1/2. Noduloulcerative or "malignant" syphilis occurring in an otherwise healthy woman: report and review of a dramatic dermatosis.We present the case of an otherwise healthy woman with noduloulcerative ("malignant") syphilis, the first female patient reported with this dermatosis in fifty years. This rare form of secondary syphilis is characterized by noduloulcerative lesions with rupioid crusts that dramatically involve the face while usually sparing the palms and soles. The aggression and destruction of the skin lesions may mimic that of other granulomatous and infiltrative dermatoses. Since the incidence of syphilis is increasing, physicians should be aware of this variant that is so disfiguring it has historically been referred to as lues maligna.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/2. Denial of illness: a reappraisal.The authors attempt to understand the nature of denial of illness by an examination of two patients with serious and disfiguring physical disorders who postponed medical treatment for over a decade. Both patients subsequently had dramatic negative reactions to the therapeutic efforts of physicians caring for them. Various social, experiential, and characterologic determinants are discussed. In addition, the authors argue that the illness served important organizing functions: it sheltered these patients from the exigencies of everyday life; it allowed them to defeat the physician's efforts to effect a cure; and, finally, the disfigured physical state appeared to correspond to their internalized defective self-image and self-esteem.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |