Dermatology in practice - 2017

Comment: Seasonal dermatology
Neill Hepburn
pp 31-31
It was not long after starting my dermatology career that I realised there was a seasonal pattern to the case mix. In the winter, we see greater numbers of itchy elderly patients – due in part to the low humidity promoted by colder weather, combined with central heating and double glazing. In the summer, patients seem to take off their clothes and, in some cases, get such a fright at what they see that they head off to show their doctor the new mole, or lesion, that has, presumably, been there for some months. In sunny Lincolnshire, dealing with the two week wait referrals is such a pressing issue for management that I have been asked to go back to running a two-week wait clinic this summer.
Avoiding skin cancer misdiagnosis: potential melanomas and squamous cell carcinomas – when to worry
Sharleen Hill and Rino Cerio
pp 32-37
The combination of rising skin cancer incidence (15,419 new cases of melanoma in the UK in 2014) with increasing patient awareness translates to patients commonly presenting to their GP with worrying ‘lumps and bumps’. Most are subsequently shown to be benign; however, some serious cancers, including melanoma, are being missed, even by skilled dermoscopists. Increasingly, misdiagnosis of melanoma remains a major cause of litigation against GPs, GPs with special interests, dermatologists and dermatopathologists.
Acne in ethnic skin – Part 2: approach to management in patients with skin of colour
Kiasha Govender and Ncoza C Dlova
pp 38-44
The pathogenesis of acne vulgaris is multifactorial and is almost similar in both light and dark skin phototypes. Treatment modalities are, therefore, similar in all ethnic groups and designed to address multiple aspects of disease pathogenesis simultaneously. Specific aetiological agents, clinical characteristics and sequelae of the disease differ in darker skin phototypes, and as such, this group of patients needs special attention.
A practical guide to basal cell carcinoma
Anusha Panthagani and Sandeep Varma
pp 46-50
Basal cell carcinoma (BCC) is the most common form of cancer in humans. Skin cancers are divided into two groups: non-melanoma skin cancer (NMSC) and melanoma. Within the NMSC group, BCC accounts for 75–80% of cases and the remainder are predominantly squamous cell carcinomas (SCC). It is difficult to know the exact incidence due to underreporting of BCC in cancer registries. There were around 132,000 new cases of non-melanoma skin cancer in the UK in 2014, though this underestimates the true incidence. However, the incidence of BCC in Europe has increased by approximately 5% annually over recent decades, and in the USA rates have increased by 2% annually. This increasing incidence of BCC is impacting on healthcare services.
A facial vitiligo experience: ‘I see it, but I don’t see it’
Vitiligo patient
pp 51-52
I recall the appearance of the skin condition called vitiligo on my face from the age of six or seven; I am now 35 years old. As a British Asian, it is the appearance of a significant milky-white patch on my chin, imposing itself amid the rest of my normal skin tone.
BSF partners with talkhealth in new online support initiative
The British Skin Foundation
pp 52-52
The British Skin Foundation has teamed up with talkhealth to offer regular online support to skin disease sufferers, with guidance from both medical experts and those who live with and manage their own skin conditions.

pp 54-54
Acne is boring. The diagnosis is rarely in doubt, it’s only cosmetic after all, just a part of growing up, and it gets better by itself. So, get over it, wash more often, maybe get something from the chemist, or go to the doctor for some antibiotics. If this is your view of acne, then perhaps you also tell depressed patients to pull themselves together and advise abstinence for birth control.
Monk's moments: It's a dog's life
Barry Monk
pp 55-55
Bob Beckman was a larger-than-life London-based New Yorker, who made and lost a fortune on the stock exchange (and then repeated the trick several times over). He eventually became disenchanted with his fellow financial gurus, and claimed that his greatest investment successes were based on reading a list of shares to his dog William, and buying or selling according to whether the dog barked.