UHS Medical Times -September 2016

UHS Medical Times 1

e-newsletter | September 2016

Department of Dermatology

Dr. Atiya Anjum

Dr. Fatma Mostafa

MBBS, Diploma in Dermatology and Venereology (DDV), Diploma in Dermatoscope (UK) Fellow of College of Physicians and Surgeons in Dermatology and Venereology (FCPS ) Bangladesh

MBBCh, MS, MD Doctorate, Laser Specialty

Specialist Dermatologist

Consultant Dermatology

Introduction: The Dermatology department provides consultations for skin, hair fall, baldness, other nail related problems and sexually transmitted diseases.

The department has facilities for all kinds of dermatosurgeries including vitiligo surgery, nail surgeries, acne scar surgeries, hair removal, scar revisions, removal of cysts, skin growths & tumors, microdermabrasions, dermabrasions, electro surgeries, radiofrequency surgeries, cryosurgeries etc, with management of critical dermatological ailments like Steven's Johnsons Syndrome, Scleroderma, Severe drug reactions etc.

It is outďŹ tted with the most modern technical equipment necessary to assist in the diagnosis, analysis and treatment of various skin diseases.

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e-newsletter | September 2016

Dermatology Department Equipment:

Electric Cauterizing machines and Cryo Therapy for the treatment of warts and benign skin tumors and redundancy cuticles Ultraviolet Radiation machines for the treatment of vitiligo and psoriasis

Lasers to remove skin pigments, freckles, acne scars and hair

Machines and surgical instruments that take skin samples for the diagnosis of certain skin diseases Dermabrasion to remove the effects of skin acne

Sensitivity testing devices, which greatly increase the efficiency of doctors Platelet Rich Plasma for Treatment of Hair Fall and Skin Rejuvenation

Skin Rejuvenation, Skin Whitening and Treatment of Skin Pigmentation by Fruit Acid Peeling Treatment of Psoriasis by Advanced Biological Therapy

Advices & Suggestions by Our Doctors On a regular basis, our medical team addresses various issues related with skin problem.

Below mentioned are common issues raised in Dermatology Department:

Dry Skin & Skin Moisturizer Dry skin is a problem that affects a large portion of the population, either occasionally or chronically. A healthy moisturizing routine is the best defense against this affliction. The most effective moisturizing practices center on retaining the skin’s natural oils above all else. Since your skin is the largest organ on your body, make sure you practice good hygiene to keep it healthy.

Moisturizers are complex mixtures of chemical agents specially designed to make the external layers of the skin (epidermis) softer and more pliable. They increase the skin's hydration (water content) by reducing evaporation. Naturally occurring skin lipids and sterols, as well as artificial or natural oils, humectants, emollients, lubricants, etc., may be part of the composition of commercial skin moisturizers.

There are numerous moisturizers on the market that are formulated to treat many different skin types, including normal, dry, oily and sensitive skin. People with normal skin need a light moisturizer that contains natural oils, whereas people with dry skin may require heavier lotions with humectants to lock in moisture.

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e-newsletter | September 2016

For those with oily skin, there are oil-free moisturizers, which won't clog pores. And people with sensitive skin should look for moisturizers that are fragrance-free and contain few ingredients.

However, avoid moisturizing your face with the lotion you use on your body -- this could cause skin irritation or breakouts. For example, the oil-based lotion you use on your knees and elbows could clog pores on delicate facial skin and cause acne.

How To Use Skin Moisturizer ?

You shouldn't apply the moisturizer directly over the skin except after wetting the skin with a little drops of water.

You should use the moisturizer over the skin three times daily especially if the skin is atopic or eczematized or dry, usually after shower immediately and the remaining two times should be after wetting the skin with few drops of water, should be used all over body.

You can use oil once or twice weekly after adding it to warm water in the bathing tub and the person should stay inside the tub for 1-2 hours then, after tumble dry, apply the moisturizer all over.

After 2 weeks when itchiness, dryness or eczema disappear you can use the moisturizer once or twice daily according to severity, continue for 2-3 years especially for patients with severe dryness or atopic or psoriasis or itchthyosis.

If doctor prescribed Topical Cortisone or Pimacrolimus (eg. Elidel cream) or Protopic cream, please don't use it over the body. It should be used over the affected area only.

Usually cortisone is for 3-5 days, Elidel or Protopic is from 10-15 days after cortisone.

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e-newsletter | September 2016

The Effectiveness of Vitamin “C” Vitamin ‘C’ has a great importance in maintaining the skin health and freshness. It is an antioxidant that slows the rate of free-radical damage, which are unstable molecules that damage collagen and cause skin dryness, fine lines and wrinkles.

Dermatologists’ advice to use medicine and products containing Vitamin ‘C’ in large quantities, there are many types in the market in the form of liquid, Capsules, Injections, Gel etc. to use depends on your Dermatologist advice.

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e-newsletter | September 2016

Benefits of Vitamin “C” Sun Protection: Vitamin C protects our skin from free radicals that develop due to excess exposure to the sun, environmental pollution and regular smoking. The antioxidants in Vitamin C protect the skin from ultraviolet radiation and the effect of sunlight exposure.

Vitamin C helps to reduce sun burns caused by the exposure to ultra violet radiation to a great extent. It not only reduces sunburns but also prevents the consequences of long term sun exposure that can lead to skin cancer.

Production Of Collagen: Vitamin C is a required component for the production of hydroxyproline and hydroxylysine, both of which are needed to bind the molecules that produce collagen. This, in turn, firms and tones the skin. Collagen deficiency makes the skin dull and lifeless. Collagen rejuvenates the skin from the roots and reduces wrinkles and symptoms of aging.

Protects Against Skin Discolouration: Vitamin C protects DNA from photochemical reactions that can lead to tumor, skin discolouration and several kinds of skin cancer. It also inhibits the production of Pyrimidine dimers that are the primary cause of melanomas in humans.

It lightens dark discoloration like skin freckles and age spots and helps to get a younger and smoother skin.

Improves Skin Texture: Collagen also provides the structure for the blood vessels. The tiny blood vessels under the skin carry oxygen and nutrients that keep the skin healthy. Without enough nutrients, the skin will become rough and dry. Creams containing Vitamin C improve the appearance and texture of the skin.

Vitamin C increases the formation of elastin which thickens, protects and heals the skin cells. The thickening effect helps retain moisture, increases the skin circulation and plumps up the skin surface.

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Perioral Dermatitis Perioral dermatitis is a common skin rash that mainly affects young women. The rash affects the skin around the mouth. Use of a steroid cream on the face seems to trigger the condition in many cases. Treatment includes stopping the use of all creams and ointments to the face, including cosmetics and topical steroids.

Causes: The exact cause of perioral dermatitis is unknown. It may occur after using face creams containing steroids for another condition.

Young women are most likely to get this condition. This condition is also common in children.

Periorificial dermatitis may be brought on by:

Topical steroids, either when they are applied to the face on purpose or by accident Nasal steroids, steroid inhalers, and oral steroids Cosmetic creams, make-ups and sunscreens Fluorinated toothpaste Failing to wash the face Hormonal changes or oral contraceptives

SPECIAL ANALYSIS UNIT

Symptoms: Symptoms may include: Burning feeling around the mouth Bumps around the mouth that may be filled with fluid or pus A similar rash may appear around the eyes, nose, or forehead

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e-newsletter | September 2016

How To Avoid Dark Discolouration Around Mouth ?

Don't wet the area around mouth by your tongue.

Keep lips always moist every few hours because dry lips compel you to wet them with saliva which lead to inflammation and pigmentation.

Don't allow food or fluid to come in contact in the area around lips.

Don't allow toothpaste to come in contact with the area around mouth.

Use sunscreen every 3 hours.

Don't use perfumes on hands as you might by mistake touch the area around mouth.

Do not use perfume soaps or creams.

Avoid, mango, orange peel or juice to touch the same area.

Don't touch your face with your fingers in general because traces of sweat on your fingers might be irritating.

Hot, sour food and soups should not touch the skin of face area around mouth.

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Treatment of Acne

Use Adapalene / Benzoyl Peroxide only at night (e.g: Epiduo).

Should be used all over the affected area not only on pimples.

Never start on daily basis.

Should be started twice weekly at night then after 2 weeks, start to increase as 3 times weekly at night, then after another 2 weeks increase to 4 times weekly at night and so on till it becomes daily at night.

In case of exaggerated irritation, peeling or inammation stop it and re-consult your doctor.

Oil free sunscreen should be used in the morning and at noon during treatment with Adapalene / Benzoyl Peroxide.

Lastly, patient should bear in mind that acne might improve after a short period of treatment with Adapalene / Benzoyl Peroxide but the problem is that it will probably reoccur again because acne is a chronic disease and so using Adapalene / Benzoyl Peroxide should continue for long periods which might be for years, but still you have to consult with a doctor.

Foods which should be avoided by Acne Patient

All dairy products Hot and spicy food Chocolate Fried food Fast food

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e-newsletter | September 2016

Urticaria Urticaria, is a kind of skin rash with red, raised, itchy bumps. They may also burn or sting.

Often the patches of rash move around. Typically, they last a few days and do not leave any long lasting skin changes. Less than 5% of cases last for more than six weeks. The condition frequently recurs.

Urticaria frequently occur following an infection or as a result of an allergic reaction such as to medication, insect bites, or food. Psychological stress, cold temperature, or vibration may also be a trigger. In half of cases the cause remains unknown. Risk factors include having conditions such as hay fever or asthma. Diagnosis is typically based on the appearance. Patch testing may be useful to determine the allergy.

Urticaria can appear anywhere on the surface of the skin. Whether the trigger is allergic or not, a complex release of inflammatory mediators, including histamine from cutaneous mast cells, results in fluid leakage from superficial blood vessels. Welts may be pinpoint in size, or several inches in diameter.

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Instructions For Urticarial Patients Predisposing Factors Avoid eating these items especially in acute urticaria: Eggs, milk and its Products.

Spicy food, preservative food, beans Fish, Shrimps Cooked tomato, ketchup Banana, mango, Strawberry Chocolate Colored Food Drugs: The most frequent cause of urticaria and angiodema e.g.: Penicillin (may also present in milk and beer), Aspirin, Sulphonamides, NSAI drugs.

Inhalants: e.g. pollen grains, house dust, feathers.

Infections: Focal sepsis in tonsils, teeth pr sinuses or urinary tract infections.

Infestations: Intestinal worms.

Emotional Stress: Especially in cholinergic urticaria.

Medical Disorder: e.g. LE, carcinoma, thyrotoxicosis.

Physical Agent: Heat, cold, trauma, physical urticaria, solar urticaria (Develop in a few minutes and fades within an Hour) Risks After Procedure:

Area may remain numb for 1-2 hours It is normal for the skin around the operation site to look white. The color change is due to local anesthesia; normal color will return after a few hours when the local anesthetic wears off

Avoid blood thinners such as aspirin as it causes bleeding

You (patient) may also notice slight swelling and bruising around the operation site.

This will go down gradually as the area heals

Keep the wound area dry and clean

Avoid getting it wet, if the dressing does get wet do not worry, pat dry rather than rub vigorously If bleeding is heavy, place another dressing on top of the original one and apply ďŹ rm pressure for 10 minutes, if bleeding continues contact doctor

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e-newsletter | September 2016

Team At UHS She completed her Laser training for Erbium Yag, CO2, Nd:YAG, from Amsterdam in the year 1999 and in Dubai in the year 2013.

Dr. Fatma is a speaker for Janssen (Schering-Plough formerly) on biological therapy for Psoriasis treatment.

EXPERIENCE Dr. Fatma is a board-certified dermatologist with special expertise in skin cancer — especially Melanoma. Much of her clinical career has focused on the early detection of Melanoma in high-risk individuals. She also specializes in the treatment of all kind of skin alignment including: Treatment of severe Psoriasis by using Biological therapy Treatment of severe chronic skin diseases which need admission e.g Pemphigous Pemphigoid, Dermatomyositis, Scleroderma and Lupus Erythematosus

Dr. Fatma Mostafa MBBCh, MS, MD Doctorate, Laser Specialty Consultant Dermatology

QUALIFICATIONS Dr. Fatma obtained her Master’s Degree in Dermatology and Venerology from Cairo University, Egypt and later went to complete her doctorate (PhD) in dermatology from the same university.

Excision of skin nevi and swellings using advanced laser technique Diagnosis of chronic allergy by prick and patch test Treatment of resistant chronic Urticaria by autologous serum and IVIG

Dr. Fatma has a number of medical publications to her credit and her articles have also published in international medical journals. Dr. Fatma is a member in MOH for dermatologist evaluation committee since 1999. She is also on the MOH board in medical investigation for Medical malpractice evaluation since 1999.

SPECIAL INTEREST Diagnosis and management of Skin Cancer Prevention and early detection of Melanoma in patients with Dysplastic Nevi; Melanoma Pigmented Skin Lesions Basal/ Squamous Cell Carcinomas Mole mapping and screening Cryotherapy, Electrocautery and lasers for warts, skin tags and mole removal Botox for sweating problems and wrinkles Laser skin resurfacing Phototherapy for Psoriasis and Vitiligo Fillers and mesoglow for facial rejuvenation Laser hair removal Mesotherapy for hair loss

LANGUAGE KNOWN Arabic, English and French

Treatment of acne and warts by laser Dr. Atiya is a fellow of the College of Physicians and Surgeons in Dermatology and Venereology, FCPS Bangladesh.

EXPERIENCE Dr. Atiya is Specialist Dermatologist with 12 years of clinical experience. She worked in different medical institutions in Bangladesh before relocating to UAE in year 2008.

Pediatric Dermatology Sexually Transmitted Diseases LANGUAGE KNOWN Bengali, English, Hindi and Urdru

She has a vast experience in performing aesthetic and dermatological procedures such as cryotherapy, electrocautery, chemical peeling, interlesional injection, mesotherapy, PRP, derma roller and derma pen, patch test, botox and Laser hair removal.

Dr. Atiya Anjum MBBS, Diploma in Dermatology and Venereology (DDV), Diploma in Dermatoscope (UK) Fellow of College of Physicians and Surgeons in Dermatology and Venereology (FCPS ) Bangladesh, Specialist Dermatologist

QUALIFICATIONS Dr. Atiya Anjum, after completing her basic medical education, completed her Diploma in Dermatology and Venereology from Bangladesh and Diploma in Dermatoscope from UK.

Aside from her medical involvement, Dr. Atiya was associated as an assistant professor of Dermatology and Venereology in Taiherunnessa Memorial Medical College (TMMC) in Dhaka, Bangladesh.

She is an active member of the European Society of Aesthetic Surgery (ESLAS) and Bangladesh Dermatological Society.

SPECIAL INTEREST Aesthetic Procedures Cosmetology

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e-newsletter | September 2016

SCOPE OF SERVICES AT UHS MEDICAL SERVICES

SURGICAL SERVICES

CARDIOLOGY

NEUROPHYSIOLOGY

Anesthesiology

Bariatric Surgery

24-Hour BP Monitoring

Electroencephalogram (EEG)

Aviation Medicine

Ears, Nose and Throat Surgery

24-Hour Holter Monitoring

Electromyography (EMG)

Cardiology

General Surgery

2D/3D Echo

Evoked Potential Test

Critical Care

Neurological Surgery

3D Transesophageal Echo

Brain Auditory Evoked Potential

Dermatology

Obstetrics and Gynecologic Surgery

CT coronary Angiography

(BAEP)

Emergency Medicine

Ophthalmic Surgery

Somato Sensory Evoked Potential

Endocrinology

Orthopedic Surgery

Dobutamine Stress Echo for Ischemia and Viability Studies

Family Medicine

Pediatric Surgery

Gastroenterology

Plastic and Reconstructive Surgery

Internal Medicine

Urologic Surgery

Medical Oncology

Vascular Surgery

Neonatology Nephrology Neurology Pediatrics Psychiatry Pulmonology Rheumatology MEDICAL DIAGNOSTICS IMAGING (MDI) 128 Channel CT Scan with Coronary and Cardiac Facility

PATHOLOGY & LABORATORY MEDICINE

Interventional Cardiology Stress Test

(SSEP) Visual Evoked Potential ( VEP) Nerve Conduction Studies (NCS)

Treadmill Stress Test

AUDIOLOGY

OTHER SPECIALTY SERVICES

Biochemistry

Acoustic Reflex Threshold

24/7 Emergency Services

Blood Transfusion Medicine

Auditory Brainstem Response

Ambulance

Cytology

Auditory Steady State Response

Hemodialysis

Hematology

Cochlear Implant Mapping

Physiotherapy

Histology

Electrocochleography

Pharmacy

Immunology

Free Field Audiometry

Sharjah Breast Centre

Microbiology

Hearing Aid Fitting and Programming

Phlebotomy

Newborn Hearing Screening

Bone Densitometry

Otoacoustic Emission

Digital X-Ray and Fluoroscopy

Pure Tone Audiometry (PTA)

Mammography and Guided Breast Intervention

Speech Audiometry

MRI 1.5 TESLA

Tinnitus Evaluation

Ultrasound

Tympanometry

Vascular Interventional Lab

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