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Chien WC, Tsai TF. Pressure and Skin: A Review of Disease Entities Driven or Influenced by Mechanical Pressure. Am J Clin Dermatol 2024; 25:261-280. [PMID: 38159214 DOI: 10.1007/s40257-023-00833-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 01/03/2024]
Abstract
Skin perceives and reacts to external mechanical forces to create resistance against the external environment. Excessive or inappropriate stimuli of pressure may lead to cellular alterations of the skin and the development of both benign and malignant skin disorders. We conducted a comprehensive literature review to delve into the pressure-induced and aggravated skin disorders and their underlying pressure-related mechanisms. Dysregulated mechanical responses of the skin give rise to local inflammation, ischemia, necrosis, proliferation, hyperkeratosis, impaired regeneration, atrophy, or other injurious reactions, resulting in various disease entities. The use of personal devices, activities, occupations, weight bearing, and even unintentional object contact and postures are potential scenarios that account for the development of pressure-related skin disorders. The spectrum of these skin disorders may involve the epidermis (keratinocytes and melanocytes), hair follicles, eccrine glands, nail apparatuses, dermis (fibroblasts, mast cells, and vasculature), subcutis, and fascia. Clarifying the clinical context of each patient and recognizing how pressure at the cellular and tissue levels leads to skin lesions can enhance our comprehension of pressure-related skin disorders to attain better management.
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Affiliation(s)
- Wei-Chen Chien
- Department of Medical Education, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan
| | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan South Road, Taipei, Taiwan.
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Niarchou M, Lin GT, Lense MD, Gordon RL, Davis LK. Medical phenome of musicians: an investigation of health records collected on 9803 musically active individuals. Ann N Y Acad Sci 2021; 1505:156-168. [PMID: 34414577 PMCID: PMC8688228 DOI: 10.1111/nyas.14671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/25/2021] [Accepted: 07/12/2021] [Indexed: 11/29/2022]
Abstract
Previous studies suggest that musicians may be at higher risk for a set of medical problems; however, this literature has been limited by relatively small sample sizes, self‐reports, and lack of controls. To address such limitations, we examined trends in the medical care of musicians in an Electronic Health Record database. On the basis of a collection of keywords and regular expressions in the patients’ clinical notes, we identified 9803 “musicians” that we matched for sex, median age (across the medical record), ethnicity, race, the length of record, and the number of visits with 49,015 controls. We fitted 1263 logistic regression models to determine whether the phenotype was correlated with musicianship. Two hundred fifty‐seven phenotypes were more prevalent in musicians than controls after Bonferroni adjustment (P < 7.6 × 10–6), including diseases of the larynx and vocal cords (OR = 2.32 (95% CI: 2.25–2.40)), and hearing loss (OR = 1.36 (95% CI: 1.32–1.39)). Fifteen phenotypes were significantly more prevalent in controls than musicians, including coronary atherosclerosis (OR = 0.91 (95% CI: 0.89–0.94)). Although being a musician was related to many occupational health problems, we identified protective effects of musicianship in which certain disorders were less common in musicians than in controls, indicating that active musical engagement could have health benefits analogous to athletic engagement.
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Affiliation(s)
- Maria Niarchou
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | - George T Lin
- Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Miriam D Lense
- Department of Otolaryngology - Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Psychology, Vanderbilt University, Nashville, Tennessee
| | - Reyna L Gordon
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Otolaryngology - Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Psychology, Vanderbilt University, Nashville, Tennessee
| | - Lea K Davis
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee.,Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee
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Wortsman X, Ferreira-Wortsman C. Ultrasound in Sports and Occupational Dermatology. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:1675-1692. [PMID: 33155699 DOI: 10.1002/jum.15550] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/06/2020] [Accepted: 10/12/2020] [Indexed: 06/11/2023]
Abstract
Chronic exposure to trauma, friction, or extreme conditions can generate cutaneous or ungual lesions in sports and certain occupations. Although some of these dermatologic conditions are diagnosed with a naked-eye examination, there are cases in which the provision of the underlying anatomic alterations can be helpful for the diagnosis and management. In comparison with computed tomography or magnetic resonance imaging, ultrasound has the highest axial resolution, which is critical for the observation of anatomic changes in the skin and nail. We review the ultrasound characteristics of frequent cutaneous and ungual lesions related to sports and occupations with a clinical correlation. The ultrasound features in some particular conditions such as "biker's and surfer's panniculitis," "fiddler's neck," piezogenic papules, and lipoatrophy semicircularis, among others, are discussed.
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Affiliation(s)
- Ximena Wortsman
- Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile
- Department of Dermatology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
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Alves PB, Todo-Bom A, Regateiro FS. Viola duet: A rare case of double sensitization to contact allergens in a professional musician. Contact Dermatitis 2020; 83:523-524. [PMID: 32666527 DOI: 10.1111/cod.13662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Pedro B Alves
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Ana Todo-Bom
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,ICBR - Coimbra Institute for Clinical and Biomedical Research, CIBB, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Kraft M, Schubert S, Geier J, Worm M. Contact dermatitis and sensitization in professional musicians. Contact Dermatitis 2019; 80:273-278. [DOI: 10.1111/cod.13191] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/31/2018] [Accepted: 11/26/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Magdalena Kraft
- Department of Dermatology and Allergology, Allergy-Centre-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - Steffen Schubert
- Information Network of Departments of Dermatology (IVDK) at the University of Göttingen; Göttingen Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK) at the University of Göttingen; Göttingen Germany
| | - Margitta Worm
- Department of Dermatology and Allergology, Allergy-Centre-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
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Kluger N. [Skin and mucosal diseases in musicians]. Ann Dermatol Venereol 2017; 144:415-422. [PMID: 28391981 DOI: 10.1016/j.annder.2017.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 02/28/2017] [Accepted: 03/10/2017] [Indexed: 10/19/2022]
Abstract
Whether they are professional or amateur, musicians are exposed to a various number of complications in relation to their practice, including cutaneous ones. The latter are often a simple musical stigma and a reason for pride for the musician. If they are symptomatic and disturb the musician, they have to be treated and prevented. We reviewed here those occupational and peculiar lesions that are often not that well known to the dermatologist.
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Affiliation(s)
- N Kluger
- University of Helsinki and Helsinki University Central Hospital, Departments of Dermatology, Allergology and Venereology, Meilahdentie 2, PO Box 160, 00029 Hus, Finlande.
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Occupational Dermatitis in Instrumentalists. Dermatitis 2016; 27:151-2. [DOI: 10.1097/der.0000000000000185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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