Download Consultations in Dermatology: Studies of Orphan and Unique by Walter B. Shelley PDF

By Walter B. Shelley

This guide on dermatologic differential analysis and scientific administration specializes in sixty-two not easy medical circumstances that the authors have encountered in over fifty years of sufferer perform in dermatology. every one case is gifted as a well-written vignette, advised in a case-study sort. The authors first current the heritage of every case concisely and together with all of the scientific info. They then demonstrate the method curious about the prognosis and treatment concerned. there's additionally a bit on proper questions that the health practitioner could be contemplating.

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In this patient’s skin, they were being destroyed by an immunologic reaction. Hence, a scratch tore the epidermal sheath loose and tissue 33 16:38 P1: JZP 0521616581c08 34 CB974/Shelley 0 521 61658 1 September 19, 2005 C O N S U LTAT I O N S I N D E R M ATO L O G Y fluid filled the space, creating the blister. This, in turn, was easily rubbed off, leaving a tender raw spot. The epidermis which covers our entire body varies in thickness and adherence. It is composed largely of columns of specialized cells, the keratinocytes.

Careful questioning revealed it had all begun with the sudden appearance of hives thirty minutes after waterskiing last summer. The hives were small mosquito bite-like bumps which appeared over her trunk and upper arms. Each hive had a distinctive red zone around it. They all gave a fierce itch, until fading away in an hour or two, leaving no trace. Since that time, every bath and shower has been followed within minutes by these same small itchy hives. Indeed, swimming, sweating, or vigorous exercise did the same thing, although being under stress was not a trigger.

Dermatologists have been accused of hiding 26 16:21 P1: JZP 0521616581c06 CB974/Shelley 0 521 61658 1 September 19, 2005 UNCOMBABLE HAIR behind Greek and Latin diagnostic hedges, but here is one diagnosis that speaks with obvious authenticity and clarity. Further magnification, using the transmission electron microscope, showed that his hair had a normal whorled fingerprint patterning on the inside. X-ray microanalysis showed a normal sulfur content. The unique trihedron shape of the hairs presumably accounts for failure of the hair to lie flat after combing, because fiber thickness, tensile strength, and elasticity have been shown by others to be in the normal range.

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