Journal of the European Academy of Dermatology and Venereology : JEADV
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J Eur Acad Dermatol Venereol · Aug 2007
Malignant transformation of leg ulcers: a retrospective study of 85 cases.
Malignant transformation remains a rare, under-recognized and ominous, complication of leg ulcers, although its exact prevalence is unknown. ⋯ Malignant transformation of chronic leg ulcers of vascular origin is mainly encountered in elderly patients and manifests as an abnormally vegetating lesion, which may be occasionally bilateral. Malignant transformation usually occurs towards well-differentiated SCC and only exceptionally towards BCC. The high death rate, especially in metastatic cases, is at least partly due to delay in diagnosis. Surgery remains the treatment of choice. Leg amputation should be considered in the most extensive cases.
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J Eur Acad Dermatol Venereol · Jul 2007
Historical ArticleHippocratic messages for modern medicine (the vindication of Hippocrates).
Medicine feels the need to combine more than ever the traditional concepts of Hippocrates in perfect balance with the enormous power of modern biotechnology. In our times, the old message 'go back to Hippocrates' sounds like a utopian vision. ⋯ The realistic message for tomorrow's physicians must be 'to go forward' together with his perennial humanistic values and clinical messages, combining the recent advances of biotechnology with the Hippocratic rationalism, which is based on logical reasoning, on careful clinical examination, and on a whole humane approach to the patient and his environment. Today's physician can still learn from the Hippocratic heritage and will need to be an expert Hippocratic physician, ever more humane and competent to use all new methods and facilities of basic dermatological research.
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Hippocrates was the first to introduce the concept of 'physis' and to transform hieratic or theocratic medicine into rational medicine. The overall construction of the Asclepieion on Kos clearly indicates that he and his school followed a holistic concept, combining scientific thought with drug therapy, diet schedules, and physical and mental exercise, also asking for God's help. Hippocrates also formulated the first standards and ethical rules to be followed in medical profession, which are still valid today. ⋯ Correct use of new scientific knowledge, individualized management with a Hippocratic holistic approach and compassionate sympathy for the patient who suffers, should be considered in the years to come for maintaining the level of medical profession. The venue of our European Congress in Rhodes is very close to Kos, another historic Aegean island, the place where Hippocrates has given the first professional standards in European medicine and in medicine in general. They were established 2600 years ago and are still valid today.(1,2) If one draws a red line and marks some cornerstones of the evolution that has taken place in medicine over the past centuries, it is evident that these first rules formulated by Hippocrates and his school also reveal the future responsibilities for our profession and make them better recognizable and more conclusive.