In the five years since the first edition of this book was published, there has been an explosion
in new information relating to the nature of dry skin and its treatment. Investigators from various
disciplines, including dermatologists, pharmacists, chemists, biochemists, molecular biologists,
physiologists, pharmacologists, and even psychologists have advanced our knowledge tremendously.
We now understand that the stratum corneum has a surprisingly large number of functions in maintaining
the physiologic stability and homeostasis of the skin and mind.
Hispanic skin care, like the skin care for any “race” of people is not a one size fits all proposition.
There is no “latina skin type”. Latina skin varies widely and your needs will be unique. Like
African Americans, Latinas skin color and type varies. However, there are some useful
generalities when it comes to the care of brown skin. Darker skinned Hispanics skin care will be
very similar to the needs of African Americans. Treasured Locks is committed to helping people
with all skin types. But, our particular focus is on African American and Hispanic skin and hair
Harrison's Internal Medicine Chapter 54. Skin Manifestations of Internal Disease
Skin Manifestations of Internal Disease: Introduction
It is now a generally accepted concept in medicine that the skin can show signs of internal disease. Therefore, in textbooks of medicine one finds a chapter describing in detail the major systemic disorders that can be identified by cutaneous signs. The underlying assumption of such a chapter is that the clinician has been able to identify the disorder in the patient and needs only to read about it in the textbook.
Sensitive skin is becoming a common clinical condition that dermatologists should
be prepared to recognize, understand, and treat.
Subjects experiencing this condition report exaggerated reactions when
their skin is in contact with cosmetics, soaps, and other substances, and they
often report worsening after exposure to dry and cold climates. Sensitive skin
and subjective irritation are widespread in western countries, but still far from
being completely defined and understood.
It has long been noted anecdotally that affect, psychological
state and neurologic state have influences on
inflammatory skin diseases. Disorders such as psoriasis,
atopic dermatitis, acne and rosacea, among many
others, are reported to become exacerbated by stress.
Furthermore, it is widely believed that stress alters
cutaneous immunity. However, mechanisms responsible
for these effects have remained incompletely
understood. Scientific evidence for an influence of
the nervous system on immune and inflammatory
processes in the skin has been developed only relatively
Highlights in Skincancer is a companion handbook published expressly for all the practitionners who are interested in skin cancers: medical oncologists and dermatologists but also residents, general practitionners, surgeons, plastic surgeons. The book is designed to teach new aspects of skincancers in the context of practical clinical settings. Each topic is an expert view of a specific skincancer field.
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Harrison's Internal Medicine Chapter 52. Approach to the Patient with a Skin Disorder
APPROACH TO THE PATIENT WITH A SKIN DISORDER: INTRODUCTION The challenge of examining the skin lies in distinguishing normal from abnormal, significant findings from trivial ones, and in integrating pertinent signs and symptoms into an appropriate differential diagnosis. The fact that the largest organ in the body is visible is both an advantage and a disadvantage to those who examine it.
Allergic contact dermatitis (ACD). A. An example of ACD in its acute phase, with sharply demarcated, weeping, eczematous plaques in a perioral distribution. B. ACD in its chronic phase demonstrating an erythematous, lichenified, weeping plaque on skin chronically exposed to nickel in a metal snap. (B, Courtesy of Robert Swerlick, MD; with permission.)
As in other branches of medicine, a complete history should be obtained to emphasize the following features:
1. Evolution of lesions
a. Site of onset
b. Manner in which the eruption progressed or spread
Telangiectasias (Table 54-8) In order to distinguish the various types of telangiectasias, it is important to examine the shape and configuration of the dilated blood vessels. Linear telangiectasias are seen on the face of patients with actinically damaged skin and acne rosacea, and they are found on the legs of patients with venous hypertension and essential telangiectasia. Patients with an unusual form of mastocytosis (telangiectasia macularis eruptiva perstans) and the carcinoid syndrome (see "Acne," above) also have linear telangiectasias.
Skin primer, anti-shine and mattifier are terms that represent a " pre-foundation" products help surface issues for more improves stability in makeup wear. These products help surface skin functions....
Table 52-2 Description of Secondary Skin Lesions
Lichenification: A distinctive thickening of the skin that is characterized by accentuated skin-fold markings.
Scale: Excessive accumulation of stratum corneum.
Crust: Dried exudate of body fluids that may be either yellow (i.e., serous crust) or red (i.e., hemorrhagic crust).
Erosion: Loss of epidermis without an associated loss of dermis.
Ulcer: Loss of epidermis and at least a portion of the underlying dermis.
Excoriation: Linear, angular erosions that may be covered by crust and are caused by scratching.
Meningococcemia. An example of fulminant meningococcemia with extensive angular purpuric patches. (Courtesy of Stephen E. Gellis, MD; with permission.)
Necrotizing vasculitis. Palpable purpuric papules on the lower legs are seen in this patient with cutaneous small vessel vasculitis. (Courtesy of Robert Swerlick, MD; with permission.)[newpage]
APPROACH TO THE PATIENT: SKIN DISORDER
In examining the skin it is usually advisable to assess the patient before taking an extensive history.
A–D. The distribution of some common dermatologic diseases and lesions
Psoriasis. This papulosquamous skin disease is characterized by small and large erythematous papules and plaques with overlying adherent silvery scale.
Erythroderma (Table 54-2) Erythroderma is the term used when the majority of the skin surface is erythematous (red in color). There may be associated scale, erosions, or pustules as well as shedding of the hair and nails. Potential systemic manifestations include fever, chills, hypothermia, reactive lymphadenopathy, peripheral edema, hypoalbuminemia, and high-output cardiac failure. The major etiologies of erythroderma are (1) cutaneous diseases such as psoriasis and dermatitis (Table 54-3); (2) drugs; (3) systemic diseases, most commonly CTCL; and (4) idiopathic.
White Lesions In calcinosis cutis there are firm white to white-yellow papules with an irregular surface. When the contents are expressed, a chalky white material is seen. Dystrophic calcification is seen at sites of previous inflammation or damage to the skin. It develops in acne scars as well as on the distal extremities of patients with scleroderma and in the subcutaneous tissue and intermuscular fascial planes in DM. The latter is more extensive and is more commonly seen in children.
Harrison's Internal Medicine Chapter 83. Cancer of the Skin
Melanoma Pigmented lesions are among the most common findings on skin examination. The challenge is to distinguish cutaneous melanomas, which may be lethal, from the remainder, which with rare exceptions are benign. Examples of malignant and benign pigmented lesions are shown in Fig. 83-1.
Atypical and malignant pigmented lesions. The most common melanoma is superficial spreading melanoma (not pictured). A.