Disease Knowledge Centres

  • Dermatology - Disease Topic Overview

    Dermatology is the branch of medicine that deals with the skin, mucous membranes, hair and nails.

    The skin is the largest and heaviest organ of the body.1 It plays several key roles such as; protection against external substances, control of temperature, synthesis (vitamin D) and it also has a immune function.1 The skin has three layers; the epidermis (which is in permanent renewal) the dermis and the hypodermis which provide the fibrous framework.2 Skin color, texture and the arrangement of folds is also undeniably a psychosocial feature.1

    Acne, psoriasis and eczema (atopic dermatitis) are the most common skin diseases.2 Their psychological impact can be important as skin diseases affect body image and interfere heavily in social life.2

    Skin cancer is the most common cancer in white populations.3 Skin cancers are classified into three types; basal cell carcinoma, squamous cell carcinoma and melanoma.1 The frequency of skin cancers is steadily increasing in white populations.3 Exposure to ultraviolet radiation is the main environmental risk factor. However, other elements of risk are described, such as; light skin phototypes, advanced age, family history of skin carcinoma, light eyes and blonde hair, and immunosuppression.3

    Basal cell carcinoma is the most common skin cancer and its incidence has increased in recent decades.3 Its high prevelance is a significant burden for the health system, making the disease a public health problem.3 Despite the low mortality rates and the rare occurrence of metastases, the tumor may be locally invasive and relapse after treatment, causing significant morbidity.3

    Preventing skin cancer is based on knowledge of risk factors, early diagnosis and treatment, as well as the adoption of specific measures, especially in high-risk populations.3

    1. Graham-Brown R et al. Lecture notes: Dermatology. Blackwell Publishing. Ninth edition. 2007 2007 : 217 pages .
    2. Beers M.H. et al. The Merck manual of medical information. Merck research laboratories. Second home edition. 2003 : 1185-1241.
    3. Chinem V.P. et al. Epidemiology of basal cell carcinoma. Anais Brasileiros de Dermatologia. April 2011 ; 86 (2) : 292-305

Latest Multi Media

A Presentation Detailing Behavioural Modification Treatments for Atopic Dermatitis

Dermatology Drug Data - A-Z English

Drug Updates

Zineryt
Topical treatment of acne vulgaris.
Protopic 0.03% ointment
Protopic 0.
Neotigason 10mg Capsules
Severe extensive psoriasis which is resistant to other forms of therapy.

Latest Drug News

Picato (Leo Pharma) is FDA approved for Actinic Keratosis - 26-01-2012
The FDA has approved Picato (ingenol mebutate) gel in the 0.015%/0.05% strength from Leo Pharma for the topical treatment of Actinic Keratosis which is a precancerous condition resulting from cumulative sun exposure that has the potential to lead to squamous cell carcinoma. The drug is the first and only topical therapy available in the USA for Actinic Keratosis that can be used for as little as two or three days.
TRANSIT study of Stelara in Psoriasis - 26-10-2011
The TRANSIT Phase IV study of Stelara (ustekinumab)from Janssen Cilag compared two methods of transiting patients from methotrexate therapy to Stelara in moderate to severe psoriasis patients. The study showed serious adverse events were infrequent regardless of transition strategy: 2.9% in the methotrexate immediate cessation arm versus 2.0% in the gradual withdrawal arm and a health related quality of life benefit as assessed by the Dermatology Quality of Life Index (DLQI)in both arms of the study. The mean improvement in DLQI over 16 weeks was shown by a reduction from 8.0 in the immediate cessation arm and 9.0 in the gradual withdrawal arm at baseline to 1.0 in both arms. The study also showed substantially improved effiacy of Stelara compared to methotrexate. By week 12, 65.3% of patients in the immediate cessation arm and 69.5% in the gradual withdrawal arm achieved a Psoriasis Global Assessment rating of 'cleared' or minimal'. The medial Psoriasis Area and severity Index (PASI) score decreased from about 15 in both arms at baseline to 2.9 in the immediate cessation arm and 2.8 in the gradual withdrawal arm. The study paves the way for an application by Janssen Cilag for use of Stelara as first line therapy in Psoriasis.Data were reported at the European Academy of Dermatology and Venereology (EADV) congress in Lisbon.

Latest Social Media

Would CCTV cameras make you more likely to wash your hands?
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... why health-care workers poor compliance to hand hygiene. These include skin irritation, inaccessible supplies, interference with worker-patient ...

Is restricting GP referrals the best way of cutting NHS costs?
on doc2doc

... suggest that they would reduce referrals to that specialty (e.g. dermatology - BMJ 2002; 325: 1177 (16 Nov)) but other work suggest that GPs with a ...

Would you give your child vitamin supplements?
on doc2doc

... games, watching TV etc) or outdoors covered in suncream (for fear of skin cancer and sun burn).As a child suncream was reserved for foreign shores or ...

Latest Clinical Trials

Caspofungin Acetate or Fluconazole in Preventing Invasive Fungal Infections in Patients With Acute Myeloid Leukemia Who Are Undergoing Chemotherapy
This randomized phase III clinical trial is studying caspofungin acetate to see how it works compared to fluconazole in preventing invasive fungal infections in patients with acute myeloid leukemia who are undergoing chemotherapy.
Pre-hospital Risk Factors for Invasive Fungal Infection (SEIFEM 2010)
SEIFEM 2010 study is a prospective, multicenter registry designed to identify and analyze risk factors for developing an invasive fungal infection in patients with newly diagnosed Acute Myeloid Leukemia, with particular interest on pre-hospital risk factors (i.e. those related to normal activities of daily life, such as occupation, location and type of residence, consume of tobacco, alcohol and others).

Latest Journal Publications

Archives of Gerontology and Geriatrics
The pre- and post-operative cardiac autonomic nervous functions were compared in elderly, non-cardiac surgery patients with diabetes mellitus (DM) and without diabetes mellitus (NDM). A group of 30 unpremedicated elderly patients scheduled to undergo elective non-cardiac surgery were studied, including 15 DM patients and 15 NDM patients. Each component of heart rate variability (HRV) analysis in the frequency domain was monitored with Holter during the nights of the day before and on 1st and 2nd day after operation. After surgery, total power (TP), high frequency (HF), low frequency (LF) and very low frequency (VLF) significantly decreased as compared to the baseline values before operation in both groups (p<0.05). The LF/HF ratio was significantly changed in DM group but did not change in NDM group. On the 2nd postoperative day, TP, HF, LF and VLF in DM group were further decreased as compared to those on the 1st postoperative day and were significantly lower than those in NDM group (p<0.01 or 0.05), but these indices in NDM group did not show significant decreases. Surgery induced the cardiac autonomic nervous dysfunction in elderly patients not only with DM but also without diabetes. On the 2nd postoperative day, the disturbances of cardiac autonomic nervous activity were more sever in DM patients, compared to the 1st postoperative day, but was not significantly more sever than in the NDM patients.
International Journal of Cancer
Polymorphisms in the melanocortin 1 receptor (MC1R) gene have been associated with increased risks of melanoma, but different approaches to study design, analysis, and reporting have hindered comparisons of findings. We aimed to harmonize the published data by conducting a systematic review and meta-analysis of MC1R variants and thereby estimate relative risks and population attributable fractions (PAFs). We identified 20 analytic studies reporting on 25 populations, which presented quantitative data on melanoma risks associated with any of nine MC1R variants. We separately pooled estimates of risk per person and risk per chromosome using a random effects model. Red hair color (RHC) variants had the highest risk of melanoma [summary odds ratios (OR) 2.44, 95% confidence interval (CI) 1.72–3.45, PAF 16.8% CI 0.119–0.202], but non-RHC variants were also associated with increased risk (summary OR 1.29, 95% CI 1.10–1.51, PAF 7.4% CI 0.030–0.112). The summary risk of melanoma associated with individual variants ranged from OR 2.40 for R142H to 1.18 for V60L, although significant heterogeneity was evident for most variants. PAFs ranged from 0.55% for I155T to 6.28% for R151C. Our findings suggest the nine most common MC1R variants make a sizeable contribution to the burden of melanoma. Melanoma research would be greatly assisted by standardized classifications for MC1R variants and consistent reporting conventions. More compatible and comparable research would allow for more powerful data that could be clinically applied to predict melanoma risk.

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Dermatology