關於 fish skin disease ，我們在網路上蒐集到這些相關的討論、資訊與評價

#Applaws召回

剛剛在別的群組有人分享，英國這邊有些牌子的貓乾糧發生問題要召回，剛幫Couchi 換了一個月左右的 Applaws 就在其中😭

而且剛剛已經看到有人說她家的貓咪幾週前就因為身體出現狀況，很突然地走了，今天獸醫才告知是因為Applaws的乾糧有問題！

雖然他看起來好好地，但覺得好擔心啊！剛剛已經緊急把他的乾糧都換成別的牌子了，還好家裡都有備著不同的品牌。希望庫奇福大命大，平安健康🙏🙏🙏

以下是公告召回的品牌乾糧：

Sainsbury's:

Sainsburys Hypoallergenic Recipe complete dry cat food with salmon 1+years 800g

Sainsburys Hypoallergenic Recipe complete dry cat food with chicken 1+years 800g

Pets at Home:

Ava Kitten Chicken 300g and 2kg

Ava Adult Chicken 300g, 2kg and 4kg

Ava Adult Fish 2kg

Ava Mature Chicken 7+ 2kg and 4kg

Ava Senior Chicken 12+ 2kg

Ava Sensitive Skin & Stomach 1.5kg

Ava Weight Management 1.5kg

Ava Hairball 1.5kg

Ava Oral Care 1.5kg

Ava British Shorthair 1.5kg

Ava Persian 1.5kg

Ava Maine Coon 1.5kg

Applaws products (best before date between December 2022 to June 2023 with a site reference code of GB218E5009):

Applaws Cat Dry Chicken 400g, 2kg and 7.5kg

Applaws Cat Dry Senior Chicken 400g, 2kg and 7.5kg

Applaws Cat Dry Chicken & Salmon 400g, 2kg and 7.5kg

Applaws Kitten Dry Chicken 400g, 2kg and 7.5kg

Applaws Cat Dry Chicken & Lamb 400g, 2kg and 7.5kg

Applaws Cat Dry Chicken & Duck 400g, 2kg and 7.5kg

Applaws Cat Dry Ocean Fish 350g, 1.8kg and 6kg

請大家踴躍分享！

孫女從嬰兒時期就有異位性皮膚炎，心疼他因為癢而抓出許多血絲與常常皮膚紅腫。身為婦產科醫師的我，對這個疾病不甚了解，但最近開始閱讀這個疾病的相關知識，想與大家分享。

近二十年來，台灣的異位性皮膚炎的盛行率增加將近一倍， 有些研究顯示都市化和空氣污染會增加風險，也有些研究說媽媽在懷孕期間多吃魚會降低風險。

百分之八十的異位性皮膚炎始於5歲以下，而約有一半以上得異位性皮膚炎的小朋友，長大會”自己好” 但詳細原因不明，或許和早期疾病的控制有關。

異位性皮膚炎是一種皮膚的過敏反應，許多病人因爲皮膚天然保濕因子 (filaggrin) 不足的體質，造成過敏原更容易通過乾燥龜裂的皮膚，而誘發過敏反應，所以除了擦藥與(嚴重時)吃藥，保濕乳液對於預防復發非常重要，近幾年有些免疫阻斷劑的上市，讓對付嚴重異位性皮膚炎的 ”藥品軍火庫“ 又增加一些生力軍。

有家族病史的小朋友更容易得到異位性皮膚炎，代表基因也有關聯。約有60-70% 的異位性皮膚炎的病患，會有 Filaggrin 基因上的某些位點的突變 ，目前已知有數十個 Filaggrin 基因位點的突變，有趣的是，亞洲人與歐洲人突變的位點不盡相同。而台灣本土人口 Filaggrin 基因位點的突變，仍尚未被發表。

目前各國的皮膚科醫學會，都同意早期治療，藉以降低復發的強度與頻率，所以小朋友的皮膚如果常常乾紅癢，應該及早就醫診斷與治療。至於有家族病史但沒有發病的小朋友，是否該做Flaggrin基因檢測，而提早擦保濕乳液 ，是一個值得討論的題目。

#異位性皮膚炎
#保濕因子
#提早擦乳液

參考文獻

Chu C-Y et al. Taiwanese Dermatological Association consensus for the management of atopic dermatitis. Dermatologica Sinica. 2015 Dec 1;33(4):220–30.

Romieu I, Torrent M, Garcia-Esteban R, Ferrer C, Ribas-Fitó N, Antó JM, et al. Maternal fish intake during pregnancy and atopy and asthma in infancy. Clin Exp Allergy. 2007 Apr;37(4):518–25.

Irvine AD, McLean WHI, Leung DYM. Filaggrin mutations associated with skin and allergic diseases. N Engl J Med. 2011 Oct 6;365(14):1315–27.

Nutten S. Atopic Dermatitis: Global Epidemiology and Risk Factors. ANM. 2015;66(Suppl. 1):8–16.

＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝
My granddaughter suffers from atopic dermatitis (AD) at a young age. The constant scratching causes little spots of bleeding and roughening of her baby skin. There doesn’t seem to be a cure for this condition. Even though I am an O&G specialist by trade, I have decided to read a little bit more on this topic and share them with you.

The prevalence of AD has doubled in Taiwan in the last 20 years. Some research shows industrialisation and air pollution may be risk factors whilst fish intake during pregnancy reduces infant risks of AD.

Eighty percent of AD starts below the age of 5. And about half of the children tend to “grow out of” AD. It may be mutli-factorial but the immune tolerance may be related to early control of AD.

Atopic dermatitis is a hypersensitivity reaction of the skin, many patients are found to have defects in their skin Filaggrin, which is a naturally-occurring skin moisturiser. Therefore skin emollient is an important treatment for the prevention of AD flares. Apart from the existing immunosuppression treatments (such as topical corticosteroids and calcineurin inhibitors), there are now biological agents available for the treatment of severe AD. The therapeutic armamentarium against AD is slowly increasing as we understand more about the disease.

Many variants of mutation at the Filaggrin gene have been found in up to 70% of patients with AD. There are currently 50-60 disease-causing variants known. Interestingly, mutations found in the European population seem to be different from those found in the Asian population. The mutations specific to the Taiwanese population are yet to be found.

The consensus amongst international experts seems to agree that early treatment of AD reduces recurrence and severities. However, it would be interesting to know the utility of early moisturizer application in those testing positive for Filaggrin gene but without AD.

【蟹季到了】蟹！蟹！全部都是蟹！

#原來平常吃的七種蟹都是青蟹
#大閘蟹開售當然先吃為快
#星期四食材

智吃秋蟹免不適
正所謂「秋風起，蟹腳癢」秋風一起，菊黄蟹肥，又到了吃蟹好時節，除了一期一會的大閘蟹，奄仔、膏蟹、肉蟹、黃油蟹都各有捧場客，很多人以為它們是不同蟹種，原來統統都是不同成長階段的青蟹！

奄仔 — 3個月大、未經交配的雌青蟹，全身充滿青春期成熟的脂膏。
重皮蟹 — 奄仔蟹需要經過數次褪殼成長，新殼未硬還藏在舊殼內就是重皮蟹。
軟殼蟹 — 重皮蟹當外殼脫掉，內裡的軟殼還沒長硬便是軟殼蟹。
水蟹 — 軟殼蟹吸滿水份，當新殼變硬時，是為水蟹。
肉蟹 — 長肉後的雄性水蟹成為肉蟹。
膏蟹 — 成長後的雌性水蟹成為膏蟹。
黃油蟹 — 成熟的膏蟹產卵時喜歡爬到淺灘曬太陽，蟹膏受熱溶化流滿全身，成為黃油蟹。
大閘蟹 — 正值繁殖期的中華絨蟄蟹，豐富的蟹膏來自蟹的性腺，蟹乸的卵巢和卵細胞呈橙紅色，即紅膏；蟹公的精囊及精液呈乳白色半透明果凍狀，俗稱白膏。

至於令蟹迷瘋狂的大閘蟹，品種為中華絨蟄蟹，秋冬正值大閘蟹繁殖之時，於是體內充滿蟹黃。進食時記得把最寒的六角形蟹心位置取出，配以性溫的薑醋同吃，因為醋有開胃、活血、解魚蟹毒之效，可減低蟹的寒性，稍微紓緩吃蟹後有可能出現的胃脹不適。避免與柿、山楂、橙、李子、桃等高鞣質食物同吃，否則會出現腹瀉、嘔吐的症狀。

無論哪個品種或階段的螃蟹，從中醫角度來看都屬性寒涼，有清熱、散瘀血、通經絡的功效，氣滯、血瘀及濕熱體質人士可適量食用。不少人吃蟹後容易腹瀉，都是因為蟹屬性寒涼之故，所以體質虛寒、手腳冰冷、脾胃虛寒、容易腹瀉及胃脹人士、孕婦、坐月、行經中的婦女都應避免進食；膽固醇高和有心血管病的人不宜進食；螃蟹屬動風發物，容易透發或加重皮膚瘡瘍腫毒症狀，所以皮膚敏感、濕疹患者或容易出風癩者不宜吃。

為了消減螃蟹的寒性，除了烹調時加入薑、蔥、蒜等溫熱食材，飯後喝杯紅糖薑茶亦有暖胃驅寒作用。

紅糖薑茶
功效：驅寒暖胃
材料：薑片10片、紅糖適量
做法：煲滾約800毫升水，加入薑片，調中火煮約30分鐘，加入紅糖拌至溶化即可。

Smarter ways to eat crab
Autumn is a good season to have crab. In addition to the seasonal hairy crab, young mud crab, female mud crab, male mud crab, yellow butter crab are also popular. Many people think that they are different species. In fact, they all are mud swimming crab but in different growth stages!

Young mud crab- 3-month-old, immature female mud crab that is full of crab butter.
Double-shelled crab- The young mud crab need to be shelled several times. They become double-shelled crab with new shells are not hard and hidden in the old shell.
Soft-shell crab- The double-shelled crabs are soft shell crabs when the outer shell is taken off and the soft shell inside has not yet harden.
Water crab- When soft-shell crabs are full of water and the new shell becomes hard, they become water crab.
Mud crab (male) - when male water crabs matures and is full of meat
Mud crab (female)- when female water crabs mature and is full of butter
Yellow butter crab- Mature female mud crabs like to climb to the shallow beaches to sunbathe when they lay their eggs. The crab butter is melted by heat and the crab become the yellow butter crab.
Hairy crabs- the breeding season for Chinese mitten crab. The rich crab butter comes from the gonads of crabs. The ovaries and egg cells of female crabs are orange-red, which is red cream. The seminal vesicles and semen of male crabs are milky white translucent jelly, commonly known as white butter.

As for the hairy crabs that make crabs fans crazy, the variety is Chinese mitten crab, and the autumn and winter are when the crabs are breeding, so the body is full of crab butter. Remember to take out the coldest part of the crab which is in the center of the crab and hexagon-shaped. Have the crab with ginger vinegar. Vinegar is warm in nature and can stimulate appetite, promote blood circulation, and detoxify the toxins from the crab and fish. It can reduce the coldness of the crab and relieve any stomach discomfort after eating them. Avoid eating foods with high tannins such as persimmon, hawthorn, orange, plum, peach, as that may cause symptoms such as diarrhea and vomiting.

No matter which species or stage of crab, from Chinese medicine perspective, they are cold in nature, they can clear heat, dispel blood stasis, open up meridian. Those with qi stagnation, blood stasis and damp heat can appropriately consume. Many people are prone to diarrhea after eating crabs due to the cold nature of the crabs. Therefore, those with asthenic and cold body constitution, cold limbs, asthenic and cold spleen and stomach, prone to diarrhea and abdominal bloating, pregnant, in confinement month and menstruation should avoid eating. Those with high cholesterol and cardiovascular disease should not eat crabs too. Crabs is a wind stimulating food, easy to permeate or worsen the symptoms of skin sores, skin allergies, eczema. It is especially not suitable for those with hives.

In order to reduce the cold nature of crabs, in addition to adding warm and hot-natured ingredients such as ginger, spring onions, garlic. You can drink a cup of ginger tea with brown sugar to warm the stomach and dispel cold after the meal.

Ginger tea with brown sugar
Effects: dispels cold and warms the stomach
Ingredients: 10 slices of ginger, appropriate amounts of brown sugar
Preparation: Boil about 800ml water then add in ginger slices. Turn to medium heat and simmer for 30 minutes. Add brown sugar to taste until they melt.

#男 #女 #陽虛 #我畏寒