Dermatologic clinics
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Dermatologic clinics · Jan 1999
ReviewThe dermatologist's Baedeker. Preparation for medical assistance missions.
Dermatologists often participate in medical assistance missions in developing nations, achieving both humanitarian and personal objectives. This term outreach mission abroad and will serve as a guide for preparing oneself, personally and professionally, for the practical and philosophical aspects of humanitarian assistance. It will help one participate in such an endeavor in a safe, comfortable, healthy, productive, and enjoyable manner.
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Severe cutaneous disease and injury often is best treated in the specialized treatment environment of a burn center. Skilled burn treatment personnel combine critical care expertise with extensive clinical experience in the management of severe cutaneous injury and disease. ⋯ Recent research indicates that the burn wound is a dynamic structure whose ultimate extent is modifiable by manipulations of the local anatomic and molecular environment. The many unanswered questions on the pathogenesis and treatment of both the "medical" and "surgical" cutaneous processes require close collaboration between the dermatologist and the burn team.
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Extemporaneous compounding has long been a part of dermatology. It has served to produce niche therapies that otherwise would have been poorly treated with available drugs. ⋯ The increasing availability of new pharmaceutical drugs that fill these niches more effectively, coupled with economic and legal concerns over the practice of compounding make it a tradition with an increasingly limited role in dermatology today. It is safe to predict that in the near future, compounding will virtually disappear from dermatology, as it already has from virtually all other medical specialties.
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The delivery of drugs into and through the skin is a recognized and effective means of therapy for dermatologic, regional, and systemic disease. The selection of drug candidates and the rational design of suitable formulations depends upon the biological make-up of the skin's barrier, and the physiochemical interactions between the membrane, the delivery system technology, and the active agent. This article summarizes the state of the art and examines more recent developments that are the subject of considerable research at this time. In addition, the potential to use the skin as a portal for noninvasive clinical chemistry (e.g., for glucose monitoring in diabetics) is discussed.
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Wound care after cutaneous surgery can play an integral role in wound healing. Wound care regimens have changed dramatically over the last 35 years as the physiology of wound healing has become better understood. Foremost is the improvement in wound healing achieved by keeping the wound occluded and moist. ⋯ Finally, wound healing can be greatly impacted by what the patient does or does not do after leaving the office. Therefore, wound care instructions should be clear, detailed, and provided in both oral and written form. Information should also be provided about what to expect as the wound heals.