bluuebunny/crossref_metadata_2025 huggingface dataset:
Sarcoidosis
Authors: Marcoval Joaquim , Mañá Juan
Published: August 2023

Sarcoidosis is an antigen‐mediated disease of unknown aetiology characterized by the presence of non‐caseating epithelioid cell granulomas in multiple organs. It involves mainly the lungs, mediastinal and peripheral lymph nodes, eyes and skin. Less frequent but usually severe manifestations can occur in the liver, spleen, central nervous system, heart, upper respiratory tract and bones. Cutaneous lesions of sarcoidosis may be specific, showing histopathologically sarcoid granulomas, or non‐specific, mainly erythema nodosum. Cutaneous lesions are frequently the presentation of the disease and skin biopsy enables early diagnosis. Moreover, some types of lesions have prognostic significance and may help to predict the outcome of the systemic disease.
Panniculitis
Authors: Requena Luis
Published: August 2023

The panniculitides comprise a group of heterogeneous inflammatory diseases that involve the subcutaneous fat. Histopathological study is required for the specific diagnosis of these disorders, because different panniculitides usually show the same clinical appearance – which typically consists of erythematous nodules on the lower extremities. However, the histopathological study of panniculitis is difficult because of the poor correlation between clinical and pathological findings and the changing microscopic appearances as the lesions evolve. Furthermore, large scalpel incisional biopsies are required in order to evaluate panniculitis fully. From the histopathological point of view, all panniculitides are somewhat mixed, because the inflammatory infiltrate involves both the septa and lobules. However, differentiation between a predominantly septal and a predominantly lobular panniculitis is usually straightforward at scanning magnification on the basis of which subcutaneous structures are the more intensely involved by the inflammatory infiltrate.
Other Acquired Disorders of Subcutaneous Fat
Authors: Chen Amy Y.‐Y. , Garg Amit
Published: August 2023

This chapter addresses principally non‐inflammatory acquired disorders of subcutaneous fat with an emphasis on acquired lipodystrophy, fat hypertrophy, subcutaneous lipomatosis and lipoedema. While some of the entities discussed are very common, such as cellulite and obesity, most are much rarer. Panniculitis and genetic disorders of subcutaneous fat are addressed other chapters in the book.
Purpura
Authors: Leslie Tabi A.
Published: August 2023

This chapter discusses purpura and bruising, terms used to describe bleeding into the skin, which may occur as isolated phenomena or as part of a systemic disorder. Clinically, purpura can represent vasculitis affecting small vessels of the skin, or may be the minor or dominant features of a systemic vasculitis. Many platelet and coagulation disorders seen by haematologists present with purpura. Purpuric lesions may be seen in disorders such as vasculitis, presenting as urticarial lesions, nodules, ulcers, livedo and skin necrosis. These signs often occur in disorders where vessels are occluded. The epidemiology, pathophysiology, clinical features, differential diagnosis and management of purpura and bruising due to different causes are discussed.
Ulceration Resulting from Disorders of the Veins and Arteries
Authors: Hafner Jürg
Published: August 2023

Leg ulcers represent a serious burden of disease with an impact, both physical and psychological, that is underestimated. Approximately 50% of all leg ulcers are venous, and another 20% mixed. Venous leg ulcers (VLUs) represent the most advanced grade of chronic venous insufficiency (CVI). CVI results from chronic peripheral venous hypertension. Compression therapy – either using bandages or stockings – is the mainstay in the treatment of CVI and VLUs. Approximately half of patients with VLUs suffer from superficial venous reflux, which can be surgically abolished by a variety of methods. A mixed leg ulcer (MLU) is a VLU in a leg with peripheral arterial disease. MLUs are hard to heal. Management focuses initially on improving arterial inflow, mostly by the use of balloon catheter angioplasty, thereby transforming the MLU into a VLU. As soon as the arterial inflow is restored, management follows the algorithm for VLUs. Arterial leg ulcers result from local skin ischaemia in peripheral arterial disease. Management mainly consists of revascularization and skin grafting. Hypertensive ischaemic leg ulcers represent a form of skin infarction due to occlusive subcutaneous arteriolosclerosis. All patients have hypertension, and 60% have diabetes type 2. From the clinical aspect, these leg ulcers can easily be confused with pyoderma gangrenosum or vasculitic skin necrosis. Treatment consists of necrosectomy, negative pressure wound therapy and, eventually, skin grafting.
Disorders of the Lymphatic Vessels
Authors: Mortimer Peter S. , Gordon Kristiana
Published: August 2023

Lymphatic dysfunction interferes with fluid homeostasis, tissue immunity and peripheral fat mobilization. Any chronic oedema represents lymphatic failure. If impaired lymph drainage is solely responsible, then lymphoedema results. This produces characteristic skin changes known as elephantiasis as well as increased fat deposition in the subcutaneous tissues. Impaired immune cell trafficking results in an increased risk of infection, particularly cellulitis/erysipelas, which often becomes recurrent. This chapter describes the clinical consequences of lymphatic dysfunction and in particular the impact on the skin and subcutaneous tissues. The sections are divided according to common clinical presentations.
Flushing and Blushing
Authors: Raghallaigh Síona Ní , Powell Frank C.
Published: August 2023

Flushing and blushing are the result of transient cutaneous vasodilatation that is usually physiological in nature. A blush signifies a psychosocial response to an experienced emotion, whereas a flush is a thermoregulatory response to increased body temperature. Frequent blushing can be associated with considerable anxiety and, in some cases, social phobia. Excessive flushing may be associated with topical agents, food or alcohol intake, or rarely with underlying systemic disease. Clinical features useful in defining the diagnosis include the environmental setting in which the vascular reaction occurs, the extent and pattern of cutaneous involvement, and the presence of associated systemic symptoms. If an underlying systemic disorder is suspected, relevant investigations may be required. Understanding of the mechanisms by which these cutaneous reactions occur has increased, but treatment options remain limited.
Dermatoses of the Male Genitalia
Authors: Bunker Christopher B. , Porter William M.
Published: August 2023

A number of common skin diseases affect the genital and genito‐crural skin only incidentally, and may present in these areas with unusual features. These are dealt with briefly or by cross‐reference to their full description elsewhere. However, those conditions that are entirely or predominantly confined to these regions are discussed in detail.
Dermatoses of Perineal and Perianal Skin
Authors: Mallon Eleanor
Published: August 2023

Dermatologists should be able to assess perineal and perianal skin competently and know when to involve other disciplines. The skin of the perineum includes perianal, groin and scrotum or vulval skin. Common dermatoses easily recognized elsewhere may have a different appearance in the perineum as clinical features can be altered by the microenvironment that exists in the flexures due to heat, moisture and friction. It is important to be familiar with the cutaneous manifestations of intestinal and sexually transmitted diseases. Cutaneous features of conditions such as Crohn disease or tuberculosis are relatively non‐specific and diagnosis of these diseases is reached by demonstration of their typical histology. This chapter concentrates on important entities relevant to perineal and perianal skin including pruritus ani, anal fistula, haemorrhoids, human papillomavirus infection, anal intraepithelial neoplasia and anal cancer.
Dermatoses of the Neonate
Authors: Paige David G.
Published: August 2023

Rashes in the first 4 weeks of life are common and can be alarming for both parents and medical staff. Many of these are entirely innocent and resolve spontaneously and reassurance of the parents is all that is required. It is important to be aware of such ‘benign’ rashes (as well as the appearance of preterm and post‐term skin) when assessing genuine pathology in the neonate. Pathological dermatoses may arise by a number of different mechanisms. Iatrogenic causes (medical procedures) can cause rashes/lesions bothin uteroand in the neonatal period. Transplacental transfer of antibodies, infection or malignant cells from mother to child is another mechanism for causing neonatal rashes. Infection can also be passed on from attendant medical staff. Finally, primary dermatoses may present early in the neonatal period, especially genodermatoses such as collodion baby and epidermolysis bullosa.
Dermatoses and Haemangiomas of Infancy
Authors: Higgins Elisabeth M. , Glover Mary T.
Published: August 2023

An overview of the most common or important dermatoses occurring in the first year of life is presented, under the categories of inflammatory, infective, reactive, developmental/genetic and miscellaneous. Emphasis is given to the key features relative to this age group, and more detailed accounts of specific disorders are found in the specialist sections elsewhere in these volumes. A section on infantile and congenital haemangiomas is also included.
Benign Cutaneous Adverse Reactions to Drugs
Authors: Ardern‐Jones Michael R. , Lee Haur Yueh
Published: August 2023

Adverse drug reactions commonly involve the skin and represent a significant proportion of all drug‐induced illnesses. There is a broad spectrum of phenotypes encountered in cutaneous adverse reactions and many can mimic other inflammatory rashes. Rarely, drug hypersensitivity dermatoses can be life threatening and involve internal organs; however, most eruptions are mild, affect the skin only and are self‐limiting on drug withdrawal. These disorders can be considered as the benign cutaneous adverse reactions.
Severe Cutaneous Adverse Reactions to Drugs
Authors: Walsh Sarah , Yueh Lee Haur , Creamer Daniel
Published: August 2023

Severe life‐threatening cutaneous drug reactions are rare phenomena, and may be clinically heterogeneous. They may be broadly categorized as Stevens–Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms, acute generalized exanthematous pustulosis and drug‐induced generalized exfoliative dermatitis. Each has distinct clinical features, and is associated with systemic disturbance. Overlap syndromes with clinical features of more than one diagnosis are described.
Cutaneous Side Effects of Chemotherapy and Radiotherapy
Authors: Fearfield Louise , Natkunarajah Janakan
Published: August 2023

Chemotherapy drugs are a well‐recognized cause of iatrogenic injury to the skin. Antineoplastic agents generally target rapidly dividing cells and are toxic to organ systems with high proliferative activity, including the skin and its appendages. These adverse effects include toxic erythema, alopecia, hyperpigmentation, nail changes, photosensitivity and papulopustular eruptions. Recently, the emergence of novel targeted agents has led to new patterns of cutaneous toxicity. Occasionally, severe chemotherapy reactions occur, necessitating cessation of the drug, however most dermatoses can be managed by simple measures allowing patients to continue essential anticancer treatment. Radiotherapy‐associated skin side effects are common and can be divided into those occurring early (days to weeks) during the treatment and those occurring late (months to years). Most reactions are due to radiation‐induced dermatitis and are limited to the treated area, however rare skin side effects can occur distant from the radiotherapy‐treated zone.
Pressure Injury and Pressure Ulcers
Authors: Evans Robyn , Ott Carol , Reddy Madhuri
Published: August 2023

Pressure ulcers represent a significant health concern for patients, families and funding agencies. Pressure ulcers are known to increase the length of stay in acute care hospitals and may contribute to premature death. Pressure ulcers are largely preventable with the appropriate assessment and management of the various intrinsic (patient related) and extrinsic (pressure, shear, friction, skin microclimate) factors. They are classified by the extent of damage to the underlying tissue using the National Pressure Ulcer Advisory Panel staging system. There are many choices of support surfaces for the prevention and treatment of pressure ulcers; however, the challenge is to use the most cost‐effective surface given the available evidence. Infection in a pressure ulcer is one of the leading causes of infections in nursing homes and significantly delays healing. Detection of infection in pressure ulcers is challenging as the classic signs and symptoms may be absent in this chronic type of wound.
Cutaneous Photosensitivity Diseases
Authors: Ibbotson Sally , Dawe Robert
Published: August 2023

The photodermatoses are a diverse group of diseases, some of which, such as polymorphic light eruption, are very common and others, such as hydroa vacciniforme or xeroderma pigmentosum, are rare. It is essential not to miss the diagnosis of these conditions and referral to a specialist photodiagnostic centre is advised for many patients. Management depends on the diagnosis but includes prevention and disease suppression. Photoprotection is a mainstay approach for the photodermatoses but is often not sufficient for disease control. Desensitization using photo(chemo)therapy regimens may be feasible and systemic therapies are sometimes needed. Photosensitivity, particularly if chronic and severe, can be associated with significant psychological morbidity, which must be considered. Awareness of the possibility of vitamin D deficiency is also required.
Allergic Contact Dermatitis
Authors: Wilkinson Mark , Orton David
Published: August 2023

Allergic contact dermatitis is the classic delayed hypersensitivity reaction, developing in two phases – sensitization and elicitation. It can have profound effects on affected individuals and may result in sickness, absence from work and increased health expense. Its diagnosis requires consideration of many factors including the patient's history and a physical examination; knowledge of the skin's reaction to various chemicals is also desirable. Above all, it requires a high degree of suspicion on the part of the clinician and tenacity, skill and experience in the investigator. The diagnosis can only be confirmed by interpreting patch test results and the technique in itself has many pitfalls for the unwary. Any sensitization identified needs to be put into the context of a past or present dermatitis, and explanations for allergen avoidance or substitution need to be provided for the patient.
Irritant Contact Dermatitis
Authors: White Jonathan M. L.
Published: August 2023

Irritant contact dermatitis results from a non‐immune specific response to chemical and physical irritants. It is caused or exacerbated by genetic mutations (especially the filaggrin gene) and environmental factors such as temperature, air flow, low humidity and occlusion. These variables at least partly explain the great interindividual variability in irritant reactions. Reactions vary from subjective stinging reactions, mild skin dryness and redness, to potentially life‐threatening chemical burns. Dermatitis of the dorsum of the hand and interdigital space is commonly caused by an irritant dermatitis, although many different clinical patterns may be seen due to different exposures. Patch testing is mandatory to exclude an allergic contact dermatitis. Treatment is by primary prevention, avoidance/substitution of the known irritant (including occupational re‐deployment) and supportive measures. Personal protective equipment must be chosen carefully, with good knowledge of the chemical properties of the relevant irritants.
Occupational Dermatology
Authors: White Jonathan M. L.
Published: August 2023

Occupational skin disease is best described as ‘a skin disease, which would not have occurred if the patient had not been doing the work of that occupation’. Definite proof may be difficult, but the following are suggestive: (i) occupational contact with an agent that caused similar skin changes in others; (ii) similar dermatoses in fellow workers; (iii) consistent chronology between the exposure and the disease; (iv) distribution and morphology consistent with information of exposure, and similar to other cases; and (v) confirmatory test results. Legal definitions vary from country to country, as does the amount of compensation offered. Certain occupations are at high risk of developing skin problems, such as hairdressers, medical staff and construction workers. Irritant contact dermatitis is the commonest work‐related skin condition. Thorough history, examination, investigations and site visits with chemical testing may be required to make a secure diagnosis.
Benign Melanocytic Proliferations and Melanocytic Naevi
Authors: Stefanaki Irene , Antoniou Christina , Stratigos Alexander
Published: August 2023

Benign cutaneous melanocytic proliferations are the most common neoplasms occurring in humans. Although benign in nature, they are often problematic for the patient due to aesthetic concerns or their association with other medical conditions. For dermatologists, melanocytic lesions are generally considered risk factors, precursors or simulants of melanoma, posing significant diagnostic and management issues in clinical practice. This chapter describes the spectrum of benign melanocytic lesions, their divergent clinical varieties and underlying pathogenetic pathways, their histological features, their association with other diseases – particularly melanoma – and their current principles of treatment.
Cutaneous Cysts
Authors: Lear John T. , Madan Vishal
Published: August 2023

This chapter covers benign cystic lesions including epidermoid cysts, milia, trichilemmal cysts and steatocysts. Pathogenesis, diagnosis and management are all discussed.
Cutaneous Histiocytoses
Authors: Tran Thai Hoa , Pope Elena , Weitzman Sheila
Published: August 2023

Skin involvement is common in all forms of histiocytic disorders and is seen at all ages. In general, the histiocytoses can be divided into those involving dendritic cells and those involving the macrophage–monocyte lineage. Langerhans cell histiocytosis is the most common dendritic cell disorder and haemophagocytic lymphohistiocytosis the most common non‐dendritic disorder. Rarer disorders, the non‐Langerhans cell histiocytoses, can be divided into dendritic and non‐dendritic origin and each group further subdivided into those that mainly involve skin but occasionally have a systemic component and those that may include skin but in which the systemic component predominates. This chapter will provide an overview of histiocytic disorders including a brief discussion of possible pathogenetic mechanisms, followed by a more in‐depth discussion of the skin manifestations, pathology and therapy. The similarities and differences between childhood and adult forms of the diseases will be highlighted.
Soft‐Tissue Tumours and Tumour‐Like Conditions
Authors: Calonje Eduardo , Tsai Kenneth Y.
Published: August 2023

In this chapter, most of the mesenchymal (soft‐tissue) tumours involving the skin (including subcutaneous tissue) are described. Practically any soft‐tissue tumour can involve or originate from the skin including the subcutaneous tissue. Although most soft‐tissue tumours arising in the skin are benign or low‐grade malignant (e.g. dermatofibrosarcoma protuberans), some malignant tumours may primarily originate in the skin and their behaviour is usually aggressive. Examples of the latter include angiosarcoma and epithelioid sarcoma. Cutaneous soft‐tissue tumours are often difficult to diagnose histologically and benign lesions are often erroneously diagnosed by pathologists as malignant leading to unnecessary treatment.
Cutaneous Lymphomas
Authors: Whittaker Sean J. , Child Fiona
Published: August 2023

Primary cutaneous lymphomas are extranodal non‐Hodgkin lymphomas and consist of different variants defined by specific clinicopathological and immunophenotypic features. Primary cutaneous T‐cell lymphomas are the most common subset and are derived from resident memory T cells, whereas primary cutaneous B‐cell lymphomas are more closely related to their nodal counterparts with derivation from B cells at different stages of differentiation. Whilst the underlying pathogenesis of cutaneous lymphomas remains unclear, there is emerging evidence for a heterogenous pattern of somatic mutations and epigenetic events. Although the prognosis for many indolent primary cutaneous lymphoma variants remains excellent, the treatment of some rare variants and advanced stages of mycosis fungoides and Sezary syndrome represents an unmet medical need in view of high levels of chemotherapy resistance and limited durable responses. A variety of novel biological agents have been recently approved but long‐term remissions are rare. There is still an urgent need to clarify the underlying molecular pathogenesis and identify more effective targeted therapies for mycosis fungoides and Sézary syndrome.
Basal Cell Carcinoma
Authors: Madan Vishal , Lear John T.
Published: August 2023

Basal cell carcinomas (BCCs) are the commonest of the non‐melanoma skin cancers and are the most common human cancers. Their rising incidence and associated morbidity has generated phenomenal interest in unravelling their pathogenesis, which has also led to a keen interest in the search for newer potential non‐invasive treatments. Unlike other non‐melanoma skin cancers, the relationship between sun‐exposure patterns and pathogenesis of the various subtypes of BCC still remains undetermined. Besides, several complex genotypic, phenotypic and environmental factors contribute to the pathogenesis of BCCs, which are mainly diagnosed clinically. Histology helps in the clinical confirmation of diagnosis and to subtype the BCC. The dermatologist now has several treatment options for BCCs. These range from non‐invasive, topical and photodynamic therapies for superficial BCCs to Mohs micrographic surgery for more complex lesions. The search for other more effective and tissue salvaging therapies continues.
Dermoscopy of Melanoma and Naevi
Authors: Jaimes Natalia , Marghoob Ashfaq A.
Published: August 2023

Dermoscopy has been proven to increase the observer's diagnostic accuracy for skin lesions. It has also increased the sensitivity and specificity for the diagnosis of skin cancer, in particular melanoma, allowing for the detection of more melanomas at an early stage. While naevi usually display a symmetrical and organized dermoscopic pattern, melanomas usually manifest an asymmetrical, disorganized and chaotic pattern. Most melanomas will reveal at least one melanoma‐specific structure (i.e. atypical network, negative network, streaks, crystalline structures, atypical dots/globules, irregular blotch, blue‐white veil, regression structures, atypical vessels, peripheral tan structureless areas). Besides the aforementioned melanoma‐specific structures, melanomas located on the face, chronic sun‐damaged skin, volar skin, nails and mucosae often display other dermoscopic structures of concern such as the annular–granular pattern, polygonal lines, parallel ridge pattern and disruption in parallelism, just to mention a few. This chapter provides an overview of the dermosocopic evaluation of naevi, in particular those naevi that are frequently subjected to biopsy to rule out melanoma, and outlines the dermoscopic features of melanoma, according to their histological subtype and anatomical location.
Merkel Cell Carcinoma
Authors: Becker Jürgen C. , Schrama David , Hausen Axel zur
Published: August 2023

Merkel cell carcinoma (MCC) is a highly aggressive neuroendocrine skin cancer characterized by early and frequent metastasis, resulting in a 5‐year disease‐associated mortality rate of more than 40%. Predisposing factors include immune suppression, sun exposure and advanced age. Most MCCs are characterized by a clonal integration of the Merkel cell polyomavirus into the host genome, and virally encoded proteins appear necessary to maintain tumour cell growth. While MCC is still a rare cancer, its incidence is constantly and rapidly rising. Management of the primary tumour stage includes wide local excision, sentinel lymph node biopsy and adjuvant radiation. Management of systemic disease is, however, challenging. Indeed, while the tumour shows high response rates to chemotherapy, these responses are mostly short lived and no therapy regimen has proven survival benefit. Immunotherapy seems promising but clinical studies are needed to confirm its value.
Skin Cancer in the Immunocompromised Patient
Authors: Harwood Catherine A. , McGregor Jane M. , Proby Charlotte M.
Published: August 2023

The immune system plays a critical role in skin cancer development, progression and destruction. Skin cancers in individuals with compromised immune systems represent a growing challenge in terms of their frequency and diversity as well as their atypical and often aggressive nature. Mortality and morbidity associated with skin tumours in this clinical context are often considerable, their pathogenesis is multifactorial and an evidence base to guide management is lacking in many key areas.
The Skin and Disorders of the Haematopoietic and Immune Systems
Authors: Gniadecki Robert
Published: August 2023

This chapter reviews skin diseases and symptoms that develop secondarily to underlying malignant or benign diseases of the haematopoietic system. Skin lesions may be caused directly by infiltration of the skin with malignant cells (leukaemia cutis and lymphomatous infiltrates) or by paraproteins secreted by malignant plasma cells (amyloid light‐chain amyloidosis, type I cryoglobulinaemia and macroglobulinaemia cutis). A number of skin signs are an indirect effect of the underlying malignancy, such as paraneoplastic conditions or dermatological syndromes associated with haematological neoplasms (Schnitzler syndrome, POEMS, AESOP and TEMPI syndromes, neurofibromatosis, juvenile xanthogranuloma and juvenile myeloid leukaemia). Kikuchi–Fujimoto disease, Kimura disease, Rosai–Dorfman disease and IgG4‐related disease are idiopathic lymphoadenopathies presenting with characteristic skin lesions. Skin infections, eczematous lesions and vasculitis are the most common cutaneous signs of an underlying immunodeficiency. Chronic skin ulcers may accompany different haemoglobinopathies, such as thalassaemias and sickle cell anaemia. Finally, the skin signs of transfusion reactions (acute allergic reactions, transfusion‐associated graft‐versus‐host disease and post‐transfusion purpura) are reviewed. Diseases of the haematopoietic system often manifest themselves in the skin, and some manifestations are so typical that the dermatologist may be the first physician to detect the underlying blood disorder. More commonly, however, skin symptoms arise in the context of a known haematopoietic disease.
The Skin and Disorders of the Heart
Authors: Molin Sonja , Ruzicka Thomas
Published: August 2023

There are several diseases in which both cardiac and skin involvement may be found. Most of these are part of a syndrome or are systemic disorders affecting other organs as well. This chapter focuses on the skin signs of cardiac diseases and hereditary syndromes involving the heart, and skin and cardiac involvement in dermatoses or systemic diseases with cutaneous features.
The Skin and Disorders of the Respiratory System
Authors: Molin Sonja , Ruzicka Thomas
Published: August 2023

There are many disorders that affect both the skin and the respiratory system, ranging from common infections and allergies to complex multisystem diseases. This chapter examines the relationship between the two organ systems and discusses selected disorders from amongst the diverse groups of diseases that may affect both. After a brief discussion of allergic disorders affecting the upper respiratory tract, the chapter focuses on pulmonary involvement in autoimmune disorders, vasculitides, infections and hereditary syndromes.
Skin Ageing
Authors: Sachs Dana L. , Fisher Gary , Voorhees John J.
Published: August 2023

Skin ageing results from both the passage of time and from extrinsic forces, predominantly solar ultraviolet irradiation. Intrinsic ageing is characterized by fine wrinkling and homogenous colour on sun‐protected sites whereas extrinsic ageing is characterized by fine and coarse wrinkling, erythema and dyspigmentation on sun‐exposed sites. Two distinct phenotypes of extrinsic ageing have emerged: atrophic and hypertrophic variants. Tools to measure and quantify skin ageing have been developed and offer therapeutic and research applications. Molecular mechanisms distinguishing intrinsic and extrinsic skin ageing are discussed. The implications of skin ageing are cosmetic, medical and social in nature.
Cosmeceuticals
Authors: Koo Eubee , Kimball Alexandra B. , Wanner Molly
Published: August 2023

The term cosmeceutical refers to a category of skincare products that are purported to have active ingredients whose physiological or pharmacological actions are capable of inducing cosmetic enhancements to the skin. Given a demand for brighter, healthier, younger‐appearing skin, and relatively limited regulatory control, thousands of different cosmeceutical formulations have found their way onto store shelves and onto the skin of hopeful consumers, despite a lack of scientific evidence. This chapter summarizes new and old, common and rare cosmeceutical ingredients; their uses and side effects; and the science, where available, behind the claims.
Soft Tissue Augmentation (Fillers)
Authors: Rzany Berthold
Published: August 2023

Injectable fillers are one of the management cornerstones of aesthetic medicine. They provide a means to address the hallmark of facial ageing, which is volume loss due to fat pad atrophy and malalignment. In addition to volume augmentation, they can be used to decrease wrinkles and folds and improve skin quality. Due to strict Food and Drug Administration requirements only a few fillers are available for use in the USA; however, the remaining worldwide markets are flooded with a number of filler products, many of which have poor or limited safety and efficacy data. It is therefore preferable for the clinician to choose a filler product from a group where at least one good‐quality randomized controlled clinical trial has been published. In addition to product‐related adverse reactions, there are avoidable unwanted results based on misunderstanding of the indication, the underlying anatomy and other technique‐dependent issues. A cautious approach, particularly with new fillers and/or new indications, is recommended.
Audiences
Authors: Sullivan John L.
Published: August 2023

The notion of the audience is a central one in understanding media. The concept has its source in the Latin rootaud, suggesting the processing of auditory messages or spoken language. Indeed, in the feudal period, monarchs and hereditary rulers would often grant an “audience” to their constituents, which indicated the disparity in social station between the two. The modern parlance of the term has shifted away from face‐to‐face communication to refer to a mass audience, or a collection of anonymous individuals who receive a message transmitted via a particular medium. Contemporary scholars have noted that the audience is a fungible concept that is imagined in different contexts to suit different needs. For example, media programmers and advertisers utilize statistical agglomerations of individual viewers to help shape decisions about media content, while public opinion survey data are regularly used to shape public policy. Increasingly, thanks to the interactive nature of online media, particularly social media, the formerly clear distinctions between media producers and audiences are blurring, causing some conceptual murkiness about the nature of an audience versus media users.
Gendered Institutions/Organizations
Authors: Ruspini Elisabetta
Published: August 2023

Gender
has been defined as a complex multidimensional, multilevel, and dynamic structure of social relations that establish a specific gender order in a given society. Gender inequality involves gender norms and values which give rise to differences in the distribution of (material and nonmaterial) resources between women and men at both the micro‐level action (everyday life) and macro‐level institutions and practices. Institutions and organizations play a key role in the construction of gender and in the reinforcement of gender inequality, affecting choices and opportunities by unequally allocating resources and privilege.
Hybrid Theories of Well‐Being
Authors: Woodard Christopher
Published: August 2023

Hybrid theories of well‐being combine elements of two or more kinds of theory. The most familiar kinds of hybrid combine a subjective requirement (e.g., that a constituent of well‐being is enjoyed or desired) with an objective requirement (e.g., that it is also good). This entry discusses a number of such views, but then generalizes the discussion in two ways: first, by considering hybrids that combine two or more subjective requirements or two or more objective requirements; and, second, by considering views according to which each component amplifies the value of the other(s) rather than being a necessary condition for the value of the other(s). The upshot is that the category of hybrid theories of well‐being is much larger than is usually realized and contains many views that have not yet been explored.
Narcissism
Authors: Hopwood Mark
Published: August 2023

Deriving from the myth of Narcissus, in which a beautiful youth falls in love with his own reflection, the concept of narcissism was given its first systematic treatment in Sigmund Freud's 1914 essay “On Narcissism.” Since Freud's account of narcissism remains the starting point for most subsequent discussions of the topic, this entry begins with a brief summary of Freud's views before moving on to consider some of the major questions that have consistently arisen in philosophical treatments of narcissism and self‐love. How ought we to draw the line between healthy self‐esteem and pathological narcissism? Given the apparently ubiquitous presence of “the dear self” (to use Kant's term) in human consciousness, what would it mean to cultivate a truly nonnarcissistic concern for others, and is such a thing possible – or even desirable?
Transgender Rights
Authors: Kapusta Stephanie
Published: August 2023

In this entry, I discuss the moral rights of transgender persons – that is, of those persons who do not identify with the gender assigned to them at birth, or who otherwise cross conventional gender boundaries. So‐called “transgender rights” are not applicable only to transgender persons. They are conceived of as human rights. The reason they can be called “transgender rights” is because a historical movement – the transgender movement – has campaigned for them over the past few decades, giving them a distinct, hitherto neglected, place within rights theory and law. I analyze a selection of human rights documents to determine the content of transgender rights. Principal among these are what I call the “core gender rights”: the right to self‐defined gender identity, and the right to gender expression. I present some ethical justifications for the right to respect for self‐defined gender identity. Next, I discuss the ethical justification of the right to gender expression, and consider specific gender expressions, such as the right to access gendered spaces and the right to the modification of one's sex characteristics. I conclude with some remarks concerning the goals of transgender rights discourse.
Wu‐wei
Authors: Littlejohn Ronnie
Published: August 2023

In Chinese, Daoist morality (wu‐wei為無) is a spontaneous and effortless movement that accords in every way with the normative order of the cosmos.Wu‐weiis a conduct operator along with other terms such as action, attempt, omission, and refusal. It is morally significant in describingknowing howto move (behave); this isshownrather thansaid, and is made possible by a kind of positioning of consciousness and body characterized by stillness, emptying the mind of human distinctions, open receptiveness, and nourishing life (yangsheng養生). The result is that this type of movement shows the transformation of the person.
Atmosphärische Einträge in den Boden
Authors: Schleyer Ruprecht
Published: August 2023

Sowohl zur Beurteilung des Stoffverhaltens, als auch zur Abwendung von Gefahren für den Boden und die Menschen ist die Kenntnis der Eintragswege von Bedeutung. Im Hinblick auf die Belastungssituation (einmalige oder repetitive Einträge, aerobe oder anaerobe Bedingungen, schwach toxische bzw. toxische Konzentrationen etc.) können große Unterschiede auftreten, die zu berücksichtigen sind. Aufgrund der differierenden Expositionsbedingungen fallen die Abwehrmaßnahmen auch unterschiedlich aus. Im vorliegenden Kapitel werden die verschiedenen Möglichkeiten atmosphärischer Einträge in den Boden (z. B. Deposition) diskutiert.
Klärschlamm
Authors: Litz Norbert
Published: August 2023

Sowohl zur Beurteilung des Stoffverhaltens, als auch zur Abwendung von Gefahren für den Boden und die Menschen ist die Kenntnis der Eintragswege von Bedeutung. Im Hinblick auf die Belastungssituation (einmalige oder repetitive Einträge, aerobe oder anaerobe Bedingungen, schwach toxische bzw. toxische Konzentrationen etc.) können große Unterschiede auftreten, die zu berücksichtigen sind. Aufgrund der differierenden Expositionsbedingungen fallen die Abwehrmaßnahmen auch unterschiedlich aus. Im vorliegenden Kapitel werden die Herkunft, der Nutzen und die Inhaltstoffe (z. B. Mineralöle, polyaromatische Kohlenwasserstoffe) von Klärschlamm diskutiert. Klärschlamm ist das Produkt der Abwasserreinigung in kommunalen oder industriell/gewerblichen Abwasseraufbereitungs‐ bzw. Kläranlagen.
Altlasten
Authors: Kerndorff Helmut
Published: August 2023

Altlasten sind stillgelegte Abfallbeseitigungsanlagen sowie Grundstücke, auf denen Abfälle behandelt, gelagert oder abgelagert worden sind (Altablagerungen) und Grundstücke stillgelegter Anlagen und sonstige Grundstücke, auf denen mit umweltgefährdenden Stoffen umgegangen worden ist (Altstandorte) durch die schädliche Bodenveränderungen oder sonstige Gefahren für den Menschen hervorgerufen werden. Dies bezieht sich vorrangig auf stofflich bedingte Einträge in die Umwelt, sie zählen zu den “punktuellen” Umwelt‐Kontaminationen. Im vorliegenden Artikel werden die verschiedenen Eintragsquellen, Stoffeinträge und die Kontaminationskriterien erläutert.
Isoproturon
Authors: Schmidt Burkhard
Published: August 2023

Das Herbizid Isoproturon (CAS‐Nr.: 34123‐59‐6, auch 3‐p‐Cumenyl‐1,1‐dimethylharnstoff) ist ein zugelassenes, systemisches Boden‐ und Blattherbizid, das selektiv in toleranten Kulturen (z. B. Weizen, Gerste, Roggen) eingesetzt wird und 1974 auf den Markt gelangte. Neben der Reinsubstanz ist es teilweise in verschiedenen Mischprodukten mit weiteren Herbiziden enthalten. Das Herbizid wirkt durch Inhibierung der Photosynthese (PS II). In Böden wird Isoproturon bei praxisüblichen Aufwandmengen weitgehend abgebaut. Mit Ausnahme von Pflanzen und Algen ist die toxische Wirkung auf Organismen gering.
Toluen
Authors: Struppe Thomas
Published: August 2023

Toluen (108‐88‐3, auch Methylbenzol) findet bei der Herstellung von Saccharin, Medizinprodukten, Parfümen, Benzoesäure und ebenso als Ausgangsprodukt für Trinitrotoluol Verwendung. Ferner ist Toluen ein wichtiges Lösungsmittel in der Farbenindustrie, für Harze, Gummi und Öle. Es ist der in der Umwelt am häufigsten vorkommende Kohlenwasserstoff. Es gelangt überwiegend durch Emissionen aus der chemischen Industrie (Ausgasen aus Farben und Lacke, Verbrennungsprozesse) in die Umwelt. Toluol ist nicht persistent, wenig toxisch und die Konzentrationen in der Umwelt weiterhin abnehmend.
Düngemittel und Bodenhilfsstoffe
Authors: Schaaf Harald
Published: August 2023

Sowohl zur Beurteilung des Stoffverhaltens, als auch zur Abwendung von Gefahren für den Boden und die Menschen ist die Kenntnis der Eintragswege von Bedeutung. Die Schadstoffbewertung von Düngemitteln und Bodenhilfsstoffen ist auf der Grundlage einer abwägenden Gesamtkonzeption vorzunehmen, welche Fragen der Nachhaltigkeit im Sinne der Schonung nicht erneuerbarer Ressourcen und Fragen des Bodenschutzes gleichermaßen in die Bewertung einbezieht. Im vorliegenden Kapitel werden die Unterschiede zwischen Düngemitteln und Bodenhilfsstoffen näher erläutert und die unterschiedlichen Arten und deren Inhaltstoffe beschrieben.
Tributylzinn‐Verbindungen
Authors: Nestler Angelika , Terytze Konstantin
Published: August 2023

Tributylzinn‐Verbindungen zählen zu den Zinn‐organischen Verbindungen (Synonym: Organozinn‐Verbindungen) mit einer oder mehreren Sn‐C‐Bindungen und leiten sich mit wenigen Ausnahmen vom vierwertigen Zinn ab. Allgemein gehören sie zu den Metall‐organischen Verbindungen. Tributylzinn (TBT)‐Verbindungen stellen eine Untergruppe der Stoffgruppe der Trialkyl‐Organozinn‐Verbindungen (ebenfalls noch Trimethylzinn‐ und Trioktylzinn‐Verbindungen) dar. Trialkyl‐Organozinn‐Verbindungen sind ohne einen Substituenten einwertige Kationen. Tributylzinn‐Verbindungen werden aufgrund ihrer bioziden Wirkung in Antifouling‐Agenzien, im industriellen Holzschutz, als Zusatz für Polyvinylchlorid sowie im Materialschutz eingesetzt: Ihre Verwendung ist rückläufig. Sie zählen zu den giftigsten Stoffen für aquatische Organismen, die jemals in Gewässer eingetragen worden sind! Relative lange Abbauzeiten von TBT‐Verbindungen in Böden ermöglichen eine Akkumulation. Die Verwendung muss daher streng reglementiert und Emissionen überwacht werden.
Love withdrawal use by toddlers: Multi‐informant associations with aggression and parents' use of love withdrawal
Authors: Brittain Heather , Vaillancourt Tracy
Published: August 2023

Love withdrawal is a form of interpersonal manipulation that shares many features with relational aggression; its use by children has not been examined. Guided by social learning theory, we sought to investigate the prevalence of toddlers' use of love withdrawal toward caregivers (parents and teachers) and further investigate how this behavior was associated with relational and physical aggression and parents' use of love withdrawal. These aims were examined using parent and teacher reports in a sample of 198 toddlers (Mage = 33.62 months; SD = 5.00 months; 50.5% girls). We found that most toddlers used love withdrawal directed at parents (79.2%) and teachers (72.1%) when angry and displayed this type of behavior more than relational and physical aggression. Accounting for household income, hours per week in childcare, and child age in months, as well as classroom clustering, we found that relational aggression, and not physical aggression, predicted the use of love withdrawal by toddlers (teacher reports), and that the associations were stronger for love withdrawal and relational aggression than for physical aggression. We also found that parents' use of love withdrawal toward their child was correlated with their reports of their child's use of love withdrawal, but not with their child's use of aggression. These results highlight the importance of considering the use of love withdrawal by children given its association with aggression which is linked to poorer psychosocial functioning.
Disease progression of spinocerebellar ataxia types 1, 2, 3 and 6 before and after ataxia onset
Authors: Jacobi Heike , Schaprian Tamara , Schmitz‐Hübsch Tanja , Schmid Matthias , Klockgether Thomas ,   the EUROSCA and RISCA Study Groups
Published: August 2023

Objective

Our aim was to study the evolution of ataxia and neurological symptoms before and after ataxia onset in the most common spinocerebellar ataxias (SCAs), SCA1, SCA2, SCA3 and SCA6. We therefore jointly analysed the data of the EUROSCA and RISCA studies, which recruited ataxic and non‐ataxic mutation carriers.

Methods

We used mixed effect models to analyse the evolution of Scale for the Rating and Assessment of Ataxia (SARA) scores, SCA Functional Index (SCAFI) and Inventory of Non‐Ataxia Signs (INAS) counts. We applied multivariable modelling to identify factors associated with SARA progression. In the time interval 5 years prior to and after ataxia onset, we calculated sensitivity to change ratios (SCS) of SARA, SCAFI and INAS.

Results

2740 visits of 677 participants were analysed. All measures showed non‐linear progression that was best fitted by linear mixed models with linear, quadratic and cubic time effects. R2 values indicating quality of the fit ranged from 0.70 to 0.97. CAG repeat was associated with faster progression in SCA1, SCA2 and SCA3, but not SCA6. 5 years prior to and after ataxia onset, SARA had the highest SCS of all measures with a mean of 1.21 (95% CI: 1.20, 1.21) in SCA1, 0.94 (0.93, 0.94) in SCA2 and 1.23 (1.22, 1.23) in SCA3.

Interpretation

Our data have important implications for the understanding of disease progression in SCA1, SCA2, SCA3 and SCA6 across the lifespan. Furthermore, our study provides information for the design of interventional trials, especially in pre‐ataxic mutation carriers close to ataxia onset and patients in early disease stages.
Adaptive non‐singular second‐order terminal sliding mode control for cyber‐physical systems subject to actuator cyber‐attacks and unwanted disturbances
Authors: Nemati Abbas , Peimani Mansour , Mobayen Saleh , Sayyedfattahi Sayyedjavad
Published: August 2023

In this study, a novel strategy of the adaptive non‐singular second‐order terminal sliding mode (SOTSM) control technique for the finite time stabilization of cyber‐physical systems (CPSs) is proposed. By utilizing the proposed nonlinear sliding surface, the reaching phase is obliterated and the entire system's robust operation is ameliorated. The offered online adaptive laws deal with the unwanted disturbances and cyber‐attacks, so that there is no need to identify their upper bounds. The designed adaptive non‐singular SOTSM control technique provides the strong robustness of CPSs in the presence of the unwanted disturbances and cyber‐attacks. Also, it guarantees high precision, pliable performance, fast response, smooth control, chattering‐free operation without transient oscillations, and appropriate convergence in the finite time. Numerical simulation results demonstrate effectiveness and success of the proposed adaptive non‐singular SOTSM control technique compared to the results of state feedback control (SFC), conventional sliding mode control (SMC), and integral‐type SMC methods.