Textbook of Primary Care Dermatology

Acknowledgements
Contents
About the Editors
Part I: Overview
1: Dermatology in Primary Care
1.1 Introduction
1.2 The Patient’s Perspective
1.3 Websites and Apps
1.4 Patient Information Leaflets
1.5 The GP Perspective
1.6 Primary Care Dermatology
References
2: History Taking and Examination
2.1 Introduction
2.2 History Taking
2.3 Physical Examination
2.4 Conclusion
References
3: Investigations and Treatment in Primary Care Dermatology
3.1 Introduction
3.2 Investigations
3.3 Treatment Approach
3.4 Conclusion
References
4: Structure and Function of the Skin
4.1 Introduction
4.2 Structure and Function of the Skin
4.3 Hair and Nails
4.4 Function of the Skin
4.5 Conclusion
Reference
5: Terminology in Dermatology
5.1 Introduction
5.2 Descriptive Terms [1]
5.3 Colour
5.4 Shape or Configuration of Lesions
5.5 Texture or Morphology of Skin Lesion and Rashes
5.6 Feel, Form or Structure of a Lesion
5.7 The Distribution of a Rash
5.8 Secondary Skin Changes
5.9 Nail Changes
5.10 Conclusion
Reference
6: Teledermatology
6.1 Introduction
6.2 What Can Be Sent? What Should Not Be Sent?
6.2.1 Types of TD
6.3 Delivery Modalities
6.4 Settings
6.5 A Good Photograph
6.6 Actors
6.7 Patient Empowerment
6.8 Conclusion
References
Part II: Adnexal Disease
7: A Stepwise Approach to the Management of Acne in Primary Care
7.1 Introduction
7.2 Clinical Features and Diagnosis
7.3 Differential Diagnosis
7.4 Pathophysiology
7.5 Treatment
7.6 Topical Treatments
7.7 Systemic Treatments
7.8 Acne in Women
7.9 Other Treatments
7.10 Maintenance Treatment
7.11 Acne Scars
7.12 Rare Variants of Acne
7.13 Conclusion
References
8: Oral Isotretinoin for Severe Acne
8.1 Introduction
8.2 Mode of Action
8.3 Side Effects
8.4 Monitoring
8.5 Dosage
8.6 Outcome
8.7 Conclusion
References
9: Polycystic Ovarian Syndrome (PCOS)
9.1 Introduction
9.2 Clinical Features and Diagnosis
9.3 Differential Diagnosis
9.4 Pathophysiology
9.5 Treatment
9.6 Conclusion
References
10: Rosacea
10.1 Introduction
10.2 Clinical Features and Diagnosis
10.3 Differential Diagnosis
10.4 Pathophysiology
10.5 Topical Treatments
10.6 Systemic Treatments
10.7 Conclusion
Reference
11: Hidradenitis Suppurativa
11.1 Introduction
11.2 Clinical Features and Diagnosis
11.3 Differential Diagnosis
11.4 Pathophysiology
11.5 Treatment
11.6 Conclusion
11.7 Useful Information for Patients Is Available from the Following Sites
References
12: Hyperhidrosis (Excessive Sweating)
12.1 Introduction
12.2 Clinical Features and Diagnosis
12.3 Differential Diagnosis
12.4 Pathophysiology
12.5 Treatment
12.6 Conclusion
References
Part III: Papulosquamous and Eczematous Dermatoses
13: Atopic Eczema in Children
13.1 Introduction
13.2 Clinical Features and Diagnosis
13.3 Differential Diagnosis (Table 13.2)
13.4 Pathophysiology
13.5 Treatment
13.6 Skin Infection
13.7 Moisturisers
13.8 Avoiding Irritants
13.9 Stepwise Approach to Atopic Eczema (Tables 13.3 and 13.4)
13.10 Topical Steroids (TS)
13.11 Topical Calcineurin Inhibitors (TCI)
13.12 Clothing
13.13 Antihistamines
13.14 Allergies
13.15 Systemic Treatment
13.16 Newer Biologic Agents for Severe AE
13.17 Conclusion
References
14: Management of Eczema/Dermatitis in Adults
14.1 Introduction
14.2 Clinical Features and Diagnosis
14.3 Differential Diagnosis
14.4 Pathophysiology
14.5 Treatment
14.6 Emollients
14.7 Soap Substitutes
14.8 Topical Steroids
14.9 Anti-histamines
14.10 Topical Calcineurin Inhibitors
14.11 Antibacterials
14.12 Habit Reversal
14.13 Systemic Treatments
14.14 Conclusion
References
15: Management of Psoriasis in Primary Care
15.1 Introduction
15.2 Clinical Features and Diagnosis
15.3 Differential Diagnosis
15.4 Pathophysiology
15.5 Topical Treatments
15.6 Systemic treatments
15.7 Conclusion
References
16: Seborrhoeic Dermatitis (SD)
16.1 Introduction
16.2 Clinical Features and Diagnosis
16.2.1 Infantile Seborrhoeic Dermatitis
16.2.2 Adult Seborrhoeic Dermatitis
16.3 Differential Diagnosis
16.4 Pathophysiology
16.5 Treatment of adult SD
16.6 Conclusion
References
17: The Red Face
17.1 Introduction
17.2 Telangiectasia (Broken or Thread Veins)
17.3 Flushing/Blushing
17.4 Rosacea
17.5 Seborrhoeic Dermatitis (SD) and Psoriasis
17.6 Steroid Damage
17.7 Cellulitis and Erysipelas
17.8 Lupus Erythematosus
17.9 Eczema/Dermatitis
17.10 Keratosis Pilaris
17.11 Sunburn and Photosensitive Rashes on Face
17.12 Dermatomyositis
17.13 Conclusion
References
18: Papulo-Pustular Rashes on the Face
18.1 Introduction
18.2 Rosacea
18.3 Perioral Dermatitis (Periorificial Dermatitis)
18.4 Steroid Rosacea
18.5 Folliculitis
18.6 Gram Negative Folliculitis
18.7 Pseudofolliculitis Barbae (Razor Bumps, Shaving Rash)
18.8 Tinea Barbae
18.9 Drug Induced Acneiform Eruptions
18.10 Pyoderma Faciale
18.11 Conclusions
19: Lichen Planus (LP)
19.1 Introduction
19.2 Clinical Features and Diagnosis
19.3 Differential Diagnosis
19.4 Pathophysiology
19.5 Treatment
19.6 Conclusion
References
Part IV: Urticaria, Erythrema and Vesiculobullous Disease
20: Urticaria
20.1 Introduction
20.2 Clinical Features and Diagnosis
20.3 Differential Diagnosis
20.4 Pathophysiology
20.5 Treatment
20.6 Conclusion
References
21: Allergic Skin Disorders
21.1 Introduction
21.2 Urticaria
21.3 Eczema/Dermatitis
21.4 Anaphalyxis
21.5 Fixed Drug Eruptions
21.6 Latex Allergy
21.7 Allergy Testing
21.8 Conclusion
References
22: Generalised Rashes in Adults
22.1 Introduction
22.2 Clinical Features and Diagnosis
22.3 Differential Diagnosis
22.4 Investigations
22.5 Generalised, Scaly, Non Itchy or Mildly Itch Rashes
22.5.1 Pityriasis Rosacea
22.5.2 Pityriasis Versicolour (Tinea Versicolour)
22.5.3 Seborrhoeic Dermatitis
22.5.4 Subacute Lupus Erythematosus
22.5.5 Drug Eruptions
22.5.6 Ichthyosis
22.5.7 Tinea Corporis
22.5.8 Secondary Syphilis
22.6 Generalised, Scaly, Itchy Rashes
22.6.1 Discoid Eczema
22.6.2 Dermatitis Herpetiformis
22.6.3 Erythroderma
22.6.4 Pruritic Papular Eruption of HIV
22.6.5 Nodular Prurigo
22.7 Generalised, Non Scaly Rashes With Little Or No Itch
22.7.1 Generalised Folliculitis
22.7.2 Urticarial Vasculitis
22.7.3 Erythrema Multiforme
22.8 Generalised, Non Scaly, Very Itchy Rashes
22.9 Conclusion
References
23: Blistering Eruptions
23.1 Introduction
23.2 Common Benign Blistering Disorders
23.3 Common Skin Disorders That Occasionally Blister
23.4 Rare Primary Blistering Eruptions
23.5 Conclusion
References
24: The Ageing Skin
24.1 Introduction
24.2 Photoageing
24.3 Senile Purpura (Bateman Purpura or Actinic Purpura)
24.4 Seborrhoeic Keratosis
24.5 Cherry Angioma (Campbell de Morgan Spots)
24.6 Generalised Pruritus
24.7 Cutaneous Adverse Drug Reactions
24.8 Bed Sores (Pressure Sores) or Decubitus Ulcers
24.9 Other Common Skin Dermatosis in the Elderly
24.10 Conclusion
25: Skin Diseases in Pregnancy
25.1 Introduction
25.2 Skin Changes During Pregnancy
25.3 Specific Dermatosis of Pregnancy
25.3.1 Atopic Eruption of Pregnancy
25.3.2 Polymorphic Eruption of Pregnancy
25.3.3 Intrahepatic Cholestasis of Pregnancy (ICP)
25.3.4 Pemphigoid Gestationis (PG)
25.4 Febrile Rashes
25.5 Sexually Transmitted Diseases (STD)
25.6 Conclusion
References
Part V: Paediatric Dermatology
26: Paediatric Dermatology
26.1 Introduction
26.2 Neonatal Milia
26.3 Napkin Dermatitis
26.4 Infantile Seborrhoeic Dermatitis
26.5 Infantile Psoriasis
26.6 Infantile Acne
26.7 Keratosis Pilaris
26.8 Impetigo
26.9 Tinea Capitis (Scalp Ringworm)
26.10 Scabies in Babies
26.11 Conclusion
References
27: Exanthems and Infectious Rashes in Childhood
27.1 Introduction
27.2 Chickenpox (Varicella)
27.3 Measles
27.4 Rubella
27.5 Roseola Infantum
27.6 Fifth Disease (Slapped Cheek Syndrome)
27.7 Kawasaki Disease
27.8 Gianotti-Crosti Syndrome
27.9 Scarlet Fever
27.10 Infectious Mononucleosis (Glandular Fever)
27.11 Hand, Foot and Mouth Disease
27.12 Meningococcal Disease
27.13 Staphylococcal Scalded Skin Syndrome (SSSS)
27.14 Conclusion
References
28: Genodermatosis: Inherited Skin Diseases
28.1 Introduction
28.2 Down Syndrome (Trisomy 21)
28.3 Neurofibromatosis
28.3.1 Neurofibromatosis Type 1 (von-Recklinghausen’s = NF1)
28.3.2 Neurofibromatosis Type 2 (Bilateral Acoustic Neurofibromatosis)
28.4 Tuberous Sclerosis
28.5 Ehlers-Danlos Syndrome
28.6 Darier’s Disease
28.7 Albinism
28.8 Conclusion
29: Congenital Nevi, Melanocytic Naevi (Moles) and Vascular Tumors in Newborns and Children
29.1 Introduction
29.2 Congenital Vascular Lesions
29.3 Congenital Melanocytic Nevi
29.4 Acquired Melanocytic Nevi
29.5 Conclusion
Part VI: Infections, Infestations and Bites
30: Common Bacterial Skin Infections in General Practice
30.1 Introduction
30.2 Bites
30.3 Impetigo
30.4 Folliculitis
30.5 Boils (Furuncles or Carbuncles)
30.6 Secondary Infection of Eczema
30.7 Methicillin-Resistant Staphylococcus Aureus (MRSA)
30.8 Leg Ulcers
30.9 Streptococci Infections
30.9.1 Erysipelas
30.9.2 Cellulitis
30.10 Conclusion
31: Fungal and Yeast Infection of Skin, Hair and Nails
31.1 Introduction
31.2 Ringworm
31.3 Tinea Pedis
31.4 Tinea Manuum
31.5 Tinea Cruris
31.6 Tinea Capitis
31.7 Tinea Unguium (Onychomycosis)
31.8 Tinea (Pityriasis) Versicolor
31.9 Conclusion
References
32: Cutaneous Viral Skin Infections
32.1 Introduction
32.2 Herpex Simplex
32.3 Genital Herpes
32.4 Erythema Multiforme
32.5 Varicella Zoster
32.6 Shingles (Herpes Zoster)
32.7 Post-Herpetic Neuralgia
32.8 HIV
32.9 Herpangina
32.10 Orf
32.11 Warts
32.12 Molluscum Contagiosum
32.13 Conclusion
References
33: COVID-19 and the Skin
33.1 Introduction
33.2 Skin Manifestations of COVID-19
33.3 Hand Eczema/Dermatitis
33.4 Immunosuppressants and COVID-19
33.5 Teledermatology
33.6 Dermoscopy
33.7 Conclusions
References
34: Management of Warts in General Practice
34.1 Introduction
34.2 Clinical Features and Diagnosis
34.3 Differential Diagnosis
34.4 Pathophysiology
34.5 Treatment
34.6 Ano-Genital Warts
34.7 Vaccination
34.8 Conclusion
References
35: Bugs and Bites
35.1 Introduction
35.2 Scabies (Sarcoptes scabiei var. hominis)
35.3 Head Lice (Pediculus Humanus Capitis)
35.4 Pubic Lice (Crabs)
35.5 Papular Urticaria
35.6 Bed Bugs (Cimex lectularius)
35.7 Tick Bites and Lyme Disease
35.8 Conclusion
References
Part VII: Regional Dermatology
36: Regional Dermatology
36.1 Introduction
36.2 Diagnosis and Clinical Features
36.3 Lesions and Rashes on the Head and Neck
36.4 Scalp Rashes and Lesions
36.4.1 The Hair Bearing Scalp
36.4.2 Scalp Rashes and Lesions on the Non-hairy Areas of the Scalp
36.5 Scalp Lesions
36.6 Beard Rashes
36.7 Forehead and Cheek Lesions and Rashes
36.8 Rashes and Lesions on the Ear
36.9 Ulcers, Blisters and Nodules on the Ears
36.10 Rashes and Lesions on the Eyelids and Inner Canthus
36.11 Nasal Lesion and Rashes
36.12 Rashes and Lesions on the Lips and in the Mouth
36.13 Ulcers and Nodules on the Lips and in the Mouth
36.14 Neck Rashes and Lesions
36.15 Rashes and Lesions on the Trunk
36.16 Flexural Rashes
36.17 Hand Rashes and Lesions
36.18 Rashes and Lesions on the Feet
36.19 Genital and Perianal Rashes and Lesions
36.19.1 Female Genital Rashes, Ulcers and Lesions
36.19.2 Ulcerating and Nodular Lesions in the Vulva
36.20 Male Genital Rashes and Lesions
36.20.1 Rahes on the Penis and Scrotum
36.20.2 Lesions on the Penis and Scrotum
36.20.3 Genital Ulceration in Men
36.21 Perianal Itch, Rashes and Lesions
36.22 Lower Leg Rashes, Lesions, Ulcers and Blisters
36.22.1 Ulcers and Blisters on the Pretibial Area
36.22.2 Lesions on the Lower Legs
36.23 Conclusion
References
37: Leg Ulcers: A Treatment Programme
37.1 Introduction
37.2 Clinical Features and Diagnosis
37.3 Differential Diagnosis
37.4 Pathophysiology
37.5 Treatment
37.6 Wound Care
37.7 Compression Bandaging
37.8 Compression Stockings (Hosiery)
37.9 Conclusion
References
38: Wound Care
38.1 Introduction
38.2 Tissue
38.2.1 Post-operative Wound Dressings
38.2.2 Epithelializing Wounds
38.2.3 Over Granulating Wounds
38.2.4 Malodours Wounds
38.2.5 Yellow, Sloughy Wounds
38.3 Infections
38.3.1 Wound Dressings for Infected Wounds
38.4 Moisture
38.4.1 Heavily Exudating or Bleeding Wounds
38.4.2 Dry, Black, Necrotic, Leathery Wounds
38.5 Edges
38.6 Surrounding Skin
38.7 Negative Pressure Wound Therapy
38.8 Conclusion
References
39: The Red Leg
39.1 Introduction
39.2 Itchy Red Leg
39.3 Red Leg with Little or No Itch
39.4 Painful Red Leg
39.5 Conclusion
Part VIII: Hair and Nail Problems
40: Hair Loss and Hair Growth
40.1 Introduction
40.2 Patterned, Non Scarring Alopecia
40.3 Patchy Non Scarring Alopecia
40.4 Diffuse Non Scarring Alopecia Without Scale
40.5 Diffuse, Non Scarring Alopecia with Scale
40.6 Scarring Alopecia (Cicatricial Alopecia)
40.7 Hirsutism
40.8 Conclusion
References
41: Nail Problems in General Practice
41.1 Introduction
41.2 Local Factors Affecting the Nail
41.3 Nail Changes Associated with Common Dermatoses
41.4 The Nail in Systemic Disease
41.5 Conclusion
References
Part IX: Lesion Recognition
42: Lesion Recognition
42.1 Introduction
42.2 Benign versus Malignant Skin Lesions
42.3 Dermoscopy
42.4 Clinical Examination of Skin Lesions
42.5 Conclusion
References
43: Pigmented Lesions
43.1 Introduction
43.1.1 Pigmented Macular (Flat) Lesions
43.1.2 Pigmented Ulcerated Lesions
43.1.3 Pigmented Nodular (Raised Up) Lesions
43.1.4 Pigmented, Scaly/Warty Nodules
43.1.5 Pigmented, Nodular, Smooth, Dome Shaped Lesions
43.1.6 Pigmented, Fleshy, Ulcerated, Nodule
43.2 Conclusion
References
44: Non-pigmented Lesions
44.1 Introduction
44.2 Non-pigmented Macular Lesions
44.3 Non-Pigmented Ulcerating Lesions
44.4 Non-Pigmented Nodular Lesions
44.4.1 Non-Pigmented Scaly/Warty Nodules
44.4.2 Non-Pigmented Fleshy Ulcerating Nodules
44.4.3 Non-Pigmented Smooth Dome Shaped Nodules
44.4.4 Red, Smooth, Dome Shapes Nodules
44.4.5 Small, Discrete, Smooth, Dome-Shaped, Non-pigmented Nodules
44.4.6 Large (>5 mm), Discrete, Smooth, Dome Shaped, Non-pigmented Nodules
44.5 Conclusion
References
45: Cancer and Pre-Cancer of the Skin
45.1 Introduction
45.2 Epidemiology
45.3 Algorithms for Skin Cancer Detection
45.4 Skin Biopsy
45.5 Actinic Keratosis (AK) (Solar Keratosis)
45.6 Bowen’s Disease (SCC In Situ)
45.7 Squamous Cell Carcinomas (SCCs)
45.8 Basal Cell Carcinomas (BCCs)
45.9 Melanoma
45.10 Merkel Cell Carcinoma (MCC)
45.11 Dermatofibrosarcoma Protruberans (DFSP)
45.12 Kaposi Sarcoma
45.13 Paget’s Disease
45.14 Secondary Skin Cancer
45.15 Conclusion
References
46: Dermoscopy for the General Practitioner
46.1 Introduction
46.2 The Dermatoscope
46.3 Melanocytic Lesions
46.4 Digital Photography
46.5 Conclusion
References
Part X: Pigment and the Skin
47: Disorders of Pigmentation
47.1 Introduction
47.2 Hyperpigmentation
47.3 Hypopigmentation
47.4 Conclusion
References
48: Skin of Colour
48.1 Introduction
48.2 Epidemiology
48.3 Acne in Dark Coloured Skin
48.4 Hyperpigmentation
48.5 Dermatosis Papulosa Nigra
48.6 HIV Disease
48.7 Hair and Scalp Problems in Individuals with Type 6 Skin
48.8 Tinea Infections
48.9 Keloids and Hypertropic Scars
48.10 Folliculitis Keloidalis Nuchae
48.11 Tropical Diseases in the Ethnic Population
48.12 Conclusion
References
Part XI: Disorders Due to Physical Agents, Systemic Conditions and the Mind
49: Photobiology and the Skin
49.1 Introduction
49.2 Skin Conditions that Are Usually Helped by UVL
49.3 Skin Conditions that May Be Aggravated by UVL
49.4 Primary Photodermatoses
49.5 Drug Induced Photosensitivity
49.6 Phytophotodermatitis
49.7 Polymorphic Light Eruption
49.8 Juvenile Spring Eruption
49.9 Chronic Actinic Dermatitis
49.10 Solar Urticaria
49.11 Actinic Prurigo
49.12 Hydroa Vacciniforme
49.13 Xeroderma Pigmentosum
49.14 ‘‘Fake Tan”
49.15 Conclusion
50: Pruritus (Itch)
50.1 Introduction
50.2 Aetiology
50.3 Management
50.4 Drug Therapy for Chronic Itch
50.5 Conclusion
References
51: Skin in Systemic Disease
51.1 Introduction
51.2 Rheumatoid Arthritis (RA)
51.3 Palmar Erythrema
51.4 Cutaneous Signs of Anorexia Nervosa (AN)
51.5 Vitiligo
51.6 Granuloma Annulare
51.7 Lupus Erythematosus
51.7.1 Systemic Lupus Erythematosus (SLE)
51.7.2 Subacute Lupus Erythematosus (SLE)
51.7.3 Discoid Lupus Erythematosus (DLE)
51.8 Erythema Nodosum
51.9 Dermatitis Herpetiformis (DH)
51.10 Dermatomyositis
51.11 Acanthosis Nigricans
51.12 Neutrophilic Dermatosis
51.12.1 Pyoderma Gangrenosum
51.12.2 Acute Febrile Neutrophilic Dermatosis
51.12.3 Erythema Annulare Centrifugum
51.13 Scleroderma
51.13.1 Morphoea
51.13.2 Systemic Sclerosis
51.14 Porphyria Cutanea Tarda (PCT)
51.15 Cutaneous Sarcoidosis
51.16 Conclusion
References
52: Skin Problems Associated with Diabetes
52.1 Introduction
52.2 Infections
52.3 Cutaneous Manifestations of Diabetic Complications
52.4 Skin Reactions to Diabetic Treatment
52.5 Skin Lesions with an Association with Diabetes
52.5.1 Necrobiosis Lipoidica
52.5.2 Granuloma Annulare
52.5.3 Acanthosis Nigricans
52.5.4 Diabetic Dermopathy (“Shin Spots”)
52.5.5 Diabetic Bullae
52.5.6 Diabetic Stiff Skin
52.5.7 Eruptive Xanthomas
52.6 Skin diseases that are more common in patients with diabetes
52.7 Conclusion
References
53: Skin and the Mind (Psychodermatology)
53.1 Introduction
53.2 Psychological Aspect of Skin Disorders
53.2.1 Ideas, Concerns and Expectations (I.C.E.)
53.3 Skin Aspect of Psychiatric Disease
53.3.1 Habit Biters and Pickers
53.3.2 Skin Picking Disorder (SPD) (“Pickers Dermatitis”)
53.3.3 Body Dysmorphic Disorder (BDD) (Delusional Dysmorphophobia)
53.3.4 Delusional Infestation (Parasitophobia)
53.3.5 Dermatitis Artefacta
53.3.6 Other psychiatric conditions with skin manifestations
53.4 Conclusion
References
54: Cutaneous Vasculitis
54.1 Introduction
54.2 Cutaneous Vasculitis
54.3 Henoch-Schönlein purpura (HSP, also called anaphylactoid purpura)
54.4 Meningococcal Septicaemia
54.5 Urticarial Vasculitis
54.6 Conclusion
References
55: Emergencies in Dermatology
55.1 Introduction
55.2 Dermatological Emergencies
55.3 Burns
55.4 Bites
55.5 Meningococcal Disease
55.6 Acute Generalized Pustular Psoriasis (AGPP)
55.7 Erythroderma
55.8 Erythema Multiforme and Stevens–Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN)
55.9 Drug Rash with Eosinophilia and Systemic Symptoms Syndrome (DRESS)
55.10 Necrotizing Fasciitis (NF)
55.11 Conclusion
References
Part XII: Surgical Therapies
56: Local Anaesthesia for Skin Surgery
56.1 Introduction
56.2 Topical Anaesthetic
56.3 Local Infiltration of Anaesthesia
56.4 Toxicity, Anaphalylaxis and Fainting
56.5 Conclusion
References
57: Simple Skin Surgery
57.1 Key Points
57.2 What to Tell the Patient
57.3 Introduction
57.4 Instruments
57.5 Histology
57.6 Bleeding and Infection
57.7 Sutures
57.8 Punch Biopsy
57.9 Shave Biopsy
57.10 Snip Biopsy
57.11 Curettage
57.12 Conclusion
References
58: Cryosurgery in Primary Care
58.1 Introduction
58.2 Indications
58.3 Safety
58.4 Freeze-Thaw Cycle
58.5 Immunocryosurgery
58.6 Side Effects
58.7 Conclusion
References
59: Cryosurgery for Warts in General Practice
59.1 Introduction
59.2 Cryogen
59.3 Equipment
59.4 Patient Selection
59.5 Technique
59.6 What is a 10 second Freeze-Thaw Cycle?
59.7 Immunocryosurgery
59.8 Side Effects
59.9 Conclusion
References
60: A Practice Nurse Led Cryosurgery Clinic
60.1 Introduction
60.2 Techniques
60.3 Conclusion
Reference
Part XIII: Pharmacology and the Skin
61: Pharmacists and Skin Disease
61.1 Introduction
61.2 Diagnosis
61.3 Treatment of Skin Diseases
61.4 Health Promotion
61.5 Chronic Disease Management
61.6 Conclusion
Reference
62: Emollients and Moisturisers
62.1 What to Tell the Patient
62.2 Introduction
62.3 Ointments Versus Creams
62.4 Active Ingredients
62.5 Soap Substitutes and Bath Oils
62.6 Conclusion
References
63: Steroids in Dermatology
63.1 What to Tell the Patient
63.2 Introduction
63.3 Potency
63.4 The Fingertip Unit (FTU)
63.5 Topical Steroid Vehicle (Base)
63.6 Compliance
63.7 Conclusion
Reference
64: Topical Immunomodulators (TIMs)
64.1 What to Tell the Patient
64.2 Introduction
64.3 Tacrolimus (“Protopic®”) Ointment
64.4 Pimecrolimus (“Edilel®”) Cream
64.5 Conclusion
References
Part XIV: Nurses, Patients, Courses and Websites
65: Nursing Care of the Dermatology Patient
65.1 Introduction
65.2 Topical Therapies
65.3 Dermatological Surgery
65.4 Allergy Testing
65.5 Skin Cancer Screening and Treatment
65.6 Nurse Lead Wart Clinics
65.7 Professional Nursing Associations
65.8 Conclusion
References
66: Patient Information Leaflets (PIL)
66.1 Acne
66.1.1 Acne—how to treat it
66.1.2 Isotretinoin (“Roaccutance®”): What patients need to know
66.2 Consent Forms
66.2.1 CONSENT FORM
66.2.2 Photography Consent
66.3 Eczema/Dermatitis
66.3.1 Cow’s Milk (Dairy) Allergy
66.3.2 Hand care tips for hand eczema and dermatitis
66.3.3 Ketoconazole (“Nizoral®”) Shampoo
66.3.4 Management of Dry Sensitive Skin Conditions
66.3.5 Milton Baths
66.3.6 Tacrolimus (“Protopic®”) + pimecrolimus (Elidel®)
66.3.7 Topical Steroids; There safe use
66.3.8 Wet wraps
66.4 Hair Loss
66.4.1 Hair Loss in Men
66.4.2 Hair Loss in Women
66.5 Infections and Infestations
66.5.1 All about Warts
66.5.2 Patients instructions on detection and treatment of head lice
66.5.3 Treating Fungal Nail Infections with terbinafine (“Lamisil®”) Anti-fungal Tablets
66.5.4 Treatment of Scabies
66.5.4.1 Instructions for Use
66.6 Skin Cancer
66.6.1 5 Fluorouracil (“Effudix®”)
66.6.2 Primary Melanomas
66.6.3 Skin cancer screening
66.6.4 Skin cancer. What to look out for
66.6.5 Warning signs for melanoma
66.7 Skin Surgery
66.7.1 Anticoagulants and surgery-patient information
66.7.2 Care of your wound after surgery
66.7.3 Cryosurgery clinic
66.8 Sun Protection
66.8.1 Be safe in the sun
66.8.2 The Sun and Vitamin D
66.9 Miscellaneous
66.9.1 Advice for patients with varicose ulcers
66.9.2 Hyperhydrosis
66.9.3 Keratosis Pilaris
66.9.4 Methotrexate Information
66.9.5 Pruritis Ani
66.9.6 Tinea Versicolor Treatment
66.9.7 Top ten self-care tips for people with psoriasis
67: Useful Websites, Courses, Bibliography and Patient Support Groups
67.1 General Dermatology Resources for Patients
67.2 Websites for Healthcare Professionals
67.3 Patient Information Videos
67.4 Courses and Diplomas
67.5 Textbooks
67.5.1 Diagnosis
67.5.2 Dermoscopy
67.5.3 Treatment
67.5.4 Dermatological Surgery
67.5.5 Cryosurgery Books
Index