DEAR DR. DONOHUE: I hope you don’t find pinworms as repulsive as I do. My second-grader has them. He is constantly scratching. How do I know for sure if it’s pinworms, and how are they treated? We have a dog. Is he involved in this? This subject makes me ill. – S.S.

ANSWER: Pinworms don’t repulse me. I’m sure they have a purpose in the grand scheme of things, but I don’t know what that purpose is. They’re the most common worm infection in the United States and Canada, and many, many mothers face the same challenge you do: getting rid of them.

They have nothing to do with personal cleanliness or poor housekeeping.

Pinworms live in the terminal portion of the small intestine. At night, pregnant worms sashay down the colon to the skin surrounding the anus, where they lay their eggs.

The eggs initiate a profound itch, to which the infected person responds with an equally profound scratch. Most itching occurs at night, and the child (or adult) reflexively scratches while still asleep. Scratching glues eggs to the fingers and under the fingernails, and the scratcher can pass them to others.

Aside from the itch, pinworms are almost never associated with any serious illness.

You can identify the worms by looking for them with a magnifying glass. They’re white, about 0.4 inches long and as thick as a strand of thread. If this proves too much for you, let your doctor do the job of identification.

Vermox and Albenza are two medicines that usually can end a pinworm invasion.

Pets do not get human pinworms. Your dog is off the hook.

DEAR DR. DONOHUE: Is molluscum the same as a wart? My daughter has a few, and the doctor doesn’t seem a bit concerned about it – but I am. He hasn’t prescribed anything for her. She’s in kindergarten. How long does this last? – C.K.

ANSWER: Molluscum contagiosum is a viral skin infection, as are warts, but the similarity ends there. The molluscum virus produces a tiny, dome-shaped, pearly skin bump whose center becomes depressed. It looks like a small version of a volcano, somewhat similar to a goose bump.

The face, eyelids, neck and thighs are places where these bumps are most often found. Most children (or adults) have a small number of the bumps, two to 20. If the immune system is on the fritz or if the infected person also has eczema, the outbreak can be widespread and the bumps are numerous.

For most, molluscum contagiosum regresses in anywhere from two months to two years. The doctor can scrape them off with a special instrument or can prescribe creams or ointments that hasten their departure. It’s sometimes wiser to leave them be, since overly aggressive treatment can cause scarring.

DEAR DR. DONOHUE: Please discuss TMJ. I think I might have it. My jaw hurts all the time. My cousin has it. She and I have similar bone structure, so I believe I could have it too. – L.M.

ANSWER: TMJ is the temporomandibular joint, the joint where the jawbone joins the skull. If you put a finger slightly low in front of your ear and open your mouth, you can feel the TMJ joint.

The TMJ syndrome is pain in that joint, sometimes with clicking or popping sounds when the mouth opens and closes, at times with the jaw locking in place, and often with limited joint motion.

Causes of the syndrome are many. Spasms of the jaw muscles can produce it. They also cause teeth grinding – especially at night. Arthritis of the joint is another cause. Misalignment of the jaw with the skull is a possible cause.

Your dentist is an expert on TMJ syndrome, and you should consult him or her for confirmation of your suspicion.

If you do have it, simple measures like hot compresses to the joint many times a day can be most helpful. Anti-inflammatory drugs, ones used for arthritis – ibuprofen, naproxen, etc. – often eliminate the pain. Your dentist will tell you if you need a mouth guard during sleep to relax the jaw muscles and the jaw joint.



DEAR DR. DONOHUE: What can you tell me about polycythemia? My doctor thinks I have it. I feel great, but I had some lab work done in preparation for a physical exam, and the doctor called to tell me about my blood count. I’m afraid to keep the follow-up appointment. Is this cancer? – R.R.

ANSWER: Polycythemia isn’t cancer. It’s too many red blood cells (and white blood cells and platelets). The bone marrow shifts into high gear in its production of these cells. Headache, dizziness, fatigue and bleeding are some of its symptoms. If you do have polycythemia, treatment is quite straightforward: remove the excessive number of blood cells by removing blood. If need be, there are medicines for treatment too. Hydroxyurea is one.

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. Readers may also order health newsletters from www.rbmamall.com