Business Insight Presented by Arlington Dermatology Topical vs Systemic There are mostly two kinds of patients presenting to the dermatologic office: patients with skin reactions and skin diseases and patients with diseases expressing through the skin but originating in internal, usually immune system organs and cells. It is crucial to differentiate these two due to the methods of treatment and expected outcomes. The presenting through the skin is a rash. There are as many types of rashes as you can count but most commonly, they are associated with skin reactions to some external or internal triggers. They can be chemicals, new soaps, new laundry detergents, but also some ingredients of products that were consumed, like cleaning chemicals used to clean produce. Once the triggered component is removed, rashes disappear. If, in the meantime, they created local skin inflammation, we use gentle steroids in a form of cream to help skin heal. The healing process is usually short and uncomplicated and itching symptoms go away with rashes. In medical terms, we call these problem contact dermatitis. Topical steroid medication is usually the solution and the problems resolves. Sometimes, the reaction to the chemical factors or consumed product can involve much more than skin. If a patient is allergic to some of the mentioned products, the reactions developed might be much more severe and cause disorder of the whole body. Redness, swelling, oozing lesions, or hives over the entire body usually indicate more than just a skin reaction. Allergies as well as eczemas are linked to the immune system and treating them locally with topical medication will not bring relief. It might help some symptoms like itching or burning but only the systemic medication can resolve the problem that is more internal than skin alone. Oral steroids or steroid injections are usually the best solution, at least for an immediate most common skin disorder which will block overreactive immune reaction. This is of course a big simplification in describing this quite complex mechanism of action but the truth is that immunotherapies are the most targeted treatments and the most natural treatments. Medical science has developed many of immunotherapies, some more well-known are in psoriasis. This does not mean that the targeted therapies with biologics have no effect on the body. Like everything in medicine, patients should be evaluated individually to make sure their risk of utilizing these treatments is minimal in comparison to benefits they will gain as a part of the therapy. Individual assessment of each patient should involve the extend of the disease, severity, influence of the disease on daily life, and many other factors. It is very important for patients to understand the origin of their 'skin' problem. Patients' education in that regards is the best path to establish the most optimal treatment. Patients who do not receive and short term. Systemic steroid medication is not targeted. Thus, it helps with many origins of immune system problems but is not a long-term solution. The key to assist in resolving the immune system skin problems is to identify the actual problem and use the most possible targeted therapy. Targeted systemic therapy is sometimes called immunotherapy. If the disease has an established immune sequencing and it is known which part of the immune system and how it is responsible for that disease, medical science can offer anti-bodies or anti-proteins proper information about their problem tend to over- and under- utilize their treatment and miss the desired outcomes. Asking questions never hurt anyone and might help you gain not only better knowledge but also better treatment results. Michael Bukhalo, MD Arlington Dermatology 5301 Keystone Court Rolling Meadows, IL 60008 Tel. 847 392 5440 | www.arlingtondermatology.net Business Insight Presented by Arlington Dermatology Topical vs Systemic There are mostly two kinds of patients presenting to the dermatologic office: patients with skin reactions and skin diseases and patients with diseases expressing through the skin but originating in internal, usually immune system organs and cells. It is crucial to differentiate these two due to the methods of treatment and expected outcomes. The presenting through the skin is a rash. There are as many types of rashes as you can count but most commonly, they are associated with skin reactions to some external or internal triggers. They can be chemicals, new soaps, new laundry detergents, but also some ingredients of products that were consumed, like cleaning chemicals used to clean produce. Once the triggered component is removed, rashes disappear. If, in the meantime, they created local skin inflammation, we use gentle steroids in a form of cream to help skin heal. The healing process is usually short and uncomplicated and itching symptoms go away with rashes. In medical terms, we call these problem contact dermatitis. Topical steroid medication is usually the solution and the problems resolves. Sometimes, the reaction to the chemical factors or consumed product can involve much more than skin. If a patient is allergic to some of the mentioned products, the reactions developed might be much more severe and cause disorder of the whole body. Redness, swelling, oozing lesions, or hives over the entire body usually indicate more than just a skin reaction. Allergies as well as eczemas are linked to the immune system and treating them locally with topical medication will not bring relief. It might help some symptoms like itching or burning but only the systemic medication can resolve the problem that is more internal than skin alone. Oral steroids or steroid injections are usually the best solution, at least for an immediate most common skin disorder which will block overreactive immune reaction. This is of course a big simplification in describing this quite complex mechanism of action but the truth is that immunotherapies are the most targeted treatments and the most natural treatments. Medical science has developed many of immunotherapies, some more well-known are in psoriasis. This does not mean that the targeted therapies with biologics have no effect on the body. Like everything in medicine, patients should be evaluated individually to make sure their risk of utilizing these treatments is minimal in comparison to benefits they will gain as a part of the therapy. Individual assessment of each patient should involve the extend of the disease, severity, influence of the disease on daily life, and many other factors. It is very important for patients to understand the origin of their 'skin' problem. Patients' education in that regards is the best path to establish the most optimal treatment. Patients who do not receive and short term. Systemic steroid medication is not targeted. Thus, it helps with many origins of immune system problems but is not a long-term solution. The key to assist in resolving the immune system skin problems is to identify the actual problem and use the most possible targeted therapy. Targeted systemic therapy is sometimes called immunotherapy. If the disease has an established immune sequencing and it is known which part of the immune system and how it is responsible for that disease, medical science can offer anti-bodies or anti-proteins proper information about their problem tend to over- and under- utilize their treatment and miss the desired outcomes. Asking questions never hurt anyone and might help you gain not only better knowledge but also better treatment results. Michael Bukhalo, MD Arlington Dermatology 5301 Keystone Court Rolling Meadows, IL 60008 Tel. 847 392 5440 | www.arlingtondermatology.net