Request for information on military medicine/physician education

[Madhu]

Very helpful. Educational links which I will explore more fully when I have time.

I was thinking something along the lines of the following:

Veterans from the first Gulf War with embedded shrapnel have stronger skin reactions to metal allergy than those without shrapnel, according to the first study of cutaneous reactivity to traumatically implanted metals.
.
Dr. Marianna Shvartsbeyn and her colleagues patch tested 40 Gulf War I veterans to an extensive number of metal allergens and found that, overall, 25% were reactive to zinc and 12.5% to manganese.

http://www.skinandallergynews.com/sp...bcc0c3506.html



Brief and initial reaction based on what I already know and what I've learned from a quick skimming of certain materials:


1. Prior sites of skin trauma (scars) may serve as sites of re-flaring or flaring of chronic inflammatory skin conditions such as psoriasis, sarcoidosis, eczema, etc.

2. TBI may affect portions of the brain involved with touch perception and patients may experience sensations of skin tingling, burning, pain, pruritis ("itching").

a. This may result in skin manipulation by the patient (scratching, etc.)

3. A skin injury may introduce an infectious agent with cutaneous symptoms manifesting at a later date (the following pdf is interesting but I haven't had a chance to go through it fully so I don't know if it relates to this point):

(Returning Veterans From Iraq pdf/slides):
www.sgim.org/userfiles/file/AMHandouts/AM06/handouts/WD04.pdf

4. Patients theoretically may present with metal allergies to shrapnel although I haven't explored that in detail and I don't know the data or studies very well.


I am sure there are more to go on this list. I will update as I find out more.