Diseases & Conditions Archive

The potential causes may be hard to pin down. Here are some of the most common ones — and what to do about them.

Sometimes it's easy to know why a particular part of your body is itchy. Maybe you have a bug bite, allergies, or a visible skin condition such as eczema. It's harder to know the cause when there's nothing obvious behind all-over, generalized itching. "It's the most common skin complaint in people over age 65," says Dr. Kenneth Arndt, a dermatologist and former medical editor of the Harvard Special Health Report Skin Care and Repair.

Potential causes

Generalized itching has many potential triggers. One is aging. "The skin barrier doesn't work as well as it used to, and things that may not have irritated you before may now be absorbed in the skin and cause itching," Dr. Arndt explains. "The skin also develops a somewhat impaired immune response, a reduction in fat and blood flow, and altered sensory perception, making it more prone to itching."

Experts say that while there are many unknowns about long-term COVID effects, it's hoped that more information will be available soon.

A growing number of Americans have now experienced a bout of COVID-19, and doctors are only just beginning to learn more about the aftereffects of the infection.

"Reports are coming out describing long-term lung effects — which is not surprising, as scarring may occur and cause permanent impairment — and also of neurological, cardio­vascular, and kidney effects," says Dr. David Christiani, a professor of medicine at Harvard Medical School and a pulmonary physician at Massachusetts General Hospital.

If you have chickenpox as a child, the virus stays in your body, and can emerge later in life as a painful, burning rash called shingles. It’s not fully understood what triggers a resurgence of the virus, but factors that weaken the immune system increase the risk of developing shingles, and it is more common in people over age 60.

News briefs

If your doctor or pharmacist offers a service to monitor blood pressure measurements you send from home (called telemonitoring), consider taking advantage of it. Past research has shown that telemonitoring — often paid for by Medicare — may help you reduce your blood pressure. And a study published online Aug. 31, 2020, by Hypertension suggests telemonitoring is also associated with a long-term reduction in heart attacks, strokes, and medical costs. The recent study is a follow-up to a randomized controlled trial from 2013 that divided 450 people into two groups: those who received routine primary care, and those who received a year of telemonitoring services with a pharmacist who helped manage their treatment. People in the telemonitoring group had lower blood pressure for up to two years afterward, compared with people who received routine care. In the recently published follow-up, which followed the same participants for five years, researchers found there were about half as many heart attacks, strokes, and hospitalizations in the telemonitoring group as there were in the group that received routine care. Because there were fewer cardiovascular problems, people in the telemonitoring group also saved an estimated $1,900 each in medical costs.

On call

Q. I would occasionally get some swelling in my legs. But now I notice it by late afternoon every day. I otherwise feel fine. Should I be worried?

A. It sounds like you have edema, swelling in your legs due to fluid in the soft tissues beneath your skin. This usually occurs when pressure from the fluid inside your veins is high, which forces water out of the blood vessels and into the surrounding tissues.

About half of all heart attacks are mistaken for less serious problems and can increase your risk of dying from coronary artery disease.

 Image: goir/Getty Images

You can have a heart attack and not even know it. A silent heart attack, known as a silent myocardial infarction (SMI), account for 45% of heart attacks and strike men more than women.

They are described as "silent" because when they occur, their symptoms lack the intensity of a classic heart attack, such as extreme chest pain and pressure; stabbing pain in the arm, neck, or jaw; sudden shortness of breath; sweating, and dizziness.

On call

Q. My blood pressure stays low. Sometimes it drops so low, it causes dizziness and weakness. What causes this?

A. Of the possible causes of low blood pressure, two are at the top of my list. First, I would review your medications. Drugs prescribed to treat high blood pressure and heart disease are the ones that most often cause this side effect. Reducing the dose with your doctor's approval may be all you need.

On call

Q. What would cause my tongue to suddenly swell? Could this be a possible side effect of medication, or something else?

A. There are many reasons for a swollen tongue. Indeed, a reaction to a medication is one of the more common causes. For example, a well-known side effect of ACE inhibitors (a class of drugs used to control blood pressure) is a condition called angioneurotic edema. Swelling of the face, lips, and tongue can happen quickly in people who take an ACE inhibitor. The reaction may occur soon after it's first taken or at any time thereafter. Sometimes people get this reaction even though they have used the drug for several years. ACE inhibitors are more likely to cause angioneurotic edema in African Americans.

New guidelines suggest doing more of the same. The problem is that many people don't.

You never forget your first gout attack. The severe pain, swelling, and redness hits hard and fast. The initial attack often strikes your big toe's large joint, but later ones might affect the foot or ankle. Other hot spots include the knees, hands, and wrists.

First-line treatment is quite effective and includes anti-inflammatory medications, ice therapy, and rest. A combination of diet and lifestyle changes and prescription drugs — an approach called urate-lowering therapy, or ULT — is typically recommended if attacks recur or become more severe.