Evaluation of Patients Who Have Skin Diseases

OBJECTIVES:

Primary

- Determine the natural history of selected dermatologic or systemic diseases with
cutaneous manifestations.

- Provide clinical material to fulfill the educational mission of the Dermatology Branch.

Secondary

- Screen patients for inclusion in other protocols.

- Assist the treating physicians with determining the diagnosis and appropriate medical
or surgical therapy for patients with rare skin diseases.

OUTLINE: Samples of blood, urine, stool, exudates, skin scrapings, hair, and nails are
collected from patients and then are analyzed, as medically indicated, using the following
diagnostic tests:

- Chemistry

- Serology

- Pregnancy testing

- Cultures

- Cytology

- Microscopic examination for fungi, bacteria, and parasites

- Immunopathologic tests, including:

- Direct and indirect immunofluorescence microscopy

- Direct and indirect immunoelectron microscopy

- Characterization of circulating autoantibodies by immunoprecipitation and/or
immunoblotting

- HIV testing

- Electrocardiogram

- Diagnostic x-ray and other imaging procedures

- Patch testing

- Photography, including infrared photography

- Skin biopsies (punch, shave or tangential, and excisional)

- Fluorescent-activated cell sorter

- Polymerase chain reaction for infectious agents

- Immunohistochemistry

- Special stains Patients also undergo consultation with other services, as medically
indicated. Diagnostic test results are used to assist the treating physicians with
determining the diagnosis and appropriate medical or surgical therapy. Patients also
may participate in clinical medical conferences.

PROJECTED ACCRUAL: A total of 500 patients will be accrued for this study.