Dermatology in practice - 2016


Comment: Dermatology: nobody dies, nobody gets better!
Neill Hepburn
pp 3-3
Dermatologists get a fair bit of flak from colleagues, be it enquiries about how we cope with the onerous ‘on call’ or patronising remarks about being simply ‘pattern recognition specialists’. Fortunately, dermatology is a specialty that affords many challenges to keep the ‘grey matter’ in good working order.
TB or not TB? That is the question
Samantha Keegan and Natalie Stone
pp 4-7
Erythema induratum is a rare condition first described by the French physician Ernest Bazin in 1861, at a time when the tubercle bacillus had not yet been identified. In Bazin’s words, it was a condition occurring ‘on the legs of female launderesses and in young and plump well-nourished women with the typical phenotype of those with scrofula’.
The epidemic of allergic contact dermatitis to methylisothiazolinone
Zoe C Venables and Graham A Johnston
pp 8-10
Methylisothiazolinone (MI) is a preservative found in many household, personal care and industrial products. In the recent years, there has been an unprecedented increase in sensitisation to MI due to its widespread use in personal care products, resulting in allergic contact dermatitis (ACD). The first case series of MI-related ACD was described in 2010. By 2013, MI had been dubbed the contact allergen of the year, in what has been described as an ACD epidemic caused by MI. In this article we review the history of the epidemic, and clinical presentation and management of MI-induced allergic contact dermatitis.
Ethnic dermatology: a new series to guide practice
Ophelia E Dadzie
pp 12-13
Britain's population is becoming increasingly ethnically and racially diverse. The findings of the 2011 census for England and Wales show an increase in the non-white population from 8.7% in 2001 to 14% in 2011. Asians represent the largest proportion of the UK's non-white population (7.5%), followed by Africans and Afro-Caribbeans (3.3%). London is the most ethnically diverse region with the lowest proportion of white British people across England and Wales (44.9%).
The QualityCareTM psoriasis programme: an opinion-based review
Keith Freeman
pp 14-15
QualityCareTM is a personalised support programme developed by LEO Pharma for patients with psoriasis and for carers. Designed to meet individual needs, it utilises a variety of channels including a website, email, text messaging and an online magazine.
Dermoscopy in general practice: pattern analysis of pigmented skin lesions
Stephen F Hayes
pp 16-19
The increasing incidence of skin cancer constitutes a global epidemic, with 2,148 fatalities in the UK in 2012. The excision of early, thin melanomas leads to cure in most cases, but due to the variable nature of skin lesions, accurate early diagnosis requires skill.
Acne scarring: a review of current treatment options
Alison V Sears and Shernaz Walton
pp 20-25
Acne vulgaris is the most common skin disease affecting up to 95% of adolescents. A large proportion of patients with moderate and severe acne develop persistent erythema, post inflammatory dyspigmentation and significant physical and psychological scarring. Acne and subsequent acne scarring, regardless of severity, may have a profound psychosocial and emotional impact, which is often underestimated. An individual’s quality of life may be substantially affected, with reduced self esteem, social functioning and academic and professional achievements, as well as associated psychiatric disturbances.
Bookshelf: Vulval Dermatologic Diagnosis – Diagnosis by Clinical Presenting Sign
Neill Hepburn
pp 26-26
Vulval disease is one of the areas of practice in which I feel less confident. While in training, I asked to attend a few sessions of the vulval clinic. The consultant in charge rebuffed my request, telling me that a female colleague would manage those patients, so there was nothing that I needed to learn in that area. In reality, it was more than 12 years before I had the privilege of working with a female consultant. Most of our consultants are now women. But vulval disease remains an area in which I feel less confident. I was, therefore, pleased to be asked to review this book.
Resources: PCDS
Neil Shroff
pp 26-26
As a full-time GP, I am struggling to cope with the current workload, but I still have some way to go before I can retire from the rigours of general practice. On my day off I currently work as a GP with an extended role in dermatology – something I have a passion for. The pace is a bit more leisurely, which gives time for reflection. It actually does not feel like work, and I look forward to that day of the week.
Monk's moments: Ninety not out
Barry E Monk
pp 27-27
With my advancing years, I am not quite as enthusiastic as I once was about birthday parties. However, a few weeks back, I was delighted to attend a tea party to mark the 90th birthday of one of the legends of British medicine, Harold Ellis. Harold is probably known to you as the author of Lecture Notes on Surgery and Clinical Anatomy – books that got many of us through final exams – and anyone who has been taught by him or has heard him lecture will not have forgotten the experience. Having qualified six months before the creation of the NHS, and after a distinguished career in general surgery (in the days when there were general surgeons), he still teaches anatomy full time, and is cherished by his grateful students. His teaching style would no doubt make modern educationalists blanche, but he is consistently voted the favourite lecturer in the medical school.