This book is dedicated to our readers with the intention of providing an informative exposition of the myositis syndromes. It is also presented in the hope that perhaps it may serve to inspire and stimulate discussion and research into these disabling disorders. Included are descriptions of clinical features, differential diagnosis, pathogenetic mechanisms, and approaches to therapy. Current concepts of classi- cation and diagnostic techniques are also presented. The production staff at Humana Springer, especially Ms. F. Louie and Ms. C. Walsh, have been instrumental and invaluable in allowing this work to see the light of day. Above all, the scholarly essays of the contributing authors are acknowledged with gratitude. They have given this volume its character and existence. New York, NY Lawrence J. Kagen v Contents Preface ...v Contributors ...ix 1 Evaluation of the Patient ...1 Lawrence J. Kagen 2 Classification of Idiopathic Inflammatory Myopathies ...15 Frederick W. Miller 3 The Inflammatory Milieu: Cells and Cytokines...29 Ann M. Reed and Thomas A. Griffin 4 Juvenile Dermatomyositis: An Update on Clinical and Laboratory Findings ...55 Lauren M. Pachman 5 Inclusion Body Myositis ...87 Lawrence J. Kagen 6 The Role of Muscle Biopsy in the Diagnosis of Inflammatory Myopathy ...95 Sakir Humayun Gultekin 7 Electromyography ...1 1 1 Hans L. Carlson 8 Magnetic Resonance Imaging of Myopathies and Myositis ...127 Carolyn M. Sofka 9 Ultrasound in the Evaluation of the Inflammatory Myopathies ...147 Ronald S. Adler and Giovanna Garofalo vii viii Contents 10 Serological Findings ...165 Ira N.

This fully revised and updated second edition of Sexual Health and Genital Medicine in Clinical Practice covers the range of conditions seen in genitourinary medicine, sexual health and sexually transmitted infection clinics, making it a useful and practical guide to all health practitioners in this area. This book is aimed at medical practitioners who require a quick reference guide to help with diagnosis and management of genital problems. In addition, it provides essential guidance on what to do next when faced with a patient presenting with a genital complaint, whether the patient can be successfully treated with a drug regimen or needs to be referred up to the Sexual Health and Genital Medicine specialist. Sexual Health and Genital Medicine in Clinical Practice will be of particular interest to residents on their rotations through this field of medicine, doctors in training, specialist nurses, and primary care practitioners.

Das Buch beinhaltet in praxisgerechter Form die Darstellung der aktuellen und gAngigen Methoden der phlebologischen Diagnostik und Therapie inklusive der bildgebenden Verfahren i. S. der immer wichtiger werdenden Duplexsonographie und Phlebographie. Es wird umfassend auf die konservative Therapie eingegangen, insbesondere die Kompressionstherapie, aber auch auf die Pharmakotherapie bei der chronisch-venAsen Insuffizienz. Aktuelle Aspekte der Thromboseprophylaxe und -therapie werden berA1/4cksichtigt. Das Buch enthAlt zahlreiche Tabellen und Abbildungen in Form von Zeichnungen und Fotodokumentationen. Der besondere Nutzen besteht in der AktualitAt der BeitrAge und der MAglichkeit, in vergleichsweise kurzer Zeit einen Aoeberblick A1/4ber phlebologische Fragestellungen zu bekommen.

The book will educate and decode the role of vitamins, essential fatty acids and other nutraceuticals on skin health and their tremendous impact to the current needs of the skin care industry. Focus on conditions, as acne, dermatitis, dry scaly skin or alopecia will provide a comprehensive knowledge of the relationship of nutrition and skin as well as the current attempts in nutritional or dermatological research. It will stimulate food professionals to brainstorm for new products and opportunities that will target the emerging antiaging and wellness trends and modern consumer needs.

Clinical cases are a key component in modern medical education, assisting the trainee or recertifying clinician to work through unusual cases using best practice techniques. Integrative Dermatology is an important discipline in this regard since it is a highly visual subject requiring the reader to describe often very subtle differences in the presentation of patients and define accurately the diagnostic and management criteria to base their clinical decision-making on. In 1992 the National Institutes of Health established the National Center for Complementary and Alternative Medicine (now also called Integrative Medicine), which has led to increased evidence-based research. The objective of this book is to provide readers with an overview of traditional and complementary treatment options for the most common skin problems encountered in clinical practice.

In this updated third edition, expert physicians assemble user-friendly, clinically-oriented guides to aid in the day-to-day management of the allergic patient. With an emphasis on common allergic diseases and the pharmacological tools to control them, this book disseminates the practical knowledge that practitioners have accumulated through practice and teaching. Three new chapters focus on antihistamines, antileukotrienes, and children experiencing recurrent respiratory tract infections. This book is intended for the front-line physician who cares for allergic patients. It will help any physician improve the care offered to those patients.

This book discusses lasers and light technologies in dermatology. The innovation is due to the book format: a handbook. It is the first handbook of lasers in dermatology, facilitating access to information to all individuals interested in lasers in this specific medical field . The most recent lasers devices and its applications will be discussed. Illustrations and tables will make the book didactic and comprehensive. Lasers in dermatology are a constantly evolving field. Over the past few decades, novel devices have been developed and new indications for their use have emerged. A broad understanding of the relationship between science and laser principles is the foundation of a solid dermatologic practice. The Lasers in Dermatology Handbook is a tool to understand the use of lasers in clinical practice. Important topics such as vascular lesions, warts, acne, scars, and pigmented lesions are presented and discussed in all aspects. The wide spectrum of laser and light technologies available for skin resurfacing and rejuvenation will be covered as well. Written by internationally renowned authors, this handbook serves as a cornerstone for laser applications and provides updated information for all physicians, particularly dermatologists, interested in implementing lasers in their practice.

Dermatopathology is both exciting and exasperating. tum corneum cells. This occurs in disorders of keratiniza Skin has an elegant simplicity in its functions yet a tion because the process of desquamation is disturbed (Figure 1. 1). ferocious complexity in its structure. This is one of the paradoxes that underly the pathology of skin disease Parakeratosis. The presence of nucleated horn cells in and may go some way in explaining the multitudinous the stratum corneum. Normally the horn cells (corneocy disorders to which the skin is subject. The ready visibility tes) are thin lamellae of less than 1 f. lm thickness. They of the skin may also help explain why straightforward contain no detectable cytoplasmic contents as these are histological examination cannot always provide an lost in the granular cell layer. Parakeratosis occurs when answer to a clinicians's question. Quite dramatic appear the process of keratinization is disturbed such as when ances may be due to alterations of the relative rates of the rate of epidermal cell production is increased (as in blood flow, with or without oedema, in the different psoriasis) so that nuclei are not broken down before the vascular plexuses or around different structures in the stratum corneum is reached and when damage occurs horizontal dimension, neither of which may result in to the upper epidermis (Figure 1. 2). 'much to see' histologically. The inherent sampling error Porokeratosis.

Therapeutic breakthroughs in medicine are usually accompanied by a wealth of data. Often they result in a change of disease treatment paradigms. Tacrolimus ointment is the first in the new class of steroid-free Topical Immunomodulators (TIMs), and as such represents the first true breakthrough since the introduction of topical steroids more than 50 years ago for the treatment of T-cell mediated inflammatory skin diseases such as atopic dermatitis. This book gives an easy-to-read overview of the discovery and the development of Tacrolimus ointment for the treatment of atopic dermatitis. Summarising the largest clinical trial program ever conducted in dermatology for a new treatment with more than 13000 patients, it offers a detailed insight into the efficacy and safety profile of Tacrolimus ointment. Based on this large body of data and extensive personal experience, the authors offer practical and hands-on guidance for the physician as to when and how to use Tacrolimus ointment in daily practice.

This is the first primary care dermatology reference written by and for nurses. It is unique in its focus on approximately 60 skin conditions that are commonly seen in primary care settings and its use of decision trees to assist in accurate diagnosis. Organized for quick access, it presents conditions alphabetically and includes evidence-based treatment and management information along with full color photos and a digital photo archive.

The resource provides an overview of dermatology basics including skin anatomy and physiology. Illustrations, graphs, and skin terminology help to document rashes, lesions, and diseases during diagnostic evaluations. The book also includes risk factors in relation to skin conditions and diseases. It addresses dermatologic diagnostics such as skin assessment, specimen collection procedures, and evidence-based topical, systemic, and surgical treatment options. A broad spectrum of management strategies are included along with alerts when expert follow-up is indicated. Additionally, the book supplies patient education information.

Key Features: Focuses on more than 60 commonly seen dermatological conditions with high-quality, full color photos Presents four unique decision trees to foster accurate diagnosis and clinical decision-making Delivers evidence-based protocols for diagnosis, treatment, and management Uses a consistent format to promote quick access to information Written by advanced practice nurses with nurses' informational needs in mind

Rheumatologic diseases are highly associated with clinical symptoms of the skin, nails, and mucosal membranes. This book provides the practicing rheumatologist with a rapid, easy to consult reference to help interpret the nature of these cutaneous lesions and then quickly decide upon the appropriate follow-up tests. Utilizing an abundance of informative photographs, it contains all of the essential information needed for early diagnosis and treatment. This comprehensive guide properly orients the practitioner within the challenging world of rheumatologic disorders of the skin and gives insight into when consultation with a dermatologist is advisable.

"The Handbook of Dermatologic Surgery"incorporatesthe most cutting edge technology applicable to dermatologists and dermatologic surgeons today. Designed as a reference guide for dermatologic surgery and aesthetic procedures, it disseminates key scientific information in an easy-to-use pocket book.

This handbook is designed to be readily transportable for dermatologists and dermatologic surgeons, as well as those in training, dermatology residents and fellows, and medical students rotating through dermatology. "

This book is the most up-to-date publication on fluorescence diagnostic (FDAP) and photodynamic therapy (PDT) methods used in dermatology. Both techniques are presently world wide introduced as standards for the delineation and the treatment of cutaneous precancerous stages and tumors, which show steadily increasing numbers due to e.g. more frequent sun exposure. Summarizing experiences on more than 5.000 treated patients, it offers a comprehensive information on every aspect of skin tumor detection and treatment. The main part of the book focuses on the clinical aspects giving detailed descriptions on skin tumor detection as well as photodynamic treatment of selected diseases (solar keratoses, basal cell carcinomas, squamous cell carcinomas, Bowen's disease, psoriasis lesions, etc.). The clinically oriented chapters are supplemented by practical guidelines for PDT and FDAP. The included atlas is comprised of 270 high quality color figures allowing daily use as a handbook.

Chronic venous insufficiency, manifesting as disabling open leg ulcers, lipodermatosclerosis and severe cutaneous hyperpigmentation is thought to affect five percent of the population over age 80 and a significant proportion, probably greater than one percent, of Western populations under age 65. To date little has been known about how to treat this condition cost-effectively beyond supportive and palliative care. Thus, the most important feature of Chronic Venous Insufficiency is that it describes the interventions which markedly ameliorate, and in some cases cure, the condition. The authoritative text has been skilfully illustrated to show how new methods of endovascular and endoscopic interventions can be integrated with radiologic techniques to correct totally the abnormalities which produce chronic venous insufficiency. Taken as a whole this volume will enable general surgeons, vascular surgeons, dermatologists and interventional radiologists to treat a condition that was, until recently, thought to be untreatable.

This volume is the first of its kind to emphasize the visual approach in the diagnosis of cutaneous lymphoid infiltrates. Written and designed in an accessible yet highly detailed format by an expert in the field, this book bridges the knowledge gaps so often found when dealing with skin lymphomas. Complete with more than two hundred high quality images and illustrations, Diagnosis of Cutaneous Lymphoid Infiltrates offers pearls and pitfalls as well as differential diagnoses. Additionally, images are explained and decoded with the use of illustrations and analogies, proving to be an invaluable resource for pathologists, dermatologists, dermatopathologists, hematopathologists, and residents and fellows in these fields.

Venous valves rank among the smallest and most delicate organs of the human and animal bodies - so why devote an entire book to them? We were induced to do so by several reasons. First of all we would point out the clinical significance of venous valves. In the pathogenesis of a number of widespread diseases, such as varicose veins or the post-thrombotic syndrome, venous valves are involved as the underlying cause or at least a factor contributory to the symptoms. According to Taheri et al. these venous diseases occur ten times more frequently than arterial obliterations. Incompetence of venous valves also plays a causal role in varicocele, the most frequent cause of male infertility. But not only pathogenetic reasons induced us to write this book. In more recent times there has been a growing tendency to reconstruct functional valve disorders therapeutically; several surgical methods have been developed, which are critically reviewed in this book. It was our aim to sum up existing knowledge with respect to structure and function of venous valves and to expand that knowl edge by findings of our own. Examinations of semi-thin sections and unilayered en-face preparations have hardly been published so far, and systematic studies of the ultrastructure by electron-microscopy were not to be found in the literature. We are very grateful, therefore, to Dr. Silvana Geleff for having undertaken such a study upon our suggestion."

Practical Patch Testing and Chemical Allergens in Contact Dermatitis covers the most relevant allergens in a concise and algorithmic fashion, with practical tips for patch testing. This book assists practitioners and trainees with educating patients on how to avoid their irritants and allergens to effectively manage contact dermatitis. Clinical pearls for patch testing of certain allergens are clearly outlined in this book to help providers avoid common pitfalls and reduce the risk of incorrect diagnoses, making it an essential reference for all involved in the treatment of contact dermatitis.

Children with skin diseases maypresent to family physicians, pediatricians or dermatologists. In book we have tried to provide a concise and under standable source of information about common skin disorders which will be useful to any physician encountering children with cutaneous signsand symptoms. We have concentrated on 26 common skin diseases which account for morethan 90% ofallskin-related doctor visits by children and adolescents, regardless of the orientation of the physician. The format of each chapter is uniform. The clinical description is accompanied by several typical photographs. The differential diagnostic approach withbriefcriteriais pre sentedin a table. Themajoremphasis is on the treatment; wehave tried to combine our long years of experience in pediatricdermatology withthe in ternationalliteratureand especially more recent evidence-based studies. We have tried to present a rangeof therapeutic possibilities, but also give firm recommendations. There have already been two successful German editions of this book. We hopethat this first English editionalsofinds a receptive readership. We are committed to the concept that childhood skin diseases are best treated whenall involved physicians have onlyone goal - the best possible carefor all children. "Turf" battles between various specialties overaspects of care only harm our patients and in the end our own self-respect. The back ground of the three editors reflects this theme; there are two dermatolo gists, one German (DA) and one American (WB), and a pediatrician (He)."

This comprehensive, yet user friendly, volume specifically focuses on cutaneous soft tissue tumors, one of the most challenging areas in dermatopathology. The text is richly illustrated and written in a user friendly fashion, by well-known experts in cutaneous soft tissue tumors, with an emphasis on a practical diagnostic approach. The text opens with a brief introduction on how to approach soft tissue tumors, followed by a guide to ancillary diagnostic tests and a thorough discussion of cutaneous soft tissue tumors and their non-mesenchymal mimics. The entities are described in terms of their clinical and pathologic features and differential diagnoses. Key pathologic features are summarized in a table format. Soft Tissue Tumors of the Skin will be of great value to surgical pathologists and dermatopathologists as well as residents and fellows in pathology and dermatology.

This, the seventh volume in the New Clinical Applications Series, has an international flavour, with contributions from Australia (Mr N.e. Davis), Great Britain (Drs A.W. Macfarlane, N.C. Smith, M.F. Spittle, J.L.Verbov), and USA (Dr M.e. Finan and Professor R.K. Winkelmann). Dr Smith discusses some common skin tumours with his character istic informative clarity. It is appropriate that an authority such as Mr Davis should discuss a tumour that has a particularly high inci dence in his own country. Dr Spittle is a recognized authority on lymphomas and she writes succinctly on their management. Dr Finan and Professor Winkelmann have extensive experience of the rare condition, necrobiotic xanthogranuloma, and Drs Macfarlane and Verbov have been involved in the management of many patients with scleromyxoedema. I am very pleased to have had the opportunity of working with the contributors and thank them most sincerely for their efforts. I hope that this volume will interest dermatologists, oncologists, pathologists, radiotherapists and surgeons. JULIAN VERBOV ix ABOUT THE EDITOR Dr Julian Verbov is Consultant Dermatologist to Liverpool Health Authority and Clinical Lecturer in Dermatology at the University of Liverpool. He is a member of the British Association of Dermatologists, rep resenting the British Society for Paediatric Dermatology on its Executive Committee. He is a Committee Member of the North of England Dermatological Society, and Editor of its Proceedings."

Since the incidence of skin neoplasms is constantly increasing as the population ages, there is a need for a monograph about radiation treatment of skin neoplasms and diseases. Excellent cosmetic and functional results can be shown with this treatment modality. This book comprehensively examines the indications for radiation therapy of cutaneous cancers, pre-cancerous lesions and benign dermatological disorders. The monograph provides concise introduction to physical and radiobiological principles, selection of radiation factors, dose definitions, as well as radiation reactions and risk assessments. Specific indications for radiotherapy of cutaneous neoplasms and radiation protection measures are discussed. Topics include radiation therapy of basal cell carcinoma, squamous cell carcinoma, lymphomas, Kaposi's sarcoma, Lentigo maligna melanoma, and Merkel cell tumor. A separate chapter discusses the skin reactions after nuclear accidents. Major scientific publications of the past 10 years are reviewed.

Gene therapy is a novel concept of treating diseases at the molec- ular level by rescuing genetic defects through the introduction of corrective genes. The knowledge of genetic defects underlying var- ious diseases is being rapidly accumulated, and new genotypic findings are being reported with striking frequency. The elucida- tion of the genetic background of many diseases, including hered- itary blistering and hyperkeratotic skin disorders, has provided the necessary knowledge to correct inborn genetic aberrations in ani- mal models and patient-derived tissue. However,skin is not only a target organ for gene therapy ofcutaneous disorders. Dueto its bio- logical properties, easy accessibility, and convenient, established culture conditions and grafting techniques, skin has rapidly be- come an important target for correcting other diseases as well. Both skin fibroblasts and epidermal keratinocytes have been successfully transfected ex vivo and in vivo using viral and nonvir- al gene transfer methods. Notably,in the first corrective gene ther- apy approach in 1987, fibroblasts from adenosine-deaminase (ADA)-deficienthumans with severe combined immunodeficiency (SCID) syndrome were transduced using retroviral vectors. More- over, skin cells are capable of synthesizing various proteins that are therapeutic, either locally or systemically. Human epidermal grafts expressing human growth hormone after retroviral gene transfer and grafting onto athymic mice released human growth hormone into the bloodstream of the transplanted mice, for a lim- ited time.

The latest techniques in utilising ultrapulsed CO2 lasers in aesthetic plastic surgery. Edited by an expert and pioneer in the field, this handy manual teaches practitioners the clinical applications of lasers in facelifts, blepharoplasty, resurfacing of the skin, pigmented lesions, vascular lesions, and sun damage, etc. - including material on surgical "pearls", complications, patient selection and management, together with the advantages and disadvantages of each technique. With over 200 full-colour illustrations, and chapters by top contributors, plastic surgeons, cosmetic surgeons, and dermatologists will all find this to be a valuable resource in becoming skilled in the use of lasers.