Medicine by Alexandros G. Sfakianakis

Τετάρτη 13 Δεκεμβρίου 2017

What’s in a Name—Dermoscopy vs Dermatoscopy

Dermoscopy improves diagnostic accuracy by uncovering dimensions of skin morphologic characteristics imperceptible to the naked eye. While the practice of dermoscopy has become common among dermatologists only in recent years, microscopic examination of the skin is actually a centuries-old practice.

Industry Influence in Dermatology Clinical Practice Guideline Development

In his farewell address to the nation, in 1961, President Dwight D. Eisenhower warned about the rising influence of the military establishment and the arms industry. "The potential for the disastrous rise of misplaced power exists," the President said, referring to the military-industrial complex, "and will persist."

The Most Beautiful People

This study used People magazine to compare standards of beauty in 1990 with present-day standards.

Chronic Urticaria in Children

Six years ago, we reviewed what was then known about chronic urticaria (CU) in children. We came to the conclusion that many important and interesting questions were unanswered. These included, but were not limited to, how common chronic spontaneous urticaria (CSU) and inducible urticaria are in children, the clinical presentation, underlying causes, impact on everyday life of CU in children, and the natural course of pediatric CU. We also suggested strategies to address and answer these questions and encouraged further studies to do so.

December 2017

The Epidemic of Guns

The shooting in Las Vegas, Nevada, that left 59 people dead, 10 times that number wounded, and thousands of people with the psychological distress from being present at the scene during and after the massacre has once again raised the issue of what we as a nation can and should do about guns. The solution lies in not just focusing on Las Vegas and the hundreds of other mass shootings that have occurred in the United States in the last 14 months, but rather to underscore that on average almost 100 people die each day in the United States from gun violence. The 36 252 deaths from firearms in the United States in 2015 exceeded the number of deaths from motor vehicle traffic crashes that year (36 161). That same year, the US Centers for Disease Control and Prevention reported that 5 people died from terrorism. Since 1968, more individuals in the United States have died from gun violence than in battle during all the wars the country has fought since its inception.

A Transgender Woman With Anogenital Lichen Sclerosus

This case report describes a transgender woman with anogenital lichen sclerosus.

Industry Payments Among Dermatology Clinical Practice Guidelines Authors

This study uses data extraction from the Open Payments database to evaluate the monetary values and types of payments received by physician authors of dermatology guidelines and the accuracy of conflict of interest disclosure statements.

Dermatology in Epic Poetry—From Beowulf to The Odyssey

Epic poems have captured the imaginations of readers, listeners, and artists alike for millennia. Michelangelo painted part of the Sistine Chapel after being inspired by Dante's Divine Comedy. Shakespeare's 1602 play, Troilus and Cressida, is based on The Iliad, an ancient Greek epic poem attributed to Homer. All told, epic poems are captivating tales full of wonder and adventure. Particularly, they have often integrated dermatology in their unique plots. Beowulf is an Old English poem (written circa ad 700-1000) that tells of the powerful Geat hero Beowulf, who visits the mead hall, Heorot, to kill the evil monster Grendel. Grendel, bothered by the sounds of joy, has gruesomely slaughtered Heorot's inhabitants for years. Owing to his magical gifts, no one has been able to slay him. Grendel not only possesses incredible strength, but his skin is also impenetrable to any blade: "Every nail, claw-scale, of that heathen brute…was like barbed steel. To pierced him through, no time proofed blade could cut his brutal, blood-caked claw." Beowulf notably does not use a sword, but rather kills Grendel by directly ripping his arm off, causing him to bleed to death. In the 13th century German epic poem Das Nibelungenlied (The Song of the Nibelungs), the skin of a main character is a weakness rather than a strength. In the beginning of the story, the knight Siegfried is said to have slaughtered a dragon and bathed in his blood—rendering him invulnerable to weaponry. However, a leaf from a linden tree fell between his shoulders during this bath, leaving that area untouched with blood. His wife, Kriemhild, mentions, "There one might stab him, and thence is my care and dole," indicating that this is his only weakness (similar to Achilles' heel). Unfortunately, Siegfried is later murdered by Hagen, who spears the unsuspecting knight while he is drinking from a brook. His death inspires Kriemhild's revenge, which is the focus of the second half of Das Nibelungenlied. The Odyssey, a Greek epic poem by Homer, details the legendary return of Odysseus to his home of Ithaca after the Trojan war. Arriving after 20 years, he discovers that multiple suitors are courting his wife, Penelope, presuming he is dead. Odysseus is then transformed by Athena (the goddess of war) into an old man as a disguise. However, his housekeeper, Eurycleia, identifies him because of a hunting scar on his leg: "She immediately recognized the scar; which once a boar inflicted upon him." This discovery demonstrates Eurycleia's loyalty and allows the Odysseus and Penelope to reunite. Together, they plot to kill the suitors and eventually restore peace to Odysseus' kingdom. Ultimately, epic poems are full of fantastic details and magical characters. Many tales involve the skin, demonstrating dermatology's unique significance in literature. Hopefully, epic poetry will continue inspiring many more for ages to come.

Factors Associated With Chronic Urticaria in Children

This cohort study examined the resolution rate of chronic urticaria in children and whether there are biomarkers that can predict resolution.

Barber Recognition of Pseudofolliculitis Barbae and Acne Keloidalis Nuchae

This cross-sectional study analysis assesses barber knowledge and recommendations regarding various dermatologic conditions common among clients who use predominantly African American barbershops.

Diagnostic Accuracy of Pediatric Teledermatology Using Parent-Submitted Photographs

This randomized clinical trial assesses whether smartphone photographs of pediatric skin conditions taken by parents are of sufficient quality to permit accurate diagnosis.

Treatment of Psychiatric Disorders and Skin-Restricted Lupus Remission

This observational cohort study investigates the association between treatment of psychiatric disorders and skin-restricted lupus remission in a patient cohort over 2.5 years.

Sclerotherapy for Reticular Veins in the Lower Limbs

This randomized clinical trial compares sclerotherapy of reticular veins of the lower limb with 2% polidocanol diluted in 70% hypertonic glucose vs hypertonic glucose alone.

Prescription-Strength Topical Steroids Sold Without Prescription

This case report describes the use of a prescription-strength topical steroids obtained without prescription.

Alcohol-Related Mortality in Patients With Psoriasis

This cohort study investigates whether patients with psoriasis have an elevated risk of alcohol-related mortality.

Joseph Goldberger—Public Health Champion and Investigator of Pellagra

Joseph Goldberger, MD (1874-1929), was an American physician whose commitment to public health led him to risk his own health and to confront the medical and political establishments of his day. In 1899, not long after graduating from Bellevue Hospital Medical College, Goldberger joined the US Marine Hospital Service (later the Public Health Service). Initially, his duties included inspecting immigrants in the Port of New York, but he soon became fascinated by epidemiology and infectious diseases. As a quarantine officer, Goldberger traveled extensively to study outbreaks of yellow fever, dengue fever, and typhus, and managed to contract each of these on his visits.