Dermatology in practice - 2005


Comment: A world gone mad … but safe
Neil H Cox
pp 4-4
In his column that appears at the end of each Dermatology in Practice issue, Barry Monk recently wrote of ludicrous warnings – such as those on paper cups on trains, which tell you the contents may be hot (may be; not necessarily will be). It started me thinking about things of a similar ilk. In fact, it took me almost no time to discover a remarkably labelled item in our kitchen – a container of liquid soap listing contents that included about 20 potential contact sensitizers, followed by the statement ‘Suitable for vegetarians’.
An approach to cutaneous lupus erythematosus
Walayat Hussain and Jennifer Yell
pp 6-8
Systemic lupus erythematosus (SLE) is a multisystem disease with a variety of cutaneous manifestations. The presence of skin disease may be the only clinical feature of underlying lupus but can also represent the first sign of ‘systemic’ disease. This article discusses the diverse skin manifestations of SLE and provides an overview of the available management strategies.
Managing skin problems in the florist industry
Maureen Connolly and Chris Lovell
pp 10-12
Floral workers are prone to developing skin problems, such as irritant or allergic contact dermatitis, contact urticaria or phytophotodermatitis. This is because they work with plants in a wet environment and have direct contact with numerous physical irritants, chemical irritants and allergens. They are three times as likely to develop hand dermatitis when compared with other retail workers.
Features of streptococcal disease and cellulitis
Ian Pearson
pp 14-16
Streptococci were first identified by Billroth in 1874 in infected wounds and to this day remain one of the most important human pathogens. Traditional classification of streptococci is by Lancefield groups and haemolytic activity on blood agar, but recent genetic analysis has allowed more accurate subdivision into six groups. Of these groups, the pyogenic streptococci (groups A, B, C and G) are the most important skin pathogens.
How to set up a GPwSI service in dermatology
Neill Hepburn
pp 18-21
The NHS modernisation agenda is all about improving the quality, access and equity of care for patients. Although skin diseases are common, many dermatology patients have traditionally had a poor deal from the NHS. There is little dermatology in the undergraduate curriculum, it is not a component of most general practice vocational training schemes, and the dermatology provision in secondary care service is meagre, compared with elsewhere in Europe and the USA.
A guide to management of hirsutism in general practice
Stephen Kownacki
pp 22-24
The scope of this article will consider only hirsutism as it applies to women. However, excessive hair in men can be a problem – especially when the current fashion, notably among footballers, appears to demand removal of all body hair! Hirsutism may be defined in this context as the presence of terminal coarse hair growth in male patterns in women with normal or elevated circulating androgen levels, where the impact of the hair growth on the woman’s quality of life has prompted her to seek medical advice.
National safety guidelines for oral methotrexate
Rebecca Davis and Megan Dixon
pp 26-27
Oral methotrexate is an antimitotic drug that reduces cell division within the body. High doses are prescribed as a cytotoxic agent for certain cancers. Low doses are used for severe psoriasis and some inflammatory skin diseases. It can produce serious side-effects, such as suppression of the immune system. According to the National Patient Safety Agency (NPSA), ‘Oral methotrexate is a safe and effective medication if taken at the right dose and with appropriate monitoring’.
Achievements in 50 years of public health dermatology
Terence J Ryan
pp 28-30
Fifty years ago, dermatology was a specialty concerned with infection, even in the clinics of the developed world. In the UK it had not yet fully separated from venereology and, as a medical student, one had a fair chance of seeing at least one case of syphilis, leprosy, anthrax or tuberculosis (TB) of the skin, as well as impetigo and fungal infection. By 1970, we were concerned, however, that there was no consensus on terminology, classification or prevalence and the backwardness of dermatology was acknowledged.
Monk's moments: Rummaging in the loft
Barry Monk
pp 31-31
Until recently I was our trust’s research and development lead, and in this capacity I used to receive regular updates from the Department of Health on the huge sums that it is spending on research each year. Yet, curiously, whenever I applied for even very modest amounts for what I thought were tremendously exciting projects, it proved almost impossible to achieve success.