The smear layer is a layer of microcrystalline and organic particle debris that is found spread on root canal walls after root canal instrumentation. It was first described in 1975 and much research has been performed since then to evaluate its importance in assisting or preventing the penetration of bacteria into the dentinal tubules. More broadly, it is the organic layer found over all hard tooth surfaces.

Dentin hypersensitivity (abbreviated to DH, or DHS, and also termed sensitive dentin, dentin sensitivity, cervical sensitivity, and cervical hypersensitivity) is dental pain which is sharp in character and of short duration, arising from exposed dentin surfaces in response to stimuli, typically thermal, evaporative, tactile, osmotic, chemical or electrical; and which cannot be ascribed to any other dental disease.

A degree of dentin sensitivity is normal, but pain is not usually experienced in everyday activities like drinking a cooled drink. Therefore, although the terms "dentin sensitivity" and "sensitive dentin" are used interchangeably to refer to dental hypersensitivity, the latter term is the most accurate.

The pain is sharp and sudden, in response to an external stimulus. The most common trigger is cold, with 75% of people with hypersensitivity reporting pain upon application of a cold stimulus. Other types of stimuli may also trigger pain in dentin hypersensitivity, including:

- Thermal – hot and cold drinks and foods, cold air, coolant water jet from a dental instrument.

- Electrical – electric pulp testers.

- Mechanical–tactile – dental probe during dental examination, periodontal scaling and root planing, toothbrushing.

- Osmotic – hypertonic solutions such as sugars.

- Evaporation – air blast from a dental instrument.

- Chemical – acids, e.g. dietary, gastric, acid etch during dental treatments.

The frequency and severity with which the pain occurs are variable.

Clark-Holke et al. (2003) focused on determining the effect of the smear layer on the magnitude of bacterial penetration through the apical foramen around obturating materials. Thirty extracted teeth were classified into two test groups; the first group had the smear layer removed by rinsing with 17% EDTA while in the second group the smear layer was left intact. Canal preparation and obturation using lateral condensation, gutta-percha, and AH 26 sealer was performed on all of the teeth. The model systems consisted of an upper chamber attached to the cemento-enamel junction and a lower chamber at the apices of the teeth. Standardized bacterial suspensions containing "Fusobacterium nucleatum", "Campylobacter rectus" and "Peptostreptococcus micros" were inoculated into the upper chambers. Models were incubated anaerobically at 37 degrees C. Leakage results were as follows: In the first group 6 teeth showed bacterial leakage, the second group and third groups showed no bacterial leakage. This study indicated that removal of the smear layer reduced the leakage of bacteria through the root canal system.

Kokkas et al. (2004) examined the effect of the smear layer on the penetration depth of three different sealers (AH Plus, Apexit, and a Grossman type-Roth 811) into the dentinal tubules. Sixty four extracted human single-rooted teeth were used and divided into two groups. The smear layer remained intact in all the roots of group A. Complete removal of the smear layer in group B was achieved after irrigation with 3 ml of 17% EDTA for 3 min, followed by 3 ml of 1% NaOCl solution. Ten roots from each group were obturated with AH Plus and laterally condensed gutta-percha points. The same process was repeated for the remaining roots by using sealers Apexit and Roth 811 correspondingly. After complete setting, the maximum penetration depth of the sealers into the dentinal tubules was examined in upper, middle, and lower levels. The smear layer prevented all the sealers from penetrating dentinal tubules. In contrast, in smear layer–free root canals, all the sealers penetrated dentinal tubules, although the depth of penetration varied between the sealers. Furthermore smear layer adversely affected the coronal and apical sealing ability of sealers.

Çobankara et al. (2004) determined the effect of the smear layer on apical and coronal leakage in root canals obturated with AH26 or RoekoSeal sealers. A total of 160 maxillary anterior teeth were used. Eight groups were created by all possible combinations of three factors: smear layer (present/absent), leakage assessment (apical/coronal), and sealer used (AH26/Roeko-Seal). All teeth were obturated using lateral condensation technique of gutta-percha. A fluid filtration method was used to test apical or coronal leakage. According to the results of this study, the smear (+) groups displayed higher apical and coronal leakage than those smear (-) groups for both root canal sealers. Apical leakage was significantly higher than coronal leakage for both root canal sealers used in this study. It was determined that that removal of the smear layer has a positive effect in reducing apical and coronal leakage for both AH26 and RoekoSeal root canal sealers.

However Bertacci et al. (2007) evaluated the ability of a warm gutta-percha obturation system Thermafil to fill lateral channels in the presence or absence of the smear layer. Forty single-rooted extracted human teeth were randomly divided into two groups one of which had the smear layer removed by 5 ml of 5% NaOCl followed by 2.5 ml of 17% EDTA. Obturation was performed using AH Plus sealer and Thermafil. Specimens were cleared in methyl salicylate and analyzed under a stereomicroscope to evaluate the number, length, and diameter of lateral channels. All lateral channels were found to be filled in both groups. No statistically significant differences regarding number, length, and diameter were observed between the two groups. It was concluded that the smear layer did not prevent the sealing of lateral channels.

Yildirim et al. (2008) investigated the effect of the smear layer on apical microleakage in teeth obturated with MTA. Fifty single-rooted central maxillary teeth were used in this study. The selected teeth were instrumented and randomly divided into 2 groups. In the first group (smear [+]), the teeth were irrigated with only 5.25% NaOCl. In the second group (smear [-]), the teeth were irrigated with EDTA (17%) and NaOCl (5.25%) to remove the smear layer. The teeth were then filled with MTA. The computerized fluid filtration method was used for evaluation of apical microleakage. The quantitative apical leakage of each tooth was measured after 2, 30, and 180 days. It was found that there was no difference between the groups after 2 days but removal of the smear layer caused significantly more apical microleakage than when the smear layer was left intact after 30 and 180 days. It was concluded that the apical microleakage of MTA is less when the smear layer is present than when it is absent.

Saleh et al. (2008) studied the effect of the smear layer on the penetration of bacteria along different root canal filling materials. A total of 110 human root segments were instrumented to size 80 under irrigation with 1% sodium hypochlorite. Half of the roots were irrigated with a 5-mL rinse of 17% EDTA to remove the smear layer. Roots were filled with gutta-percha (GP) and AH Plus sealer (AH), GP and Apexit sealer (AP), or RealSeal cones and sealer (RS). Following storage in humid conditions at 37 degrees C for 7 days, the specimens were mounted into a bacterial leakage test model for 135 days. Survival analyses were performed to calculate the median time of leakage and log-rank test was used for pairwise comparisons of groups. Selected specimens were longitudinally sectioned and inspected by scanning electron microscopy for the presence of bacteria at the interfaces. In the presence of the smear layer, RS and AP leaked significantly more slowly than in its absence. In the absence of the smear layer, AH leaked significantly more slowly than RS. It was concluded that removal of the smear layer did not impair bacterial penetration along root canal fillings. A comparison of the sealers revealed no difference except that AH performed better than RS in the absence of the smear layer.

Fachin et al.(2009) evaluated whether smear layer removal has any influence on the filling of the root canal system, by examining the obturation of lateral canals, secondary canals and apical deltas. Eighty canines were randomly divided into two groups, according to their irrigation regimen. Both groups were irrigated with 1% NaOCl during canal shaping, but only the teeth in Group II received a final irrigation with 17% EDTA for smear layer removal. The root canals were obturated with lateral condensation of gutta-percha and the specimens were cleared, allowing for observation under the microscope. The results showed that In Groups I and II, 42.5% and 37.5% of the teeth, respectively, presented at least one filled canal ramification. In conclusion, smear layer removal under the conditions tested in this study did not affect the obturation of root canal ramifications when lateral condensation of gutta-percha was the technique used for root canal filling.

The term hyperkeratosis is often used in connection with lesions of the mucous membranes, such as leukoplakia. Because of the differences between mucous membranes and the skin (e.g. keratinizing mucosa does not have a stratum lucidum and non keratinizing mucosa does not have this layer or normally a stratum corneum or a stratum granulosum), sometimes specialized texts give slightly different definitions of hyperkeratosis in the context of mucosae. Examples are "an excessive formation of keratin (e.g., as seen in leukoplakia)" and "an increase in the thickness of the keratin layer of the epithelium, or the presence of such a layer in a site where none would normally be expected."

"Distribution" refers to how lesions are localized. They may be confined to a single area (a patch) or may exist in several places. Some distributions correlate with the means by which a given area becomes affected. For example, contact dermatitis correlates with locations where allergen has elicited an allergic immune response. Varicella zoster virus is known to recur (after its initial presentation as chicken pox) as herpes zoster ("shingles"). Chicken pox appears nearly everywhere on the body, but herpes zoster tends to follow one or two dermatomes; for example, the eruptions may appear along the bra line, on either or both sides of the patient.

- Generalized

- Symmetric: one side mirrors the other

- Flexural: on the front of the fingers

- Extensor: on the back of the fingers

- Intertriginous: in an area where two skin areas may touch or rub together

- Morbilliform: resembling measles

- Palmoplantar: on the palm of the hand or bottom of the foot

- Periorificial: around an orifice such as the mouth

- Periungual/subungual: around or under a fingernail or toenail

- Blaschkoid: following the path of Blaschko's lines in the skin

- Photodistributed: in places where sunlight reaches

- Zosteriform or dermatomal: associated with a particular nerve

Hyperkeratosis is thickening of the stratum corneum (the outermost layer of the epidermis), often associated with the presence of an abnormal quantity of keratin, and also usually accompanied by an increase in the granular layer. As the corneum layer normally varies greatly in thickness in different sites, some experience is needed to assess minor degrees of hyperkeratosis.

It can be caused by vitamin A deficiency or chronic exposure to arsenic.

Hyperkeratosis can also be caused by B-Raf inhibitor drugs such as Vemurafenib and Dabrafenib.

It can be treated with urea-containing creams, which dissolve the intercellular matrix of the cells of the stratum corneum, promoting desquamation of scaly skin, eventually resulting in softening of hyperkeratotic areas.

Most cases of leukoplakia cause no symptoms, but infrequently there may be discomfort or pain. The exact appearance of the lesion is variable. Leukoplakia may be white, whitish yellow or grey. The size can range from a small area to much larger lesions. The most common sites affected are the buccal mucosa, the labial mucosa and the alveolar mucosa, although any mucosal surface in the mouth may be involved. The clinical appearance, including the surface texture and color, may be homogenous or non-homogenous (see: classification). Some signs are generally associated with a higher risk of cancerous changes (see: prognosis).

Leukoplakia may rarely be associated with esophageal carcinoma.

Atypical infections are the key clinical manifestation of SGD. Within the first few years of life, patients will experience repeated pyogenic infections by species such as "Staphylococcus aureus", "Pseudomonas aeruginosa" or other Enterobacteriaceae, and "Candida albicans". Cutaneous ulcers or abscesses and pneumonia and chronic lung disease are common. Patients may also develop sepsis, mastoiditis, otitis media, and lymphadenopathy. Infants may present with vomiting, diarrhea, and failure to thrive.

Diagnosis can be made based upon CEBPE gene mutation or a pathognomonic finding of a blood smear showing lack of specific granules. Neutrophils and eosinophils will contain hyposegmented nuclei (a pseudo-Pelger–Huet anomaly).

In the context of lesions of the mucous membrane lining of the bladder, leukoplakia is a historic term used to describe a visualized white patch which histologically represents keratinization in an area of squamous metaplasia. The symptoms may include frequency, suprapubic pain (pain felt above the pubis), hematuria (blood in the urine), dysuria (difficult urination or pain during urination), urgency, and urge incontinence. The white lesion may be seen during cystoscopy, where it appears as a whitish-gray or yellow lesion, on a background of inflamed urothelium and there may be floating debris in the bladder. Leukoplakia of the bladder may undergo cancerous changes, so biopsy and long term follow up are usually indicated.

Muscardine is a disease of insects. It is caused by many species of entomopathogenic fungus. Many muscardines are known for affecting silkworms. Muscardine may also be called calcino.

While studying muscardine in silkworms in the 19th century, Agostino Bassi found that the causal agent was a fungus. This was the first demonstration of the germ theory of disease, the first time a microorganism was recognized as an animal pathogen.

There are many types of muscardine. They are often named for the color of the conidial layer each fungus leaves on its host.

In medicine, the term collodion baby applies to newborns who appear to have an extra layer of skin (known as a "collodion membrane") that has a collodion-like quality. It is a descriptive term, not a specific diagnosis or disorder (as such, it is a syndrome).

"Configuration" refers to how lesions are locally grouped ("organized"), which contrasts with how they are distributed (see next section).

- Agminate: in clusters

- Annular or circinate: ring-shaped

- Arciform or arcuate: arc-shaped

- Digitate: with finger-like projections

- Discoid or nummular: round or disc-shaped

- Figurate: with a particular shape

- Guttate: resembling drops

- Gyrate: coiled or spiral-shaped

- Herpetiform: resembling herpes

- Linear

- Mammillated: with rounded, breast-like projections

- Reticular or reticulated: resembling a net

- Serpiginous: with a wavy border

- Stellate: star-shaped

- Targetoid: resembling a bullseye

- Verrucous: wart-like

Affected babies are born in a collodion membrane, a shiny, waxy-appearing outer layer to the skin. This is shed 10–14 days after birth, revealing the main symptom of the disease, extensive scaling of the skin caused by hyperkeratosis.

With increasing age, the scaling tends to be concentrated around joints in areas such as the groin, the armpits, the inside of the elbow and the neck. The scales often tile the skin and may resemble fish scales.

In both healthy and immunocompromised hosts, Majocchi's granuloma often presents as nodules and papules on areas that are most exposed to mechanical abuse—wear and tear—such as the upper and lower extremities. Patients will complain about papules, pustules, or even plaques and nodules at the site of infection. The papules will be pink-red and will be located in a perifollicular location. Hair shafts can be easily removed from the pustules and papules. Itching is also very common. Firm or fluctuant subcutaneous nodules or abscesses represent a second form of MG that is generally observed in immunosuppressed hosts. Nodules may develop in any hair-bearing part of the body but are most often observed on the forearms, hands, and legs of infected individuals. Involvement of the scalp and face is rarely observed. Lesions start as solitary or multiple well-circumscribed perifollicular papulopustules and nodules with or without background erythema and scaling. In rare circumstances, the lesions may have keloidal features.

Cervical ectropion can be associated with excessive but non-purulent vaginal discharge due to the increased surface area of columnar epithelium containing mucus-secreting glands. It may also give rise to post-coital bleeding, as fine blood vessels present within the columnar epithelium are easily traumatised.

"Cervical ectropion" (or cervical eversion) is a condition in which the cells from the ‘inside’ of the cervical canal known as glandular cells (or columnar epithelium), are present on the ‘outside’ of the vaginal portion of the cervix. The cells on the ‘outside’ of the cervix are called squamous epithelial cells. Where the two cells meet is called the transformation zone also known as the stratified squamous epithelium. Although having this condition is not an abnormality, it is indistinguishable from early cervical cancer. When at a routine check up, it can be seen by the nurse when a cervical screening test (or smear test) is done. The area may look red because the glandular cells are red. While many women are born with cervical ectropion, it can be caused by a number of reasons, such as:

- Hormonal changes, so meaning it can be common in young women.

- Taking “the pill” to protect from pregnancy

- Pregnancy

Onychomycosis, also known as tinea unguium, is a fungal infection of the nail. This condition may affect toenails or fingernails, but toenail infections are particularly common.

Treatment may be based on the signs. Treatment may be with the medication terbinafine.

It occurs in about 10 percent of the adult population. It is the most common disease of the nails and constitutes about half of all nail abnormalities.

The term is from Ancient Greek ὄνυξ "ónux" "nail", μύκης "múkēs" "fungus" and -ωσις "ōsis" "functional disease."

The most common symptom of a fungal nail infection is the nail becoming thickened and discoloured: white, black, yellow or green. As the infection progresses the nail can become brittle, with pieces breaking off or coming away from the toe or finger completely. If left untreated, the skin underneath and around the nail can become inflamed and painful. There may also be white or yellow patches on the nailbed or scaly skin next to the nail, and a foul smell. There is usually no pain or other bodily symptoms, unless the disease is severe. People with onychomycosis may experience significant psychosocial problems due to the appearance of the nail, particularly when fingers – which are always visible – rather than toenails are affected.

Dermatophytids are fungus-free skin lesions that sometimes form as a result of a fungus infection in another part of the body. This could take the form of a rash or itch in an area of the body that is not infected with the fungus. Dermatophytids can be thought of as an allergic reaction to the fungus.

Rokitansky–Aschoff sinuses, also entrapped epithelial crypts, are pseudodiverticula or pockets in the wall of the gallbladder. They may be microscopic or macroscopic.

Histologically, they are outpouchings of gallbladder mucosa into the gallbladder muscle layer and subserosal tissue as a result of hyperplasia and herniation of epithelial cells through the fibromuscular layer of the gallbladder wall. They are usually referred to as adenomyomatosis.

They are not of themselves considered abnormal, but they can be associated with cholecystitis.

They form as a result of increased pressure in the gallbladder and recurrent damage to the wall of the gallbladder.

Majocchi's disease (also known as Majocchi's Granuloma, "Purpura annularis telangiectodes,", and "Purpura annularis telangiectodes of Majocchi") is well-recognized but uncommon skin condition characterized by purple/bluish-red 1- to 3-cm annular patches composed of dark red telangiectases with petechiae. The name Majocchi's comes from the Professor Domenico Majocchi who first discovered the disorder in 1883. Domenico Majocchi was a professor of dermatology at the University of Parma and later the University of Bologna. Majocchi's disease can be defined as an infection of the dermal and subcutaneous tissues due to a fungal mold infection on the cutaneous layer of the skin. The most common dermatophyte is called "Trichophyton rubrum." This disease can affect both immunocompetent and immunocompromised hosts. However, immunocompromised individuals have a higher risk.

Symptoms include recurring attacks of severe acute ocular pain, foreign-body sensation, photophobia (i.e. sensitivity to bright lights), and tearing often at the time of awakening or during sleep when the eyelids are rubbed or opened. Signs of the condition include corneal abrasion or localized roughening of the corneal epithelium, sometimes with map-like lines, epithelial dots or microcysts, or fingerprint patterns. An epithelial defect may be present, usually in the inferior interpalpebral zone.

Sarcoma botryoides or botryoid sarcoma or botryoid rhabdomyosarcoma is a subtype of embryonal rhabdomyosarcoma, that can be observed in the walls of hollow, mucosa lined structures such as the nasopharynx, common bile duct, urinary bladder of infants and young children or the vagina in females, typically younger than age 8. The name comes from the gross appearance of "grape bunches" ("botryoid" in Greek).

For botryoid rhabdomyosarcoma of the vagina, the most common clinical finding is vaginal bleeding but vaginal bleeding is not specific for sarcoma botryoides: other vaginal cancers are possible. They may appear as a polypoid mass, somewhat yellow in color and are friable: thus, they (possibly) may break off, leading to vaginal bleeding or infections.