Dermatology in practice - 2015


Comment: Guidelines – they get everywhere!
Neill Hepburn
pp 3-3
There was a time when doctors were able to consider a problem, and then, drawing on their education, training and experience, recommend a treatment without fear of challenge or contradiction. Those days are long gone. We are now subjects of scrutiny, and while this has benefits when it comes to reining in the maverick, it does make life more pedestrian. However, at least we do not need to think too hard, as once the diagnosis is established, the guidelines provide a recipe to follow.
The cost of topical medicines
Emilia Duarte Williamson, Deirdre A Buckley, Tim Root
pp 4-6
A 45-year-old man presented with an erythematous, scaly, inflamed, pruritic plaque on his left hand. There were no lesions elsewhere. He was not atopic. Scrapings for mycology were negative and he was diagnosed with psoriasiform eczema. He was very troubled with the itchy and sore rash, which impaired his daily activities and work.
Potassium iodide: a Dickensian drug for dermatological diseases
Faisal R Ali, Zenas Z N Yiu, Jennifer Yell
pp 7-8
Potassium iodide, a drug of long historical heritage, remains a useful and important part of a dermatologist’s armamentarium in the treatment of neutrophilic dermatoses and panniculitis, as well as infections such as sporotrichosis. Here we report an illustrative case of granulomatous panniculitis treated with potassium iodide to excellent clinical effect. We also provide a review of the important aspects surrounding the prescription of potassium iodide, including indications, dosage regimens and side effect profile.
The BAD guidelines for bullous pemphigoid – a summary
Ashish Sharma, Frances Humphreys
pp 10-11
Bullous pemphigoid (BP) is a blistering autoimmune disease that commonly affects the elderly, with a mean age of onset of 80 years. Autoantibodies attack the adhesion complex of the basement membrane zone (BMZ), which connects the epidermis and dermis. The two main autoantigens in the BMZ are BP230 and BP180.
Living with hyperhidrosis - a junior doctor's experience
Aileen Alexander
pp 14-15
I first noticed my axillary hyperhidrosis at the age of 15. I felt dirty, wet and cold all the time and I had a constant paranoia that I smelt and would be judged by my peers. Even in the summer I felt I had to wear a black cardigan to hide my huge sweat patches. My mother had to scrub and bleach my white undergarments, which would stain yellow a few days after purchase. The matter only got worse; it was all I could think about in class. I concurrently suffered from severe acne, for which I was prescribed a course of isotretinoin. I was badly bullied at school for my acne; this plus the hyperhidrosis destroyed my self-esteem.
Body image concern in dermatology - could we do better?
Inge M Kreuser-Genis, Reenah B Shah, Andrew Affleck
pp 16-17
How to recognise, and assess the severity of, body dysmorphic disorder (BDD). How to engage with and treat patients with body image concern or BDD, in a dermatology setting.
Keeping it sharp
Barry Monk
pp 19-19
Sheffield was once famous the world over for steel-making; indeed the local football team, Sheffield United, is still nicknamed ‘the Blades’. Sadly, as with much of British industry, steel-making in Sheffield has all but vanished. But one rather remarkable company is still flourishing: Swann-Morton Ltd still manufactures its renowned surgical blades in the city, as it has for over eighty years, and its blades are almost certainly the ones you use every day in your dermatology clinic. And if you do, you will be in good company, because these products are used by doctors all over the world.