Dermatology in practice - 2000


Comment: Another train of thought
Neil Cox
pp 4-4
In the last issue, I brought to your attention some political health issues from newspapers that I have read while on train journeys recently. Happily, much of the non-dermatological medicine that I learn while travelling is more interesting than the politics. So, here I am sitting on the train documenting a few further snippets gleaned in recent months.
Child abuse and the dermatological differential diagnosis
Aileen E M Taylor
pp 6-8
Child abuse encompasses a spectrum from minor neglect of the child and emotional abuse by threat and ridicule, through to serious nonaccidental injury resulting in physical harm, and sexual abuse. These maltreatments can produce cutaneous abnormalities that may mimic true disease. Dermatological diagnoses must be considered and excluded. There are numerous reports of cutaneous entities which have been misdiagnosed as injury secondary to abuse. While it is vital that suspected cases are reported, the implications of a false accusation of child abuse are far reaching.
Cryotherapy in the treatment of common viral warts
John F Bourke
pp 9-11
Viral warts are one of the commonest skin complaints presenting to general practitioners and dermatologists. Epidemiological studies estimate a prevalence of 4–5% in schoolchildren.1 In the main, they are more of a nuisance than a debilitating problem. Treatment is generally requested for cosmetic reasons (often for the parents rather than the children!) although plantar warts may be painful and interfere with walking.
Is clinical dermatology research under threat in the new NHS?
Hywel C Williams
pp 14-16
Many readers know that I dabble in epidemiological research, but few know that I also direct research and development for the large NHS trust in which I work. One of the most useful things that I have learned from my role as Director of R&D is understanding more about how money moves to support research in NHS trusts and other providers.
Sensitivity and eczema
Sheila Powell
pp 17-20
Sensitivity is a widely used term and in any dialogue with patient or colleague it is important that the word is defined so that all use it in the same context. It is a word commonly used by our patients, in phrases such as: ‘There must be some sensitivity’, ‘What am I sensitive to?’ and, ‘I have a sensitive skin’.
Non-venous leg ulcers
Susan M Cooper and Terence J Ryan
pp 22-25
Although the majority of leg ulcers are venous, there are many other possible causes of leg ulcer. The diagnostic challenge makes working with leg ulcers anything other than boring! The prevalence of leg ulcers has been estimated at 1.5 per 1,000 but rises sharply to 20 per 1,000 in the over-80s. Leg ulcers are, therefore, a common problem and are likely to rise in number with an increasingly elderly population. In this article we will discuss the assessment of the patient with a leg ulcer, highlight the features that may suggest a nonvenous cause for an ulcer, and discuss some of the more important causes of ulceration.
Common skin disorders of the foot
Ivan Bristow
pp 28-29
The podiatrist is a foot specialist, working as part of the healthcare team, but often the GP is the first port of call for the patient. In this article, three commonly presenting foot problems are discussed along with their management. Hyperkeratosis Ð a thickening of the stratum corneum Ð is the problem most commonly presented to the podiatrist. In most cases, its presence signifies mechanical stresses generated by the foot interacting with the ground and footwear.
A spot of Savin: The man who was allergic to aeroplanes
John Savin
pp 31-31
An elderly dermatologist, now long retired, told me recently about a politician who had come to believe that he was allergic to aeroplanes. I could just remember seeing the man in question on television, many years ago, offering a flow of self-righteous sound bites that were popular with producers. At first sight his aeroplane allergy theory seemed implausible – little better than that of another patient who felt he was allergic to leather. 'I must be,' he insisted, 'every time I wake up with my shoes on, I've got a hell of a headache.'