Make the Diagnosis: A Painful, Deep Pustule: Part of a Bigger Problem?

(MedPage Today) — Case Findings: A 55-year-old man with a history of inflammatory bowel disease reported a very painful, deep-seated pustule on his leg that looked like it might eventually rupture. He also had a fever and some arthralgia, but he wasn’t sure if they were related.

Can you diagnose the patient?
Source: Dermatology

Make the Diagnosis: Rash Rush to the ED

(MedPage Today) — Case Findings: A 43-year-old man went to the emergency department with a symmetrical rash of palpable purpura on his legs. He also complained of a fever and arthralgia, but denied any headache or neck pain. The patient disclosed a current infection with hepatitis C virus.

Can you diagnose the patient?
Source: Dermatology

Make the Diagnosis: Itchy Fingers from IV Therapy?

(MedPage Today) — Case Findings: A 48-year-old woman who was receiving IV immunoglobulin therapy complained to her doctor that over the past few weeks small vesicles had formed along the sides of her fingers. Some had ruptured and become scaly papules. Her fingers were extremely pruritic, and she said it was “driving her crazy.”

Can you diagnose the patient?
Source: Dermatology

Sarah Hyland Weighs 92 Lbs. and Has 49% Body Fat—but Is That Even Possible?

When it comes to understanding body weight versus BMI versus body composition, things can get confusing. Even more confusing is when the numbers don’t seem quite right, which is exactly what happened when actress Sarah Hyland stepped on the scale to determine her body composition (AKA how much of her weight is fat versus lean mass) yesterday.

“Yeah. My scale says I’m 48% fat. Soooo…how’s your Monday?” the Modern Family star captioned a photo she posted on Instagram stories last night. According to Hyland’s body composition scale, she weighs 92.8 pounds, with 49% body fat, 11% muscle, 37% water, and 3% bone. Hmm.

According to the American Council on Exercise, normal body fat percentages for women range from 10% to 31%, with a body fat percentage over 32% being considered obese. At 5’2” and 92 pounds, Hyland is anything but obese. So we had some questions.

RELATED: Kourtney Kardashian Weighs 98 Lbs. Here’s Why That’s Not Necessarily a Bad Thing

First off, is it even possible to be 92 pounds and have 49% body fat? “While it is possible to have that high of a percentage of body fat, it would be very abnormal for half of her body weight to be fat,” says Amy Rothberg, MD, director of the University of Michigan's Weight Management Clinic.

Samuel Klein, MD, director of the Center for Human Nutrition at the Washington University School of Medicine in St. Louis agrees: “Women tend to have more body fat than men, but it's highly unlikely that she would be 92 pounds and almost 50% body fat.”

RELATED: The Number One Thing You Need to Do to Lose Weight Forever, According to Experts

It’s not surprising that Hyland’s home scale provided questionable results. According to Dr. Klein, there's so much variability in home body composition devices that they aren’t always reliable sources. Plus, body composition scales (or the regular versions, for that matter) don’t account for the distribution of fat throughout the body, which is actually just as important as the amount of fat one carries. Why? Belly fat is linked to an increased risk of metabolic diseases like diabetes and heart disease compared to fat stored in the buttocks and legs.

When assessing body fat, it's critical to consider distribution in addition to composition, says Dr. Klein: “Measuring your waist circumference, for example, will give you a better estimate of your fat distribution than stepping on a scale.”

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According to Dr. Rothberg, the most reliable way to measure body composition is with a DEXA scan or Bod Pod device, two tools that are typically found at medical centers, fitness clinics, or in research settings—not your bathroom–and use high-tech methods to compare fat tissue to lean mass.

We weren’t the only ones who were skeptical of Hyland’s home scale reading. The actress captioned her body comp score, “Definition of #skinnyfat or my scale is broken.” We’re going to guess it’s broken.

Source: Health bests

Is Your Body Really Programmed to Be a Certain Weight?

The set point theory is the idea that the body has a preprogrammed weight that it likes to be at to function efficiently. And there is scientific evidence that suggests there is some truth to this; the body uses a variety of metabolic and hormonal mechanisms—like slowing down metabolism when you cut your calorie intake, for instance—to maintain its weight when you try to slim down.

So does this mean that trying to lose weight below your “set point” is futile, since your body will try to fight it and always win? No, weight management is more complicated than that. Many parameters control weight, including genetics, but so do external factors, like stress and your eating behaviors. Plenty of people slim down and settle at a lower weight permanently—but you should follow a safe, gradual weightloss plan so that your body can adapt over time. (Plus, you’ll be more likely to keep the pounds off in the long term if you take on sustainable healthy eating habits.) Crash dieting (like restricting your calories too intensely) can cause your body to try to hold on to fat so it stays at its happy weight—don’t try it.

 

Health’s medical editor, Roshini Rajapaksa, MD, is assistant professor of medicine at the NYU School of Medicine.

Source: Health bests