By Hans Joachim Schwanitz M.D., Ph.D. (auth.)
The box of dermatology has a great deal replaced over the past a long time. An ever-increasing wisdom concerning the pathogenesis of ailments of the surface has made it attainable not to simply larger classify but in addition to make dermatoses larger explainable and comprehensible. the current publication exemplifies this with a truly universal affliction, the dyshidrotic eczema of the palms. most present textbooks nonetheless describe "dyshidrosis" as a illness of the eccrine sweat glands, as was once first postulated in 1873 by means of T. Fox. In 1962, R. D. G. P. Simons challenged this idea and because then, it has no longer been attainable to set up a uniform pathogenetic suggestion concerning "dyshidrosis". the single often authorized view is that the dermatosis has a number of etiologies. This monograph is meant to be a follow-up to Simons' e-book released in 1966, entitled Eczema of the fingers. Investigations into Dyshidrosiform Eruptions. It repre sents an try to view the medical and experimental features of atopic palmoplantar eczema as a foundation for an realizing of the complete entity of dyshidrosis. My unique thank you visit Prof. Dr. E. Macher, Miinster, who made it attainable for me to accomplish this paintings, to Prof. Dr. S. Nolting, Miinster, who aroused my curiosity within the topic, and to Prof. Dr. P. Frosch, Heidelberg, who generously supplied the mandatory technical gear for investiga tional use. scientific examinations are most unlikely with no sufferers and keep an eye on in keeping with sons. i want to thank all of the those who took half during this project.
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Forty of the 45 patients had social difficulties (Fig. 17). The distribution of the patients' scoring from 1 to 3 can be seen in both figures. In both cases, patients chose the rating 'considerable' most frequently, while 'slight' and 'severe' were chosen to about the same extent. CODE 3. *. SEVERE 10) 2. ************************* I I 1• o. CONSIDERABLE ************ 1 SLIGHT I ** 1 I ( NONE 24) 11) 1) 1 ••••••••• 1 ••••••••• I ••••••••• l ••••••••• I ••••••••• l 10 30 40 20 50 o FREQUENCY Fig. 16.
They observed that among atopic patients, heating of one arm caused a cooling of the other unaffected arm. In healthy patients, the other extremity warms up instead with the heat-treated extremity. The authors concluded that atopic dermatitis has a higher tendency to vasoconstriction because of a deficit of j1-adrenergic receptors. This is based on the theory of Szentivanyi concerning the atopy syndrome, which is further discussed in chapter 5. In summary, one can say that dyshidrosis is accompanied by elevated temperatures of the affected hands.
The human body air quiet air _rn_ _ePidermis_~-t corium+subcutis 'U' conduction of heat convection of heat ~ infrared radiation transpiration Fig. 18. Mechanisms of heat transfer. (Modified after Stiittgen and Flesch 1984) 44 Experimental Studies radiates heat in the spectral range between infrared and ultrared. As the tissue is almost impenetrable for this type of radiation, heat transfer through thermal radiation within the body can be neglected. 4. Transpiration in the form of sensible or insensible sweating is a function of the sweat glands.
Atopic Palmoplantar Eczema by Hans Joachim Schwanitz M.D., Ph.D. (auth.)