Clinics in dermatology最新文献

In comparison to Non-Hispanic White individuals, cutaneous melanoma is far less common in skin of color (SOC) patients but carries a poorer prognosis. Melanomas in SOC populations are more often identified on sun-protected locations such as acral surfaces, nail units, and mucous membranes, providing a challenge to identify in early stages due to unfamiliar clinical and dermatoscopic features. Additionally, racial healthcare disparities compound the difficulty in diagnosis and ultimately contribute to poorer prognosis. We explore the epidemiology, clinical presentation, and healthcare disparities surrounding melanoma in SOC individuals to increase awareness of the intricacies and nuances in identifying these malignancies.

Leprosy is one of the major mycobacterial diseases caused by Mycobacterium (M.) leprae or M. lepromatosis. Although there is scientific evidence for human leprosy from the Iron Age, it became more prevalent during medieval times, deeply affecting society and social life. Leprosy was considered a consequence of sin and was later thought to a certain extent to be inherited. Lepers were declared legally dead and excluded from normal social life. In the 14th century, the medicalization of leprosy began. Leprosaria became the earliest hospitals in the Middle Ages that were specialized for a single disease. They had their own churches, cemeteries, and priests. Treatment included medical and spiritual approaches.

Anna Constantia von Brockdorff (1689-1765), once considered the most beautiful woman in the whole of Europe, was an extremely accentuated personality. Shortly after her divorce from Adolph Magnus von Hoym, her rise in the Dresden court began in 1705. She became the most famous mistress of Augustus II (the Strong), Elector of Saxony, King of Poland, and Grand Duke of Lithuania. The king signed a secret wedding treaty with her, even though he was already officially married to Christiane Eberhardine von Brandenburg-Bayreuth. He made his mistress the Countess Cosel. The perfection of her beauty makes her the ultimate luxury. In the early 18th century, an unknown painter created her portrait in oil on canvas for the Palais Bärenstein, Saxony. The painting was acquired in 2006 by the State Painting Gallery Old Masters, Dresden. Her beautiful smile expressed self-confidence and erotic charisma. As the painting shows a craquelé-a sign of aging-the countess lost eventually her outstanding position at the Dresden court and ended imprisoned in the castle of Stolpen. It was said that she preserved her beauty worthy of the throne.

A skin cancer diagnosis imposes not only a psychosocial burden but also significant financial stress due to treatment costs. This stress can intensify dramatically for patients who suddenly lose health insurance coverage, especially considering that uninsured patients are more likely to experience late-stage melanoma diagnoses and face a higher overall incidence of skin cancer than the general population. Dermatology clinics and physicians serving uninsured and vulnerable populations should be equipped with resources and strategies to ensure these patients receive adequate and timely care. We explore the ethical and actual challenges uninsured patients encounter in accessing dermatologic care for skin cancer and offer practical solutions to address and mitigate these barriers.

The smile is a complex human facial expression, most commonly associated with joy. We present a detailed view on Leonardo Da Vinci's painting of Saint John the Baptist, between 1513 and 1516, which illustrates a smiling saint, which has evoked multiple explanations and theories. Discussing Da Vinci's concept of painting as science media and the two merely contradictory painting techniques chiaroscuro and sfumato, we attempt to approach this picture. Chiaroscuro is describing the strong contrasts between light and shadow, whereas sfumato represents another painting technique for softening the transition between colors. In the context of the positioning of John in the space, the closed smile shown in the picture, is possibly an expression of facing the Sacred.

In dermatology, the art and skill of morphologic assessment is key to generating logical differential diagnoses and understanding disease pathogenesis. Dr. Irwin M. Braverman, Professor Emeritus of Dermatology at the Yale School of Medicine, is a master morphologist and his book, Skin Signs of Systemic Disease, provided key insights into the relationships between cutaneous lesions and internal disease. In an interview with Dr. Braverman, he stressed the importance morphology plays in how dermatologists diagnosis skin disorders. From Dr. Braverman, we learned an approach to the study of morphology through the lens of an art connoisseur, in addition to how to appreciate subtle clues that suggest a diagnosis and how examination of the skin brings us closer to understanding our patient, what ails them, and how we can heal them.

There is a significant amount of research examining the link between psoriasis and common mental health disorders; however, studies on less common psychiatric disorders, such as bipolar disorder (BD), remain limited. We conducted a systematic review of studies in the PubMed and Cochrane databases that explored the relationship between BD and psoriasis. In addition, we evaluated the impact of lithium on psoriasis in patients with BD and included a quality assessment of all the studies. This review covers five studies that addressed the connection between psoriasis and psychiatric disorders, three studies on medical conditions in patients with BD, and four studies examining the effects of lithium intake on psoriasis in BD patients. We found substantial evidence supporting a link between psoriasis and BD, suggesting that psoriasis is an independent risk factor for BD. Patients with psoriasis are also more likely to use psychotropic medications. A limited number of studies indicate that lithium therapy may trigger or worsen psoriasis. We also explore the mechanisms of lithium-induced or lithium-aggravated psoriasis, highlighting the intricate interplay between lithium treatment, inositol depletion, and psoriasis in patients with BD. In a placebo-controlled, randomized study, inositol supplementation could mitigate psoriasis in patients taking lithium. Additional research is needed to evaluate the efficacy of inositol supplementation for patients with psoriasis who need to continue lithium treatment for their BD.

Media portrayals of medical disorders can influence public beliefs about those disorders. There have been no previous studies about the depiction of dermatological conditions in cartoons. The aim of this study was to describe the portrayal of skin moles in cartoons. The image sections of internet search engines Google, Yahoo, Bing and DuckDuckGo were inspected for single-panel cartoons which referred to skin moles. Each cartoon was examined according to characteristics of the patient, mole(s) and treatment. Sixty-six cartoons were identified. One third of the moles were portrayed as suspicious, a quality often conveyed by a furtive-looking mole creature on the patient. Most cartoons depicted or mentioned a medical doctor; a dermatologist featured in 12 cases. There was discretion in how the moles were managed. Among the treatment options were excision, hitting the mole with a mallet, and observation over time. It was noteworthy that none of the cartoons made specific reference to melanoma. The study findings may creatively inform efforts to educate the public and health professionals about moles and their management.