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81. Guidelines on autopsy practice: Industrial/occupational-related lung disease deaths including asbestos

macules (impalpable) secondary dust nodules (palpable) diffuse interstitial fibrosis. · complicated coal workers pneumoconiosis progressive massive fibrosis (lesions >1 cm). · coal dust tattoos · diffuse interstitial fibrosis. [Level of evidence: B.] 4 Specific health and safety aspects Subjects with silicosis are at increased risk of tuberculosis. [Level of evidence: B.] No other aspects beyond standard health and safety standards. [Level of evidence: GPP.] 5 Clinical information relevant (...) post mortem confirmed to examination of the thoracic cavity is considered sub-optimal. [Level of evidence: GPP.] 7 Specific significant organ systems Organ Pathology Agent Skin Linear tattoos Coal Corns (knuckles, finger tips) Asbestos Thorax/lungs Adult respiratory distress syndrome (shock lung) Smoke, fumes Emphysema Coal Macules Coal, silicates, iron Nodular fibrosis Coal, silica Silicate (talc, mica) Progressive massive fibrosis Coal, silica, silicates Diffuse interstitial fibrosis, lower zone

2017 Royal College of Pathologists

82. Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy Full Text available with Trip Pro

presentations vary with focal to diffuse distributions, including flexural, inverse, and erythrodermic variants. Pruritus can be severe and is the most common associated symptom. Vitiligo presents as well-demarcated depigmented macules and patches, reported exclusively in patients with melanoma. Besides varying clinical presentation, the time to onset varies greatly among these rashes, as vitiligo can appear months after treatment initiation; however, the inflammatory dermatoses usually present within

2018 American Society of Clinical Oncology Guidelines

83. Shingrix vaccine for herpes zoster

may be preceded by prodromal pain or itching, after which erythematous macules or papules appear. These progress into vesicular lesions, then into pustules. The pustules typically crust over within the course of about ten days. In many patients, the HZ rash heals and painful symptoms resolve entirely within about four weeks. 6 In up to about thirty percent of patients, however, the pain will persist for months beyond the initial rash, known as postherpetic neuralgia (PHN). 3 PHN is conventionally

2018 Therapeutics Letter

84. Herpes Zoster - Diagnosis

. Agius, T. M. Lesser, and J. Sellner. The ?nal recommendations were formally con- sented within the expert panel of the guideline. Generalconsiderations Classically, HZ is a unilateral, dermatomal 18–20 eruption, with skin lesions evolving simultaneously from erythematous macules to papules, vesicles, pustules, and ?nal crusting after about 5– 7 days. Usually not the entire dermatome is involved. Clinical signs include pruritus, paresthesia, dysesthesia or anaesthesia. Local lymphadenopathy may

2017 European Dermatology Forum

85. CRACKCast E130 – Viruses

sclerosing panencephalitis (SSPE) Viral, droplet spread Should be isolated at home Can be life threatening Worry about congenital rubella* In pregnant patients, the virus spreads to the placenta with subsequent infection of fetal organs. Clinical presentation Fever and a skin eruption. Well children 6 months to 3 years old. May occur post febrile seizure The rash typically appears with defervescence. The lesions are discrete pink or rose-colored macules or maculopapules 2 or 3 mm in diameter that blanch

2017 CandiEM

86. CRACKCast E120 – Dermatologic presentations

of the lesions Systemic illness Diagnostic tests Category of rash Infectious Immune Vascular Allergic Malignancy Treatment Core questions [1] List five broad categories of rashes Infectious Allergic Autoimmune Vascular Malignancy-related [2] Describe the primary skin lesion types (table) The primary skin lesions result directly from the disease process. Primary Lesions (For original table, see Rosen’s Table 110.1) Lesion Description Size Macule Flat circumscribed pigmented area <0.5cm in diameter Patch Flat (...) - ceous macules, papules, vesicles, or bullae. Their distribution is often symmetric , most commonly involving the soles and palms, the backs of the hands or feet, and the extensor surfaces of the extremities. The presence of lesions of the palms and soles is particularly characteristic . The target lesion with three zones of color is the hallmark of erythema multiforme commonly begins with prodromal symptoms , such as fever , malaise , rhinitis , sore throat , and myal – gias . These are followed

2017 CandiEM

87. CRACKCast E118 – SLE and Vasculitides

Methylprednisolone Glucocorticoid 1-2mg/kg IV once daily Prednisone Glucocorticoid 1-2mg/kg PO once daily Hydroxychloroquine Anti-malarial 200-400mg PO once daily Cyclophosphamide Alkylating agent 500-750mg/m 2 IV once Azathioprine Antimetabolite 25-50mg/day IV or PO [6] How does neonatal lupus present? Rash Erythematous annular lesions or arcuate macules with slight central atrophy and raised active margins look on scalp and face Can be confused with fungal infection, present at delivery or not until child has

2017 CandiEM

88. Lymphangioleiomyomatosis Diagnosis and Management Part II: An Official ATS/JRS Clinical Practice Guideline

the diagnosis of TSC. Features suggestive of TSC include the presence of any of the following: subungual ?bromas, facial angio?bromas, hypomelanotic macules, confetti lesions, Shagreen patches, positive family history of TSC, history of seizures or cognitive impairment, or presence of cortical dysplasias, subependymal nodules, and/or subependymal giant cell astrocytomas on brain imaging. Routine brain imaging is not indicated if clinical suspicion for TSC is low. Detailed diagnostic criteria for TSC

2017 American Thoracic Society

89. Gastrointestinal Stromal Tumours: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up

–Stratakis syndrome, marked by a dyad of GIST and paraganglioma [4, 5]; and • Neuro?bromatosis type 1(NF1), possibly leading to wild-type (WT), often multicentric GIST, predominantly located in the small bowel [6]. Families with germline autosomal dominant mutations ofKIT are an extremely rare ?nding, presenting with multiple GISTs at an early age, possibly along with other associated features such as pigmented skin macules, urticaria pigmentosa and diffuse hyper- plasia of the interstitial cells

2018 European Society for Medical Oncology

91. The UK guidelines for management and surveillance of Tuberous Sclerosis Complex Full Text available with Trip Pro

is available should be considered for treatment with an mTOR inhibitor. Those likely to benefit from an mTOR inhibitor according to current evidence are those with progressive deterioration in lung function and those with chylous complications. Skin Skin involvement is common in TSC. Lesions such as facial angiofibromatosis, hypomelanotic macules, shagreen patches, forehead fibrous plaques, skin tags and periungual fibromas are observed in individuals with TSC. Facial angiofibromas can affect approximately

2018 Tuberous Sclerosis Association

92. CRACKCast E087 – Peripheral Arteriovascular Disease

that lodge in distal small arteries. (Ischemic strokes, cool painful cyanotic toes). Thrombosis (arterial thrombosis) ●In-stitu formation of blood clots in the arteriovascular system. ●Usually due to atherosclerosis ●Often caused by atherosclerotic plaque rupture or endothelial injury due to trauma or vasculitis Inflammation ●Can be due to drugs, irradiation, mechanical trauma, bacterial invasion, IVDU, etc. ●Noninfectious systemic: necrotizing vasculitis ( look for macules, papules, vesicles, bullae

2017 CandiEM

93. CRACKCast E083 – Infective Endocarditis and Valvular Disease

embolization (thromboembolic) avoided by higher INR goal of 2.5-3.5 usually CNS strokes at high risk for hemorrhagic conversion hemolysis hemolytic anemia due to sheer forces fatigue, jaundice, dark urine, dyspnea, endocarditis highest during the initial months post-op early <60 days Vary based on valve type: mechanical bioprosthetic 1) Describe the following lesions Janeway lesions Non-tender erythematous macules on the palms and soles. They are micro-abscesses. Much more common than Oslers and Roths

2017 CandiEM

94. Acquired Bilateral Nevus of Ota-like Macules: An Immunohistological Analysis of Dermal Melanogenic Paracrine Cytokine Networks. (Abstract)

Acquired Bilateral Nevus of Ota-like Macules: An Immunohistological Analysis of Dermal Melanogenic Paracrine Cytokine Networks. Acquired bilateral naevus of Ota-like macules (ABNOM) is similar to melasma with regard to their clinical features, including female predominance, acquired onset, and predominant involvement of the malar area. The similar clinical features suggest the possibility of a shared pathogenesis. Dermal factors including vascularity and melanogenic paracrine networks

2010 British Journal of Dermatology

95. A Population-Based Study of Acquired Bilateral Nevus-of-Ota-Like Macules in Shanghai, China. Full Text available with Trip Pro

A Population-Based Study of Acquired Bilateral Nevus-of-Ota-Like Macules in Shanghai, China. Acquired bilateral nevus-of-Ota-like macule (ABNOM) is a common skin dyspigmentation in Asian females. Although its clinical characteristics are well defined, its epidemiology and pathogenesis remain unclear. A large population-based cross-sectional study was conducted to determine the prevalence and risk factors of ABNOM. A total of 8,680 subjects (ages ranging from newborn to 99 years old; 54% female

2010 Journal of Investigative Dermatology

96. Phenotypic variability among café-au-lait macules in neurofibromatosis type 1. Full Text available with Trip Pro

Phenotypic variability among café-au-lait macules in neurofibromatosis type 1. Café-au-lait macules (CALMs) in neurofibromatosis type 1 (NF1) are an early and accessible phenotype in NF1, but have not been extensively studied.We sought to more fully characterize the phenotype of CALMs in patients with NF1.In all, 24 patients with a diagnosis of NF1 confirmed through clinical diagnosis or molecular genetic testing were recruited from patients seen in the genetics department at the University

2010 Journal of American Academy of Dermatology

97. The Impact of In Vivo Reflectance Confocal Microscopy on the Diagnostic Accuracy of Lentigo Maligna and Equivocal Pigmented and Nonpigmented Macules of the Face. Full Text available with Trip Pro

The Impact of In Vivo Reflectance Confocal Microscopy on the Diagnostic Accuracy of Lentigo Maligna and Equivocal Pigmented and Nonpigmented Macules of the Face. Limited studies have reported the in vivo reflectance confocal microscopy (RCM) features of lentigo maligna (LM). A total of 64 RCM features were scored retrospectively and blinded to diagnosis in a consecutive series of RCM sampled, clinically equivocal, macules of the face (n=81 LM, n=203 benign macules (BMs)). In addition

2010 Journal of Investigative Dermatology

98. VivaScope 1500 and 3000 imaging systems for detecting skin cancer lesions

RCM features could distinguish lentigo maligna (LM) from benign macules of the face such as solar lentigo, actinic keratosis and seborrheic keratosis, and tested different algorithms for diagnosing LM. A LM score of 2 or more resulted in a sensitivity of 85% and specificity of 76% for the diagnosis of LM (odds ratio [OR] for LM 18.6; 95% confidence interval [CI] 9.3 to 37.1). 5.19 Rao et al. (2013) assessed the accuracy of VivaScope 1500 compared with histopathology in the diagnosis of 284

2015 National Institute for Health and Clinical Excellence - Diagnostics Guidance

99. Public health guidance on varicella vaccination in the European Union

adulthood. Infection from primary varicella usually confers lifetime immunity. The life-time risk of developing HZ was calculated to be 28% for England and Wales [30]. It is more usual in immunocompromised patients and patients over 50 years, and is unusual in children [31]. Varicella is characterised by fever and a generalised, pruritic, vesicular rash, typically consisting of 200 to 500 lesions in varying stages of development and resolution. The rash progresses rapidly from macules to papules

2015 European Centre for Disease Prevention and Control - Public Health Guidance

100. Meningitis - bacterial meningitis and meningococcal disease

of meningococcal disease? When a non-blanching rash is present , it may appear as a: Scanty petechial rash (red or purple non-blanching macules smaller than 2 mm in diameter). Purpuric (haemorrhagic) rash (spots larger than 2 mm in diameter) — this may be absent in the early phase of the illness and may initially be blanching or macular in nature. Images of petechial, purpuric, and meningococcal rashes can be found in the document by the Meningitis Research Foundation (available at ). Examine the whole body

2019 NICE Clinical Knowledge Summaries

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