This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!) On episode 3 of season 8 (named “Charity Case”), altruist millionaire Benjamin Byrd collapses in the street right after he donated a large sum of money to another foundation. The team argues wether his altruism is a symptom or not, and meanwhile he develops tachycardia (fast heartbeat) and his hands are shaking. When he offers to donate both his kidneys the presence of mental symptoms is obvious, and when understanding that his symptoms got worse after he received contrast media containing iodine, he is diagnosed with Plummer’s Disease. .

Danger level: Low

What is it?

In Plummer’s Disease (also known as Toxic Nodular Goiter), an area in the thyroid gland works with no control, and causes a state called hyperthyroidism – too much thyroid hormone in the blood.

Who gets it?

The disease is responsible for 15-30% of the hyperthyroidism cases. It usually develops in adults older than 50, and is more common in women. The disease is also more common in areas of the world where iodine deficiency is common.

What causes it?

As explained before about another disease which causes hyperthyroidism (Graves Disease), the thyroid gland normally produces thyroid hormone in response to a molecule called TSH that comes from the brain. In Plummer’s disease, an area in the thyroid gland (a nodule) starts producing thyroid hormone independently – without TSH. Such nodules are called toxic nodules – there is also such thing as non-toxic nodules, which don’t produce thyroid hormone or any other substance.

The disease is related to exposure to iodine (which is an important factor in the function of the thyroid gland).

How does it feel?

Plummer’s disease can cause symptoms that are related to hyperthyroidism and symptoms that are related to the presence of the nodules themselves.

• Hyperthyroidism can cause weight loss with increased appetite, frequent bowel movements, tremor, intolerance to heat, heart palpitations and a fast heart beat (tachycardia), hyperactivity and irritability and muscle weakness.
• If the nodule is large enough, you can see an enlargement of the gland called goiter, that looks like this:

This is a very large goiter (very rare today).

• Also, when the nodule is very large, it may compress other organs in the neck and cause problems with breathing and swallowing, and sometimes also hoarseness or voice changes.

How is it discovered?

First, the doctor will want to check if the level of thyroid hormone in the blood is high. This can be done by testing the levels of the hormone itself and also by checking the levels of TSH (which will be low).

Ultrasound of the thyroid gland can help recognize nodules in the thyroid (which look like balls in different sizes), and another test called thyroid scan can differentiate between toxic and non-toxic nodules. Sometimes the doctor will want to take a biopsy from the nodule to make sure that it’s not cancer.

How is it treated?

There are two ways to treat Plummer’s disease – the first one is to remove the toxic nodule in surgery (like on the House episode), and the second is to use radioactive iodine that is injected to the bloodstream, concentrates in the nodule and destroys it.

What happens after treatment?

Treatment usually cures the disease, but even when untreated the disease is usually not life threatening (though it’s not very pleasant to live with).

The bottom line – how do I avoid it?

Most of the time there is no specific way to prevent the disease. People with low levels of iodine in their blood are at risk for the disease, so it’s important to consume enough iodine in the diet. In the United States iodine is added to table salt and other foods so iodine deficiency in the diet is very rare.

Related posts:

1. Graves Disease – Why Some People Are Hyperactive For A Reason
2. Appendicitis – A Small Part of The Intestine That Can Cause Big Trouble
3. Hashimoto’s Thyroiditis – Do You Suffer From Weight Gain, Fatigue or Hair Loss? This Might Just Be The Cause

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)


On episode 18 of season 7, called “The Dig”, a science teacher has symptoms matching Q fever (we’ll cover this disease in the future). The team finds out, while visiting his house, he has been hoarding – keeping almost everything he encountered. Later they also find his wife among those things, and it is found that she’s the hoarder, and also that she and him both have Q fever caused by raccoon scat in the house. After his wife has a heart attack and it’s found out she’d had miscarriages, the team reaches the conclusion that she has Ehler-Danlos Syndrome, which caused miscarriages (and the heart attack), and the hoarding came as a compensation for lost babies. Complicated? We think so too. Out of the 3 diseases mentioned here, we’ll go this time with the most interesting one – Hoarding.

Photo by NBCUniversal

Danger level: Low

What is it?

Hoarding is the excessive collection of possessions, with an inability to get rid of them when they are no longer useful or needed. Some view it as a condition by itself, while others say it’s part of obsessive compulsive disorder (OCD).

Who gets it?

Hoarding usually starts in early adolescence (around age 13) and tends to worsen with age (although cases of people as young as 3 years old (!) have been reported). It tends to affect women more than men.

Since, as you’ll read ahead, hoarders don’t see it as a problem and don’t usually seek help, it’s hard to tell how common the condition is. Still, some suggest the numbers are around 1 in 20 people.

There are some risk factors connected with hoarding, which may raise the risk of developing the condition. They include:

1. Family history – If a close family member is a hoarder.
2. Stress – Some people develop hoarding after a stressful event in their life (as was the case in the House episode, where the woman started hoarding after going through miscarriages).
3. Perfectionism – These people tend to worry about making the right decision about what to do with each possession. They avoid the distress involved in making the decision by just keeping it.
4. Emotional instability – Such as depression or anxiety.
5. Problems processing information – This is something similar to ADHD, when the person has a problem with attention. They find it difficult to concentrate on a task without being distracted by other things. One such task is categorizing their possessions and organizing them.

What causes it?

Studies have found that hoarding may be related to abnormalities in specific brain regions. Describing those is beyond the scope of this article, though.

How does it feel?

Living room of a hoarder. Photo by Shadwwulf

First thing about the problem is collecting too many things. The most common way they do that is by shopping, but they also collect free things. They may also collect things that don’t require acquiring specifically – such as packing material that comes with new purchases.

The second thing is difficulty getting rid of these items. It’s very difficult for them to throw away, sell, give away, or even recycle their items. To most people, most of the things saved may seem worthless or worn-out.

They also find it hard to organize their possessions – they just spend hours moving them from one place to another without any effective result.

The main problem with hoarding is that hoarders usually don’t see it as a problem.

This video is from a reality show on TLC called “Hoarding: Buried Alive”, which depicts the lives of real people as they try to overcome hoarding:

How is it discovered?

Along with experiencing the above mentioned problems, which a psychiatrist can recognize as hoarding, there are also tests (sort of questionnaires) that can help with the diagnosis.

How is it treated?

There are several ways to treat hoarding. Unfortunately medications aren’t usually part of them (although they may help reduce the symptoms). Treatment includes challenging the hoarder’s thoughts and beliefs about the need to keep items, practicing removal of clutter with the help of a clinician or a coach, and other behavioral techniques.

Do you hoard or know of a person that hoards? Let us know in the comments below.

No related posts.

This is a guest post by Dr. Ido Weinberg.  Ido is a Vascular Medicine physician trained in the Massachusetts General Hospital, Harvard Medical School, Boston, MA.  He founded and operates a Vascular Medicine evidence based website – www.angiologist.com.

Danger level: Low

What is it?

Chilblains are lesions of the skin that are most common on the fingers and toes that may appear as a response to cold. These lesions sometimes look like ulcers and are sometimes accompanied by blue toes.  Chilblains are not dangerous, but it is important because it may seem similar to other, more dangerous conditions.

Who gets it?

There are not many descriptions of chilblains in the medical literature. Because of this, it is difficult to say with precision who gets it.  According to one review that summarized the available descriptions chilblains occurred more commonly in lean women.  This does not mean that overweight men cannot have these lesions, though.  Typically chilblains have been described in Western Europe, in countries such as England and France.  However many modern cases have been described in North America.

What causes it?

The exact cause of chilblains is unknown.  Chilblains are related to cold weather. Although severe exposure to cold may result in frostbite, repetitive exposure to above freezing temperature, especially in damp regions, may result in these lesions.

How does it feel?

The lesions of chilblains have several presentations.  The most common presentation for chilblains are raised lesions that seem like small vesicles.  These lesions are painful and come and go, often for years or at least for the cold season.  Other types of lesions are ulcers and blue discoloration of the fingers and toes.  The most common parts of the body that are affected are the fingers and toes but other exposed areas such as the nose and ears may be affected as well.

How is it discovered?

Chilblains are diagnosed by talking to the patient and looking for cold exposure.  Examination will show the typical lesions, most commonly on more than one finger and on both sides. There are no specific laboratory tests that help with the diagnosis.

How is it treated?

Chilblains are treated by time and by avoiding cold.  By the word ‘time’ we mean that these lesions often wax and wain and often disappear over time.  Cold avoidance and protecting extremities from cold are also effective.  Several medications have also been used such as medications that dilate blood vessels, but there is not much proof that they work.

What happens after treatment?

Chilblains often take there course over several weeks to months until they disappear.  The most important aspect of chilblains in making the proper diagnosis.  Since blue toes and lesions on the toes may appear to doctors similar to more dangerous diseases (such as lesions that are caused by pieces of plaque clogging the arteries), if the diagnosis is not made properly, patients may be subject to complex and sometimes invasive procedures that may endanger them.

Seeking the advice of vascular specialists when you have blue lesions on your fingers or toes gives you the best chance for the right diagnosis to be made and for the right treatment to be given, and more importantly, the wrong treatment to be avoided.

Related posts:

1. No Chicken Soup for You. Zinc Is All You Need If You Have A Cold
2. Which Humidifier Should You Get for A Cold
3. Muckle-Wells Syndrome – When Being Cold Gets You Warm (As Seen On House, MD)

Danger level: Low

What is it?

Irritable bowel syndrome (IBS) is a chronic condition of the digestive system causing pain and a change in bowel habits.

Who gets it?

It’s estimated that as much as 10-20% of the population in the US suffer from IBS.

Women are 2-3 times more likely to develop IBS than men in Western countries. In the Indian subcontinent, on the other hand, 70-80% of sufferers are men.

The condition starts before age 35 in about 50% of people.

If you have someone in your close family (parents, siblings) with IBS, you may have a higher chance of developing it yourself.

What causes it?

The reason behind IBS isn’t known yet, although there are many theories.

The symptoms of IBS (which we will discuss next) are caused by changes in our bowel habits. Our intestines move the food we eat along the gastrointestinal tract by contraction and relaxation of muscles in the intestines’ walls.

In IBS, these contractions may be stronger and longer, leading to food passing more quickly than normal in the intestines. This can cause gas, bloating and diarrhea. In other people, contractions may be weaker, causing the stools to stay longer in the intestines, making them hard and dry. This may lead to constipation.

The intestines. For some people, they just don’t work the way they’re supposed to. Photo by Curious Expeditions. 

People with IBS have a sensitivity to certain triggers which other people don’t respond to. For example -

1. Foods: Some foods worsen the symptoms in some IBS patients. Examples of such foods include chocolate, milk and alcohol. Also carbonated beverages and some fruits and vegetables may cause discomfort.
2. Stress: Stressful events may aggravate the symptoms.

How does it feel?

1. Abdominal pain – The pain is usually crampy and located in the lower left abdomen. Sometimes, as mentioned above, stress and eating may worsen the pain. Going to the toilet may relieve the pain.

   
   Abdominal pain is the most common symptom of IBS. Photo by Peter Gerdes.

2. Changes in bowel habits – This can include diarrhea, constipation, or an alternation between the two. The diarrhea usually happens during the daytime, most often in the mornings or after meals. People often feel they just have to run to the toilet, and after emptying they often feel not completely emptied. The constipation can last from days to months.
3. Other symptoms – These can include bloating, gas, belching, heartburn, difficulty swallowing, an early feeling of fullness with eating, and nausea.

How is it discovered?

There are no specific tests which can be done to determine if you have IBS. Instead, there are some criteria, called the Rome 3 diagnostic criteria for IBS, which may help the doctor (and you) determine if you have IBS.

The criteria say that if you have abdominal pain or discomfort that lasts for at least 3 days per month in the last 3 months which are associated with either:

- Improvement with defecation

- It started with a change in bowel frequency

- It started with  a change in the appearance of stools

Then you may have IBS.

IBS isn’t a life threatening disorder, but other diseases that may be life threatening may show up with the same symptoms. This is why the doctor may perform tests to rule out other conditions before deciding you have IBS.

How is it treated?

There is really no cure for IBS, so treatment is usually a long term process. Treatment includes:

1. Monitoring symptoms – This helps to identify which things cause you to feel worse so that you may avoid them. It can be done with a daily diary.
2. Diet changes – Eliminating foods that may worsen your symptoms is part of the treatment. It shouldn’t be done without a doctor’s consultation, though. This may include lowering your daily intake of dairy products, eating less foods that may cause gas, eating foods which may be easier to digest, and increasing your dietary fiber.
3. Psychosocial therapy – Since stress and anxiety may worsen the disease for some people, learning to deal with them may ease the disease.
4. Medications – None of those cure the disease, but may help with the symptoms. Consult your doctor for info about those.

What happens after treatment?

Although IBS can cause substantial physical discomfort and emotional distress, the condition isn’t life threatening. Most people with the condition learn to control their symptoms with time.

The bottom line – How do I avoid it?

There is no known way to prevent IBS, since no one really knows what causes it. If you do have the condition, dealing with stress and eating a proper diet may help to avoid its symptoms.

This video showcases a personal story of IBS, as seen on the Discovery Channel:

Do you suffer from IBS or know someone who does? Share your story in the comments below.

Related posts:

1. Crohn’s Disease – Inflammation in The Intestines Which Can Influence Your Whole Life
2. Asperger Syndrome – A Life of Misunderstandings
3. Peptic Ulcer Disease – Wounds in your stomach and intestines

As reported by The Huffington Post this week, a McDonald’s food handler at a Milan, Illinois, restaurant was carrying the hepatitis A virus, and allegedly exposed up to 10,000 people to the virus. What does this mean for the infected people who ate at the restaurant, and how can you avoid being infected yourself?

Danger level: Low

What is it?

Hepatitis A is a type of virus which can infect your liver.

Who gets it?

The hepatitis A virus is found in the stool of an infected person. When someone eats food or drinks beverages that came in contact with the infected stool, they can get infected themselves. How can the foods come in contact with the stool? If, for example, a restaurant employee is infected and doesn’t wash his or her hands well after visiting the bathroom. When that employee goes on to prepare food, anyone eating that food is in danger of getting infected themselves.

Eating raw oysters or undercooked clams may also raise your risk of infection, if these shellfish came from water polluted with sewage.

The disease can also be transferred if you come in close contact with an infected person. This includes having sex with the person or sharing needles with them.

What causes it?

As mentioned above, the hepatitis a virus causes the disease.

A group of hepatitis A viruses, as seen under a microscope.

This virus attacks our liver. Our liver is responsible for many functions in our body, including processing nutrients absorbed in the intestines, removing drugs and alcohol from the blood, and manufacturing bile (which helps us digest fats).

How does it feel?

The symptoms don’t come right after the infection. Rather, the virus starts replicating in the body, and only after 2-7 weeks do you start feeling its presence. The symptoms usually last for about 2 months, and can include:

1. Feeling tired
2. Nausea, vomiting, diarrhea or appetite loss
3. Losing weight
4. Abdominal pain (usually located in the right upper abdomen, where the liver is)
5. Fever
6. Jaundice (yellowing of the skin or of the whites of the eyes) and a dark urine
7. Itching
8. Muscle pain

How is it discovered?

Blood tests can discover if you have been infected with the virus recently.

How is it treated?

Usually the infection goes away on its own, and you get well within a few months. People with hepatitis A usually need rest, and also need to eat well, while avoiding alcohol and fatty foods.

What happens after treatment?

There is more than one type of hepatitis virus. This article deals with hepatitis A, but there are also B, C, D, and E viruses. Unlike the other hepatitis viruses, hepatitis A usually goes away after you recover from the disease, while most of the others may stay for good in your body.

1. Follow safety precautions for international travelers – While the McDonald’s case this week shows that no place is absolutely safe, hepatitis A is more common in developing countries, where sanitation isn’t advanced. You can see which areas are high risk in the map below. When traveling to such areas, it’s recommended that you peel and wash all your fresh fruits and vegetables yourself and avoid raw or undercooked meat and fish. Drink bottled water (or boil tap water for at least 10 minutes if no bottled water is available) and avoid ice cubes in beverages.  This also applies to the water you use for tooth brushing.
   You should be careful when visiting countries marked in red or orange. Map by PhilippN.
2. Get vaccinated – There is a vaccination against hepatitis A. According to the Centers for Disease Control and Prevention (CDC), it’s recommended for the following people:
   a. All children at age 1 year
   b. Travelers to countries that have high rates of hepatitis A
   c. Men who have sexual contact with other men
   d. Users of injection and non-injection illegal drugs
   e. People with chronic (lifelong) liver diseases, such as hepatitis B or hepatitis C
   f. People who are treated with clotting-factor concentrates
   g. People who work with hepatitis A infected animals or in a hepatitis A research laboratory

On a final note, the McDonald’s case  wasn’t the first one, and probably will not be the last. The following video shows the scare following a similar case at a P.F. Changs restaurant in West Chester, back in April 2008:

Related posts:

1. In The News – Swine Flu (Influenza) – All You Wanted To Know
2. Necrotizing Fasciitis (Flesh Eating Bacteria) – Are You At Risk, and How Can You Avoid It
3. In The News – Plague – The Next Swine Flu?

About 90% of headaches are caused by one of three conditions: migraines, cluster headaches and tension headaches. Today we’ll cover the last one.

Danger level: Low

What is it?

Tension headaches (or tension-type headaches) are the most common cause of headaches.

Who gets it?

Tension headaches can happen at any age, but it happens mostly in young adults.

About 30-80% of the adult US population suffers from tension headaches from time to time. It happens twice as much in women.

What causes it?

The exact cause isn’t known. One of the theories behind tension headaches is that the pain is the result of muscle tension in the face, neck and scalp. Yet this hasn’t been proven. Other evidence shows that there is a change in chemicals in our brain which causes this type of headache.

Whatever the cause may be, there are certain triggers, or things which are believed to bring about the headache:

1. Stress – Such as problems at home or with family, around exam time, deadlines at work, etc.
2. Depression and anxiety
3. Not enough rest
4. Poor posture
5. Working in awkward positions or holding one position for a long time
6. Jaw clenching

Stress. It can bring about tension headaches. Photo by vidrio.

How does it feel?

The pain in tension headache is usually mild to moderate. It feels like pressure or tightness around both sides of the head or neck (people will say it feels like a vice). The muscles in the head, neck or shoulders may feel tender.

The pain is usually steady, and activity doesn’t make it worse. It lasts for anything from 30 minutes to several days. It typically starts several hours after waking and worsens as the day progresses.

Unlike migraine headaches, tension headaches usually don’t involve nausea or vomiting, sensitivity to light and sounds or auras (you can read our article about migraine headaches to see what aura means).

Tension headaches can be divided into three categories, according to how often they occur:

1. Infrequent episodic – When it happens less than once per month
2. Frequent episodic – When it occurs 1-14 times per month
3. Chronic – When it happens 15 days or more in a month

Usually people can go on with their daily routine in spite of the headache.

How is it discovered?

The story and physical check are usually enough to diagnose tension headaches, and no special tests are needed.

If the doctor suspects another cause, they may order other tests (such as a CT scan) to rule out other problems.

How is it treated?

A lot of people will just take over-the-counter painkillers for their tension headaches. This can be a problem, since taking too much of those can cause headaches by itself. (these headaches are then called “medication-overuse headaches”).

There are a couple of drugs which can be used against tension headaches:

1. Anti inflammatory drugs – These drugs can both take down inflammation and relieve pain. They are the first drugs used for tension headaches. Examples of such drugs include aspirin, ibuprofen, naproxen, indomethacin, and ketorlac. Acetaminophen may also help. Most of these drugs are over-the-counter drugs (OTC. meaning you don’t need a prescription for them). If OTC drugs don’t work, your doctor may write a prescription for something stronger.
2. Behavioral and psychological interventions – Sometimes relaxation and stress management can help, especially when combined with drugs.

What happens after treatment?

Usually treatment provides relief from the headaches. As long as not too much of the medications is taken (which may cause headaches by itself) they can be controlled.

If you tend to get tension headaches, there are medications which can be taken to prevent these headaches from occurring. These include drugs like antidepressants (those usually used to treat depression), blood pressure medications, and anti-seizure medications. You should consult your doctor about these drugs.

Another option is to deal with the stressors in your life that may bring about these headaches in the first place.

This video sums it up:

Related posts:

1. The Connection Between Exercise and Headache
2. Living With Fibromyalgia [Personal Story]

Danger level: Low

What is it?

Migraine headaches are the second most common  type of headache. It affects many people, causing periods of pain and sometimes debilitation.

Who gets it?

More than 23 million people in the United States alone suffer from migraine headaches. They usually affect women more than men (about 75% of the people who experience migraines are women).

What causes it?

The mechanism behind migraines isn’t completely understood. There are a few theories:

1. It might be related to blood vessels in the brain – One theory says that they constrict (for unknown reasons) and then dilate too much, with the dilatation causing the pain.
2. There might be a depression of the activity of neurons in certain parts of the brain, leading to inflammation of the area.
3. It might be related to a substance called serotonin, which causes the change in blood vessels mentioned above.

There are other theories, but the bottom line is the same – no one really knows.

How does it feel?

It’s important to distinguish migraine headaches from other types of headache, since other types may be life threatening, while migraine headaches are usually a benign condition.

Migraines. They suck. Photo by annia316

Migraine headaches come in the form of attacks – this means that between attacks you don’t feel anything. These attacks usually occur in the morning, but can happen at anytime. These are the symptoms that usually come with it:

1. Pain – It usually begins gradually and intensifies over the course of minutes to hours. It also resolves gradually. The pain usually lasts a few hours, but it can last up to 3 days. It can be dull and deep, or it can be throbbing or pulsatile (meaning you’ll feel it “knocking” in your head). In most cases it affects only one side of the head There are things that classically make migraine headaches worse:
   a. Exposure to light – People prefer being in a dark, quiet place white experiencing an attack.
   b. Moving the head rapidly, such as in sneezing.
   c. Noise
2. Aura – This is a visual phenomenon that usually comes before the headache begins. It lasts for up to 60 minutes. These are things you “see” before the headache, and include things like flashing lights or bright spots, zigzag lines.
   An aura doesn’t have to be visual – people can have a feeling of “pins-and-needles” in their hands and arms, or alongside the mouth and nose. They can also smell or hear things that aren’t there or have other neurological symptoms.
   Example of a visual aura in a migraine attack.
3. Nausea and vomiting – Are common in migraine attacks.
4. Other things – Other things that might accompany a migraine attack include a runny nose and tears.

1. If the headache start suddenly and is very severe
2. If the headache is persisting beyond 72 hours
3. If the headache first  appears in life after the age of 55
4. If the headache appears after an injury to the head
5. If there is also a stiff neck, fever or a rash
6. Headaches that wake you up at night
7. If the headache involves weakness, dizziness, loss of balance or falling, paralysis, problems speaking, confusion, seizures, inappropriate behavior, double vision

In any of these cases, seek medical care immediately.

Usually no special lab tests are needed. Usually it’s enough for the doctor to hear the description of a headache that contains an aura, comes in attacks, lasts for up to 72 hours and involves vomiting, to know that this is a case of a migraine headache.

If the doctor suspects a different problem, they might run some tests.

How is it treated?

Treatment can be given at the time of the attack or beforehand, to prevent it.

1. Treating the attack itself – This is best if done at the first sign of the attack (when the aura appears or when the pain just starts). The treatment includes a few types of drugs:
   a. Pain medications – Such as aspirin, Advil and others.
   b. Drugs that stop the vomiting
   c. Triptans – This is a special type of drug that was specially created to treat migraine headaches. Examples include Imitrex, Zomig, Amerge, Maxalt, Axert, Relpax or Frova.
2. Treatments to prevent an attack from coming – There are many types of drug here, that usually take 3-4 weeks of taking them to see the benefits. Consult your doctor about these (they are not included here because of a lot of medical mumbo-jumbo that’s needed to explain how they work).

What happens after treatment?

Most people can bring their attacks under control by using the above mentioned drugs and by avoiding triggers (see ahead), although some people with severe migraines don’t respond well to drugs.

There are some things thought to bring about a migraine attack in people susceptible to it. These are called triggers. Avoiding them can help avoid the attack. They include:

1. Chocolate
2. Red wine
3. Cheese
4. Monosodium glutamate (a type of food additive, found frequently in Chinese food)
5. Aspartame (Nutrasweet)
6. Caffeine
7. Nuts
8. Strong odors, flickering lights or a strong light, noise
9. Not eating
10. Poor sleep habits
11. Sometimes the monthly period, or replacement hormones

There are also other triggers. The important point is to find out which trigger causes your migraine, and to avoid it if possible.

Do you suffer from migraines or know someone who does? Share in the comments.

Related posts:

1. Cluster Headaches – Excruciating Attacks of Headaches
2. Aortic Dissection – A Life Threatening Tear in Your Aorta
3. Tension Headache – The Toll We Pay for a Stressful Living

Danger level: low

What is it?

Vitiligo is a disease in which there are patches of white skin. 

Who gets it?

It happens to 1-2% of people worldwide. About 30% of those have a family member with the disease.

Vitiligo usually appears in the ages 10-30.

What causes it?

As mentioned in the melanoma article, our skin is composed of layers of cells. Melanocytes is the name of one type of cells in our skin, and they are responsible for creating a pigment, or color material, which gives our skin color and which is also responsible for the color we get when we tan.

For unknown reasons, in vitiligo the melanocytes are destroyed. This might be related to an autoimmune process, meaning that the body’s immune system attacks the body instead of intruders. In this case it attacks the melanocytes. (We have talked about other autoimmune diseases here before, like lupus and Graves disease).

How does it feel?

It looks like white patches on the skin. It can range from one or two patches to areas covering a large part of the body. It’s most remarkable in people with dark skin (in fact, Michael Jackson claims his white skin is a result of vitiligo. Also, Lee Thomas, an anchor for Fox confessed in 2007 to having vitiligo).

A hand of a woman with vitiligo (Photo by Produnis).

These patches can grow, shrink or not change at all. They usually appear in a symmetrical way, on both sides of the body.

Maybe the main problem is the psychological affect it can have on patients, especially in dark skinned people.

How is it discovered?

Usually the looks of the skin are enough for the doctor to know it’s vitiligo. Sometimes, to make sure, the doctor might perform a biopsy (cut a small piece) of the skin or look at the skin under a special lamp called a “Wood’s lamp”.

How is it treated?

There is no cure for vitiligo: there are treatments that might help with the skin appearance, but the underlying process in the body will still happen. In some cases, the color may return by itself.

Treatments that can be tried include steroid creams, drugs that weaken the immune system (which, as said above, attacks the body here), or simply applying makeup to darken the area.

Exposure to UV light (same as the light produced by the sun) in a doctor’s office can cause the melanocytes not destroyed to produce the pigment and can help.

Skin grafting can also be used if areas of skin don’t respond to the above treatments (even melanocytes alone have been implanted successfully). Another option is skin bleaching, in order to give the skin an even color throughout (this is irreversible).

What happens after treatment?

Like mentioned here, there is no cure for vitiligo. While in some patients the color may return by itself, the process in most people is still there.

Unfortunately, there is no known way to prevent vitiligo.

Related posts:

1. In The News – Michael Jackson – What is A Sudden Cardiac Arrest?
2. Following Michael Douglas – Oropharyngeal Cancer – What Is It and How Can You Protect Yourself?
3. As Seen on Grey’s Anatomy – Melanoma – You Can Avoid It if It’s Found on Time

Danger Level: Low

What is it?

Osgood-Schlatter is a disease that causes inflammation and pain in the knee.

Who gets it?

Children who are physically active, around the ages of 10-15 (especially in sports). It used to be more common in boys for that reason, but as girls are more active in sports, they also get the disease.

It usually happens at a period when the child has a growth spurt – the time when bones are lengthening fast.

What causes it?

The muscles in the front of our thighs are called the quadriceps. They are attached to the bones in our knees by a tendon called the patellar tendon. When there is a growth spurt, the repeated pulling that happens on the tendon when doing sports causes stress on the knee bones.

This causes tiny fractures in the bone and an inflammation, which causes the bone to swell.

How does it feel?

The knee hurts during activities, and is swollen and sensitive to touch. The pain eases when you rest and gets worse during activities.

How is it discovered?

Usually the story and looks of the knee are enough. Sometimes, when not certain, the doctor will take an x-ray picture of the knee, which will show that the knee bone is enlarged or has broken into fragments. Here’s an example:

The arrow in red shows the consequence of the disease (Photo by Lucien Monfils)

How is it treated?

The treatment consists of rest and things that lessen the pain, such as ice packs or drugs that relieve pain or inflammation.

What happens after treatment?

Usually within a few months the disease goes away.

Obviously, if you don’t participate in sports your chances of getting Osgood-Schlatter are much lower. But, as you can see in the danger level above, and in the fact that this condition usually goes away by itself, it is not recommended to refrain from sports.

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1. Kawasaki Disease – A Childhood Disease That Can Endanger The Heart