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PubMedDate not supplied

Clinical diagnosis and management of suspicious pigmented skin lesions--a survey of GPs.

BACKGROUND: The ability of general practitioners to make important clinical decisions about the diagnosis and management of skin lesions is poorly understood. METHODS: A questionnaire on the diagnosis and management of eight photographed skin lesions was sent to 150 GPs in southeast Queensland. RESULTS: The questionnaire was completed by 114 GPs (response rate 77%). General practitioners' provisional diagnoses and management of photographed skin lesions were mostly or always correct, and there was general high consistency between diagnosis and intended management. Pigmented seborrhoeic keratoses were the most difficult lesions for GPs to diagnose correctly. Whether a lesion was different to usual moles appears to have the strongest association with clinical diagnosis. DISCUSSION: The high ability of GPs as measured in this artificial study is encouraging. The strong association between identifying moles that appear different to usual and correct clinical diagnoses suggest that unless GPs can increase the number of skin lesions they see as part of their typical workload, their clinical ability may not increase further.

Clinical Competence↗
PubMed1983

[Hermansky-Pudlak syndrome in a Valais village].

Amongst 13 subjects with albinism observed in a village in the Valais, 7 present the clinical and laboratory findings of the Hermansky-Pudlak syndrome. Because of the close family links and the numerous consanguine marriages present in the pedigree, it is probable that the 5 subjects who could not be examined also suffer from the same syndrome. It has an autosomal recessive mode of inheritance. In this isolate the gene and heterozygote frequencies are, respectively, 1:12 and 1:6. Clinically the hemorrhagic diathesis is moderate, the visual and cutaneous symptoms predominate. The platelet dysfunction results from a lack of storage of components (Ca++, nucleotides, amines) normally present in the dense granules. The lack of dense granules is demonstrated by electron and fluorescence microscopy. This structural anomaly is present in the megacaryocyte before individualization of the platelets. Giant melanosomes were found in skin melanocytes.

Abnormalities, Multiple↗
PubMed1994

Retinal distribution of tyrosine hydroxylase immunoreactive cells in two strains of quails Coturnix coturnix japonica.

We have compared the distribution of tyrosine-hydroxylase immunoreactive (TH-I) somata in the retina of two strains of japanese quails, one normally pigmented and one hypopigmented mutant which develops a glaucoma, three months after their hatching. TH-I cells were observed among amacrine and presumptive interplexiform cells in both strains. They were distributed in areas of decreasing densities from an area centralis, located in the central upper retina to the retinal periphery. We have arbitrarilly grouped them in four classes of different densities: A class with 41 cells/mm2 and more, B class (from 31 to 40 c/mm2), C class (from 21 to 30 c/mm2) and D class (20 c/mm2 and less) and drawn isodensity lines. The comparison of cell mean density in each zone showed no major differences between the strains. Conversely, the comparison of the relative retinal surface occupied by each zone demonstrated a significant variation of C and D zones which appeared to be counterbalanced: the C zone being larger and the D zone smaller in pigmented quails compared with mutant quails. The possible involvement of such a TH-I cell distribution and consequently of the dopaminergic system in the development of glaucoma is discussed.

Animals↗
PubMed1976

Neurofibromatous scoliosis. Natural history and results of treatment in thirty-seven cases.

Of 400 patients with the diagnosis of neurofibromatosis on their hospital records, 141 actually had the disease. The presence of at least two of the following features was considered diagnostic: positive family history; positive biopsy; a minimum of six cafe-au-lait spots, each with a diameter of at least 1.5 centimeters; and multiple subcutaneous neurofibromas. Scoliosis was present in thirty-seven patients (26 per cent), most commonly associated with cafe-au-lait spots (thirty-five patients). In many of the patients with scoliosis there were associated medical and surgical problems. Although no standard pattern of spinal deformity could be identified, a sharp single right thoracic curve involving more than five vertebrae was the most common. For the whole group the initial measurement of the scoliosis averaged 42 degrees. Double curves were more sever, buth kyphosis was uncommon and no cases of paraplegia were recorded. In patients with progressive scoliosis, the best results were obtained with early Harrington instrumentation and posterior spine fusion. Progression of the scoliosis was observed both before treatment and postoperatively. The amount of progression was not necessarily related to the severity of other manifestations of neurofibromatosis, and was not significantly dependent on the length of the curve.

Adolescent↗
PubMed1988

Cutaneous reaction patterns in blacks.

The study of black skin continues to be an important part of the field of dermatology. Black skin is unique and has as the result demonstrable complexities that are often inherent in diagnosing its disorders accurately. Even when the more common dermatoses are encountered on black skin, a keen diagnostic acumen is required in order to adjust for the presence of pigmentation and still arrive at the correct diagnosis. This pigmentation, coupled with the common tendency of black skin to present peculiar patterns of reaction to even the most common dermatoses, contributes to the confusion that often results when such a patient presents for dermatologic consultation. Some dermatoses that are of concern to the patient and physician alike may be nothing more than part of the patient's "blackness"; those conditions that are merely normal variants. Then, too, it is important to be aware of the pharmacologic effects of dermatologic therapy on black skin in order to minimize the undesirable side effects. It is hoped that the reader has, through this brief overview, gained a greater respect for and understanding of the uniqueness that defines black skin.

Black People↗
PubMed1990

Incontinentia pigmenti in identical twins with separate skin and neurological disorders.

Incontinentia pigmenti in female identical twins is reported. The first baby showed the typical pigmentation of incontinentia pigmenti, while the second baby had hydrocephalus (colpocephaly) without pigmentation. They were identical, with a rate of 99.9% in 18 blood-type studies. Virus was not detected and cytogenetic studies proved normal. Both showed peripheral eosinophilia. The individual expressions of Incontinentia pigmenti in these identical twins were separated into cutaneous lesions and lesion of the central nervous system (intra-uterine hydrocephalus). Cutaneous lesions developed after birth. Twins with Incontinentia pigmenti are extremely rare and in this family showed different expressions of this disease in space and time.

Diseases in Twins↗