Dermatology in practice - 2002


Comment: The Wizard of Oz and other short stories
Neil Cox
pp 4-4
One of the problems of MEDLINE is being led astray by apparently fascinating snippets of information. Having tripped across an article about merlin protein, which sounded vaguely interesting, and being fed up with an overdose of Harry Pottermania among my offspring, I decided to look at a few other magical and wizardry terms. Let’s do the science first.
GP perspective on the diagnosis and management of actinic keratosis
Timothy Mitchell
pp 6-8
The diagnosis and management of skin ‘lesions’ have become a priority area since the introduction of the two-week wait policy for cancer. This has caused concern among many in dermatology as it could lead to compromises in the care of patients with chronic inflammatory dermatoses, which often have a profound effect on quality of life. Therefore, it is important that GPs improve their skills in diagnosing both pigmented and non-pigmented skin lesions to avoid swamping consultant clinics with unnecessary referrals. Once confidence is gained in diagnosis, GPs should then move on to firstline management of suitable conditions.
Dermatological diseases affecting the nipple
Corinna O Mendonça and A David Burden
pp 10-13
A wide variety of inflammatory and neoplastic conditions may manifest in the nipple and it is important that the practitioner is able to manage these appropriately. This article briefly reviews the anatomy and physiology of this specialised region and gives an overview of the common dermatoses that are seen in routine clinical practice.
Dermatoscopy features of common pigmented lesions
Colin Fleming
pp 16-18
The incidence of malignant melanoma has risen rapidly in fair-skinned communities across the world in the past 25 years. This has led to increased public recognition of the dangers of melanoma, and increased consultations for pigmented skin tumours in primary and secondary care. A variety of tools have been used in the last 30 years to improve accuracy of diagnosis of pigmented skin lesions. The best known of these is the dermatoscope, also known as the dermoscope or epiluminescent light microscope. This article reviews the dermatoscopy features of common pigmented skin lesions.
Antibiotic resistance and the use of combination treatments for acne
Tony Chu
pp 19-20
Acne vulgaris is one of the most common skin conditions to affect mankind. It affects over 90% of adolescents, and in up to 30% of patients acne persists into adult life. At the age of 40, the incidence is 5% in women and 1% in men. The standard treatment for acne involves the use of topical retinoids or other comedolytic agents to address the primary lesion of acne, the microcomedone, while antibacterial agents or antibiotics are used to control Propionibacterium acnes and thus to control the inflammatory lesions of acne.
The cost of eczema – a UK perspective
Ceri J Phillips
pp 22-24
Atopic eczema is a common disease affecting children and adults worldwide. The onset is in infancy in 60% of patients and before five years in 90%. Although atopic eczema is particularly common in children aged between one and five years and relatively rare in people aged over 40 years, it may persist in up to 60% of adults who were affected in childhoood. Estimates of the prevalence of atopic eczema in Western countries range between 15% and 20% of the population aged between seven and 18 years, although it has recently been shown to exceed 30% in Australia.
Hair therapeutics – recent advances
Alexander J Chamberlain and Rodney PR Dawber
pp 26-29
Tinea capitis or scalp ringworm is an increasingly common fungal infection of childhood. A large number of species of dermatophyte may be responsible for invading hair and as a result, effective therapy must be guided by identification of the offending pathogen. The past few decades have seen shifting trends in the various species responsible for tinea capitis. Microsporum canis has been the predominant pathogen responsible for tinea capitis in Europe for some time. In recent years, however, there has been an increase in the prevalence of Trichophyton tonsurans infections in the UK (T tonsurans is the predominant cause of tinea capitis in the USA).
Monk's moments: Monkey business
Barry Monk
pp 31-31
A couple of years ago I was in the north-east of England with my wife. It was a fine summer’s evening, and looking at the map we found that we were not far from the coast. A walk along the beach seemed an inviting idea. It is not an area that either of us knows well, which explains how, some 30 minutes later, we found ourselves on the seafront at Hartlepool. Even in June an icy wind blew off a grey North Sea. The Côte d’Azur it was not.