Treatment of Skin Diseases: A Practical Guide

547 Pages·2019·27.47 MB·English

by  Zohra Zaidi

Treatment of Skin
Diseases
A Practical Guide
Zohra Zaidi
Khalid Hussain
Simi Sudhakaran
123
Treatment of Skin Diseases
Zohra Zaidi • Khalid Hussain
Simi Sudhakaran
Treatment of Skin
Diseases
A Practical Guide
Zohra Zaidi Khalid Hussain
Retired Honorary Consultant Department of Dermatology
Dow University of Health Sciences Lincoln County Hospital
Karachi Lincoln
Pakistan United Kingdom
Simi Sudhakaran
Modality Faith House Surgery
Hull
United Kingdom
ISBN 978-3-319-89580-2 ISBN 978-3-319-89581-9 (eBook)
https://doi.org/10.1007/978-3-319-89581-9
Library of Congress Control Number: 2018954073
© Springer International Publishing AG, part of Springer Nature 2019
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This book is dedicated to the memory of my
grandfather Dr. Nasir Hussain Rizvi, a
psychiatrist. A person loved and admired by
all those who met him. Raees Amrohwi, a
famous poet of the Indian subcontinent,
wrote this on his death:
He was a beacon to humanity
Compassionate and caring
And a doctor par excellence
(Translated from Urdu)
Dr. Zohra Zaidi
The book is dedicated to my darling
husband Renjith and lovely daughter Amelia.
To my mum and dad for being the pillars of
endless support. To my teachers for their
help and guidance in writing this book.
Dr. Simi Sudhakaran
Foreword
This book is an excellent example of comprehensive treatment delivered in a user
friendly way for general practitioners (GPs). It tackles common skin conditions
encountered by GPs in the community and gives useful tips to help with the diagno-
sis and then outlines treatment in a methodical and logical manner.
Dermatology consultations form about 66% of a GPs workload, and therefore it
is important to have a sound understanding of these common skin conditions so
treatment can be made more effective. This book combines basic knowledge, diag-
nostic clues and advice on treatment, saving resources on referrals to secondary
care. It is very well illustrated helping with pattern recognition, which is the first
most important step in the diagnosis of skin conditions.
The fact that the book is written by a dermatologist and a GP with a special inter-
est in dermatology adds to the relevance of treatment of skin conditions in the
community.
The book will be especially useful to GPs, trainee GPs and allied healthcare
professionals wishing to improve their knowledge of clinical dermatology without
having to delve into large textbooks of dermatology.
Shernaz Walton
Hull and East Yorkshire Hospitals, Hull, UK
Hull York Medical School, University of Hull, York, UK
vii
Preface
The book gives a comprehensive account on the treatment of common skin diseases
at the primary care level. It covers diseases of both developed and underdeveloped
countries. In an underdeveloped country a primary care physician especially of the
rural areas has to see every skin disease because medical facilities are very limited.
An accurate diagnosis is the key to successful treatment. Keeping this in mind we
have included a brief description of the disease followed by the treatment. The first
line of treatment is given in detail; the other treatment options are briefly referred.
Important investigations and practical points to help in diagnosis are mentioned
where required. Photographs are included for most diseases and an atlas of differen-
tials is included to help the young doctors to diagnose and treat skin diseases.
To further help in the treatment, a section is included on the management of
common skin problems. The book also has an appendix of topical and systemic
drugs used in dermatology. The therapeutic doses are taken from the standard text-
books and British National Formulary (BNF).
Indications for referrals to consultants or secondary care are given where neces-
sary. This should guide the primary care professionals to make the right decision at
the right time, thus preventing any delay in referral and at the same time reducing
burden at secondary and tertiary care level.
Cosmetic dermatology is included because it is in vogue, and a primary care
physician is often asked about these procedures before the patient decides for them.
This book should not only help primary care physicians but can also be a man-
agement guide for allied health professionals, students, hospital doctors in wards,
those interested in dermatology and trainee dermatologists.
Karachi, Pakistan Zohra Zaidi
Lincoln, UK Khalid Hussain
Hull, UK Simi Sudhakaran
ix
Symbol of Medicine

Then the Lord said to Moses, ‘Make a fiery serpent and set it on a pole, so it shall
be that anyone who is bitten by it when he looks at it will live’. So Moses made a
bronze serpent and put it on a pole and so it was; if the bronze serpent had bitten
anyone when he looked at it, he lived. (Numbers 21: 8–9; the Bible).
xi
xii Symbol of Medicine
Historically, serpents and snakes represent fertility or a creative life force. As
snakes shed their skin through sloughing, they are symbols of rebirth, transforma-
tion, immortality and healing.
In Greek mythology, the Rod of Asclepius, also known as the Staff of Asclepius, is
a serpent-entwined rod wielded by the Greek god Asclepius, a deity associated with
healing and medicine.
Many medical organisations use a symbol of a short rod entwined by two snakes
and topped by a pair of wings, which is actually the caduceus or magic wand of the
Greek god Hermes (Roman Mercury), messenger of the gods, inventor of magical
incantations, conductor of the dead and protector of merchants. Hermes was a mes-
senger between the gods and humans (which explains the wings) and a guide to the
underworld (which explains the staff), and the snake is the symbol of healing.
Some commentators have interpreted the symbol as a direct representation of
traditional treatment of dracunculiasis, the Guinea worm disease. The traditional
treatment was to slowly pull the worm out of the wound over a period of hours to
weeks and wind it around a stick.
Acknowledgements
First and foremost, we thank God for His help in writing this manuscript. We thank
Dr. Rahanuddin, Head of the Department of Dermatology PNS Shifa; Dr. Badr
Dhanani, Consultant Dermatologist, Institute of Skin Diseases; Dr. Daulat Panjwani,
Consultant Dermatologist, Institute of Skin Diseases; and Dr. Naseema Kapadia,
Consultant Aga Khan University for the photographs of the book. We thank Matron
Angela Oswald of the Hull Royal Infirmary for the valuable suggestions on nursing
care. Esen Rizvi, an artist, and Simi Sudhakaran for their input on the illustrations
of the book. Our special thanks to Mr. Grant Weston and the staff of Springer-Verlag
responsible for the publication of the book. Finally, a big thank you to our family
members; without their help this manuscript would have been impossible.
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