Dermatology in practice - 2007


Comment: Too much monkey business
Neil H Cox
pp 3-3
I must apologise in advance to those who think I’m going to give an exposition on important rock’n’roll songs (for those who are not aware of it, the title of this editorial is also a song title made famous by Chuck Berry, and covered by the Yardbirds, Elvis and others). So, I’m not going to discuss music but it’s not that big a leap, as I am going to discuss some issues about communication.
Teaching dermatology to medical students
Sue Burge
pp 4-6
Dermatological problems are common, but time for learning and teaching dermatology in undergraduate medical courses is limited. However, all medical students undertake attachments in primary care, which provide an ideal opportunity for learning dermatology. How might GPs optimise teaching so that medical students can acquire the skills of looking at, and not through, the skin?
Fragrance allergy – new tests, new laws
Chamandeep K Thind and Anthony D Ormerod
pp 8-10
Fragrances or perfumes can be found in almost every product we use, from household products to cosmetics and even car washing liquid, to make them more appealing to our olfactory senses. Many mild reactions to fragrances are unreported and the true extent of this problem is therefore hard to define. Fragrances used in cosmetics are responsible for the greatest number of mild reactions. Buckley et al found that the incidence of fragrance allergy was 8.5% in females and 6.7% in males in London.
Guidelines for GPwSIs in dermatology
Julia Schofield
pp 12-14
The NHS Plan published in 2000 proposed that, ‘By 2004 … there will be up to 1,000 specialist GPs taking referrals from fellow GPs’. Dermatology was identified as a specialty in which GPs with a Special Interest (GPwSIs) services might be usefully developed. The NHS Improvement Plan published in June 2004 confirmed, ‘We now have around 1,300 GPs with a special interest providing 700,000 procedures in the community previously done only in hospital’.
Guidelines versus the real world
Tony Chu
pp 16-18
In this article, the author reviews the National Institute for Health and Clinical Excellence (NICE) appraisal system of combined Health Technology Assessments (HTAs) and Single Technology Appraisals (STAs) and wonders whether the committee’s advice bears any relation to how clinicians approach the difficult decisions that face them when prescribing a long-term therapy for an individual patient with a chronic condition such as plaque psoriasis.
Update on identifying measles, mumps and rubella
Susan Lipscombe
pp 20-20
One of the lovely things about this journal is that so many people, from many different disciplines, read it and are helpful enough to write in and make suggestions as to how we can improve and update information written in our articles. I was lucky enough to receive a letter from Dr Fink, Clinical Virologist and Honorary Senior Lecturer at The University of Warwick, who kindly gave updated information on my article Measles, mumps and rubella – can you identify them? (Dermatology in Practice 2006, Volume 14 Number 3).
Naevi and melanoma
Rachel Jacoby, James Crane, FIonna Martin and Sandeep Varma
pp 21-24
There are 8,000 new cases a year of malignant melanoma in the UK, with 1,800 deaths, making it the most serious skin cancer despite being one of the least common. Recognition and early referral to dermatologists is paramount in achieving the best prognosis. However, it is not always easy to differentiate benign lesions from malignant ones. Of all the benign lesions confused for malignant melanoma, melanocytic naevi (MN) feature prominently. Greater awareness of the classical features of both naevi and melanoma will minimise misdiagnoses.
New applications for cutaneous laser therapy
Nanda Kandamany and Barry Monk
pp 26-28
Laser surgery is an ever-expanding technological discipline that is contributing to a broad and rapid expansion of both diagnostic and treatment procedures. With some definite advantages in the surgical and medical treatment of a variety of disorders, laser surgery is becoming indispensable in our everyday practice. The concept of selective photothermolysis is not new and since the 1960s, lasers have been used extensively in dermatology. Most wavelengths have found applicability, depending on the underlying disease process, and with advancements in laser technology over the years there have been new and exciting ways of applying this to practice.
Monk's moments: Too much of a good thing
Barry Monk
pp 30-30
As a hospital doctor, I can only imagine what goes on in general practice, particularly when a patient is being referred to a consultant. In Bedford, where I work, we are particularly fortunate in that GPs and hospital specialists tend to know each other, so I fondly imagine that when a GP is faced with a challenging rash, he says something along the lines of, ‘I’ll send you along to see my old friend Barry; he’s a bit of a grumpy old devil, but don’t take any notice because he’ll sort your skin out for you’.
Exploring occupational barriers due to skin disease
Ian Foulds
pp 32-35
It is estimated that approximately 20% of the UK population suffer with some form of skin disease at a given time. Eczema, acne and infectious disorders (for example, athlete’s foot) are the most commonly presented skin complaints. About 15–20% of a GP’s workload and 6% of hospital outpatient referrals are for skin problems. A 2001–2002 self-reported, work-related illness survey estimated the prevalence of self-reported, work-related skin disease in Great Britain at 39,000 cases.