Seventh Edition
This edition first published 2019
© 2019 by John Wiley & Sons Ltd
Edition History [6th edition, 2014]
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Library of Congress Cataloging‐in‐Publication Data
Names: Morris‐Jones, Rachael, editor.
Title: ABC of dermatology / [edited by] Rachael Morris‐Jones.
Description: Seventh edition. | Hoboken, NJ : Wiley‐Blackwell, 2019. | Includes bibliographical references and index. |
Identifiers: LCCN 2019008588 (print) | LCCN 2019011508 (ebook) | ISBN 9781119488996 (Adobe PDF) | ISBN 9781119489009 (ePub) | ISBN 9781119488989 (pbk.)
Subjects: | MESH: Skin Diseases
Classification: LCC RL74 (ebook) | LCC RL74 (print) | NLM WR 140 | DDC 616.5–dc23
LC record available at https://lccn.loc.gov/2019008588
Cover Design: Wiley
Cover Image: Courtesy of Dermatology Department, Kings College Hospital, London, UK.
Dr Saqib J. Bashir
Consultant Dermatologist
Department of Dermatology King’s College Hospital, London, UK;
Skin55 Ltd, Harley Street, London, UK
(Lasers, Intense Pulsed Light and Photodynamic Therapy chapter)
Dr David de Berker
Consultant Dermatologist
United Bristol Healthcare Trust
Bristol, UK
(Diseases of the Nails chapter)
Dr Kapil Bhargava
Consultant Dermatologist
St John’s Institute of Dermatology
Guy’s and St. Thomas’ Hospitals
London, UK
(Hair and Scalp chapter)
Nurse Specialist Bernadette Byrne
Tissue Viability, King’s College Hospital NHS Trust, London, UK
(Wounds, Dressings, and Bandages chapter)
Dr Emma Craythorne
Consultant Dermatologist
Dermatology Surgery and Laser Unit
St John’s Institute of Dermatology
Guy’s and St. Thomas’ Hospitals, London, UK
(Cosmetic Dermatology chapter)
Dr Alun Evans
Consultant Dermatologist
Princess of Wales Hospital
Bridgend, Wales, UK
(Lasers, Intense Pulsed Light, and Photodynamic Therapy chapter)
Dr David Fenton
Consultant Dermatologist
St John’s Institute of Dermatology
Guy’s and St. Thomas’ Hospitals
London, UK
(Hair and Scalp chapter)
Dr John S. Ferguson
Consultant Dermatologist
St John's Institute of Dermatology
Guy’s and St. Thomas’ Hospitals
London, UK
(Skin and Photosensitivity chapter)
Dr Fiona Lewis
Consultant Dermatologist
St John's Institute of Dermatology
Guy’s and St. Thomas’ Hospitals
London, UK
(Genital Dermatology chapter)
Dr Raj Mallipeddi
Consultant Dermatologist
Dermatological Laser and Surgery Unit
St John’s Institute of Dermatology
Guy’s and St. Thomas’ Hospitals
London, UK
(Practical Procedures and Skin Surgery chapter)
Dr Rachael Morris‐Jones
Dermatology Consultant
Guy’s and St Thomas’ NHS Foundation Trust
London, UK
Dr Aisling Ryan
Consultant Dermatologist
Department of Dermatology
King’s College Hospital, London, UK
(Formulary chapter)
Dr Sarah Walsh
Consultant Dermatologist
King’s College Hospital
London, UK
(Drug Rashes chapter)
Dr Karen Watson
Consultant Dermatologist
Orpington Hospital
Orpington, Kent, UK
(Formulary chapter)
The 7th edition of the ABC of Dermatology incorporates all the latest scientific advances in genetics, pathophysiology, and management strategies whilst at the same time remaining a practical clinical approach to dermatology. There are also additional new chapters to reflect current learning needs around cosmetic dermatology procedures and genital dermatology. The emphasis as always is to produce a valuable resource for any medical and nurse practitioner who is diagnosing and managing skin disease.
As well as a wholly practical approach to clinical dermatology, the 7th edition gives insights into the latest thinking around the pathophysiological processes that explain the characteristic features of skin disease and the current approach to the management of skin disease, including the newer biological agents for treating inflammatory disease and tumours.
The fascination of dermatology lies partly in the visual nature of discipline but also in one's ability to diagnose systemic disease through examination of the skin surface. Manifestations of underlying disease can form specific patterns in the skin which in some instances are pathognomonic. However, where there is any diagnostic doubt a simple skin biopsy for histopathology/immunohistochemistry and/or culture is fantastically helpful in most cases.
For those working in resource‐poor settings there may be little access to modern investigations for skin disease patients and therefore the clinical diagnosis will be the benchmark on which skin disease is managed. To this end the 7th edition is full of clinical photographs eliciting the appearances of skin disease in a multitude of different pigmented skin tones and ethnic groups. Descriptions of skin management include simple and relatively cheap interventions as well as sophisticated cutting‐edge immunotherapies.
On a global scale the number of people with access to the internet via computers or mobile devices is increasing at a rapid pace. This enables them access to a multitude of resources including those related to the diagnosis and management of human disease. Many patients are increasingly using the internet to attempt to self‐diagnose (‘Doctor Google’) their own skin conditions, identify any known underlying causes and gain some insights into the possible treatment strategies. An informed patient can be hugely beneficial to everyone involved in the provision of healthcare. However, at times this can lead to patients becoming overly anxious or misinformed. There is an increasing use of teledermatology in many parts of the world where populations are a long distance from a skin specialist, where images of the patient's skin complaint are taken and sent to an expert for a ‘virtual opinion’. Mobile phone consultations with a remote doctor are also being seen as a way to meet the increasing demand for GP consultations. However, remote dermatology can be tricky as it may be difficult to examine the patient thoroughly and there is no way of feeling the skin texture and induration of rashes/lesions. Remote dermatology can be immensely helpful, but ultimately the gold standard for accurate diagnosis and management of skin disease remains seeing patients in person, preferably by a practitioner with knowledge of skin disease.
We trust the 7th edition of the ABC of Dermatology will not only introduce the reader to a fascinating clinical discipline but will also help them to diagnose and manage skin disease in whichever part of the world they are working.
I would very much like to sincerely thank all my co‐contributors, whose expertise in specialist areas of dermatology has been invaluable in ensuring that this Seventh Edition is right up to date and written by experts in their field.
Dr Fiona Lewis has written a chapter on genital dermatology, which is a very valuable new edition to the ABC of Dermatology; genital disease can be a challenging area even for seasoned dermatologists, so her practical approach to the diagnosis/management of genital disease is hugely welcomed. Cosmetic procedures are increasing globally, with many more women and men undertaking rejuvenation procedures. This area of medicine remains a bit of a mystery to those of us who have only benefited from conventional medical training, so the addition of a chapter dedicated to cosmetic dermatology is fantastically helpful for all of us. Dr Emma Craythorne (alongside her skin cancer surgery work) has expertise in treating scars and performing cosmetic procedures and has written this new chapter on cosmetic procedures to give us an insight into what can be done and what the outcomes and pitfalls might be. Even if we don't practice cosmetic dermatology ourselves, patients may ask for our advice and we may also see patients with complications following procedures, so well informed is hopefully well prepared.
Tissue viability clinical nurse specialist Bernadette Byrne works alongside plastic surgeons, and they have contributed to her wound chapter in this Seventh Edition, so we can understand more about biological dressings, which are being increasingly used in challenging wounds. Bernadette has an impressive depth of knowledge as well as decades of experience managing literally thousands of complex wounds in patients from the outpatient setting to the intensive care unit. Her clinical practical approach is an invaluable guide to wound management in any setting.
Dr Saqib Bashir has taken over writing the chapter on lasers and photodynamic therapy and intense pulsed light from Alun Evans. Saqib has a huge wealth of expertise in using multiple different lasers and light devices. He has great skill in prudently treating patients with a variety of skin tones, and he brings this expertise and his high standards of care to the chapter.
Dr Aisling Ryan is a dedicated dermatology consultant with a wealth of expertise in medical dermatology, specifically in the rapidly expanding field of biological therapies. She has taken over writing the Formulary chapter from Karen Watson. Aisling helps keep us up to date with the new molecular targets for biological therapy, indications, outcomes and adverse events. In the future most of us will all be looking after patients who may be suitable for or already taking biological therapies, so this area is hugely important for all of us to keep us abreast of cutting‐edge medicine.
Dr John Ferguson has taken over the Skin and Photosensitivity chapter from me. He has developed an area of expertise in photobiology and had just joined the specialist clinic at St John's Institute of Dermatology. He has hugely enhanced this chapter with his detailed knowledge of how UV light can affect the skin.
A large proportion of the illustrations in the Seventh Edition of the ABC of Dermatology comes from King's College Hospital, London, UK. I am indebted to the medical photography department at King's for their very professional, high‐quality clinical images, without which this book would be of little use. Many of the images in the hair and scalp, genital and cosmetic chapters have been provided by the St John's Institute of Dermatology, St Thomas' Hospital, London, UK. Dr Stephen Morris‐Jones, consultant in Infectious Diseases, University College Hospital, London, UK, provided some of the cutaneous infection images and we have retained some of Dr Barbara Leppard's photographs in the tropical dermatology chapter that she took whilst working in Africa. Bernadette Byrne and the Plastics Team at King's College Hospital, London, UK, have provided the wound chapter photos in addition to some photographs retained from previous editions which come from the Victoria Hospital, Kirkcaldy and Queen Margaret Hospital, Dunfermline, Fife, the Royal Infirmary, Edinburgh and from Paul Buxton's own collection. Dr Jon Salisbury, a consultant histopathologist at King's College Hospital, London, UK, provided all the histopathology images to demonstrate cutaneous disease at the cellular level and Dr Edward Davies, consultant immunologist at King's College Hospital, London, UK, provided the direct immunofluorescence images of the skin in immunobullous disease.
I owe a huge debt of gratitude to all my Dermatology colleagues at King's College Hospital who diagnosed and managed many of the patients you will see in the illustrations in this Seventh Edition. I would specifically like to thank Dr Daniel Creamer, Dr Sarah Walsh, Dr Saqib Bashir and Prof Roderick Hay and Dr Tanya Basu.
I am especially indebted to all the patients for consenting to include their clinical images in the ABC of Dermatology to help us to demonstrate the features presenting in a multitude of skin/nail and hair disorders far better than any written description would do.