Dermatology in practice - 2004

Comment: Shrinking croissant syndrome
Neil H Cox
pp 4-4
Readers of this journal may not appreciate how lucky they are to be at the cutting edge of medicine. I thought you should be the first to know about this new syndrome that has been discovered in my department. I’ve even included a bonus report of a condition that shows a strong female predilection (at least where I work, it does). Two new entities for the price of one; what other journal gives such good value?
Isotretinoin therapy in acne and modern practice
Mark Goodfield
pp 6-8
Since its introduction into widespread use in the early 1980s, isotretinoin has been a dramatically successful therapy for severe and persistent acne. Initially used only for severe cystic acne, its use has been gradually extended for those with significant but milder disease that has been persistent despite the use of conventional topical and oral therapies. It has an important role in those with scarring because of their acne, and also in those with dysmorphophobia. Most studies indicate a success rate of almost 100%, and confirm that approximately two-thirds of patients have no relapse when treatment is discontinued. However, it is not clear whether these figures are correct for the patient profile now being treated. The existing licence does not cover current accepted usage.
Conducting a practice-based audit of Dianette® prescribing
Jill Murie and Pauline Russell
pp 10-14
An audit of co-cyprindiol (Dianette® Schering Health, UK) prescribing was conducted in January 2003 in response to the recommendations of the Committee on Safety of Medicines (CSM). The individual recommendations were based on epidemiological evidence that Dianette®, a combined oral contraceptive containing cyproterone acetate and ethinylestradiol, was associated with an increased risk of venous thromboembolism (VTE).
How to recognise hair-shaft disorders – a brief overview
Iaisha Ali and Rodney Dawber
pp 16-19
Hair-shaft disorders are a group of rare and interesting conditions with variable presentations. The disorder may consist of an abnormality of the mechanical structure or chemical composition of the hair, and can be either genetic or environmentally acquired.
Benign and malignant tumours of skin appendages
Andrew G Affleck and Sandeep Varma
pp 22-25
Most physicians and other non-dermatologists are aware of common skin cancers – basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and malignant melanoma (MM) – but if asked about tumours of skin appendages, they may appear rather puzzled. This is not surprising as this group of tumours is uncommon; additionally, they have long, complicated names which are derived from Greek or Latin and as such are easily forgettable. The situation is difficult as there is no consensus agreement as to the best classification and nomenclature system, even among experts. However, tumours of skin appendages, also known as appendicular, appendageal or adnexal tumours, constitute a huge but important group and in one major textbook, 36 different types are listed. In this article, we will aim to clarify them by applying basic principles and illustrating some of the more common examples.
Bringing dermatology expertise to a Nepali clinic
Olga Kerr
pp 27-30
‘Visitors may choose to avoid this area as it is highly malarious and is in the heart of Maoist activity’, read the sign as I left the airport. Hardly the most auspicious welcome to two weeks working in Nepal. Certainly, it was enough to make me ponder whether the reply of interest I had sent in response to a British Association of Dermatology (BAD) circular requesting voluntary dermatologists had been an error.
Monk's moments: What to do when the numbers don’t add up
Barry Monk
pp 31-31
It has recently been suggested that schoolchildren should be able to drop maths at 14, because, it is argued, what is taught thereafter won’t be much use to them. The criterion of utility seems a strange one. I was helping my son revise for his GCSEs and I am not entirely sure of the ‘usefulness’ of Mussolini’s foreign policy, or Ovid’s poetry, or the electrolytic purification of copper, but I feel happy that they are bound to come in handy one day (especially in his intended career as a comedian).