Dermatology in practice - 2006


Comment: You can’t argue with faith
Neil H Cox
pp 4-4
I recently read about a stain on the wall of a Chicago subway, interpreted by many as an image of the Virgin Mary embracing the recently deceased Pope, which is now a shrine named ‘Our Lady of the Underpass’. Frankly, other than its surrounding candles and crucifixes, the stain looks like many others on walls below ground level. It is different only in that it appears natural rather than due to an underpass-subclass interaction. (Too obscure? Think about the type of individual who paints crude graffiti in subways.) The official explanation is salt-containing water dripping from the road above.
Photosensitive skin reactions – diagnosis and management
Frank Muller and Sally H Ibbotson
pp 6-10
Photosensitivity is an abnormal reaction, either quantitatively and/or qualitatively, to ultraviolet (UV) and/or visible light. There is a wide variety of heterogeneous photosensitivity diseases, and if a patient has a history or examination findings suggestive of photosensitivity, subsequent management will depend on the clinical picture.
How we approach widespread chronic plaque psoriasis
Stephen A Bushby and Andrew J Carmichael
pp 12-14
How widespread chronic plaque psoriasis is managed epitomises modern medical management in dermatology, supporting the patient as they move from an appropriately timed consultation, which allows exchange of information, through to the team approach to therapy. In this article, we will focus on widespread chronic plaque psoriasis. The diagnosis is based on clinical presentation with well-demarcated, erythematous, scaly plaques distributed symmetrically over the extensor surfaces of the limbs. When extensive, these ‘stable’, usually asymptomatic, plaques can spill onto intervening skin, giving the skin an elephantine quality.
The psychological implications of dermatological conditions
Linda Papadopoulos
pp 15-16
The psychological implications of dermatological conditions
The psychological implications of dermatological conditions
pp 15-17
The link between dermatological conditions and psychological problems has long been prominent in the literature. Several theories postulate psychophysiological mechanisms underlying various dermatological disorders. Indeed, skin and psyche share not only their embryonic origin but also they are also closely intertwined from a social, emotional and psychological perspective. Unlike other medical conditions, skin disorders are rarely life-threatening or physically handicapping. However, they are often visible to others. Consequently, they bring with them a variety of life changes and challenges.
Using biological therapies for psoriasis and other inflammatory dermatoses
Lucy Stewart, Andrea Roberts, Richard Warren and Christopher Griffiths
pp 18-21
This review will focus on the use of biological therapies (therapeutic agents produced by the application of recombinant biotechnology) in psoriasis but will also highlight the growing list of dermatological diseases where these novel drugs may have a role. Biological therapies are proteins with a pharmacological activity, which have been extracted from animal tissue or produced via recombinant DNA technologies. Advances over the past 25 years have meant that these manufactured proteins can be used in the management of a variety of inflammatory conditions, such as Crohn’s disease and rheumatoid arthritis, as well as in dermatological conditions such as psoriasis.
Dermatological emergencies – part 2
Vishal Madan and Neil H Cox
pp 22-26
This is the second in the two-part article on dermatological emergencies. In this article we will discuss the second two of the four major categories of dermatological emergencies, namely inflammatory ‘rashes’ and infections. Erythroderma is a disease process in which most (>90%), and sometimes all, of the skin is involved in erythematous inflammation, resulting in massive scaling. Some causes of erythroderma are: eczema (atopic, contact allergies, seborrhoeic); psoriasis; drug eruptions (allopurinol, sulfonamides, anticonvulsants, penicillins, imanitib); cutaneous lymphomas and Sézary syndrome; and others, such as pityriasis rubra pilaris, icthyosiform erythrodermas, severe dermatophytosis and infestations.
Monk's moments: Let’s be more gung-ho!
Barry Monk
pp 27-27
I would be rather upset if anyone described me as being gung-ho. I have always taken the expression to imply a rather reckless bravado or behaviour, which fails to take into account the realities of a situation. Indeed, in my less charitable moments, it could even be an expression that I might apply to some of the more cavalier health service managers one encounters in the brave new NHS (though not, I hasten to add, at Bedford Hospital).