Search Results

In the year 2000, Dr. Gordon Sauer, an American dermatologist, published an article, “Charles Darwin Consults a Dermatologist”, in which he diagnosed Darwin's skin disease as being atopic eczema. This was the first time in nearly 120 years of comments on Darwin's illness that anyone had proposed a diagnosis for his dermatological symptoms. While Dr. Sauer believes that this allergic state is a cause for Darwin's skin symptoms, he does not believe that allergy can account for the other symptoms of Darwin's illness, as has been proposed by Fabienne Smith. The evidence for his dermatological diagnosis is presented. Whether or not Darwin had atopic dermatitis can only be confirmed by allergen tests that have been developed since his death, and he may occasionally have had other kinds of skin disorders. But the diagnosis of atopic dermatitis fits what is known about the nature and history of his dermatitis better than any other diagnosis.

This chapter explains how mold spores can cause allergies. Spores carry proteins on their surface, and those that act as antigens can cause a cascade of immune responses resulting in the miseries of allergic rhinitis or hay fever, allergic conjunctivitis, skin allergies, asthma, eczema or atopic dermatitis, and hypersensitivity pneumonitis. This chapter describes interactions between immune cells in allergies mediated by IgE and IgG, providing a primer on this complex field of medicine. The idea that allergy is a perversion of a response that evolved to combat parasitic infestations is discussed, along with the hygiene hypothesis that has been advanced as an explanation for the increasing prevalence of asthma.

After reading how his enemy Richard Owen had mendaciously criticized the work of his friend Hugh Falconer, Charles Darwin had feelings of “burning...indignation” that interfered with sleep, and produced an episode of eczema which took “off the epidermis a dozen times clean off”. The eczema subsided, and he had no further complaints of illness in January of that year. His wellness was then sharply broken by the onset of an illness that would become prolonged and that resulted from his disturbed feelings on reading Charles Lyell's book, The Antiquity of Man. He also continued to be ill with vomiting and weakness. His treatment regimens under Drs. James Ayerst, James Gully, William Brinton, and William Jenner are described.

A 58-year-old woman was admitted to the acute medical unit with an eight-day history of feeling unwell and a painful spreading rash. It had commenced on her trunk and extended to the limbs. She had missed the last two days of work as a machinist. She had a previous history of slight scalp psoriasis. Two weeks ago, she had commenced medication for joint pains. She had a past medical history of a myocardial infarction and hypertension. Her medication included atenolol, bendroflumethiazide, aspirin, and diclofenac.

On examination, she had a temperature of 39.2°C, pulse 120 beats per minute, and a blood pressure of 130/92 mmHg. Respiratory, abdominal, and neurological systems were normal. Skin examination revealed sheeted erythema of her back and loins, with areas of superficial skin shedding revealing moist underlying eroded areas on most of her back, the axillae, and beneath the breasts amounting to 20% body surface area. There was patchy redness with purpuric macules on the limbs, palms, and soles. She had painful eyes and small foci of oral mucosal erosion. The genital mucosa was uninvolved, but there was redness of the inguinal and perineal creases with a well-demarcated edge and satellite patches beyond. She had scaling of the scalp.

Questions

52-year-old man presents to the clinic for review some six weeks after starting phenytoin for complex partial seizures. He is very concerned as he has a rash which began on his face but quickly spread over the upper body. It begins as large,...

Questions

A 72-year-old man had begun to mobilize four days after admission with a left lower lobe pneumonia, complicated by renal impairment. His renal function was improving and his chest X-ray, on day 4, showed only a small left pleural effusion. However, the nurses...

The aim of this chapter is to provide nurses with the knowledge to be able to assess, manage, and care for people with skin conditions in an evidence-based and person-centred way. The chapter will provide a comprehensive overview of the commonest skin diseases and their causes before exploring best practice to assess and help patients to manage skin conditions. Nursing priorities are highlighted throughout, and the nursing management of the symptoms and common health problems associated with skin conditions can be found in Chapters 19, 20, 21, 24, 27, and 28 on skin care and the maintenance of skin hygiene, skin barrier integrity, the prevention of skin breakdown, and wound management, respectively. Skin care is a fundamental area of nursing responsibility. The skin, or integumentary system, is the largest organ of the body and has significant protective and thermoregulatory functions. Skin disease is common, accounting for approximately 24% of GP visits (Schofield et al., 2009). It may have a major psychosocial impact on a person’s quality of life through its influence on appearance, body image, and self-esteem. This chapter introduces you to the common skin diseases that you are likely to encounter when caring for adult patients and outlines the nursing problems that you will need to manage. The cause or aetiology of common skin conditions lies with the interaction between genetic and environmental factors. For example, a child’s eczema is influenced by his or her genotype and his or her exposure to environmental allergens. Within the UK population, 23舑25% have a skin problem at some time in their lives that can benefit from medical care (Schofield et al., 2009). Skin problems are the commonest reason for consulting a GP, with 6% referred for specialist advice. As such, all registered nurses should have the knowledge and skills to manage the common conditions. The commonest skin conditions in the Western hemisphere are chronic inflammatory skin diseases (CISDs), such as eczema. In developing countries, the common conditions are infections and infestations. The quality-of-life impact of CISDs can exceed that for life-threatening conditions such as cancer (Rapp et al., 1999; Kingman, 2005).