Dermatology in practice - 2003

Comment: Taking a fresh look at medical research
Neil Cox
pp 4-4
In a previous issue, I discussed a couple of dermatological examples of articles awarded the Ig Nobel prize over the last decade for unlikely or bizarre research. Here are a few more...
Skin manifestations of diabetes mellitus
Jamshed Niazi and Sivakumar Natarajan
pp 6-10
Diabetes mellitus is a multisystem disorder causing myriad complications. Skin manifestations occur in 30% of patients with diabetes at some stage of the disease. Skin manifestations of diabetes mellitus can be divided into four groups: Infections, skin diseases associated with diabetes mellitus, skin diseases directly related to diabetic complications, and skin complications resulting from antidiabetic treatments.
Managing familial melanoma
Julia Newton Bishop
pp 12-15
Melanoma sometimes occurs in families, a fact that is indicative of genetic susceptibility to the disease. Around 5% of melanoma patients in the UK report a family history, but this figure is higher in hotter areas of the world; for example, 7% of Canadian patients and 11% of patients in an Australian study. The significance of the observation that different rates of clustering occur in countries at different latitudes is as yet unconfirmed and merits further study. One explanation for this phenomenon may be that it indicates an effect of both shared genes and environment (sun exposure) in determining familial clustering.
The sclerodermas
Lindsay Shaw and Chris Lovell
pp 18-20
The term ‘scleroderma’ is derived from the Greek meaning ‘hard skin’. As a diagnostic label it is applied to two distinct clinical entities with similar pathology: localised scleroderma (morphoea) and systemic sclerosis. In both conditions, lesions in the target organ progress through inflammation, fibrosis and atrophy. Morphoea rarely, if ever, evolves into systemic disease.
Methicillin-resistant Staphylococcus aureus
Sid Orpin
pp 22-26
With the ever-increasing frequency of tabloid headlines describing the development of ‘super bugs’ that are resistant to modern antibiotics, it is easy to fall into the trap of regarding such events as a purely modern phenomenon. In fact, resistance to antimicrobial agents rapidly followed their initial introduction. The emergence of one such organism, methicillin-resistant Staphylococcus aureus (MRSA), has perhaps had more impact on medical care for patients and implications for the health workers dealing with them than any other. Healthcare facilities all over the world invest resources to try to reduce the threat it poses to those they care for, with varying levels of success. This article reviews the emergence of MRSA, its epidemiology, treatment and basic infection control measures.
Vitiligo – recent advances
Beth Collin and Irshad Zaki
pp 28-30
The prevalence of vitiligo is estimated at between 0.5–1 % of the population with equal sex incidence. Around 50% of cases manifest before the age of 20 years. Vitiligo is a clinical diagnosis based on the appearance of chalk-white macules with well demarcated borders. Macules of depigmentation may appear anywhere on the body and lesions are often distributed symmetrically. The disease is classified according to its extent and distribution. The natural history of vitiligo is relatively poorly documented. The tendency is for lesions to expand with time and for new lesions to appear. In many patients, the disease stabilises and lesions become static. It is rare for lesions to spontaneously repigment.
Monk's moments: Chips with everything (or laughing from the inside)
Barry Monk
pp 31-31
The Nobel Prize for physics for the year 2002 was awarded to the scientists whose experiments proved the existence of neutrinos. These subatomic particles, which have neither mass nor electrical charge, had been predicted on theoretical grounds since the 1930s, but demonstrating them had been an elusive task.