Dermatology in practice - 2001


Comment: Mobile phones, the Stewart report and a resurrected neurocutaneous syndrome
Neil Cox
pp 4-4
Mobile phones have been extensively in the news over recent months. First there were concerns about brain cancers, followed by major job losses in the mobile phone industry (a sort of proof that what goes up must come down), and most recently the problems of the changes to telephone numbers. I won't elaborate on the latter. Suffice it to say that 25% of phone owners were apparently unaware of the fact that numbers were about to change, and found that their phones were dead.
Childhood fungal infections
Pascale C Gruber and Ravi Ratnavel
pp 6-10
Superficial fungal infections account for 7–15% of the disorders seen in a paediatric clinic. Common fungal infections seen in children may be divided into three categories: dermatophyte or ringworm infections, pityriasis versicolor, and candidiasis. Fungal skin infections in children are generally similar to those seen in adults, but can occasionally be atypical and, as such, pose a diagnostic challenge.
Diseases of black skin
Kate A Short
pp 12-15
Some skin conditions occur so commonly in the black population that they are considered, essentially, to be normal variants. These include Fuchter’s (or Voight’s) lines, midline hypopigmentation and nail pigmentation. Certain features of skin disease may be more difficult to recognise; for example, erythema. Additionally, the anticipated clinical features of common conditions such as lichen planus may be masked by associated post-inflammatory hypopigmentary or hyperpigmentary change.
Neonatal skin lesions
Catherine S Jury and A David Burden
pp 18-20
Lesions presenting on the skin of neonates can arise for a variety of reasons and are a cause of concern to both parents and doctors. Making a firm diagnosis allows early discussion of prognosis, provides reassurance for parents and enables commencement of treatment where appropriate. We aim to outline the more common and more important lesions that present at birth and in the perinatal period, focusing on clinical presentation, natural history, associated complications and treatment.
Latex allergy and glove usage
Angela Forsyth
pp 22-24
‘Rubber allergy’ in the form of allergic contact dermatitis (ACD) has been well recognised for decades. During the past 20 years an acute immediate reaction to rubber items has been demonstrated in some subjects. This can be very dramatic and is potentially fatal. The first type of ACD reaction is due to additives (accelerators, antioxidants and vulcanising agents in rubber). The second type is due to the natural rubber latex protein in the rubber.
Actinic keratosis
Kathryn F Thomson and Graeme Stables
pp 26-29
Actinic keratoses, otherwise known as solar keratoses, are the most common premalignant skin lesion. Strongly associated with chronic exposure to ultraviolet light, their presence provides an indicator of high cumulative exposure and can be a risk indicator for nonmelanoma skin malignancies. There is debate as to whether AKs are genuinely premalignant, or whether they are actually early-stage squamous cell carcinoma (SCC). In a series of 459 patients with cutaneous SCC, 97% were associated with an adjacent actinic keratosis. The rate of progression of the lesions on to invasive SCC has been reported as being anywhere from 1:1,000 to as high as 1:5, although the general consensus favours the former.
Monk's moments: Faith restored
Barry Monk
pp 31-31
The President of the General Medical Council, Sir Donald Irvine, has recently spoken of the changing relationship between the public and the medical profession. One of the more obvious manifestations of this changing relationship is the apparent readiness of patients to sue their doctors, a phenomenon almost unheard of 30 years ago.