Infections

Celebrities are just like us–they get skin infections too!
Reality TV's Queen of the Selfie got caught in the paparazzi's glare with this crusted lip blemish.  Looks like Kim Kardashian has a cold sore.
As a rule, posting paparazzi pics are not the policy of skinema.com, but these images of actress Katie Holmes have been so downloaded, dissected, and discussed that they are practically public property. The starlet sports dry, crusty, chafed skin around the mouth with an inflamed blemish on her lip. What a hassle for Holmes:  Herpes!

As Holmes herself reported in a 2003 interview with Allure magazine:

"Holmes does have one less-than-glowing memory of her childhood: recurrent cold sores. Not the little kind on the lip, but the large, festering blisters that sometimes would invade her throat and even her eyes. 'I'd get them everywhere--I'd just walk around eating ice cream.' Even today, she says, 'If I break out in a million zits I'm so excited it's not a cold sore.'"

Holmes is not alone. Some estimate that 50-80 % of Americans deal with this type of oral herpetic hassle. In this scene from “The Witches of Eastwick,” actress Michelle Pfeiffer is cursed and becomes feverish and confused.  Herpetic lesions can develop during other infections, hence the lay term “fever blister.”  Some say that Pfeiffer’s sores were not from makeup, showing up in other films as well. Since cold sores are so common, the days of fever blisters causing a near suicidal stigma should go the way of Hawthorne's "Scarlet Letter." It's the 21st century people: Get over it.

Or treat it. Celebs like Kim Kardashian can’t avoid red carpet events just because of a pesky virus. Outbreaks can be safely controlled with antiviral medicines. Topical salves like Abreva and Denavir may soothe the inflamed skin. But like Kardashians conquering TV ratings, oral meds like Valtrex, Famvir, and Zovirax have been shown to temporarily vanquish the virus. Cures for craving media attention are harder to come by.

Since the herpes virus is contagious, Kardashian's husband Kanye West has a vested interest in her treatment. Anti-viral pills, taken consistently, can limit the chance of spread during romance.

In December 2014, media icon Angelina Jolie made an announcement that went viral. Literally.  Jolie announced she could not attend a movie because of an infection.  A herpes virus infection. Look closely, several tiny blisters are seen on her face. You may wonder why anyone would want to make a point of admitting to such an affliction.  And why should that restrict them from the red carpet?

Turns out Jolie had been stricken with an adult case of chickenpox (varicella).  In ancient times (before the mid 1990’s) this was a common childhood ailment.  Kids would get low grade fevers and outbreaks of small very itchy water blisters that could scar. Angelina Jolie was not announcing she had herpes, yet technically chickenpox is a herpes virus (family) infection.  Until this terminology is altered, confusion will remain.  With anti-viral treatment, rest and support, Jolie’s career was back on track.

In 2003, comedian and talk show host David Letterman developed swelling and pain of his face and eye. His affliction was no joke: Shingles. Yes, the sneaky chicken pox virus, that remains hidden in the spinal nerves of any of us who succumbed to the itchy rash in childhood, broke out in a band-like pattern and sidelined Letterman from his show for an entire month. (Shingles not shown in this image).

Shingles also spread to the sports world.  In 2011, St. Louis Cardinals manager Tony La Russa came down with shingles on his face. Note the characteristically bizarre appearance of a rash that follows the nervous system showing swelling and blisters that abruptly stop in the midline. While his team went on to win the World Series 6 months later, he then abruptly retired, a decision that some speculated was partly due to the ongoing pain of shingles.  Which is why American's new favorite pastime may be getting a shingles vaccine. Healthier than popcorn and a hot dog, the FDA has approved this vaccine for adults age 50 and above. It safely boosts the body's immune response against the virus. For the majority of those vaccinated, shingles is entirely avoided. Some may progress to shingles, but usually with a milder, less painful version. Batter up!

On the long-standing reality television show "Survivor,” contestants struggle to stay with the tribe from week to week. With his splotchy trunk and shoulders, it is a wonder that Aras Baskauskas of the 2006 season wasn't banished by his team mates immediately. Not to worry: his blotchy, scaly rash was not contagious. "Tinea versicolor" (abbreviated as TV), is a common affliction of the young, sweaty, and sun exposed. It is caused by an overgrowth of a common skin yeast, spurred by excessive perspiration.

 

The organism then causes pigment cells to create more, or (in this case) less color, hence the term versicolor. The yeast can be temporarily exiled with the topical application of certain dandruff shampoos, anti-yeast creams, or even anti-fungal pills. Unfortunately for our reality show star, the skin then takes a few months to regain an even tone. This annoying yeast didn’t hamper Aras’ performance—he finished the season on top, outplaying and outlasting both his tribe-mates and tinea versicolor!

 

In "Insomnia," veteran actor Al Pacino plays a guilt ridden cop in an Alaskan summer. He can't sleep--the sun barely sets and he can't shake the feeling that he's got unseen company. In a way, he isn't alone. Close-up shots of Pacino's fingers show some nails with dark stains and lifting of the nail tips. This appearance is classic for nail infection with fungus. Fungus, the same pest that can cause "athlete's foot" and "jock itch," can also set up residence in finger and toe nails. This creepy critter is constantly closer to Pacino than any celebrity stalker could conceive. No wonder he can't sleep. 

 

For a time, hard working actor Samuel Jackson, also appeared to have a fungus in his thumbnail.  Here he comforts his daughter in the drama "Eve's Bayou." 

 

She doesn't seem comfortable as she stares at Jackson's deformed nail. Fungi can preferentially infect certain nails, sparing others for years at a time. While topical anti-fungal creams can clear this organism from the skin, usually anti-fungal pills like Sporonox or Lamisil are needed to cleanse the nails. They can either be taken daily for 2-3 months, or may work at higher doses taken a week at a time (pulse-dosing). Though rare, a potential side effect of these medicines is liver inflammation. Recent roles show that Jackson, who often takes out movie competitors with wit and violence, appears to have dispatched this infection.

British R & B chanteuse Amy Winehouse was hounded by paparazzi until her death from alcohol poisoning in 2011.  These images, taken in 2008, provide a haunting record of the downward spiral of her health.  The swollen and crusted rash represent the classic appearance of the bacterial condition impetigo. Whether due to strep or staph organisms, antibiotics, topically, by mouth or even intravenously are paramount to clear the infection.  At various times, Winehouse was reported to be addicted to heroin. IV drug use, both by breaking the skin, but also by slowing the immune response, may have put her at risk for impetigo.  We hope that the current perspective that addiction is a disease, and not a moral flaw, may prevent health issues and deaths.

 

 

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