1
|
So T, Un S, Lestari KD, Fuller LC, Elyazar I, Bendick C, Grijsen ML. Scabies in monasteries in Phnom Penh, Cambodia. J Eur Acad Dermatol Venereol 2021; 35:e871-e873. [PMID: 34138494 DOI: 10.1111/jdv.17458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/17/2021] [Accepted: 06/09/2021] [Indexed: 11/27/2022]
Affiliation(s)
- T So
- Department of Dermatology, Municipal Referral Hospital, Phnom Penh, Cambodia
| | - S Un
- Department of Dermatology, Calmette Hospital, Phnom Penh, Cambodia
| | - K D Lestari
- Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia
| | - L C Fuller
- Department of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.,International Foundation for Dermatology, London, UK
| | - I Elyazar
- Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia
| | - C Bendick
- International Society of Dermatology in the Tropics, AG Cambodia, Cologne, Germany
| | - M L Grijsen
- Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| |
Collapse
|
2
|
Wolfe C, Rudd E, Ng J, Weir J, Fuller LC. An unusual dermoscopic appearance of scabies. Br J Dermatol 2021; 185:e69. [PMID: 34096040 DOI: 10.1111/bjd.20423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 11/28/2022]
Affiliation(s)
- C Wolfe
- Barts Health NHS Trust, The Royal Hospital, London, UK
| | - E Rudd
- Department of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - J Ng
- Department of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - J Weir
- Department of Histopathology, Imperial College Healthcare NHS Trust, London, UK
| | - L C Fuller
- Department of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.,International Foundation for Dermatology, London, UK
| |
Collapse
|
3
|
McMahon DE, Oyesiku L, Amerson E, Beltraminelli H, Chang AY, Forrestel A, Hay R, Knapp A, Kovarik C, Maurer T, Norton SA, Rehmus W, Van Hees C, Wanat KA, Williams VL, Fuller LC, Freeman EE. Identifying gaps in global health dermatology: a survey of GLODERM members. Br J Dermatol 2021; 185:212-214. [PMID: 33657642 DOI: 10.1111/bjd.19889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 02/03/2021] [Indexed: 12/16/2022]
|
4
|
Cox V, Fuller LC, Engelman D, Steer A, Hay RJ. Estimating the global burden of scabies: what else do we need? Br J Dermatol 2020; 184:237-242. [PMID: 32358799 DOI: 10.1111/bjd.19170] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2020] [Indexed: 02/06/2023]
Abstract
Scabies is one of the most common disorders identified in any estimate of global skin disease prevalence. Furthermore, quantifying its impact on individuals and societies has been problematic. There has been a lack of clear case definitions and laboratory tests. There have been few epidemiological studies, particularly those focusing on low-income countries, variation in prevalence within high-income countries, or estimates of the effect of scabies on health beyond the skin, such as renal disease or mental wellbeing. Economic studies are also lacking. However, the new strategy of integrating surveillance for skin Neglected Tropical Diseases may well produce advancements on these issues, in addition to providing an overarching structure for health improvement and disease control.
Collapse
Affiliation(s)
- V Cox
- Royal Darwin Hospital, Darwin, Australia
| | - L C Fuller
- International Foundation for Dermatology, London, UK.,Chelsea and Westminster NHS Foundation Trust, London, UK
| | - D Engelman
- Tropical Diseases Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Melbourne Children's Global Health, Melbourne, Australia
| | - A Steer
- Tropical Diseases Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Melbourne Children's Global Health, Melbourne, Australia
| | - R J Hay
- International Foundation for Dermatology, London, UK.,St John's Institute of Dermatology, King's College London, London, UK
| |
Collapse
|
5
|
Schmid-Grendelmeier P, Takaoka R, Ahogo KC, Belachew WA, Brown SJ, Correia JC, Correia M, Degboe B, Dorizy-Vuong V, Faye O, Fuller LC, Grando K, Hsu C, Kayitenkore K, Lunjani N, Ly F, Mahamadou G, Manuel RCF, Kebe Dia M, Masenga EJ, Muteba Baseke C, Ouedraogo AN, Rapelanoro Rabenja F, Su J, Teclessou JN, Todd G, Taïeb A. Position Statement on Atopic Dermatitis in Sub-Saharan Africa: current status and roadmap. J Eur Acad Dermatol Venereol 2020; 33:2019-2028. [PMID: 31713914 PMCID: PMC6899619 DOI: 10.1111/jdv.15972] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/05/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND The first International Society of Atopic Dermatitis (ISAD) global meeting dedicated to atopic dermatitis (AD) in Sub-Saharan Africa (SSA) was held in Geneva, Switzerland in April 2019. A total of 30 participants were present at the meeting, including those from 17 SSA countries, representatives of the World Health Organization (WHO), the International Foundation for Dermatology (IFD) (a committee of the International League of Dermatological Societies, ILDS www.ilds.org), the Fondation pour la Dermatite Atopique, as well as specialists in telemedicine, artificial intelligence and therapeutic patient education (TPE). RESULTS AD is one of the most prevalent chronic inflammatory skin diseases in SSA. Besides neglected tropical diseases (NTDs) with a dermatological presentation, AD requires closer attention from the WHO and national Departments of Health. CONCLUSIONS A roadmap has been defined with top priorities such as access to essential medicines and devices for AD care, in particular emollients, better education of primary healthcare workers for adequate triage (e.g. better educational materials for skin diseases in pigmented skin generally and AD in particular, especially targeted to Africa), involvement of traditional healers and to a certain extent also patient education, bearing in mind the barriers to effective healthcare faced in SSA countries such as travel distances to health facilities, limited resources and the lack of dermatological expertise. In addition, several initiatives concerning AD research in SSA were discussed and should be implemented in close collaboration with the WHO and assessed at follow-up meetings, in particular, at the next ISAD meeting in Seoul, South Korea and African Society of Dermatology and Venereology (ASDV) meeting in Nairobi, Kenya, both in 2020.
Collapse
Affiliation(s)
| | - R Takaoka
- Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil
| | - K C Ahogo
- Département de médecine et Spécialités Médicales, Dermatologie et Vénérologie, CHU Treichville, Université Félix Houphouët-Boigny UFR Sciences Médicales, Abidjan, Côte d'Ivoire
| | - W A Belachew
- College of Health Science, Ayder Comprehensive Specialized Teaching Hospital, Mekelle University, Mekelle, Ethiopia
| | - S J Brown
- Skin Research Group, School of Medicine, Ninewells Hospital & Medical School, University of Dundee, Dundee, UK
| | - J C Correia
- Division of Therapeutic Education for Chronic Diseases, WHO Collaborating Center, Department of First Aid Medecine, Geneva University Hospitals, Geneva, Switzerland
| | - M Correia
- Department of Dermatology, Hospital Cuf Descobertas and Hospital Cuf Torres Vedras, Torres Vedras, Portugal
| | - B Degboe
- Department of Dermatology, Faculty of Health Sciences, National and Teaching Hospital HKM of Cotonou, University of Abomey-Calavi, Cotonou, Benin
| | - V Dorizy-Vuong
- Department of Adult and Pediatric Dermatology, CHU Bordeaux, Bordeaux, France.,INSERM U 1035, University of Bordeaux, Bordeaux, France
| | - O Faye
- Department of Dermatology, Faculty of Medicine, CNAM, Bamako, Mali
| | - L C Fuller
- Chair of International Foundation for Dermatology, Chelsea and Westminster Hospital, London, UK
| | - K Grando
- Allergy Unit, Department of Dermatology, University Hospital, Zurich, Switzerland
| | - C Hsu
- Department of Dermatology, Teledermatology and AI, University Hospital of Basel, Basel, Switzerland
| | - K Kayitenkore
- Kigali Dermatology Center, University of Rwanda, Kigali, Rwanda
| | - N Lunjani
- University of Cape Town, Cape Town, South Africa
| | - F Ly
- Université Cheikh Anta Diop, Dakar, Senegal
| | - G Mahamadou
- Department of Adult and Pediatric Dermatology, CHU Bordeaux, Bordeaux, France.,Service de Dermatologie-Vénéréologie, CHU Sylvanus Olympio, Lomé, Togo
| | - R C F Manuel
- Department of Dermatology, Ministry of Health, Hospital Central de Maputo, Maputo, Mozambique
| | | | - E J Masenga
- Regional Dermatology Training Center, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - C Muteba Baseke
- Clinique Bondeko, Kinshasa-Limete, Democratic Republic of the Congo
| | - A N Ouedraogo
- University Hospital Yalgado Ouedraogo of Ouagadougou, University Ouaga I Pr Joseph Ki-Zerbo Ouagadougou, Ouagadougou, Burkina Faso
| | - F Rapelanoro Rabenja
- Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar
| | - J Su
- Department of Paediatrics, Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - J N Teclessou
- Service dermatologie et IST, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo
| | - G Todd
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - A Taïeb
- Department of Adult and Pediatric Dermatology, CHU Bordeaux, Bordeaux, France.,INSERM U 1035, University of Bordeaux, Bordeaux, France
| |
Collapse
|
6
|
Child FJ, Fuller LC, Higgins EM, du Vivier AW, Mufti GJ. Cutaneous Presentation of Fusarium Solani Infection in a Bone Marrow Transplant Recipient. J R Soc Med 2018; 89:647-8. [PMID: 9135599 PMCID: PMC1296006 DOI: 10.1177/014107689608901116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- F J Child
- Department of Dermatology, King's Healthcare NHS Trust, London, England
| | | | | | | | | |
Collapse
|
7
|
Florence L, Fuller LC. Washing with water and glycerine improves skin barrier function and quality of life in patients with podoconiosis. Br J Dermatol 2017; 177:1166. [PMID: 29192997 DOI: 10.1111/bjd.15941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- L Florence
- Ealing Hospital, London North West Healthcare NHS Trust, London, U.K
| | - L C Fuller
- Chelsea and Westminster Hospital NHS Foundation Trust, London, U.K
| |
Collapse
|
8
|
Yeshanehe WE, Tamiru A, Fuller LC. Surgical nodulectomies can heal in patients with lymphoedema secondary to podoconiosis in resource-poor settings. Br J Dermatol 2017; 177:e128-e129. [PMID: 28256715 DOI: 10.1111/bjd.15420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | - A Tamiru
- International Orthodox Christian Charities, Debre Markos, Ethiopia
| | - L C Fuller
- Department of Dermatology, Chelsea & Westminster Hospital, London, U.K.,International Foundation for Dermatology, 4 Fitzroy Square, London, W1T 5HQ, U.K
| |
Collapse
|
9
|
Thompson MJ, Engelman D, Gholam K, Fuller LC, Steer AC. Systematic review of the diagnosis of scabies in therapeutic trials. Clin Exp Dermatol 2017; 42:481-487. [DOI: 10.1111/ced.13152] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2016] [Indexed: 11/26/2022]
Affiliation(s)
- M. J. Thompson
- Department of Paediatrics and Child Health; Western Australia Country Health Service; Kimberley Region Australia
| | - D. Engelman
- Department of Paediatrics; Centre for International Child Health; University of Melbourne; Melbourne Australia
- Group A Streptococcal Research; Murdoch Childrens Research Institute; Melbourne Australia
| | - K. Gholam
- Dermatology Department; Great Ormond Street Hospital; London UK
| | - L. C. Fuller
- International Foundation for Dermatology; London UK
- Department of Dermatology; Chelsea and Westminster NHS Foundation Trust; London UK
| | - A. C. Steer
- Department of Paediatrics; Centre for International Child Health; University of Melbourne; Melbourne Australia
- Group A Streptococcal Research; Murdoch Childrens Research Institute; Melbourne Australia
| |
Collapse
|
10
|
Noy M, Merika EE, Morar N, Nelson M, Fuller LC. aSKINg advice-the need for specialist dermatologists in HIV units. HIV Med 2016; 18:64-65. [PMID: 27905675 DOI: 10.1111/hiv.12385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M Noy
- Dermatology Department, Chelsea and Westminster Hospital, London, UK
| | - E E Merika
- Dermatology Department, Chelsea and Westminster Hospital, London, UK
| | - N Morar
- Dermatology Department, Chelsea and Westminster Hospital, London, UK
| | - M Nelson
- HIV Department, Chelsea and Westminster Hospital, London, UK
| | - L C Fuller
- Dermatology Department, Chelsea and Westminster Hospital, London, UK
| |
Collapse
|
11
|
Affiliation(s)
- L C Fuller
- Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, U.K.,International Foundation for Dermatology, Willan House, 4 Fitzroy Square, London, W1T 5HQ, U.K
| | - R J Hay
- International Foundation for Dermatology, Willan House, 4 Fitzroy Square, London, W1T 5HQ, U.K.,Department of Dermatology, King's College Hospital, Denmark Hill, Camberwell, London, SE5 9RS, U.K
| |
Collapse
|
12
|
Hay RJ, Fuller LC. Global burden of skin disease in the elderly: a grand challenge to skin health. GIORN ITAL DERMAT V 2015; 150:693-698. [PMID: 26325226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Skin diseases, as estimated in the global burden of disease study 2010, are a significant health problem in all global regions and many of those analyzed in this study show an increasing burden over recent years, extending into old age. Some of the conditions which have the highest impact on the elderly include non-melanoma skin cancer and skin ulceration, but bacterial skin infection, fungal disease or pruritus are all significant problems. With predicted changes in demography and a higher proportion of individuals above the age of 80 in the coming years concentrating new resources on gathering better data and devising preventative, therapeutic and palliative strategies is a priority.
Collapse
Affiliation(s)
- R J Hay
- Dermatology Department, Kings College Hospital NHS Trust, London, UK
| | | |
Collapse
|
13
|
Fuller LC, Barton RC, Mohd Mustapa MF, Proudfoot LE, Punjabi SP, Higgins EM. British Association of Dermatologists' guidelines for the management of tinea capitis 2014. Br J Dermatol 2015; 171:454-63. [PMID: 25234064 DOI: 10.1111/bjd.13196] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2014] [Indexed: 01/19/2023]
Affiliation(s)
- L C Fuller
- Department of Dermatology, Chelsea & Westminster Hospital, Fulham Road, London, SW10 9NH, U.K
| | | | | | | | | | | |
Collapse
|
14
|
Affiliation(s)
- K L Lecamwasam
- Department of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - T M Lim
- Department of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - L C Fuller
- Department of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| |
Collapse
|
15
|
Affiliation(s)
- A. D. Scott
- Department of Dermatology; Chelsea and Westminster NHS Foundation Trust; London UK
| | - A. Robinson
- St John's Institute; St Thomas’ Hospital; London UK
| | - L. C. Fuller
- Department of Dermatology; Chelsea and Westminster NHS Foundation Trust; London UK
| |
Collapse
|
16
|
Short KA, Williams A, Creamer D, Fuller LC. Sebaceous gland hyperplasia, human immunodeficiency virus and highly active anti-retroviral therapy. Clin Exp Dermatol 2008; 33:354-5. [DOI: 10.1111/j.1365-2230.2007.02670.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
17
|
Al-Ghnaniem R, Short K, Pullen A, Fuller LC, Rennie JA, Leather AJM. 1% hydrocortisone ointment is an effective treatment of pruritus ani: a pilot randomized controlled crossover trial. Int J Colorectal Dis 2007; 22:1463. [PMID: 17534634 DOI: 10.1007/s00384-007-0325-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2007] [Indexed: 02/04/2023]
Abstract
BACKGROUND Pruritus ani (PA) is a common condition which is difficult to treat in the absence of obvious predisposing factors. There is paucity of evidence-based guidelines on the treatment of this condition. We examined whether 1% hydrocortisone ointment is an effective treatment for PA. MATERIALS AND METHODS A pilot randomized, double-blind, placebo-controlled, crossover trial was carried out. Eleven patients consented to take part in the trial and ten completed the study. After a 2-week run-in period, patients with primary PA were randomly allocated to receive 1% hydrocortisone ointment or placebo for 2 weeks followed by the opposite treatment for a further 2-week period. There was a washout period of 2 weeks between treatments. The primary outcome measure was reduction in itch using a visual analogue score (VAS). The secondary outcome measures were improvement in quality of life measured using a validated questionnaire (Dermatology Life Quality Index, DLQI) and improvement in clinical appearance of the perianal skin using the Eczema Area and Severity Index (EASI) score. RESULTS Treatment with 1% hydrocortisone ointment resulted in a 68% reduction in VAS compared with placebo (P=0.019), a 75% reduction in DLQI score (P=0.067), and 81% reduction in EASI score (P=0.01). CONCLUSION A short course of mild steroid ointment is an effective treatment for PA.
Collapse
Affiliation(s)
- R Al-Ghnaniem
- Department of Surgery, King's College Hospital, Denmark Hill, London, SE5 9RS, UK.
| | - K Short
- Department of Dermatology, King's College Hospital, London, UK
| | - A Pullen
- Department of Surgery, King's College Hospital, Denmark Hill, London, SE5 9RS, UK
| | - L C Fuller
- Department of Dermatology, King's College Hospital, London, UK
| | - J A Rennie
- Department of Surgery, King's College Hospital, Denmark Hill, London, SE5 9RS, UK
| | - A J M Leather
- Department of Surgery, King's College Hospital, Denmark Hill, London, SE5 9RS, UK
| |
Collapse
|
18
|
White JML, Higgins EM, Fuller LC. Screening for asymptomatic carriage of Trichophyton tonsurans in household contacts of patients with tinea capitis: results of 209 patients from South London. J Eur Acad Dermatol Venereol 2007; 21:1061-4. [PMID: 17714125 DOI: 10.1111/j.1468-3083.2007.02173.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is currently an epidemic of tinea capitis in urban areas of developed countries caused by Trichophyton tonsurans. Recurrence or re-infection with dermatophyte is not uncommon after adequate oral treatment. Asymptomatic carriers who are household contacts may partly explain this observation by forming a reservoir for infection. PATIENTS/METHODS Two-hundred and nine household contacts of patients with tinea capitis were examined and screened for asymptomatic carriage of dermatophyte. RESULTS Only 7.2% had clinically evident disease yet 44.5% had silent fungal carriage on the scalp. Children under 16 years were much more likely to be carriers than adults (P < 0.001) and males were less likely than females to be affected (P < 0.01). CONCLUSION This evidence poses questions about factors relevant in transmission of dermatophytes. The authors propose that all household contacts of patients with tinea capitis should be offered screening to eradicate a potential reservoir of infection.
Collapse
Affiliation(s)
- J M L White
- Department of Cutaneous Allergy, St. John's Institute of Dermatology, London, UK.
| | | | | |
Collapse
|
19
|
Abstract
A 4-year-old girl presented with a linear, indurated area of dusky erythema and hyperpigmentation down the left leg, present since birth. Histology suggested syringomata. The clinical course and appearances suggest a novel entity for which we have coined the term 'linear syringomatous hamartoma'.
Collapse
Affiliation(s)
- J M L White
- Department of Dermatology, King's College Hospital, London, UK.
| | | | | | | |
Collapse
|
20
|
Harman KE, Fuller LC, Salisbury JR, Higgins EM, du Vivier AWP. Trends in the presentation of cutaneous malignant melanoma over three decades at King's College Hospital, London. Clin Exp Dermatol 2004; 29:563-6. [PMID: 15347357 DOI: 10.1111/j.1365-2230.2004.01620.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of this study was to examine trends in the presentation of cutaneous malignant melanoma at King's College Hospital (KCH) over the last three decades (1970-2000). KCH was one of seven centres that participated in the 1987 Cancer Research Campaign (CRC) publicity campaign aimed at promoting earlier self-recognition of melanoma. Data included patient age at presentation, sex, tumour site, Breslow thickness and histological subtype. The late 1980s saw a threefold increase in the annual number of melanomas and an eightfold increase in thin melanomas compared to the 1970s. The increase occurred in both sexes and was particularly marked after the CRC campaign but numbers had already begun to increase prior to this. The increase has predominantly been thin (Breslow < 1.5 mm) tumours of the superficial spreading variety with a resultant fall in mean Breslow thickness. There has been a decline in the annual number of melanomas since the peak in 1992 which is not explained by increased proportion of in situ tumours. The CRC campaign may have contributed to the documented increase in thin tumours but this trend had begun prior to 1987 suggesting factors other than public awareness and earlier presentation are important. It is encouraging that the number of melanomas has declined over the last 5 years at KCH but it is yet to be seen whether this reflects a real decrease in the incidence of melanoma.
Collapse
Affiliation(s)
- K E Harman
- Department of Dermatology, King's College Hospital, Denmark Hill, London, UK.
| | | | | | | | | |
Collapse
|
21
|
White JML, MacBean AD, Bentley RP, Fuller LC. Case 1. Cervicofacial actinomycosis. Clin Exp Dermatol 2003; 28:681-2. [PMID: 14616850 DOI: 10.1046/j.1365-2230.2003.01370.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- J M L White
- King's College Hospital, Department of Dermatology, London, UK.
| | | | | | | |
Collapse
|
22
|
Alam NA, Rowan AJ, Wortham NC, Pollard PJ, Mitchell M, Tyrer JP, Barclay E, Calonje E, Manek S, Adams SJ, Bowers PW, Burrows NP, Charles-Holmes R, Cook LJ, Daly BM, Ford GP, Fuller LC, Hadfield-Jones SE, Hardwick N, Highet AS, Keefe M, MacDonald-Hull SP, Potts EDA, Crone M, Wilkinson S, Camacho-Martinez F, Jablonska S, Ratnavel R, MacDonald A, Mann RJ, Grice K, Guillet G, Lewis-Jones MS, McGrath H, Seukeran DC, Morrison PJ, Fleming S, Rahman S, Kelsell D, Leigh I, Olpin S, Tomlinson IPM. Genetic and functional analyses of FH mutations in multiple cutaneous and uterine leiomyomatosis, hereditary leiomyomatosis and renal cancer, and fumarate hydratase deficiency. Hum Mol Genet 2003; 12:1241-52. [PMID: 12761039 DOI: 10.1093/hmg/ddg148] [Citation(s) in RCA: 246] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Germline mutations of the fumarate hydratase (FH, fumarase) gene are found in the recessive FH deficiency syndrome and in dominantly inherited susceptibility to multiple cutaneous and uterine leiomyomatosis (MCUL). We have previously reported a number of germline FH mutations from MCUL patients. In this study, we report additional FH mutations in MCUL and FH deficiency patients. Mutations can readily be found in about 75% of MCUL cases and most cases of FH deficiency. Some of the more common FH mutations are probably derived from founding individuals. Protein-truncating FH mutations are functionally null alleles. Disease-associated missense FH changes map to highly conserved residues, mostly in or around the enzyme's active site or activation site; we predict that these mutations severely compromise enzyme function. The mutation spectra in FH deficiency and MCUL are similar, although in the latter mutations tend to occur earlier in the gene and, perhaps, are more likely to result in a truncated or absent protein. We have found that not all mutation-carrier parents of FH deficiency children have a strong predisposition to leiomyomata. We have confirmed that renal carcinoma is sometimes part of MCUL, as part of the variant hereditary leiomyomatosis and renal cancer (HLRCC) syndrome, and have shown that these cancers may have either type II papillary or collecting duct morphology. We have found no association between the type or site of FH mutation and any aspect of the MCUL phenotype. Biochemical assay for reduced FH functional activity in the germline of MCUL patients can indicate carriers of FH mutations with high sensitivity and specificity, and can detect reduced FH activity in some patients without detectable FH mutations. We conclude that MCUL is probably a genetically homogeneous tumour predisposition syndrome, primarily resulting from absent or severely reduced fumarase activity, with currently unknown functional consequences for the smooth muscle or kidney cell.
Collapse
Affiliation(s)
- N A Alam
- Molecular and Population Genetics Laboratory, Cancer Research UK, Lincoln's Inn Fields, London WC2A 3PX, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Fuller LC, Child FC, Midgley G, Higgins EM. Scalp ringworm in south-east London and an analysis of a cohort of patients from a paediatric dermatology department. Br J Dermatol 2003; 148:985-8. [PMID: 12786830 DOI: 10.1046/j.1365-2133.2003.05022.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Scalp ringworm or tinea capitis has become an increasingly important public health issue in the past decade in Great Britain. Recently, certain dermatology departments in London have seen a large increase in tinea capitis in all its forms. OBJECTIVES The aim of this paper is to present the detailed analysis of a cohort of 277 patients with tinea capitis seen during a 2-year period together with the latest local figures of tinea capitis cases from an inner city paediatric dermatology service. Methods Demographic, clinical and laboratory data were collected prospectively over 2 years from all cases of ringworm in patients seen in a paediatric clinic specially set up for scalp problems. RESULTS Sixty-two per cent of 277 cases of scalp ringworm were caused by Trichophyton tonsurans, occurring mainly (91%) in patients with Afro-Caribbean hair type, more often in boys (68%), and in the 3-8 year olds (70%). Only 7% of the patients had received appropriate treatment with oral griseofulvin. An additional 156 cases from the general paediatric dermatology clinic showed 91%T. tonsurans infections. CONCLUSIONS The prevalence of scalp ringworm appears to be reaching epidemic proportions in certain areas that include south-east London. The clinical problem is not yet well recognized by local general practitioners.
Collapse
Affiliation(s)
- L C Fuller
- Department of Dermatology, King's College Hospital, Denmark Hill, Camberwell, London SE5 9RS, UK.
| | | | | | | |
Collapse
|
24
|
Affiliation(s)
- G E N Osborne
- Department of Dermatology, Kings College Hospital, Denmark Hill, London SE5 9RS, UK
| | | | | |
Collapse
|
25
|
Affiliation(s)
- L C Fuller
- King's College Hospital, London SE5 9RS.
| | | | | | | |
Collapse
|
26
|
Affiliation(s)
- G E N Osborne
- Department of Dermatology, King's College Hospital, Denmark Hill, London SE5 9RS, UK
| | | | | |
Collapse
|
27
|
Abstract
Fixed drug eruption is characterized by recurrent well-defined lesions appearing in the same location each time the drug responsible is taken. A number of agents have been implicated. Metronidazole, a nitroimidazole agent widely used for its antibacterial and antiprotozoal activity, has been reported only rarely as the causative agent. We describe a patient with FDE due to metronidazole in whom we were able to induce the clinical and histological features of FDE by topical provocation testing. In agreement with the published literature we commend the use of topical provocation testing as a possible first-line investigation in the diagnosis of FDE. This may avoid the need for subsequent oral provocation testing and therefore the prevention of possible adverse sequelae.
Collapse
Affiliation(s)
- K A Short
- Departments of Dermatology and Histopathology, King's College Hospital, London, UK.
| | | | | |
Collapse
|
28
|
Affiliation(s)
- E B Wu
- Cardiothoracic Centre, Guy's and St Thomas' Hospitals, London, UK
| | | | | | | |
Collapse
|
29
|
Abstract
Lipoatrophy semicircularis is thought to be a rare condition characterized by band-like horizontal depressions of the skin typically involving the lower limbs. Previous literature has suggested that repetitive trauma to the lower limbs could explain this condition; however, no direct causal link has ever been clearly established. There have also been several reports where no preceding history of trauma could be found. In our series we report seven cases of lipoatrophy semicircularis representing over one-third of the staff in a particular office. We propose that the most logical explanation for the indentations present in these individuals is repetitive trauma to their thighs by the sharp edge of the desks. The consistent nature of the distance between the floor and the horizontal indentations on the lower limbs despite differences in height weight and body mass index support this theory. It is likely that this condition is more common than initially thought.
Collapse
Affiliation(s)
- P C Gruber
- Department of Dermatology, King's College Hospital, London, UK.
| | | |
Collapse
|
30
|
Fuller LC, Smith CH, Cerio R, Marsden RA, Midgley G, Beard AL, Higgins EM, Hay RJ. A randomized comparison of 4 weeks of terbinafine vs. 8 weeks of griseofulvin for the treatment of tinea capitis. Br J Dermatol 2001; 144:321-7. [PMID: 11251566 DOI: 10.1046/j.1365-2133.2001.04022.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Tinea capitis is a common childhood infection that has recently become more frequent in urban areas in Europe and the U.S.A. The current licensed treatment in children is griseofulvin 10 mg kg(-1) daily, which is usually given for 6--8 weeks. OBJECTIVES To compare this treatment with a 4-week course of oral terbinafine. METHODS Terbinafine was given at the following doses: in children weighing < 20 kg, 62.5 mg daily; 20--40 kg, 125 mg daily; > 40 kg, 250 mg daily. Two hundred and ten children aged 2--16 years, with mycologically confirmed tinea capitis, were randomized to 4 weeks treatment with terbinafine or 8 weeks with griseofulvin, and followed for a total of 24 weeks to determine the difference between treatments with respect to short- and long-term efficacy and tolerability. RESULTS One hundred and forty-seven patients were evaluable (terbinafine 77, griseofulvin 70). Although the 4-week course of terbinafine resulted in a trend to more rapid clearance of tinea capitis, there were no statistically significant differences between the two drugs in terms of overall outcome or tolerability, apart from in a subgroup of patients with Trichophyton infections, and weighing > 20 kg, who responded better to terbinafine than to griseofulvin at 4 weeks. By contrast, there was a better response to griseofulvin than to terbinafine in patients with Microsporum audouinii infections. CONCLUSIONS Overall, the study showed that 4 weeks of treatment with oral terbinafine has similar efficacy to 8 weeks of treatment with griseofulvin for the management of tinea capitis in children.
Collapse
Affiliation(s)
- L C Fuller
- Department of Dermatology, King's College Hospital, London SE5 9RS, UK
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Abstract
These guidelines for the management of tinea capitis have been prepared for dermatologists on behalf of the British Association of Dermatologists. They present evidence-based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, and a brief overview of epidemiological aspects, diagnosis and investigation.
Collapse
Affiliation(s)
- E M Higgins
- King's College Hospital, London SE5 9RS, U.K
| | | | | |
Collapse
|
32
|
Affiliation(s)
- D A Buckley
- Department of Dermatology, King's College Hospital, London SE5 9RS.
| | | | | | | |
Collapse
|
33
|
Abstract
We recorded the diagnosis made in 461 black patients (187 children and 274 adults) attending a dermatology clinic between January and March 1996. In the childhood population, atopic eczema and tinea capitis were the most frequent dermatoses, comprising 63% of diagnoses recorded. In the adult population, acne and acne keloidalis nuchae were seen most frequently. Other conditions observed commonly were eczema, psoriasis, keloid scarring, pityriasis versicolor and postinflammatory changes. Our study demonstrates a wide spectrum of skin disease and includes disorders more common in black skin, disorders unique to black skin, those which present a greater cosmetic disability, and normal findings which have been mistaken for pathological disease.
Collapse
Affiliation(s)
- F J Child
- Department of Dermatology, King's College Hospital, Denmark Hill, London SE5 9RS, UK
| | | | | | | |
Collapse
|
34
|
Abstract
Recalcitrant viral warts are a troublesome therapeutic problem. Immunotherapy with the universal allergic contact sensitizer diphencyprone (DCP) has been used successfully in such cases. We have reviewed our experience of the use of DCP in the treatment of resistant hand and foot warts during an 8-year period. Sixty patients were sensitized to DCP during this time; the median duration of warts was 3 years. Twelve patients defaulted from treatment. Of the remaining 48 individuals, 42 (88%) cleared of all warts. The median number of treatments to clear was five (range one to 22) and the median time to clear was 5 months (range 0.5-14). Adverse effects occurred in 27 of 48 patients (56%), most commonly painful local blistering (n = 11), blistering at the sensitization site (n = 9), pompholyx-like reactions (n = 7) and eczematous eruptions (n = 4). Three of those who defaulted did so due to side-effects, one became pregnant and eight dropped out for unknown reasons. Three of the 48 patients who cleared or had at least six treatments also discontinued DCP therapy due to side-effects, but most tolerated treatment well. Twenty-five patients were followed up for periods of 1 month to 8 years (median 2 years) and none had a recurrence. DCP immunotherapy is an effective option for the treatment of recalcitrant viral warts but patients must be motivated to attend for sequential applications and must be warned about potential uncomfortable side-effects.
Collapse
Affiliation(s)
- D A Buckley
- Department of Dermatology, King's College Hospital, Denmark Hill, London SE5 9RS, UK
| | | | | | | | | | | |
Collapse
|
35
|
Abstract
BACKGROUND Skin diseases represent one of the most frequent causes of morbidity in developing countries; however, little is known about the dermatologic needs of the population. The prevalence of skin disease in two different rural communities in southwestern Ethiopia was determined using descriptive epidemiologic techniques. METHODS A household survey, designed to ascertain demographic information and dermatologic needs, was given to all households in both communities (827). The point prevalence of skin diseases was determined after examination by dermatologists of 768 self-selected individuals (40% of individuals were invited to attend dermatologic examination, either those self-reporting skin disease or identified as positive cases during the household survey); an individual survey form was given to all of these patients. RESULTS Although 47% (S/UO) and 59% (Kishe) of the households in the two communities reported skin symptoms, the true dermatologic needs of these settlements were far greater than the expressed values, as examination by dermatologists of randomly selected households revealed that 67% of householders not reporting dermatoses had significant skin disease. During the point prevalence study, the commonest complaints were parasitic (scabies, pediculosis, and onchocerciasis) infestations (46% of diagnoses), followed by bacterial and fungal infections (33%); other conditions included endemic nonfilarial elephantiasis. Overcrowding was the main risk factor for infection. Thirty-two per cent (S/UO) and 39% (Kishe) of examined individuals had received previous treatments, which were ineffective in 74% and 63% respectively. CONCLUSIONS Subsistence farmers spend a high proportion of their limited cash income on ineffective treatment. Simple schemes of management for the most common dermatoses, which local health workers could be trained to recognize and manage, could do much to redress the burden of skin disease in this population.
Collapse
Affiliation(s)
- J I Figueroa
- St John's Institute of Dermatology (UMDS), Guys' Hospital, London
| | | | | | | |
Collapse
|
36
|
Abstract
We report a patient with purely cutaneous Rosai-Dorfman disease (RDD) who presented with a solitary, asymptomatic plaque on the back of her left thigh, with characteristic, large histiocytoid cells exhibiting emperipolesis histologically. Cutaneous lesions occur in 27% of patients with lymph node involvement in RDD however purely cutaneous disease has only been reported on 18 previous occasions. The aetiology is unknown, although it is though to be a reactive disorder rather than neoplastic, possibly an immunological response to an infectious agent.
Collapse
Affiliation(s)
- F J Child
- Department of Dermatology, King's College Hospital, London, U.K
| | | | | | | |
Collapse
|
37
|
Abraha HD, Fuller LC, Du Vivier AW, Higgins EM, Sherwood RA. Serum S-100 protein: a potentially useful prognostic marker in cutaneous melanoma. Br J Dermatol 1997; 137:381-5. [PMID: 9349333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
S-100, an acidic calcium-binding protein, is present within cells of neuroendocrine origin. Its value in the immunohistochemical diagnosis of tumours of melanocytic origin is well established. More recently, a potential role has been proposed for the serum concentration of this protein as a marker of metastatic melanoma disease activity. In the present study, the concentration of serum S-100 protein was measured in 97 patients with histologically proven malignant melanoma who were attending a dermatology and/or oncology department for the follow-up of their disease. Serum S-100 was also measured in 48 control subjects without malignant melanoma. The clinical stage of the patients was classified according to the criteria of the American Joint Committee on Cancer into stages I-IV. The median (range) serum S-100 protein concentration was significantly higher in stage I (0.11 (0.1-0.21) microgram/L, P < 0.001), stage II (0.11 (0.05-0.22) microgram/L, P < 0.001), stage III (0.24 (0.07-0.41) microgram/L, P < 0.0001) and stage IV (0.39 (0.06-15.0) microgram/L, P < 0.0001) compared with the control group (0.1 (0.05-0.15) microgram/L). At a threshold value of 0.2 microgram/L, the sensitivity and specificity for detection of advanced disease were 82% and 91%, respectively. Thus serum S-100 protein may be a valuable prognostic marker for malignant melanoma and for monitoring therapy. Serum S-100 protein concentration was also compared with the Breslow thickness of the tumours. There was a significant correlation between these variables (n = 72, rs = 0.32, P < 0.01). Combining a serum S-100 threshold value of > 0.22 microgram/L and a Breslow thickness of > 4 mm improved the sensitivity and specificity for the presence of secondary spread to 91% and 95%, respectively. Therefore, a combination of both baseline serum S-100 protein and Breslow thickness may provide a better indication of the prognosis at diagnosis.
Collapse
Affiliation(s)
- H D Abraha
- Department of Clinical Biochemistry, King's College School of Medicine and Dentistry, London, U.K
| | | | | | | | | |
Collapse
|
38
|
Higgins EM, Fuller LC, du Vivier AW, Tovey D. GP training in dermatology. Br J Gen Pract 1997; 47:594. [PMID: 9406504 PMCID: PMC1313119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
|
39
|
|
40
|
Nandwani R, Pozniak AL, Fuller LC, Wade J. Crusted ("Norwegian") scabies in a specialist HIV unit. Genitourin Med 1996; 72:453. [PMID: 9038654 PMCID: PMC1195746 DOI: 10.1136/sti.72.6.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
41
|
Abstract
It is always assumed that the prevalence of skin diseases in developing countries is very high, and that infestations and skin infections are highly endemic in poor rural communities; however, very few epidemiologic reports verify these assumptions. As part of a continuing study of dermatologic needs in southwestern Ethiopia, and to estimate the prevalence of treatable skin disease in children, a school survey was undertaken in Shebe. In October 1992, 112 children were examined by a team of dermatologists and their conditions were recorded. Twenty-two children (19.6%) were considered healthy and 90 (80.4%) had one or more skin diseases. A total of 140 conditions were identified and considered treatable in 98% of children. Infestations were the most prevalent skin pathology, 81.2%, followed by fungal infections, 13.4%.
Collapse
Affiliation(s)
- J I Figueroa
- St John's Institute of Dermatology, United Medical School of Guys, St. Thomas's, Guys' Hospital, London, United Kingdom
| | | | | | | |
Collapse
|
42
|
Fuller LC, Allen MH, Montesu M, Barker JN, Macdonald DM. Expression of E-cadherin in human epidermal non-melanoma cutaneous tumours. Br J Dermatol 1996; 134:28-32. [PMID: 8745882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
E-cadherin is a calcium-sensitive, cell-to-cell, adhesion molecule that is expressed widely in normal human epithelial tissue. Abnormal expression has been described in colorectal, breast and nasopharyngeal squamous cell carcinomas, where loss of E-cadherin is associated with an increased metastatic potential. We have examined, by standard immunohistochemical techniques using the monoclonal antibody HECD-1 (E-cadherin monoclonal antibody), the distribution of E-cadherin in normal human skin and in non-melanoma neoplastic lesions. In the normal epidermis, E-cadherin was strongly expressed on the surface of keratinocytes and specialized epithelial structures. Staining was absent from the lower pole of basal keratinocytes in contact with the basement membrane. Weak cytoplasmic staining was also noted in basal keratinocytes. No reactivity was demonstrated in dermal structures. The assessment of cutaneous tumours demonstrated an altered pattern of staining in most cases. Cell surface expression was reduced in 28 of 30 cases of basal cell carcinomas (BCC). Twenty showed an additional feature of positive staining on the dermal aspect of peripheral cells of tumour lobules. In squamous cell carcinomas (SCC) (n = 16), surface expression was attenuated in eight and absent in a further four. Strong surface expression, similar to normal skin was seen in all examples of Bowen's disease (n = 6), viral wart (n = 3), seborrhoeic keratosis (n = 3) and actinic keratosis (n = 4). This study demonstrates that, in BCC and SCC, but not in premalignant lesions, cell-surface expression of E-cadherin is reduced, consistent with the observation that the loss of E-cadherin is associated with tumour invasion.
Collapse
Affiliation(s)
- L C Fuller
- St John's Institute of Dermatology, Guy's Hospital, London, U.K
| | | | | | | | | |
Collapse
|
43
|
Abstract
Confluent and reticulate papillomatosis is a rare disorder producing sharply circumscribed hyperpigmented ichthyosiform scaling lesions in a seborrhoeic distribution. Its exact aetiology is unknown and its response to therapy is poor. This case is unusual in responding to minocycline having failed with the more conventional approaches.
Collapse
Affiliation(s)
- L C Fuller
- St John's Institute of Dermatology, London, UK
| | | |
Collapse
|