Part 1 Foundations of Dermatology
- 1History of Dermatology
- 2Structure and Function of the Skin
- Overview
- Components of normal human skin
- Skin development
- Epidermal and adnexal structures
- Keratinocytes
- Eccrine and apocrine glands
- Pilosebaceous unit
- Nails
- Merkel cells
- Innate immunity
- Skin microbiome
- Langerhans cells
- Immune surveillance
- Mast cells
- Melanocytes
- Desmosomes
- Adherens junctions
- Gap junctions
- Tight junctions
- Dermal–epidermal basement membrane
- Basement membrane collagen
- Laminins
- Hemidesmosomes
- Anchoring fibrils
- Extracellular matrix
- Collagens
- Collagen biosynthesis
- Collagen biology
- Collagen cross‐linking
- Collagen degradation
- Elastic fibres
- Elastin
- Elastin‐associated microfibrils
- Proteoglycan/glycosaminoglycans
- Fibroblasts
- Blood vessels and lymphatics
- Subcutaneous fat
- Physiological functions of skin
- Skin homeostasis
- Skin ageing
- References
- 3Histopathology of the Skin: General Principles
- Overview
- Introduction
- Biopsy of the skin
- Laboratory methods
- Immunopathology
- Other diagnostic methods
- Artefacts
- Approach to microscopic examination of tissue sections
- Preparing for microscopy
- Microscopic interpretation
- How to produce a histopathology skin report
- Commonly used descriptive terms in dermatopathology, and their diagnostic significance
- Acantholysis
- Acanthosis
- Anaplasia
- Apoptosis
- Basal lamina
- Bullae
- Colloid body
- Crust
- Curlicue (storiform) pattern
- Degenerations
- Desmoplasia
- Dyskeratosis
- Dysplasia
- Exocytosis
- Granuloma
- Grenz zone
- Hypergranulosis
- Hyperkeratosis
- Kamino bodies (eosinophilic globules)
- Karyorrhexis
- Lichenoid tissue reaction
- Metaplasia
- Necrobiosis
- Necrolysis
- Necrosis
- Papilloma
- Papillomatosis
- Parakeratosis
- Pigmentary incontinence
- Pleomorphism
- Polymorphism
- Pustules and abscesses
- Pyknosis
- Saw‐toothing
- Spongiosis
- Storiform patterning
- Theque
- Villi
- Histological sections that reveal little or no abnormality
- Conclusions
- References
- 4Diagnosis of Skin Disease
- Overview
- Fundamentals of diagnosis
- Disease definition
- The history
- Quality of life in dermatology patients
- Examination of the skin
- Description of skin lesions
- Clinical microscopy, dermoscopy and other imaging systems
- Fine‐needle aspiration of lymph nodes
- Radiological and imaging examinations
- Skin testing (prick and scratch, intradermal and patch testing)
- Teledermatology
- Mobile smartphone applications
- References
- 5Epidemiology of Skin Disease
- Overview
- What is epidemiology and why is it relevant to dermatology?
- Thinking in terms of populations rather than individuals
- How much of a public health problem is skin disease?
- What determines the frequency of skin disease in populations?
- Describing the natural history and associations of specific skin diseases
- Health services research in dermatology
- Conclusions
- Glossary of epidemiological terms
- Checklist for reading ‘epidemiological studies' in dermatology
- Recommended further reading and useful dermatoepidemiology resources
- References
- 6Health Economics and Skin Disease
- 7Genetics and the Skin
- 8Inflammation, Immunology and Allergy
- Overview
- Clinical characteristics of inflammation
- Phases of inflammation
- Cellular components of cutaneous inflammation
- Innate immune defence mechanisms
- Cells regulating innate immunity
- Adaptive immune system
- Mediators of inflammation
- Acute‐phase proteins
- Cytokines
- Interleukins
- Interferons
- Tumour necrosis factor
- Cytokine suppressors and inhibitors
- Chemokines
- Chemokine receptors
- Proteases
- Matrix metalloproteinases
- Lysosomal mediators
- Radical oxygen species
- Nitric oxide
- Histamine
- Platelet‐activating factor
- Prostaglandins and thromboxanes
- Leukotrienes
- Neuromediators
- Cell apoptosis and inflammation
- Allergy
- Immunity, T cells and dendritic cells
- Overview of the phases in an allergic reaction
- Phase of sensitization with focus on IgE
- Special properties of proteins alleviate allergy development
- IgE structure and biology
- IgE receptors and IgE amplification mechanisms
- Effector phase in allergy
- Early‐phase or immediate response initiates the allergic reaction in type I hypersensitivity
- Late‐phase response in allergic reactions
- Hypersensitivity type II, III and IV reactions
- References
- 9Photobiology
- 10Cutaneous Response to Injury and Wound Healing
- 11Psychological and Social Impact of Long‐term Dermatological Conditions
- Overview
- Psychological and social challenges of dermatological conditions
- Psychological impact of dermatological conditions with emphasis on psoriasis
- Social impact of dermatology conditions
- Skin conditions and associated co‐morbidities
- Treatment challenges
- Implications of psychological and social impact of dermatological conditions for integrated clinical management
- References
- 12Adverse Immunological Reactions to Drugs
- 13Topical Drug Delivery
- Overview
- Introduction: skin barrier function
- Penetration pathways: mechanisms of percutaneous absorption
- Factors determining drug permeation into the skin
- Topical drug formulations used to treat dermatological disease
- Assessment of topical drug bioavailability and bioequivalence between formulations
- Optimization of dermatological medicines
- Conclusions
- References
- 14Clinical Pharmacology
Part 2 Management
- 15Principles of Holistic Management of Skin Disease
- 16Principles of Measurement and Assessment in Dermatology
- Overview
- Measurement of skin disease severity
- Assessment tools
- Objective methods for measuring skin properties
- Measurement of the impact of skin disease
- Quality of life measures used in dermatology
- General health measures
- Dermatology‐specific measures
- Disease‐specific quality of life measures
- Patient‐specific and utility measures
- Measuring the impact of skin disease in children and adolescents
- Measuring the impact of skin disease on partners and the family
- Assessing life course impairment resulting from skin disease
- Practical clinical use of quality of life measures: a vital sign?
- References
- 17Principles of Evidence‐based Dermatology
- Overview
- Evidence‐based medicine
- Formulating questions and finding evidence
- Critically appraising evidence and applying it to individual patients
- Evaluating the data in clinical research papers and a shortcut method for reading clinical research papers
- References
- 18Principles of Topical Therapy
- Overview
- Introduction
- Prescribing topical treatment
- Hazards associated with topical treatment
- Formulation of topical medicaments
- Topical treatments used in the management of skin disease
- Emollients
- Astringents
- Anti‐infective agents
- Antifungal agents
- Antiviral agents
- Antiparasitic agents
- Topical glucocorticoids
- Calcineurin inhibitors
- Retinoids
- Vitamin D analogues (deltanoids, secosteroids)
- Cytotoxic and antineoplastic agents
- Depigmenting agents
- Depilatories
- Sensitizing agents
- Sunscreens
- Tars
- Antihistamines
- Antiperspirants
- Traditional remedies
- Miscellaneous agents
- References
- 19Principles of Systemic Therapy
- Overview
- Introduction
- Immunomodulatory drugs
- Antihistamines
- Antimalarial agents
- Azathioprine
- Ciclosporin
- Colchicine
- Dapsone
- Fumaric acid esters
- Systemic glucocorticoids
- Hydroxycarbamide
- Methotrexate
- Mycophenolate mofetil
- Potassium iodide
- Biological therapies (protein therapeutics)
- Intravenous immunoglobulin therapy
- Systemic retinoids
- Thalidomide
- Antimicrobial drugs
- References
- 20Principles of Skin Surgery
- Overview
- Introduction
- Critical anatomical considerations
- Equipment and sterilization
- Safety aspects
- Complications
- Local anaesthetics
- Biopsy techniques
- Preoperative preparation
- Simple excision, suture technique and wound closure
- Dressings and postoperative care
- Flaps
- Skin grafts
- Other techniques for facilitating closure
- Mohs micrographic surgery
- Electrocautery and electrosurgery
- Cryosurgery
- Caustics
- Intralesional corticosteroid therapy
- Intralesional therapies for skin malignancies
- Miscellaneous surgical procedures and techniques
- Management of specific conditions
- Epidermoid cysts
- Lipomas
- Hidradenitis suppurativa
- Chondrodermatitis nodularis
- Digital myxoid cysts
- Axillary and palmar hyperhidrosis
- Hypertrophic scars and keloids
- Lesions on the shoulder, upper back and sternum
- Benign naevi
- Non‐melanoma skin cancer: basal cell and squamous cell carcinomas
- Lesions of the mucous membranes
- Keratoacanthoma
- Pigmented lesions
- Minor skin lesions: mollusca, milia and comedones
- References
- 21Principles of Phototherapy
- Overview
- Introduction
- History and background
- Ultraviolet radiation
- Indications for phototherapy
- How different therapies are administered
- Adverse effects
- Patient selection, assessment and education
- Patient and staff safety
- Patient follow‐up: skin cancer surveillance
- Clinical governance
- How to set up a phototherapy unit
- What's new: developments
- References
- 22Principles of Photodynamic Therapy
- 23Principles of Cutaneous Laser Therapy
- Overview
- Introduction
- Light and laser light characteristics
- Clinical applications of lasers and flashlamps
- General considerations
- Vascular lesions and vascular lasers
- Tattoos and pigmentary disorders
- Hair reduction
- Photothermal ablation in the treatment of skin disorders
- Non‐ablative and fractional modalities
- Low‐power lasers
- Laser‐assisted lipolysis
- References
- 24Principles of Radiotherapy
- Overview
- Introduction
- Ionizing radiation in the treatment of skin cancer
- Superficial radiotherapy treatment technique
- Megavoltage X‐ray therapy technique
- Radiosensitivity
- Indications for radiotherapy
- Benign disease
- Keloids
- Malignant skin disease
- Basal cell carcinoma and squamous cell carcinoma of the skin
- Radiotherapy dose fractionation and treatment regimens
- Radiotherapy for particular skin sites: basal cell and squamous cell carcinoma
- Radiotherapy for particular skin tumours
- Basal cell carcinoma
- Squamous cell carcinoma of the skin
- Bowen disease
- Melanoma
- Lentigo maligna and lentigo maligna melanoma
- Merkel cell carcinoma
- Kaposi sarcoma
- Dermatofibrosarcoma protuberans
- Carcinoma metastatic to the skin from other primaries
- Squamous cell and basal cell carcinoma in transplant patients
- Cutaneous lymphoma
- Mycosis fungoides
- Other lymphomas
- Acute radiation reaction (acute radiodermatitis)
- Late radiation reaction (chronic radiodermatitis)
- Tumour recurrence after radiotherapy
- Radiation‐induced tumours
- Rare tumours associated with previous irradiation
- References
Part 3 Infections & Infestations
- 25Viral Infections
- Overview
- Introduction
- POXVIRUS INFECTIONS
- General description of disease domain
- Basic biology
- Smallpox
- Vaccinia
- Monkeypox
- Cowpox
- Buffalopox
- Orf (contagious pustular dermatosis)
- Milker's nodule
- Molluscum contagiosum
- Tanapox
- HERPESVIRUS INFECTIONS
- General description of disease domain
- Basic biology
- HERPES SIMPLEX VIRUS INFECTIONS
- General description of disease domain
- Basic biology
- Herpes simplex: primary herpetic ginigivostomatitis
- Herpes simplex: recurrent oro‐facial and cutaneous
- Herpes simplex: primary genital
- Herpes simplex: recurrent genital
- Herpes simplex: neonatal
- Herpes simplex: inoculation
- VARICELLA‐ZOSTER VIRUS INFECTIONS
- General description of disease domain
- Basic biology
- EPSTEIN–BARR VIRUS INFECTIONS
- Introduction
- General description of disease domain
- Basic biology
- HUMAN HERPESVIRUS 6 AND 7 VIRUS INFECTIONS
- OTHER HERPESVIRUS INFECTIONS
- POLYOMAVIRUS INFECTIONS
- HUMAN PAPILLOMAVIRUS INFECTIONS
- Definition
- General description of disease domain
- Basic biology
- Subclinical and latent human papillomavirus infection
- Immunity to human papillomavirus
- Human papillomavirus (HPV): cutaneous warts
- Human papillomavirus (HPV): anogenital warts
- Human papillomavirus (HPV) associated intraepithelial and invasive neoplasias of genitalia and mucosae
- Epidermodysplasia verruciformis
- Human papillomavirus (HPV) in immune compromise
- HEPATITIS INFECTIONS
- PARVOVIRUS INFECTIONS
- HUMAN RETROVIRUS INFECTION
- VIRAL INSECT‐BORNE AND HAEMORRHAGIC FEVERS
- General description of disease domain
- Basic biology
- ARENAVIRUS INFECTIONS
- BUNYAVIRUS INFECTIONS
- FILOVIRUS INFECTIONS
- FLAVIVIRUS INFECTIONS
- TOGAVIRUS INFECTIONS
- PICORNAVIRUS INFECTIONS (ENTEROVIRUSES)
- RHABDOVIRUS INFECTIONS
- MYXOVIRUS INFECTIONS AND RELATED RNA VIRUSES
- OTHER CUTANEOUS PROBLEMS ASSOCIATED WITH VIRAL INFECTIONS
- General description of disease domain
- Papular–pruritic gloves and socks syndrome
- TORCH syndrome
- Gianotti–Crosti syndrome (infantile papular acrodermatitis)
- Asymmetric periflexural exanthema of childhood
- Pityriasis rosea
- General description of disease domain
- References
- 26Bacterial Infections
- Overview
- Introduction: normal skin bacteria and bacterial microbiome
- GRAM‐POSITIVE BACTERIA
- STAPHYLOCOCCUS AUREUS
- COAGULASE‐NEGATIVE STAPHYLOCOCCI
- STREPTOCOCCI
- STAPHYLOCOCCAL AND STREPTOCOCCAL INFECTIONS
- Clinical history
- Staphylococcus and Streptococcus in atopic eczema
- Impetigo
- Ecthyma
- Erysipelas and cellulitis
- Folliculitis
- Furuncle (boil, abscess)
- Carbuncle
- Sycosis
- Staphylococcal scalded skin syndrome
- Toxic shock syndrome
- Toxin‐mediated perineal erythema, recurrent
- Streptococcal vulvovaginitis
- Streptococcal cellulitis, perianal
- Blistering distal dactylitis
- Toxin‐mediated streptococcal disease
- Clinical history
- CORYNEFORM BACTERIA
- ARCANOBACTERIUM HAEMOLYTICUM INFECTION
- TRUEPERELLA PYOGENES INFECTION
- PROPIONIBACTERIA
- BACILLUS
- LISTERIA MONOCYTOGENES
- ERYSIPELOTHRIX RUSIOPATHIAE
- CLOSTRIDIUM
- GRAM‐NEGATIVE BACTERIA
- Neisseria meningitides
- ACINETOBACTER INFECTION
- MORAXELLA INFECTION
- PSEUDOMONAS AERUGINOSA
- BURKHOLDERIA
- STENOTROPHOMONAS MALTOPHILIA
- KLEBSIELLA PNEUMONIAE RHINOSCLEROMATIS
- FRANCISELLA TULARENSIS
- PASTEURELLA
- YERSINIA INFECTIONS
- BRUCELLA
- BARTONELLA
- EHRLICHIA
- OTHER GRAM‐NEGATIVE BACILLI
- ANAEROBIC BACTERIA
- SPIROCHAETES AND SPIRAL BACTERIA
- LEGIONELLOSIS
- MISCELLANEOUS
- MYCOPLASMA INFECTIONS
- CHLAMYDIAE
- RICKETTSIAL INFECTIONS
- Rickettsial infections: epidemic typhus
- Rickettsial infections: Brill‐Zinsser disease
- Rickettsial infections: murine typhus
- Spotted fever group
- ACTINOMYCETE INFECTIONS
- DERMATOSES POSSIBLY ATTRIBUTABLE TO BACTERIA
- References
- 27Mycobacterial Infections
- Overview
- Introduction
- MYCOBACTERIAL INFECTION
- TUBERCULOSIS OF THE SKIN
- Classification
- General description
- Basic biology
- Diagnostic tests for cutaneous tuberculosis
- Treatment
- BCG vaccination
- Tuberculosis and anti‐TNF‐α treatment
- Tuberculosis: primary inoculation
- Tuberculosis: scrofuloderma
- Tuberculosis: orificial
- Tuberculosis: acute cutaneous miliary
- Metastatic tuberculous abscess
- Tuberculosis: warty (tuberculosis verrucosa cutis)
- Tuberculosis: lupus vulgaris
-
TUBERCULIDS
- Classification
- General description
- Basic biology
- Lichen scrofulosorum
- Papulonecrotic tuberculid
- Erythema induratum of Bazin
- Other nodular
- NON‐TUBERCULOUS (ATYPICAL) MYCOBACTERIA
- Classification
- General description
- Basic biology
- Mycobacterium marinum infection
- Mycobacterium kansasii infection
- Mycobacterium ulcerans infection
- Mycobacterium avium complex (M. avium and M. intracellulare) infection
- Mycobacterium haemophilum infection
- Mycobacterium scrofulaceum infection
- Mycobacterium szulgai infection
- Mycobacterial infections due to fast‐growing mycobacteria
- References
- 28Leprosy
- Overview
-
Leprosy
- Definition and nomenclature
- Introduction and general description
- Epidemiology
- Pathophysiology
- Clinical features
- Investigations
- Management
- References
- 29Syphilis and Congenital Syphilis
- 30Other Sexually Transmitted Bacterial Diseases
- Overview
- Gonorrhoea
- Chlamydia infection, genital
- Lymphogranuloma venereum (ulcerative genital Chlamydia trachomatis infection)
- Chancroid (Haemophilus ducreyi infection)
- Granuloma inguinale (donovanosis)
- References
- 31HIV and the Skin
- Overview
- HIV INFECTION AND AIDS
- DERMATOLOGICAL MANIFESTATIONS OF HIV INFECTION
- INTRODUCTION
- HIV‐ASSOCIATED DERMATOSES: PRURITUS, XEROSIS AND ICHTHYOSIS
- HIV‐ASSOCIATED DERMATOSES: PIGMENTARY
- HIV‐ASSOCIATED COAGULOPATHIES
- INFLAMMATORY DERMATOSES
- HIV‐associated dermatoses: erythroderma
- HIV‐associated dermatoses: seborrhoeic dermatitis
- HIV‐associated dermatoses: atopic eczema
- HIV‐associated dermatoses: psoriasis
- HIV‐associated dermatoses: eosinophilic folliculitis
- HIV‐associated dermatoses: pruritic papular eruption
- HIV‐associated dermatoses: granuloma annulare
- HIV‐associated dermatoses: porphyria cutanea tarda
- HIV‐associated drug reactions
- INFECTIONS
- HIV‐ASSOCIATED NEOPLASMS
- SPECIAL SITUATIONS
- References
- 32Fungal Infections
- Overview
- Introduction
- Basic biology
- SUPERFICIAL MYCOSES
- Classification
- General description
- Identification
- SKIN DISEASE CAUSED BY MALASSEZIA SPECIES
- SUPERFICIAL MYCOSES CAUSED BY OTHER SPECIES
- DERMATOPHYTOSIS
- Classification
- General description
- Basic biology
- Pathophysiology
- Identification
- Management
- Superficial mycoses caused by dermatophyte infection
- Dermatophytosis: tinea corporis
- Dermatophytosis: tinea capitis
- Dermatophytosis: tinea barbae
- Dermatophytosis: tinea faciei
- Dermatophytosis: tinea pedis
- Dermatophytosis: tinea manuum
- Dermatophytosis: tinea cruris
- Onychomycosis caused by dermatophytes
- Dermatophytosis: steroid‐modified tinea (tinea incognita)
- Dermatophytide reactions
- SUPERFICIAL MYCOSES DUE TO OTHER HYPHAL FUNGI
- ONYCHOMYCOSIS CAUSED BY OTHER NON‐DERMATOPHYTE MOULDS
- CANDIDOSIS
- Definition and nomenclature
- Classification
- General description
- Basic biology
- Pathophysiology
- Identification
- Management
- General principles of management
- Therapeutic agents
- First line
- Candidosis of oral mucous membranes
- Candidosis of skin and genital mucous membranes
- Candidosis of the nail and paronychium
- Other Candida diseases
- SUBCUTANEOUS MYCOSES
- Classification
- General description
- Identification
- Collection of samples
- Direct examination and histopathology
- Culture and identification of isolates
- Sporotrichosis
- Mycetoma
- Chromoblastomycosis
- Phaeohyphomycosis
- Lobomycosis
- Rhinosporidiosis
- Basidiobolomycosis and Conidiobolomycosis
- SYSTEMIC MYCOSES
- Pathophysiology
- Identification
- Serological tests
- Direct examination and histopathology
- Culture and identification of isolates
- Glossary of terms
- References
- 33Parasitic Diseases
- Overview
- INFECTION WITH HUMAN NEMATODES
- INFECTION WITH NEMATODES OF OTHER ANIMALS
- INFECTION WITH TREMATODES
- INFECTION WITH CESTODES
- INFECTION WITH PROTOZOA
- Malaria
- Amoebiasis
- Trichomoniasis
- Trypansomiasis
- Leishmaniasis
-
Leishmaniasis, cutaneous
- Definition
- Introduction and general description
- Epidemiology
- Pathophysiology
- Clinical features
- Presentation
- Clinical variants
- Old World
- Cutaneous leishmaniasis due to L. major: wet, rural or zoonotic cutaneous leishmaniasis
- Cutaneous leishmaniasis due to L. tropica: dry, urban or anthroponotic leishmaniasis
- Cutaneous leishmaniasis due to L. aethiopica
- Cutaneous leishmaniasis due to L. donovani infantum
- Leishmaniasis recidivans: chronic leishmaniasis, lupoid leishmaniasis
- Diffuse cutaneous leishmaniasis: disseminated cutaneous leishmaniasis, leishmaniasis cutis diffusa
- American cutaneous leishmaniasis and mucocutaneous leishmaniasis
- Cutaneous leishmaniasis due to L. mexicana complex
- Cutaneous leishmaniasis due to L. brasiliensis complex
- Cutaneous leishmaniasis due to L. b. peruviana: ‘uta’
- Old World
- Investigations
- Management
- Leishmaniasis, visceral
-
Leishmaniasis, cutaneous
- Toxoplasmosis
- References
- 34Arthropods
- Overview
- SKIN DISEASE DUE TO ARTHROPODS
- CLASS INSECTA
- Mosquitoes, gnats, midges and flies (Diptera)
- Definition
- Classification
- Pathology
- Clinical features
- Management
- Myiasis
- Fleas (Siphonaptera)
- Hymenoptera (bees, wasps and ants), cutaneous reactions to
- Lice (Phthiraptera)
-
Bugs (Hemiptera), cutaneous reactions to
- Definition
- Classification
- Family Cimicidae, including bedbugs
- Family Reduviidae (kissing bugs, assassin bugs and cone‐nosed bugs)
- Family Anthocoridae, commonly called minute pirate bugs or flower bugs
- Family Pentatomidae, commonly called stink bugs
- Family Belostomatidae (giant water bugs)
- Thrips (Thysanoptera), cutaneous reactions to
- Beetles (Coleoptera), cutaneous reactions to
- Cockroaches (Dictyoptera), cutaneous reactions to
- Locusts (Orthoptera), cutaneous reactions to
- Butterflies and moths (Lepidoptera), cutaneous reactions to
- Mosquitoes, gnats, midges and flies (Diptera)
- CLASS ARACHNIDA
- Spiders (Araneae), cutaneous reactions to
- Scorpions (Scorpiones), cutaneous reactions to
- Ticks (Acari), cutaneous reactions to
- Mites (Acari)
- Scabies, human classical
- Scabies, human crusted
- Scabies, animal
- Family Knemidokoptidae
- Family Psoroptidae
- Family Listrophoridae
- Mites of stored products: cutaneous reactions to
- Mites, house‐dust: cutaneous reactions to
- Mites, Pyemotes: cutaneous reactions to
- Mites, Tydeidae: cutaneous reactions to
- Mites, plant: cutaneous reactions to
- Mites, Cheyletiella: cutaneous reactions to
- Mites, harvest (Trombiculidae): cutaneous reactions to
- Mites, bird, rodent and reptile (Gamasida): cutaneous reactions to
- Mites, follicle (Demodicidae): cutaneous reactions to
- CLASS CHILOPODA (CENTIPEDES) AND DIPLOPODA (MILLIPEDES)