herpetic whitlow or dyshidrotic eczema

Image courtesy of DermNet New Zealand. What to do if I have eczema on my face and my girlfriend has gential herpes? According to the World Health Organization , about 67% of people under the age of 50 have HSV-1, globally. A. Not very itchy nor any pain. by 7 . We look at the symptoms, causes, and treatment options. Most herpes simplex virus infections are easy for physicians to diagnose. This forms a shallow ulcer with a crust-like scab. Learn more. The symptoms usually last 2 to 3 weeks at a time. I read on the internet that herpes and eczema can for into eczema herpeticum. Since dyshidrotic eczema can be triggered by stress, using techniques like meditation can help provide a dose of calm for your mind and body. This uses ultraviolet (UV) light to clear up your skin. The skin tends to become dry and crack or peel as it starts to heal. A culture of the vesicles may rule out a secondary infection. What is de Quervain's tenosynovitis, and how is it treated? Last medically reviewed on August 6, 2020, Cold sores have no cure, but a range of medications can ease the discomfort and reduce the duration of an outbreak. You can treat herpetic whitlow at home by: Due to the contagious nature of this condition, you should keep the blistered area covered until it heals. I cannot confirm anything without examination but it is less likely to be dyshidrotic eczema if the lumps are not itchy. Blood tests may also be performed.Untreated HSV infections will go away on their own, but medications can reduce the symptoms and shorten the duration of outbreaks. Pompholyx usually starts as intense itching and burning of the skin on the hands and fingers. The eruptions most commonly occur on the lateral aspect of the fingers, and they resolve with treatment of the inciting inflammatory process.1, Palmoplantar pustulosis is a type of pustular psoriasis that is localized to the palms and soles. Dont Miss: How To Get Rid Of Eczema Rash. People with other skin conditions, like contact dermatitis or seborrheic dermatitis , can also get eczema herpeticum from a herpes simplex virus infection . The herpes simplex virus (HSV) causes this condition. These eventually burst and scab over. The condition is most contagious when you have blisters on your skin. She said that mild cases are not always itchy. Das S, Samudrala S, Chander R. Herpetic whitlow masquerading as pompholyx in a healthcare worker: revisiting the entity in today's era. How do I prevent the condition from returning. It occurs predominantly in patients with a history of smoking.6 Palmoplantar pustulosis has a similar appearance to dyshidrotic eczema that is secondarily infected, but the pruritus is typically less severe. Epub 2021 Mar 1. Eczema herpeticum, also called Kaposi varicelliform eruption, is the rapid dissemination of a herpes simplex viral . Since it is caused by a virus, the best treatment for eczema herpeticum is an antiviral medication, like acyclovir or valacyclovir . Herpes simplex, the virus that causes the herpetic whitlow, can cause genital herpes (HSV-2), which is a sexually transmitted infection. Betz, D., & Fane, K. (2020). These sores or blisters are often painful and develop after direct contact with a contagious sore. This discomfort can sometimes become so severe during a flare that youre limited in how much you use your hands, or even walk. It can happen when areas of the skin that eczema affects come into contact with the herpes virus. Dr. J. Lawrence Dohan answered Dermatology 58 years experience Whitlow hurts: Herpes on finger is painful, localized, heals in 1 or 2 weeks. These treatments are available from pharmacies without a prescription. If you have any form of eczema and you develop a different kind of rash, especially one that is painful or forms blisters, see your healthcare provider for an evaluation. What is herpes keratitis? Can you catch herpes eczema from holding hands if you had a damaged cuticle? Herpetic whitlow isnt a sexually transmitted infection (STI or STD). Doctors arent sure what causes dyshidrotic eczema, About half of all people with dyshidrotic eczema also have other types of eczema such as contact and atopic dermatitis, No lab test can confirm that you have dyshidrotic eczema, but, Your doctor can prescribe an ointment or cream with a steroid in it to bring down swelling and help get rid of the blisters. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. Complications of this infection may include: Immediate treatment for eczema herpeticum can reduce the risk of complications from the virus. how can I avoid this? You might get a medicine first to help your skin respond better to the light. Eventually, the blister or group of blisters ruptures. Your skin will take in the medicine better if you put a wet compress on it after you use the cream. The reddish-brown rash is bilateral and varies in morphology from macular to papulonodular. An antihistamine like diphenhydramine (Benadryl) or loratadine (Alavert, Claritin) can help with the itch, too. Pain preceding the appearance of the skin lesions is a very important clue to this diagnosis. HSV-1 is very contagious. Hello. Pompholyx (also called dyshidrotic eczema) is a type of eczema that affects the hands or feet. The most common symptoms of dyshidrotic eczema include: Small, firm blisters on the sides of your palms, fingers and soles. A prompt medical evaluation will help confirm your diagnosis and establish treatment to offset signs and symptoms. Laboratory studies include a complete The small, itchy blisters are the most noticeable sign of dyshidrotic eczema. I'm not sure what this maybe 3 weeks ago i noticed bruises well it looked like bruises or small red patches under my underarm, im not sure if it was because i shaved, I do have sensitive skin but i never had eczema there before.I do have genital herpes bu. Patch tests can show if you have an allergy to nickel or another metal. Herpetic whitlow. Herpetic whitlow can affect anyone at any age, but the condition is most common in: Infection is uncommon. During these tests, your doctor will put patches with a small amount of different metals or other things on your skin to see whether you react to them. It causes raised, pearl-like. Why would my lips be sore and red on the outside? Covering your blisters also prevents the spread of the virus to others. Author disclosure: No relevant financial affiliations to disclose. Around 7 years ago, I idiotically used neat apple cider vinegar on my sc Hello, Eczema types: Dyshidrotic eczema diagnosis and treatment. Herpetic whitlow is an infection of the skin around your fingernail. By using this Site you agree to the following, By using this Site you agree to the following, Whats making me itch and irratated on my scalp face neck chest arms under arms etc, Please help my dry fingers (not exzema or psoriasis), The Best IOL for 2022 RXSight Light Adjusted Lens, Will refractive surgery such as LASIK keep me out of glasses all my life. People with atopic dermatitis are more susceptible to impetigo than those without eczema. Some with whitlow only have symptoms once, but the infection recurs in 3050% of people who develop it. Herpetic whitlow may resemble the following conditions: Yes, herpetic whitlow can occur on your toes, though its infrequent. These symptoms may last for several weeks at a time. Paranoid. Get the details on key signs, diagnosis, and. When sores or blisters appear, this is called a herpes outbreak. You may have a skin infection. Sometimes eczema herpeticum resembles another skin infection called impetigo. Painful blisters. Patients with Darier disease or seborrheic dermatitis can also acquire it. Herpetic gingivostomatitis in young children. It appears as an erythematous eruption that varies in morphology from vesicular to pustular and has a chronic, recurrent course. 2002-2023 National Eczema Association, All rights reserved. Recurrent herpes simplex labialis is a condition of the mouth caused by the herpes simplex virus. Although cold sores usually appear on your mouth, they can also appear in or around your nose. It mostly affects adults ages 20 to 40, and it's twice as common in women as in men. help? CMV is a type of herpes virus. Herpetic whitlow typically forms as grouped vesicles on the lateral edge of the thumb. Wash your hands and feet every day. Herpetic whitlow causes painful blisters on your fingers around your nails. I also experience the same thing, except mine are red and inflammed. These drugs help fight off the current outbreak but do not prevent future flare-ups. Our expert physicians and surgeons provide a full range of dermatologic, reconstructive and aesthetic treatments options at Cleveland Clinic. Herpetic whitlow is an infection of the skin around your fingernail. According to the World Health Organization (WHO), about 67% of people under the age of 50 have HSV-1, globally. There isnt a cure for herpetic whitlow. It is most likely to result from contact with a cold sore (HSV-1) and usually occurs on the: Symptoms of eczema herpeticum usually appear 512 days after exposure to sores from the herpes virus. Don't scratch the blisters. . Also Check: Dove Baby Body Wash For Eczema. DE and other eczemas commonly start due to an abrasion on the skin surface allowing contaminants in and starting an immune response that can then become a sensitivity and thus eczema. For others, the pain and itching may limit the use of their hands or feet. Created for people with ongoing healthcare needs but benefits everyone. In less obvious cases, rapid plasma reagin testing and a potassium hydroxide preparation should be considered as part of the diagnostic workup. Draining the blisters. Learn about dyshidrotic eczema, a common form of skin condition that causes blisters. You can learn more about how we ensure our content is accurate and current by reading our. You're more likely to get it if you have allergies like hay fever, a family history of dyshidrotic eczema, or other forms of eczema.. Once a person has one of these viruses, it will stay in their body for life. Image courtesy of DermNet New Zealand. Cardiovascular health: Insomnia linked to greater risk of heart attack. Blisters on your hands can make it hard to do things like cook, type, or wash dishes. There are two types of herpes: oral and genital. In this situation, hospital admission and IV antivirals will be necessary. Eczema herpeticum can also appear in people who have contact dermatitis or seborrheic dermatitis. However, recurrent outbreaks of herpetic whitlow are usually less severe and heal faster because the body has developed antibodies to take measures against the virus. Its possible to get recurrent outbreaks after an initial outbreak, but this is rare. A culture could have been done to confirm the diagnosis, but that would entail opening a vesicle to collect the fluid and then waiting at least 2 weeks for the results. The condition is most common in persons who come in contact with saliva, such as dental hygienists and. The condition usually heals within a few weeks without medication, but a prescription antiviral drug can shorten the duration of an outbreak. Although the presence of a blister is a common sign of this condition, your fingers may become red or swollen before a blister forms. If these treatments don't work well for you, you might try one of these: Light therapy. 2005 - 2023 WebMD LLC. I notice I get bumps all the time on my hands and fingers and sometimes toes ans I'm now thinking it could be eczema and not always the herpes causing the bumps. Ads are what helps us bring you premium content! Eczema herpeticum can also appear in people who have contact dermatitis or seborrheic dermatitis. The condition can spread from person to person through physical contact. There are different strains of the herpes simplex virus (HSV), including HSV-1, the main cause of cold sores, and HSV-2, the main cause of genital herpes. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. A person can develop herpetic whitlow through direct contact with skin containing the virus, which might be on the genitals, face, or hands. Herpetic whitlow is a viral condition where small blisters form on the fingers and the fleshy area around the fingertips. Some people get bacterial skin infections on top of the viral infection and need antibiotics as well. Herpes simplex type 1. Learn how we can help 3.8k views Reviewed >2 years ago Thank Dr. Warren Foster agrees 2 thanks Get answers from Allergists and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. Read on for more, Molluscum contagiosum is a common viral skin infection that an infected person can pass on through close, direct contact. They will often also recommend continuing any ongoing eczema treatment. CMV is very common and may have few or mild symptoms or, in some people, may cause serious conditions. It is most often seen as a complication of atopic dermatitis /eczema. There are several types of herpes, but the two common ones are herpes simplex virus types 1 and 2. Eczema herpeticum is also known as Kaposi varicelliform eruption because it was initially described by Kaposi in 1887, who thought it resembled . They can also reduce the chances of it spreading from person to person, but they cannot eliminate the risk. The only way of ruling it out is by getting yourself tested for herpes. The condition usually resolves within two to three weeks. Doctors can usually identify viral conditions based on the appearance of sores or lesions. All Rights Reserved. Some people with atopic dermatitis may develop dyshidrotic eczema. If your hands are affected, make sure to remove rings and jewelry whenever you wash your hands so water doesnt linger on your skin. At this point, there may be a color change, such as reddening. This is because the skin on the hands and fingers is much thicker than the skin on the genitals or lips. Eczema herpeticum is an infection usually caused by the herpes simplex 1 virus or "oral herpes" - the virus that causes cold sores to appear around and inside the mouth. But you can manage them with medicine, moisturizers, and good hygiene. The infection leads to redness, soreness, and fluid-filled blisters. While home remedies may not be as effective as a doctor-recommended medication, they can help ease symptoms. Recommended Reading: I Think I Have Eczema. It can affect your palms, the sides of your fingers, and the soles of your feet. Some people with eczema herpeticum may need to spend time in the hospital. An estimated 2 people per 100,000 receive a herpetic whitlow diagnosis in the United States. You can also soak the affected areas for 15 minutes your doctor may know some good inflammation-lowering medicated soaks. What is the latest research on the form of cancer Jimmy Carter has? Antivirals also help lower the risk of transmitting the virus to other people. hsv1 on my genitalia. Signs and symptoms of herpetic whitlow include: The herpes simplex virus (type 1 or type 2) causes herpetic whitlow. See permissionsforcopyrightquestions and/or permission requests. In severe cases, the blisters may be quite large and may spread to the backs of the hands, feet and limbs. How do I know which i have? People with atopic dermatitis are more susceptible to skin infection in general, including eczema herpeticum. Managing eczema can minimize discomfort and improve quality of life, but it can also help prevent a serious skin infection. (2019). The symptoms typically present as follows: Eczema herpeticum is a medical emergency because it can lead to severe and sometimes life threatening complications, such as: Eczema herpeticum can occur in people with any condition or injury that involves damaged skin, such as: HSV-1 commonly causes cold sores, known as oral herpes. I thought that it was herpes since I do get cold sores every 6-7 months. I have been treated for herpes, eczema, yeast infection? MNT is the registered trade mark of Healthline Media. This condition isn't contagious. Recommended Reading: How To Treat Pompholyx Eczema, Infection in the cornea of the eye known as herpetic keratitis, which left untreated, can lead to blindness, In rare cases, organ failure and death if the virus spreads to the brain, lungs and liver, National Eczema Association | 505 San Marin Drive, #B300 | Novato, CA 94945. Get the latest eczema news delivered to your inbox. Created for people with ongoing healthcare needs but benefits everyone. Get useful, helpful and relevant health + wellness information. Heart failure: Could a low sodium diet sometimes do more harm than good? Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. He or she may begin by scraping the infected skin and looking at the contents of the blisters under the microscope . However, if a person with eczema becomes infected with one of the herpes simplex viruses HSV-1 or HSV-2 they may develop eczema herpeticum. Eczema herpeticum affects people with atopic dermatitis and other inflammatory skin diseases. Because the causes are unknown and the triggers are so personal, theres no one way to completely prevent or control outbreaks of dyshidrotic eczema. As a result the skin may also fissure. The appearance of a sore or blister on your finger isnt usually a cause for concern. You may experience a burning or tingling pain thats worse than what you would expect from the blisters. And be educated when shopping for cosmetics. Keep the affected area well moisturized at all times. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Within a few days, a crust will form, along with drying and healing. The first symptoms of a dyshidrotic eczema flare may be a burning, itching sensation without any visual clues. Dermatology 1999; 198:265. We offer this Site AS IS and without any warranties. Itch??? Could it be eczema or dermatitis or herpes/cold sores, I do not have blisters. If the herpetic whitlow were to recur in the same location, prompt treatment could be initiated, which would likely shorten the disease course and reduce symptoms. Do not burst the blisters. 2 and a half years ago I had a false negative come back for herpes. In addition, your sleep may be disrupted if the itching or pain is severe. Typically herpes does n What do you advise if I'm paranoid! Eczema herpeticum is a rare but potentially serious complication. Dyshidrotic eczema, also known as dyshidrosis and pompholyx, is a vesicular eruption that primarily affects the palmar aspect of the hands and lateral aspects of the fingers. Learn the symptoms and treatment for eye herpes, or ocular herpes, caused by the herpes simplex virus (HSV). Once they show up, they last about two weeks and don't itch. But the skin underneath can be red and tender for a while. Symptoms of eczema herpeticum usually appear 5-12 days after exposure to sores from the herpes virus. Hoff N, et al. In 3050% of people with herpetic whitlow, the infection reoccurs over time, often in the same place. It is characterized by deep-seated lesions ranging from small vesicles to large, tense bullae clinically and by spongiotic vesicles histologically. If your situation suggests a herpetic whitlow diagnosis, a healthcare provider will complete an evaluation. Color changes to the skin around your nail, usually darker than your normal skin tone, or red to purple. , National Eczema Association: "Favorite earrings got you feeling irritated? In immunosuppressed patients, herpes simplex can become generalised and may be life-threatening. Eczema: Tips on how to manage atopic dermatitis in . We avoid using tertiary references. Call your doctor or 911 if you think you may have a medical emergency. About 11% of people around the world have HSV-2. Botulinum toxin. Can poor sleep impact your weight loss goals? This series is coordinated by John E. Delzell Jr., MD, MSPH, associate medical editor. Copyright 2023 American Academy of Family Physicians. The virus usually penetrates your skin if you have a cut. The additional testing mentioned can help differentiate between the two when necessary. Pompholyx is also called dyshidrotic eczema. All rights reserved. During remission, the symptoms disappear, but during a flare, they worsen. Learn now what our authors are saying about dyshidrotic eczema herpetic whitlow. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. What are the symptoms of herpetic whitlow? Best food forward: Are algae the future of sustainable nutrition? You could make the eczema worse. Unfortunately, theres currently no cure for HSV, though researchers are making progress on future treatments. Histopathologic and laboratory studies are indicated for patients with suspected perniosis to distinguish between idiopathic perniosis and secondary perniosis. taking a pain reliever such as acetaminophen or ibuprofen to help reduce pain and fever, applying a cold compress several times a day to help reduce swelling, cleaning the affected area daily and covering it with gauze. :(. The virus infects the soft tissue and causes localized: A person may feel a burning or tingling sensation or pain before the finger, or fingertip, swells. (2012). We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. Check out this roundup of the best at-home herpes tests to find out everything you need to. My best advice is for you to schedule a visit with your primary care provider or a dermatologist if that is an option for you. Dyshidrotic eczema is a sudden rash of small, itchy blisters on your palms and along the sides of your fingers. Herpetic whitlow, or whitlow finger, is a painful infection caused by the herpes simplex virus. Pimecrolimus cream, tacrolimus ointment, or Eucrisa, are typically used to treat atopic dermatitis. A doctor can usually recognize eczema herpeticum by looking at the symptoms. Herpetic whitlow may recur, especially with finger cuts, but recurrent episodes are usually less symptomatic. Prevention may be difficult, but the following measures can help: Herpetic whitlow is a temporary, painful condition that typically resolves in two to three weeks. Healthline Media does not provide medical advice, diagnosis, or treatment. Signs of an infection can include the blisters becoming very painful and oozing pus or becoming covered in a golden crust. Whitlow usually causes very pronounced symptoms: pronounced redness and blistering, and significant pain and discomfort. HSV-1 can spread through sexual contact from the mouth to the genitals, but it is not necessarily a sexually transmitted infection . Please support this website by adding us to your whitelist in your ad blocker. Wear gloves with cotton liners whenever your hands are in water, like when you wash dishes. For mild flare-ups, your doctor may recommend: Eczema, or atopic dermatitis, is more common in children and infants than in adults. About 10 to 20 percent have some form of eczema. You also might use a cream that has dimethicone to protect your skin. I have tried everything under the sun from steroid creams to antibiotics, deuch cleaners I itch non stop for 2years plus. Is the ketogenic diet right for autoimmune conditions? Complications of this infection may include: Immediate treatment for eczema herpeticum can reduce the risk of complications from the virus. People with atopic dermatitis, contact dermatitis and other types of eczema should avoid contact with anyone who has a cold sore. Stopping your child from sucking their fingers, especially their thumb. Most people refer to herpes simplex viruses as herpes. Get The Answer. We examine the symptoms, treatment options, and management tips for this. herpetic keratitis, an infection in the cornea of the eye that can lead to vision loss without treatment, organ failure and death, if the virus spreads to the brain, lungs, and liver, people whose eczema is severe or developed at an early age, a person with eczema who has undergone a skin peel, dermabrasion, or other cosmetic procedure, those with eczema who have sustained an injury to the skin, metals, for example, in watch straps and jewelry. HSV-1 can spread through sexual contact from the mouth to the genitals, but it is not necessarily a sexually transmitted infection (STI). Early treatment can help prevent complications and stop HSV from spreading to vital organs. They do not usually leave scars unless people pick or scratch them. Patients with atopy are often susceptible to all types of skin infections: bacterial, fungal, and viral. Use an emollient as a soap substitute and wear cotton-lined gloves when youre at risk of contact with other potentially irritating substances, such as when washing your hair or doing housework. Your dermatologist can drain fluid from the blisters. Distribution ranges from the palms and soles to the entire body and mucous membranes. Eczema herpeticum usually appears on the face and neck. An eczema herpeticum happens when the herpes virus infects large areas of the skin. The herpes simplex virus causes the condition when the virus penetrates your skin through a break in your skin near your nail. Email submissions toafpphoto@aafp.org. If your doctor suspects a virus, a skin swab or blood test can confirm or rule out herpetic whitlow. Theyll look at your hands and feet, as well as your nails. But they have also been shown to be effective for dyshidrotic eczema. By then, this whitlow would have long since resolved. The lesions contain a sterile infiltrate, consisting of neutrophils and eosinophils.6, Secondary syphilis, caused by Treponema pallidum, occurs one to six months after the initial (primary) infection. Herpetic Whitlow or Dyshidrotic Eczema The main complication of dyshidrotic eczema is usually the discomfort from itching and the pain from the blisters. Acyclovir treats certain viruses, including the cause of cold sores, chicken pox, and shingles. To confirm a diagnosis, the doctor may take a swab from a blister to check for bacteria or a virus. Herpetic whitlow causes painful blisters on your fingers. How careful do I need to be with my herpes to not give her eczema herpeticum? These viruses transmit from one person to another and can cause painful or itchy blisters or open sores. Theres no cure, so these blisters will come and go over time. Weve rounded up 32 of the best herpes home remedies and natural treatments backed by a mix of scientific and anecdotal evidence. It may or may not reactivate and cause symptoms. Healthcare workers, like dental hygienists and respiratory therapists with exposure to peoples mouths (oral mucosa). I did got to the dermatologist who said that t looks like dyshidrotic eczema. Started out on just 2 fingers a week ago. Or you might hold a cold, wet compress on the blisters for 15 minutes at a time several times a day. Both of these strains can cause herpetic whitlow. If allergies set off your eczema, try to stay away from things that trigger them. nhs.uk/conditions/herpetic-whitlow/Pages/Introduction.aspx, journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1008076, Everything You Need to Know About Oral and Genital Herpes, Everything You Should Know About Eye Herpes, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI, 32 Home Remedies for Herpes Simplex Virus 1 and Virus 2, Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT, How to Identify and Treat a Cold Sore in the Nose. HSV to other sites (eg, herpetic whitlow , herpetic keratitis , eczema herpeticum , encephalitis, esophagitis, pneumonitis, eczema herpeticum ), lip adhesions, and secondary . Herpetic whitlow doesnt require treatment. This article reviews all you need to, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. These drugs can be options if you don't want to take steroids. Impetigo is a bacterial skin infection, usually with Staphylococcus aureus or Streptococcus pyogenes, which are common skin bacteria. So on the hand the virus must exert considerably more force to break through to the skin surface. Feels like little slivers of glass are stuck under my skin. Policy. If youve contracted HSV, herpetic whitlow may occur as a secondary condition. Porter, D. (2020). Treatment simply helps relieve signs and symptoms and makes them go away faster. As with all HSV infections in the immunocompetent, treatment with acyclovir must be started in the first 2 to 3 days to have any effectso such treatment in this case would be useless. WebMD does not provide medical advice, diagnosis or treatment. Physical examination revealed multiple vesicles on the palms in various stages of healing with faint surrounding erythema (see accompanying figure). In fact, human papillomavirus infection manifesting as multiple warts is not uncommon in this population. Its common and spreads easily. Medicines that slow your immune system. Thank you! Don't try to do this yourself. Your provider will diagnose herpetic whitlow based on the appearance of the signs and symptoms localized on your finger. Nickel is in foods like chocolate, broccoli, legumes, and nuts. I presume that you have already been treated by your GYN but still have not had a satisfactory response. It's usually a long-term condition, but treatment can help control the symptoms.

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