Clinics in dermatology最新文献

Pellagra is a non-hereditary disorder of the niacin and tryptophan metabolism. Cutaneous and gastrointestinal symptoms are early signs of the disease, but neuropsychiatric symptoms follow, if the disease is not recognized and treated soon enough. Although Pellagra has not been identified as a separate entity before 1735, artists have noticed the characteristic cutaneous manifestations. An example is Pietro Bellotti's masterpiece Vecchia popolana con un ragazzo (Old Peasant Woman with a Boy; ca. 1680-1690) with a most realistic style. In 1786, the German writer and scientist Goethe traveled to Northern Italy. In his book Italienische Reise (Italian Journey) he made remarks about cutaneous findings in the rural population suggesting pellagra. He missed the scaling and fissuring of skin since he traveled in autumn and not spring, when the disease has its seasonal peak. The association of pellagra to art is further illustrated by two examples of the early 20th century - painter John Wesley Carroll from Kansas and medical illustrator Amedeo John Engel Terzi from Sicily. Their multicolored illustrations supported education about the disease before high-quality color photography became available.

Psychodermatology is an interdisciplinary field of medicine that examines the interrelationships between mental state and skin function. This contribution presents the biologic and theoretic foundations of these relationships, with particular emphasis on the role of stress, the brain-skin axis, and neuroimmunologic mechanisms. The historic development of psychodermatology is discussed, including the evolution of terminology and classification of disorders, as well as the emergence of structures facilitating interdisciplinary collaboration. Attention is drawn to the clinical and psychosocial consequences of chronic skin diseases, including reduced quality of life, anxiety and depressive symptoms, and patient stigmatization. Current challenges facing psychodermatology include the lack of diagnostic standardization and the need for further development of integrated models of care. Psychodermatology is presented as an essential component of a holistic approach to the treatment of skin diseases.

The Limberg rhomboid flap, first described in 1928 by the Russian surgeon Alexander Alexandrovich Limberg (1894-1974), represents a milestone in reconstructive plastic surgery. Based on precise geometric principles, the flap has become one of the most versatile and widely used techniques for closing skin defects in different body regions, particularly in the treatment of the pilonidal sinus. This contribution revisits the history of its creation, its mathematic planning .and its technical and scientific principles, as well as its contemporary relevance in surgical and reconstructive practice.

The painting of Cosmas and Damian appears to depict these Saints working with Angels to transplant a leg in the 3^rd century CE. This would be the first composite tissue allotransplantation. There has been much written about this painting, describing what it might have represented in the 3^rd century and when it was painted in the 16^th century. This manuscript discusses how this painting has additional meaning in our current time, when the stresses of medical practice are more pronounced, and how contemplating it can be helpful to us today.

Menopause transition or perimenopause is the transitional period preceding menopause, marked by hormonal variability and menstrual irregularity. This period is associated with a wide range of clinical symptoms due to reduced levels of estrogen. The skin, in particular, is affected by the decline in estrogen, specifically 17β-estradiol and dehydroepiandrosterone, along with an increase in cortisol. The sudden onset of various menopause symptoms can be distressing for many women and significantly impacts their quality of life. The genitourinary syndrome of menopause, a typical result of hypoestrogenism, is characterized by signs and symptoms relevant to urogenital atrophy. In this discussion, we focus on the aesthetically relevant symptoms of perimenopause and the approach to management. Most of these findings, including hot flushes, rosacea flares, worsening skin quality with dryness, sagging, and increased wrinkling, dyschromia, hair thinning, and cellulite, can be effectively managed. The provider should be aware of the emotional changes that occur during perimenopause and ensure that patients have a healthy and balanced motivation for seeking treatment. We discuss valid treatment options such as hormonal replacement therapy, minimally invasive procedures, and topical products, including the new dermocosmetic regimens. Because many of these treatments are geared toward maintaining results, consistency is paramount for achieving successful outcomes.

Jugular venous distention, implying the presence of a superior vena cava syndrome has been described in both Hellenistic sculpture and early modern painting. This is unusual and remarkable considering this was done before the discovery of the true nature of the human circulatory system (1628) or the discovery of the superior vena cava syndrome (1757). One has to wonder whether these artists demonstrate what they saw or were aware of what they were depicting in their work. Caravaggio is the only artist who demonstrated this finding in his paintings and for whom we know enough to comment. This manuscript discusses the influence of Michelangelo, who had anatomic training, in Caravaggio's work. It also discusses Caravaggio's knowledge and his use of messages in his work, as well as what was known about the human circulation during his lifetime. This discussion is intended to help us appreciate what Caravaggio could have known and been trying to convey through his art, and in using this, aid us in the practice of medicine by improving our awareness of life's mysteries.

Melasma is associated with genetic factors, exposure to ultraviolet light, and hormonal influences. Because UV exposure is a crucial factor in the pathogenesis of melasma, the preventive effect of sunscreen use is established. This cross-sectional study investigated the relationship between the clinical features of melasma and the use of sunscreen among 126 women attending outpatient dermatology clinics in two centers. Patient's age, occupation, body mass index, use of photosensitizer drugs, hormone replacement therapy and, or oral contraceptive, and family history of melasma were thoroughly documented. Comprehensive information about the patients' sunscreen usage was also recorded. Melasma location and depth were evaluated, and the melasma severity index (MASI) score was calculated. The mean participant age was 39.67 years, mean disease duration 25.08 months, and mean MASI score 5.22. Fitzpatrick phototype III was the most common phototype. Melasma was widespread and dermal in most patients. Thirty-one percent of patients did not use sunscreen with SPF >50. The mean duration of sunscreen use was 23.85 months. MASI scores showed a significant difference based on sunscreen use status (P = 0.001). Year-round sunscreen use was associated with significantly lower MASI score (P = 0.001), whereas daily frequency and reapplication showed no relationship. Disease location was not associated with occupation and sunscreen use. In a multivariate analysis, melasma depth emerged as the strongest independent determinant of sunscreen use, whereas the year-round sunscreen use was independently associated with lower MASI scores.

There is a long-term relationship between humans and the human flea Pulex irritans. The invention of the microscope in the late 1500s was a turning-point for scientific investigation of the flea. Microscopists like Robert Hooke (1635-1702) or Antony van Leeuwenhoek (1632-1723) became most attracted. Leeuwenhoek discovered the sexual reproduction of fleas. During the Victorian period their role as vectors of disease was scientifically determined and recorded, which was stimulated by the plague epidemic of 1894 in Canton and in Hong-Kong. The flea's position as an annoying but harmless housemate underwent a change, as the (human) flea was now also perceived as a vector of deadly infectious diseases. We review the different appraches to control and combat the (human) flea inhouse and on the human body from the 16.-19. Centruy. We proviode a short review on repellents and early insecticides, mainly made by herbs. We also refer to flea traps made from animal skins, wool or woods, ivory up to the manufactory production of the 19th century.

The heyday of printed funeral sermons dates to the period between 1550 and 1750 in the German speaking countries with the Reformation movement. The modern funeral sermon did not focus on the salvation of the soul of the deceased. It was aimed at the bereaved, proclaimed the gospel to them and strove to comfort, edify and instruct them. The printed sermons consisted of various parts including a curriculum vitae of the deceased that sometimes also contained medial information about medical history, symptoms, diagnosis and treatment. In this review, we will focus on the documentation of cutaneous findings and skin diseases in printed funeral sermons from two German towns, Ulm and Rudolstadt. In most cases, it is about a layman's perspective on illness and death. Nevertheless, these printed texts provide a unique opportunity to study the course and treatment of skin diseases.