This book shall assist the microscopist in a practical way, with the help of three mainstays, a. clinical information, b. the resources a standard histopathology laboratory may offer and c. the light microscope, to approach and solve the diagnostic problems he/she may face in the field of dermatopathology. In fact, this is the way in which the senior author of this book has been successfully working over thirty years in his capacity as director of a private dermatopathology laboratory.

The term "lymphoma" was originally used by Billroth in 1871 [55], and by Virehow [763] some years before that, for the designation of swelling of lymph nodes that was not due to "eareinoma, sareoma, ehondroma, myxoma, ete. " In his paper, Billroth reeounted sueeessful treatment with arsenie (" Fowler's solution") of multiple "lymphomas" that had developed in a 40-year-old woman during a 10-month period. From this report it is not entirely clear if the multiple" lymphomas" deseribed were infeetious or if they were eonsis- te nt with what we now mean by "malignant lymphoma. " Today, the term "malignant lymphoma" is generally used eolleetively for malignant lymphoproliferative neoplasms that tend to arise in lymph nodes and also eneompasses Hodgkin's disease and non-Hodgkin's lymphomas. The adjeetive "malignant" seems somewhat superfluous sinee, in addition to Bill- roth's original eonnotation, the sense of malignaney is nowadays read into the word "lymphoma. " To be sure, true, i. e. , malignant, lymphomas have to be differentiated from "pseudolymphomas," or to put it more exaetly, "pseudomalignant lymphomas. " In this book, "lymphoma" and "malignant lymphoma" are used interehan- geably for malignant neoplastie lymphoproliferative disorders, and "pseudo- lymphoma" is used for benign lymphomatous proeesses. Our editorial eonsultant, Dr. M. Leider, disagrees with all of this. In his Dictionary of Dermatological Words, Terms, and Phrases [421] and other works, he maintains that there is no etymologieal basis for words bearing the eontrived suffix" -oma" or the true Greek suffix" -ma" to denote malignaney.

Challenging Cases in Allergic and Immunologic Diseases of the Skin offers clinicians a wide range of challenging cases that are certain to provide hours of thoughtful and instructive review. Using a case study format and including excellent quality color images, Challenging Cases in Allergic and Immunologic Diseases of the Skin consists of five parts and 20 chapters. The chapters cover such areas as allergic rhinitis, allergic diseases of the eye, drug-induced urticaria, cosmetic allergy, drug allergy, latex allergy, atopic dermatitis, vasculitis, and a range of other commonly seen disorders of the skin. Each chapter comprises at least two cases that are followed by a differential diagnosis, discussion, and five multiple choice questions for thoughtful stimulation and excellent value as a teaching tool. Comprehensive, concise, and well-designed in presentation, Challenging Cases in Allergic and Immunologic Diseases of the Skin is a one-of-a-kind resource that will become a standard resource for all clinicians who care for patients with allergic and immunologic diseases of the skin.

There are many human cancers which actively synthesize specific characteristic proteins such as melanomas, thyroid cancer and squamous cell carcinoma. Many cancer researchers have of course tried to utilize this specific activity as a key for the selective treatment of cancers. In the past for example, the molecular hybrid compound of DOPA, a substrate of melanin, and nitrogen mustard N-oxide hydrochloride, a ctyotoxic anti-tumor drug, was synthesized as Melphalan and used to treat malignant melanoma. A major problem arose though in that it was soon found to be highly suppressive toward bone marrow and quite toxic while not being remarkably effective. Thus, malignant melanoma could not be cured by it. Such failure led us to develop a novel bimodal therapeutic system which includes the use of non-toxic potentially cytocidal chemicals which selectively accumulate within the cancer cells and which are converted by a controllable modality into an actively cytocidal element in situ. We can now non-surgically cure malignant melanoma and glioblastoma with our selective cancer treatment, neutron capture therapy (NCT); as can be found in this volume. Included are 124 papers on the latest breaking developments discussed at the Sixth International Symposium on NCT for Cancer held in Kobe during the late autumn of 1994.

Understanding Skin Cancer Anatomical Chart, Third Edition, is a highly illustrated chart providing clear, easy-to-understand information on skin cancer, now fully up to date with treatment information for each type of condition/cancer discussed and updated drawings and photographs. It defines and depicts precancerous growths, atypical moles, and malignant melanoma and nonmelanoma, as well as skin cancer prevention and self-examination. This edition includes updated drawings with inclusive representation and condition photos shown on various skin tones. Featured sections: Risk Factors Precancerous Growths Atypical Moles Types of Skin Cancer (Nonmelanoma) Malignant Melanoma Skin Cancer Prevention Self-Examination Self-examination illustrations Illustrations and photographs included: Anatomical illustration of skin layers Self-examination illustrations Actinic keratoses, atypical nevus, basal cell carcinoma, and squamous cell carcinoma Malignant melanoma with examples of "ABCDE" features (asymmetry, border, color, diameter, evolving) 20" x 26" heavy paper laminated with grommets at top corners

Measurement of Wound Healing will update the knowledge base and promote the use of measurements in order to improve both understanding of wounds and their management. This book will feature well used vascular measurements, pathological measurements, imaging measurements and so on. There will be chapters on techniques/measurements that have much promise. This book is led by 3 experienced clinician scientists from different backgrounds who have successfully worked together on projects.

An essential component of inflammation is the migration of circulating leukocytes from blood into tissues. This process is characterized by a multistep paradigm of sequential cell adhesion and activation events that lead to the extravasation of specific leukocyte subsets to different tissues in health and disease. The first step of leukocyte extravasation, the rolling of leukocytes, is primarily mediated by the interactions of selectins and their ligands. It has recently become evident that fucosyltransferases are crucial for selectin ligand synthesis, inflammation, and skin homing. This book provides an in-depth overview of the mechanisms of leukocyte trafficking and of the molecular mechanisms of selectin/selectin ligand interactions and discusses options for pharmacological intervention to treat inflammatory diseases.

Humanhairisananocompositebiological?ber. Maintainingthehealth,feel,shine, color,softness,andoverallaestheticsofthehairishighlydesired. Haircarepr- ucts such as shampoos and conditioners, along with damaging processes such as chemical dyeing and permanent wave treatments, affect the maintenance and groomingprocessandareimportanttostudybecausetheyaltermanyhairprop- ties. Nanoscalecharacterizationofthecellularstructure,mechanicalproperties,and morphological, frictional,andadhesive properties(tribologicalproperties)ofhair areessentialtoevaluateanddevelopbettercosmeticproductsandtoadvancethe understandingofbiologicalandcosmeticscience. Theatomic/frictionforcemic- scope(AFM/FFM)andnanoindenterhavebecomeimportanttoolsforstudyingthe micro/nanoscalepropertiesofhumanhair. Inthisbook,wepresentacomprehensive review of structural, nanomechanical, and nanotribological properties of various hairandskinasafunctionofethnicity,damage,conditioningtreatment,andvarious environments. Variouscellularstructuresofhumanhairand?nesublamellarstr- turesofthecuticleareidenti?edandstudied. Nanomechanicalpropertiessuchas hardness,elasticmodulus,tensiledeformation,fatigue,creep,andscratchresistance arediscussed. Nanotribologicalpropertiessuchasroughness,friction,andadhesion are presented, as well as investigations of conditioner distribution, thickness, and bindinginteractions. Tounderstandtheelectrostaticchargebuilduponhair,surface potentialstudiesarealsopresented. Thebookshouldserveasareferencebookonthebiophysicsofhumanhairand hairtreatments. TheresearchreportedinthisbookwassupportedbyProcter&GambleCo. in Cincinnati,Ohio,andKobe,Japan. IwouldliketothankCarmenLaTorrewhohad assistedinvariouspublicationsonhairresearch. Iwouldalsoliketothankmywife Sudha,whohasbeenforbearingduringthepreparationofthisbook. Powell,OH BharatBhushan November2010 v Contents 1 Introduction-Human Hair, Skin, and Hair Care Products...1 1. 1 HumanHair ...1 1. 1. 1 TheCuticle ...3 1. 1. 2 TheCortexandMedulla...6 1. 2 Skin...7 1. 3 HairCare:CleaningandConditioningTreatments,andDamaging Processes ...10 1. 3. 1 CleaningandConditioningTreatments:Shampoo andConditioner...13 1. 3. 2 DamagingProcesses...18 1. 4 OrganizationoftheBook ...19 2 Experimental Methods...21 2. 1 ExperimentalApparatuses...23 2. 2 ExperimentalProcedure ...26 2. 2. 1 StructuralCharacterizationUsinganAFM...26 2. 2. 2 SurfacePotentialStudiesUsingAFM-Based KelvinProbeMicroscopy...29 2. 2. 3 NanomechanicalCharacterizationUsingNanoindentation ...30 2. 2. 4 InSituTensileDeformationCharacterizationUsingAFM ...32 2. 2. 5 Macroscale Tribological Characterization UsingaFrictionTestApparatus...33 2. 2. 6 Micro/nanotribologicalCharacterizationUsinganAFM...35 2. 3 HairandSkinSamples ...41 3 Structural Characterization Using an AFM ...45 3. 1 StructureofHairCrossSectionandLongitudinalSection ...45 3. 1. 1 CrossSectionofHair...45 3. 1. 2 LongitudinalSectionofHair...45 3. 2 StructureofVariousCuticleLayers...48 3. 2. 1 VirginHair...48 vii viii Contents 3. 2. 2 ChemicallyDamagedHair...50 3. 2. 3 Conditioner-TreatedHair...52 3. 2. 4 EffectofHumidityonMorphologyandCellularStructure ofHairSurface...54 3. 3 Summary...55 4 Nanomechanical Characterization Using Nanoindentation, Nanoscratch, and AFM...57 4. 1 Hardness,Young'sModulus,andCreep...

Jacques Barzun, the noted Columbia University historian of ideas and culture, once described the feeling that some people experience when they come upon a new reference book. He wrote: "Hand over to one of us a new Dictionary, "Companion," or Guide, and our eyes first light up and then turn dreamy: we have seized the volume and are off, arm in arm with the guide i or companion. ..." The book now in your hands made my eyes light up. Thyroid Disorders with Cutaneous Manifestations is that kind of book. Heymann, who has been fascinated by this sometimes controversial subject for decades, has brought not only his own expertise, but that of many experts from the fields of the skin and the thyroid gland. Steven Jay Gould wrote about overlapping and nonoverlapping magisteria-this book demonstrates just how much important overlap there is. But it also covers the basics in such a way that dermatologists can find what they need to know about the thyroid and thyroidologists can find what they need to know about the skin. Thyroid Disorders with Cutaneous Manifestations falls neatly into the tra- tion of medical monographs that become standards. They fulfill the roles of gathering, digesting, and synthesizing current knowledge, and they do so in a way that review articles cannot approach and that the scientific literature is not designed to accomplish.

Over the past 30 years, there has been increasing recognition of psoriatic arthritis as a distinct clinical entity. Psoriatic arthritis occurs mostly in patients with psoriasis and may affect up to 1% of the general population. It has many similarities to other forms of spondyloarthritis, and must be differentiated from related conditions. Given that most patients with psoriatic arthritis have skin and musculoskeletal diseases that significantly affect their quality of life and function, patients are ideally managed in a multidisciplinary clinic with rheumatologists, dermatologists and a nurse specialist, physical therapist and occupational therapist. Psoriatic Arthritis covers the epidemiology and diagnostic and classification criteria, describing the clinical features of the disease, including skin and nail involvement, articular, and other extra-articular manifestations. Laboratory features and imaging characteristics are covered in detail, along with co-morbidities and their impact. A comprehensive review of skin disease therapy is also provided, along with the various treatment options for joint disease, including traditional disease modifying therapy and newer biologic agents . This comprehensive yet concise and practical volume is the perfect guide to psoriatic arthritis for the busy practitioner, and will be of interest to trainees and specialists in rheumatology and dermatology.

Taking advantage of the accessibility of the skin "in vivo," non-invasive methods were developed about 40 years ago, which have now developed as accurate sources to measure skin properties and structures at the microscopic and macroscopic levels. However, even at the dawn of the twenty-first century, the mechanisms involved in these properties are still only partly understood. As in many domains, including biomedical engineering, numerical modeling has appeared as a complementary key actor for improving our knowledge on skin physiology.

This book gathers, for the first time, chapters describing scientific computing and numerical modeling for a deeper understanding of mechanisms involved in skin physiology. The book is structured around some skin properties and functions, including optical and biomechanical properties, skin barrier function, and homeostasis, covered through several chapters describing either biological or physical models at different scales.

Major skin diseases, including acne, psoriasis and eczcma, affect the majority of the population at some time in their lives. In general, these diseases are physically and psychologically disfiguring for the sufferers; furthermore, by their very chronic nature skin diseases, unlike most other disease processes, present both acute and chronic therapy problems. In addition, the chronic nature of these diseases can present certain economic problems. Firstly, chronic therapy is becoming increasingly expensive and secondly, patients adhering to a strict treatment regimen will frequently be absent from their gainful employment for either medical consultation or treatment. Given that in all NATO countries the average age of the population is continually increasing, these chronic skin diseases will increase in importance in the coming years. Furthermore, as the average population age increases, additional disease processes such as skin photodamage and carcinogenicity risk becoming major areas of therapeutic concern. This book reviews in detail the major scientific areas of interest for research and clinical scientists working in skin pharmacology and toxicology. The basic principles relating to an understanding of how drugs and chemicals may influence either the skin or the body as a whole are discussed in detail by recognized international scientific experts.

Features a wealth of clinical illustration Features anatomical correlation for the points being made Features many clinical tips and tricks to enhance results

Melanocytic neoplasms are of capital importance for all surgical pathologists and dermatopathologists. These tumors span a huge range of morphologic expression and biologic behavior, are potentially of the highest medical significance and are often fraught with diagnostic pitfalls and high litigation risk.

"Pathology of Challenging Melanocytic Neoplasms "offers a dynamic text where readers will encounter a broad spectrum of challenging melanocytic lesions, both benign and malignant and will thereby acquire a solid, working knowledge that they can immediately apply to daily diagnosis. The authors aim to clarify this often thorny field, keeping a steady focus on patient-related issues. The volume emphasizes the practical application of basic morphologic principles, immunohistochemistry and molecular methods in order to secure a confident diagnosis. Abundant illustrations display the characteristic features of the most important disease entities.

Rather than being yet another encyclopedic work of reference, this volume takes a fresh approach as it resembles a series of stimulating seminars employing exemplary case material to highlight, illustrate, and succinctly discuss the key points. To this end, the reader will be guided through a series of paired cases that pose a significant diagnostic challenge. By comprehensively comparing and contrasting two related entities, each such chapter will illuminate an intellectual pathway through which an important diagnostic puzzle can be solved. To broaden the differential diagnosis even further, additional illustrative cases are added to each discussion. Algorithms and tables summarize key points. Clinically relevant, up-to-date references will be provided to guide further study. Written by experts in the field, this novel text will be of great value to surgical pathologists in practice and dermatologists as well as residents and fellows training in these specialties.

Liposuction began as a contouring procedure but has evolved into the treatment of obese patients, gynecomastia, ptosis, macromastia, and even patients who have complications from heart disease or diabetes. Other disorders such as axillary sweat hypersecretion, lipomas, and angiomas are also potential disorders that may be treated with liposuction.

Physicians performing liposuction must be adequately trained and experienced in the potential and actual complications before attempting to perform liposuction. Patient safety is the most important aspect of all surgeries, but especially of cosmetic surgery, which is an elective procedure.

New technology helps improve results but experience, care, and skill of the cosmetic surgeon is necessary to obtain optimal results that satisfy the patient.

The contributors to this book have spent time and effort presenting the cosmetic and plastic surgeon as much information as possible on the techniques and uses of liposuction for cosmetic and non-cosmetic surgery purposes.

Skin diseases caused by aquatic organisms are continually on the increase owing to the great number of people who now converge on the hydrosphere for holidays, sports and professional activities. Aquatic skin diseases are no longer only a seasonal affliction but can be observed at any period, thanks to the tourist boom promoting aquatic holidaymaking throughout the year. This book aims to contribute to the knowledge of some aquatic animals that have only developed a poisonous apparatus to protect themselves and adapt to their environment, as well as of the various clinical pictures induced by different pathogenic mechanisms. Besides the afflictions caused by biotoxins, skin reactions to microscopic organisms present in seawater, freshwater, swimming pools and aquariums are described, together with some non-biotic forms induced by direct contact with salt and freshwater. A better knowledge of the aquatic environment may help people to enjoy this enthralling habitat at lesser risk.

The Microsystems Series has as its goal the creation of an outstanding set of textbooks, references, and monographs on subjects that span the broad field of microsystems. Exceptional PhD dissertations provide a good starting point for such a series, because, unlike monographs by more senior authors, which must compete with other professional duties for attention, the dissertation becomes the sole focus of the author until it is completed. Conversion to book form is then a streamlined process, with final editing and book production completed within a few months. Thus we are able to bring important and timely material into book form at a pace which tracks this rapidly developing field. Our first four books in the series were drawn from the more physics-oriented side of the microsystems field, including such diverse subjects as computer-aided design, atomic-force microscopy, and ultrasonic motion detection. Now, with Sangeeta Bhatia's work, we enter the realm of biology. Her use of artifically structured substrates to encourage the liver cells to form orderly assemblies is a fine example of how microfabrication technology can contribute to cell biology and medicine. I am pleased to be able to add this very new and very interesting work to the Microsystems Series. Stephen D. Senturia Cambridge MA Microfabrication in Tissue Engineering and Bioartificial Organs Foreword One of the emerging applications of microsystems technology in biology and medicine is in the field of tissue engineering and artificial organs. In order to function, cells need to receive proper signals from their environment.

This method of local anaethesia, developed by a dermatologist and a pharmacologist, is presented to demonstrate its use in cosmetic liposuction and other procedures. Richly illustrated to show details of the technique and with serialphotographs of many clinical cases, the book explains the advantages of this new technique and provides practical instruction in how to perform it.

Biometrics in dermatology is an essential tool where data evaluation results in valid interpretations. This book will be the first in this area. One part of the book will describe principal aspects of dermatological research focussing on practical advice. A special part will cover applied biometrics to provide the clinician and researcher with state-of-the-art guidelines to assess the severity of common skin diseases. An additional aspect that will be of interest to pharmacologists addresses pharmacologic assays.

The disciplines of rheumatology and dermatology are involved in the care of several diseases that share cutaneous and locomotor as well as, quite often, systemic involvement. While traditionally remaining separate, it has long been recognized that there are several areas of common interest in these two specialties. Indeed, this had been realized by sev- eral far-sighted physicians, both rheumatologists and dermatologists, such asG. Rodnan and 1. Gilliam. A number of books have been published over the past few years specifi- cally dealing with skin involvement in the connective tissue diseases, both inherited and acquired. These include The Skin in Rheumatic Disease, by C. R. Lovell, P. 1. Maddison, and G. V. Campion (Chapman and Hall Medical, 1990), Connective Tissue Diseases o(the Skin, edited by C. M. Lapiere and T. Krieg (Marcel Dekker, Inc. 1993), and Cutaneous Manifestations of Rheumatic Diseases, edited by R. D. Sontheimer and T. T. Provost (Wil- liams and Wilkins, 1996). However, despite this shared interest, meetings combining the two specialties were generally limited to small interest groups. It had long been felt that a workshop should be organized that could bring together the views of specialists from the two areas and focus on the challenges that this common ground brings to these two disciplines.

Metastases determine malignancy. The main attention so far has been focused upon organ metastases. The molecular mechanisms thereof, while far from being totally elucidated, are increasingly well understood. Modern diagnostic tools now enable detection and precise localization of small lesions. In contrast, our knowl edge and diagnostic capabilities regarding metastatic spread to the'lymphatic system are rather limited. However, there have re cently been a number of interesting advances. It is the aim of this volume to submit these developments to detailed analysis. The therapeutic relevance of enhanced sensitivity in detection of lymph node metastases has to be considered in the light of in creased morbidity versus eventual prognostic improvements by modification of therapy. An interesting concept which might im prove diagnostic accuracy while reducing operative morbidity is the "sentinel node" technique. Surgical standards are lacking, however, and many fundamental questions pertaining to precise lymphatic mapping remain unanswered. Whether the sentinel node concept is of general relevance or whether it is applicable in only a few organs remains to be determined. This book offers intensive discussion of the concept from methodological and tu mor biological viewpoints. World-renowned experts with long term involvement in related basic and clinical research provide the reader with a broad survey of actual knowledge together with a critical appraisal of recent and future developments. We sincerely hope this book succeeds in providing an outlook as a reference for all clinicians on future prospects and serving and researchers in this extremely important field.

It is remarkable how much we take for granted the tremendous energy and vitality that the sun provides earth's inhabitants. As we enter the new millennium, it is worthwhile to review how our ancestors perceived the biologic effects of sunlight, and how science and medicine have advanced our knowledge about the biologic effects of light. At the turn of the century, a multitude of investigators explored the use of sunlight and artificial radiation for treating a multitude of diseases. These explorations gave rise to photodynamic therapy, phototherapy, and chemophototherapy. However, enthusiasm for using sunlight and artificial radiation to treat disease was dampened with the birth of pharmacology. It was the goal of the Fifth International Arnold Rikli Symposium on the Biologic Effects of Light, held in Basel, Switzerland, on November 1-3, 1998, to review the history of phototherapy and have some of the world's leading experts on the biologic effects of light provide new perspectives on the positive and negative effects of light. The general topics included a broad range of biologic effects of sunlight, artificial ultraviolet radiation and electromagnetic radiation. Special sessions on radiation and vitamin D and bone health, photoimmunology, biopositive effects of UV radiation, effects of electromagnetic currents and fields, and ocular and non-ocular regulation of circadian rhythms and melatonin, should be of particular interest to readers of Biologic Effects of Light.

Proof of the efficacy of dermatological products is a prerequisite for clinical testing and registration. Now, efficacy claims for cosmetics must be equally substantiated. This book provides a concise, practical but comprehensive overview of experimental models used to screen, develop and select dermatological and cosmetic formulations. The authors are recognized specialists in their field and use a standardized approach to the projects facilitating the reading for the stressed scientist, for the R+D managers general view as well as for the beginners in the field.

Over the generations the skin has been the site for immunization against smallpox. This method of immunization was described in a letter written by Lady Mary Montagu on April 1, 1717 in Adrianopole, Turkey: "The small-pox, so fatal, and so general amongst us, is here entirely harmless by the invention of ingrafting, which is the term they give it. . . The old woman comes with a nut-shell full of the matter of the best sort of small-pox . . . She immediately rips open (the skin) with a large needle . . . and puts into the vein as much venom as can lie upon the head of her needle, and after binds up the wound. There is no example of anyone that died of it; and you may believe that I am satisfied of the safety of this experiment since I intend to try it on my dear little son" (Letters from the right Honourable Lady Mary Montagu 1709-1762. Published by J. M. Dent and Co. London, 2nd edition, September, 1906, p. 124. ) The "variolation" method was, 80 years later, markedly improved by the use of cowpox virus, as reported by Edward Jenner in 1796. The successful method of intradermal immunization against smallpox and later against other virus diseases is in fact based on the presence of anitigen-presenting dendritic cells in the skin.

Significant progress has been made in recent years in understanding the origins of cutaneous maligant melanoma. Knowledge of the relationship between solar radiation and melanoma has changed and it now appears that both the character and timing of exposure may be more important than total cumulative dose in accounting for risk. The melanoma-sunlight model may prove an instructive heuristic exercise for environmental epidemiology, as we currently tend to restrict ourselves to a search for uniform total dose--response relationships between cancers and suspected environmental carcinogens. The study of the relationship between acquired melanocytic nevi and melanoma has led to useful new information about predictors of melanoma risk, and in addition has opened new perspectives on the development of nevi in children. Definition of the factors for nevus development in children may lead to the possibility of primary prevention programs for melanoma in younger generations of children. Recent new evidence suggests that certain occupational groups may be at elevated risk of melanoma. A great deal of work is going into the study of ways of screening high risk populations in order to detect melanoma at its earliest stages when current treatment protocols are most effective. The visibility of lesions on the skin challenges classical definitions of early detection and screening in epidemiology.