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Xanthoma
Definition:
A xanthoma is a yellowish nodule or swelling under the skin resulting from deposits of fat. They are soft to touch, with a smooth surface and well defined margins. They can occur anywhere on the body, most commonly on the elbows, joints, tendons, knees, hands, feet, or buttocks. In the middle aged or elderly, they may appear as clusters of tiny nodules around the eyelids, and are then called "xanthelasma".
Who is at risk?
- People with raised cholesterol levels;
- Patients with familial lipid disorders (Meaning: disorders indicated by high cholesterol or triglyceride levels);
- Patients with diabetes mellitus or certain liver diseases such as biliary cirrhosis (Meaning: a liver disease that slowly destroys the bile ducts in the liver).
Symptoms:
Apart from the swellings, there is no other symptom. They are neither painful nor itchy.
Treatment:
The swellings, when unsightly or obstructive, may be treated surgically, but there is a tendency to reappear, especially if the underlying disorder is not treated, therefore treatment should be targeted towards the underlying disorders.
Those with abnormal blood lipid levels are also at risk of having fatty plaque blocking their coronary arteries and arteries to the brain, making them prone to heart attacks and strokes. These patients may need to take daily medicine to help control their blood lipid levels.
Prevention:
- Have your blood lipid levels checked at intervals (say at least once a year).
- Eat a diet low in animal fat and cholesterol.
- Do regular exercises.
- Diabetic patients should take care to control their blood sugar levels.
Xerostomia (Dry Mouth)
Definition:
Xerostomia is the medical term for a dry mouth due to a lack of saliva. Xerostomia is not a disease but can be a symptom of certain diseases, such as Sjogren's syndrome (meaning: an autoimmune disease caused by inflammation in the glands of the body, characterized by the abnormal production of extra antibodies in the blood that are directed against various tissues of the body), or poorly controlled diabetes, or Eaton-Lambert syndrome (meaning: bodily conditions characterized by muscular weaknesses). Xerostomia is often a contributing factor for both minor and serious health problems. It can affect nutrition and dental, as well as psychological, health. Some common problems associated with xerostomia include a constant sore throat, burning sensation, difficulty speaking and swallowing, hoarseness and/or dry nasal passages. If left untreated, xerostomia decreases the oral pH and significantly increases the development of plaque and dental cavities, and gum diseases. Oral candidiasis is one of the most common oral infections seen in association with xerostomia.
Who is at risk?
Xerostomia is a frequent complaint in the elderly, especially women. Hundreds of medications can cause xerostomia, such as antihypertensives, antihistamines, antidepressants, analgesics, tranquilizers and diuretics.
Other causes of insufficient saliva include the side effects of drugs, medications, or alcohol, trauma to the salivary glands or their ducts or nerves, dehydration, excessive mouth breathing, or previous radiation therapy.
Xerostomia is a frequent side effect of cancer therapy. Chemotherapeutic drugs can change the flow and composition of the saliva. Radiation treatment that is focused on or near the salivary gland can temporarily or permanently damage the salivary glands.
Xerostomia can be an early sign of Sjogren's syndrome - an autoimmune disease that causes xerostomia and dry eyes. Other chronic illness such as bone marrow transplants, endocrine disorders, stress, anxiety, depression, and nutritional deficiencies may cause xerostomia.
Trauma to the head and neck area or surgery around the region can damage the nerves that supply sensation to the mouth, resulting in xerostomia.
Symptoms:
Individuals with xerostomia often complain of problems with eating, speaking, swallowing and wearing dentures. Dry, crumbly foods, such as cereals and crackers, may be particularly difficult to chew and swallow.
Denture wearers may have problems with denture retention, denture sores and the tongue sticking to the palate.
Patients with xerostomia often complain of taste disorders, a painful tongue and an increased need to drink water, especially at night.
As the protective effect of saliva is no longer present, xerostomia can lead to markedly increased dentalcavities, parotid gland enlargement, inflammation and fissuring of the lips, inflammation or ulcers of the tongue and buccal mucosa, oral candidiasis, salivary gland infection, halitosis (a medical term for bad breath) and cracking and fissuring of the oral mucosa.
Treatment:
Treatment involves finding any correctable causes and fixing those if possible. In many cases it is not possible to correct the xerostomia itself, and treatment focuses on relieving the symptoms and preventing cavities.
Patients with xerostomia should avoid the use of decongestants and antihistamines, and pay careful attention to oral hygiene. Sipping sugarless fluids frequently, chewing xylitol-containing gum, and using a carboxymethylcellulose saliva substitute as a mouthwash may help.
A cold air humidifier may aid mouth breathers who typically have their worst symptoms at night.
Artificial saliva or saliva substitutes are available commercially and can be used to replace moisture and lubricate the mouth.
Drugs such as Pilocarpine may stimulate residual-functioning salivary glands in Sjogren's syndrome or after radiotherapy for cancer of the head and neck.
Prevention:
Tobacco and alcohol intake should be eliminated as these tend to aggravate xerostomia. Patients should also avoid irritating foods that are dry, spicy, astringent or excessively hot or cold. They should avoid sugary or acidic foods or beverages.
The elderly are particularly prone to xerostomia. Dentures should not be worn during sleep and should be kept clean by overnight soaking. Acrylic appliances should be soaked in a sodium hypochlorite solution, and metal dentures should be soaked in chlorhexidine. Products containing sodium lauryl sulfate should be avoided as they may contribute to the formation of aphthous ulcers or canker sores.
Patients should take meticulous care to oral hygiene and brush and floss their teeth at least twice daily. Plaque removal and treatment of gingival infections or inflammation and dental caries are essential.
