Clinics in Dermatology

The period of National Socialism (1933-1945) had a seismic impact on the medical profession in Europe and beyond. This study aimed to identify Jewish dermatologists who fled Europe as a result of National Socialism and migrated to the Australian state of New South Wales (NSW), document their struggles, and describe their contribution to dermatology. Five dermatologists who survived the horrors of Nazism and migrated to NSW were identified. Frederik Goldschlag (1893-1973), Richard Kantor (1886-1954), Isidor Knossew (1898-1965), Emil Milder (1902-1973) and Emery Kocsard (1912-2005) arrived in NSW in the period 1938-1951...

An island in Antarctica has been named in honor of the distinguished Bulgarian dermatologist Nikolai Tsankov. This contribution tells the story of Tsankov Island, and the remarkable man behind the eponym. He has has participated in multiple expeditions to Antarctica as a pioneer in studying the effects its climactic conditions on healthy skin.

Harvey S. Moser is a retired dermatologist who in 1939, at age 11 years old, was a passenger with his family aboard the St.Louis, a German ship en route to Cuba, that was carrying over 900 Jews fleeing Nazi persecution. The passengers were denied entry to Cuba, the United States, and Canada, so the ship sailed back to Europe. Finally, Great Britain, Belgium, France and the Netherlands agreed to admit the refugees. Unfortunately 254 of the St. Louis passengers were later murdered by the Nazis after Germany conquered the latter three counties in 1940...

The word "pox" indicated, during the late 15th Century, a disease characterized by eruptive sores. When an outbreak of syphilis began in Europe during that time, it was called by many names including the French term "La Grosse Verole" ("the great pox") to distinguish it from smallpox which was termed "La Petite Verole" ("the small pox"). Chickenpox was initially confused with smallpox until 1767, when the English physician William Heberden (1710-1801) provided a detailed description of chickenpox, differentiating it from smallpox...

This multi-part feature celebrates the Jewish contribution to dermatology over the past 200 years, as reflected by medical eponyms that honor the names of Jewish physicians. Many of these physicians practiced in Germany and Austria, following the emancipation of Jews in Europe. Part one discusses 17 physicians, who practiced medicine before the Nazi takeover of Germany during 1933. Examples of such eponyms from this period include the Auspitz phenomenon, Henoch-Schonlein purpura, Kaposi's sarcoma, Koebner phenomenon, Koplik spots, Lassar paste, Neisseria gonorrhoeae, and Unna boot...

Chronic stress is an inextricable part of modern daily living; practically all human diseases are negatively affected by it, particularly cancer. Numerous studies have shown that stressors, depression, social isolation, and adversity correlate with a worse prognosis for patients with cancer, with increased symptoms, early metastasis, and a shortened life span. Prolonged or very intense adverse life episodes are perceived and assessed by the brain that translate into physiologic responses mediated through relays to the hypothalamus and locus coereleus...

The perception of beauty is fluid within society and can morph based on cultural practices and societal interaction, such as social media exposure. The exposure to digital conference platforms has increased significantly, leading users to check their appearance constantly and find flaws in their perceived virtual appearance. Studies have shown that frequent social media use may lead to unrealistic body image ideals, a significant concern with appearance, and anxiety. Also, social media exposure can worsen body image dissatisfaction, social networking site addiction, and comorbidities of body dysmorphic disorder (BDD) such as depression and eating disorders...

Vitiligo is a depigmenting skin disease that can carry significant psychosocial impact. Health care providers play a crucial role in shaping patients' understanding of their condition, approach to treatment, and coping mechanisms. In this article, we review the psychosocial aspects of vitiligo management, including the debate over the "disease-ification" of vitiligo, its effects on quality of life and mental health, and methods to holistically assist affected individuals beyond just treatment of the vitiligo itself...

Eating disorders (EDs) such as anorexia nervosa and bulimia nervosa have a plethora of skin manifestations. They can be categorized into skin signs of self-purging, skin signs of starvation, skin signs related to drug abuse, skin signs of psychiatric comorbidity, and miscellaneous signs. "Guiding signs" are valuable, because they are pointers to the diagnosis of an ED. They include hypertrichosis (lanugo-like hair), Russell's sign (knuckle calluses), self-induced dermatitis, and perimylolysis (tooth enamel erosion)...

Chronic skin diseases can substantially impact a patient's physical, psychologic, and social well-being. Physicians may play a critical role in identifying and managing the psychologic sequelae of the most common chronic skin conditions. Acne, atopic dermatitis, psoriasis, vitiligo, alopecia areata, and hidradenitis suppurativa are chronic dermatologic diseases that put patients at high risk for symptoms of depression, anxiety, and decreased quality of life. Both general and disease-specific scales exist to assess the quality of life in patients with chronic skin disease, the most common being the Dermatology Life Quality Index...

Manipulation of the skin is ubiquitous in most individuals along a spectrum of extent and severity. Skin picking that results in clinically evident changes or scarring to the skin, hair, and nails or significantly impairs intrapsychic, psychosocial, or occupational function is considered pathological picking. Several psychiatric conditions are associated with skin picking, including obsessive-compulsive disorder, body-focused repetitive behaviors, borderline personality disorder, and depressive disorder. It is also associated with pruritus and other dysesthetic disorders...

The pathogenesis of vitiligo and schizophrenia has not been adequately clarified. We explore the role of lipids in these diseases. Both conditions have been associated with stress in several observations and studies. Research data indicate complex interactions between oxidative stress and metabolic syndrome-with lipid abnormalities being a significant component of the latter-in these diseases. The impaired membrane lipid homeostasis mechanism is related to the increased phospholipid remodeling caused by excessive oxidative stress in schizophrenia...

Dermatitis artefacta (factitious skin disorder) is a rare psychocutaneous disorder that poses a complex clinical challenge to clinicians. The hallmarks of diagnosis include self-inflicted lesions in accessible areas of the face and extremities that do not correlate with organic disease patterns. Importantly, patients are unable to take ownership of the cutaneous signs. It is essential to acknowledge and focus on the psychological disorders and life stressors that have predisposed the condition rather than the mechanism of self-injury...

Managing a delusional patient is one of the most challenging situations experienced by dermatologists. This is exacerbated by the scarcity of psychodermatology training offered in residency and similar training programs. A few practical management tips can be easily employed in the initial visit to avoid an unsuccessful encounter. We highlight the most important management and communication techniques needed for a successful first encounter with this traditionally tricky patient population. Topics, such as diagnosing primary vs...

Dysesthesia is symptomatology that includes, but is not limited to, sensations of pain, burning, crawling, biting, numbness, piercing, pulling, cold, shock-like, pulling, wetness, and heat. These sensations can cause significant emotional distress and functional impairment in affected individuals. While some cases of dysesthesias are secondary to organic etiologies, most cases exist without an identifiable infectious, inflammatory, autoimmune, metabolic, or neoplastic process. Ongoing vigilance is required for concurrent or evolving processes, including paraneoplastic presentations...

Body dysmorphic disorder (BDD) is a psychiatric condition characterized by profound concern about a minor or imagined defect in the appearance of individuals and increased preoccupation with the imagined/perceived defect. Individuals with BDD often undergo cosmetic intervention for the perceived imperfection but rarely experience improvement in their signs and symptoms following such treatment. It is recommended that aesthetic providers evaluate individuals face-to-face and screen for BDD with approved scales preoperatively to determine the candidate's suitability for the procedure...

No abstract text is available yet for this article.

Personality disorders are characterized by 'ego-syntonic' maladaptive behaviors that impair functioning. This contribution outlines the relevant characteristics and approach to patients with personality disorders pertaining to the dermatology setting. For patients with Cluster A personality disorders (paranoid, schizoid, and schizotypal), it is crucial to avoid being overly contradictory of eccentric beliefs and to take a straightforward, unemotional approach. Cluster B includes antisocial, borderline, histrionic, and narcissistic personality disorders...

Dermatologists are often the first to treat the medical consequences of body-focused repetitive behaviors (BFRBs) such as hair pulling, skin picking, and others. BFRBs are still under-recognized, and effectiveness of treatments is known only in limited circles. Patients exhibit varied presentations of BFRBs and repeatedly engage in these despite the physical and functional impairments. Dermatologists are uniquely placed to guide patients lacking knowledge about BFRBs and experiencing stigma, shame, and isolation...

The power of beauty influences many aspects of modern society and daily life-perceptions surrounding beauty date to ancient philosophers and have evolved significantly throughout history. Still, there appear to be universally accepted physical characteristics of beauty that span different cultures. Human beings have an inherent ability to distinguish between attractive and non-attractive based on physical features that include facial averageness, symmetry, skin homogeneity, and sexual dimorphism (sex-typical characteristics)...