The object of this book is to provide the non-dermatologist with a practical guide to the diagnosis and treatment of skin conditions. One advantage of dealing with skin conditions is that the lesions are easily examined and can be interpreted without the need for complex investigations, although a biopsy may be required to make or confirm the diagnosis. An understanding of the microscopic changes underlying the clinical presentation makes this interpretation easier and more interesting.
In the early chapters the relationship between the clinical presentation and the underlying pathological changes is discussed for a few important conditions, such as psoriasis. These are then used as a model for comparison with other skin diseases. This approach is suitable for skin conditions that present with characteristic lesions.
In other disorders a variety of causes may produce the same type of lesion. In this case it is more helpful to describe the characteristic clinical pattern that results. For example, similar inflamatory changes may result from drug allergy, autoimmune disease, or infection.
Tumours, acne, and leg ulcers are covered as separate subjects, as are diseases of the hair and nails.
The same condition is sometimes dealt with in more than one section, for example, fungal infections are discussed under "Rashes with epidermal changes" and again under "Fungal and yeast infections", giving different perspectives of the same disorder.
Skin lesions are sometimes an indication of internal disease and may be the first clinical sign. For example, the girl in the photograph presented with a rash on her face, made worse by sunlight. She then mentioned that she was aware of lassitude, weight loss, and vague musculoskeletal symptoms which, in conjunction with the appearance of the rash, suggested lupus erythematosus. This was confirmed by further investigations and appropriate treatment was initiated. Other dermatological associations with systemic disease are discussed in the relevant sections.
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