Dermatology in practice - 2003

Comment: Performing seals and bedpans at dawn
Neil H Cox
pp 4-4
It is a specific, if hitherto unappreciated, perk of the job that the editor has discretion to mix metaphors, split infinitives and produce apparently disjointed titles for the editorial comment. But read on: there is a strand of logic to link the items in the title.
The hazards of sunbeds
Lesley E Rhodes
pp 6-8
Sunbed use has become a popular pastime, with surveys revealing that the preponderance of users are in their teens and twenties. Ultraviolet radiation (UVR) is the primary cause of skin cancers, and there is no reason to believe that sunbeds will be less dangerous than natural sun. Further complications of their use are provocation of photosensitivity disorders and drug phototoxicity, premature skin aging and eye disorders.
Patterns of purpura
Neil H Cox
pp 10-12
Purpura is the term used to describe extravasation of erythrocytes. It is diagnosed by the failure of lesions to blanch on pressure, but there are some pitfalls of this physical sign as, in particular, tiny angiomas, such as multiple minute Campbell de Morgan spots, may be impossible to blanch using the usual technique of compression with a glass slide.
Cutaneous vasculitis – can you spot it?
Joanne S Deacon and Irshad Zaki
pp 14-18
The term ‘vasculitis’ may instil a sense of dread in many clinicians, as it remains one of the least understood areas in dermatology and contains a confusing diversity of conditions and classifications. This article aims to highlight basic principles of cutaneous vasculitis and to outline the important recognised syndromes.
Varieties of scarring alopecia
Andrew Messenger
pp 20-23
Scarring alopecia (cicatricial alopecia) is a type of hair loss in which hair follicles are permanently destroyed. A wide range of pathologies can cause loss of hair follicles and it is important to realise that scarring alopecia is a clinicopathological reaction pattern and not a diagnosis in itself. Broadly speaking, scarring alopecias can be divided into those forms in which the hair follicle is targeted by an inflammatory infiltrate, or occasionally a neoplastic infiltrate, and those in which follicular destruction is secondary to a general scarring process in the skin caused, for example, by trauma, infection or ionising radiation. This article is devoted to the first of these categories. All forms of scarring alopecias are uncommon and little is known of the underlying pathological mechanisms. Their classification is also the subject of controversy and these difficulties are compounded by the inadequacies of treatment.
A guide to diagnosing and treating hirsutism
Iaisha Ali and Rodney Dawber
pp 26-30
Hirsutism can be defined as terminal hair growth occurring in women in a pattern that is more typically associated with men. It is a common and often quite distressing condition which can sometimes have serious medical implications, although the majority of cases are idiopathic or within the normal range of hair growth, and may reflect racial or genetic variation.
Monk's moments: The long arm of the law
Barry Monk
pp 31-31
Medicolegal work is one of the growth industries in medical practice, but rather like fishpaste sandwiches, it isn’t exactly everyone’s cup of tea. I had always been rather proud of the fact that in 28 years of medical practice I had never had to appear in court – either to give evidence or, indeed, as a defendant. I have written plenty of medical reports (patients claiming that their dermatitis had been caused by their employer or their cosmetics and the like), but fortunately all the cases seem to have been settled without my needing to give evidence.