Subsequently, fibroblasts differentiate into osteoblast-like cells, which results in abnormal bone matrix deposition leading to progressive valvular calcification and stenosis.As a consequence of this stenosis, the left ventricle must generate a higher pressure with each contraction to effectively move blood forward into the aorta. Initially, the LV generates this increased pressure by thickening its muscular walls (myocardial hypertrophy). The type of hypertrophy most commonly seen in AS is known as concentric hypertrophy, in which the walls of the LV are (approximately) equally thickened. In the later stages, the left ventricle dilates, the wall thins, and the systolic function deteriorates (resulting in impaired ability to pump blood forward). Morris and Innasimuthu et al. showed that different coronary anatomy is associated with different valve diseases. Research was in progress in 2010 to see if different coronary anatomy might lead to turbulent flow at the level of valves leading to inflammation and degeneration. Diagnosis
Palpation
Aortic stenosis is most often diagnosed when it is asymptomatic and can sometimes be detected during routine examination of the heart and circulatory system. Good evidence exists to demonstrate that certain characteristics of the peripheral pulse can rule in the diagnosis. In particular, there may be a slow and/or sustained upstroke of the arterial pulse, and the pulse may be of low volume. This is sometimes referred to as pulsus parvus et tardus. There may also be a noticeable delay between the first heart sound (on auscultation) and the corresponding pulse in the carotid artery (apical-carotid delay).
Lepidopterism is an irritant contact dermatitis caused by irritating caterpillar or moth hairs coming into contact with the skin or mucosa. When referring to the cause, moth dermatitis and caterpillar dermatitis are commonly used; Caripito itch (known as papillonite in French) is an older name referring to the moth dermatitis caused by some Hylesia species. See also
Millipede burn
List of cutaneous conditions

References
Further reading
Hossler EW (2009). "Caterpillars and moths". Dermatol Ther. 22 (4): 353–66. doi:10.1111/j.1529-8019.2009.01247.x. PMID 19580579. S2CID 31799282. Hossler EW (January 2010). "Caterpillars and moths: Part II. Dermatologic manifestations of encounters with Lepidoptera". J. Am. Acad. Dermatol. 62 (1): 13–28, quiz 29–30. doi:10.1016/j.jaad.2009.08.061. PMID 20082887. Hossler EW (January 2010). "Caterpillars and moths: Part I. Dermatologic manifestations of encounters with Lepidoptera". J. Am. Acad. Dermatol. 62 (1): 1–10, quiz 11–2. doi:10.1016/j.jaad.2009.08.060. PMID 20082886. Katzenellenbogen, I. (1955). "Caterpillar Dermatitis as an Occupational Disease". Dermatologica. 111 (2): 99–106. doi:10.1159/000256344. PMID 13277355. Werno, J.; Lesthelle, S.; Doerman, F.; Vincendeau, P. (2002). "Envenimations par les lépidoptères". Revue Française des Laboratoires. 2002 (342): 35. doi:10.1016/S0338-9898(02)80059-2. External links
Caterpillar envenomation on eMedicine