Dermatology in practice - 2006

Comment: Zap, splat and the warrior role in disease management
Neil H Cox
pp 4-4
One of my patients recently brought me a newspaper article titled ‘Microwaves that can zap psoriasis’. It made me think about the way that language is used when newspapers, and even medical personnel, discuss approaches to disease management. The article in question describes the use of a machine termed Veinwave, attached to a probe with a fine needle that is placed on the skin and causes heating ‘to 85°C for a fraction of a second’.
Cutaneous manifestations of rheumatoid arthritis
Aparna Sinha, Sivakumar Natarajan and James AA Langtry
pp 6-9
Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects approximately 1% of the population worldwide, with women affected two to three times more commonly than men. It is characterised by destructive polyarthritis and extra-articular organ involvement, including the skin, eye, heart, lung, renal, nervous and gastrointestinal systems. Extra-articular organ involvement in RA (ExRA) is more frequently seen in patients with severe, active disease and is associated with increased mortality. Cutaneous manifestations are the most common presentation of ExRA, and are often the initial feature.
Quality of life and measures of psoriasis severity
Brian Kirby
pp 10-12
Psoriasis is a chronic lifelong skin condition that causes significant psychosocial morbidity but is rarely life-threatening. This simple sentence summarises the challenges inherent in treating the disease and assessing its severity. The understanding that psoriasis is a skin disease with psychological sequelae, and that these sequelae are not necessarily related to the amount of physical skin disease, led to objectively measuring the impact of psoriasis on quality of life. Inherent in any measure of quality of life is the psychological burden that patients with a disease have to endure.
Local anaesthetics for the GP
Muzlifah Haniffa and Clifford Lawrence
pp 14-18
Local anaesthetics are used to provide a reversible loss of sensation in a limited area of skin, allowing cutaneous surgery to be performed with minimal risk and discomfort to the patient. Local anaesthetics act by preventing the initiation and propagation of the nerve action potential. This article describes the essential practical aspects of local anaesthetics used in cutaneous surgery.
Eflornithine treatment of excess facial hair – a review
Iltefat H Hamzavi and Michael R Owen
pp 19-20
According to statistics, excessive unwanted facial hair bothers approximately 41 million women in the USA. In addition, there are a variety of diseases that are centred on the hair follicles (for example, pseudofolliculitis barbae). There have been a number of different hair removal options available to women for thousands of years; however, they all have either limited efficacy or potential side-effects, such as pain, skin infections, scarring or discolouration.
Communication issues in the dermatology setting
Aoife Lally and Susan Burge
pp 22-24
In this article, we discuss communication issues that may arise when doctors are caring for patients with skin diseases, and reflect on how such diseases may affect the way patients communicate. In addition, we suggest that doctors could use the media more effectively to influence the public’s perception of what is normal skin and to raise the profile of skin disease.
Exploring the work of the British Skin Foundation
Mathew Patey and William J Cunliffe
pp 26-26
The British Skin Foundation (BSF) is the only charity dedicated to skin disease research in the UK. Aiming to help the eight million people in the UK who have a significant skin condition, the BSF works closely with many of the country’s leading dermatology departments and patient support groups. We enjoy a close relationship with the British Association of Dermatologists (BAD), who put their administrative resources at our disposal and pay the salaries of the BSF team. This means that every penny raised by the BSF goes towards skin disease research.
Nitric oxide – a remarkable and useful molecule
Faisal Khalifa and Richard Weller
pp 28-29
Nitric oxide (NO), an inorganic free radical gas, is one of the smallest biologically active molecules. It is the most studied endogenous molecule of the last decade, and research on NO has entered into almost all areas of biology and medicine. The field received a burst of publicity in 1998 with the award of that year’s Nobel Prize in Physiology and Medicine to Drs Furchgott, Ignarro and Murad for their pioneering work.
Monk's moments: Keep your feet on the ground
Barry Monk
pp 31-31
I must confess to having mixed feelings about patient support groups and medical charities. A few years ago, a close relative was diagnosed as having a chronic and progressive neurological disorder; naturally, he was distraught, and looked to me, the doctor in the family, for advice and support, and for answers to all the horrible, unanswerable questions. I felt equally at a loss as to what to do for the best, and somewhat guilty, in the way that doctors always do when it is their own who are involved.