DEAR DR. DONOHUE: I was recently told I have guttate psoriasis. It’s on my scalp. I have used prescription shampoos and treatments, but now I go to a tanning booth. I think it has worked. My head itches so bad. My arms are also affected. What causes it? How do you treat it at home? – C.B.

ANSWER: Psoriasis affects around 2.5 percent of the white population and 1.3 percent of the black population, and that makes it a pretty common disorder. The immune system somehow triggers a rapid proliferation of immature skin cells that reach the skin’s surface before they should. The result is patches of red skin covered with silvery scales, and the skin might or might not itch. This is the most common kind of psoriasis, called plaque-type. A plaque is a patch of slightly raised skin larger than .4 inches (1 cm). The patches can be found anywhere, but the usual sites are the scalp, elbows, behind the knees and the buttocks.

Guttate psoriasis is the next most common variety. “Guttate” means droplike. Here, the skin lesions are small and red. They, too, are covered with silvery scales. Often guttate psoriasis suddenly develops after a strep infection.

Home remedies are few and not always effective. Sunlight benefits psoriatic skin, but you have to be careful about not overdosing with it, and you have to take into account that ultraviolet light can cause skin cancers. If you live near saltwater, a dip in it, followed by sunlight exposure, gives a better response. Or you can take a saltwater bath before going into the sun. Keep your skin hydrated by applying a moisturizer after bathing or showering. Petroleum jelly (Vaseline) works fine.

Today there is such an array of effective psoriasis medicines that you should consider using one under a doctor’s care. Cortisone creams, lotions and sprays work well for those with mild to moderate psoriasis, but the effective ones require a prescription. Dovonex skin cream or lotion, used in conjunction with the cortisone medicines, works even better and lessens cortisone’s side effects. I can’t mention all treatments. I would like to mention the newer ones called biologicals. Amevive, Enbrel and Humira are three examples. They are given by weekly injections. The biologicals have ushered in a new treatment era.

DEAR DR. DONOHUE: Please do an article on Sturge-Weber syndrome. My grandson has it, and few people are aware of it. He is often stared at and treated as if he is handicapped. He is an active 7-year-old with a mild case, but he does have glaucoma in one eye. He has a port-wine birthmark over half his face, although he is having laser treatments. – P.D.

ANSWER: Sturge-Weber syndrome involves an unusual formation of blood vessels beneath the facial skin. The result is a port-wine stain – a large pink to purple blotch. In addition to the port-wine stain, a similar blood vessel malformation occurs on the brain’s coverings, the meninges. That malformation can cause seizures. Glaucoma is another possible effect of the syndrome.

My uncle had a port-wine stain but did not have the vessel problem on the brain coverings. That doesn’t count as Sturge-Weber syndrome.

Laser treatments can lighten the birthmark. Your grandson sounds like he is doing fine. I am happy to bring this condition to people’s attention and to make them aware of the Sturge-Weber Foundation. People can contact the foundation on the Internet at www.sturge-weber.org or at 800-627-5482.

DEAR DR. DONOHUE: How is an underactive thyroid treated (hypothyroidism)? – T.K.

ANSWER: Thank you, T.K. I like an easy question.

An underactive thyroid gland is treated by giving thyroid hormone in pill form. That supplies the body with the hormone its own gland isn’t making. Treatment is usually for life.

DEAR DR. DONOHUE: I have a copy of the EKG report I had taken some weeks ago. It says I have a right bundle branch block. The doctor hasn’t spoken to me about this. Does it mean I have a heart problem? – R.D.

ANSWER: The right and left bundles are cables in the heart that conduct the electrical signal from the upper part of the heart to the lower two heart chambers. Those two lower chambers contract and pump out blood when the signal arrives. A right bundle branch block indicates a short-circuit in that cable.

The electrical signal still makes its way to the right pumping chamber, but it has to make a slight detour to reach it. Most of the time, this doesn’t signify any serious heart problem.

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.

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