Dermatology in practice - 2000


Comment: Dermatology culture shocks
Neil Cox
pp 4-4
It is a laudable concept that doctors should conform to certain standards and shared approaches to a problem, up to a point. However, if we were all from the same clone, medical advances would grind to a halt. Debate on diagnosis and treatment is a feature of dermatological clinical meetings, and is one of the strengths of a small specialty whose proponents actually communicate with each other.
Managing urticaria
Clive Grattan
pp 6-10
Urticaria is characterised by short-lived, itchy, and sometimes painful, swellings of the skin or mouth due to transient plasma leakage. There is a wide spectrum of clinical presentations. Superficial swellings are known as wheals, deeper swellings are called angioedema. Wheals and angioedema often occur together, although not necessarily at the same time.
The treatment of leg ulcers in a clinic setting
Lynn McCullagh
pp 11-13
Leg ulceration is a common problem in the UK with around 1% of the population affected at some time in their lives. Although associated with old age, there is a significant prevalence in the under 50s. Within our service, clients as young as 18 years have presented. The cost of treating leg ulcers has been estimated at 2% of total health spending for the UK. Moreover, this figure does not take into account the personal cost to the patientÕs quality of life, including pain, social isolation, immobility and odour.
Telemedicine – the arguments for and against
Philip Harrison
pp 16-18
A simple definition of telemedicine is the practice of medicine at a distance. However, this definition would include many everyday clinical activities and would not encompass the modern use of computers and telecommunication equipment. Most people would now regard telemedicine as involving some method of electronic data transfer, thereby achieving some degree of medical practice remotely.
Do topical medicaments cause more harm than good?
Natalie Stone and Sheila Powell
pp 20-23
Topical medicaments are estimated to account for between 20–30% of all cases of allergic contact dermatitis. It is important that we are aware of the potential risks of contact sensitisation to particular medicaments, the contact irritancy that can occur with some products, and the sites of application which are of particular risk of contact sensitisation.
Contact sensitivity and the mouth
Manu Shah
pp 24-25
The oral mucous membranes may be involved in a variety of dermatological disorders. Oral symptoms may be a manifestation of systemic disease. However, there is a group of patients in whom no obvious dermatological or systemic cause can be found to account for their oral symptoms. Contact allergy should be considered in all patients with unexplained oral symptoms. Contact sensitivity has been described as a factor in recurrent oral ulceration, oral lichenoid reactions, the burning mouth syndrome and persistent perioral swelling.
Dermatology in genitourinary medicine clinics
Sylvia Bates and David Hicks
pp 28-30
Patients frequently present to genitourinary medicine clinics with conditions affecting the skin. These may be manifestations of sexually transmitted infections but this is not always the case, and other skin disorders need to be considered in the differential diagnosis.
A spot of Savin: Can we beat pemphigus?
John Savin
pp 31-31
If you read only one scientific paper this year, make it the one listed below – by Proby et al. It contains a strikingly original idea on how to deal with pemphigus. Admittedly you may find the paper fairly hard work; one sentence in the summary, for example, runs: ‘The epitopes of these monoclonal antibodies were mapped on the amino terminal EC1 and part of EC2, a region considered functionally important in cadherins’. Your best plan is probably to read first the commentary on the paper that the editors of the British Journal of Dermatology have thoughtfully provided. If you find this difficult too, then simply plough on to the end of this page.