Dermatology in practice - 2003

Comment: Clothing dermatitis
Neil H Cox
pp 4-4
All medical disciplines have their idiosyncrasies, with dermatologists obviously being renowned for their descriptive abilities. However, it only recently struck me that clothing and jewellery are perhaps over-represented in our descriptive armamentarium.
The trials of treating warts – a review of therapy options
Sam Gibbs
pp 6-8
Occasionally, the rationale for a particular therapy is clear and straightforward but, if we are honest, we know the factors that influence most therapeutic decisions are somewhat murky. If you’ve ever been involved in a cryotherapy (cryo) clinic for treating warts, I would be very surprised if some such nagging question had not emerged at some stage. Is it not extraordinary that, in this modern age, the humble wart is still assaulted with treatments that in mechanism, if not in technology, are frankly mediaeval? Is it not also exasperating that the same wart often remains so resolutely defiant in the face of such treatment?
The impact of skin diseases
Peter Lapsley
pp 9-9
The many misconceptions surrounding skin disease led the All Party Parliamentary Group on Skin (APPGS) to conduct an enquiry into the impact of skin diseases on people’s lives. The enquiry’s report was published in July this year. The key findings may be useful in ensuring that skin diseases are taken as seriously as they should be and that appropriate resources are allocated to them.
The use and abuse of systemic antifungal therapy
Neil H Cox and Dai T Roberts
pp 10-14
Clinical diagnosis of skin and nail fungal infections is not always easy. This article discusses the need to establish a diagnosis before instituting therapy, in order to avoid a number of pitfalls. In particular, inappropriate antifungal therapy has significant cost implications for the NHS.
How to take specimens for fungal microscopy and culture
Barry Monk
pp 16-17
Why bother to take specimens for culture in cases of suspected fungal infection of the skin or nails?
The role of wet wrapping in the management of eczema
Paula E Beattie
pp 20-22
Wet wrap bandages provide a physical barrier to scratching, cool the skin and hydrate the stratum corneum, leading to a reduction in the severity of AD. They are also believed to improve itch and, therefore, sleep. For this reason, they have the potential to improve quality of life for the patient and, in the case of a child, for the family. In a survey of members of the British Society for Paediatric Dermatology (BSPD), 70% felt that WWT reduced admissions to hospital.
Fabry disease – the importance of correct and early diagnosis
Sonya Hutchinson
pp 24-27
Fabry disease is a rare genetic disorder associated with early mortality. It is frequently misdiagnosed or not diagnosed until end-organ damage has occurred. Until recently, treatment has been symptomatic but, now that enzyme replacement therapy is available, it is more important than ever to make a correct and early diagnosis.
Identifying tuberous sclerosis – dermatological features
Charles Shaw- Smith and Nigel Burrows
pp 29-30
Tuberous sclerosis, now known as tuberous sclerosis complex (TSC) (and also referred to as epiloia and Bourneville’s disease), is a disorder with protean manifestations due to the potential involvement of almost any organ. TSC occurs in approximately one in 10,000 children and, although the most common manifestation is infantile seizures, it may present initially to the dermatologist. Classical cases are usually easy to recognise but, when few signs are present, the diagnosis can be more difficult.
Monk's moments: Determined to succeed
Barry Monk
pp 31-31
Royal Marine Liam Armstrong recently became the most junior British serviceman ever to be awarded the Military Cross. The award was for his outstanding gallantry last year in Afghanistan when he found himself facing nine heavily armed Taliban, and the citation mentioned his exceptional bravery, level headedness and determination. However, the marines had not been his first choice of career; at the age of 15 he had been a trainee at a professional football club, but they released him because he was said not to have sufficient determination. One can only speculate what might have happened if he had been allowed to stick to football.