DEAR DR. DONOHUE: Could you send me the answer to a question about scleroderma that was published on Feb. 19, 2001? I felt much better when I took what you mentioned, but I lost the bottle and can’t remember what it was. – V.W.

ANSWER:
I suggested an over-the-counter medicine for scleroderma? I don’t think so.

Let’s rehash the scleroderma (SKLAIR-uh-DER-muh) details. Its name comes from two Greek words meaning “hard skin.” For unclear reasons, the body shifts into an overproduction of collagen. Collagen is a tough protein that serves as a scaffold for body organs, including the skin, and as a filler material to absorb the rough treatment the body endures every day.

The excessive amount of collagen hardens and constricts the skin. The skin of the hands can become so tight that it draws the fingers downward into the palms and can render them immobile. Facial skin can be so taut that it is impossible to smile.

Bad as the skin consequences are, internal organ consequences are worse. The lungs can fill with so much collagen that it makes people breathless. Collagen invasion of the kidneys can render them ineffective in cleaning the blood. Kidney involvement can raise blood pressure. When collagen infiltrates the esophagus, the muscular tunnel that runs from throat to stomach, swallowing can be difficult.

I looked up the article you mentioned. You had the right date. I spoke about Relaxin, a drug that is no longer used. I also spoke about drugs that modify the immune system, the alleged cause for the unrestrained production of collagen. Two such drugs are azathioprine and methotrexate. Cortisone drugs are also employed for the same reason. All of these require a prescription. Rather than search for medicines, contact the Scleroderma Foundation – 1-800-722-4673 or www.scleroderma.org. You’ll find that the foundation is a friend and a source of information. And, please, have the scleroderma diagnosis confirmed by a doctor.

DEAR DR. DONOHUE: I have 38 little bags of skin growing under my arms, on my neck and on my legs. I saw a doctor, but all he would tell me is that they are skin tags. Why are they growing on me? Can I put a stop to them? – G.D.

ANSWER:
Skin tags are flesh-colored or brownish, and they hang like little icicles dangling from the skin. By age 69, more than half the population has some.

They tend to cluster on the neck, under the arms and on the eyelids, but they can pop up just about anywhere.

You can’t stop them from sprouting but your doctor can clip them off, if that is your desire. It’s not major surgery.

DEAR DR. DONOHUE: Our son is 40 and an alcoholic. He stopped drinking in his 20s and has since married and has two wonderful children. He told us he has started to drink one glass of red wine to prevent circulatory problems and heart attacks. What is your opinion? Does the medicinal effect of wine outweigh the problem of possibly slipping back into alcoholism? – D.T.

ANSWER:
The evidence that alcohol protects people from heart attacks and artery hardening is quite compelling. Red wine is cited most often as the alcoholic beverage that provides this protection, but just about any alcoholic drink bestows similar benefits.

Alcohol increases the blood level of HDL cholesterol – good cholesterol, the kind that trucks cholesterol from artery walls to the liver for disposal. It also stops blood platelets from sticking to each other and forming clots in heart arteries, the cause of heart attacks. And it restores the way the body responds to insulin, another factor in clogging heart arteries.

All this good news about alcohol does not justify its use in people who have had a problem controlling the amount of alcohol they drink. Your son should not drink alcohol in light of his history. There are many other ways to keep the heart and arteries healthy.

DEAR DR. DONOHUE: I live in the Deep South, and it’s beginning to get hot. I know I am going to break out in a rash. I always do. The rash looks like a bunch of tiny blisters that sit on a red base. They burn and sting. Would you hazard a guess as to what this might be and how I might treat it? – D.M.

ANSWER:
Your description fits the profile of prickly heat. Its medical name is miliaria, and it has a number of variations. Yours appears to be miliaria rubra. The “rubra” is thrown in because of the red base on which the small blisters sit.

Prickly heat comes from an occlusion of sweat ducts.

Air conditioning is the best treatment and preventative for it. Short of air conditioning, fans can fill in.

Anhydrous lanolin unclogs sweat ducts, and the pharmacist can direct you to brand names. A cool bath in which Aveeno colloidal oatmeal has been sprinkled is another way to relieve prickly heat.

If all this falls apart, then my diagnosis is wrong, and you must then see your doctor.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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