Dermatology in practice - 2016


Comment: What a week...
Neill Hepburn
pp 87-87
I hope you find the articles in this issue of Dermatology in practice as relevant to your practice as I have this week. On Monday evening, I visited an elderly lady in a nursing home in Lincoln who was too unwell to come to clinic. She has many excoriations on the right side of her body – the opposite side from her previous stroke. Skin picking disorder often causes concern and confusion, so George Johnson’s article is good reading.
Paediatric hair disorders
Nisha Rishi Arujuna, Caroline Champagne & Paul Farrant
pp 88-94
Hair disorders in children can cause considerable anxiety among both parents and their children. As part of the assessment of common hair problems in the paediatric population, one also needs to consider rarer congenital and hereditary causes of hair loss, which can occasionally present as part of a multisystem syndrome.
Skin picking disorder: unpicking a topical issue
George Johnson, Oliver Johnson, Kate Martin & Jon Goulding
pp 95-98
Despite being first reported in the medical literature in 1875, pathological picking of the skin remains poorly understood, under-diagnosed and, in many cases, inadequately treated. Previously coined terms include ‘neurotic excoriations’, ‘dermatillomania’, ‘psychogenic excoriations’, ‘acne excoriee’ and ‘pathological skin picking’. In 2013, skin picking disorder (SPD) was formally recognised as an independent condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM- 5) (See Box 1). SPD is estimated to occur in 2–4% of the population and is characterised by recurrent picking of the skin, resulting in persistent skin lesions. With less than 20% of afflicted patients feeling their clinician ‘knew much’ about their condition, it is imperative that knowledge, screening and awareness of SPD is raised, to ensure medical professionals can provide optimal care for their patients. This is particularly important given the often marked psychological distress which may be associated with the disorder, and the potential for serious psychiatric and medical complications.
Syphilis: a review of the history, clinical features, and management
Aria Vazimia, Michael Zumwalt & Sharon E Jacob
pp 100-104
At the turn of the 20th century, the father of modern medicine,Sir William Osler, famously said, ‘The physician who knows syphilis knows medicine’. Syphilis refers to the sexually transmitted infection caused by the spirochete Treponema pallidum, which progresses through four distinct clinical stages, characterised by a unique set of cutaneous and/or extracutaneous manifestations. Since its entry into the scholarly literature as early as the 16th century, syphilis earned the reputation as a ‘great imitator’, due to its wide array of presentations. The extensive study of syphilis has been a topic of paramount interest to dermatologists worldwide. According to JE Lane in 1925, the field of dermatology was born from syphilology, a field necessitating intricate descriptions of the cutaneous lesions. In this review, we summarise the key features of syphilis, including its history, epidemiology, clinical presentation and management, with a special focus on the dermatological aspects of the disease.
Facial hyperpigmentation in darker skin types – Part 2
Harini Rajgopal Bala & Michelle Rodrigues
pp 105-108
In the first part of our two-part article published in Dermatology in practice issue 22.3, the various causes of facial hyperpigmentation in darker skin types were discussed. This included melasma, post-inflammatory hyperpigmentation, erythema dyschromicum perstans, lichen planus pigmentosus, Hori's naevus, naevus of Ota and medication-induced pigmentation. In the second part, we focus on the management of hyperpigmentation in darker skin types, the most commonly used treatments and which treatments work best with each cause.
A day out with the British Skin Foundation – celebrating 20 years of research!
Annabel Gammon
pp 109-110
At 6am,myself and my colleague Harriet briskly made our way to catch our train. Joined by an array of yawning commuters, we discussed what we thought we discussed what we thought we could expect from the day. London was as bustling and full of life as ever, an ironic contrast to our still zombie-like demeanour. After a couple of wrong turns, we found ourselves admiring the iconic masterpiece – the Royal College of Physicians. Inside, a warm welcome awaited us from Lisa Bickerstaffe, spokesperson for the British Skin Foundation and the collection of people who were also gathered for the press breakfast.
Resources – PCDS
Dr Michelle Ralph
pp 110-110
As the nights draw in and, with unnerving relentless progression, we hear of the decreasing numbers of ‘sleeps’ to the festive period, I wonder what 2017 may have in store for the ever stretched and ‘creaking’ NHS.
Colditz syndrome
Barry Monk
pp 111-111
Colditz was a notorious German prisoner of war camp, officially known as Oflag IV-C, immortalised in various books, films and TV programmes, where the most troublesome captured British and other allied officers were sent in an attempt to prevent them getting up to mischief. Prior to the War, Colditz had been a rather posh lunatic asylum for deranged members of the German aristocracy.