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Atopic dermatitis (AD) is a common skin disease that can occur in all age groups. An intriguing phenomenon associated with AD is spontaneous remission, in which the symptoms can disappear even without any treatment, especially for patients at a young age. From the point of view of dynamical evolution, spontaneous remission in AD is a transient phenomenon. A clinic implication is that, if the transient time is short, then aggressive treatment may not be necessary. A key question is thus, statistically, how long the transient time can be? Due to the lack of clinic data, mathematical modeling is a viable approach to addressing this question. Modeling AD as a nonsmooth dynamical system and regarding the disease as a transient phenomenon with spontaneous remission marking the end of the transient, we obtain a quantitative understanding of the statistical characteristics of AD. In particular, we find that, depending on the immune state, two different types of transient behaviors can arise. For type-I spontaneous remission characterized by a healthy immune level with its skin state exhibiting mild oscillations, the transient time is short, which typically occurs in patients between infancy and childhood. In contrast, type-II spontaneous remission is characterized by a low immune level and its skin state exhibits severe oscillations with a long recovering time. Quantitatively, a scaling relation exists between the average transient time (or recovery time) and some key physiological parameters, revealing that the transient is superpersistent in the sense that its average lifetime can diverge in a drastic way: e ∞ as a bifurcation parameter approaches a critical value. In this case, the disease is essentially permanent, thereby requiring and justifying active treatment. • Spontaneous remission in atopic dermatitis is a transient process. • Two different types of spontaneous remission can arise, SR-1 and SR-II. • SR-I is characterized by a healthy immune level with a short recovery time. • SR-II is characterized by a low immune level with a long recovery time. • A scaling relation for the average recovery time satisfies superpersistence. [ABSTRACT FROM AUTHOR]

As an American medical student, I spent the summer break between my first and second year in Lourdes, France, the site where the Immaculate Conception appeared eighteen times to St. Bernadette in 1858 as proclaimed approved by the Catholic Church and whose water is associated with over seven thousand unexplained cures. During this time I volunteered with St. Joseph's Service and Poste Secour, followed several medical teams taking care of large pilgrim groups, and shadowed Dr. Alessandro de Franciscis the president of Le Bureau des Constations Médicales, the office in Lourdes charged with investigating claims of miracles. Through my experiences, I found the mission of medicine in Lourdes to be twofold: to provide the critical care needed to give sick persons the chance to transform their experience of disease through their faith; and secondly, through the efforts of the Medical Bureau, to be an instrument by which we can comprehend the wonders of the work of God. I conclude that this twofold mission should inform the work of every Catholic in health care or research, and Lourdes provides the venue par excellence to cultivate this mission. Lay Summary: Lourdes is a pilgrimage site in southern France that has been associated with medical miracles for the past 150 years. The site is unique in that throughout its history, physicians, of any or no faith, have been invited to participate in the proceedings of the investigations of each claimed cure. The investigations have formalized into a process handled by the Lourdes Medical Bureau and the Lourdes International Medical Association. Travis Dichoso, an American medical student, writes about his experiences as part of this process. [ABSTRACT FROM AUTHOR]