Aldara [Generic] is beneficial for treating diverse skin conditions. This formulation is presently the best-known treatment for Genital Warts, besides Acitinic Keratosis [resulting in a flat, dry, scaly growth on the body due to prolonged exposure to the sun], and superficial Basal Cell Carcinoma [a common skin cancer caused by over-exposure to ultraviolet rays or sunlight]. Imiquimod enhances the body’s immunity to fight off the Human Papillomavirus – that is responsible for causing genital warts in men and women.
Generic Imiquimod, the medicinal compound in Aldara Cream, acts as an immune response modifier by strengthening the body’s immune system in combating infection, and is particularly useful in treating infections caused by the Human Papillomavirus [HPV]. It is known to enable hitherto hidden lesions to be seen, which can be treated on detection, as in Acitinic Keratosis [AK] and superficial Basal Cell Carcinoma [sBCC]. Imiquimod is believed to activate immune cells that, in turn, secrete cytokines such as interferon that regulate the immune response in a manner which inhibits viral replication and suppresses further cell proliferation. For this reason, it is beneficial in treating people who may suffer from sBCC and Genital Warts.
AK – a condition of the skin comprising reddish-brown, yellowish-black, or skin-colored patches, that are flat and dry – occurs often in people who have had over-exposure to the sunlight, and are fair complexioned. The growth can be a teeny-weeny pinhead size or spread out to an inch. It is itchy, and gives a pricking sensation, especially when the person is out in the sun. There is some danger of the formation of a skin cancer that is known as Squamous Cell Cancer, if AK is not treated. Aldara Cream is used to treat specific kinds of AK, on the face and scalp of the person thus affected, who has a normal immune function.
In superficial Basal Cell Carcinoma [sBCC], a common skin cancer that occurs because of undue exposure to sunlight or ultraviolet light, the disease manifests itself in the form of lesions on the skin, appearing in different shapes and colors. These lesions can be in the form of a new growth, or a change in the older growth, or an open sore that may bleed. For any suspicious growth, a visit to the dermatologist is vital, as sBCC can be readily treated if detected in time.
Genital and Perianal Warts take the shape of growths or bumps around the entrance of the vagina or anus, or on the penis, scrotum, groin or thigh. The Genital Warts [also known as Condylomata acuminata] can occur singly or in clusters, varying in size, but are mostly painless, and blend with the skin. If one partner is infected by HPV, these can be sexually transmitted. Warts may take weeks to years to appear. Usage of condoms is recommended to prevent transmission of HPV, but sexual contact should be avoided while using Aldara Cream for Genital Warts, for as long as the cream is on the skin, it may weaken condoms and diaphragms.
While the HPV strains that cause Genital Warts do not normally cause cancer, but a person who may be infected with other “high-risk” types of HPV may be in danger of having anal, vaginal, penile, or oropharyngeal [throat-tonsils-tongue] cancer. As HPV infection can exist for several years, it increases the risk of cervical cancer in women, though the infection does not usually show any symptoms. Having more than one partner, many children, and smoking are all contributory factors to HPV infection.
Before your treatment begins, it is important for you to inform the physician about all the ailments you’ve suffered from; all the medicines [including OTC and prescription], nutritional supplements, herbal supplements you take; informing the dermatologist especially if you have psoriasis [a skin condition that can worsen because of Imiquimod]; if you are taking another treatment for AK, sBCC, or Genital/Anal Warts, as you cannot apply this cream until your skin has healed from other treatments; or, if you are pregnant/lactating/planning to have a child. Inform the physician if you are allergic to anything, including Imiquimod; whether you have undergone any recent surgery that is unhealed on the skin area to be treated; whether you have any autoimmune disease like rheumatoid arthritis, or lupus; whether you have HIV; whether you suffer from high blood pressure; or, have a chronic graft-versus-host disease.
The side effects are mild and commonly include: reddening, or flaking of the skin; crusting; swelling; itching; burning; or, lightening of the skin color. Side effects that are uncommon can include: headache, muscular pain, backache, swollen lymph nodes, flu-like symptoms, diarrhea, or fungal infections. The area being treated may become worse before improving, while in some patients the treated area may become permanently light or dark. In case of severe reaction, some patients may be required to take a break in the treatment.
Aldara is meant for the skin only, so while applying it, you have to steer clear of the eyes, lips, nostrils, or any open wounds. It is used once a day, 2-5 days in a week, for a period of 6-16 weeks – depending on the nature of your infection. The cream is best applied at night, left on the skin for 8 hours, after which the treated area has to be washed with a mild soap and water. It is recommended that the treated site should not be covered with a bandage/closed dressing, though cotton gauze/underwear is permitted. For those using Aldara Cream for AK or sBCC, protective clothing [including use of a hat], and avoiding exposure to sunlight/sunlamps is a must as Imiquimod is liable to make you more sensitive to the sun.
The medicine has to be stored at a room temperature below 25oC; you can refrigerate, but don’t freeze it. Any frozen medicine should be discarded, as well as any partly used packet. Stick to the dose prescribed for you, informing the dermatologist if your condition worsens, or persists. Aldara Cream is not recommended for children below 12 for the treatment of Genital/Perianal Warts, and not meant for those below 18 in the treatment of AK and sBCC. Keep the medicine away from children and pets.
While lupus can be a debilitating disease, it doesn’t have to be. If you can find a way to relieve the pain of lupus, you can continue on with most of your normal, day to day activities.
Here are some ways you can find Lupus Pain relief
Lupus can cause pain, swelling and stiffness of the joints. NSAIDs (or non-steroidal anti-inflammatory drugs) can relieve all of these symptoms.
Lupus can also cause chest pains, usually the result of swelling around the heart and lungs. NSAIDs can relieve this swelling and the resulting pain.
There are many NSAIDs available over the counter. Some of them include aspirin, naproxen sodium (found in Aleve) and ibuprofen (found in Motrin). There are also prescription strength NSAIDs that are much stronger and can be prescribed to you by a doctor. However, be careful. Taking these drugs can cause stomach problems. In fact, if you already suffer from stomach problems, like ulcers, you should avoid taking NSAIDs.
Ask Your Doctor about Antimalarial Drugs
Many people suffering from lupus can go for long periods when their symptoms decrease, or even disappear altogether. On the other hand, they can also experience flares, periods when their symptoms, including pain, are unusually severe.
Doctors have found that antimalarial drugs, drugs meant to prevent and treat malaria, can also be used to prevent flares. And while there can be some side effects (like muscle weakness and vision problems) many find them easier to deal with than the pain a lupus flare can cause.
There was a time when those suffering from lupus just had to suffer with the pain their condition caused. But thanks to advances in medical science, you can find lupus pain relief.
What To Do If You Are Pregnant and Have Lupus or RA
Author: Angie Carter
RA and lupus are autoimmune diseases and in autoimmune diseases the immune system, which is suppose to protect your body from any foreign substances that may harm it, malfunctions and attacks your own body’s tissues. If you have RA or lupus you are probably taking medication that reduces the immune systems activity to a greater or lesser degree. But pregnancy has its own impact on the immune system and your system must make some adjustments so that your body won’t attack what it perceives to be foreign, the genes that come from the father of your baby. These adjustments make it possible for your baby to grow safely. But there are other effects which can impact your rheumatic conditions such as RA and lupus in different ways.
Something to think about.
It can be hard to determine whether the changes in the way you feel are from the pregnancy or your RA or lupus. Unfortunately when you are pregnant you can become anemic, which can cause you to be tired and have a lack of energy, this also happens when you have RA or lupus. Your pregnancy will also affect certain markers of inflammation, doctors use blood test to measure your inflammation called a erythrocyte sedimentation rate or ESR, which is often high if you have RA or lupus. These markers can also be high when you’re pregnant so measuring ESR may not be the best way to gauge how active your RA or lupus is. Also, your pregnancy may make blood clots more likely, but if you have lupus, there is also an increased risk that you will have blood clots because there is a protein called antiphospholipid antibodies in your blood, and these proteins is what increases your risk.
Your pregnancy can also cause musculoskeletal problems because as your baby grows, your ligaments will relax to allow the pelvis to stretch. You will also put on weight, which is a healthy thing but this can cause your posture to change which can result in joint aches and back pain. Another thing is carpal tunnel syndrome (CTS), which causes wrist pain and numbness, is a common complication of your pregnancy, especially during the second and third trimesters but is is also associated with RA and lupus. All these things can make it tricky to figure out whether or not they are problems with the pregnancy or are a part of your rheumatic conditions.
Things to do if you have RA.
RA mainly affects the joints and it will make them stiff, painful, swollen and sometimes, unstable and deformed, but it can also cause fatigue and you may have problems with your heart and your eyes. There is between 1% and 2% of the United States population that have RA, and it is most common among women than men. It will usually appear when you are in your twenties or thirties, the child bearing years, so finding women with RA who are considering pregnancy is not all that surprising.
The first thing you will want to know, if you have RA and are considering having a baby, is whether or not your arthritis is going to flare-up during your pregnancy. The thought of carrying around an extra 20 – 30 pounds of weight on replaced joints or on joints that are sometimes swollen and sore can be a bit discerning. Luckily there are about 70% – 80% of women who have RA that go into remission during their pregnancy, another words their symptoms go away. For the rest of those women with RA who don’t go into remission, their symptoms may become milder and easier to manage. It’s hard to predict just who will go into remission but despite this uncertainty, some doctors will tell their patients to stop taking their RA medications when they become pregnant because of the high likelihood that they will go into remission and not need treatment. But there are some steps you can take before you get pregnant that can help you during and after the pregnancy.
Work out a plan with your rheumatologist for what medication you will take if you do have a flare during your pregnancy.
You will also have to consider the type of delivery you will have. Most women with RA can safely go through the labor and vaginal delivery, but if your RA affects your pelvis and legs extensively, a vaginal delivery may not be what you want to do. Your doctor may opt for a planned cesarean section.
For some of you with RA, you may find that after you have your baby your arthritis flares up. Because arthritis flares can make it difficult to care for a newborn, you will want to plan very carefully just how you will manage this period. By planning you can ease the adjustment of this postpartum period.
If you are planning on breast feeding you will need to discuss this with your rheumatologist, obstetrician and pediatrician ahead of time. There are some RA medications that are compatible with breast-feeding. Try to decide which one you want to take just in case you have a flare after your baby is born.
If it’s possible, try to have someone to help you at home during the transition time. If you are unable to, there are some things you can do to make it easier on yourself, such as; having some extra meals stashed in the freezer so that all you have to do is to pull them out of the freezer when things get difficult.
Planning is the key and it will go a long ways to helping you ease the stress of your worst flare. The good news is that RA doesn’t have a negative impact on the baby, it doesn’t increase the rate of miscarriages, and it doesn’t cause any problems in the baby.
What if you have lupus
If you have systemic lupus erythematosus, it’s a bit more complicated. The reason it’s more complicated is that lupus can affect many parts of the body, such as the skin, joints, kidneys, blood cells, heart and lungs. The most common symptoms are a rash on the face, pain and swelling in the joints and a fever with kidney disease being the most serious symptom. Lupus is more common in women then men and it will usually show up when you are between the ages of 15 and 45.
Doctors of the past would often counsel women with lupus against getting pregnant based on the assumption that pregnancy would always cause lupus flares, possibly serious flares, and that babies would do so well. These were and are valid concerns, but there is now a better understanding of lupus and how to treat it that has made pregnancy very realistic and a safe option if you decide to get pregnant.
There are several studies that have shown that being pregnant may increase your risk of flares and yet other studies that have found that it doesn’t. This confusion in part lies with how the different researchers measure and define a flare. And also, during any nine-month period you may have a flare or flares whether you are pregnant or not, so flares during your pregnancy are not exactly related to your pregnancy. Headaches, fatigue, shortness of breath and joint pain are all symptoms of a lupus flare as well as the possibility being a part of your pregnancy. The most likely risk is that women with lupus have a slightly higher chance of having a flare-up but for many women it can be controlled with medication.
You will most likely flare and not do so well during pregnancy if your lupus was active at the time of conception. This will be the case if your lupus has affected your kidneys because pregnancy will also stress your kidneys. Most doctors will generally not recommend getting pregnant until you have been in remission from kidney disease and active lupus for six months.
The most ideal situation is if when you have decided to become pregnant, that you see your rheumatologist ahead of time so he can run blood tests that will determine just how active your lupus is. The blood test will also establish a baseline that your doctor can refer to later during your pregnancy in case there are any difficulties. If you don’t get these test done before you get pregnant then definitely get them done shortly after. You will also want to consult with an obstetrician who has experience with treating women who have lupus or possibly an obstetrician who specializes in high risk pregnancies. It is also a good idea if when you become pregnant, you are taking medication to control you lupus and that you can continue to take them safely during your pregnancy. Although, if you have RA you are able to stop taking your medications during your pregnancy, this may not be the case if you have lupus. You and your rheumatologist will need to plan for what medications you can take if you have a lupus flare during your pregnancy.
If your blood tests show that you have the antibodies called anti-RO (SSA) or anti-La (SSB), you will have a small risk of having a baby born with a rare condition called neonatal lupus. The main symptom of neonatal lupus is a skin rash, and it will usually disappear in six months. There is a very small percentage of babies with neonatal lupus, about 2% to 5%, who will develop heart block, which causes the heart to beat abnormally. If you are known to have the anti-RO or anti-La antibodies, you will probably have an ultrasound at 18 to 24 weeks into the pregnancy to see if there is heart block. The doctor may prescribe a corticosteroid in an attempt to treat the heart block if there is one. Although, research doesn’t show a clear benefit of doing this. It may become necessary to deliver the baby early but most babies born with heart block need to have a pacemaker implanted, wither at birth or later in life.
There are other complications that come with lupus and that includes preeclampsia, premature rupture of the membranes, which means the baby will be born prematurely, and low-birth-weight babies. In preeclampsia, or pregnancy-induced hypertension, you will have high blood pressure and retain fluid among other symptoms. Preclampsia is thought to be more common if you have lupus and most often it can be hard to distinguish between preeclampsia and a lupus flare. But if it’s not treated appropriately, preeclampsia can damage your kidneys and liver as well as increase the risk for a miscarriage and premature birth or even cause the baby to be very small. If you have preeclampsia your doctor may recommend that you deliver the baby early, either by induced labor or a C-section.
The same advice that applies if you have RA applies to you if you have lupus as far as the period after the birth of your baby. Planning makes all the difference and having help lined up in case you have a lupus flare prevents you from taking care of your baby. As with RA, you will want to have ready-to-eat meals in the freezer and be sure to know what your options are in terms of breast-feeding and medications.
As you can see, there are some very special considerations for you if you have lupus and are considering having a baby, but if you have a clear understanding that your chances are good that our outcome will be nearly as good as someone who doesn’t have lupus. Remember that the best approach is to have your health care team, your rheumatologist and obstetrician, working hand in hand and also good communication and close follow-up with this these team members is the key.
There are many medicines that are used to treat RA and lupus that are relatively safe during pregnancy, but some of the drugs used for rheumatic conditions increase the risk of birth defects, and it’s also important to remember that birth defects occur in about 3% of pregnancies where the mother doesn’t take any medications. When you are considering if a medication is safe during pregnancy, you should determine if the risk of birth defects is greater than 3%. Your doctor should be able to help you figure it out.
NSAIDs: Non-steroidal anti-inflammatory drugs treat the pain and inflammation of arthritis. These NSAIDs include the COX-2 inhibitor celecoxib (Clelbrex) and traditional NSAIDs such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn) and the many other, both prescription and over the counter. There are studies in animals that have shown that NSAIDs can cause birth defects, but there hasn’t been any findings in humans. It is possible to take these medicines safely during your pregnancy up to the third trimester. Taking NSAIDs during the third trimester, will increase the risk that one of the baby’s heart vessels will close prematurely, a good reason to stop taking them at 24 weeks of pregnancy. If you are trying to get pregnant you may want to stop taking the NSAIDs, including COX-2 inhibitors, from the time of ovulation until their next menstrual period because there is a hypothetical risk that these medicines will interfere with the implanting of a fertilized egg.
Corticosteroids: Corticosteroids decreases the inflammation throughout the body and these drugs are often the mainstay of treatment for people with inflammatory conditions such as RA and lupus. Prednisone and prednisolone are the most commonly prescribed drugs that your doctor will give you and you can continue to take these medicines during your pregnancy if you need to. But before you do, remember that if you take the corticosteroids during the first trimester of your pregnancy, your baby could be born with a cleft palate. This risk is still fairly low, with cleft palate happening in roughly 1 in 300 babies exposed to the drugs in the womb compared to 1 in 1,000 when there is no exposure. Babies born to mothers who take corticosteroids during pregnancy are also more likely to be smaller and born prematurely. They also will raise your risk of pregnancy induced hypertension, gestational diabetes, a form of diabetes that happens only during pregnancy, and pregnancy-induced osteopenia or bone thinning. Corticosteroids are often a reasonable choice during pregnancy for the management of both RA and lupus despite the potential side effects.
Hydroxychloroquie: It was thought that hydroxychloroquine or Plaquenil, was not compatible with pregnancy but over the past decade that idea has changed. Right now most rheumatologists in the United States and elsewhere with patients who need hydroxychloroquine to keep their condition stable will keep them on it during their pregnancy. Studies have been done to substantiate the claim that the medicine might cause problems with the development of the fetus’s visual and hearing systems, but the studies didn’t prove it.
Sulfasalazine: Sulfasalazine or Azulfidine, is considered to be safe to use when you are pregnant.
Azathioprine and cyclosporine: These drugs are immunosuppressive drugs that are used mainly to maintain organ transplants. Doctors will also subscribe them to treat RA and lupus. There is information from world wide transplant registries of literally thousands of babies that were exposed to these medications in the womb. This information shows that there were no increased rates of birth defects, but the babies do seem to be smaller and to be born earlier. There are many doctors will use these medications if they need to control RA or lupus activity in women who are pregnant.
Methotrexate, leflunomide, mycophenolate mofetil, cyclophosphamide: These medications can cause early fetal death and birth defects at a rate higher than what you would expect. You shouldn’t take them during your pregnancy and also if you are planning a pregnancy you should stop taking methotrexate or CellCept at least one menstrual cycle before trying to get pregnant. If you’re a man taking these medications then you will want to stop taking them three months ahead of time. If you are taking leflunomide you will need to to stop taking it two years before you try to get pregnant, or you could under go a two-week procedure to wash the medicine out of your bloodstream.
Biologics: There isn’t enough data to conclude whether or not this newer type of drug is absolutely safe during pregnancy. However, we do know that TNF-alpha blockers, etanercept (Enbrel), infliximab (Remicade), and adalimumab (Humira) may contribute to birth defects according to recent evidence. You will want to stop taking biologic drugs before trying to become pregnant.
In just about all circumstances, if you have RA or lupus, you can be sure it is safe to become pregnant as long as you are sure your RA and lupus are under control and your pregnancy is planned. If you have lupus it is particularly important to keep the communications open with your rheumatologist and that you have an obstetrician that is experienced in dealing with women with lupus or high risk pregnancies. With careful monitoring and the appropriate use of your medicines, it will be possible to successfully manage your pregnancy when you have RA or lupus.
Angela Carter is the owner of Coastal Health Information Services, located in Savannah, GA. She has been writing articles about Arthritis since 2007 after she was diagnosed in 1999 with rheumatoid arthritis, osteoarthritis and fibromyalgia. In 2010 she was also diagnosed with Gout, and Sjogren’s Syndrome (Show-grin’s).
You may contact her at ACarterccis@usa.com or visit her website at http://www.ccis.web.officelive.com or her blog at http://www.chisarthritisinfo.blogspot.com
Lupus Diets : What You Eat Will Affect Your Lupus Symptoms
Author: Scott Michale
the foods you eat can also have an effect on your lupus symptoms. Some foods can relieve your symptoms, while others will make them worse. And creating a alupus dieta comes down to eating more of the former, and avoiding the latter.
Avoid Saturated Fats
Lupus can increase your chances of developing heart disease. And eating saturated fats makes you even more susceptible. Saturated fats can also cause inflammation, which is a major contributor to lupus pain. So those who are suffering from lupus should stick to foods that are low in fat.
Eat More Fish
Fish can be beneficial to people suffering from many different autoimmune diseases, including rheumatoid arthritis, Raynaud’s disease, and lupus. The fish oil found in really fatty fish can help alleviate symptoms like pain and swelling of the joints, and inflammation around the heart and lungs. So try to work more mackerel, albacore tuna, anchovies, herring, and Pacific salmon into your diet.
Other Foods to Avoid
There are many other foods that can worsen lupus symptoms and cause lupus flares. Alfalfa can stimulate the immune system. While this is usually a good thing, it isn’t in those whose immune systems are attacking their own bodies. Eating eggs can cause your body to produce biochemicals that can potentially cause or worsen inflammation. And eating hot dogs, cured meats, beans and mushrooms can also aggravate lupus symptoms.
Keep a Food Diary
But not everyone with lupus is affected in the same ways by the same foods. So consider keeping a food diary. Write down any foods you eat, and also make a note any time your symptoms seem worse than usual. If you symptoms get worse every time you eat a certain food, this is probably a food you should avoid.
By learning how different foods can affect lupus, you can create a alupus dieta that will help keep your symptoms under control.