Dermatology in practice - 2001

Comment: Who to refer?
Neil Cox
pp 3-3
Let me start by saying that those of you who read the title of this item and think that all your problems are over will be disappointed. This is not an editorial listing conditions that ought to be seen by dermatologists (although maybe that is something we should consider for a future article); it is more of a comment on a trend that I have observed over several years.
Varicose eczema
Sonal Shankar and Peter Mortimer
pp 6-9
Varicose eczema is also known as stasis dermatitis and describes dermatitis affecting the lower legs as a result of impaired venous circulation (chronic venous insufficiency). Chronic venous insufficiency is where venous blood fails to return efficiently to the heart. The resultant rise in capillary pressure produces changes such as stasis dermatitis, oedema, haemosiderin deposition, fibrosis of the skin and subcutaneous tissue (lipodermatosclerosis) and ulcer formation. Chronic venous insufficiency results from primary varicose veins or following deep vein thrombosis. As the likelihood of developing varicose veins is familial, the tendency to develop varicose eczema can also be familial.
Occupational dermatitis in factory workers
Iain Foulds
pp 12-14
Occupational dermatitis can be defined as a pathological condition of the skin for which occupational exposure can be shown to be a major contributory factor, and which would not have occurred if the individual had not been doing that type of work. Legal definitions of occupational dermatitis vary considerably between countries. In the UK the majority are defined by Prescribed Disease D5 by the Department of Health and Social Security as 'non-infective dermatitis of external origin (including chrome ulceration of the skin but excluding dermatitis due to ionising particles or electromagnetic radiation other than radiant heat)'.
Wet wrapping – a missed opportunity in primary care
Neil Cox
pp 15-18
Wet wraps are a useful option in the management of atopic eczema, and have been discussed in detail in this journal previously as well as in our sister journal, the British Journal of Dermatological Nursing. These articles provide details of the rationale for use of wet wraps, as well as practical instruction on how to apply them and use them to best effect.
Dermatology and GP trainees
Meg Price
pp 20-21
Why, when dermatology features so widely in general practice, is so little emphasis placed on it in training? I believe this is because when training programmes in general practice were initially devised, the service needs of the hospital remained the dominant factor governing the structure of the schemes. Thus two out of three years were allocated to hospital posts and, within those two years, GP trainees were expected to work primarily with inpatients in order to provide adequate cover on the wards.
Seborrhoeic keratoses – what you need to know
Bruce C Gee and Richard Turner
pp 22-24
Seborrhoeic keratoses are common, benign epidermal tumours without significant malignant potential. Their benign nature does not lessen the importance of making the correct diagnosis in view of their clinical similarities to malignant lesions and occasional association with internal malignancy.
Eye involvement in disorders of the skin
Peggy Frith
pp 28-30
Many conditions that affect the skin may also affect the eye. These include allergic reactions, seborrhoeic eczema, rosacea, infections, tumours and bullous diseases. This article discusses the clinical features and management of these conditions. Allergy of the eye surface is always uncomfortable, and the occasional patient will develop a persistent problem with sight. Eczema of the eyelids may occur alone, or with conjunctivitis. The cardinal symptom is itching, which may be acute, seasonal or chronic. Likely cause and management depend on the type of allergic stimulus.
A spot of Savin: Of music and maggots
John Savin
pp 31-31
Not long ago I introduced you to the joys of index hopping – the art of combing the index of a large textbook for amusing oddities. I have now been asked to take the subject further, beyond the items previously flushed out of the index of the current Rook Book, all of which were listed under A and B. I can now start on the Cs, beginning, as promised, with ‘cello scrotum’.