By William D. James MD, Timothy Berger MD, Dirk Elston MD

The eleventh version of the vintage Andrews' ailments of the outside, by means of Drs. William D. James, Timothy G. Berger and Dirk M. Elston, presents the final word origin in dermatology with finished suggestions to successfully diagnose and deal with a variety of dermis stipulations. those hugely revered authors stability evidence-based therapy guidance with suggestion from their very own medical adventure, providing a pragmatic and sensible scientific point of view. up to date all through with the most recent dermatologic findings and a brand new bankruptcy on beauty surgical ideas, this name is helping you retain present, enhance your talents, and get ready for checks. additionally it is on-line entry to the whole textual content, photographs, and bonus illustrations making this an imperative, handy reference for trainees and practising dermatologists. perform with self belief in the course of the valued authorship of pro pros Dr. William D. James, Dr. Timothy G. Berger, and Dr. Dirk M. Elston. quickly increase your wisdom of pores and skin stipulations via a concise, clinically centred, elementary structure. receive thorough tips on medical presentation and treatment for a whole diversity of universal and infrequent pores and skin ailments. ensure your diagnoses via evaluating your scientific findings to greater than 1,150 illustrations, forty% of that are fresh. replace your surgical abilities with chapters dedicated to easy dermatologic, laser, and plastic surgery, contributed by means of Dr. Issac M. Neuhaus. seek the total contents on-line, obtain all of the illustrations, and think about an extra four hundred photographs, at www.expertconsult.com. In Andrews' illnesses of the surface, the authors offer training dermatologists and citizens with the center info wanted.

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Extra info for Andrews' Diseases of the Skin: Clinical Dermatology - Expert Consult - Online and Print (James, Andrew's Disease of the Skin), 11th Edition

Sample text

Lesions of the arms and legs are also common and usually exhibit a prurigo nodule-like configuration (Fig. 3-24). The eruption may extend to involve sun-protected areas, especially the buttocks, but lesions in these areas are always less severe. In adults, chronic, dry papules and plaques are most typical, and cheilitis and crusting occur less frequently. Skin lesions tend to persist throughout the year in the tropics, although they are clearly worse during periods of increased sun exposure. In temperate and high-latitude regions, lesions occur from March through the summer and substantially remit in the winter.

Phototesting produces variable results. Schornagel et al reported that one protocol, which produced positive results in 83% of tested patients, used four exposures of UVB, UVA, or a combination in previously affected sites. However, the light sources are not readily available and reported protocols vary widely. In clinical practice the diagnosis is usually made clinically. In the differential diagnosis of PLE, the following should be considered: lupus erythematosus, photosensitive drug eruption, prurigo nodularis, and photoallergic contact dermatitis.

Histopathologic examination, ANA testing, and direct immunofluorescence (DIF) are helpful in distinguishing these diseases. Serologic testing alone may not distinguish PLE from SLE, due to the possibility of positive ANA tests in PLE patients. Lupus erythematosus may present initially with photosensitivity before other features of lupus erythematosus occur. Therapeutically, most patients with mild disease can be managed by avoiding the sun and using barrier protection and high-SPF, broad-spectrum sunscreens.

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