Skin manifestations of sarcoidosis lesions of sarcoidosis accompanied by substantial fibrosis, simulating morphea. Erythrodermic sarcoidosis is a cutaneous condition and very rare form of sarcoidosis. Hypopigmented sarcoidosis is a cutaneous condition characterized by areas of hypopigmented skin. It is usually diagnosed in darkly pigmented races and may be the earliest sign of sarcoidosis. Papular sarcoid is a cutaneous condition characterized by papules, which are the most common morphology of cutaneous sarcoidosis. Ichthyosiform sarcoidosis is a cutaneous condition resembling ichthyosis vulgaris or acquired ichthyosis, with fine scaling usually on the distal extremities, by caused by sarcoidosis. Subcutaneous sarcoidosis (also known as "Darier–Roussy disease" and "Darier-Roussy
Emergency medical services in the Netherlands The exceptional level of training permits what is, for the most part, independent practice, conducted according to a set of National Emergency Care Protocols, issued by the Dutch Ambulance Institute, and reviewed and revised every four years. Medical oversight for protocol compliance is conducted by each service's Medical Manager, who is a licensed physician. On those occasions when the patient's condition actually exceeds the paramedic protocols, the paramedic has the option of either calling their own Medical Manager for additional instructions, or requesting the response of a mobile medical team. All ambulances are staffed by a crew of two. These