Clinical Dermatology -- Contents -- Preface to the Fifth Edition -- Acknowledgements -- Introduction -- Dermatology on the internet -- Further reading -- 1 Skin Disease in Perspective -- The many roles of the skin -- The prevalence and cost of skin disorders -- The impact of skin disorders -- Disfigurement -- Discomfort -- Disability -- Depression -- Death -- Further reading -- 2 The Function and Structure of the Skin -- Epidermis -- Keratinocytes -- Keratinization -- Cell cohesion and desquamation -- The epidermal barrier -- Epidermopoiesis and its regulation -- Vitamin D synthesis -- Other cells in the epidermis -- Melanocytes -- Langerhans cells -- Merkel cells -- Epidermal appendages -- Dermo-epidermal junction -- Dermis -- Cells of the dermis -- Fibres of the dermis -- Ground substance of the dermis -- Muscles -- Blood vessels -- Cutaneous lymphatics -- Nerves -- The skin immune system -- Cellular components of the skin immune system -- Keratinocytes (p. 7) -- Langerhans cells (p. 13) -- Dermal dendritic cells -- T lymphocytes -- Other (non-T, non-B) lymphocytes -- Mast cells -- Molecular components of the skin immune system -- Antigens -- Superantigens -- Antibodies (immunoglobulins) -- Cytokines -- Adhesion molecules -- Histocompatibility antigens -- Types of immune reactions in the skin -- Innate immune system -- Adaptive immune system -- Type I: Immediate hypersensitivity reactions -- Type II: Humoral cytotoxic reactions -- Type III: Immune complex-mediated reactions -- Type IV: Cell-mediated immune reactions -- Allergic contact dermatitis -- Induction (sensitization) phase (Figure) -- Elicitation (challenge) phase (Figure) -- Response to intracellular antigens -- Granulomas -- Further reading -- 3 Diagnosis of Skin Disorders -- History -- Examination -- Distribution -- Morphology -- Terminology of lesions (Figure 3.2) -- Primary lesions.

Secondary lesions -- Configuration -- Special tools and techniques -- Assessment -- Side-room and office tests -- Potassium hydroxide preparations for fungal infections -- Bacterial swabs -- Detection of a scabies mite -- Cytology (Tzanck smear) -- Patch tests -- Prick testing -- Skin biopsy -- Local anaesthetic -- Scalpel biopsy -- Punch biopsy -- Laboratory tests -- Conclusions -- Further reading -- 4 Disorders of Keratinization -- The ichthyoses -- Common ichthyoses -- Ichthyosis vulgaris -- Cause -- Presentation -- Clinical course -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Recessive X-linked ichthyosis -- Cause -- Presentation and course -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Autosomal recessive congenital ichthyoses -- Lamellar ichthyosis and congenital ichthyosiform erythroderma -- Harlequin fetus -- Keratinopathic ichthyoses -- Epidermolytic ichthyosis (previously called bullous ichthyosiform erythroderma) -- Other ichthyosiform disorders -- Acquired ichthyosis -- Other disorders of keratinization -- Keratosis pilaris -- Cause -- Presentation and course -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Keratosis follicularis (Dariers disease) -- Cause -- Presentation -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Keratoderma of the palms and soles -- Inherited types -- Acquired types -- Knuckle pads -- Cause -- Presentation -- Differential diagnosis -- Investigations -- Treatment -- Callosities and corns -- Further reading -- 5 Psoriasis -- Cause and pathogenesis -- Genetics -- Epidermal cell kinetics -- Angiogenesis -- Inflammation -- Precipitating factors -- Histology (Figure 5.2) -- Presentation -- Plaque pattern -- Guttate pattern -- Less common patterns -- Complications -- Psoriatic arthropathy.

Psoriasis and systemic disease -- Differential diagnosis -- Discoid eczema (p. 93) -- Seborrhoeic eczema (p. 92) -- Pityriasis rosea (p. 68) -- Secondary syphilis (p. 219) -- Cutaneous T-cell lymphoma (p. 307) -- Tinea unguium (p. 240) -- Investigations -- Treatment -- General measures -- Main types of treatment -- Further reading -- 6 Other Papulosquamous Disorders -- Pityriasis rosea -- Cause -- Presentation -- Course -- Differential diagnosis -- Investigations -- Treatment -- Lichen planus -- Cause -- Presentation -- Course -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Pityriasis rubra pilaris -- Cause -- Presentation -- Course -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Parapsoriasis and premycotic eruption -- Cause -- Presentation -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Pityriasis lichenoides -- Treatment -- Other papulosquamous diseases -- Erythroderma/exfoliative dermatitis -- Further reading -- 7 Eczema and Dermatitis -- Terminology -- Pathogenesis -- Histology -- Clinical appearance -- Acute eczema -- Chronic eczema -- Complications -- Differential diagnosis -- Investigations -- Exogenous eczema -- Other types of eczema -- Systemic treatment -- Acute weeping eczema -- Subacute eczema -- Chronic eczema -- Common patterns of eczema -- Irritant contact dermatitis -- Allergic contact dermatitis -- Occupational dermatitis -- Atopic eczema -- Seborrhoeic eczema -- Discoid (nummular) eczema -- Pompholyx -- Gravitational (stasis) eczema -- Asteatotic eczema -- Localized neurodermatitis (lichen simplex) -- Juvenile plantar dermatosis (Figure 7.28) -- Napkin (diaper) dermatitis -- Further reading -- 8 Reactive Erythemas and Vasculitis -- Urticaria (hives, 'nettle-rash') -- Cause -- Classification -- Physical urticarias -- Cold urticaria.

Solar urticaria -- Heat urticaria -- Cholinergic urticaria -- Dermographism (Figure 8.3) -- Delayed pressure urticaria -- Other types of urticaria -- Hypersensitivity urticaria -- Autoimmune urticaria -- Pharmacological urticaria -- Contact urticaria -- Presentation -- Course -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Hereditary angioedema -- Erythema multiforme -- Cause -- Presentation -- Course -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Erythema nodosum -- Presentation -- Course -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Acute febrile neutophilic dermatosis (Sweets syndrome) -- Vasculitis -- Cutaneous small vessel vasculitis (involving small vessels) Syn: cutaneous leucocytoclastic angiitis, leucocytoclastic vasculitis, allergic or hypersensitivity vasculitis, anaphylactoid purpura -- Cause -- Presentation -- Course -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Wegeners granulomatosis (involving small and medium-sized vessels) -- Polyarteritis nodosa (involving medium-sized vessels) -- Cause -- Presentation -- Course -- Differential diagnosis -- Investigations -- Treatment -- Further reading -- 9 Bullous Diseases -- Bullous disorders of immunological origin -- The Pemphigus family -- Cause -- Presentation -- Course -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Hailey-Hailey disease -- Other causes of subcorneal and intraepidermal blistering -- Bullous impetigo (p. 215) -- Scalded skin syndrome (p. 217) -- Miliaria crystallina (p. 169) -- Subcorneal pustular dermatosis -- Acute dermatitis (see Chapter 7) -- Pompholyx (p. 94) -- Viral infections (see Chapter 16) -- Subepidermal immunobullous disorders -- The Pemphigoid family -- Presentation -- Course -- Complications.

Differential diagnosis -- Investigations -- Treatment -- Pemphigoid gestationis (herpes gestationis) -- Mucous membrane pemphigoid (cicatricial pemphigoid) (Figure 9.8) -- Linear IgA bullous disease -- Acquired epidermolysis bullosa (epidermolysis bullosa acquisita) -- Dermatitis herpetiformis -- Cause -- Presentation -- Course -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Other causes of subepidermal blisters -- Porphyria cutanea tarda (p. 316) -- Blisters in diabetes and renal disease -- Bullous lupus erythematosus -- Bullous erythema multiforme -- Stevens-Johnson syndrometoxic epidermal necrolysis (Lyells disease) -- Cause -- Presentation -- Course -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Epidermolysis bullosa (also known as the mechanobullous disorders) -- Epidermolysis bullosa simplex -- Junctional epidermolysis bullosa -- Dystrophic epidermolysis bullosa -- Dominant dystrophic epidermolysis bullosa -- Recessive dystrophic epidermolysis bullosa -- Kindler syndrome -- Treatment -- Further reading -- 10 Connective Tissue Disorders -- Lupus erythematosus -- Systemic lupus erythematosus -- Cause -- Presentation -- Course -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Subacute cutaneous lupus erythematosus -- Presentation -- Course -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Discoid lupus erythematosus -- Presentation -- Course -- Differential diagnosis -- Investigations -- Treatment -- Tumid lupus erythematosus -- Dermatomyositis -- Presentation -- Course -- Complications -- Differential diagnosis -- Investigations -- Treatment -- Systemic sclerosis -- Cause -- Localized cutaneous systemic sclerosis (CREST syndrome) -- Diffuse cutaneous systemic sclerosis -- Complications -- Differential diagnosis -- Investigations.

Treatment.