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Related Concept Videos

Skin Cancer01:30

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Skin cancer is a type of cancer that occurs when there is an abnormal growth of skin cells, usually triggered by damage to the DNA within the skin cells. It is primarily caused by exposure to ultraviolet (UV) radiation from the sun or artificial sources like tanning beds. Skin cancer is the most common type of cancer worldwide, and its incidence continues to rise.
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Sensory Functions of the Skin01:16

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The skin is the largest organ of the human body and plays a crucial role in our sensory perception. It contains a vast network of sensory receptors that contribute to the skin's protective function by perceiving physical, biological, and environmental cues and generating relevant responses.
There are two main categories of receptors on the skin: capsulated and non-capsulated. The non-capsulated ones are mainly the pain receptors. The capsulated ones can be further categorized based on the...
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Skin Diseases and Disorders01:23

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Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
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Role of Skin in Vitamin D Synthesis01:23

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The skin plays a crucial role in the synthesis of vitamin D, a vital nutrient for various physiological processes in the body. Vitamin D is unique because it can be synthesized in the skin through a series of chemical reactions triggered by exposure to ultraviolet B (UVB) radiation from sunlight.
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Accessory Structures of the Skin: Nails01:05

Accessory Structures of the Skin: Nails

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Nails are one of the important accessory structures of the skin. They are hard, protective structures that cover the dorsal surface of the distal phalanges of fingers and toes. Nails are composed of specialized keratinized cells and serve various functions, including protection, sensation, and manual dexterity.
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Updated: Feb 9, 2026

Deep Dermal Injection As a Model of Candida albicans Skin Infection for Histological Analyses
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Deep Dermal Injection As a Model of Candida albicans Skin Infection for Histological Analyses

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More than skin deep.

Constanza Riquelme-Mc Loughlin1, Priscila Giavedoni1, José M Mascaró1

  • 1Department of Dermatology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.

The American Journal of Emergency Medicine
|June 5, 2018
PubMed
Summary
This summary is machine-generated.

A long-term methotrexate user experienced acute toxicity manifesting as severe mucositis and pancytopenia after dehydration and NSAID use. Prompt folinic acid treatment and supportive care led to recovery.

Keywords:
IntoxicationMethotrexateMucositisPancytopeniaPsoriasis

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Area of Science:

  • Dermatology
  • Toxicology
  • Pharmacology

Background:

  • Methotrexate (MTX) is a common treatment for psoriasis.
  • Long-term MTX use can lead to toxicity, especially with contributing factors like dehydration and NSAID use.
  • Psoriasis patients with comorbidities like diabetes and chronic kidney disease may be at higher risk.

Observation:

  • A woman with psoriasis on long-term MTX developed oral mucositis and skin ulcers after a flight, dehydration, and NSAID consumption.
  • Initial laboratory tests revealed macrocytic anemia, thrombocytopenia, and impaired kidney function.
  • Despite normal MTX levels, acute MTX toxicity was diagnosed.

Findings:

  • Intravenous folinic acid administration was initiated for acute methotrexate toxicity.
  • The patient developed severe pancytopenia within 24 hours, requiring colony-stimulating factors, platelet, and blood transfusions.
  • Complete blood count normalized after 10 days, and cutaneous lesions resolved.

Implications:

  • This case highlights the potential for acute methotrexate toxicity even with normal drug levels in patients with specific risk factors.
  • Early recognition and intervention with folinic acid and supportive care are crucial for managing severe methotrexate-induced toxicity.
  • Careful consideration of drug interactions and patient comorbidities is essential for safe long-term methotrexate therapy.