Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete
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A sudden onset of unilateral swelling and tenderness on pressure of the calf with no history of trauma is suggestive of vein thrombosis. Baker cysts, especially if ruptured, mimic the clinical picture of deep vein leg thrombosis. The examination method of choice is duplex sonography. ⋯ No intra-articular lesions of the knee joint were revealed by arthroscopy. Histological examination of the biopsy specimens of the synovia showed no specific pathologic condition. The clinical signs improved with conservative treatment.
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Neither section 5 of the Statute on Occupational Illnesses nor Lt no. 59 of the "physicians' agreement" stipulates whether a physician should have the right to issue a "green report" or a "dermatologist's report" without the consent of the patient. The decisive regulation for this question is section 100 of the social legislation book (SGB X). In connection with other decisions, this regulation has the following consequences: (1) the consent of the patient is always necessary if the "green report" or the "dermatologist's report" is issued at the request of the treating physician or any other physician, i.e., not at the request of the accident insurance company; (2) if the accident insurance company demands that the "green report" or the "dermatologist's report" be issued, the treating physician does not need the patient's consent. ⋯ As a rule, the physician can assume the consent of the patient. If not, it depends in individual cases on whether consent is not granted expressly or conclusively. The decision then rests with the physician.
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We report a case of Down's syndrome in a 22-year-old woman who developed vitamin C deficiency with subsequent appearance of the characteristic joint pains and cutaneous and mucosal lesions of scurvy. A low intake of vitamin C due to peculiar eating habits and reduced absorption due to cardiac insufficiency and treatment with a platelet-aggregation inhibitor were considered to have caused the deficiency. Follicular purpura is a diagnostic skin sign of scurvy.