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The Twentieth Century and Beyond
Published in Scott M. Jackson, Skin Disease and the History of Dermatology, 2023
At the turn of the twentieth century, dermatologists could speak the modern language (macules, papules, pustules, etc.) with ease, and they had a lengthy list of diagnoses from which to choose after isolating the primary lesion and applying knowledge of morphology to evaluating the differential diagnosis of that skin lesion. They had a working knowledge of primary and secondary skin lesions, and all of the common skin diseases and many of the not-so-common were known. A skin biopsy could be performed to confirm or deny the clinical diagnosis. Scrapings of skin could also be taken to the microscope for examination of microorganisms. The dermatologist could read textbooks and journals from all over the world and look at photographs of skin diseases in atlases instead of drawings. They could attend conferences and meetings and discuss every aspect of the dermatologic specialty with domestic and international colleagues. The dermatologist at the end of the century could work in a private practice, a public clinic, a hospital ward, or an academic institution. For the dermatologist of the early twentieth century, things did not vary significantly from the way they are today.
Chronic erythematous rash and lesions on trunk and limbs
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
This rare condition is inherited as an autosomal dominant trait. The rash consists of follicular papules that coalesce into plaques affecting the trunk, upper arms, face and flexures. The surface is covered with a yellow-brown greasy crust. A skin biopsy is diagnostic. Other changes are longitudinal ridging of the nails (Fig. 14.08, p. 324), pits on the palms and soles, and plane wart-like papules on the dorsum of the hands and feet.
Acquired anorectal disorders: Prolapse, fistula, and hemorrhoids
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
In an older child where Crohn's disease is suspected, placement of a loose, non-cutting seton across the fistula may be safer while other investigations are carried out. A Park's retractor is used to display the anatomy. A probe (Lockhart–Mummery or probe with an eyelet) is passed along the fistula (Figure 50.4). Either a vascular sling or a braided non-absorbable suture is looped around the fistula and tied loosely. Skin biopsy is recommended.
Functional and morphometric assessment of small-fibre damage in late-onset hereditary transthyretin amyloidosis with polyneuropathy: the controversial relation between small-fibre-related symptoms and diagnostic test findings
Published in Amyloid, 2023
Eleonora Galosi, Luca Leonardi, Pietro Falco, Giuseppe Di Pietro, Alessandra Fasolino, Nicoletta Esposito, Caterina Leone, Giulia Di Stefano, Maurizio Inghilleri, Marco Luigetti, Antonini Giovanni, Andrea Truini
Quantitative sensory testing (QST) and Sudoscan are widely accepted diagnostic tests to assess thermo-nociceptive and autonomic small-fibre function [7–9]. Skin biopsy is the reference standard method for small nerve fibres assessment [10]. This morphometric diagnostic test provides quantitative information on intraepidermal nerve fibre density (IENFD) and on autonomic nerve fibres of cutaneous annexes in the dermis [11]. However, how these functional and morphometric diagnostic tests reflect small-fibre-related clinical symptoms in patients with ATTRv-PN is a matter of debate. Only a few studies have investigated the association between QST and skin biopsy variables and neuropathic pain in patients with ATTRv-PN [12], and previous studies that assessed correlations between Sudoscan, skin biopsy abnormalities and autonomic symptoms reported conflicting data [13–15].
Use of the optimized sodium thiosulfate regimen for the treatment of calciphylaxis in Chinese patients
Published in Renal Failure, 2022
Xin Yang, Yuqiu Liu, Xiaotong Xie, Wen Shi, Jiyi Si, Xiaomin Li, Xiaoliang Zhang, Bicheng Liu
Twenty-seven patients (87.10%) exhibited typical skin lesions, and 66.70% of them showed ulceration with a median number of wounds being 3 (range: 1–4). The remaining patients showed atypical clinical manifestation such as local hyperpigmentation or induration. The lesions were distributed predominantly peripherally (18/27, 66.67%) rather than centrally (3/27, 11.11%) or systemically (6/27, 22.22%). The distribution of calcium deposition confirmed by single-photon emission computed tomography/computed tomography was classified as nonspecific (7.41%), extremities (48.15%), trunk (14.81%), combination 1 (extremities and trunk without internal organ involvement, 14.81%), internal organs (3.70%) and combination 2 (internal organ and extremities or/and trunk, 11.11%). Twenty-two patients (70.97%) underwent skin biopsy, and the positive results were as well as the negative results. (Table 2)
Revisiting techniques to evaluate drug permeation through skin
Published in Expert Opinion on Drug Delivery, 2021
Vamshi Krishna Rapalli, Arisha Mahmood, Tejashree Waghule, Srividya Gorantla, Sunil Kumar Dubey, Amit Alexander, Gautam Singhvi
Skin biopsy is an invasive technique that is performed under the effect of local anesthesia. Drug content estimation from biopsy samples provides information on total drug concentrations, i.e. free, bound, and vascular concentrations. Since it does not yield direct information of the unbound concentration, the results are difficult to interpret. On the one hand, the technique underestimates the concentration of those drugs that rapidly equilibrate with the extracellular fluid such as β-lactam antibiotics and, on the other hand, overestimates the concentration of drugs that accumulate in the intercellular fluid, such as quinolone antibiotics or macrolides. Skin biopsy includes two types, shave biopsy (which is restricted to the dermis only) and punch biopsy (reaching subcutaneous tissue level). Due to obvious reasons for being tedious and time-consuming, skin biopsy techniques are not used for routine tissue sampling and in vivo analysis. Although skin biopsy gives a clear image of drug deposition in various subsections of skin, due to its degree of invasiveness, it is only employed during in vivo animal experimentation [42,47].