... 052. ApproachtothePatient
with a Skin Disorder
(Part 1)
Harrison's Internal Medicine > Chapter 52. ApproachtothePatientwith
a Skin Disorder
APPROACH TOTHEPATIENTWITH ... assume that the erosion is the primary lesion andthe redness and scale
are secondary, while the correct interpretation would be that thepatient has a
pruritic eczematous dermatitis with erosions ... Fig. 52-3) andto
formulate a differential diagnosis (Table 52-4). For instance, the finding of scaling
papules (present in patients with psoriasis or atopic dermatitis) places thepatient
in...
... elicits the desire to scratch. Pruritus is often the
predominant symptom of inflammatory skin diseases (e.g., atopic dermatitis,
allergic contact dermatitis); it is also commonly associated with ...
Table 52-3 Common Dermatologic Terms
A schematic representation of several common primary skin lesions
(see Table 52-1).
Chapter 052. ApproachtothePatient
with a Skin Disorder
(Part ... epidermal atrophy).
Scar: A change in the skin secondary to trauma or inflammation. Sites may
be erythematous, hypopigmented, or hyperpigmented depending on their age or
character. Sites on hair-bearing...
... MD; with permission.)[newpage]
APPROACH TOTHE PATIENT: SKIN DISORDER
In examining the skin it is usually advisable to assess thepatient before
taking an extensive history. This way, the ... missing important individual skin lesions
and make it possible to assess the distribution of the eruption accurately. The
Chapter 052. ApproachtothePatient
with a Skin Disorder
(Part 4)
Figure ... correlates highly with diagnosis (Fig. 52-6).
For example, a hospitalized patientwith a generalized erythematous exanthem is
more likely to have a drug eruption than is a patientwith a similar...
... is characterized by small and
large erythematous papules and plaques with overlying adherent silvery scale.
Figure 52-8
Chapter 052. ApproachtothePatient
with a Skin Disorder
(Part...
... lesions with a
generalized arrangement are common and suggest a systemic etiology.
Figure 52-9
Erythema multiforme.
This eruption is characterized by multiple erythematous plaques with ... represents a hypersensitivity reaction to drugs
(e.g., sulfonylamides) or infections (e.g., HSV). (Courtesy of the Yale Resident's
Slide Collection; with permission.)
Figure 52-10
...
... against the surface of the
skin and rotated with downward pressure until it penetrates tothe subcutaneous
tissue. The circular biopsy is then lifted with forceps, andthe bottom is cut with
iris ... of systems
9. Family history (particularly relevant for patients with melanoma,
atopy, psoriasis, or acne)
10. Social, sexual, or travel history as relevant tothepatient
DIAGNOSTIC TECHNIQUES ...
gently with a no. 15 scalpel blade, andthe removed scale is collected on a glass
microscope slide then treated with 1 to 2 drops of a solution of 10–20% KOH.
KOH dissolves keratin and allows...
... in their published work and were not able to overcome
the emerging division of labor between religious and theological studies,
on the one hand, andthe anthropology of religion, on the other ... E”
The two approaches tothe study of “religious experience,” which I will
refer to as the sui generis model andthe ascription model, are summa-
rized in table 1.1. They differ over whether there ... which the religiousness of the experience is understood to
be inherent (sui generis) in the experience itself andthe other in which
it is viewed as ascribed to it. I will opt for the latter approach...
... will then
be possible to identify the appetite or attitude to
that type of risk, together withthe capacity of the
organisation to withstand that risk. Finally, the
organisation can determine the ... need to
understand the risks being taken when seeking to
achieve objectives and attain the desired level of
reward. Organisations need to understand the
overall level of risk embedded within their
processes ... responses. The objective is to achieve
maximum sustainable value from all the activities
of the organisation. Risk management enhances
the understanding of the potential upside and
downside of the factors...
... of these cytochromes have been proposed to be ter-
minal Fe(III) and Mn(IV) reductases, although their role in the reduction
of other metals is less well understood. To obtain more insight into ... anaerobic
growth on either of the electron acceptors U(VI) and
Se(VI) is due tothe decaheme cytochromes c not
recognizing either of these electron acceptors, we
probed the relative affinities via ... involved in
the reduction of either Fe(III) or Mn(IV) in MR-1 is
thought to be composed of cytochromes and a qui-
none, located in both the cytoplasmic membrane
(CymA and menaquinone) andthe outer...
... substrate client protein [the latter
probably as a complex with Hsc70 and Ydj1(Hsp40)]. ATP
binding tothe Hsp90 N-terminal domains in the Hsp90
dimer then causes these N-domains to associate [32]. ... change may also be the signal
for Hsc70, Ydj1 and Sti(Hop) to be displaced from the
complex and for other cochaperone proteins, including
Sba1(p23), to bind so as to produce the later multiprotein
complexes ... streaked onto plates containing GA and
RD. This revealed the Dpdr5 mutant to be hypersensitive to
both drugs andthe Dsnq2 mutant to be slightly sensitive to
RD (Fig. 4B). Pdr5p is a broad-specificity...