The stress of having skin disease The potentially harsh psychological effects of chronic skin disease tend to be underestimated. Up to 30% of skin outpatients suffer ‘psychological distress’ from their condition. This is understandable in the teenager with acne, or…
Skin disease is very common. About 10% of a GP’s workload and 6% of hospital outpatient referrals can be accounted for by skin problems. Skin disease is also economically significant; it is a major occupational cause of loss of time…
Medical treatments for skin disease are increasingly focussed on systemic therapy, especially in secondary care. Biologic drugs are being developed to target specific pathways in the pathogenetic mechanisms of several skin diseases. Biologics are discussed in Chapter 61 . When…
The treatment of skin disease includes topical, systemic, intralesional, radiation and surgical modalities. Specific treatments are detailed below. First is an overview of dermatological therapies. Topical therapy Topical treatment has the advantage of direct delivery and reduced systemic toxicity. It…
The practice of close visual examination of skin lesions with a handheld magnifying glass and a light has been employed by dermatologists for many years. Dermoscopy (syn. dermatoscopy) was developed in the 1990s as a tool to reduce the reflectance…
Dermatologists make use of several diagnostic and therapeutic procedures in their everyday clinical practice. Diagnostic procedures The ability to diagnose a skin disease is improved by the use of better methods of observing lesions and by appropriate use of samples…
The skin needs to be examined in good, preferably natural, light. The whole of the skin should be examined, ideally. This is essential for atypical or widespread eruptions ( Fig. 9.1 ). Looking at the whole skin often reveals diagnostic…
The truism that ‘there is no substitute for a good history’ is just as applicable in dermatology as in any other branch of medicine. Indeed, history-taking is a core skill in the medical curriculum. The time needed to take a…
Dermatology has a vocabulary that is quite distinct from that of other medical specialties and without which it is impossible to describe skin disorders (a skill vital in dermatologist training curricula). A lesion is a general term for an area…
Recent and rapid advances in genetics have had an impact on our understanding of skin diseases. The Human Genome Project has now mapped all human genes, of which there are about 35 000. Whilst the original Mendelian concept of single…