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NAPE Q & A

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Q  Can a person with PXE take a baby aspirin every day? I am 67 years old.

A There is no easy answer to this like yes or no.  As always in medicine…it depends...

In order to come to the right conclusion for a single patient one needs to know the reason why someone wants to take a baby aspirin.

1. Does the person suffer from proven cardiovascular disease and does the person want to use aspirin as second line prevention against further cardiovascular injury events?

2. Does the person expect cardiovascular disease events due to age and wants to use regular aspirin intake to prevent cardiovascular disease events?

3. What is the current visual status?

    3a. Has the person had retinal bleeds?
    3b. Has the person angioid streaks running through the
          macular?
    3c. Is there any evidence that these streaks tend to leak?

4. What is the gastrointestinal status?

   4a. Has the person had stomach or duodenal ulcers?
   4b. Has the person ever had a gastrointestinal bleed?

5. What is the major health concern?

   5a. Is it to suffer a first stroke or heart attack?
   5b. Is it to prevent a second stroke or heart attack?
   5c. Is the worst thing to imagine the loss of your central vision?

Depending on the individual answers to these questions the individual recommendation for aspirin may vary. In general the recommendation is that one should take a baby aspirin a day if there is proven cardiovascular disease, unless there are severe contra indications against aspirin intake. In order for you to come to the right individual conclusion (whether to take aspirin or not) answer these questions with your doctors. Your primary care physician, your cardiologist and your retinologist will need to work out the right answer for your individual case.

- Berthold Struk, MD, Cardiologist

Q  I am 68 years old and have been itching where my skin has PXE lesions, especially on the neck and inner elbows. There is no redness or other changes to the skin. I have tried several ointments that have not helped.

A Skin lesions of PXE do not usually itch. The fact that the lesions itch strongly suggests there are other external factors involved. There is a good chance that you have developed an allergy to one of the products you’ve been using. And just scratching the areas of skin will gradually irritate the site and cause itching which can be severe. Patients with eczema often have similar problems. It’s called neurodermatitis.

Therefore, without knowing more about the history, the first advice is to stop everything being used. Topical cortisone is one of the best topical anti-itch medications available. You can buy hydrocortisone ointment 1% without prescription. Just be sure it is 1% and in an ointment base (not cream or lotion). Apply sparingly three or four times daily. It should give relief in a few days. If it does not help, there are other stronger cortisone preparations, but these require a prescription. Consult a dermatologist if the itching continues.

- Kenneth Neldner, MD, Dermatologist 

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