Dr. ABBAS 

Abnormal Skin coloration

Q. I have developed abnormal pigmentation on my body. I am so disturbed about it and would like your help. Can you let me know about it?

Worried Reader, DSM.

A. You have not mentioned your age, gender or part of the body which is effected. Change in skin normal skin coloration can be caused by deficient or excess pigmentation, but the term also includes localized conditions. There are various diseases with pigment disorders as a symptom, such as hereditary conditions like albinism, phenylketonuria, etc. Infection such as leprosy can also cause such disorders; here pigment loss is related to nerve failure. Fungal infection such as pityriasis versicolor or over exposure to radiation can also cause a pale patch, a possible form of skin cancer. A local pigment excess may be a birthmark or naevus. Excess pigmentation can occur in pregnancy (chloasma) or by an oral contraceptive or be caused by a melanoma. Post-inflammatory conditions like eczema, psoriasis, sarcoidosis, etc can all cause disturbances in pigment. Other causes are vitiligo, due to drug application or some medication when taken orally for hypopituitarism, Addison’s disease, Cushing syndrome, etc. Even when the underlying condition is treated, pigmentation may well not return to normal; redistribution of pigment is a lengthy process.
 

Allergy

Q. I am 23 years old and have been suffering from several allergies to things. Can you tell us briefly about allergy?

 Concern Reader, DSM.

A. It is variation in the normal immune reaction. Immune reactions normally occur when a harmful substance enters the body; antibodies are formed in the blood, which render the foreign substances harmless and clear them away. Some people develop the same reactions against which antibodies are formed on the first contact, without perceptible reaction, usually becoming more violent on each renewed contact. Examples of harmless substances that can cause allergic reaction are household dust, grass pollen, fur and feathers, food, medicines or insect bites. The cause of allergies is generally not known, it is possible that heredity is involved, because allergies often occur more frequently within a family. The complaint is frequent; roughly 1 person in 10 is allergic to something. Allergic reactions are often the partial cause of asthma attack. An asthma sufferer can be allergic to house dust, smoke, cat or guinea pig hairs etc, and when they come into contact with them, antibodies are formed causing narrowing of the air passage and thus an attack. Allergic reactions are however not the only factors which can cause asthma attacks. If it can be established to which substances the patient is allergic then his environment can be kept as free of them as possible. It is only sensible to part with a pet if it can be shown that a sufferer is allergic to the hair or flakes of skin of that animal. Allergic reaction to foods, medicines or insects bites is a more general one affecting the whole body and causing red itchy skin eruptions and can be so serious that it can lead to serious reaction and can be dangerous. The first treatment of allergy is avoiding as much as possible substance to which one is allergic, but if a reaction occurs it can blocked by medication, for example with anti-histamines or steroids. One can also attempt to desensitize patients by repeated injections of small quantities of the substance concerned, to discourage formation of antibodies.

Sex & Intimacy
Q. My wife is not interested in the little things that make up intimacy, like holding hands, a special night out, or just talking about couple stuff. It’s like living with a roommate, but it’s becoming more like living with a cellmate. I tried explaining what’s missing and asked for more kissing, touching, talking, and special nights. She told me that she simply cannot do it. I think she loves me, but it does not feel like it. What should I do?

Concerned Reader, Bukoba.

A.You do not say whether this is a recent change in her behavior. Remember that she agreed to marry you. Even if she’s never been able to show signs of affection, perhaps she does love you. She might become more open with therapy, but there’s no guarantee of that. If this is a change in the way she conducts herself, then something must have happened to prompt her new behavior. Either she is angry with you for some reason, or there is some outside factor. Perhaps she’s even fallen in love with somebody else. Since she won’t talk to you about it, perhaps what you need is professional help. If she won’t go, then you should go on your own. While it will be difficult to resolve the problem without her, sometimes going to your doctor shows a partner how serious an issue really is and this may convince her to go for help too