, a type of white blood cell. The receptor then binds to DNA in the cells and directs the cells to make more of an enzyme that shuts down inflammatory signaling.
The researchers found that vitamin D at or above a concentration of 30 nanograms per milliliter was enough to do the job. 30 ng/ml is a widely accepted lower limit for vitamin D in blood serum. (I recently had my own vitamin D level assayed and found it was 32 ng/ml.)
The research was published in the Journal of Immunology. [paper] [media summary] The authors say that vitamin D not only is important in maintaining calcium levels and bone health, but also plays an important role in the immune response.
That’s what I’ve found in my reading, although there’s also a lot of people on the internet who would like you to believe that taking vitamin D supplements—sometimes to an extreme degree—is a good idea for your health and in particular for relieving eczema. I remain wary. If vitamin D is so important then you need to maintain a proper level, not overdose yourself. All drugs are toxic when ingested beyond ranges established to be safe in clinical trials.
What I like about this paper is that the authors have gone out of their way to conduct their experiments in an environment that is similar to the human body, as far as concentrations of various substances go (including vitamin D). They also used monocytes taken from human donors instead of cells from some purified, genetically altered strain, as is so often the case with cell biologists dabbling in medical applications. So their results mean something to you and me.
One question that I do have is whether the same kind of inflammation studied here—caused by LPS, a bacterial molecule that triggers an anti-infection response—is at work in chronic eczema. Is there one major inflammatory response, or are there several?
According to a group led by Elena Goleva at National Jewish Health Center in Denver, vitamin D binds to a receptor in monocytes, a type of white blood cell. The receptor then binds to DNA in the cells and directs the cells to make more of an enzyme that shuts down inflammatory signaling.
The researchers found that vitamin D at or above a concentration of 30 nanograms per milliliter was enough to do the job. 30 ng/ml is a widely accepted lower limit for vitamin D in blood serum. (I recently had my own vitamin D level assayed and found it was 32 ng/ml.)
The research was published in the Journal of Immunology. [paper] [media summary] The authors say that vitamin D not only is important in maintaining calcium levels and bone health, but also plays an important role in the immune response.
That’s what I’ve found in my reading, although there’s also a lot of people on the internet who would like you to believe that taking vitamin D supplements—sometimes to an extreme degree—is a good idea for your health and in particular for relieving eczema. I remain wary. If vitamin D is so important then you need to maintain a proper level, not overdose yourself. All drugs are toxic when ingested beyond ranges established to be safe in clinical trials.
What I like about this paper is that the authors have gone out of their way to conduct their experiments in an environment that is similar to the human body, as far as concentrations of various substances go (including vitamin D). They also used monocytes taken from human donors instead of cells from some purified, genetically altered strain, as is so often the case with cell biologists dabbling in medical applications. So their results mean something to you and me.
One question that I do have is whether the same kind of inflammation studied here—caused by LPS, a bacterial molecule that triggers an anti-infection response—is at work in chronic eczema. Is there one major inflammatory response, or are there several?
Thursday, February 23, 2012
Habit reversal works for scalp itching
Training myself in habit-reversal, to replace compulsive scratching with more socially acceptable behavior, has not been easy.
It's hard because you have to be on all the time. You have to intercept those impulses to scratch before the action happens. Of course the goal is to make the behavior automatic, so you don't have to consciously think about it, but you do at the start.
And I fail all the time. I'll just discover my hand doing something it's not supposed to, and I'll have to yank it away. Fortunately the inventors of habit-reversal acknowledge that you'll fail. You just have to try your best.
I haven't quantified the results yet but I do see one significant improvement. I've been able to stop scratching my scalp, especially on the days that I wash my hair with shampoo (tar shampoo, naturally). Just a few weeks ago, my scalp was covered with dry skin and little scabs that I was picking at. It's annoying to feel itchy all the time, and everyone knows how embarrassing dandruff is.
But, in this completely unscientific experiment lacking any sort of control, I observe that I am hardly scratching my head at all any more. To some extent, I have broken the itch-scratch cycle for this specific behavior. And that's great.
However, elsewhere on my body, particularly the backs of my knees, I've got red and inflamed skin from scratching that I haven't brought under control. It's like a different type of itch, although there's certainly a psychological contribution.
My ability to implement habit-reversal is strongest in the morning. Later in the day--especially after I get back from work and the circus of getting the kids through bathtime and into bed begins--the stress mounts and I find myself scratching various places vigorously. (Not the scalp though.) I'd guess that's because whatever part of my brain I need to control scratching is busy thinking about how to keep the kids disciplined instead. Or it could just be that the urge to scratch gets brought on by stress, and there's little more stressful than fighting with your two- and five-year olds to brush their damn teeth and get into the tub and stop trying to drown your sister and stop whining and crying about how she's got your rubber dolphin, etc.
I need some stress-reduction technique--something more powerful than the beer I open after the kids are in bed.
It's hard because you have to be on all the time. You have to intercept those impulses to scratch before the action happens. Of course the goal is to make the behavior automatic, so you don't have to consciously think about it, but you do at the start.
And I fail all the time. I'll just discover my hand doing something it's not supposed to, and I'll have to yank it away. Fortunately the inventors of habit-reversal acknowledge that you'll fail. You just have to try your best.
I haven't quantified the results yet but I do see one significant improvement. I've been able to stop scratching my scalp, especially on the days that I wash my hair with shampoo (tar shampoo, naturally). Just a few weeks ago, my scalp was covered with dry skin and little scabs that I was picking at. It's annoying to feel itchy all the time, and everyone knows how embarrassing dandruff is.
But, in this completely unscientific experiment lacking any sort of control, I observe that I am hardly scratching my head at all any more. To some extent, I have broken the itch-scratch cycle for this specific behavior. And that's great.
However, elsewhere on my body, particularly the backs of my knees, I've got red and inflamed skin from scratching that I haven't brought under control. It's like a different type of itch, although there's certainly a psychological contribution.
My ability to implement habit-reversal is strongest in the morning. Later in the day--especially after I get back from work and the circus of getting the kids through bathtime and into bed begins--the stress mounts and I find myself scratching various places vigorously. (Not the scalp though.) I'd guess that's because whatever part of my brain I need to control scratching is busy thinking about how to keep the kids disciplined instead. Or it could just be that the urge to scratch gets brought on by stress, and there's little more stressful than fighting with your two- and five-year olds to brush their damn teeth and get into the tub and stop trying to drown your sister and stop whining and crying about how she's got your rubber dolphin, etc.
I need some stress-reduction technique--something more powerful than the beer I open after the kids are in bed.
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