Dermatology in practice - 2018

What a summer....!
Neill Hepburn
pp 59-59

It’s been a remarkable summer – I really can’t remember such superb weather for so long. My holidays in Edinburgh, the Lake District and the Isle of Man have all been enjoyed without my Goretex™ anorak! It just doesn’t seem quite right! The clinics have also been busy – with patients getting a fright when they see themselves (or somebody else does) without the usual protection from clothing. Dermatological referrals always go up in the summer (rather like respiratory referrals go up in the winter) but it seems busier this year. I have spent a lot of time with my paediatric colleagues this summer and I have been reminded how quickly children become ill and bounce back. One moment the ward is full, and within a few hours it can be almost empty. This is such a contrast to the slower pace at which most skin diseases evolve.

Implementation of eHealth for patients with chronic skin disease
Nina Goad
pp 60-64

Health education interventions are initiatives designed to positively influence health status for an individual, a community or on a population level. Traditionally, such interventions have existed in a range of formats, be those face-to-face interactions or printed resources, delivered through a variety of forums, including mass media and educational and medical establishments. The advent of the internet and social media as mainstream communication devices has allowed for health interventions to be delivered and shared online, where they are often referred to under the umbrella term of ‘eHealth’.

British Association of Dermatologists – 98th Annual Meeting, Edinburgh
Neill Hepburn
pp 66-66

The British Association of Dermatologists Annual Meeting has evolved over the 25 years I have attended; from a networking event focussed on basic science, which was of little use to most of those in clinical practice, to a real educational update meeting. Twenty-five years ago, registrars presented their basic science research, the guest lectures were esoteric basic science and the pharmaceutical exhibition was enormous. In contrast, at the 2018 meeting there was a plenary session, with relevant presentations, running all day, complemented by several parallel sessions covering a host of special interests. The organisers’ aim was to provide practical updates across most of dermatology, as practiced in the UK.

Acne vulgaris
Jonathan Cooke
pp 68-70

Acne vulgaris is a common skin disorder that affects most people at least once during their life. While its incidence peaks during the late teens, there are many adults that are affected – 12% of women and 3% of men over 25 years old.

Dear colleagues
Angelika Razzaque - PCDS Executive Chair
pp 70-70

After a fabulous British summer, we are gradually seeing signs of autumn approaching and with it our Autumn meeting. By the time you read this, it will have taken place (20th September) in Brighton at the Hilton Metropole. Kash Bhatti has put together a fantastic programme with a cornucopia of topics ranging from oral, hair, nail and anogenital disorders, drug reactions and contact allergies, to discussing the important matter of the sun and skin cancer. Like many other PCDS events, I’m certain it will have been just as successful.

Miss Europe World takes on Mount Elbrus challenge for British Skin Foundation research
British Skin Foundation
pp 71-71

On average 26 people die trying to climb Mount Elbrus every year, which is a higher death toll than that of Mount Everest. The British Skin Foundation ambassador is trying to raise £50,000 for skin disease research as she has both psoriasis and eczema herself.

Yellow-orange papuloeruptive lesions with haematological malignancy
Eimear O’Brennan, Rajeev Shukla, Arti Bakshi and Richard AG Parslew
pp 74-75

A 16-year-old male was referred with a six-month history of asymptomatic yellow-orange coloured papules affecting the face. Past medical history included common acute lymphoblastic leukaemia (ALL) diagnosed one year previously. He is being treated as per ALL regime B and is currently on Cycle 7 of maintenance chemotherapy, which includes vincristine, methotrexate, prednisolone and mercaptopurine. He is doing very well on this treatment. His past medical history includes depression and systemic candidiasis. Family history includes hyperlipidaemia, but no xanthomas were reported.

Psychological trauma and dermatology
Andrew Affleck and Zoe Chouliara
pp 76-80

Psychological trauma is the result of an extraordinary and distressing event. Intense emotions and high stress levels overwhelm and exceed a person’s ability to cope, leading to changes in the ecological stress response.

An experience of tinea incognito
Lathika Wickramasinghe
pp 82-82

Tinea incognito was first described more than fifty years ago and occurs worldwide. It is a fungal infection of the skin, commonly caused by dermatophyte trichophyton (less frequently by microsporum. The typical features of the fungal skin eruption are masked due to altered/impaired local immunity by the use of topical steroids or calcineurin inhibitors. Other predisposing causes are diabetes, systemic immunosuppressants and HIV/AIDS.

Photoprotection for ethnic skin
Camille Fitoussi
pp 84-86

Photoprotection is the term widely used to describe protection against the harmful effects of UV radiation on the skin. Ethnic skin is commonly thought to be naturally photoprotected; however, this is not always entirely correct as there are several factors to take into account, e.g., the complexion of the individual, loss of pigmentation due to lack of sun exposure and cosmetic skin lightening.

Painting by numbers
Barry Monk
pp 87-87

Graves’ disease, manifesting as goitre, hyperthyroidism, and exophthalmos is eponymously named after the nineteenth century Dublin physician Dr Robert Graves, who was one of the first to describe it. It occasionally presents to dermatologists as pretibial myxoedema.