Conditions

Atopic eczema is a common skin condition that can start from infancy and childhood. There are multiple factors that predispose a patient to develop eczema, including gentic and environmental factors. An alteration in the gene which is important to maintain the skin barrier function is seen in patients.

This makes the atopic skin more susceptible to dryness, infection and irritation leading to itching and inflammation.

Alopecia is a general term for hair loss. Alopecia can be localised or generalised, can be scarring or non scarring type. Alopecia includes:

• Alopecia Areata
• Male Pattern Hair Loss
• Female Pattern Hair Loss
• Scarring Alopecia
• Telogen effluvium

Male Pattern Hair Loss

Male Pattern Hair Loss also known as androgentic alopecia is the most common type of hair loss found in men.

Female Pattern Hair Loss

Female Pattern Hair Loss is a diffuse form of hair loss occuring in women which is caused by a combination of genetic and hormonal factors.

Scarring Alopecia

Scarring hair loss can occur in conditions where there is inflammation and destruction of hair follicles.

Telogen Effluvium

Telogen Effluvium is a reversible form of hair loss in which there is increased hair shedding. This can occur due to a disturbance of the normal hair cycle. Triggers include child birth, stressful events, severe trauma or weight loss.

Lichen planus is an itchy rash that occurs on the skin, but can also affect the lips inside the mouth and the genital area. It can also occur on the nails and scalp.

The cause of lichen planus is thought to be related to an over-reaction of the skin’s defence mechanism. Some medications can also cause lichen planus like skin eruptions (‘lichenoid’drug reactions).

Lichen planus can heal with more pigmentation and can spread at sites of trauma. In most patients, lichen planus can subside with treatment in about 18 months, but the disease can recur or persist in some types such as those patients who have scalp, nail, oral or genital lichen planus.

Psoriasis is a common skin disease affecting 1 in 50 people at any age occuring equally in men and women. Psoriasis is a long-term condition which may come and go throughout your lifetime.

It is not infectious; therefore you cannot catch psoriasis from someone else. It does not scar the skin although sometimes it can cause a temporary increase or reduction in skin colour. Although psoriasis is a longterm condition there are many effective treatments available to keep it under good control.

Skin cancers are tumours in which there is an uncontrolled proliferation of any of the skin cells.The three main types of skin cancers are:

Basal cell carcinoma (BCC)

A basal cell carcinoma (BCC) is a type of non-melanoma skin cancer and is the most common type of all skin cancer in Australia. The most common cause is exposure to ultraviolet (UV) light from the sun or sunbeds. Although they can occur anywhere on the body, they often occur on sun exposed areas of the skin such as face, head, neck and ears. BCCs can appear as red patches, scabs that bleed, a new lump on the skin or as an ulcer that does not heal (rodent ulcer). BCCs rarely spread to the lymph nodes or other organs of the body unlike other skin cancers, however early diagnosis results in a better treatment outcome.

Squamous cell carcinoma (SCC), including keratoacanthoma

Squamous cell carcinoma is a non-melanoma skin cancer and is the second most common type of skin cancer. The most common cause is excessive sun exposure or UV light from other sources. SCCs can also occur in skin damaged by other forms of radiation, in immunocompromised individuals. SCCs can occur on any part of the body although more common on sun exposed areas. Although the vast majority of SCCs can be treated with surgery, a small percentage of SCCs can spread to the lymph nodes or to other parts of the body.

Melanoma

Melanoma is a skin cancer which arises from the pigment cells (melanocytes) in the skin. It is considered to be the most serious type of skin cancer as there is a risk of melanoma spreading from the skin to the lymph nodes and to other organs of the body leading to increased morbidity and mortality.
The cancerous growth of melanocytes results in melanoma. Melanoma can occur anywhere on the body and is not confined to sun exposed areas.

Most melanomas have characteristics described by the Glasgow 7-point checklist or by the ABCDE criteria of melanoma. Not all lesions with these characteristics are malignant. Not all melanomas show these characteristics.

Glasgow 7-point checklist

Major features

• Change in size
• Irregular shape
• Irregular colour

Minor features

• Diameter >7 mm
• Inflammation
• Oozing
• Change in sensation

The ABCDEs of Melanoma

• A- Asymmetry
• B- Border irregularity
• C- Colour variation
• D- Diameter over 6 mm
• E- Evolving (enlarging, changing)

The ‘EFGs’ of melanoma

• E- Elevated
• F- Firm
• G- Growing

Urticaria also known as hives is a skin rash triggered by a reaction to food, medicine or physical triggers such as cold, pressure, or friction. It is caused by the release of histamine from specific cells in the skin called mast cells.

The main symptom of urticaria is itch, but in some patients, pain and swelling may be present. This is particularly evident in patients with angioedema which can be life-threatening.

Vitiligo is a condition in which the skin loses its pigment cells(melanocytes). Melanocytes produce melanin which is resposible for skin colour.

Vitiligo is an auto immune condition in which the body’s own immune system attacks its own melanocytes.