Seek help from teaching hospital

Dear Dr. Gott: About seven years ago my forehead started itching. This spread to my ankles, legs, arms and onto my neck. One dermatologist said it was contact dermatitis. Two others said it was dry skin and prescribed prednisone. This medicine did not help, and I have now taken allergy shots for 14 months. No improvement. Would you have any idea what my problem could be?

Dear Reader: Itching can be a maddeningly difficult symptom to treat, and the cause can be a real medical challenge to diagnose. Almost any skin inflammation — including contact dermatitis (an allergic skin reaction) and scabies (infection with the itch mite) — can lead to chronic itching that can be cured with appropriate creams or lotions.

Because your dermatologists seem unable to agree on your diagnosis, I recommend that you self-refer to a dermatology clinic at a teaching hospital, where super-specialists delight in difficult cases. In my opinion, you need an examination and further testing in such a diagnostic clinic.

To give you related information, I am sending you a copy of my Health Report “Eczema and Psoriasis.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: Can you tell me what respiratory acidosis is?

Dear Reader: Carbon dioxide acts like a weak acid in the body. When too much is present, a person is said to have respiratory acidosis. This is diagnosed by blood tests.

Excess carbon dioxide can build up acutely (from asphyxiation, pneumonia or heart failure), or it can be present for years in patients with chronic lung disorders such as emphysema.

Acute respiratory acidosis causes an increase in the breathing rate as the body attempts to expel the redundant gas. As the underlying condition is corrected, the acidosis vanishes.

Chronic respiratory acidosis by itself rarely causes problems because the body can adapt to it. Patients with chronic pulmonary diseases are short of breath primarily because they are unable to absorb enough oxygen. As a result, doctors are less concerned about chronic respiratory acidosis than they are about increasing the amount of oxygen that such patients need.

Dear Dr. Gott: I have very ugly, blotchy areas of swollen veins on both thighs. How can these be treated?

Dear Reader: Known as “starburst” veins, these blood vessels in the skin swell and dilate due to the aging process. Although unsightly, they are harmless. Plastic surgeons are skilled at removing them, either with laser therapy or cosmetic surgery.

In my experience, starbursts tend to run in families, as do varicose veins, to which they are related. To my knowledge, there is no preventive and no compelling medical reason to have them treated.