Dermatology in practice - 2003

Comment: The things some people do …
Neil H Cox
pp 4-4
The human race never ceases to be a source of amazement. Tempting as it is to give you more from the Darwin awards, I’m actually going to stick to dermatology this time. Probably.
Pigmentary disorders – possible causes of change
Phil Preston and Irshad Zaki
pp 6-10
The colour of our skin is the result of a blend of pigments that combine to make the appearance of our skin distinctive to others. Like any other physiological system, abnormalities may arise as a result of disease. In this article, we aim to conduct a whistle-stop tour of this broad topic, briefly discussing along the way some important issues regarding the more common presentations.
Treatment, management and prevention of skin cancer
Polly Buchanan
pp 12-13
Skin cancer is the most commonly diagnosed cancer in the UK; recent reports state that almost 60,000 cases are diagnosed each year. However, evidence indicates that this figure may be underestimated by as much as 50 per cent.2 The same reports state that the number of cases diagnosed has doubled in the last 20 years and that deaths due to melanoma have doubled in the last decade,2 with over 2,000 people dying from the condition each year.
Polymorphic light eruption
Jane M McGregor and Thomas P Millard
pp 20-21
Polymorphic light eruption (PLE) is the most common of the so-called idiopathic photodermatoses, affecting 15% of healthy people in the UK, with a female to male prevalence ratio of around 2–3:1. It is typically characterised by the intermittent occurrence of transient, non-scarring, pruritic papules and vesicles, which develop hours, or sometimes days, after sun exposure and resolve over a period of between several days and a week or so. Most cases are mild, responding to caution during sun exposure, and such patients rarely present to dermatologists. However, those with moderate-to-severe disease may experience considerable discomfort and restriction of their lifestyles. This article examines the available treatment options for PLE.
Introducing the Patient Information Gateway Project
Pippa Hemingway and Hywel Williams
pp 24-26
Are you spending too much time searching for dermatological information for your patients? Is the quality of that information variable? Do patients regularly arrive with a handful of internet printouts about their skin problem, that you then have to decipher? If the answer to any or all of these questions is ‘yes’, then your problems might be solved by a new patient information gateway project, which started in October 2002, funded by the British Association of Dermatologists (BAD) and NHS Action On Dermatology.
Pyoderma gangrenosum – recognition and treatment
Venkat Gudi and Anthony Ormerod
pp 27-30
PG is an immunologically mediated acute destructive ulcerating condition of the skin. It is characterised by severe pain, rapid centrifugal extension of ulceration and also by its response to immunosuppressive or immunomodulant therapy. Its effects are devastating and, unless prompt therapy is initiated, enormous tissue destruction can occur quite rapidly. In more than half of patients with PG, there is an associated autoimmune or malignant disease.
Monk's moments: Out of the blue
Barry Monk
pp 31-31
Just occasionally a case arises that seems to make medicine worthwhile. A few weeks ago, I was greeted at the entrance to the hospital by one of my consultant physician colleagues. ‘Would you mind coming up to the ward to have a quick look at a patient who came in last night?’ I hate being asked to ‘have a quick look’ as I always feel that that’s where people go wrong with dermatology – a long, careful look (and a proper history first) is so much better. But it’s always nice to be wanted, so I followed him as he told me the story.