PAGET'S DISEASE OF BONE

Proper Name:

osteitis deformans

Common Name:

Paget's disease of bone

Age of Onset:

Most people who are diagnosed with Paget's disease of bone are over forty years old; earlier diagnoses are extremely rare.

Duration:

Paget's disease of the bone, once the onset occurs, does not go away. It progresses at different rates and is sometimes only a minor nuisance, but it never "heals."

Males/Females/Race:

Osteitis deformans is shown to run in families, and it is much more prominent among men.

Cause:

Scientists believe that Paget's disease of bone is caused by a viral infection. More specifically, it is caused by a paramyxovirus, such as the measles or canine distemper virus. Studies also point to a genetic cause, because the likelihood of a family member having the disease is about six times higher than the likelihood of a total stranger having the disease.

Symptoms:

The most obvious symptom of Paget's disease is bone pain. The soreness is often most prominent near joints. Depending on which part of the body the disease is affecting, different symptoms occur. If the disease is affecting the head, the affected could lose hearing or experience chronic headaches. Lack of blood flow to the brain (steal syndrome) can lead to paralysis or fatigue. If the disease is affecting the spine, a permament curvature may result. In the mouth, teeth are pushed out in all directions. Joint damamge caused by Paget's may lead to arthritis, which makes the disease even more difficult to diagnose--less severe cases are often mistaken for arthritis.

Prognosis:

If caught before severe damage is done to the affected bones, Paget's is easily treatable. The symptoms increase very slowly, and the disease usually stays localized in the appendicular skeleton or the legs and does not spread. Although osteitis deformans is not curable, the disease can be stopped and symptoms can be treated. Those affected can lead perfectly normal lives.

Treatment Options:

Paget's disease of bone has many different treatment options. The first of these is drug therapy; patients are either given bisphosphonates (osteoclast inhibitors) or calcitonin (counteracts PTH). Another option is surgery. Surgery, unlike drug therapy, does not attack the problem at its core. Instead, it treats the symptoms. Broken bones can be reset, deformed bones can be moved to allow for better weight-bearing and mobility, joints can be replaced. Lastly, a consistent lifestyle with diet and exercise help to keep bones healthy (calcium and vitamin D are vital to bone health) and therefore slows the progression of the disease.

Link:

http://orthoinfo.aaos.org/topic.cfm?topic=A00076

VITILIGO

Proper Name:
leukoderma

Common Name:

vitiligo

Age of Onset:

Over half of the people suffering from vitiligo notice symptoms before they turn twenty. This is not a requirement, and the disease can begin at any time.

Duration: Vitiligo will never go away naturally. Once it appears, it is there for good.

Males/Females/Race: Some people are genetically disposed towards having vitiligo, but race and sex are not factors.

Cause: There is no single isolated cause for vitiligo, but a genetic disposition towards the disease does exist (NALP1 gene). Vitiligo can also be caused by stress; the immune system will begin eliminating pigment. Those with Addison's disease are also more likely to have vitiligo.

Symptoms: The common identifying symptom of vitigo is a collection of white patches on the skin. These patches are most often found on the extremities (arms and legs), but can also be on the torso, face, and groin. In extreme cases, they cover the entire body. The lack of pigment also changes the hair color of the affected areas to white. This explains why many people with the condition have streaks of pale hair; their scalps have white patches. People with vitiligo tend to gray prematurely. Mucous membranes such as the mouth, nose, and eyes are also affected and turn a purple or golden brown. The eye can even become inflamed, sometimes causing blindness. However, blindness is not a symptom of vitiligo. Due to the lack of protective pigment, people suffering from vitiligo are more sensitive to the sun.

Prognosis: Vitiligo will never go away naturally, but it will move around on your skin. White patches may repigment, and pigmented patches may become white. Patients suffering from vitiligo will notice an increase in white patches over time; sometimes it will overtake the entire body, but it will often stop before that stage and refuse to get any bigger. Its progress is extremely erratic.

Treatment Options: Eating Ginkgo biloba (Gingko trees!) pills will inhibit the spread of white patches. Staying out of the sun and avoiding becoming tan will make the vitiligo patches less noticeable. Cortico steroid cream is the most common treatment, and creams such as Protopic and Elidel may stimulate some repigmentation. UV radiation may also cause repigmentation. Because vilitigo is caused by the lack of melanocytes (pigment-making cells), some patients have melanocyte graphs on their skin to restore pigment. Others take the other extreme and have all of their melanocytes removed chemically, making their skin an even porcelain white.

Link:
http://www.nlm.nih.gov/medlineplus/vitiligo.html