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PubMed1986

The future of computers in dermatology.

Computer technology has advanced rapidly over the past 30 years as the computer has been more and more integrated into the practice of medicine. Current horizons of research have begun to make use of this newer technology in 1986. The numerous amounts of change and advances in computer systems with respect to medicine and specifically to dermatology will make the computer even more of an integral tool for the practice of this specialty in the future.

Computer Systems↗
PubMed1986

[The use of microcrystalline cellulose dispersions for the production of dermatologic agents].

The employment oft microcrystalline cellulose of the Heweten-type (cellulose powder(AB-GDR) for the production of dermatological preparations as aqueous and aqueous-oily multicomponent systems can contribute to the opening of a further field of application of this auxiliary substance in pharmaceutical factories and pharmacies. By means of intensive shearing and mixing forces, e.g. a colloid mill, it is possible to produce dispersions with fluid media, which proved to be stable when they contained a solid content over 8 p.c. Such dispersions can improve the utilization properties of various preparations. By varying the solid content concentration one can produce dispersions of different properties. Microcrystalline cellulose powders meet the demands which characterize an auxiliary substance in general. Special attention has to be drawn on the problem of microbiological stability because of the necessarily high moisture content of the dispersion. Preparations manufactured by colloid wet grinding with microcrystalline cellulose are distinguished by a high physicochemical stability.

Cellulose↗
PubMed1986

Blood pressure as a parameter in dermatologic surgery.

Elevated blood pressure is a major cause of perioperative bleeding and postoperative hematoma. Seventy-five patients scheduled for dermatologic surgical procedures were prospectively asked if they were aware of any personal history of hypertension. If patient response alone is relied on as a preoperative screen for hypertension, over half of the individuals affected with this disease will be missed. Epinephrine-containing local anesthetics were found not to increase blood pressure in doses commonly employed by dermatologists; in fact, they lowered blood pressure in hypertensive individuals.

Adolescent↗
PubMed1985

[Vitamin A and vitamin E in dermatology].

Vitamin A is necessary to maintain the integrity and the differentiation of epithelia of the skin and adnexa. Evident deficiency of vitamin A in chronic diseases, malabsorption and liver affections may result in skin xerosis, follicular keratosis, and metaplasia of mucous membranes. The remarkable toxicity of vitamin A in high doses does not recommend its usage in dermatology. On the contrary the employ of retinoids, synthetic derivatives of vitamin A, brings to excellent results. These vitamin A compounds are much more effective, even if they show important side-effects. Etretinate and isotretinoin are widely used in psoriasis, keratinization disorders, and severe acne. Vitamin E functions in skin biology are not totally known. Vitamin E is used in the treatment of dermolytic recessive epidermolysis bullosa, with controversial results.

Dermatology↗
PubMed1986

Detailed, controlled, and documented self-experimentation in dermatology.

Because the skin is easily available, the combination of frequent periods of critical observation, the dermatologist's clinical experience, and carefully controlled documentation of these observations allow for self-experimentation in dermatologic disorders on the part of clinicians. The practical value of such self-experimentation has been shown over many years, especially by the use of skin surface microscopy at moderate magnification to examine various lesions; to document sensitization experiments with nickel, Japanese lacquer, and nitrogen mustard; to examine prolonged use of topical fungicides for the treatment of onychomycoses; and to contribute to extensive and continuing experiments in laser medicine.

Cryosurgery↗
PubMed1985

Treatment of dermatological conditions with a combination of an antibacterial agent, an antifungal agent and an antiinflammatory steroid.

Thirty-eight patients suffering from dermatological conditions of various natures were treated by means of the simultaneous application of a combination of three creams, the bases of which were sodium fusidate, ketoconazole and clobetasone butyrate respectively. Positive results, in the form of remission of symptoms, were obtained in 86.7% of the cases. Local tolerance was excellent in all cases and no adverse reactions were observed.

Administration, Topical↗
PubMed1983

[Side effects of dermatologic local therapy].

After application of dermatics systemic as well as topical side effects are to be expected, the latter also by usage of remedies and cosmetics. Even though life-threatening or lethal complications caused by potent substances like mercury compounds, phenols, salicylic acid, boric acid and others seldom have been observed, it is necessary to prevent them completely. Most frequent are allergic contact eczemas, but occasionally also toxic irritations of the skin can be registered. The side effects discussed, especially those caused by steroids and antibiotics, demand strong criteria for indication, scientific mode of administration and intensification of the topical efforts for standardization of dermatological treatment.

Administration, Topical↗
PubMed1984

[Institutional organization of a hospital dermatology service with a responsibility for psychosomatic care].

Clinicians trained in dermatology and having submitted themselves to psychoanalysis have developed an original psychosomatic approach to skin disease at the Tarnier Hospital (Cochin-Port Royal University Hospital Center). Its mainspring is detection and management of the patient's distress. The author analyzes the conditions under which it was possible to carry out this experiment and the implications of this approach which is directed at achieving a change in the way the department is run rather than adding one more specialized appendage to the outpatient care activity.

Dermatology↗
PubMed1983

History of medicine. Alphonse Loewenthal (1903-1983)--the uncrowned king of dermatology in Africa.

The career and achievements of Dr L. J. A. Loewenthal, M.D., F.R.C.P., as a dermatologist in Africa are sketched. He made notable contributions to local dermatology. Starting in 1931 in Uganda with studies on tropical ulcer and vitamin A deficiency, he ended his career in Johannesburg 40 years later with investigations on the skin of miners. Over this period it is doubtful whether any dermatologist on the African continent equalled his accomplishments.

Dermatology↗
PubMed1984

Dermatology manpower projections.

Since an oversupply of physician specialists leads to a waste of professional resources, planning of the number of physicians may be desirable. A model projecting the future supply of dermatologists was formulated on the basis of current residency capacity, which produces about 270 dermatologists per year, and on experience regarding the average length of active clinical practice. How changes in the training capacity affect the future supply of dermatologists was also examined. The model projects an equilibrium supply of about 9,500 dermatologists, or 3.2 per 100,000 population early in the 21st century, provided the number of new graduates remains at its present level. Assuming no economic barriers to access, 2.8 to three dermatologists per 100,000 population should be adequate to meet demand. Because of many unpredictable factors, periodic reassessment of dermatology training capacity is necessary.

Dermatology↗
PubMed1983

Topical dermatologic therapy.

Topical therapy is a useful and versatile treatment modality which can bring a great deal of satisfaction to the patient with a skin disorder. Understanding the basic principles of skin hydration and emollient therapy can often prevent dermatitis in patients with "sensitive skin" which appears to flare at the slightest provocation. Understanding the underlying principles of topical skin care when prescribing the more potent steroid-containing preparations can make dermatologic therapy effective and rewarding.

Administration, Topical↗
PubMed1982

Instant color print photography in dermatology.

The use of instant color print photography in dermatology is explored and evaluated in this article. Recent advances in the technology of instant photography have made it possible for the creation of fast, accurate, clinical photographs by people with little experience or training. The Polaroid SX-70 Sonar camera with the CU-70 close-up kit is evaluated and compared to the Kodak instant close-up camera kit as marketed by the Lester A. Dine Company. The advantages and disadvantages of the two camera systems are presented. Techniques such as lighting, proper distance, and exposure are discussed with mention of the method of converting prints into slides. The many and varied applications of this modality are reviewed. Rapid, sharp, reproducible clinical photographs can now be obtained instantaneously by the busy clinician.

Dermatology↗
PubMed1981

Ozone production by dermatologic phototherapy equipment.

Phototherapy is an extremely effective and popular physical modality used by many dermatologists to treat a wide variety of cutaneous disorders. The major dermatologic journals frequently have articles on new applications for phototherapy. The science of photobiology has advanced rapidly over the last ten years and probably will continue to do so. One fact that should be kept in mind when using an ultraviolet light apparatus is the possibility of the generation of ozone, a toxic gas. In this study, a number of devices commonly used by many dermatologists in phototherapy were monitored for ozone production. Although some of the equipment examined can produce ozone, it is produced at very low levels, dissipates quickly, and poses no health threat.

Dermatology↗
PubMed1995

Dermatologic health services research.

Health services research is a field that uses techniques from many other disciplines to study health care, especially its quality and costs. This article presents examples that illustrate how health services research addresses the delivery of dermatologic care--for example, the development and use of sound quantitative measures of the outcomes of our care, the implementation of strategies to improve these outcomes, the assessment of patients' access to care and their satisfaction with care, and determinations of the cost-effectiveness of our care. Following these examples is a brief review of principles of experimental inquiry and common methodologic pitfalls in health services research, as a guide for readers in the interpretation of published studies.

Dermatology↗
PubMed1995

The reorganisation of a dermatology department.

In one dermatology unit, work patterns were restructured to improve continuity of care. The creation of nursing teams working in both the ward and outpatients' department has meant the effective use of nursing resources and multi-skilling of nursing staff.

Continuity of Patient Care↗
PubMed1995

Nurses' perceptions of dermatology.

There has been a reduction in the provision of specialist nursing care for dermatology patients. Low-status specialties are at greatest risk of erosion of their services. Lack of understanding results in a specialty being perceived as of low status.

Attitude of Health Personnel↗
PubMed1994

Better dermatologic office photography: getting started.

In an earlier paper, we defined a medical photograph as one that accurately maximizes clinical information while minimizing irrelevant data. This paper expands on this concept, providing specific hints to assist the practitioner in obtaining consistent high-quality clinical photos. We review the important question every medical photographer must ask when looking through the viewfinder as well as the difference between photography for practitioners of plastic surgery and dermatology.

Dermatology↗