Clinical Features

Clinical features of melasma usually evolve rapidly, especially after UV exposure. Lesions are uniformly light to dark brown, often symmetric, and three clinical patterns can be distinguished  

Two thirds of cases of melasma are localized on the face (cheeks, forehead, nose, superior lip and chin), while one third is localized on the dorsal forearms. 

Solar lentigo are a macular area of brown pigmentation appearing after either acute or chronic sun exposure. The term solar lentigo is preferred to senile lentigo, which is sometimes 

Lentigo are so common that it is difficult to make an exact statement about their epidemiology. 

In younger patients solar lentigo are seen on sun-exposed areas (Fig. 18.1). There is usually a 

In older patients tbese lesions are commonly seen on the face and back of the hands after chronic sun exposure (Figs. 18.2) [1]. 

Biochemically, cyanide affects the citric acid cycle, strongly inhibits catalases and pro-teinases, induces glycolysis in protozoans, fish, and mammals, produces vitamin B12 deficiency, and modifies the phosphorylation mechanism of respiratory mitochondrial enzymes, causing arrested respiration due to 

---

Primary generalized seizures are also heterogeneous with respect to their clinical features. Such seizures can impose as absence epilepsy, which is characterized by a brief interruption of consciousness due to highly synchronized neuronal activity involving thalamocortical networks without increases in neuronal firing rate. On the other hand, tonic-clonic convulsions with loss of consciousness are often also primarily generalized. 

Airway inflammation is a characteristic clinical feature of asthma. The distinction between the LAR and chronic inflammation becomes more difficult as the disease progresses. Infiltrated leukocytes release ototoxic mediators such as reactive oxygen species (ROS) and cationic (basic) proteins causing epithelial damage and cyfo/cmas that perpetuate the inflammation. Sustained inflammation leads to airway hyperrespon-siveness and airway remodeling. 

Clinical features NCEPATPIII criteria S3 of the criteria below WHO criteria impaired glucose regulation/insulin resistance and >2 other criteria... 

It is an autoantibody whose autoantigen is the Fc portion of IgG. Rheumatoid factors may be of any immunoglobulin isotype but it is IgM rheumatoid factor that is commonly measured in rheumatoid arthritis. Classification criteria for rheumatoid arthritis include only one serological test, namely rheumatoid factor. However, it is not diagnostic test rather it may be confirmatory when a number of other clinical features are present. 

Fatal hereditary disorder that typically presents in the neonatal period. Clinical features include an array of hepatic, renal and neurological dysfunctions. Patients with Zellweger syndrome rarely survive the first year of life. The disease is caused by mutations in the Pex proteins leading to an defective import of peroxisomal matrix proteins and consequently to a loss of most peroxisomal metabolic pathways. 

Clinical features include neonatal hypotonia, a tendency toward congenital hip dislocation and diffuse muscle weakness. Later on children are frequently of short stature and low body weight and often have long thin faces and high-arched palates. Respiratory difficulties, where present, occur early on and tend to improve with time. In others a virtually static clinical picture is seen. 

This group of conditions, in which myotonia (the failure of voluntary muscle to relax following contraction) may be a feature, can now be classified according to the primary molecular defect responsible for the relevant condition. The clinical features of the different conditions within this group can show some significant differences, even among the diseases now known to be due to mutations within the same genes (Table 1). 

Primary hyperparathyroidism occurs as a result of hyperplasia or the occurrence of adenoma. Secondary hyperparathyroidism may result from renal failure because of the associated phosphate retention, resistance to the metabolic actions of PTH, or impaired vitamin D metabolism. The last-mentioned factor is primarily responsible for the development of osteomalacia. Muscle symptoms are much more common in patients with osteomalacia than in primary hyperparathyroidism. Muscle biopsy has revealed disseminated atrophy, sometimes confined to type 2 fibers, but in other cases involving both fiber types. Clinical features of osteomalacic myopathy are proximal limb weakness and associated bone pain the condition responds well to treatment with vitamin D. 

Kono J, Miyata H, Ushijima S, et al Nicotine, alcohol, methamphetamine, and inhalant dependence a comparison of clinical features with the use of a new clinical evaluation form. Alcohol 24 99-106, 2001... 

Diagnosis is based on clinical features. Biopsy and histologic examination maybe useful when clinical appearance is not typical. 

Skin conditions share some clinical features with rosacea ... 

Yang MS, Lee SH, Kim TW, et al Epidemiologic and clinical features of anaphylaxis in Korea. Ann Allergy Asthma Immunol 2008 100 31-36. 

BrockowKjJoferQ BehrendtH,RingJ Anaphylaxis 70 in patients with mastocytosis a study on history, clinical features and risk factors in 120 patients. Allergy 2008 63 226-232. 71... 

Specific Clinical Features of Anesthesia Induced Anaphylaxis... 

The epidemiology and clinical features of anaphylactic and anaphylactoid reactions in the periopera- 9 live period in Japan a survey with a questionnaire of 529 hospitals approved by Japan Society of Anesthesiology. Masui 1992 41 1825. 

All defects in urea synthesis result in ammonia intoxication. Intoxication is more severe when the metabolic block occurs at reactions 1 or 2 since some covalent linking of ammonia to carbon has already occurred if citrulline can be synthesized. Clinical symptoms common to all urea cycle disorders include vomiting, avoidance of high-protein foods, intermittent ataxia, irritability, lethargy, and mental retardation. The clinical features and treatment of all five disorders discussed below are similar. Significant improvement and minimization of brain damage accompany a low-protein diet ingested as frequent small meals to avoid sudden increases in blood ammonia levels. 

HIV-associated PNS disorder HIV disease stage Course Clinical features Mechanism... 

---