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.

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.

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.

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.

Written by one of the very few pathologists who has real expertise in this field, this book is a comprehensive key for the identification of fungal infections in tissues. With updated terminology and presentation, all invasive mycoses-types are covered, detailing their epidemiology, pathology, histomorphology of fungal elements, and differential diagnoses. Each of the separate fungal groups has a good combination of text and high-quality illustrations which is a critical feature for clinicians to state the mycopathological diagnoses. Key Features: 1. Elaborates on the histological observations of both the pathological reaction and the histomorphology of fungal elements, guiding the reader in the right direction for obtaining a diagnosis of the infection. 2. Includes key observations that can be a game-changer for infectious diseases specialists and histopathologists studying the combination of fungal morphology and host response. 3. Follows a logical layout, structure, and organization with a wealth of high-quality illustrations of the various fungi in tissues elucidated by different stains.

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.

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."

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.

This is a multi-authored textbook that is simple, practical, and up-to-date and supported by instructional videos for cosmetic procedures that can be performed in an office setting. The focus of the book is on fillers, neurotoxins, and various laser, broad band light, radio-frequency, and ultrasound devices that are currently being used or about to be released. It also covers suture suspension lifts, chemical peels, and microdermabrasion. There are supporting chapters on various local, topical, nerve-blocking, and sedation anesthetic techniques that are typically used in an office setting. The book s format and contents are a bold departure from many textbooks. In addition to chapters discussing the theory behind the products and chapters reviewing categories of products or devices that provide the reader with an overview and some comparative discussion, there are short sections for each individual popular branded type of product. The book is useful for both experienced practitioners interested in the latest trends around the world and those who are starting out or are simply interested in adding new procedures to a practice that already includes certain cosmetic procedures.

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."

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.

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."