Dear Drs. Donohue and Roach: I am covered with bruises. It looks like I've been in a ring doing mixed martial arts. I haven't. I haven't bumped myself. I do my best to cover them up, but I wonder what's up. Do you have any idea? I don't feel sick. I'm 27, and never have had a major illness.
Easy bruising in an older person comes mostly from loss of protection of tissues that cushion blood vessels.
In a younger person, one your age, more serious illnesses have to be considered. One of those illnesses is immune thrombocytopenic purpura, ITP, formerly called idiopathic thrombocytopenic purpura. The name change comes about because the cause of this illness wasn't known. Therefore, it was called "idiopathic" - cause unknown. Now it's known to result from an immune attack on platelets.
Platelets are the smallest blood cells, whose function is to seal broken blood vessels with a clot. The immune system has attacked blood platelets and diminished their numbers. It also decreases platelet production. "Thrombocytopenia" expresses in one word "platelet deficiency." "Purpura" means "bruises."
In children, ITP comes on suddenly and most often cures itself.
In adults, ITP tends to follow a more chronic course, with periods of sufficient platelets alternating with periods of defective supply.
For you, the important thing is to see a doctor right away. Your platelet count will determine what the next step will be.
If your count is above 30,000, observation is the usual course of action. If the count is much less than that, treatment is initiated. And if the count is between 5,000 and 10,000, treatment is urgent.
High doses of the cortisone drug prednisone are the usual treatment. Sometimes it's combined with immunoglobulin.
If neither approach restores platelet numbers, the doctor has to turn to other treatments. Removal of the spleen is one of those other treatments. The spleen gobbles platelets.
Dear Drs. Donohue and Roach: Upon coming out of the shower, I happened to turn my head and saw my back in the mirror. There are about four or five dark-brown to tan blemishes on it. My immediate though was melanoma. I made an appointment with a dermatologist immediately.
The doctor said that these blotches are not melanoma, but are seborrheic keratoses.
I was relieved, but forgot to ask if seborrheic keratoses can turn into cancer. I don't want to call that doctor again. Will you please tell me?
Seborrheic keratoses make their appearance after age 50. They're not cancerous and don't become cancer. They're various shades of brown, are about half an inch in diameter and have a rough, warty surface. The back, chest, upper arms and face are the places where they're usually found.
You can have them removed if you wish, but it's not necessary. A doctor can freeze them off or scrape them off.
Dear Drs. Donohue and Roach: Does overuse of sunglasses affect the vision? How about in the future? My teenage daughter wears hers constantly, inside the house too. I asked her why, and she said she likes the look. She thinks they make her look mature.
Constant wearing of sunglasses doesn't damage the eyes. In dimly lit places, your daughter will have a hard time seeing, but I guess she'll maintain her "mature" look.
Outside, wearing sunglasses protects the eyes from ultraviolet light. Make sure she has glasses that filter ultraviolet A and B rays.
Drs. Donohue and Roach regret that they are unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may write the doctors or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers also may order health newsletters from www.rbmamall.com.