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Dermatitis artefacta in soldiers.

BACKGROUND: Dermatitis artifacta is not an uncommon disease in military settings. Soldiers may intentionally produce skin lesions to achieve sick leave from military duties. The aim of this work was to describe a series of soldiers with dermatitis artifacta. METHODS: A prospective study was conducted among soldiers of the Israel Defense Force. RESULTS: Fourteen soldiers from the Israel Defense Force were included in the study. There were 13 men and one woman. The ages of the patients ranged between 19 and 26 years. For all patients, dermatitis artifacta was characterized by the acute appearance of a pruritic rash located on readily accessible areas of the limbs and abdomen. The rash was associated with systemic symptoms for 12 (85.7%) of 14 patients. None of the patients admitted to intentionally inflicting the skin lesions. The rash consisted of erythematous patches with numerous papules and pustules arranged in a linear pattern. All patients were treated with topical corticosteroids, four patients were treated with antibiotics, and three patients were treated with systemic corticosteroids. For all patients, the eruption resolved completely within 1 to 3 weeks. CONCLUSIONS: In the context of soldiers standing to gain sick leave by assuming the sick role, dermatitis artifacta can be reliably diagnosed by noting the characteristic location and morphological features of the skin lesions.

Adrenal Cortex Hormones↗

Student attendance during college-based lectures: a pilot study.

AIM: To identify the factors that influence attendance and absenteeism among a group of second-year nursing students during the theory component of the Fitness for Practice (FFP) curriculum. METHOD: In 2004, a non-randomised questionnaire was used to elicit information about the factors surrounding absenteeism from 75 adult branch nursing students within the first FFP cohort. The questionnaire consisted of 48 questions and was designed to generate a mixture of quantitative and qualitative data. Absence was recorded for the first 91 weeks of the programme. RESULTS: The main reasons identified for absence included: illness, family commitments, dental and medical appointments, and impending assignment submissions. Other factors that might influence college attendance included a dislike of certain subjects, with ethics, law and social policy identified as the least popular subjects. Students also admitted to an increase in absence around the time when assignments are due for submission and occasionally pretended to be ill. CONCLUSION: Further studies should be undertaken with other pre-registration nursing student cohorts to compare the results with this research. There should be: an increase in self-directed learning; a 'family-friendly' approach to the curriculum by allocating self-directed study during school holidays; a reduction in the number of theory hours to coincide with students' external commitments and to assist them with the demands of studying; and time for private study before the submission of theoretical assignments.

Absenteeism↗

Disease by design.

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Hospitalization↗

Exaggerated placental site erroneously diagnosed as non-metastatic trophoblastic disease. A case report.

BACKGROUND: Exaggerated placental site (EPS) is classified as a non-neoplastic trophoblastic lesion, and histologically it consists of endometrial and myometrial invasion of intermediate trophoblasts and syncytiotrophoblasts and it differs morphologically from placental site trophoblastic tumors and placental nodules. The purpose of this report is to increase physicians' awareness of this lesion. CASE: A 48-year-old woman with post-molar rising betahCG titers and a clinical diagnosis of non-metastatic trophoblastic disease underwent hysterectomy. Final histopathology showed exaggerated placental site--a lesion often unfamiliar to clinicians. CONCLUSION: It is suggested that operative hysteroscopy may be useful in the diagnosis and management of EPS.

Diagnosis, Differential↗