... (Part 1) Harrison's Internal Medicine > Chapter 52. Approachto the Patientwith a Skin Disorder APPROACH TO THE PATIENTWITH A SKIN DISORDER: INTRODUCTION The challenge of examining ... interpretation would be that the patient has a pruritic eczematous dermatitis with erosions caused by scratching. Figure 52-1 Chapter 052. Approachto the Patient with a Skin Disorder (Part ... Fig. 52-3) and to formulate a differential diagnosis (Table 52-4). For instance, the finding of scaling papules (present in patients with psoriasis or atopic dermatitis) places the patient in...
... 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 xerosis ... representation of several common primary skin lesions (see Table 52-1). Chapter 052. Approachto the Patient with a Skin Disorder (Part 2) Table 52-2 Description of Secondary Skin Lesions ... depression with intact epidermis (i.e., loss of dermal or subcutaneous tissue) or as sites of shiny, delicate, wrinkled lesions (i.e., epidermal atrophy). Scar: A change in the skin secondary to trauma...
... 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 ... Swerlick, MD; with permission.)[newpage] APPROACH TO THE PATIENT: SKIN DISORDER In examining the skin it is usually advisable to assess the patient before taking an extensive history. This ... possible to assess the distribution of the eruption accurately. The Chapter 052. Approachto the Patient with a Skin Disorder (Part 4) Figure 52-5 ...
... characterized by small and large erythematous papules and plaques with overlying adherent silvery scale. Figure 52-8 Chapter 052. Approachto the Patient with a Skin Disorder (Part 5) Figure...
... 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 ...
... Family history (particularly relevant for patients with melanoma, atopy, psoriasis, or acne) 10. Social, sexual, or travel history as relevant to the patient DIAGNOSTIC TECHNIQUES Many ... systemic symptoms (e.g., malaise, fever, arthralgias) 5. Ongoing or previous illnesses 6. History of allergies 7. Presence of photosensitivity 8. Review of systems 9. Family history (particularly ... of the skin and rotated with downward pressure until it penetrates to the subcutaneous tissue. The circular biopsy is then lifted with forceps, and the bottom is cut with iris scissors. Biopsy...
... Granulomas often have an opaque to transparent, brown-pink "apple jelly" appearance on diascopy. Figure 52-11 Chapter 052. Approachto the Patient with a Skin Disorder (Part 8) ... and in recognition of ash leaf spots in patients with tuberous sclerosis. Figure 52-12 Diascopy is designed to assess whether a skin lesion will blanch with pressure as, for example, in determining ... al (eds): Fitzpatrick's Dermatology in General Medicine, 7th ed. New York, McGraw-Hill, 2008 Urticaria. Discrete and confluent, edematous, erythematous papules and plaques are characteristic...
... Chapter 077. Approachto the Patient with Cancer (Part 1) Harrison's Internal Medicine > Chapter 77. Approachto the Patientwith Cancer Approach to the Patientwith Cancer: Introduction ... two of three patients diagnosed with cancer. Nevertheless, patients experience the diagnosis of cancer as one of the most traumatic and revolutionary events that has ever happened to them. Independent ... the prognosis of the person with aortic stenosis who develops the first symptoms of congestive heart failure (median survival, ~8 months). However, the patient with heart disease may remain...
... important factor for consideration of treatment is the patient s willingness to be treated and to conform to the treatment requirements. Treatment is generally contraindicated in patients with major ... hepatic steatosis, a common presentation in HCV infected patients. 5. Approachto Treatment of Chronic HCV Infection Initial Evaluation of Patients with Chronic HCV Infection 1) History Obtaining ... significant heart disease. Patients with autoimmune hepatitis or other conditions known to be exacerbated by interferon and ribavirin or known to have hypersensitivity to these drugs should not...
... Spanish only. Consider the following example: (7) (i) John went to the store when Mary arrived. (it) John had gone to the store when Mary arrived. In Dorr (1991), we discussed the selection ... features described in the last section. To translate (7)0) and (it) into Spanish, we must choose between the lexical tokens cuando and al in or- der to generate the equivalent temporal connective ... traditionally used to indicate a revoked consequence state (e.g., the consequence state that results after returning from the "going to the store" event), but it is generally intended to indicate...