Dermatologic Manifestations of Musicians: a Case Report and Review of Skin Conditions in Musicians

Total Page:16

File Type:pdf, Size:1020Kb

Dermatologic Manifestations of Musicians: a Case Report and Review of Skin Conditions in Musicians ContaCt Dermatitis Dermatologic Manifestations of Musicians: A Case Report and Review of Skin Conditions in Musicians Kathleen Vine, MD; Vincent DeLeo, MD Chronic practice and performance with a musi- musician with a unique allergic contact dermatitis cal instrument predisposes musicians to several to nickel sulfate and possibly palladium and cobalt unique and characteristic dermatoses, reflecting chloride in his tuba. We also review several der- the hours of dedication to practice to advance matologic manifestations of musical instrument– their artistic skill. This article briefly discusses related dermatitides. a case of a professional musician with a unique allergic contact dermatitis to nickel sulfate Case Report and possibly palladium and cobalt chloride in A 23-year-old man with a medical history of his tuba. We also review several dermatologic asthma as a child presented with an itchy rash on causes and manifestations of musical instrument– his bilateral arms and chest of 6 months’ duration related dermatitides. CUTIS(Figure). He was in good general health, was not tak- Cutis. 2011;87:117-121. ing any medications, and had no known medication allergies. The patient was a full-time music student who specialized in playing the tuba. His daily routine usicians, both amateur and professional, included several hours of practice with his tuba to are a unique subpopulation of dermatology perfect his art. On physical examination, the patient M patients, as their skin and mucosal surfaces exhibited well-demarcated, erythematous, scaling are exposedDo to mechanical forcesNot and chemical sub- plaques Copy on his bilateral forearms, bilateral upper stances characteristic to the instrument of their spe- arms, and chest. cialty. Often these skin findings are manifestations To rule out allergic contact dermatitis, the patient of countless hours of dedication to both practice and underwent patch testing using the standard North performance with their musical instrument. Several American Contact Dermatitis Group contact aller- dermatologic findings with names identifying the gens as well as allergens from a supplemental tray culprit instrument coupled with the characteris- containing several metals (ie, titanium, molyb- tic distribution of skin lesions have been coined, denum, chromate, gold, silver, platinum, tin, including fiddler’s neck, flautist’s chin, guitarist’s copper). It was believed that the patient was likely nipple, and harpist’s finger. The underlying process allergic to one of the metals he was exposed to triggering the skin manifestations may be related in his tuba. The patch tests results revealed that to localized pressure, friction-induced mechanical the patient had a positive reaction to nickel sul- shearing forces, allergic or irritant contact dermatitis, fate, palladium, and cobalt chloride. The tuba infections (bacterial or viral), psychological factors was made of brass, which does not contain any of (anxiety), or excessive saliva or sweat production. these metals. The possibility of the patient having This article briefly discusses a case of a professional an allergic contact dermatitis to one or several of the metal connectors and posts on the tuba, which were not brass, was then suspected. On further investiga- From the Department of Dermatology, St. Luke’s-Roosevelt Hospital tion, a dimethylglyoxime test revealed that several of Center, New York, New York. The authors report no conflict of interest. the nonbrass metal connectors and posts on the tuba Correspondence: Kathleen Vine, MD, 1090 Amsterdam Ave, Ste 11B, did in fact contain nickel. The patient was given New York, NY 10025 ([email protected]). a diagnosis of allergic contact dermatitis to nickel WWW.CUTIS.COM VOLUME 87, MARCH 2011 117 Copyright Cutis 2011. No part of this publication may be reproduced, stored, or transmitted without the prior written permission of the Publisher. Contact Dermatitis Table 1. Mechanisms Contributing to Dermatologic Conditions in Musicians Trauma (ie, pressure/friction) Blisters Calluses Erosions Hemorrhage Onycholysis A 23-year-old man with well-demarcated, erythematous, Allergic Contact Dermatitis scaling plaques on his bilateral forearm and bilateral upper arm, corresponding to areas of contact with Exotic woods his tuba. Metals Resins sulfate and possibly palladium and cobalt chloride Stains that he was exposed to in the nonbrass parts and Varnishes connections of his tuba. He was instructed to wear protective clothing on his arms while practicing and Irritant Contact Dermatitis performing to minimize his exposure to nickel. The Acne mechanica patient was relieved to discoverCUTIS the etiology of his Cheilitis skin lesions. Following use of a mild topical corti- costeroid and protective clothing, his skin lesions Fiddler’s neck greatly improved. The patient is considering the purchase of a new tuba made of silver. Infection Abscess Comment Bacterial infections Long-termDo practice and performance Not with a musical Copy instrument predisposes musicians to several unique Folliculitis and characteristic dermatoses reflecting the hours Herpes labialis of dedication to practice to advance their artistic Paronychia skill. The mechanisms contributing to the resulting dermatologic condition(s) include one or a combina- Psychological-Related Skin Disorders tion of the following causes: trauma, allergic contact (ie, anxiety) dermatitis, irritant contact dermatitis, infection, and psychological effects (Table 1). Hyperhidrosis In a self-reported survey of 412 musicians con- Hypersalivation 1 ducted by Gambichler et al, roughly 21% of musi- Xerostomia cians described an instrument-related skin disorder. Trauma and contact dermatitis were among the main reasons for development of instrument-related dermatoses and findings were significantly associated with both high practice frequency (P5.022) and professional musician status (P5.001).1 marks,’ which may denote the occupation of the One of the most common causes of skin conditions person.” For instance, Garrod pads are calluses often in musicians is repetitive physical trauma. According found on the dorsal proximal interphalangeal joints to Adams,2 “formation of calluses in instrumentalists of the index or middle fingers of violinists from long- may provide protection against additional trauma term skin trauma.3 Adams2 also discusses chronic and can thus be considered valid ‘occupational paronychia of pianists and harpists and onycholysis 118 CUTIS® WWW.CUTIS.COM Copyright Cutis 2011. No part of this publication may be reproduced, stored, or transmitted without the prior written permission of the Publisher. Contact Dermatitis with subungual hemorrhage that develops secondary to repeated nail trauma from plucking string instru- Table 2. ments. Finger callosities of harpists and drummers Common Allergens Used for Patch as well as lip callosities of clarinet, oboe, and horn 2-4 players also are fairly common among both amateur Testing in Musicians and professional musicians.2 Multiple etiologies (ie, traumatic and allergic Chromium contact mechanisms) often overlap and contribute to Cobalt instrument-associated dermatitis. Cohen3 addressed both traumatic and allergic causes of skin lesions on Colophony (rosin) the fingertips of musicians of string instruments. He Exotic woods (Makassar ebony, Cocobolo, discussed the case of a 6-year-old girl who developed African Blackwood, Brazilian and Indian a left index finger blister while learning to play the rosewood, ebony wood) harp. The blister was attributed to repeated trauma from contact with taut harp strings; however, in addi- Nickel sulfate tion to trauma-induced lesions, Cohen3 added that string instrumentalists may develop allergic contact Paraphenylenediamine dermatitis to chromium and nickel present in the Propolis (bee glue) cello, guitar, harp, sitar, and violin. Electric guitarists are exposed to chromium in the strings, bridge, frets, Wood alcohols and chromate leather guitar accessories. Cellists and violinists are exposed to nickel in the handles and clamp components of their instruments.3 Exposure to these allergic substances in addition to chronic trauma leads to development of a characteristic instrument-related dermatitis. Musicians also may developCUTIS allergic contact der- skin conditions were seen in violin and viola players. matitis to nonmetal components of their instruments Most responders reported fiddler’s neck, a localized including paraphenylenediamine, which is found in lichenification of the left side of the neck just below black-dyed stringed bows and instrument chin rests; the angle of the jaw. A combination of factors were propolis (bee glue) used in violin varnish; cane reed attributed to development of fiddler’s neck, includ- found in mouthpieces of saxophones; and rare woods ing increased pressure, friction, and occlusion on the (ie, Brazilian, Indian, and East Indian rosewood, and skin from the instrument; a poorly fitted chin rest; ebony)Do used to construct fingerboardsNot and structural poor hygiene;Copy and excessive perspiration.5 components of string instruments.3 A literature Moreno et al6 also discussed allergic and irri- search conducted by Lombardi et al4 found that the tant contact dermatitis–induced fiddler’s neck in most frequently reported allergic contact sensitizers 2 female viola players. Each musician exhibited affecting string and wind instrument players were well-demarcated, erythematous, scaling, infiltrated colophony, exotic woods (Makassar ebony found in plaques on
Recommended publications
  • Lecture Three Systems Systems
    Complex Complex Sociotechnical Press... Sociotechnical Lecture Three Systems Systems Stories of Complex Sociotechnical Systems: Measuring Measuring Measurement, Mechanisms, and Meaning Happiness Happiness Some motivation Some motivation Measuring emotional Measuring emotional Lipari Summer School, Summer, 2012 content content Data sets Data sets Analysis I “Social Scientists wade into the Tweet Analysis Songs Songs Prof. Peter Dodds Blogs stream” by Greg Miller, Blogs Tweets Science, 333, 1814–1815, 2011 [15] Tweets Positivity Bias Positivity Bias Department of Mathematics & Statistics | Center for Complex Systems | “Does a Nation’s Mood Lurk in Its Songs and Vermont Advanced Computing Center | University of Vermont References I References Blogs?” by Benedict Carey New York Times, August 2009. () I More here: http://www.uvm.edu/∼pdodds/research/ () Licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License. 1 of 83 4 of 83 Complex Complex Outline Sociotechnical Happiness: Sociotechnical Systems Systems Measuring Measuring Measuring Happiness Happiness Happiness Some motivation Some motivation Some motivation Measuring emotional Measuring emotional content content Measuring emotional content Data sets Data sets Data sets Analysis Analysis Songs Songs Blogs Blogs Tweets Tweets Analysis Positivity Bias Positivity Bias Songs References References Blogs Tweets Bentham: Jefferson: Positivity Bias Socrates et al.: hedonistic . the pursuit of eudaimonia [8] calculus happiness References 2 of 83 6 of 83 Complex Complex
    [Show full text]
  • June 2020 Volume 87 / Number 6
    JUNE 2020 VOLUME 87 / NUMBER 6 President Kevin Maher Publisher Frank Alkyer Editor Bobby Reed Reviews Editor Dave Cantor Contributing Editor Ed Enright Creative Director ŽanetaÎuntová Design Assistant Will Dutton Assistant to the Publisher Sue Mahal Bookkeeper Evelyn Oakes ADVERTISING SALES Record Companies & Schools Jennifer Ruban-Gentile Vice President of Sales 630-359-9345 [email protected] Musical Instruments & East Coast Schools Ritche Deraney Vice President of Sales 201-445-6260 [email protected] Advertising Sales Associate Grace Blackford 630-359-9358 [email protected] OFFICES 102 N. Haven Road, Elmhurst, IL 60126–2970 630-941-2030 / Fax: 630-941-3210 http://downbeat.com [email protected] CUSTOMER SERVICE 877-904-5299 / [email protected] CONTRIBUTORS Senior Contributors: Michael Bourne, Aaron Cohen, Howard Mandel, John McDonough Atlanta: Jon Ross; Boston: Fred Bouchard, Frank-John Hadley; Chicago: Alain Drouot, Michael Jackson, Jeff Johnson, Peter Margasak, Bill Meyer, Paul Natkin, Howard Reich; Indiana: Mark Sheldon; Los Angeles: Earl Gibson, Andy Hermann, Sean J. O’Connell, Chris Walker, Josef Woodard, Scott Yanow; Michigan: John Ephland; Minneapolis: Andrea Canter; Nashville: Bob Doerschuk; New Orleans: Erika Goldring, Jennifer Odell; New York: Herb Boyd, Bill Douthart, Philip Freeman, Stephanie Jones, Matthew Kassel, Jimmy Katz, Suzanne Lorge, Phillip Lutz, Jim Macnie, Ken Micallef, Bill Milkowski, Allen Morrison, Dan Ouellette, Ted Panken, Tom Staudter, Jack Vartoogian; Philadelphia: Shaun Brady; Portland: Robert Ham; San Francisco: Yoshi Kato, Denise Sullivan; Seattle: Paul de Barros; Washington, D.C.: Willard Jenkins, John Murph, Michael Wilderman; Canada: J.D. Considine, James Hale; France: Jean Szlamowicz; Germany: Hyou Vielz; Great Britain: Andrew Jones; Portugal: José Duarte; Romania: Virgil Mihaiu; Russia: Cyril Moshkow.
    [Show full text]
  • UF Student Becomes Youngest Elected Official In
    We Inform. You Decide. www.alligator.org VOLUME 115 ISSUE 12 MONDAY, NOVEMBER 16, 2020 Not officially associated with the University of Florida Published by Campus Communications, Inc. of Gainesville, Florida Is it enough? UF students ask for more mental health services CWC FUNDING CRITICISMS Escoto said program directors HAVE COMPOUNDED began researching virtual counsel- AS STUDENTS EXPRESS ing alternatives, setting up technol- DISSATISFACTION WITH THE ogy and training staff to jumpstart STATE OF THE PROGRAM their tele-mental health services as soon as UF moved online. The cen- By Jack Prator ter dipped into its savings to pay Alligator Staff Writer for these unforeseen expenses. He expects that remote CWC Editor’s note: This article services are not just a temporary contains a reference to suicidal solution to the challenges of the thoughts. Students were granted pandemic. anonymity for reasons including “We’re kind of surprised that it the sensitivity of the topic and actually works,” Escoto said. “It’s their ongoing interactions with been pretty effective in a lot of the CWC. spaces. And so, there is no reason for us to go back to fully providing “U Matter, We Care” is the slo- everything in person.” gan adopted by UF’s Counseling He said he expects to see a hy- & Wellness Center. It feels like an brid option developed, when it is empty gesture to some students safe to do so in light of the pan- who have sought out the center’s demic, with the hope it provides services. better flexibility for students. Students’ experiences vary, After being on the waitlist for with accounts of long wait times, two weeks, a 19-year-old UF astro- feelings of being brushed off by physics sophomore said she saw CWC counselors and a lack of a CWC counselor for four months transparency about UF’s available before the pandemic hit.
    [Show full text]
  • Canadian Clinical Practice Guideline on the Management of Acne (Full Guideline)
    Appendix 4 (as supplied by the authors): Canadian Clinical Practice Guideline on the Management of Acne (full guideline) Asai, Y 1, Baibergenova A 2, Dutil M 3, Humphrey S 4, Hull P 5, Lynde C 6, Poulin Y 7, Shear N 8, Tan J 9, Toole J 10, Zip C 11 1. Assistant Professor, Queens University, Kingston, Ontario 2. Private practice, Markham, Ontario 3. Assistant Professor, University of Toronto, Toronto, Ontario 4. Clinical Assistant Professor, University of British Columbia, Vancouver, British Columbia 5. Professor, Dalhousie University, Halifax, Nova Scotia 6. Associate Professor, University of Toronto, Toronto, Ontario 7. Associate Clinical Professor, Laval University, Laval, Quebec 8. Professor, University of Toronto, Toronto, Ontario 9. Adjunct Professor, University of Western Ontario, Windsor, Ontario 10. Professor, University of Manitoba, Winnipeg, Manitoba 11. Clinical Associate Professor, University of Calgary, Calgary, Alberta Appendix to: Asai Y, Baibergenova A, Dutil M, et al. Management of acne: Canadian clinical practice guideline. CMAJ 2015. DOI:10.1503/cmaj.140665. Copyright © 2016 The Author(s) or their employer(s). To receive this resource in an accessible format, please contact us at [email protected]. Contents List of Tables and Figures ............................................................................................................. v I. Introduction ................................................................................................................................ 1 I.1 Is a Clinical Practice Guideline
    [Show full text]
  • The Malware Book 2016
    See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/305469492 Handbook of Malware 2016 - A Wikipedia Book Book · July 2016 DOI: 10.13140/RG.2.1.5039.5122 CITATIONS READS 0 13,014 2 authors, including: Reiner Creutzburg Brandenburg University of Applied Sciences 489 PUBLICATIONS 472 CITATIONS SEE PROFILE Some of the authors of this publication are also working on these related projects: NDT CE – Assessment of structures || ZfPBau – ZfPStatik View project 14. Nachwuchswissenschaftlerkonferenz Ost- und Mitteldeutscher Fachhochschulen (NWK 14) View project All content following this page was uploaded by Reiner Creutzburg on 20 July 2016. The user has requested enhancement of the downloaded file. Handbook of Malware 2016 A Wikipedia Book By Wikipedians Edited by: Reiner Creutzburg Technische Hochschule Brandenburg Fachbereich Informatik und Medien PF 2132 D-14737 Brandenburg Germany Email: [email protected] Contents 1 Malware - Introduction 1 1.1 Malware .................................................. 1 1.1.1 Purposes ............................................. 1 1.1.2 Proliferation ........................................... 2 1.1.3 Infectious malware: viruses and worms ............................. 3 1.1.4 Concealment: Viruses, trojan horses, rootkits, backdoors and evasion .............. 3 1.1.5 Vulnerability to malware ..................................... 4 1.1.6 Anti-malware strategies ..................................... 5 1.1.7 Grayware ............................................
    [Show full text]
  • International Journal of Scientific Research
    ORIGINAL RESEARCH PAPER Volume-9 | Issue-1 | January-2020 | PRINT ISSN No. 2277 - 8179 | DOI : 10.36106/ijsr INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH TYPES AND VARIANTS OF ACNE Dermatology Shailee Patel ABSTRACT Acne occur when pores of skin are blocked with oil, dead skin, or bacteria. It can occur when excessive oil is produced by follicles, bacteria build up in pores, and dead skin cells accumulate in pores. All these problem contribute in development of pimple. Acne are majorly seen among teenagers but they can also occur in adults. There are varying from of acne, and their varying treatment. KEYWORDS 1.INTRODUCTION ulcerative colitis and Crohn's disease and syndromes, such as Acne is linked to the change in hormone level during puberty. Acne is a synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) and disorder that is seen worldwide. Acne is a disease of the teenagers but pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) can be seen even in newborn children and also adults. Age and gender syndromes. also play a very important role in onset of acne. Acne most commonly occur between the ages of 10-13 years. Girls have an earlier onset 3.4 Occupational Acne which easily contribute to the onset of puberty in girls than in boys. The Occupational acne is defined as development of acne-like lesions after disease severity in more in boys during the late adolescence. Acne exposure to occupational agents in persons not prone to develop acne mostly develops on areas of skin that have abundant oil glands, like the and who have not had acne before engaging in the said occupation.
    [Show full text]
  • Aars Hot Topics Member Newsletter
    AARS HOT TOPICS MEMBER NEWSLETTER American Acne and Rosacea Society 201 Claremont Avenue • Montclair, NJ 07042 (888) 744-DERM (3376) • [email protected] www.acneandrosacea.org Like Our YouTube Page Visit acneandrosacea.org to Become an AARS Member and TABLE OF CONTENTS Donate Now on Industry News acneandrosacea.org/donate Galderma and Aklief unveil "Me Being Me" campaign ............................................... 2 Ortho Dermatologics opens applications for 2021 Aspire Higher ............................... 2 Our Officers New Medical Research Hidradenitis suppurativa in the pediatric population ................................................... 3 J. Mark Jackson, MD Clinical evaluation of the efficacy of a facial serum .................................................... 4 AARS President Combination of 5-Aminolevulinic acid photodynamic therapy and isotretinoin ........... 4 Zinc(II) complexes of amino acids as new active ingredients ..................................... 5 Andrea Zaenglein, MD Vulvar hidradenitis suppurativa ................................................................................... 5 AARS President-Elect Oral clindamycin and rifampicin in the treatment of hidradenitis suppurativa ............ 5 A comparative study between once-weekly and alternating twice-weekly regimen ... 6 Joshua Zeichner, MD Clascoterone: A novel topical androgen receptor inhibitor for the treatment of acne . 6 AARS Treasurer Epithelialized tunnels are a source of inflammation in hidradenitis suppurativa......... 7 Bethanee Schlosser,
    [Show full text]
  • Pathophysiology of Acne Pathophysiologie Der Akne
    316 Academy DOI: 10.1111/j.1610-0387.2007.06274.x CME Pathophysiology of acne Pathophysiologie der Akne Klaus Degitz, Marianne Placzek, Claudia Borelli, Gerd Plewig Department of Dermatology and Allergy, University of Munich, Germany Section Editor Prof. Dr. Michael Landthaler, Regensburg Introduction Acne is the most common skin disease [1]. In Germany, as in other Western industri- alized nations, a majority of the population has signs and symptoms of acne at least Epidemiologic data suggests up to during puberty. Epidemiologic data suggests up to 80% of individuals are affected 80% of individuals are affected. [2]. Men and women develop acne about equally. The disease has its onset at age 10–14 years and regresses by age 20–25 years. In some patients acne persists into the The clinical spectrum of acne ranges fourth or fifth decade of life (persistent acne). The clinical spectrum of acne ranges from mild manifestations up to from mild manifestations (a few comedones with occasional inflamed papulopus- severe inflammation and abscess for- tules, sometimes termed “physiologic” acne in contrast to “clinical” acne in more se- mation. vere cases) up to severe inflammation and abscess formation on the face or upper trunk (Figure 1). Several classifications exist to describe the severity of acne [1, 3]. In- dependent of its severity, acne can be a heavy emotional burden on the patient. Genetics There is a genetic predisposition to acne and the concordance rate is high among Probably several genes are involved identical twins. Little is known about specific hereditary mechanisms. Probably sev- in the predisposition for acne eral genes are involved in the predisposition for acne [4].
    [Show full text]
  • Acne and Related Conditions
    Rosanne Paul, DO Madeline Tarrillion, DO Miesha Merati, DO Gregory Delost, DO Emily Shelley, DO Jenifer R. Lloyd, DO, FAAD American Osteopathic College of Dermatology Disclosures • We do not have any relevant disclosures. Cleveland before June 2016 Cleveland after June 2016 Overview • Acne Vulgaris • Folliculitis & other – Pathogenesis follicular disorders – Clinical Features • Variants – Treatments • Rosacea – Pathogenesis – Classification & clinical features • Rosacea-like disorders – Treatment Acne vulgaris • Pathogenesis • Multifactorial • Genetics – role remains uncertain • Sebum – hormonal stimulation • Comedo • Inflammatory response • Propionibacterium acnes • Hormonal influences • Diet Bolognia et al. Dermatology. 2012. Acne vulgaris • Clinical Features • Face & upper trunk • Non-inflammatory lesions • Open & closed comedones • Inflammatory lesions • Pustules, nodules & cysts • Post-inflammatory hyperpigmentation • Scarring • Pitted or hypertrophic Bolognia et al. Dermatology. 2012. Bolognia et al. Dermatology. 2012. Acne variants • Acne fulminans • Acne conglobata • PAPA syndrome • Solid facial edema • Acne mechanica • Acne excoriée • Drug-induced Bolognia et al. Dermatology. 2012. Bolognia et al. Dermatology. 2012. Bolognia et al. Dermatology. 2012. Bolognia et al. Dermatology. 2012. Acne variants • Occupational • Chloracne • Neonatal acne (neonatal cephalic pustulosis) • Infantile acne • Endocrinological abnormalities • Apert syndrome Bolognia et al. Dermatology. 2012. Bolognia et al. Dermatology. 2012. Acne variants • Acneiform
    [Show full text]
  • Pathogenesis & Treatment Hidradenitis Suppurativa
    Hidradenitis Hidradenitis suppurativa s uppurativa: Pathogenesis & t re atmen t Hessel van der Zee Pathogenesis and t reatment H.H.van der Z e e ISBn: 978-90-73436-97-8 Hidradenitis Suppurativa: Pathogenesis and Treatment Hessel BW.indd 1 11-Oct-11 10:36:28 AM Financial support for printing of this thesis was generously provided by Merck Sharp & Dohme BV Pfi zer BV Janssen-Cilag BV Smith & Nephew BV ABBOTT BV Astellas Pharma BV Medi Nederland BV Galderma SA LEO Pharma BV Novartis Pharma BV Oldekamp Medisch BV KCI Medical BV Fagron BV Laservision Instruments BV MT-Diagnostics Netherlands BV BD Biosciences Louis Widmer Nederland Clean Air Techniek BV La Roche-Posay Mölnlycke Health Care Glaxo Smith Kline Beiersdorf NV Yo medical BV ISBN: 978-90-73436-97-8 Layout and printing: Optima Grafi sche Communicatie, Rotterdam, The Netherlands Copyright © H.H. van der Zee No part of this thesis may be reproduced or transmitted in any form of by any means, electronic or mechanically, including photocopying, recording or any information storage and retrieval system, without the permission in writing of the author, or when appropriate, of the publishers of the publications. Hessel BW.indd 2 11-Oct-11 10:36:29 AM Hidradenitis Suppurativa: Pathogenesis and Treatment Hidradenitis Suppurativa: Pathogenese en behandeling Proefschrift ter verkrijging van de graad van doctor aan de Erasmus Universiteit Rotterdam, op gezag van de Rector Magnifi cus Prof.dr. H.G. Schmidt en volgens besluit van het College voor Promoties. De openbare verdediging zal plaatsvinden op woensdag 7 december 2011 om 11:30 uur door Hindrik Hessel van der Zee geboren te Leiderdorp Hessel BW.indd 3 11-Oct-11 10:36:29 AM PROMOTIECOMMISSIE Promotoren: Prof.
    [Show full text]
  • (12) United States Patent (10) Patent No.: US 7,359,748 B1 Drugge (45) Date of Patent: Apr
    USOO7359748B1 (12) United States Patent (10) Patent No.: US 7,359,748 B1 Drugge (45) Date of Patent: Apr. 15, 2008 (54) APPARATUS FOR TOTAL IMMERSION 6,339,216 B1* 1/2002 Wake ..................... 250,214. A PHOTOGRAPHY 6,397,091 B2 * 5/2002 Diab et al. .................. 600,323 6,556,858 B1 * 4/2003 Zeman ............. ... 600,473 (76) Inventor: Rhett Drugge, 50 Glenbrook Rd., Suite 6,597,941 B2. T/2003 Fontenot et al. ............ 600/473 1C, Stamford, NH (US) 06902-2914 7,092,014 B1 8/2006 Li et al. .................. 348.218.1 (*) Notice: Subject to any disclaimer, the term of this k cited. by examiner patent is extended or adjusted under 35 Primary Examiner Daniel Robinson U.S.C. 154(b) by 802 days. (74) Attorney, Agent, or Firm—McCarter & English, LLP (21) Appl. No.: 09/625,712 (57) ABSTRACT (22) Filed: Jul. 26, 2000 Total Immersion Photography (TIP) is disclosed, preferably for the use of screening for various medical and cosmetic (51) Int. Cl. conditions. TIP, in a preferred embodiment, comprises an A6 IB 6/00 (2006.01) enclosed structure that may be sized in accordance with an (52) U.S. Cl. ....................................... 600/476; 600/477 entire person, or individual body parts. Disposed therein are (58) Field of Classification Search ................ 600/476, a plurality of imaging means which may gather a variety of 600/162,407, 477, 478,479, 480; A61 B 6/00 information, e.g., chemical, light, temperature, etc. In a See application file for complete search history. preferred embodiment, a computer and plurality of USB (56) References Cited hubs are used to remotely operate and control digital cam eras.
    [Show full text]
  • Infection Control for Instruments
    Infection Control for Instruments by ShelB Rindahl with Laurel Partin & Christina Colston hosted by Acknowledgements & Disclaimer Most heartfelt thanks to: Eastman Music Company, for hosting the introductory video series, for graphic design support, and for housing the literature online, in perpetuity, for free public use. Without Eastman, ICI would not have been as inclusive or as accessible to all those who need it. Key members of Eastman’s team were Meagan Dolce, who hosted the webinars and managed the web migration, as well as Chad Archibald, Abigail Brooks, and Beau Foster, who built the online resources and provided graphic design support. The National Association of Professional Band Instrument Repair Technicians (NAPBIRT), for the platform that first shared ICI, and for their long-time commitment to the professional development of instrument repairers, including the creator of ICI and all of its contributors. Without NAPBIRT, and the strong mentorship of its members, ICI would not have been inspired or developed in this way. Our test readers, Christina Colston, Meagan Dolce, Jessica Ganska, Kim Jurens, Reese Mandeville, Yvonne Rodriguez, and Steven Thompson, who suffered long hours and many revisions to make sense of our translations. Our families, friends, and colleagues, who made suggestions for content or organization, and who offered tremendous strength and tireless support along the way. Disclaimer: Infection Control for Instruments (ICI) is offered in good faith, but reader and user discretion are advised. The ICI team, our hosts, and our presenters, do not assume liability for decisions or actions of readers and users. ICI is not written or approved by licensed medical practitioners or infection control specialists and is not peer-reviewed.
    [Show full text]