Table of Contents

1. Cover
2. List of Contributors
3. Preface
4. Acknowledgements
5. CHAPTER 1: Introduction
   1. Introduction
   2. The significance of skin disease
   3. Descriptive terms of clinical inspection
   4. Clinical approach to the diagnosis of rashes
   5. Symmetry
   6. Diagnosis
   7. Distribution
   8. Morphology
   9. Assessment of the patient
   10. Further reading
6. CHAPTER 2: Psoriasis
   1. Introduction
   2. Clinical appearance
   3. The typical patient
   4. Clinical presentation
   5. Psoriatic arthritis – pathophysiology
   6. Psoriatic arthritis – clinical presentation
   7. Psoriasis and systemic disease
   8. Further reading
7. CHAPTER 3: Management of Psoriasis
   1. Introduction
   2. Dermatology day treatment units
   3. Topical treatment
   4. Scalp psoriasis
   5. Ultraviolet treatment – phototherapy and photochemotherapy
   6. Ultraviolet B (UVB)
   7. Ultraviolet A (UVA)
   8. Systemic treatment
   9. Methotrexate
   10. Acitretin
   11. Ciclosporin A
   12. Mycophenolate mofetil (MMF)
   13. Biological therapy
   14. Etanercept
   15. Infliximab
   16. Adalimumab
   17. Ustekinumab
   18. Ixekizumab
   19. Secukinumab
   20. Apremilast
   21. Further reading
8. CHAPTER 4: Eczema (Dermatitis)
   1. Clinical features
   2. Pathophysiology
   3. Pathology
   4. Types of eczema
   5. Classification of eczema
   6. Clinical features
   7. Allergic contact dermatitis
   8. Irritant contact dermatitis
   9. Photodermatitis
   10. Occupational dermatitis
   11. Investigations of contact dermatitis
   12. Patch testing
   13. General management of eczema
   14. Biological treatment for atopic dermatitis
   15. Pruritus
   16. Pruritus with skin changes
   17. Pruritus with normal skin
   18. Management of pruritus
   19. Further reading
9. CHAPTER 5: Urticaria and Angio‐oedema
   1. Introduction
   2. Pathophysiology
   3. Clinical history
   4. Classification of urticaria
   5. Ordinary urticaria
   6. Cholinergic urticaria
   7. Solar urticaria
   8. Pressure urticaria
   9. Angio‐oedema
   10. General investigations
   11. General management
   12. Further reading
10. CHAPTER 6: Skin and Photosensitivity
    1. Ultraviolet radiation
    2. Skin pigmentation and fitzpatrick skin type
    3. Oculocutaneous albinism
    4. Xeroderma pigmentosum
    5. Medications causing photosensitivity
    6. Photosensitive disorders
    7. Vitamin D levels and sun protection
    8. Reference
    9. Further reading
11. CHAPTER 7: Drug Rashes
    1. Introduction
    2. History
    3. Examination
    4. Investigation of a suspected drug reaction
    5. Classification of drug reactions in the skin
    6. Further reading
12. CHAPTER 8: Immunobullous and Other Blistering Disorders
    1. Introduction
    2. Pathophysiology
    3. Differential diagnosis
    4. Clinical features of immunobullous disorders
    5. Investigation of immunobullous disease
    6. Management of immunobullous disease
    7. Further reading
13. CHAPTER 9: Connective Tissue Disease, Vasculitis, and Related Disorders
    1. Introduction
    2. Connective tissue disease
    3. Vasculitis
    4. Polyarteritis nodosa (PAN)
    5. Henoch–schönlein purpura (IgA vasculitis)
    6. Management of cutaneous vasculitis
    7. Chilblains (perniosis)
    8. Raynaud's phenomenon
    9. Systemic sclerosis (SSc)
    10. Lichen planus (LP)
    11. Lupus erythematosus (LE)
    12. Dermatomyositis
    13. Mixed connective tissue disease (MCTD)
    14. Further reading
14. CHAPTER 10: The Skin and Systemic Disease
    1. Introduction
    2. Skin reactions associated with infections
    3. Sarcoidosis
    4. Skin changes associated with hormonal imbalance
    5. Thyroid disease
    6. Skin changes associated with disorders of the gastrointestinal system and liver
    7. Liver disease and the skin
    8. Pigmentation disorders
    9. Skin manifestations of underlying malignancy
    10. Pregnancy and the skin
    11. Genetics and skin disease
    12. Single gene disorders
    13. Further reading
15. CHAPTER 11: Leg Ulcers
    1. Introduction
    2. Venous ulcers
    3. Arterial ulcers
    4. Diabetic/neuropathic ulcers
    5. Inflammatory conditions
    6. Infectious ulcers
    7. Malignant diseases
    8. Trauma
    9. Further reading
16. CHAPTER 12: Acne, Rosacea, and Hidradenitis Suppurativa
    1. Introduction
    2. What is acne?
    3. Underlying causes
    4. Diet
    5. Types of acne
    6. Treatment of acne
    7. Rosacea
    8. Management
    9. Further reading
17. CHAPTER 13: Bacterial Infections
    1. Introduction
    2. Clinical presentation
    3. Bacterial investigations
    4. General approach to management
    5. Superficial infections
    6. Deeper infections
    7. Mycobacterial disease
    8. Other infections
    9. Further reading
18. CHAPTER 14: Viral Infections
    1. Introduction
    2. Herpes viruses
    3. Treatment
    4. Viral diseases with rashes
    5. Further reading
19. CHAPTER 15: HIV and the Skin
    1. Introduction
    2. Stages of HIV
    3. Skin disorders in HIV
    4. Infections
    5. Further reading
20. CHAPTER 16: Fungal Infections
    1. Introduction
    2. Investigations
    3. General features of fungi in the skin
    4. Yeast infections
    5. Deep fungal infections
    6. Systemic antifungal drugs
    7. Further reading
21. CHAPTER 17: Insect Bites and Infestations
    1. Insect bites and stings
    2. Delusions of parasitosis (DoP)
    3. Allergic reaction to bites
    4. Management of bite reactions
    5. Prevention of bites
    6. Insect bites transmitting parasites
    7. Lyme disease
    8. Spider bites
    9. Wasp and bee stings
    10. Treatment
    11. Infestations
    12. Cutaneous larva migrans
    13. Further reading
22. CHAPTER 18: Tropical Dermatology
    1. Introduction
    2. Bacterial Infections
    3. Superficial fungal infections
    4. Deep fungal infections
    5. Infestations
    6. Further reading
23. CHAPTER 19: Hair and Scalp
    1. Introduction
    2. The hair follicle and hair cycle
    3. Hair loss
    4. Non‐scarring alopecias
    5. Other non‐scarring alopecias
    6. Tinea capitis
    7. Scarring alopecias
    8. Excessive hair
    9. Skin disease involving the scalp
    10. Further reading
24. CHAPTER 20: Diseases of the Nails
    1. Introduction
    2. Changes of shape, surface, and attachment
    3. Nail bed changes
    4. Nail plate changes
    5. Common dermatoses and the nail unit
    6. Infection
    7. Trauma
    8. General diseases affecting the nails
    9. Treatment of nail conditions
    10. Further reading
25. CHAPTER 21: Genital Dermatoses
    1. Introduction
    2. History and examination
    3. Eczema
    4. Lichen simplex
    5. Balanitis and balano‐posthitis
    6. Psoriasis
    7. Lichen sclerosus
    8. Lichen planus
    9. Other inflammatory dermatoses
    10. Ulcers
    11. Pigmentation
    12. Infections
    13. Intra‐epithelial neoplasia
    14. Extra‐mammary paget’s disease
    15. Vulval and penile pain
    16. Further reading
26. CHAPTER 22: Benign Skin Tumours
    1. Introduction
    2. Pigmented benign tumours
    3. Melanocytic naevi
    4. Dermatofibroma (benign fibrous histiocytoma)
    5. Benign vascular tumours
    6. Benign tumour papules
    7. Benign tumour nodules
    8. Benign tumour plaques
    9. Further reading
27. CHAPTER 23: Premalignant and Malignant Skin Lesions
    1. Introduction
    2. Premalignant skin tumours
    3. Malignant skin tumours
    4. Moles/naevi: benign or malignant?
    5. Dysplastic naevi
    6. Melanoma
    7. Cutaneous lymphoma
    8. Other cutaneous malignancies
    9. Further reading
28. CHAPTER 24: Practical Procedures and Skin Surgery
    1. Introduction
    2. Application technique
    3. Risks and precautions
    4. Skin lesions suitable for freezing
    5. Electrosurgery
    6. Curettage
    7. Diagnostic biopsies
    8. Incisional biopsy
    9. Surgical excision
    10. Mohs micrographic surgery
    11. Further reading
29. CHAPTER 25: Lasers, Intense Pulsed Light, and Photodynamic Therapy
    1. Lasers in dermatology
    2. Lasers versus intense pulsed light
    3. Laser treatment
    4. Dermabrasion and chemical peels
    5. Intense pulsed light
    6. Photodynamic therapy
    7. Summary
    8. Further reading
30. CHAPTER 26: Cosmetic Dermatology
    1. Beauty and visible ageing
    2. The preoperative assessment
    3. Soft tissue augmentation
    4. Botulinum toxins
    5. Chemical peels
    6. Skin tightening devices
    7. Further reading
31. CHAPTER 27: Wounds, Dressings, and Bandages
    1. Introduction
    2. Wounds
    3. Dressings
    4. Bandages
    5. References
    6. Further reading
32. CHAPTER 28: Formulary
    1. Introduction
    2. Topical therapy
    3. Emollients
    4. Topical immunomodulatory treatments
    5. Phototherapy
    6. Systemic therapy
    7. Biological therapies
    8. Miscellaneous
    9. Further reading
33. Index
34. End User License Agreement

List of Tables

1. Chapter 3
   1. Table 3.1 Management of psoriasis.
2. Chapter 6
   1. Table 6.1 Common photosensitive drugs and associated features.
3. Chapter 7
   1. Table 7.1 Cutaneous reactions and the most commonly implicated drugs.
   2. Table 7.2 Time from drug commencement to drug rash.
   3. Table 7.3 SCORTEN parameters.
4. Chapter 8
   1. Table 8.1 Differential diagnosis of immunobullous disorders – other causes of...
   2. Table 8.2 Clinical features of immunobullous disorders.
   3. Table 8.3 Skin biopsy findings in immunobullous disorders.
5. Chapter 10
   1. Table 10.1 Clinical signs of thyroid disease.
   2. Table 10.2 Abnormality underlying some inherited skin disorders.
6. Chapter 12
   1. Table 12.1 Treatment of acne.
7. Chapter 13
   1. Table 13.1 Common patterns of bacterial infection in the skin.
8. Chapter 17
   1. Table 17.1 Skin lesions associated with insect bites.
9. Chapter 18
   1. Table 18.1 Tropical fungal infections of the skin.
10. Chapter 19
    1. Table 19.1 Causes of telogen effluvium.
    2. Table 19.2 Causes of scarring alopecia.
    3. Table 19.3 Causes of hirsutism.
    4. Table 19.4 Hypertrichosis due to drugs.
11. Chapter 21
    1. Table 21.1 Causes of genital ulceration.
12. Chapter 22
    1. Table 22.1 Differential diagnosis of common benign skin tumours.
13. Chapter 23
    1. Table 23.1 Prognosis in melanoma according to staging.
14. Chapter 25
    1. Table 25.1 Laser indications and selection.
    2. Table 25.2 Possible complications of laser treatment.
    3. Table 25.3 Laser selection by colour for tattoo removal.
15. Chapter 27
    1. Table 27.1 Wound types and suitable dressings.
    2. Table 27.2 Wound dressing categories.
16. Chapter 28
    1. Table 28.1 Comparison of formulations for topical therapy.
    2. Table 28.2 Relative potency of topical corticosteroids.
    3. Table 28.3 Topical antimicrobials used in the treatment of superficial infect...
    4. Table 28.4 Miscellaneous preparations used in the treatment of psoriasis.
    5. Table 28.5 Antibiotics used in dermatology, their method of action, indicatio...
    6. Table 28.6 Side effects of systemic retinoids.

List of Illustrations

1. Chapter 1
   1. Figure 1.1 Psoriasis with nail changes.
   2. Figure 1.2 Erythema nodosum in pregnancy.
   3. Figure 1.3 Superficial spreading melanoma.
   4. Figure 1.4 Section through skin.
   5. Figure 1.5 Erythema due to a drug reaction.
   6. Figure 1.6 Section through skin with a papule.
   7. Figure 1.7 Papules in lichen planus.
   8. Figure 1.8 Nodules in hypertrophic lichen planus.
   9. Figure 1.9 Section through skin with plaque.
   10. Figure 1.10 Psoriasis plaques on the knees.
   11. Figure 1.11 Bullae on the palm from multidermatomal shingles.
   12. Figure 1.12 Section through skin showing sites of vesicle and bulla.
   13. Figure 1.13 Lichenification due to chronic eczema in nickel allergy.
   14. Figure 1.14 Discoid lesions in discoid eczema.
   15. Figure 1.15 Inflammatory pustules secondary to contact dermatitis with Argon...
   16. Figure 1.16 Epidermal atrophy in extra‐genital lichen sclerosus.
   17. Figure 1.17 Ulceration in pyoderma gangrenosum.
   18. Figure 1.18 Erosions (loss of epidermis) in paraneoplastic bullous pemphigoi...
   19. Figure 1.19 Excoriation of epidermis in atopic dermatitis.
   20. Figure 1.20 Crusted lesions in pemphigus vulgaris.
   21. Figure 1.21 Desquamation following a severe drug reaction.
   22. Figure 1.22 Annular (ring‐shaped) lesions in neonatal lupus.
   23. Figure 1.23 Reticulate pattern in vasculitis.
   24. Figure 1.24 Symmetrical hypopigmented plaques of cutaneous T‐cell lymphoma....
   25. Figure 1.25 Irritant eczema on dominant hand of chef.
   26. Figure 1.26 Bilateral contact dermatitis to cement.
   27. Figure 1.27 Chronic actinic dermatitis.
   28. Figure 1.28 Eczema: intraepidermal vesicle (arrow).
   29. Figure 1.29 Vesicles and bullae in erythema multiforme.
   30. Figure 1.30 Vesicles in herpes simplex.
   31. Figure 1.31 Vesicles and bullae in bullous pemphigoid.
   32. Figure 1.32 Bullae in cellulitis on lower leg.
   33. Figure 1.33 Bullae from insect bite reactions.
   34. Figure 1.34 Possible precipitating factors in psoriasis.
2. Chapter 2
   1. Figure 2.1 Pathophysiological mechanisms involved in the development of psor...
   2. Figure 2.2 (Diagram/histology composite) Increased epidermal proliferation....
   3. Figure 2.3 (a) Pitting and onycholysis of the nails. (b) Hyperkeratotic nail...
   4. Figure 2.4 Multiple small plaques.
   5. Figure 2.5 Large chronic plaques.
   6. Figure 2.6 Common patterns of distribution of psoriasis.
   7. Figure 2.7 Generalised plaques.
   8. Figure 2.8 Psoriatic plaques on the trunk.
   9. Figure 2.9 Annular plaques.
   10. Figure 2.10 Koebner's phenomenon: psoriasis in surgical scar.
   11. Figure 2.11 Hyperkeratotic palmar psoriasis.
   12. Figure 2.12 Scalp psoriasis.
   13. Figure 2.13 Onycholysis in nail psoriasis.
   14. Figure 2.14 Guttate psoriasis.
   15. Figure 2.15 Palmar pustular psoriasis.
   16. Figure 2.16 Acute unstable pustular psoriasis.
   17. Figure 2.17 Flexural psoriasis.
   18. Figure 2.18 Napkin psoriasis.
   19. Figure 2.19 Erythrodermic psoriasis.
   20. Figure 2.20 Chronic psoriatic arthropathy.
   21. Figure 2.21 Acute arthropathy X‐ray signs.
3. Chapter 3
   1. Figure 3.1 Psoriasis suitable for topical dithranol treatment.
   2. Figure 3.2 Scalp psoriasis.
   3. Figure 3.3 Thin plaques of psoriasis suitable for TL01.
   4. Figure 3.4 Psoralen with ultraviolet A (PUVA) cabinet.
   5. Figure 3.5 Psoriasis before phototherapy.
   6. Figure 3.6 Skin after phototherapy.
   7. Figure 3.7 (a, b) Hand and foot PUVA.
   8. Figure 3.8 Severe psoriasis suitable for systemic therapy.
   9. Figure 3.9 Severe unstable pustulating psoriasis suitable for treatment with...
4. Chapter 4
   1. Figure 4.1 Chronic atopic dermatitis.
   2. Figure 4.2 Histology of eczema.
   3. Figure 4.3 Facial atopic dermatitis.
   4. Figure 4.4 Chronic lichenified eczema on the legs.
   5. Figure 4.5 Distribution of atopic dermatitis.
   6. Figure 4.6 Factors leading to the exacerbation of atopic dermatitis.
   7. Figure 4.7 Eczema herpeticum.
   8. Figure 4.8 Plantar dermatitis.
   9. Figure 4.9 Lichen simplex.
   10. Figure 4.10 Asteatotic eczema.
   11. Figure 4.11 Discoid eczema.
   12. Figure 4.12 Pompholyx eczema.
   13. Figure 4.13 Varicose eczema.
   14. Figure 4.14 Infected eczema.
   15. Figure 4.15 Paget's disease of the nipple – beware unilateral ‘eczema’.
   16. Figure 4.16 Common sources of contact dermatitis by body site.
   17. Figure 4.17 Severe contact dermatitis to potassium dichromate in leather sho...
   18. Figure 4.18 Contact dermatitis to iodine.
   19. Figure 4.19 Allergic contact dermatitis to melamine formaldehyde resin.
   20. Figure 4.20 Contact dermatitis to fragrance in facial cream.
   21. Figure 4.21 (a) Contact dermatitis to neomycin cream and (b) after stopping ...
   22. Figure 4.22 Acute PPD allergy in a ‘henna’ tattoo.
   23. Figure 4.23 Contact allergy to morphine dressing.
   24. Figure 4.24 Immunological response leading to the development of contact der...
   25. Figure 4.25 Chronic actinic dermatitis.
   26. Figure 4.26 Irritant hand eczema in a chef.
   27. Figure 4.27 Test patches in place.
   28. Figure 4.28 Patches being removed after 48 hours.
   29. Figure 4.29 Positive patch test reactions.
5. Chapter 5
   1. Figure 5.1 Urticarial vasculitis with bruising.
   2. Figure 5.2 Ordinary urticaria.
   3. Figure 5.3 Urticaria from contact with brown caterpillar moths.
   4. Figure 5.4 Cold‐induced urticaria on the cheeks.
   5. Figure 5.5 Ordinary urticaria with dermatographism.
   6. Figure 5.6 Annular urticaria.
   7. Figure 5.7 Angio‐oedema of the hand.
   8. Figure 5.8 Dermatographism.
6. Chapter 6
   1. Figure 6.1 Non‐ionising, visible, and infrared radiation.
   2. Figure 6.2 Porphyia cutanea tarda.
   3. Figure 6.3 Erythropoietic protoporphyria.
   4. Figure 6.4 Photosensitive drug eruption showing typical ‘phototoxic’ or exag...
   5. Figure 6.5 Phytophotodermatitis to lime juice.
   6. Figure 6.6 (a) Polymorphous light eruption (PMLE). (b) PMLE papular and eryt...
   7. Figure 6.7 Chronic actinic dermatitis.
7. Chapter 7
   1. Figure 7.1 (a) Photosensitive eruption. (b) Phototoxic eruption.
   2. Figure 7.2 Diltiazem pigmentation on the face.
   3. Figure 7.3 Maculopapular exanthem.
   4. Figure 7.4 Urticaria secondary to penicillin.
   5. Figure 7.5 Drug‐induced lupus.
   6. Figure 7.6 Drug‐induced vasculitis.
   7. Figure 7.7 (a) Lichenoid drug reaction to nifedipine. (b) Lichenoid drug rea...
   8. Figure 7.8 Fixed drug eruption.
   9. Figure 7.9 (a) Toxic epidermal necrolysis on the trunk. (b) Toxic epidermal ...
   10. Figure 7.10 (a) DRESS swollen ears. (b) DRESS cutaneous eruption.
   11. Figure 7.11 (a) Acute generalised exanthematous pustulosis multiple pustules...
8. Chapter 8
   1. Figure 8.1 Section through the skin with (a) intraepidermal blister and (b) ...
   2. Figure 8.2 Bullous pemphigoid.
   3. Figure 8.3 Urticated plaques in pre‐bullous pemphigoid.
   4. Figure 8.4 Bullous pemphigoid: showing mouth erosions.
   5. Figure 8.5 Pemphigoid gestationis on the abdomen.
   6. Figure 8.6 Mucous membrane pemphigoid: scarring skin eruption.
   7. Figure 8.7 Mucous membrane pemphigoid on the scalp.
   8. Figure 8.8 Mucous membrane pemphigoid: eyes.
   9. Figure 8.9 Pemphigus vulgaris on the trunk.
   10. Figure 8.10 Pemphigus vulgaris in the mouth.
   11. Figure 8.11 Dermatitis herpetiformis on the knees.
   12. Figure 8.12 Linear IgA on the trunk.
   13. Figure 8.13 Histopathology of bullous pemphigoid.
   14. Figure 8.14 Histopathology of pemphigus vulgaris.
   15. Figure 8.15 Immunofluorescence of bullous pemphigoid.
   16. Figure 8.16 Immunofluorescence of pemphigus vulgaris.
9. Chapter 9
   1. Figure 9.1 Vasculitis.
   2. Figure 9.2 Bullous vasculitis with necrosis.
   3. Figure 9.3 Livedo reticularis with skin necrosis in polyarteritis nodosa.
   4. Figure 9.4 Perniosis on the knees from outdoor work in the winter.
   5. Figure 9.5 Morphoea seen as hyperpigmented indurated plaques in the torso.
   6. Figure 9.6 Calcinosis cutis.
   7. Figure 9.7 CREST syndrome.
   8. Figure 9.8 Lichen planus on the wrist.
   9. Figure 9.9 Lichen planus in the mouth.
   10. Figure 9.10 Bullous lichen planus.
   11. Figure 9.11 Antiphospholipid syndrome in systemic lupus erythematosus affect...
   12. Figure 9.12 Systemic lupus erythematosus.
   13. Figure 9.13 Subacute lupus erythematosus triggered by terbinafine.
   14. Figure 9.14 (a) Discoid lupus erythematosus classically affects the ears. (b...
   15. Figure 9.15 Neonatal lupus erythematosus.
   16. Figure 9.16 Dermatomyositis rash on the ‘V’ of the neck.
   17. Figure 9.17 Dermatomyositis of the hands.
   18. Figure 9.18 Dermatomyositis: ragged cuticles.
10. Chapter 10
    1. Figure 10.1 Toxic erythema reactive morbilliform rash.
    2. Figure 10.2 Erythema multiforme.
    3. Figure 10.3 Erythema nodosum.
    4. Figure 10.4 Annular erythema.
    5. Figure 10.5 Sarcoid.
    6. Figure 10.6 Melasma.
    7. Figure 10.7 Acanthosis nigricans.
    8. Figure 10.8 Necrobiosis lipoidica on the shin.
    9. Figure 10.9 Granuloma annulare.
    10. Figure 10.10 Pretibial myxoedema.
    11. Figure 10.11 Zinc deficiency.
    12. Figure 10.12 Shiitake mushroom flagellate dermatosis.
    13. Figure 10.13 Pyoderma gangrenosum.
    14. Figure 10.14 Dermatitis herpetiformis.
    15. Figure 10.15 Porphyria cutanea tarda.
    16. Figure 10.16 Xanthomas in Alagille syndrome.
    17. Figure 10.17 Piebaldism.
    18. Figure 10.18 Vitiligo being treated with phototherapy (TL‐01).
    19. Figure 10.19 Haemochromatosis.
    20. Figure 10.20 Sézary syndrome (erythroderma with abnormal circulating Sézary ...
    21. Figure 10.21 Cutaneous B‐cell lymphoma.
    22. Figure 10.22 Poikiloderma.
    23. Figure 10.23 Polymorphous eruption of pregnancy (PEP).
    24. Figure 10.24 Pemphigoid gestationis.
    25. Figure 10.25 Ichthyosis vulgaris.
    26. Figure 10.26 Blashko's lines.
    27. Figure 10.27 Epidermal naevus following Blashko's lines.
11. Chapter 11
    1. Figure 11.1 Venous leg ulcer.
    2. Figure 11.2 Healthy valves in legs.
    3. Figure 11.3 Incompetent valves in legs.
    4. Figure 11.4 Varicose veins.
    5. Figure 11.5 Varicose eczema.
    6. Figure 11.6 Atrophie blanche.
    7. Figure 11.7 Lymphoedema.
    8. Figure 11.8 Lipodermatosclerosis.
    9. Figure 11.9 Compression bandaging.
    10. Figure 11.10 Cleaning leg ulcers.
    11. Figure 11.11 Arterial ulcer.
    12. Figure 11.12 (a) Martorell ulcer caused by uncontrolled hypertension. (b) He...
    13. Figure 11.13 Ulcers in diabetic foot.
    14. Figure 11.14 Vasculitis and perniosis pre‐ulceration.
    15. Figure 11.15 Pyoderma gangrenosum.
    16. Figure 11.16 Buruli ulcer on the arm.
    17. Figure 11.17 Squamous cell carcinoma in a chronic diabetic ulcer.
    18. Figure 11.18 Dermatitis artefacta.
12. Chapter 12
    1. Figure 12.1 (a) Sebaceous gland: pathology in acne. (b) Histology of acne.
    2. Figure 12.2 Acne with closed comedones.
    3. Figure 12.3 Acne with open comedones, cysts, and scars.
    4. Figure 12.4 Perioral dermatitis.
    5. Figure 12.5 Acne vulgaris with inflammatory papules and pustules.
    6. Figure 12.6 Acne keloidalis nuchae hypertrophic scarring affecting posterior...
    7. Figure 12.7 Types of atrophic acne scars (A, boxcar; B, ice‐pick; C, rolling...
    8. Figure 12.8 ‘Ice‐pick’ scars.
    9. Figure 12.9 (a) and (b) Keloid scars secondary to acne.
    10. Figure 12.10 Acne excoriée.
    11. Figure 12.11 Acne conglobate on the back.
    12. Figure 12.12 Acne fulminans on the chin.
    13. Figure 12.13 Dry lips as a result of oral isotretinoin.
    14. Figure 12.14 Classic xerotic rash on the dorsal hand secondary to taking ora...
    15. Figure 12.15 Rosacea.
    16. Figure 12.16 Rosacea localised to the nose.
    17. Figure 12.17 Rhinophyma.
    18. Figure 12.18 Blepharitis.
    19. Figure 12.19 Hidradenitis suppurativa (Hurley stage III) affecting the axill...
13. Chapter 13
    1. Figure 13.1 Multiple abscesses due to PVL Staphylococcus aureus infection.
    2. Figure 13.2 Impetigo with golden crusting.
    3. Figure 13.3 Impetigo with bullae and erosions.
    4. Figure 13.4 Bacterial folliculitis.
    5. Figure 13.5 Pseudofolliculitis: forehead.
    6. Figure 13.6 Acne keloidalis.
    7. Figure 13.7 Erythrasma.
    8. Figure 13.8 Erysipelas.
    9. Figure 13.9 Extending cellulitis.
    10. Figure 13.10 Staphylococcus scalded skin syndrome.
    11. Figure 13.11 Ecthyma.
    12. Figure 13.12 Lupus vulgaris.
    13. Figure 13.13 Erythema induratum (Bazin's disease).
    14. Figure 13.14 Sporotrichoid spread of Mycobacterium marinum.
    15. Figure 13.15 Bacillary angiomatosis.
    16. Figure 13.16 Rocky mountain spotted fever.
    17. Figure 13.17 Secondary syphilis.
14. Chapter 14
    1. Figure 14.1 Inoculation herpes.
    2. Figure 14.2 Herpes ‘cold sore’.
    3. Figure 14.3 Herpes simplex vesicles on posterior pinna.
    4. Figure 14.4 Eczema herpeticum.
    5. Figure 14.5 Varicella zoster virus chickenpox infection in an adult.
    6. Figure 14.6 Herpes zoster in a dermatome (shingles).
    7. Figure 14.7 Multidermatomal varicella zoster virus (shingles).
    8. Figure 14.8 Mandibular nerve zoster.
    9. Figure 14.9 (a) Herald patch of pityriasis rosea. (b) Rash of pityriasis ros...
    10. Figure 14.10 Molluscum contagiosum.
    11. Figure 14.11 Histology showing molluscum bodies.
    12. Figure 14.12 Orf.
    13. Figure 14.13 Filiform HPV wart.
    14. Figure 14.14 Periungual hyperkeratotic HPV warts.
    15. Figure 14.15 Plantar warts (verrucas).
    16. Figure 14.16 Koplick's spots in measles.
    17. Figure 14.17 Measles rash.
    18. Figure 14.18 Rubella.
    19. Figure 14.19 Erythema infectiosum.
    20. Figure 14.20 Gianotti–Crosti syndrome.
    21. Figure 14.21 Classic oval blisters in HFMD Coxsackie A16.
    22. Figure 14.22 (a and b) More severe form of HFMD Coxsackie A6.
    23. Figure 14.23 Onychomadesis (nail shedding) one to two months after HFMD Coxs...
15. Chapter 15
    1. Figure 15.1 Primary HIV infection: seroconversion rash.
    2. Figure 15.2 Seborrhoeic dermatitis.
    3. Figure 15.3 Eosinophilic folliculitis.
    4. Figure 15.4 Nodular prurigo.
    5. Figure 15.5 Flexural Candida infection.
    6. Figure 15.6 Pseudomembranous Candida.
    7. Figure 15.7 Bacillary angiomatosis.
    8. Figure 15.8 Secondary syphilis.
    9. Figure 15.9 (a) HSV (immune reconstitution inflammatory syndrome, IRIS). (b)...
    10. Figure 15.10 Oral hairy leukoplakia.
    11. Figure 15.11 Kaposi's sarcoma on the hard palate.
    12. Figure 15.12 Kaposi's sarcoma nodules.
    13. Figure 15.13 Molluscum contagiosum.
    14. Figure 15.14 Human papillomavirus warts: extensive.
    15. Figure 15.15 Crusted scabies on the hand.
    16. Figure 15.16 Toxic epidermal necrolysis.
16. Chapter 16
    1. Figure 16.1 Animal ringworm.
    2. Figure 16.2 Tinea capitis: Microsporum.
    3. Figure 16.3 Patchy alopecia in tinea capitis caused by Trichophyton tonsuran...
    4. Figure 16.4 Scaling with alopecia in the scalp and scaly rash on the neck ca...
    5. Figure 16.5 Kerion in T. tonsurans tinea capitis.
    6. Figure 16.6 ‘Id reaction’ after commencing oral treatment for tinea capitis....
    7. Figure 16.7 Tinea incognito.
    8. Figure 16.8 Seborrhoeic dermatitis.
    9. Figure 16.9 Tinea pedis.
    10. Figure 16.10 Toeweb tinea pedis.
    11. Figure 16.11 Tinea corporis.
    12. Figure 16.12 Tinea cruris.
    13. Figure 16.13 Pityriasis versicolor with hyperpigmented scaling.
    14. Figure 16.14 Pityriasis versicolor with hypopigmented scaling.
    15. Figure 16.15 Onychomycosis caused by Trichophyton rubrum.
    16. Figure 16.16 Candida onychomycosis.
    17. Figure 16.17 Candida infection in the groin.
    18. Figure 16.18 Candida albicans stomatitis.
    19. Figure 16.19 Fusarium infection in a bone marrow recipient.
    20. Figure 16.20 Deep fungal infection.
17. Chapter 17
    1. Figure 17.1 Severe bed bug bites.
    2. Figure 17.2 Linearity of configuration of insect bite reactions.
    3. Figure 17.3 Bulla bite reaction.
    4. Figure 17.4 Persistent insect bite reaction.
    5. Figure 17.5 Parasitophobia specimens.
    6. Figure 17.6 Tick and bite reaction.
    7. Figure 17.7 Erythema chronicum migrans in Lyme disease.
    8. Figure 17.8 Spider bite (Nigeria).
    9. Figure 17.9 Scabies burrows and papules in a child.
    10. Figure 17.10 Scabies nodules in a child.
    11. Figure 17.11 Scabies on sole of an infant.
    12. Figure 17.12 Crusted scabies on buttocks.
    13. Figure 17.13 Head lice.
    14. Figure 17.14 Pediculosis (head lice) causing an irritant rash on the posteri...
    15. Figure 17.15 Pubic lice on eyelashes.
    16. Figure 17.16 Cutaneous larva migrans.
18. Chapter 18
    1. Figure 18.1 Spectrum of clinical disease in leprosy. BB, mid‐borderline lepr...
    2. Figure 18.2 Tuberculoid leprosy: hypopigmented patches.
    3. Figure 18.3 Tuberculoid leprosy.
    4. Figure 18.4 Lepromatous leprosy.
    5. Figure 18.5 Borderline leprosy.
    6. Figure 18.6 Acute leishmaniasis.
    7. Figure 18.7 Chronic leishmaniasis.
    8. Figure 18.8 Diffuse cutaneous leishmaniasis.
    9. Figure 18.9 Superficial fungal infection.
    10. Figure 18.10 Tinea imbricata.
    11. Figure 18.11 Madura foot.
    12. Figure 18.12 Chromoblastomycosis.
    13. Figure 18.13 Paracoccidioides brasiliensis causing disseminated disease in a...
    14. Figure 18.14 Histoplasmosis in HIV infection.
    15. Figure 18.15 Tungiasis.
    16. Figure 18.16 Myiasis: larva.
    17. Figure 18.17 Lymphoedema of the legs in filariasis.
    18. Figure 18.18 ‘Leopard skin’ in onchocerciasis.
19. Chapter 19
    1. Figure 19.1 (a) Diagrammatic cross‐section of hair at various growth phases....
    2. Figure 19.2 Norwood's classification of male pattern balding.
    3. Figure 19.3 Ludwig patterns of hair loss.
    4. Figure 19.4 Patterns of hair loss in female pattern hair loss.
    5. Figure 19.5 Alopecia areata.
    6. Figure 19.6 Exclamation mark hairs.
    7. Figure 19.7 Nail pitting associated with alopecia areata.
    8. Figure 19.8 Tinea capitis.
    9. Figure 19.9 Kerion.
    10. Figure 19.10 Discoid lupus erythematosus.
    11. Figure 19.11 Lichen planopilaris.
    12. Figure 19.12 Pseudopelade of Brocq.
    13. Figure 19.13 Folliculitis decalvans.
    14. Figure 19.14 Hirsutism.
    15. Figure 19.15 Hypertrichosis.
    16. Figure 19.16 Scalp psoriasis.
    17. Figure 19.17 Pityriasis amiantacea.
20. Chapter 20
    1. Figure 20.1 Section through finger.
    2. Figure 20.2 (a) Pitting of nail and (b) pitting of nail appearance with derm...
    3. Figure 20.3 Onycholysis due to manicure beneath the nail.
    4. Figure 20.4 Onycholysis and hyperkeratosis of nail plate in psoriasis.
    5. Figure 20.5 Longitudinal ridge and partial split termed canaliform dystrophy...
    6. Figure 20.6 Darier's disease.
    7. Figure 20.7 Clubbing with loss of the angle between the proximal nail fold a...
    8. Figure 20.8 Apparent leukonychia.
    9. Figure 20.9 Yellow nail syndrome.
    10. Figure 20.10 Linear melanonychia.
    11. Figure 20.11 Nail psoriasis with onycholysis, pitting, and arthritis of the ...
    12. Figure 20.12 Eczema causing inflammatory matrix changes and compounded by pi...
    13. Figure 20.13 Lichen planus.
    14. Figure 20.14 Nail dystrophy with alopecia areata comprising multiple small, ...
    15. Figure 20.15 Dystrophy due to lupus.
    16. Figure 20.16 Pterygium formation with lupus.
    17. Figure 20.17 Chronic paronychia with alteration of nail plate shape, loss of...
    18. Figure 20.18 Fungal infection with superficial pattern (fourth toe) and dist...
    19. Figure 20.19 Chronic rubbing trauma to the proximal nail fold leads to a ‘ha...
    20. Figure 20.20 Mucoid cyst, also called myxoid pseudocyst.
    21. Figure 20.21 In situ melanoma with progressive pigmentation of nail plate.
    22. Figure 20.22 Subungual exostosis of the big toe.
21. Chapter 21
    1. Figure 21.1 Angiokeratomas, multiple small vascular lesions on labia majora....
    2. Figure 21.2 Extensive erythema in acute allergic contact dermatitis.
    3. Figure 21.3 Lichen simplex with lichenification and excoriation of labia maj...
    4. Figure 21.4 Vulval psoriasis with well‐defined plaques affecting labia major...
    5. Figure 21.5 Vulval lichen sclerosus with white sclerotic plaques on inner la...
    6. Figure 21.6 Vulval lichen sclerosus – architectural change with loss of labi...
    7. Figure 21.7 Lichen sclerosus affecting the glans penis.
    8. Figure 21.8 Erosive vulval lichen planus with vestibular erosions and archit...
    9. Figure 21.9 Erosive lichen planus of glans penis.
    10. Figure 21.10 Vulval melanosis – irregular pigmentation inner labia.
    11. Figure 21.11 Vulval intra‐epithelial neoplasia with white hyperkeratotic pla...
    12. Figure 21.12 Perianal HPV‐associated intra‐epithelial neoplasia.
22. Chapter 22
    1. Figure 22.1 Seborrhoeic keratoses on the trunk, there is a melanoma on the r...
    2. Figure 22.2 Seborrhoeic keratoses.
    3. Figure 22.3 Dermatosis papulosa nigra.
    4. Figure 22.4 Skin tags.
    5. Figure 22.5 Lentigines on upper back.
    6. Figure 22.6 Congenital melanocytic naevus.
    7. Figure 22.7 Mongolian blue spot.
    8. Figure 22.8 Junctional naevus.
    9. Figure 22.9 Compound naevus.
    10. Figure 22.10 Intradermal naevus.
    11. Figure 22.11 Blue naevus.
    12. Figure 22.12 Spitz naevus.
    13. Figure 22.13 Halo naevi.
    14. Figure 22.14 Becker's naevus.
    15. Figure 22.15 Dermatofibroma.
    16. Figure 22.16 Naevus flammeus neonatorum.
    17. Figure 22.17 Sturge–Weber syndrome.
    18. Figure 22.18 (a) Cavernous (strawberry) haemangioma and (b) ulcerating and b...
    19. Figure 22.19 Spider telangiectasia.
    20. Figure 22.20 Campbell de Morgan angiomas.
    21. Figure 22.21 (a) Pyogenic granuloma. (b) Multiple eruptive pyogenic granulom...
    22. Figure 22.22 Syringomas.
    23. Figure 22.23 Trichoepitheliomas.
    24. Figure 22.24 Apocrine hidrocystomas.
    25. Figure 22.25 Milia.
    26. Figure 22.26 Sebaceous gland hyperplasia.
    27. Figure 22.27 Lipoma.
    28. Figure 22.28 Leiomyoma on scalp vertex.
    29. Figure 22.29 Epidermoid cyst.
    30. Figure 22.30 Eccrine poroma.
    31. Figure 22.31 Keloid scar secondary to ear piercing.
    32. Figure 22.32 Naevus sebaceous.
    33. Figure 22.33 Epidermal naevus.
    34. Figure 22.34 Inflammatory linear verrucous epidermal naevus (ILVEN).
23. Chapter 23
    1. Figure 23.1 Sun‐damaged skin with multiple actinic keratoses.
    2. Figure 23.2 Bowen's disease.
    3. Figure 23.3 Nodular‐type basal cell carcinoma inner canthus of the eye.
    4. Figure 23.4 Nodular basal cell carcinoma histology.
    5. Figure 23.5 Recurrent nodular basal cell carcinoma arising in a hypopigmente...
    6. Figure 23.6 Superficial basal cell carcinoma.
    7. Figure 23.7 Pigmented basal cell carcinoma.
    8. Figure 23.8 Morphoeic basal cell carcinoma.
    9. Figure 23.9 Squamous cell carcinoma: initial stages on the pinna.
    10. Figure 23.10 Hyperkeratotic rapidly enlarging squamous cell carcinoma on the...
    11. Figure 23.11 Squamous cell carcinoma histology.
    12. Figure 23.12 Keratoacanthoma‐like squamous cell carcinoma on the lip.
    13. Figure 23.13 Dysplastic naevus.
    14. Figure 22.14 Superficial spreading melanoma on the right upper back.
    15. Figure 23.15 Melanoma with a pale area of regression around it.
    16. Figure 23.16 (a) Lentigo maligna pre‐imiquimod treatment and (b) lentigo mal...
    17. Figure 23.17 Lentigo maligna melanoma.
    18. Figure 23.18 Nodular melanoma.
    19. Figure 23.19 Acral melanoma.
    20. Figure 23.20 Amelanotic melanoma.
    21. Figure 23.21 Desmoplastic melanoma.
    22. Figure 23.22 Ulcerating melanoma with satellites and in transit metastasis....
    23. Figure 23.23 Mycosis fungoides.
    24. Figure 23.24 Primary cutaneous B‐cell lymphoma.
    25. Figure 23.25 Paget's disease of the nipple.
24. Chapter 24
    1. Figure 24.1 Cryotherapy.
    2. Figure 24.2 Electrodessication during surgery.
    3. Figure 24.3 (a) Spoon curettage. (b) Ring curettage.
    4. Figure 24.4 Punch biopsy tools.
    5. Figure 24.5 Punch biopsy: injecting local anaesthetic.
    6. Figure 24.6 Punch biopsy: tool insertion.
    7. Figure 24.7 Punch biopsy: plug of skin.
    8. Figure 24.8 Punch biopsy: raising a plug of skin.
    9. Figure 24.9 Punch biopsy: specimen taken.
    10. Figure 24.10 Incisional biopsy: marked area for sampling.
    11. Figure 24.11 Surgical excision: ‘skin wrinkle lines’ of the trunk.
    12. Figure 24.12 Surgical excision: ‘skin wrinkle lines’ of the limbs.
    13. Figure 24.13 Surgical excision: ‘skin wrinkle lines’ of the face.
    14. Figure 24.14 Surgical excision of BCC from lower back. Ellipse design includ...
    15. Figure 24.15 Surgical excision of BCC: removal of specimen illustrating the ...
    16. Figure 24.16 Surgical excision of BCC: after suturing, showing wound eversio...
    17. Figure 24.17 Placement of epidermal sutures.
    18. Figure 24.18 Methods of placing buried dermal sutures.
25. Chapter 25
    1. Figure 25.1 Port wine stain (a) before and (b) after treatment with a pulsed...
    2. Figure 25.2 Bruising following pulsed dye laser treatment.
    3. Figure 25.3 Café au lait macule (a) before and (b) after treatment with a Q‐...
    4. Figure 25.4 Tattoo subjected to laser removal. (a) Before treatment. (b) Fad...
    5. Figure 25.5 Superficial basal cell carcinoma on the lower back. (a, b) Befor...
26. Chapter 26
    1. Figure 26.1 Age‐related facial changes as a consequence of bone loss, fat pa...
    2. Figure 26.2 Glogu classification scale for photodamage.
    3. Figure 26.3 Filling agents should be placed within the skin at a site that b...
    4. Figure 26.4 (a and b) Placement of hyaluronic acid, with a needle, just belo...
    5. Figure 26.5 (a and b) Botulinum toxin injected into the upper forehead to re...
    6. Figure 26.6 (a and b) Botulinum toxin to the platysma muscle and mentalis.
    7. Figure 26.7 Solar lentigines on the cheek after 35% TCA peel.
    8. Figure 26.8 Classification of depth of peel penetration and common agents us...
    9. Figure 26.9 Application of trichloroacetic acid on the cheek. Note frosting ...
    10. Figure 26.10 Chemical burn as a consequence of accidental spillage of 50% TC...
27. Chapter 27
    1. Figure 27.1 Wound assessment.
    2. Figure 27.2 The wound healing continuum is represented by the colour of the ...
    3. Figure 27.3 Types of wound dressings.
    4. Figure 27.4 Larvae dressing in a second toe amputation site.
    5. Figure 27.5 Negative pressure wound therapy (NPWT) dressings applied to a de...
    6. Figure 27.6 Integra skin substitute applied to lower leg wound.
    7. Figure 27.7 Example of a four‐layer system.
    8. Figure 27.8 Example of a two‐layer system with a foam bandage underneath.
    9. Figure 27.9 Example of a different two‐layer compression system with printed...
28. Chapter 28
    1. Figure 28.1 Liberal application of a potent topical steroid resulting in str...
    2. Figure 28.2 Perioral dermatitis caused by local application of topical stero...
    3. Figure 28.3 Potent topical steroid‐induced atrophy and acne.

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