Telangiectasia

Dear Diary,

Today, a man came to me asking me if there is anything for that black mark on his lips. Apparently, the black mark seemed to be beneath the epidermis of the lower lip (near the surface of the skin) but clearly visible. He rattled off that he saw one of the top cosmetic surgeons or aesthetic doctors (whose name I shall not disclose), and the specialist doctor told him that he may need to undergo Intense Pulsed Light (IPL) therapy. Hmmm… he continued to say that the doctor surprisingly advised him to try some topical creams (without naming the cream) from the pharmacy first as a $700 IPL or laser treatment may cause a depression on the lip. He then told me he read that he could be suffering from a side effect from using steroids.

“What steroid are you using?” I asked… knitting my brows. “Seretide”, He replied. Hmmm… does inhaled steroid cause any black mark on the lips? Telangiectasia? I don’t think you can get telangiectasia with chronic INHALED steroids. That’s more for chronic use of topical steroids, right? The risk is far too low. I took one more look at that black mark on his lower lip and asked him if he ever knocked into something before. His eyes beamed with amazement… “How did you know?” He questioned. I smiled and asked him when was that knock. He said that it was about 2 months ago. I told him that the black mark is likely to be a blood clot from the bursting of a small blood vessel.

“Why did the black mark grow in size?” He asked. Somehow… I just came out with an explanation of blood stasis leading to enlargement of clots. That guy was totally amazed by my explanation and asked me how to solve it. I told him to go to a general practitioner (GP) and suggest my hypothesis to the doctor. Then I told him to suggest the doctor to do an incision & drainage (I&D) to clear the clot, and then doing proper wound care after that. He was thrilled with my “diagnosis” and thanked me profusely.

Oh well… I sure hope I was right. Then again, after picking up possible rhabdomyolysis from statin uses, chronic cough from angiotensin-converting enzyme inhibitors (ACEI), … so far, no one really came back to tell me if my diagnoses were correct. The least they could do was to write a compliment letter for me, right? Haha…

Yesterday early morning, I made a trip down to NUS to meet up with a former professor. It was really nice to see her and had a 25-minute chat with her. She told me that the pharmacy department actually wondered who was that “Andrew” who attended that high-level advisory committee by the Pharmacy Board. Cool… news fly. I saw two of my former classmates and had a chat with them. How nice to see them indeed. They said I looked like when I was in the university. Yeah… still young… haha… I rushed off to work after that. Back to the routine life.

That’s all for my update… think this blog is fading away. I don’t have much stories to tell these days, keke… Goodnight!

God Bless,

Andrew