Some teens
call them zits, pimples or goobers. Others may call them wooglites or doohickeys.
Many know the skin condition as acne and view it like the plague.
An irritation
on a baby's bottom may be diaper rash, but older folk may call it eczema
or scabies. Anyway, it itches.
Altogether
they are diseases of the largest organ of the human body -- the skin. But
just what is that red rash? Is it serious?
In order to
give some meaning to the thousands of spots and lesions that can inflict
the skin, the National Institutes of Health has given a $2.1 million grant
to the University of Rochester Medical School to create the Dermatological
Lexicon Project -- a controlled vocabulary -- that dermatologists around
the world can use.
"There are
up to 10,000 dermatological diagnoses, and there is a lot of overlap, and
some physicians use terms interchangeably and that can cause miscommunication,"
Dr. Arthur Papier, assistant professor of dermatology at the University
of Rochester Medical School, told United Press International.
"At best, it
causes confusion; at worst it can cause medical error."
Papier is coordinating
the efforts of 25 people from around the world including a team in Germany
and in England. The team plans to organize disparate terms and develop
a quality control system for the words doctors use to describe conditions
of the skin.
"We take digital
pictures of the patient's skin, and we label that picture and put it in
a database," said Papier.
"If we don't
have a shared vocabulary of diagnoses and symptoms, it will be impossible
to mine that database to look for patterns of disease -- we're seeking
uniformity of thought."
There have
been several attempts to standardize dermatological vocabulary, the first
in 1808 in England with similar efforts in French and German and the latest
in 1987, according to Dr. Jeffrey Bernhard of the University of Massachusetts
Medical School in Worcester, Mass.
"The difference
with conditions and diseases of the skin as opposed to say the liver, is
that we can see the skin so each time we see something on the skin that
causes concern, we call it something different," Bernhard told UPI. "This
doesn't happen with other organs because we can't observe them as closely
as the skin."
According to
Papier, changes in technology such as digital medical records are spurring
the effort, although the computerization of medicine has lagged.
"Computers
have come late to medicine; we still see doctors writing in the patient's
medical files, files that sometimes are inches thick of paper," Papier
said.
"Now we have
the capability of taking a digital picture and e-mailing it to colleague
a world away for a second opinion."
The biggest
problem is not for those who practice in dermatology -- they have their
own jargon, as do cardiologists and those who work in the emergency room,
as we can all see on NBC's "ER," according to Bernhard.
"The biggest
problem is for those not trained in dermatology, because while we say the
skin is the window to the soul, it's certainly the window to serious diseases
so it's important for all doctors to be able to describe, diagnose and
codify skin conditions," Papier said.
In about three
years, a prototype will be available for physicians to test, and then the
final product will be made available to doctors around the world at no
charge.
Without the
new system, communication about skin diseases is similar to an aviation
system without effective air traffic control, according to Papier.
"Imagine if
every time an airplane flew to a different country, the whole aviation
system was different -- not just a different language, but different types
of jets, different standards for safety, separate systems of classifying
the weather," Papier said. "It would be chaos."
--
Copyright 2002 by United
Press International.
All rights reserved.
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