Dermatology

When It’s Not Acne: Papule and Pustule-Associated Rosacea

Rosacea is a chronic disorder that predominantly affects the central areas of the face (nose, forehead, cheeks and chin). It is characterised by frequent flushing, persistent erythema and telangiectasia, and episodes of inflammation during which swelling, papules and pustules are evident. These symptoms are frequently accompanied by periocular inflammation and are sometimes associated with the later development of cutaneous swellings known as phymas.

Modern Medicine – Issue 2 2022

Folliculitis: Diagnosis and management of subtypes

Folliculitis is a common disorder, although the exact prevalence is unknown. It presents as erythematous pustules surrounding hair follicles. It may be due to a superficial or deep infection of the follicle, or may be secondary to trauma. Deeper infections present as sycosis and folliculitis decalvans. Good grooming and hygiene are key to treatment and long-term resolution, alongside pharmacological therapies.

Modern Medicine – Issue 1 2022

Topical Help for Clearing Rosacea, a Common Skin Disorder

Recognised as one of the most common and clinically characteristic facial skin disorders, rosacea is an inflammatory dermatosis with a reported prevalence of at least 10% among white adults. Ivermectin 1% cream has been shown to be an effective, well-tolerated, and safe treatment for papulopustular rosacea in adults in several randomised, controlled trials of subjects with moderate-to-severe disease.

Modern Medicine – Issue 1 2022

Topical Fusidic Acid Gets Stuck into Skin Infections

Topical antibacterial therapy is an important component in managing skin and soft tissue infections (SSTIs). Fusidic acid, a narrow-spectrum antibiotic active against Staphylococcus aureus, has shown good skin permeability and low allergenic potential.

Modern Medicine – Issue 6 2021

Common skin problems in children Managing atopic dermatitis

Atopic dermatitis (AD) is common in children, with severity ranging from trivial to life-ruining. Itch and associated sleep loss impact quality of life. Environmental modification, topical emollients and topical corticosteroids are key, but corticosteroid phobia impedes treatment. Allergy testing is often requested, but is usually unnecessary and does not change management. When a child fails to respond to treatment , consider noncompliance, infection, allergy or combination with another dermatosis, most often psoriasis. The prognosis for AD is good, with most children recovering by the end of primary school.

Modern Medicine – Issue 6 2021

Safety of Azelaic Acid for Treating Acne during Pregnancy

Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit and is characterised by noninflammatory (comedones) and inflammatory lesions (papules, pustules, and nodules) that can cause scarring and psychological distress. In women who are planning pregnancy or who are pregnant, this condition can be particularly bothersome given the physiologic changes as well as the unpredictable nature of acne during this time. Azelaic acid shows benefits in the treatment of patients with acne vulgaris, rosacea, and perioral dermatitis.

Modern Medicine – Issue 5 2021

Imiquimod Targets Non-Melanoma Skin Cancer

Actinic keratosis (AK) appears as a rough, dry, scaly patch or growth on the exposed skin. If it is left untreated, AKs may turn into squamous cell carcinoma or in some cases it may turn into basal cell carcinomas, the most common form of skin cancer. Topical imiquimod is approved for the treatment of AK, superficial basal cell carcinoma, and external genital warts.

Modern Medicine – Issue 4 2021

Meeting the Challenges of Onychomycosis

Onychomycosis is an increasingly common fungal nail infection, chiefly caused by dermatophyte fungi. The disease is notoriously difficult to treat due to the deep-seated nature of fungi within the nail plate, prolonged treatment requirements due to poor nail plate absorption, poor patient adherence and frequent recurrences. Given the poor efficacy of currently available topical and systemic therapies, there is a renewed interest in exploring alternative treatment modalities for onychomycosis.

Modern Medicine – Issue 3 2021

Common and Important Skin Rashes in Primary Care

Skin conditions are the 4th largest cause of nonfatal disease burden across the world. Patients can present to primary care with skin problems ranging from autoimmune and inflammatory conditions to dermatological emergencies. Autoimmune and inflammatory problems include dermatitis, psoriasis and acne. Infectious diseases such as tinea, cellulitis and scabies are also common. Occasionally, patients may present with dermatological emergencies such as Stevens-Johnson syndrome and toxic epidermal necrolysis. It is important that GPs are aware how to diagnose and manage these conditions, and know when to refer patients.

Modern Medicine – Issue 6 2020