There is no doubt among experts that the prevalence of allergic diseases has increased in many industrialized countries in recent years. The rea sons for this increase are unknown; only suppositions exist. Many people focus on environmental influences. However, the assumption that air pollution alone is responsible for this increase seems to be too simple: many other influences, including the genetic predisposition of individual patients, allergen exposure, and possibly socioeconomic factors, also have to be taken into consideration. Although our understanding of the complex mechanisms of allergic diseases has considerably improved thanks to the progress made in ex perimental immunology and allergology, we still have a long way to go before this scientific knowledge is translated into new therapeutic mo dalities. For this reason, the scientific community welcomed the gathering of scientists from very different disciplines and different parts of the world at an international symposium, "New Trends in Allergy IV" together with "Environmental Allergy and Allergotoxicology III" in Hamburg in 1995. This volume contains the invited papers, covering a wide range from basic science to practical clinical diagnosis and therapy. A further unique feature of this event was the concomitant first official workshop of the Environmental Pollution and Allergy Committee of the International Association of Allergy and Clinical Immunology (IAACI), at which the state of scientific knowledge in this field was defined and formulated."

Because skin blisters are the initial manifestation of epidermolysis bullosa (EB), patients invariably present to the dermatologist for diagnosis and treatment. However, EB is a systemic disease whose management requires input from clinicians in virtually all fields of medicine, including pediatri cians, surgeons, dentists, gastroenterologists, hematologists, otorhinolaryn gologists, dietitians, and physical therapists, to name a few. Because EB is a rare disease, few clinicians are familiar with it, and many recoil at the pros pect of caring for individuals covered with blisters caused by a disease they know little about. For patients, insult is thus added to injury and they feel abandoned, neglected, and frustrated. One way to remedy this deplorable situation is to provide clinicians with a compact source of information de tailing the principles of EB diagnosis and treatment. This text seeks to fulfill this role. From 1986-1991, The Rockefeller University Hospital has been the co ordinating center of the National EB Registry. Supported by The National Institutes of Health, this Registry consists of four university centers* commit ted to collecting clinical data concerning diagnosis, treatment, and epidemio logy on all American EB patients. As of April 1992, nearly 1,799 EB patients have enrolled nationwide. The Registry is now in its second five-year phase of operation."

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

practitioner up to date on the various aspects of conditions and diseases considered to be sexually transmitted. REFERENCES 1. Crissey JT, Denenholz DA: Development of the modern forms and concepts of syphilis. Clin Dermatol, 2(1):1-10, 1984. 2. Panconesi E, Mazzi M: The day syphilis came. Int 1 Dermatol, 23:284-286, 1984. 3. Washington AE, Johnson RE, Sanders LL: Chlamydia trachomatis infections in the United States: What are they costing us? lAMA, 257:2070-2074, 1987. 4. Bulkley LD: Syphilis in the Innocent. New York: Bailey and Fairchild, 1894. 5. Syphilis: Major perinatal killer. Med World Trib, 28(16):2, 1987. 6. Renshaw DC: Management of impotence. I. Psychological considerations. Clin Therap, 9:142-148,1987. Acknowledgments. We are very grateful to our teachers for the stimulation they provided in our studies of dermatology and sexually transmitted diseases. We partic ularly acknowledge the impetus given by Herman Beerman, M.D., Emeritus Professor of Dermatology, University of Pennsylvania School of Medicine, Philadel phia. Our office staffs have been particularly helpful, and we would like to recognize the contributions of Mrs. Carmela Ciferni. Lastly, this book was conceived through the inspiration of Dr. Jerry Stone, late Senior Medical Editor of Springer-Verlag, New York. Philadelphia, Pennsylvania LAWRENCE CHARLES PARISH Vienna, Austria FRIEDRICH GSCHNAIT Contents Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Xl . . . . . . . . . . . . . . . What are Sexually Transmitted Diseases? Chapter 1 History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 . . . . . . . . . . . . . LOIS Y. MATSUOKA Chapter 2 Definition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 . . . . . . . . . . . . HARRY L. ARNOLD, JR. Diseases Chapter 3 Syphilis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 . . . . . . . . . . . . . JOHN THORNE CRISSEY Chapter 4 Endemic Treponematoses . . . . . . . . . . .. . . . . . . . . . . . . . . . 32 . . ."

The industrialized world has witnessed a steady increase in diseases of the arteries, veins, and lymph vessels in recent years. The prevalence and incidence of arteriosclerotic vascular disease has taken on the character of an epidemic. Diseases of the superficial and deep veins are widespread. Everypracticing physician is confronted daily by arterial circulatory disorders of the supra-aortic vessels, the thoracic and abdominal aorta, and the pelvic and leg arteries as well as by venous and lymphatic diseases.Todayvascular disease isbest managed in an interdisciplinary way; interventional radiologists and neurologists should be part of the team at any established vascular center. Many older colleagues were forced to acquire their knowledge of vascular diseases on their own. There are still many medical schools and hospitals that lack vascular specialists who are capable of passing on their expertise to students. For manyyears there was no expertise in medical angiology in countries such as Great Britain or the United States. All of vascular medicine resided in the hands of vascular surgeons. It is only in the last few years that vascular internists have appeared in these countries as well

A comprehensive source of information on variations found in skin diseases throughout the world is offered here. By considering the overall problems of hereditary variables, climate fluctuations, and therapeutic differences, this volume provides an appraisal of the diverse factors that make up the composite picture of cutaneous medicine. Divided by continent and then further organized into countries or regions, each entry presents basic information on the disease indigenous to the area, including its definition and symptoms, etiology, clinical manifestations, histopathology, appropriate laboratory tests, differential diagnosis, management, prevention and references. Additional chapters discuss the influence of travel and migration as well as of variables such as climate. 38 full color plates superbly illustrate the many variations of major dermatologic diseases. As technology has made global travel far quicker and more commonplace, this book is a must for all dermatologists, infectious disease specialists, and for all family practitioners and general internists.

Where do you begin to look for a recent, authoritative article on the diagnosis or management of a particular malignancy? The few general oncology textbooks are generally out of date. Single papers in specialized journals are informative but seldom comprehensive; these are more often preliminary reports on a very limited number of patients. Certain general journals frequently publish good in-depth reviews of cancer topics, and published symposium lectures are often the best overviews available. Un fortunately, these reviews and supplements appear sporadically, and the reader can never be sure when a topic of special interest will be covered. Cancer Treatment and Research is a series of authoritative volumes that aim to meet this need. It is an attempt to establish a critical mass of oncology literature covering virtually all oncology topics, revised frequently to keep the coverage up to date, easily available on a single library shelf or by a single personal subscription. We have approached the problem in the following fashion: first, by dividing the oncology literature into specific subdivisions such as lung can cer, genitourinary cancer, pediatric oncology, etc.; second, by asking emi nent authorities in each of these areas to edit a volume on the specific topic on an annual or biannual basis. Each topic and tumor type is covered in a volume appearing frequently and predictably, discussing current diagnosis, staging, markers, all forms of treatment modalities, basic biology, and more."

Praxisgerecht aufbereitet vermittelt Ihnen das Buch die neuesten Erkenntnisse der AIDS-Forschung. o Aktuelle Daten zu Epidemiologie und Klinik o Moderne Labordiagnostik wie PCR o Neue Behandlungsformen und -strategien Im Mittelpunkt stehen die aktuellen Therapiekonzepte, z.B.: - Kombinationstherapie mit Nucleosid- und Proteinaseinhibitoren, - therapeutische Beeinflussung des Wasting-Syndroms, - Therapie der opportunistischen Erkrankungen, des Kaposi-Sarkoms und HIV-assoziierter Lymphome, - neue psycho-neuro-immunologische Konzepte. Mit diesem topaktuellen Uberblick bringen Sie Ihr Wissen uber HIV schnell auf den neuesten Stand!

Infectious diseases remain a major problem for physicians and other health professionals dealing with problems of the reproductive system. Accordingly, this two-volume comprehensive presentation of infectious diseases involving the male and female reproductive systems promises to be a major contribution in this field and to fill a much-needed vacuum. During the past three decades, the introduction of antimicrobial therapy has dramatically altered both the clinical presentation and the therapeutic approaches employed in dealing with the traditional infections of the repro ductive system. In addition, the changing demographics of infectious problems in the industrial countries and the developing world have been a source of concern. A good deal of important information on this topic is included in this series. In recent years, considerable attention has been given to the role of Myco plasma and Chlamydia in both male and female infertility and the problems related to genital herpes and human papilloma virus infections. Current clinical information is included on these infections as well as on newer aspects of diagnosis, such as the use of laparoscopy in the diagnosis and treatment of pelvic inflammatory disease. Also addressed is new information regarding the role of actinomycosis in pelvic infections; current problems such as toxic shock syndrome and acquired immune deficiency syndrome (AIDS) are reviewed as well. New concepts are included in these volumes to complement the clinical information. The attachment of microbial organisms to sperm may help to explain access of these and other organisms to the upper female genital tract."

This is the eighth volume in the New Clinical Applications Dermatology Series. Awareness of relationships is of prime importance in der matology. Professor Scully and Dr Porter cover the skin and mouth in a comprehensive and informative manner. Mr Peter Wright effortlessly and concisely brings the eye and the skin together. Dr C. Rowland Payne both relates and speculates on the enigma of sarcoidosis. Pro fessor Elder concludes the book with a scholarly update on porphyria and the skin. I thank all the above for their fine contributions. This volume should have widespread appeal. JULIAN VERBOV ABOUT THE EDITOR Dr Julian Verbov is Consultant Dermatologist to Liverpool Health Authority and Honorary Clinical Lecturer in Dermatology at the University of Liverpool. He is a member of the British Association of Dermatologists, repre senting the British Society for Paediatric Dermatology on its Executive Committee. He is Editor of the Proceedings of the North of England Dermatological Society. He is a Fellow of the Zoological Society of London and a Member of the Society of Authors. He is a popular national and international speaker and author of more than 200 publications."

G. Piekarski appears not to have been brought home to at Forty years have passed since Trussent pub- least some clinicians. Of special importance in lished an important book in the English lan- this connection are T. vaginalis and Pentatri- guage on Trichomonas vaginalis Donne and uro- chomonas hominis (Davaine), the intestinal tri- genital trichomoniasis. During the intervening chomonads of many mammalian species, in- four decades, much information has been accu- cluding humans. Some practitioners still tell mulated on trichomonads parasitic in humans their patients about the possibility of an intesti- and on the diseases they cause. In light of this, nal origin of trichomonal infection of the uro- many parasitologists and clinicians believe that the time has come for a complete review, in genital tract. book form, of various aspects of these parasites Trichomonas vaginalis infection of new- and of the trichomonad parasitemias. This need borns, infants, and young children constitutes has been further reinforced by the finding that, an interesting, although not extensively pur- despite the use of effective anti trichomonal sued, area of investigation. For hitherto incom- drugs during the past years, the prevalence of pletely understood reasons, the period of preg- human urogenital trichomoniasis, the world's nancy appears to favor the increase of most common sexually transmitted disease, has symptomatic trichomoniasis; there is, there- been increasing significantly. As might have fore, little doubt that infants can be infected been expected, therefore, discussion of various during birth.

The skin, the body's largest organ, is strategically located at the interface with the external environment where it detects, integrates and responds to a diverse range of stressors, including solar radiation. It has already been established that the skin is an important peripheral neuroendocrine-immune organ that is closely networked with central regulatory systems. These capabilities contribute to the maintenance of peripheral homeostasis. Specifically, epidermal and dermal cells produce and respond to classical stress neurotransmitters, neuropeptides and hormones, production which is stimulated by ultraviolet radiation (UVR), biological factors (infectious and non-infectious) and other physical and chemical agents. Examples of local biologically active products are cytokines, biogenic amines (catecholamines, histamine, serotonin and N-acetyl-serotonin), melatonin, acetylocholine, neuropeptides including pituitary (proopiomelanocortin-derived ACTH, b-endorphin or MSH peptides, thyroid stimulating hormone) and hypothalamic (corticotropin-releasing factor and related urocortins, thyroid-releasing hormone) hormones, as well as enkephalins and dynorphins, thyroid hormones, steroids (glucocorticoids, mineralocorticoids, sex hormones, 7- steroids), secosteroids, opioids and endocannabinoids. The production of these molecules is hierarchical, organized along the algorithms of classical neuroendocrine axes such as the hypothalamic pituitary adrenal axis (HPA), hypothalamic-thyroid axis (HPT), serotoninergic, melatoninergic, catecholaminergic, cholinergic, steroid/secosteroidogenic, opioid and endocannabinoid systems. Disruptions of these axes or of communication between them may lead to skin and/or systemic diseases. These local neuroendocrine networks also serve to limit the effect of noxious environmental agents to preserve local and consequently global homeostasis. Moreover, the skin-derived factors/systems can also activate cutaneous nerve endings to alert the brain to changes in the epidermal or dermal environments, or alternatively to activate other coordinating centers by direct (spinal cord) neurotransmission without brain involvement. Furthermore, rapid and reciprocal communications between epidermal and dermal and adnexal compartments are also mediated by neurotransmission including antidromic modes of conduction. Lastly, skin cells and the skin as an organ coordinate and/or regulate not only peripheral but also global homeostasis.

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

This book will, it is hoped, fill the gap between cur rent, smaller texts on dermatology and the standard, large reference books. It should be helpful to those embarking on a career in dermatology and to general practitioners and primary physicians with a special interest in this field. In this book the emphasis is on clinical aspects of skin diseases, and it is assumed that the reader has some knowledge of the anatomy and physiology of the skin. The differential diagnosis of each disorder is extensively discussed and sex predilection and age of onset are illustrated diagrammatically. As in other branches of medicine, treatments are now frequently changing and these are fully covered. Aetiological factors in skin disorders are now becoming clearer and separate sections on this subject are discussed for each disease. Prognosis and natural history are not always adequately covered in texts on derma tology, so these topics are set out under separate headings. A small number of the illustrations have been loaned from colleagues and institutions, and we gratefully acknowledge this assistance from the following: The Wellcome Museum of Medical Science; Photographic Department, Institute of Dermatology, St John's Hospital; Dr Roger Clayton; Dr W. H. Jopling; and Dr P. Rodin. We are also grateful to the staff of MTP for their assistance in preparing this book."

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.

This comprehensive volume examines the possible complications that can arise in cutaneous surgery. The demand for outpatient cutaneous surgery procedures has increased at a rapid rate over the last several decades. As the number of cutaneous surgery procedures rises, so will the rate of complications, which are inevitable and occur even with the most skilled, careful, and meticulous surgeons. This work will help the practicing physician to formulate a preoperative strategy that will prevent complications before they occur as well as properly diagnose and manage complications if they arise, allowing the physician to provide optimal care to the patient.

This is an invaluable collection of information designed to help residents, fellows, and students - as well as any already qualified medical professional interested in revising the essentials of skin conditions - to master the basics of skin pathology. Using the principle of pattern recognition, it simplifies the multitude of dermatopathologic signs by using easy-to-memorize images of what the key features look like - photomnemonics. There are also helpful sections on the technical aspects of dermatopathology and on the key findings at each level of the skin. Organized simply and abundantly illustrated, this text will be an indispensable guide to revision for all its readers.

The recent interest in the pharmacology of the skin and the treatment of its diseases has come about for two reasons. The first is a realisation that many aspects of pharmacology can be studied as easily in human skin, where they may be more relevant to human physiology and diseases, as in animal models. Examples of this are the action of various vasoactive agents and the isolation of mediators of inflammation after UV irradiation and antigen-induced dermatitis. The second reason is the fortuitous realisation that a pharmacological approach to the treatment of skin disease need not always await the full elucidation of etiology and mechanism. For example, whilst the argument continued unresolved as to whether the pilo-sebaceous infection which constitutes acne was due to a blocked duct or to a simple increase in sebum production, 13-cis-retinoic acid was found quite by chance totally to ablate the disease; again, whilst cyclosporin, fresh from its triumphs in organ transplantation, has been found able to suppress the rash of psoriasis, it has resuscitated the debate on etiology. We are therefore entering a new era in which the pharmacology and clinical pharmacology of skin are being studied as a fascinating new way of exploring questions of human physiology and pharmacology as well as an important step in the development and study of new drugs, use of which will improve disease control and at the same time help to define pathological mechanisms.

The epididymis has great significance in the reproductive biology of the male and it is gaining recognition as an organ worthy of study in its own right - where the secretory and absorptive activities of one tissue (the epithelium) profoundly modify the function of another (the spermatozoon). Apart from cases of epididymal agenesis or physical blockage, however, it is not yet known to what extent mal functions of the epididymis contribute to "unexplained" male infer tility, but its importance as a target for antifertility agents in the male is now widely appreciated. This monograph evolved from two lectures on epididymal func tion given at the National Research Institute for Family Planning, Beijing and the Sichuan Provincial Family Planning Research Insti tute, Chengdu, China in 1983. In order to stress for this audience the central importance of the epididymis in fertilisation, and so highlight its potential for attack by antifertility agents, the talks attempted to put the epididymis in reproductive perspective by stressing the func tional development of the sperm cells during their sojourn in the epididymis, rather than merely listing the changes observed in them."

Aromas are an integral part of our civilised society. They are not only used in fine perfumes, but also in numerous other articles with which we have daily contact. Another new development has been the agricultural use of aromas as a "biological weapon" to combat insects and other pests. In the field of dermatology, aromas are today among the most frequent sensitizers and may trigger allergic contact eczemas. This volume presents numerous aspects of the topic for the first time in comprehensive form. In an introduction, the chemistry of frequently used aroma components is described, together with the art of perfume composition that has been refined over the centuries. In a chapter on neuropharmacology, the mechanisms of scent recognition are described in detail.

Allergic Contact Dermatitis presents all up-to-date chemical and physio-chemical concepts for the study and understanding of allergic contact dermatitis (ACD). The book covers all aspects of ACD - skin penetration and metabolism, identification of sensitizers and hapten-protein interaction, including new concepts of increasing importance such as molecular recognition and quantitative structure-activity relationships. In addition, comprehensive references are provided, making this the most complete available text-book for dermatologists.
Allergic Contact Dermatitis reaches an equilibrium between fundamental concepts and clinical applications and thus presents an essential guideline to dermatologists, allergologists, biochemists and toxicologists.

The scope of dermatologic surgery is so wide that inevitably a large number and variety of complications arise. Of course the majority of complications can be prevented by careful preoperative preparation, meticulous surgical technique, and proper postoperative care, but when they do occur, they can be recognized and managed with skill and competence. This book provides a valuable source of reference for the prevention, recogni tion, and management of complications in dermatologic surgery. Avoiding pro blems is at least as important as dealing with them, and so all the chapters in this book deal with both prevention and management. This book addresses dermatologic surgeons in practice or in training and to surgeons in other specialties who may be required to undertake repair of skin defects. Many ofthe authors accepted the responsibility of contributing to this work in addition to their many other obligations. For this, I am extremely grateful to them. MARwALI HARAHAP Contents Local Anesthesia and Regional Anesthesia George B. Winton ...................................................... 1 Electrodesiccation and Curettage Harvey Finkelstein and Robert Jackson. . . . . . . . . . . . . . . . . . . . . .. . . . 16 . . . . . . . ."

In the last decade of the 15th century a new and deadly disease called Morbus Gallicus, or syphilis, appeared and spread rapidly throughout Europe. The effects of syphilis were so severe that it, and those suffering from it, where regarded with horror and despair. It is difficult for the modern reader to appreciate the fog of confusion which surrounded sexually transmitted diseases in earlier times. Those suffering with these diseases were often condemned as victims of their own "sinful lust of the flesh"; a judgement attitude which hindered most of the early attempts at control and treatment. Despite this general attitude, there were some doctors who persevered in their attempts to understand the causes and discover treatments for syphilis and other sexually transmitted diseases. The Scars of Venus is illustrated with pictures of people, places, instruments and documents. It presents the historical background and achievements of the early venereologists through to the current venereologists' fight against HIV. This book will be of interest to anyone concerned with venereal diseases: doctors, nurses, counsellors, laboratory workers, medical historians, and those working in the areas of public/world health and the spread of infectious diseases.

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

It is with great pleasure that I write this Foreword to the Proceedings of the International Conference on Behcet's Disease which was held in Berlin in June 2002. This was the first International Conference held under the auspices of the International Society for Behcet's Disease which was founded in 2000 in Seoul. First, I congratulate our colleagues in Berlin, led by Professor Christos Zouboulis of the Department of Dermatology at the Free University of Berlin, for having organised a most successful conference and for having compiled these proceedings so rapidly. It will be realised immediately on scanning the contents of this book that the conference was truly international with 210 participants from 26 countries, as Professor Zouboulis has noted in his preface. These included basic scientists, epidemiologists, pathologists, clinicians and, importantly, representatives from patient organisations. The latter held their own conference alongside the scientific-medical conference to mutual benefit. The combined session of patients and doctors (abstracts on pp 601 - 626) gave the opportunity for an exchange of information and fruitful discussion. The wide ranging scope of the communications is evident from the index and it was most encouraging to see their origin - from all parts of the world, from senior and junior colleagues and, from many different disciplines. Many communications may be regarded as preliminary reports of research in progress and we look forward to seeing the definitive publications in appropriate journals in due course."