The basic principles of the phenomenon "erection" have been known since the pioneering work of Kolliker, Eckhard and Langley in the nineteenth century. Nonetheless, under the influence of Freud, erectile dysfunction was predominantly at tributed to psychogenic factors. A more liberal perception of sexuality since the 1960s, the development of new and refined diagnostic techniques, and the expansion of basic research activity resulted in a new concept of erectile dysfunction, identifying arteriogenic, venogenic, endocrinologic or myopathic (cavernous smooth muscle dysfunction) factors. From this research other considerations such as autonomic innervation, cavernous endo thelial intactness or impaired neurotransmitter pool are being introduced into routine clinical assessment. A reevaluation of psychogenic etiology with a consequential new concept of psy chogenic impotence is on the rise. In this book the new concepts of basic knowledge on cavernous smooth muscle function and its supraspinal, spinal, and local control; the new diagnostic approaches in psychogenic and autonomic factors; and the new developments of reconstructive therapeutic options for the patient have been tied together. Outstanding and internationally renowned experts in the field of erectile dysfunction have given detailed insight into the latest basic and clinical developments. Well-established diagnostic and thera peutic techniques are presented by experienced colleagues. We hope that this book will help the reader to get an overview of the current concepts of erection. Furthermore, we hope that international collaboration in basic and clinical research in the field of erectile dysfunction will render an update necessary in the near future.

Strong body odor is a condition for which, until now, there have been few treatment methods. The Japanese authors, encouraged by the willingness of Oriental patients to undergo radical treatment, have developed the subcutaneous tissue shaving method, which eliminates the condition in a very short period of time without ugly scarring. The book Human Body Odor not only introduces the completely new subcutaneous tissue shaving method, it also questions conventional theories on the hair cycle itself and throws a new hypothesis about the process of hair generation and regeneration into the scientific arena. This could even lead in the future to a formula for retarding hair loss! Developed over the past twenty years, the authors' new surgical method for the radical treatment of bromidrosis represents a landmark in cosmetic surgery and dermatology!

It is a great pleasure for me to see this work in print. As outlined by Dr. Traupe, at least 20 different types of ichthyosis have been identified to date. This book will effectively help to establish a correct diagnosis, as a basis for genetic counseling. Dr. Traupe proposes a new classification of the ichthyoses, based on reason able clinical criteria. He lets the reader share in his enormous knowledge and safely guides him through the difficult field of nomenclature. He describes the particular nature of these scaling disorders in a manner as simple as possible. During the last few years, research on ichthyosis has become a fascinating scientific challenge due to the introduction of novel investigative approaches. The main advantage of this book lies in the fact that the author successfully combines recent achievements made in lipid analysis, enzymology, electron microscopy, and molecular genetics. Heiko Traupe began his career in dermatology 11 years ago, as a resident in the Department of Dermatology in Munster. As we were both interested in the genetic aspects of skin diseases, this was the starting point of a most fruitful collaboration, which is still continuing. During our common work in Munster, Dr. Traupe was able, thanks to his unceasing clinical curiosity, to describe many novel aspects within the field of ichthyosis, and I took pride in coauthoring papers on new items such as cryptorchidism as a fea ture associated with X-linked recessive ichthyosis, autosomal dominant lamellar ichthyosis, and alopecia ichthyotica."

Advanced skin cancer is one that has already metastasized beyond its primary origin, or one that has invaded underlying tissues such that surgical resection either is technically impossible or would lead to an unacceptable functional or cosmetic outcome. These skin cancers present a complex problem that requires the input of multiple specialties to delineate the best management plan. National guidelines utilize the best available data to guide management decisions. However, there is considerable leeway within the guidelines, enabling the ultimate care decision to be molded to best fit each individual patient. This book aims to provide instructional examples of patient cases where the input of the multidisciplinary team is critical in providing the most suitable care plan for the patient. CONTENTS: Melanoma * Squamous Cell Carcinoma * Basal Cell Carcinoma * Cutaneous Lymphoma * Kaposi's Sarcoma * Dermatofibrosarcoma Protuberans * Merkel Cell Carcinoma * Rare Cancer Presentations

The primary intent of this book is to familiarize the medical practitioner with the "nail unit" in a way which will render, correctly and more easily, the diagnosis of nail diseases. At the same time, it serves to encourage the treatment and corrective measures of the ab normalities, if possible, based on anatomical and physiological knowledge. The chapters on anatomy, regeneration, and nail formation are basic to the author's in tent. The content ofthe references quoted represents information which is proven and not controversial material. In addition, my own material not previously published is included. I would like to introduce the anatomical concept that the nail unit consists of four dif ferent epithelial structures, each with its own characteristics, yet all interrelated. These four constituents are the Proximal Nail Fold (PNF), the Matrix (M), the Nail Bed (NB) and the Hyponychium (HYP). A disease may occur in any number of or all nail unit structures. A clear understanding of the anatomy, histology, and tissue kinetics of each constituent will be necessary and is the key factor in interpreting the abnormal findings of each of these constituents as disease occurs. It follows, therefore, that treatment and Cor rective measures should include the knowledge of not only the nail but also of its relation ship to the bony phalanx and the digit.

The skin on the fingertips and palmar and plantar surfaces of man is not smooth. It is grooved by curious ridges, which form a variety of configurations. These ridge configurations have attracted the at tention of laymen for millenia. They have also evoked the serious interest of scientists for more than three centuries. The anatomist Bidloo provided a description of ridge detail in the seventeenth cen tury. Since then, additional information has been added by anthro pologists, biologists, and geneticists. For the last century, the fact that each individual's ridge configurations are unique has been uti lized as a means of personal identification especially by law enforce ment officials. Widespread medical interest in epidermal ridges de veloped only in the last several decades when it became apparent that many patients with chromosomal aberrations had unusual ridge formations. Inspection of skin ridges, therefore, promised to provide a simple, inexpensive means for determining whether a given patient had a particular chromosomal defect. However, the promise was only partially fulfilled because of the inherent variability of skin ridge configurations. It was possible to draw conclusions about ridge ab normalities in groups of patients but not always in a given individual. Patients and clinicians became somewhat disenchanted with the clinical value of studying ridges."

Professor George Fegan is a world authority on the use of sclerotherapy for the treatment of varicose veins. His technique for injecting varicose veins is regarded by many to be the best method for achieving success with sclerotherapy. Professor Fegan first published his method in 1963. This book is an update to his previous work and describes his method step by step as well as relevant information on the anatomy, physiology, pathology and investigations of varicose veins. Sclerotherapy is finding its place as an effective weapon in the phlebologist's armamentarium, and its indications are becoming clearer. All involved in the care of patients with venous disease will find this an invaluable read.

This book offers a unique insight into the world of cutaneous lymphomas. In addition to the case description it gives the clinical, histological, and in most cases also the phenotypical features and the results of molecular techniques. A commentary puts the observations into the context of cutaneous lymphomas. High quality pictures accompany this exceptional collection of rare and unusual cases. These will interest dermatologists, oncologists, pathologists and hematologists.

The international symposium "New Trends in Allergy," held in Munich from July 13 to 15, 1990, brought together for the third time since 1980 some of the most experienced researchers working in the field of allergy. This volume comprises the papers presented at this meeting. All over the world, and not merely in the industrialized countries, allergy is becoming a cause of evermore serious diseases. In recent years, research in the field of allergy has provided numerous impor tant and fascinating results extending our knowledge considerably. Despite the new insights into basic mechanisms of allergic reactions, improved diagnostic methods, and new therapeutic approaches, how ever, many questions remain to be answered, including: Are allergies really increasing in frequency? If so, what are the reasons? Especially, does environmental pollution playa role? Which factors influence IgE synthesis? Can the IgE immune response be switched off? Does the nervous system interact with allergic reactions? If so, what are the mechanisms? Are new approaches in allergy prophylaxis and allergy therapy effi cient? What measures have proven useful and deserve to be employed in daily practice? In this volume, these questions and other current topics are dealt with. As each issue is covered by authors competent in the respective fields, the result is an extensive and critical review of the state of the art. Going through these papers, one comes to the conviction that allergy research is a multifacetted, explosively expanding, most stimulating field of work."

During the last 40 years, the study of the biological basis of aging has progressed tremendously, and it has now become an independent and respectable field of study and research. The essential cause of aging is molecular damage that slowly overwhelms cellular and organismic defense, repair and maintenance systems. In recent years, a wealth of highly sophisticated research has transformed this idea from a credible hypothesis not only to a major theory, but essentially to accepted knowledge. Aging at the Molecular Level examines the key elements in this transformation.
Bringing together contributions from an international team of authors, this volume will be of interest to graduates and postgraduates in the fields of medicine and nursing, researchers of different aspects of biogerontology and those in the pharmaceutical, cosmeceutical, nutraceutical and health-care industry.

The two organs of the body most accessible to examination are the eye and the skin and its appendages. That is why, it is said, ophthalmological genetics is in such flourishing good health. Dermatological genetics does not seem to have benefited so much from the skin being on the outside, and there are but few dermatological counterparts to the volumes of Sorsby, Waardenburg, Franceschetti and Franr; ois, among others. But thanks to the growing interest in medical genetics, and the modern sophisticated tech niques of molecular, biochemical, and ultrastructural examination, der matology is beginning to catch up, as the appearance of this volume testifies. Because of the growing body of knowledge and the heightened awareness of genetics by both patients and physicians, dermatologists not only will be asked more often about the inheritance of skin conditions they diagnose but increasingly will have the opportunity to diagnose a variety of inborn errors and syndromes by their dermatologic manifestations. On the other hand, syndromologists, clinical geneticists, and physicians are continually seeing patients with diagnostic clues in the skin that they must be able to appreciate. For both groups this book will be a new and valuable source of help. Spring 1979 F. CLARKE FRASER, Ph.D., M.D."

The impact of the retinoids in clinical practice has primarily been in dermatology. When Dr Werner Bollag began his basic research and screening programme in the early 1960's, the expectation was that the retinoids would have a major impact on oncology. However, the laboratory and clinical experiences of Bollag and his colleagues in Switzerland, Stuttgen and Orfanos in Germany, led to publications on both etretinates (Tigason) and isotretinoin (Roaccutane) in the years between 1972 and 1976 in the field of dermatology. In fact the first symposium on retinoid research held in Berlin in 1981 was almost entirely dermatological. A year later a retinoid workshop in Iowa was designed to provide a forum for dermatolog ists from the USA involved in specific protocols investigating oral retinoids. In the UK, research into the retinoids began rather later than in Continental Europe or in the USA, although Tigason was first marketed here. It was felt in late 1982 that as many dermatologists had relatively little experience with these compounds it would be appropriate to hold an International Symposium on retinoid therapy in the UK. Thus on 16-18 May 1983 in London, 37 speakers from 11 countries addressed an audience of 300, aminly UK, dermatologists. The scientific organizing committee consisted of but two persons Dr William Cunliffe of Leeds General Infirmary, representing the European Society of Dermatolo gical Research, and myself from Roche Clinical Research. The Symposium was held under the auspices of the ESDR and of Roche Products Limited."

The detection of cancer risk factors and their possible avoid ance would most effectively contribute to the fight against cancer. Research in these areas depends to a substantial degree on in vivo experimental animal models and on epide miologic studies, including data from cancer registries. When the Deutsches Krebsforschungszentrum was founded in 1964, its division "Mechanisms of Tumorigenesis" and a number of other divisions became engaged in research on chemical carcinogenesis of the skin, mainly using the mouse skin as an experimental model. Their interest orig inated in part from investigations of the new and at that time controversial pathogenic principle of conditional car cinogens as represented by certain tumor promoters which are per se noncarcinogenic. During the past 25 years, conditional carcinogens in terms of tumor promoters were established as anew, nonclassical category of cancer risk factors besides the classical solitary carcinogens. In the course of this exciting period, scientists of our center started cooperative programs with clinical dermato logists of the University of Heidelberg at the Clinics of Dermatology in Heidelberg and Mannheim, to extend the scope of their investigations into clinical oncology and to contribute by experimental approaches to solving problems in clinical oncology. This led to a gradual shift from mere animal studies to the more direct analyses of human tumors and opened up for us a new phase of research.

Each of the four authors of this book has a particular interest in disorders of porphyrin metabolism and special experience in their management. Their individual involvement in the field varies from 12 to 52 years and, combined, represents more than a century of personal experience. Since it has been written by both basic scientists and practicing physicians, the book is intended to be of value to all those involved in porphyrin metab olism and the porphyrias. It is hoped that the fascination of porphyrin metabolism and the clinical challenge of the porphyrias experienced by each of the authors will be conveyed to the readers. Michael R. Moore Kenneth E. L. McColl Claude Rimington Abraham Goldberg vii CONTENTS Color Plates ............................................ xvii 1. The History, Classification, and Incidence of the Porphyrias 1 1.1. History ........................................ 1 1.1.1. Early Chemistry . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1.1.2. Early Descriptions of Porphyria .............. 4 1.1.3. Biochemical Developments .................. 4 1.1.4. Acute Porphyria . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 1.1.5. A Complete Pathway ...................... 8 1.2. Classification of the Porphyrias . . . . . . . . . . . . . . . . . . . . . 9 1.2.1. The Current Classification. . . . . . . . . . . . . . . 12 . . . .

Several years ago a friendly looking young man walked into my office at the University Department of Dermatology in Cologne, introduced himself as a diplomate chemist, executive member of a family-owned, rather small German company manufacturing hair care products, and proposed to me straight forward to organize an international meeting on hair research. In view of the large number of new developments in the field something like this should be done after all, he said; he also promised to provide financial support. Such a meeting should be on the highest possible level, I said; and he agreed. I took the challenge and my visitor kept his promise. Three years later the First International Hair Congress was organized at the sophisticated new Congress Center in Hamburg, in which 630 participants from 36 countries were registered. After three and a half days of formal sessions, informal discussions, workshops and poster presentations our unanimous feeling was that this has been a most successful meeting. The young chemist was right. The idea was excellent. The growth and presence of hair and its distribution over the human body as a cosmetic attribute has become during the last two decades a matter of tremendous emotional significance. Hair can be rather easily formed according to one's sence of style, representing his personal image and his social feeling. If it becomes unacceptable or out of fashion, the hair style can be easily changed; the hair regrows as a biological requisite, without any additional cost.

This concise practical guide is designed to facilitate the clinical decision-making process by reviewing a number of cases and defining the various diagnostic and management decisions open to clinicians. It is richly illustrated and diverse in scope, enabling the reader to obtain relevant information regarding both standard and unusual cases in a rapid, easy to digest format. The first in the series will be on Geriatric Dermatology and will be prepared within one month of acceptance and include photos. Each case will also include a narrative description and patient management tips

It goes almost without saying that there has been a marked increase in the incidence of sexually transmitted diseases throughout the world in the past two to three decades. Indeed, despite the progress that has been made in methods of diagnosis and treatment, the sexually transmitted diseases as a whole are the most common communicable diseases and as such constitute an important health problem. The increase in incidence may be accounted for by changes in sexual behaviour, the introduction of contraceptives and the increasing mobility of the population. In addition, during the same time period, the number of infectious agents recognized as being sexually transmitted has increased considerably. These include Chlamydia trachomatis, herpes simplex virus, cytomegalovirus and hepatitis B virus. Indeed, some are as dependent on sexual transmission as the agents which cause the traditional venereal diseases and collectively they cause morbidity which has out-stripped that caused by gonorrhoea and syphilis. It could almost be said that to know the sexually transmitted diseases is to know micro biology. However, the approach taken in this book has not been to consider individual infectious agents and evaluate what they do and do not cause but to consider clinical conditions and what might be responsible for them. To cover the complete spectrum of the sexually transmitted diseases in a comprehensive way now takes a text book of massive proportion."

Urticaria is one of the most common dermatological and allergological cutaneous reactions and, compared to other diseases, it is easily recognized by patients and physicians alike. Nevertheless, the disease is highly complex regarding its eliciting causes, its clinical manifestations and its therapy. Thus, a famous New York dermatologist once mentioned that he would rather have a lion than a patient with chronic urticaria walk into his office. This may seem surprising since, to the uninitiated, different types of urticaria look alike, and the pathomechanisms are rather well understood, with mast cells being almost invariably the main effector cells. In 1986, a monograph of the first editor (Prof. Czarnetzki, now with the married name Henz) appeared, giving a detailed and thorough review of the then current state of knowledge regarding all aspects of the disease. Since then, two updates of this book have appeared in the German language, with coworkers of the clinic of Prof. Henz helping in the revision of the various chapters of the old monograph, and with particular emphasis on practical aspects of the disease. The present book is mainly a translation of the second German edition, with only minor updates and with more citations from the literature since the 1986 monograph is no longer available for purchase.

Proceedings of the 5th Biannual International Meeting on Angiogenesis: From the Molecular to Integrative Pharmacology, held July 1-7, 1999, in Crete, Greece. Angiogenesis, as a vastly complex biological process, has challenged researchers from all basic scientific disciplines, including pharmacology, biochemistry, physiology, embryology and anatomy. The significance of this phenomenon for the study of disease states has also interested clinicians from a number of specialist fields. This multidisciplinary work reflects the growth of awareness of concepts such as angiogenesis based therapy, the enormous therapeutic and commercial potential of which has attracted major research and investment in recent years. This volume, which aims to bridge the gap between basic and clinical methodology and understanding, presents the most up-to-date developments in this field.

In the past two decades, considerable interest in skin cancer has developed in the public and scientific communities. There may have been several reasons for this: - The rise in the global incidence of cutaneous cancers - New molecular biology techniques resulting in a better understanding of pathogenesis and improved diagnostic procedures - The advent of new pathological entities, e. g. , the endemic form of Kaposi's sarcoma - A constantly increasing range of therapeutic modalities, providing even more efficacious treatment and manage ment of skin cancers As N. E. Fusenig describes in the first chapter of this volume, basic research is only beginning to unravel the complex mechanism involved in cellular dedifferentiation and tumor progression. Progress is dearly needed, especially in dermato oncology, where the rise in the incidence of epithelial tumors has inflated the overall skin cancer incidence. The incidence of tumors of the skin exceeds that of all other neoplasias in humans, with recreational sun exposure being a suspected primary cause. Several studies on the effects of UV radiation have been included at the beginning of this volume. Even the role of long wavelength UV (UVA) has become a focus of research activities. The main concern is that the low carcinogenicity of UVA, in comparison to UVB, may be outweighed and exceeded in its effects by increased UV A exposure, e. g.

Androgen Receptors is the most comprehensive and up to date volume on the topic, including discussions of the basic mechanisms of androgen-androgen receptor actions, their roles in the androgen-related diseases, and their potential clinical applications. Key topics covered include: -The discovery and cloning of the androgen receptor; -Androgen receptor coregulators; -Androgen related genes and their consensus DNA response elements; -Basic mechanism of action including functional analyses, cellular localization and phosphorylation studies; -Cross-talk to other signal transduction systems; -The recent connections of androgens to women's diseases, such as osteoporosis and ovarian cancer. This book is of interest to students, basic scientists, and clinicians as both a study guide and reference of research in the androgen field. It could also be used as an advanced level text in endocrinology, urology, OBGYN, or oncology.

Not since the 1965 pUblication of Skin Bacteria lind Their Role in Infection has our knowledge of clinical skin microbiology been reviewed and sum marized. In the more than a decade and a half since that publication, we have seen a careful reevaluation of the ideas and information current in 1965 and the development of important new discoveries and information. This volume, Skin Microbiology: Relevance to Clinical Infection, reviews developments in the field since 1965 and summarizes the current state ofthe art in thirty-six carefully prepared chapters. Emphasis is on the clinical per spective rather than straight microbiology, although we include enough of the latter to put the clinical aspects in a proper scientific context. The authors contributing to this volume represent a cross section of authorities in the many specialty areas that contribute to our knowledge of skin microbiology. They include investigators in microbiology, infectious disease, epidemiology, surgery, pediatrics, and dermatology. Significant ef forts have been made to minimize repetition and overlap in the various chapters. In some cases, however, information is deliberately repeated in order to provide for the reader a necessary frame of reference. We hope that this volume will be of value to dermatologists, microbio logists, pediatricians, surgeons, public health workers, nurses, and others in volved in the diagnosis and treatment of dermatologic problems caused by bacteria. The editors acknowledge with appreciation the assistance of Drs. A. Allen, F. Marzulli, F. Engley, G. Hildick-Smith, A. Kligman, M. Bruch, H. Eiermann, and D. Taplin."

With the aromatic retinoic acid analog Tigason oral and intravenous pharmacokinetic studies have been performed in 5 normal volunteers. Simultaneous fitting of single i. v. and oral data to a three-compartment model assuming first-order absorption was possible. Using Nonlin parameter estimates of the single-dose data, one is able to predict the decline in plasma levels of parent drug following cessation of a 10 days multiple dosing regimen up to 24 hours. The model is however unable to predict a phase of prolonged elimination observed beyond 24 hours. Moreover in 5 patients, who underwent chronic therapy (8-15 months), substantial plasma levels of both unchanged drug and main metabolite (corre sponding carboxylic acid) were observed up to 140 days after cessation of the therapy. An apparent half-life of elimination of 80-100 days can be calculated. The drug appears to be stored at some yet unknown storage site. Investigation of metabolism of Tigason in rats and humans revealed 19 different bio transformation products thus far, most of them appearing in the urine in low amounts (20010 of dose). A few of them (mainly the acid Ro 10-1670) after conjugation to glucuronic acid are excreted in the bile in high amounts (60-80% of dose). No drug appeared unchanged in the excreta after i. v. administration to rats. References 1. Bollag W (1971) Effects of vitamin A acid (NSC-122758) on transplantable and chemically-induced tumors. Cancer Chemother Rep 55:53-58 2."

The skin, uniquely positioned at the interface between the human body and the external world, plays a multifaceted role in the expression of cancer. Primary skin cancer is the most common cancer afflicting mankind and is rising in inci dence, despite the fact that it is often preventable. Besides primary cancer, the skin may show direct and indirect evidence of internal cancer, thus serving as a window to the body for both laymen and physicians alike. In addition, the acces sibility of the skin is useful for the study of carcinogenesis as well as cancer treat ment options. lowe much of my interest in skin cancer to Dr. Leon Goldman, the father of dermatologic laser surgery, and to Dr. Edmund Klein, the father of modern immunotherapy. We, at the Roswell Park Memorial Institute, were indeed for tunate to have a wealth of patients available for study. Many of the illustrations used in this book were of my patients at the Institute, and I kindly thank the fol lowing publications and their respective publishers for allowing me to reuse some of my photographs, most notably: Cancer Medicine (2nd edition), Journal of Surgical Oncology, Journal of the American Academy of Dermatology, Archives of Dermatology, Cancer, and Journal of Dermatologic Surgery and Oncology. We are very fortunate in this work to have some of the world's foremost authorities in their areas as contributors, such as Drs. Zackheim, Lambert, J.W. Trimble, J.R. Trimble, Jackson, Crutcher, Mashberg, Wick, Sidell, F. Helm, G.