Dr. Noorali Bharwani

July 26, 2011March 12, 2017

Skin Blemishes of Breast

(click to enlarge)

Skin lesions and blemishes are very common. Most of them are benign and have no malignant potential. But some can be malignant or potentially malignant. Some areas of the body are easy to examine but other parts of the body are not clearly visible. One such area is lower part of a woman’s breast.

Many women are very particular in doing breast self-examination but forget to do visual inspection of the nipples, areola and under surface of the breasts where moles can be missed.

Moles that are of medical concern are those that look different than other existing moles or those that first appear after age 20. If you notice changes in a mole’s colour, height, size or shape, you should have these moles checked. If the moles bleed, ooze, itch, appear scaly or become tender or painful then it is time to have them removed and checked for cancer.

The following ABCDEs are important signs of moles that could be cancerous:

Asymmetry – one half of the mole does not match the other half.

Border – the border or edges of the mole are ragged, blurred or irregular.

Colour – the colour of the mole is not the same throughout or has shades of tan, brown, black, blue, white or red.

Diameter – the diameter of a mole is six millimetres or larger.

Evolution – moles which have changed over a period of time.

Remember, there is a forecast for a sizzling summer this year. So, we should continue to remind ourselves to protect the rest of the body from sunburn. Use of sunscreen is one way to do it. There is a lot of misconception about what kind of sunscreen to use and how to apply.

Sun Protection Factor (SPF) 30 provides 30 times greater sun protection than unprotected skin when exposed to damaging sun’s ultraviolet B (UVB) rays. This does not mean you can stay in the sun for 30 hours without burning yourself. Sunscreen should be applied liberally and often depending on how much you sweat and how wet you are. Make sure the sunscreen blocks UVB and UVA. Higher SPF provides better protection. Wear protective clothings, wide brimmed hat, sunglasses which block both ultraviolet rays.

The best protection against sun’s damaging rays is to stay away from the sun and take your vitamin D regularly. I guess that is too much to ask, especially when our summers are so short. So enjoy the sun but be sun smart.

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July 12, 2011March 12, 2017

Have you checked your toenails lately?

Now that summer is here, people from all walks of life have given up on shoes and socks. Sandals, flip flops or bare feet, yes people walking bare feet, is the norm. Now look at your feet then look at your toenails. Are they full of calluses, plantar warts, ingrown toenails and/or totally deformed nails due to fungal infection?

Wow, that sounds horrific. None the less not life threatening. So, you will live long enough to fiddle fuddle with your toenails, with nail clippers and all sorts of sharp instruments people use to fix the problem themselves until they end up getting infection. And if you are a diabetic then gangrene and amputation may be the end point.

Wow again! But don’t panic. If this is getting scary then get a glass of wine (will keep your heart and feet warm), relax and read. Just pay attention to your feet and toes and toenails and you won’t lose your foot.

Nails protect the tips of our fingers and toes. Two most common problems I see with toenails are ingrown toenails and fungal infection.

Ingrown toenail of the big toe usually occurs when sweaty feet are encased in tight shoes. The situation gets worse when the nail is trimmed short and the corners are curved down. The side of the nail curls inwards and grows to form outer spikes. This causes painful infection of the overhanging nail fold.

Ingrown toenails can be prevented by keeping feet nice and clean. Wear roomy shoes and clean cotton socks. Allow the outer corners of the nail to grow over the skin margins placing small piece of cotton soaked in an antiseptic just under the outer corners of the nail. Cut the nails straight. Antibiotics will help relieve acute infection but will not cure the primary problem. Eventually, surgical procedure done in the office under local anaesthetic becomes necessary.

Fungal infection of the nails is common as well. It affects toenails more than finger nails. The nail is thickened and discolored. It is usually yellowish. The nail may grow in a twisted manner. The infection is picked up in a public place where it is transmitted from person to person. Poor feet hygiene does not help.

Fungus infection is best treated with anti-fungal therapy orally and locally for three months. Cure rate is around 80 percent. Ongoing meticulous foot care is very important to prevent recurrence. If they are thick, stubborn, deformed, ugly and painful then surgery is required.

If you love your feet and toenails then keep your feet clean and shiny…yes you can do it.

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