Clinics in dermatology最新文献

Dermatopathology, like dermatology, has evolved in many directions; yet, both fields remain true to visual morphology-based diagnosis. Dr. Irwin Braverman is a role model for the intersection of these two visual fields. One of his passions is correlating the clinical presentations of disease with histopathologic findings and teaching these skills to others at the bedside and the microscope. Dr. Braverman's innovative approach to education is exemplified by his use of paintings to hone the observational skills of trainees. His creative and inquisitive lectures, including a recent discussion of color blindness in art and medicine, stress that none of us interpret the world in the same way. Interobserver variability has implications for how we approach dermatologic diseases, highlighted herein with the example of reactive versus malignant angioendotheliomatosis. As a master dermatologist and dermatopathologist, Dr. Braverman exemplifies how deep and broad knowledge positively influences dermatology and dermatopathology.

In 1859, the New Sydenham Society undertook the publication of an Atlas of Portraits of Diseases of the Skin, having been inspired by Ferdinand Ritter von Hebra's Atlas der Hautkrankheiten. Utilizing information contained in Sir Jonathan Hutchinson's Descriptive Catalogue of the New Sydenham's Society Atlas of Portraits of Diseases of the Skin (published in 1869 and 1875), an exhibit of twenty-five illustrations of cutaneous disorders, along with teaching points, was held at the Harvey Cushing/John Jay Whitney Medical Library at Yale University. It served as an educational tool for dermatologists, dermatology residents, medical students, and even physicians from other specialties.

Disorders of the nail unit can provide important clues to underlying systemic diseases. Onychodystrophy or nail abnormalities include altered nail color, shape, or texture, with morphology and growth patterns often related to local anatomic factors such as edema, vascular supply, and neurologic innervation. Associated pain or loss of function can also affect daily activities. Because nail changes may be due to a range of systemic diseases, we chose to provide a systems-based broad overview of the common nail findings in patients with internal disease.

Sarcoidosis is a multisystem inflammatory disorder that most commonly affects the lungs, lymphatic system, eyes, and skin. Cutaneous involvement is present in approximately 20-30% of patients. Prednisone and corticotropin repositories are the only FDA-approved therapies for sarcoidosis. We review the varied cutaneous manifestations of sarcoidosis and the recommended evaluation for this disease. We also discuss histopathologic findings and outline disease pathogenesis, incorporating newer molecular data. Treatment approaches for cutaneous sarcoidosis and their associated levels of evidence are also delineated.

Dr. Irwin Braverman, a luminary in our field of dermatology, united his love of internal medicine with dermatology to pioneer our understanding of the cutaneous manifestations of systemic disease. His meticulous documentation of physical examination findings in his book Skin Signs of Systemic Disease became fundamental to the training of dermatologists worldwide for decades. In the context of autoimmune connective tissue diseases, Dr. Braverman's powerful observation skills proved pivotal in charting the clinical signs and symptoms of systemic lupus erythematosus and dermatomyositis. His legacy as a trailblazer in clinicopathologic correlation continues to influence younger dermatologists, emphasizing the crucial role of connecting pathologic findings in the skin to systemic pathology in providing outstanding patient care. We highlight some of Dr. Braverman's personal interests and contributions to lupus erythematosus and dermatomyositis.

Cutaneous T cell lymphoma (CTCL) is a form of non-Hodgkin lymphoma that can involve the skin, along with lymph nodes and blood. The two most common subtypes of CTCL are mycosis fungoides and Sézary syndrome, Since the initial description of mycosis fungoides by Dr. Jean-Louis Alibert in 1806, there have been significant advances in our understanding of the pathogenesis of CTCL, its diverse clinical and histologic variants, and the evolving treatment landscape. One major contributor to this story has been Dr. Irwin Braverman, former Vice Chair of Dermatology at Yale School of Medicine. Herein, we provide tribute to his discoveries, teaching, mentorship, and clinical care that have influenced our insights into CTCL as well as emerging treatments for this challenging malignancy.

Irwin Braverman, MD has had a lifelong interest in and appreciation of fine art and the importance of close observation as an essential skill in clinical medicine. These passions converged in his development, with Linda Friedlaender, Head of Education at the Yale Center for British Art, of a workshop for Yale medical students that brought them to the museum to examine paintings much as one would a patient with an unknown disorder. Needs to be longer.

Dr. Irwin M. Braverman has advanced our understanding of cutaneous manifestations of autoimmune connective tissue diseases (AI-CTD). Prior to the era of molecular diagnostics, Dr. Braverman's careful clinical observations and detailed descriptions of patients with AI-CTD in his textbook Skin Signs of Systemic Disease provided insights into disease characterization, progression, and evolution. Patients from Dr. Braverman's career who did not fulfill criteria for a single clinical entity, but rather were diagnosed with undifferentiated connective tissue disease or mixed connective tissue disease, are discussed. In addition, key observations of Dr. Braverman into the cutaneous manifestations of Sjögren syndrome and the systemic complications of urticarial vasculitis are highlighted.