Specialists are not Qualified Enough to Recognize and Define Dermatologic Diseases

Dermatology is a specific branch of medicine which includes dermatologic manifestations of systemic underlying diseases as well as primary cutaneous diseases. In this study, specialists’ abilities of defining and diagnosing dermatologic diseases were assessed. 381 hospitalized patients who were referred to the Dermatology Clinic were reviewed via electronic medical charts. 121 of the clinicians (31.2%) made a dermatologic definition when referring their patients to dermatology. 136 of the the clinicians (35.1%) made a pre-diagnosis for their patients’ dermatologic condition of which 90 (66,2%) were correct and 46 (33,8%) were non-relevant. Internists wrote a definitive dermatologic examination note significantly more often than surgeons (P=0.03). However, there was not a significant difference between internists and surgeons when we compared the ratio of correct and complete dermatologic definitions of patient condition (P=0.503). There was also no difference between surgeons and internists in terms of making a pre-diagnosis, making a correct diagnosis, and making a wrong diagnosis (P>0.05 for each comparison). In conclusion, dermatologic consultations are crucial and necessary for the improvement of patient care and treatment. Specialists lack basic skills to recognize and define dermatologic conditions they are confronted with

A study of dermoscopic features of nail psoriasis

Introduction : Dermoscopy is a non-invasive imaging method that enables the evaluation of pigmented and non-pigmented skin lesions. More recently, dermoscopy has been recognized as an effective tool in the diagnosis of nail diseases. Aim: To evaluate the dermoscopic features of nail psoriasis and to assess the relationship between these features and disease severity. Material and methods : A total of 67 patients with clinically evident nail psoriasis (14 women, 53 men) were prospectively enrolled. Following a thorough clinical examination, patients were graded according to the Nail Psoriasis Severity Index and physician’s global assessment score. A dermoscopic examination of all fingernails and toenails was performed using a videodermatoscope. Mann-Whitney U and 2 tests were used for statistical analysis, with a significance threshold of p < 0.05. Results: The most frequently observed dermoscopic features were splinter haemorrhage (73.1%), pitting (58.2%), distal onycholysis (55.2%), dilated hyponychial capillaries (35.8%) and the pseudo-fiber sign (34.3%). The pseudo-fiber sign, dilated hyponychial capillaries, nail plate thickening and crumbling, subungual hyperkeratosis, transverse grooves, trachyonychia, pitting and salmon patches were positively associated with disease severity. Conclusions : The pseudo-fiber sign described in this study appears to be a novel dermoscopic feature of nail psoriasis. We have demonstrated positive associations between a number of dermoscopic manifestations and disease severity. Further studies are required to support the present findings

A case of pityriasis rosea of vidal accompanied by neurofibromatosis type 1:

International audienceLes fondements chrétiens de l'obéissance au pouvoir politique étaient au XVIe siècle à la fois une évidence et un sujet de débat. Dès ses origines, le christianisme avait élaboré des théologies politiques diverses, voire contradictoires, mais le temps des Réformes, reprenant ces thèmes déjà anciens, devait les confronter aux nouveautés que représentaient la déchirure religieuse et le développement d'une monarchie aux exigences croissantes. L'historiographie récente s'est déjà beaucoup intéressée à cette question, mais en privilégiant les moments d'affrontement, où les acteurs définissent les limites de l'obéissance ou du droit à la révolte 1. Dans le royaume de France, ces affrontements atteignent bien sûr leur point culminant pendant les guerres de religion, avec d'étonnants transferts des positions et des arguments entre catholiques et protestants en fonction de la situation politique. Les débats sont nourris par la relative polysémie scripturaire sur le sujet, de l'injonction d'obéir aux puissances temporelles à la possibilité d'une résistance légitime aux pouvoirs contraires à Dieu, en passant par la séparation radicale entre ce que l'on doit rendre à César et à Dieu. Dans un contexte politique incertain, ces prises de position s'insèrent dans des réflexions bien plus larges, qui s'efforcent, chacune à leur manière, de construire un avenir viable pour un royaume en perdition. L'intensité des débats dans la période qui suit la mort de Henri II contraste avec le silence de la période qui précède. Ce silence est certes relatif et certains ont pu s'interroger, surtout à partir des années 1550, sur la nature exacte de l'obéissance due aux pouvoirs constitués, sur son éventuelle absurdité, en tout cas sur ses limites 2. Ces réflexions, parfois capables d'une radicalité étonnante, ne débouchent pas sur un véritable débat public, en tout cas pas sur une contestation organisée et durable de l'obéissance due au roi. De son côté, le pouvoir peut bien promouvoir une image qui exalte l'obéissance, mais ne passe pas obligatoirement de ces représentations, dont le décodage peut s'avérer particulièrement subtil, à une véritable théorisation officielle qui légitimerait le renforcement de l'autorité royale dans la première moitié du XVIe siècle. En ce qui concerne plus précisément les rapports entre obéissance au roi et à Dieu, les règnes de François Ier et de Henri II voient bien sûr les « mal-sentant de la 1 Voir notamment Marie-Madeleine Fragonard et Michel Péronnet (dir.), « Tout pouvoir vient de Dieu… » (St Paul. Rm. XIII, 1). Actes du VIIe colloque Jean Boisset, Montpellier, Sauramps éditions, 1993, et sur la question du tyrannicide Mario Turchetti, Tyrannie et tyrannicide de l'Antiquité à nos jours, Paris, PUF, 2001. 2 C'est évidemment à La Boétie et à son Contr'un, rédigé peut-être vers 1553, que l'on pense. Sur sa signification replacée dans le contexte du règne de Henri II, voir l'analyse d'Arlette Jouanna dans Arlette Jouanna, Philipp

A Case Of Erythema Multiforme Associated With Pustules: Coexistence Of Erythema Multiforme Minor And Acute Generalized Exanthamatous Pustulosis

Adverse cutaneous drug reactions (ACDRs) can mimic a variety of dermatologic diseases, causing confusion and additional work-up for differential diagnoses. In this report, a case who admitted with non-follicular pustules with extensive targetoid lesions during follow-up is presented. In this case, erythema multiforme (EM)-like lesions were predominant and pustules that were concordant with acute generalized exanthematous pustulosis were thought to be triggered after drug intake. ACDRs can mimic several different infectious and inflammatory entities, and they should be kept in mind in cases accompanied by EM-like lesions with pustules. To our knowledge, EM-like lesions with a small number of pustules are first described in the literature in this case report.WoSScopu

A case of Graham-Little–Piccardi–Lasseur syndrome

Graham-Little–Piccardi–Lasseur Syndrome (GLPLS) is a variant of lichen planopilaris, which is characterized by progressive cicatricial alopecia of scalp, non-cicatricial alopecia of axillae and pubic regions, and keratosis pilaris-like follicular papules over trunk and extremities. GLPLS is a disease of unknown etiology. However, recent reports support a central role for a T-cell-mediated immune response in the pathogenesis of GLPLS. Besides, although GLPLS is believed to occur sporadically, a genetic predisposition also has been implicated in the pathogenesis. On the other hand, GLPLS typically affects middle-aged women, particularly of the postmenopausal age group. A diagnosis of GLPLS is generally apparent with the presence of characteristic findings in a postmenopausal woman. Herein, we report a case of GLPLS in a 75-year-old woman with the typical triad of alopecia of the scalp, non-cicatricial alopecia of axillae and pubis, and a follicular keratotic eruption on the trunk

A rare case of trigeminal trophic syndrome with an extensive scalp, forehead, and upper eyelid ulceration in a patient with undiagnosed Alzheimer disease

Background: Trigeminal Trophic Syndrome (TTS) is a rare presentation of facial ulceration, which is characterized by the triad of anesthesia, paraesthesia, and damage of trigeminal sensory branches.Main observations: We report a unique case of TTS as an extensive forehead and scalp ulceration in a patient with undiagnosed Alzheimer disease.Conclusions: Treatment options for trigeminal trophic syndrome are limited and disappointing especially in older patients with dementia. Family education and behavioral modification therapies may be well tolerated option in this population

A rare case of trigeminal trophic syndrome with an extensive scalp, forehead, and upper eyelid ulceration in a patient with undiagnosed Alzheimer disease

Background: Trigeminal Trophic Syndrome (TTS) is a rare presentation of facial ulceration, which is characterized by the triad of anesthesia, paraesthesia, and damage of trigeminal sensory branches.Main observations: We report a unique case of TTS as an extensive forehead and scalp ulceration in a patient with undiagnosed Alzheimer disease.Conclusions: Treatment options for trigeminal trophic syndrome are limited and disappointing especially in older patients with dementia. Family education and behavioral modification therapies may be well tolerated option in this population