Art Papier

Smallpox Vaccination: A Review, Part II. Adverse Events

Smallpox vaccination of health care workers, military personnel, and some first responders has begun in the United States in 2002-2003 as one aspect of biopreparedness. Full understanding of the spectrum of adverse events and of their cause, frequency, identification, prevention, and treatment is imperative. This article describes known and suspected adverse events occurring after smallpox vaccination.

Smallpox Vaccination: A Review, Part I. Background, Vaccination Technique, Normal Vaccination and Revaccination, and Expected Normal Reactions

Because smallpox could be a factor in bioterrorism, the United States has provided guidelines for smallpox vaccination of certain members of the population, including health care workers and first responders, as well as military personnel. A plan for more extensive vaccination, if it is needed in the event of a bioterrorist attack, is being developed under the aegis of the Centers for Disease Control and Prevention. The characteristics of smallpox vaccine, the technique of administration, and the expected reactions to primary vaccination and revaccination are outlined in this article.

Framework for improved communication: the Dermatology Lexicon Project

A standardized dermatology vocabulary is central to our collective ability to gather clinical information consistently for patient care, to retrieve information for research or disease management, as well as to conduct outcomes analysis for quality improvement. The deficiencies of current classifications have been recognized by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) in their decision to fund the development of a standard complete reference terminology for dermatology. The Dermatology Lexicon will have a major impact both on clinical care and on dermatologic research. Accuracy in medical records and telemedicine communications will be improved. Reliable terminology will provide for more complete and consistent documentation and data aggregation and reporting. In order to create a useful, sustainable lexicon, involvement of the dermatology community is essential.

Dermatology and HIV/AIDS in Africa

Human immunodeficiency virus and the acquired immunodeficiency syndrome (HIV/AIDS) have greatly complicated dermatologic disease and the required care in most regions of Africa. Opportunistic infections, ectoparasites, Kaposi sarcoma, and skin manifestations of systemic infections are exceedingly common in patients with HIV/AIDS. Dermatologists have contributed significantly to our knowledge base about HIV/AIDS and have played an important educational role regarding the clinical manifestations historically. Because of the increased burden of skin disease in Africa due to the HIV/AIDS epidemic we must redouble our efforts to provide dermatology education to care providers in Africa. We review the burden of skin disease in Africa, how it relates to HIV/AIDS and global infectious disease, current educational strategies in Africa to address this need, and suggest potential solutions to move these efforts forward.

Fighting Babel with Precise Definitions of Knowledge

There are few standards for nomenclature in dermatology. Authors often designate a novel constellation of clinical, histological, biochemical, or genetic findings with a new disease appellation. If the reviewers and editors of a journal do not object, a new name enters the literature. This has been done for more than 200 years in dermatology and other clinical disciplines. Authors are often assiduous in explaining why “their condition” differs from other named/known diseases based on their review of the literature—but such reviews are performed with varying degrees of diligence, and many authors do not review literature published before the advent of computerized databases or literature that is otherwise unavailable in electronic form, resulting in incomplete results. A recent review of the past 5 years of dermatological literature showed that new-disease naming is still a frequent occurrence (A Ruiz de Luzuriaga, personal communication). This naming phenomenon would be a charming curiosity if it were not for the need for precise diagnoses for national databases, insurance-claim filing and subsequent reimbursement, and explaining diagnoses to patients.