Dermatology in practice - 2001


Comment: Do we need dedicated dermatology beds?
Neil Cox
pp 4-4
Debate about hospital beds is perennial. It may be about who owns them, whether we have enough of them, whether they are in the right place, or whether they are adequately staffed – but the debate is always there. Some readers of this column will have attended the same meeting as myself at which there was an after dinner debate on this subject. For those who weren't there, this may seem a rather dry postprandial topic. However, as the social event was not dry, the quality of debate from the floor was entertaining even if not altogether coherent.
Dermatological problems in transplant patients
Sara Brown and Janet McLelland
pp 6-9
Immunosuppressive therapy plays an important part in the management of organ transplant recipients to prevent rejection of the allograft. However, cutaneous side-effects of the immunosuppressive drugs, as well as complications of the immunosuppressed state, can cause significant morbidity and mortality.
Acne and the Pill
Julia Hepburn and Neill Hepburn
pp 10-11
The oral contraceptive pill (OCP) provides effective, safe and reversible contraception. As young women often start sexual activity at a time in their life when acne is common, the interaction between acne and the pill is frequently a cause for concern. While the oral contraceptive pill can improve acne in women, varying formulations carry different risks and benefits, knowledge of which can help the clinician select the most appropriate OCP.
Mycosis fungoides
Eileen J Parry
pp 14-18
Mycosis fungoides was first described nearly 200 years ago, in a patient with large necrotic ‘mushroom-like’ tumours on the skin. Mycosis fungoides is now recognised to be the most common variant of a heterogeneous group of non-Hodgkin’s lymphomas that present in the skin: known as cutaneous T-cell lymphoma. This article will describe the epidemiology, clinical and histological features, staging, treatment and prognosis of mycosis fungoides and of its leukaemic variant, the Sézary syndrome.
Evaluation and referral indications for atopic eczema
Malobi I Obgoli
pp 19-20
Atopic eczema is a chronic or chronically relapsing condition. It is variable in severity and age of onset. Each individual patient will experience fluctuations in their disease extent and severity which will require changes in the individual’s treatment regimen. Changes in a patient’s personal circumstances might also require modification of their care. Regular evaluation of all patients will be needed throughout the duration of their disease so that the appropriate changes can be made.
RAST – what it is and when to use it
Catherine Stroud and Gavin Spickett
pp 22-25
A diagnosis of type I (IgE mediated) allergy is made by the clinical history and confirmed by a combination of in vivo and in vitro investigations. Symptoms are highly variable, ranging from rhinitis, conjunctivitis and urticaria to shortness of breath, laryngeal oedema, hypotension and anaphylaxis. One of the useful tests available for type I allergy is the radioallergosorbent test, which measures specific IgE to an allergen. Other types of allergic reaction (types II, III and IV) are not mediated via IgE and therefore this form of testing is not appropriate.
Why wounds fail to heal
Deborah Hofman
pp 28-30
Over the last ten to 15 years wound care has increasingly become the domain of the nurse – so much so that many general practitioners profess ignorance of wound management and dressings and leave decision-making entirely to the nursing staff. Many practice and district nurses take an active and professional interest in wound management, keeping themselves up-to-date by attending conferences and reading the literature. However, this is not always the case and there is a wide diversity of expertise among nursing professionals. Even where nurses are well informed, they still frequently feel they need more support from their medical colleagues. In this issue we begin a twopart series on wound care, starting with why wounds fail to heal.
A spot of Savin: A majestic swoosh
John Savin
pp 31-31
A few weeks ago my youngest grandson went to the bathroom, for the usual reasons. He seemed to be taking rather a long time and I asked how he was getting on. ‘I am doing a majestic swoosh’, he replied. These were long words for a three-year-old, and probably borrowed from a film about dinosaurs. I was glad he did not say that he was ‘experiencing prolonged micturition’, as the flabby verbosity of some scientific writers is my theme for today.