Common Skin Diseases 18th edition

382 Pages·2011·20.382 MB·English

by  Ronald Marks, Richard Motley

Common
Skin Diseases
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Common
Skin Diseases
18TH EDITION
Ronald Marks BSc (Hons), MB,
BS (Hons), FRCP, FRCPath
Emeritus Professor,
Cardiff, UK
Richard Motley MA, MD, FRCP
Welsh Institute of Dermatology,
University Hospital of Wales,
Cardiff, UK
First published in Great Britain in 1932 by H.K. Lewis
17th edition published by Arnold in 2003 as Roxburgh’s Common Skin Diseases
This 18th edition published in 2011 by Hodder Arnold,
an imprint of Hodder Education, a division of Hachette UK,
338 Euston Road, London NW1 3BH
http://www.hodderarnold.com
© 2011 Hodder & Stoughton Ltd
All rights reserved. Apart from any use permitted under UK copyright law, this publication may
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Whilst the advice and information in this book are believed to be true and accurate at the date
of going to press, neither the author[s] nor the publisher can accept any legal responsibility
or liability for any errors or omissions that may be made. In particular (but without limiting
the generality of the preceding disclaimer) every effort has been made to check drug dosages;
however it is still possible that errors have been missed. Furthermore, dosage schedules are
constantly being revised and new side effects recognized. For these reasons the reader is
strongly urged to consult the drug companies’ printed instructions before administering any
of the drugs recommended in this book.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
A catalog record for this book is available from the Library of Congress
ISBN-13 978-0-340-98350-8
1 2 3 4 5 6 7 8 9 10
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Contents
Preface xii
Glossary of terms frequently used in dermatology xiii
1 An introduction to skin and skin disease 1
An overview 1
Skin structure and function 2
Summary 12
2 Signs and symptoms of skin disease 13
Alterations in skin colour 13
Alterations in the skin surface 15
The size, shape and thickness of skin lesions 16
Oedema, fl uid-fi lled cavities and ulcers 18
Secondary changes 20
Symptoms of skin disorder 21
Disabilities from skin disease 22
Summary 25
3 Skin damage from environmental hazards 26
Damage caused by toxic substances 27
Injury from solar ultraviolet irradiation 29
Chronic photodamage (photoageing) 30
Cold injury 35
Heat injury 36
Summary 36
4 Skin infections 38
Fungal disease of the skin/the superfi cial
mycoses/infections with ringworm fungi
(dermatophyte infections) 38
Bacterial infection of the skin 45
Viral infection of the skin 52
Summary 58
Contents
5 Infestations, insect bites and stings 60
Scabies 60
Pediculosis 66
Insect bites and stings 68
Helminthic infestations of the skin 72
Summary 73
6 Skin disease and the traveller 74
The effects of travelling on skin disease 74
Treatment and travel 75
Sun exposure 76
Skin in a cold climate 76
Summary 77
7 Immunologically mediated skin disorders 78
Urticaria and angioedema 78
Erythema multiforme 82
Erythema nodosum 84
Annular erythemas 84
Autoimmune disorders 85
Systemic sclerosis 87
Morphoea 89
Dermatomyositis 90
The vasculitis group of diseases 91
Drug eruptions 94
Summary 97
8 Blistering skin disorders 98
Blistering diseases 98
Dermatitis herpetiformis 100
Linear IgA disease 101
Epidermolysis bullosa 101
Pemphigus 102
Summary 104
9 Skin disorders in AIDS, immunodefi ciency and
venereal disease 105
Infections 106
Skin cancers 107
Other skin manifestations 107
vi
Contents
Psoriasis 108
Treatment of skin manifestations of AIDS 108
Drug-induced immunodefi ciency 109
Other causes of acquired immunodefi ciency 110
Congenital immunodefi ciencies 110
Dermatological aspects of venereal disease 110
Summary 113
10 Eczema (dermatitis) 114
Atopic dermatitis 114
Seborrhoeic dermatitis 123
Discoid eczema (nummular eczema) 126
Eczema craquelée (asteatotic eczema) 128
Lichen simplex chronicus (circumscribed neurodermatitis) 129
Contact dermatitis 130
Venous eczema (gravitational eczema; stasis dermatitis) 135
Summary 136
11 Psoriasis and lichen planus 138
Psoriasis 138
Pityriasis rubra pilaris 152
Lichen planus 154
Summary 157
12 Acne, rosacea and similar disorders 159
Acne 159
Rosacea 172
Perioral dermatitis 179
Summary 180
13 Wound healing and ulcers 182
Principles of wound healing 182
Venous hypertension, the gravitational syndrome
and venous ulceration 184
Ischaemic ulceration 188
Decubitus ulceration 189
Neuropathic ulcers 189
Less common causes of ulceration 190
Diagnosis and assessment of ulcers 192
Summary 192
vii
Contents
14 Benign tumours, moles, birthmarks and cysts 194
Tumours of epidermal origin 194
Benign tumours of sweat gland origin 197
Benign tumours of hair follicle origin 199
Melanocytic naevi (moles) 199
Degenerative changes in naevi 204
Vascular malformations (angioma)/capillary naevi 206
Dermatofi broma (histiocytoma, sclerosing
haemangioma) 210
Leiomyoma 211
Neural tumours 211
Lipoma 213
Collagen and elastic tissue naevi 213
Mast cell naevus and mastocytosis 214
Cysts 215
Treatment of benign tumours, moles and birthmarks 217
Summary 217
15 Malignant disease of the skin 219
Non-melanoma skin cancer 219
Melanoma skin cancer 231
Lymphomas of skin (cutaneous T-cell lymphoma) 237
Summary 239
16 Skin problems in infancy and old age 240
Infancy 240
Old age 246
Summary 250
17 Pregnancy and the skin 251
Physiological changes in the skin during pregnancy 251
Effects of pregnancy on intercurrent skin disease 253
Effects of intercurrent maternal disease on the fetus 253
Skin disorders occurring in pregnancy 254
Summary 255
18 Disorders of keratinization and other
genodermatoses 256
Introduction 256
Xeroderma 258
viii
Contents
Autosomal dominant ichthyosis 259
Sex-linked ichthyosis 260
Non-bullous ichthyosiform erythroderma 262
Bullous ichthyosiform erythroderma (epidermolytic
hyperkeratosis) 263
Lamellar ichthyosis 264
Collodion baby 265
Other disorders of keratinization 266
Other genodermatoses 268
Summary 269
19 Metabolic disorders and reticulohistiocytic
proliferative disorders 271
Porphyrias 271
Necrobiotic disorders 276
Reticulohistiocytic proliferative disorders 278
Summary 279
20 Disorders of hair and nails 280
Disorders of hair 280
Disorders of the nails 288
Summary 291
21 Systemic disease and the skin 293
Skin markers of malignant disease 293
Endocrine disease, diabetes and the skin 297
Skin infection and pruritus 300
Androgenization (virilization) 301
Nutrition and the skin 302
Skin and the gastrointestinal tract 304
Hepatic disease 304
Systemic causes of pruritus 305
Summary 305
22 Disorders of pigmentation 307
Generalized hypopigmentation 308
Localized hypopigmentation 309
Hyperpigmentation 311
Summary 315
ix