Dermatology Training E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1177

Veröffentlichungsjahr: 2021

Beschreibung

Dermatology Training: The Essentials helps readers understand what is required to work effectively in a demanding clinical dermatology training programme. Developed by the British Association of Dermatologists and British College of Dermatology, this accessible textbook covers all key themes outlined in the 2021 Joint Royal Colleges of Physicians Training Board (JRCPTB) curriculum.

The fundamentals of professional development, clinical practice, general dermatology, therapeutics and procedural dermatology, and specialist areas of dermatology relevant to all UK and international trainees and healthcare professionals are addressed in 29 reader-friendly chapters.

Throughout this highly practical textbook, the expert authors provide tips and advice for handling common clinical situations, developing leadership skills, getting into research and gaining surgical experience, as well as key pearls and pitfalls. The book contains over 70 Specialty Certificate Exam (SCE) questions to assist in exam preparation, and includes contributions from current trainees that offer real insights into day-to-day dermatology training. A must-have for all those involved in the dermatology training process, including educational supervisors, this textbook:

• Provides detailed descriptions of the key themes that trainees in dermatology need to understand
• Features over 500 clinical images, tables and figures including disease presentations in various skin types, and highlights relevant issues relating to skin diversity
• Aligns with the new Capabilities in Practice (CiPs) assessment tool, which evaluates the trainee’s ability to deliver and perform in the workplace

Dermatology Training: The Essentials is highly recommended reading for all trainees in dermatology, doctors taking the Certificate for Eligibility for Specialist Registration (CESR) route to accreditation in dermatology, general practitioners training for an Extended Role (GPwER), and junior doctors and medical students considering a career in dermatology.

Leseprobe

Table of Contents

Cover

Title Page

Copyright Page

Preface

About the Editors

Foreword

Authors

Acknowledgements

Conflicts of interest

Abbreviations

About the Companion Website

Section 1: Developing professionalism

1 Think critically, research and publish

Introduction

Why undertake research?

When should I do research?

What type of research should I conduct?

Where do I start and what are the hurdles?

Seeking support and funding

The path to successful research

But in the end…

FURTHER READING AND KEY RESOURCES

Textbooks

Useful websites

2 How to lead and manage

Introduction

The clinical environment in dermatology

The role of a dermatologist in multidisciplinary outpatient clinics

Acquiring the essential skills to manage an outpatient clinic

When to ask for assistance

Acute dermatology

Inpatient care

Nursing staff and day case treatments

How to demonstrate capability for inclusion in the specialist register

Teaching

Personal development plans

Working with other colleagues

The transition to the consultant role

Time management and its importance

Conclusions

FURTHER READING AND KEY RESOURCES

Textbooks

Useful websites

3 Ethical dilemmas

Introduction

‘Your mother should know’ (Figure 3.1)

‘You’re my first’

‘A picture’s worth a thousand words…’ (Figure 3.2)

‘Can’t get you out of my head’

‘What doesn’t meet the eye’

‘Please pass the peppermints’

‘Love, sex and… drama’

‘Spotted in the lift’ (Figure 3.3)

‘Workhorse, not training?’

‘Nightmare on Derm Street’

‘Does he take lidocaine?’

‘I want whatever he is having…’

‘The rep rap!’

‘Liar, liar…’

‘Show me the money!’

‘Kitchen table surgery’

‘Round ’em up’

‘Hello, is it me you’re looking for?’

Conclusions

FURTHER READING AND KEY RESOURCES

Useful websites

Section 2: Fundamentals of clinical practice

4 Basic science of the skin

Introduction

The skin: overview and functions

Epidermis

Basement membrane zone and dermoepidermal junction

Dermis

Subcutaneous tissue and hypodermis

The pilosebaceous unit and sweat glands

Nails

Embryology

Ageing

Carcinogenesis

The future

FURTHER READING AND KEY RESOURCES

Useful websites

5 Dermatopathology

Introduction

The magnification hierarchy

Help your pathologist

Regional variations of normal skin structure

Common dermatopathology terms

High‐power cytology

Further laboratory tests

Low‐power pattern recognition

Conclusions

FURTHER READING AND KEY RESOURCES

Textbooks

Useful websites

Acknowledgements

6 Teledermatology

Introduction

Teledermatology and the patient journey

Benefits, risks and limitations of teledermatology

Taking patient images

Teledermatology for inflammatory skin disease

Teledermatology for skin cancer

Information governance and medicolegal aspects

Audit and service evaluation

Artificial intelligence and the future

Conclusions

FURTHER READING AND KEY RESOURCES

Useful websites

7 Dermoscopy

Introduction

What is dermoscopy?

Why is dermoscopy important?

Types of dermatoscopes

Starting dermoscopy practice

Melanocytic lesions

Non‐melanocytic skin lesions

Approach to dermoscopic examination of skin lesions

Use of dermoscopy in non‐lesional skin conditions

Conclusions and the future

FURTHER READING AND KEY RESOURCES

Textbooks

Useful website

Acknowledgements

8 Clinical measurement methods

Introduction

Core outcome measures

Psoriasis

Eczema

Acne

Hidradenitis suppurativa

Alopecia

Melasma

Physician’s Global Assessment (PGA)

Quality of life

The future

FURTHER READING AND KEY RESOURCES

Useful websites

Conflicts of interest

9 Global and public health

Introduction

What is global health dermatology?

What is public health dermatology?

What is important in global health dermatology?

Examples of schemes to increase dermatology skills in a resource‐limited setting

Transferable skills gained in global health settings

Future global health opportunities

FURTHER READING AND KEY RESOURCES

Textbook

Useful websites

Section 3: General dermatology

10 Medical dermatology

Introduction

Psoriasis

Eczema

Atopic dermatitis

Acne

Hidradenitis suppurativa

Rosacea

Lichen planus and lichenoid disorders

Chronic spontaneous urticaria

Connective tissue diseases

Skin conditions associated with systemic diseases

Conclusions

FURTHER READING AND KEY RESOURCES

Textbooks

Useful websites

11 Paediatric dermatology

Introduction

How children are different

The clinical nurse specialist

Taking the history and examining the child (Figure 11.1)

Growth monitoring

Prescribing for children

Genetics

Infected eczema

Food allergy in infancy

Atopic eczema: treatment at school

Psoriasis

Haemangiomas

Consent in children

Problems during a procedure

Non‐accidental injury

Neonatal skin abnormalities

Conclusions

FURTHER READING AND KEY RESOURCES

Textbooks

Websites

12 Infections and infestations

Introduction

Basic microbiology

Skin infection and infestation in a well child

Skin infection and infestation in an unwell child

Skin infection and infestation in an adult

Conclusions

FURTHER READING AND KEY RESOURCES

Useful websites

13 Skin cancer

Introduction

Malignant melanoma

Basal cell carcinoma

Squamous cell carcinoma

Keratoacanthoma

Actinic keratosis

Bowen’s disease

Merkel cell carcinoma

Primary cutaneous lymphoma

Conclusions

FURTHER READING AND KEY RESOURCES

Textbook

14 Dermatology for skin of colour

Introduction

Structure and function of skin of colour

Normal variants in skin of colour

Presentation of common dermatoses in skin of colour

Skin cancer and skin of colour

Conditions more common in skin of colour

Conclusions

FURTHER READING AND KEY RESOURCES

Textbooks

Useful websites

15 Psychodermatology

Introduction

Primary dermatological disease with psychological comorbidities

Suicide in dermatological patients

Primary psychiatric disease presenting to dermatologists

Obsessive and compulsive behaviour

Dermatitis artefacta and factitious skin disease

Mental health legislation

Conclusions

FURTHER READING AND KEY RESOURCES

Textbooks

Useful websites

16 Emergency dermatology

Introduction

Erythroderma

Erythema multiforme

Stevens–Johnson syndrome and toxic epidermal necrolysis

Angio‐oedema and anaphylaxis

Blistering skin rashes

Drug reactions

Acute generalised exanthematous pustulosis

Drug reaction with eosinophilia and systemic symptoms

Vasculitis

Skin infections

Conclusions

FURTHER READING AND KEY RESOURCES

Useful website

Section 4: Therapeutics and procedural dermatology

17 Topical therapy

Introduction

Why is topical therapy for dermatology patients important?

Vehicle bases for topical therapies

Emollients

Adherence

Topical corticosteroids

Topical antibiotics, antivirals and antifungals

Acne and rosacea

Photodamage

Psoriasis

What are ‘Specials’?

Conclusions

FURTHER READING AND KEY RESOURCES

Textbook

Useful websites

18 Systemic therapy

Introduction

General considerations

Individual drugs

Antimalarials

Apremilast

Azathioprine

Ciclosporin

Colchicine

Cyclophosphamide

Dapsone

Dimethyl fumarate

Glucocorticosteroids

Intravenous immunoglobulins

Methotrexate

Mycophenolate mofetil

Retinoids

Thalidomide

Biologic therapies

Janus kinase (JAK) inhibitors

Conclusions

FURTHER READING AND KEY RESOURCES

Textbooks

Useful websites

19 Skin surgery

Introduction

Preparation for skin surgery

The skin biopsy

Anatomy

Haemostasis

Complications of electrosurgery instruments

Needles and sutures

Surgical procedures

Wound care

Safety and governance in skin surgery

Surgical treatment of melanoma

Surgical treatment of non‐melanoma skin cancer

The incompletely excised tumour

Mohs micrographic surgery

Surgical reconstruction

Nail surgery

Cryosurgery (cryotherapy)

How to stay out of trouble (Table 19.12)

Conclusions

FURTHER READING AND KEY RESOURCES

Textbooks

Useful websites

20 Wound care and dressings

Introduction

Leg ulceration

Pressure ulcers

Wound healing and management

Blistering diseases

Conclusions and the future

FURTHER READING AND KEY RESOURCES

Textbooks

Useful websites

Registered trademarks

21 Cosmetic dermatology

Introduction

Common dermatological conditions

Skin ageing and rejuvenation

Facial aesthetics and non‐surgical interventions

Other non‐surgical treatments

Complications and contraindications

Regulation

Conclusions

FURTHER READING AND KEY RESOURCES

Textbook

Useful websites

22 Laser therapy

Introduction

Fundamentals of laser therapy

Properties of laser light

Selective photothermolysis

Cooling

Anaesthesia

Laser safety

Patient selection and counselling

Practical points to consider when using lasers

Therapeutic applications of laser therapy

Laser photo‐epilation

Cutaneous resurfacing lasers

Conclusions

FURTHER READING AND KEY RESOURCES

Useful website

Section 5: Subspecialty dermatology

23 Cutaneous allergy

Introduction

Occupational skin diseases

Prick testing

Patch testing

Hand dermatitis

Conclusions

FURTHER READING AND KEY RESOURCES

Textbooks

Useful websites

24 Photosensitivity

Introduction

History and examination of the photosensitive patient

Phototesting

Photosensitivity disorders

Conclusions

FURTHER READING AND KEY RESOURCES

Textbook

Useful website

25 Phototherapy and photodynamic therapy

Introduction

Phototherapy and photochemotherapy

Photodynamic therapy

Conclusions

FURTHER READING AND KEY RESOURCES

Useful websites

26 Lymphoedema

Introduction

The lymphatic system

Lymphoedema and chronic oedema

Investigations

Management

Associated skin problems

Wound healing and lymphangiogenesis

FURTHER READING AND KEY RESOURCES

Useful website

27 Hair and nail diseases

Introduction

Hair anatomy and physiology

History, examination and investigation

Scarring alopecia

Non‐scarring alopecia

Nail diseases

Conclusions

FURTHER READING AND KEY RESOURCES

Textbooks

Useful website

28 Genital skin diseases

Introduction

Embryology of the genitalia

Vulval disease

Male genital skin disease

Female and male genital disease: common management principles

Conclusions

FURTHER READING AND KEY RESOURCES

Useful websites

29 Oral medicine

Introduction

History taking

Examination

Investigations

Clinical presentations

Conclusions

FURTHER READING AND KEY RESOURCES

Textbook

Useful website

Key resources and websites

Textbooks

Websites

British College of Dermatology Accredited Courses

Specialty Certificate Exam (SCE): questions

Specialty Certificate Exam (SCE): answers

Dermatology training and Capabilities in Practice

Index

End User License Agreement

List of Tables

Chapter 1

Table 1.1 Clinical audit categories and possible examples of the process

Table 1.2 Critical appraisal: how to question

Table 1.3 Impact factors for journals (2020)

Table 1.4 Rapid guide to writing your manuscript

Chapter 2

Table 2.1 Running and managing your outpatient clinic

Table 2.2 How to discharge outpatients appropriately

Table 2.3 Questions to ask yourself when considering discharge (traffic‐lig...

Table 2.4 On‐call cover: best practice

Table 2.5 Ward referrals

Table 2.6 Advantages of day case treatment

Table 2.7 Learning needs

Table 2.8 Appraisal points

Table 2.9 Minimising communication misunderstandings

Table 2.10 Quality improvement activities

Chapter 3

Table 3.1 Areas of ethical dilemmas

Table 3.2 Structured thinking about ethical problems

Table 3.3 Important definitions

Table 3.4 Key legal documents

Table 3.5 Key guidance documents

Table 3.6 The ‘four principles’: a medical ethics framework used for decisi...

Table 3.7 Influential negligence case law: one example

Table 3.8 Steps to assess capacity

Chapter 4

Table 4.1 Components of the basement membrane and how abnormalities in thes...

Table 4.2 The four major mechanoreceptors of glabrous skin

Chapter 5

Table 5.1 Histochemical stains commonly used in dermatopathology

Table 5.2 Common cell types in inflammatory conditions

Table 5.3 Results of direct immunofluorescence

Table 5.4 Selection of cell markers used in immunocytochemistry

Table 5.5 List of low‐power patterns seen in dermatopathology

Table 5.6 Causes of a ‘quiet’ section with little or no obvious histologica...

Chapter 6

Table 6.1 Teledermatology for inflammatory skin disease

Table 6.2 Teledermatology for skin cancer and lesions

Chapter 7

Table 7.1 Differences between polarised and non‐polarised dermoscopy

Table 7.2 Comparison between benign and suspicious pigmented melanocytic le...

Chapter 8

Table 8.1 The core outcome set and core outcome instruments for eczema clin...

Table 8.2 Psoriasis Area and Severity Index (PASI)

Table 8.3 The Global Evaluation Acne (GEA) scale

Table 8.4 The six stages of the hidradenitis suppurativa Physician’s Global...

Table 8.5 The Severity of Alopecia Tool (SALT)

Table 8.6 The Melasma Area and Severity Index (MASI)

Table 8.7 How to interpret Dermatology Life Quality Index (DLQI) scores

Chapter 9

Table 9.1 List of neglected tropical diseases

Table 9.2 Reported adverse drug reactions to herbal medications

Table 9.3 Tips for using a medical interpreter

Chapter 10

Table 10.1 Management of psoriasis

Table 10.2 Types of exogenous and endogenous eczema

Table 10.3 UK Working Party diagnostic criteria for diagnosis of atopic der...

Table 10.4 Management of atopic dermatitis

Table 10.5 Management of acne

Table 10.6 Management of rosacea

Table 10.7 Common causes of lichenoid eruptions

Table 10.8 Assessment of urticaria

Table 10.9 H1 antihistamines used in urticaria

Table 10.10 Connective tissue diseases (excluding lupus erythematosus)

Table 10.11 Skin conditions associated with systemic diseases

Chapter 11

Table 11.1 Factors influencing drug permeability through skin

Table 11.2 Drugs that can cause toxicity in children after topical applicat...

Table 11.3 Features in the history of an injury that raise suspicion of phy...

Chapter 12

Table 12.1 The normal flora

Table 12.2 Techniques of microbiological investigations

Table 12.3 Dermatophytes and their sources

Table 12.4 Causes of a macular rash

Chapter 13

Table 13.1 Risk factors for melanoma skin cancer

Table 13.2 Glasgow seven‐point checklist

Table 13.3 American ABCD(E) system for diagnosing melanoma

Table 13.4 Dermoscopic features of malignant melanoma (Chapter 7)

Table 13.5 Clark levels of melanoma

Table 13.6 Recommended surgical excision margins for malignant melanoma

Table 13.7 Breslow thickness and 5‐year survival for malignant melanoma

Table 13.8 Education points for patients with malignant melanoma

Table 13.9 Risk factors for non‐melanoma skin cancers

Table 13.10 Dermoscopic features of basal cell carcinoma (Chapter 7)

Table 13.11 Dermoscopic features of squamous cell carcinoma (Chapter 7)

Table 13.12 Squamous cell carcinoma risk classification

Table 13.13 The acronym AEIOU is used to aid in diagnosis of Merkel cell ca...

Table 13.14 Types of cutaneous T‐cell lymphoma (World Health Organization 2...

Chapter 14

Table 14.1 Comparison of common dermatological conditions

Table 14.2 Classification of vitiligo

Table 14.3 Shaving recommendations for pseudofolliculitis barbae

Table 14.4 Comparison of keloid and hypertrophic scars

Table 14.5 Keloid preventative measures

Table 14.6 Differential diagnosis of melasma

Table 14.7 Common causes of post‐inflammatory hyperpigmentation

Chapter 15

Table 15.1 Psychodermatological disease categories

Table 15.2 The psychodermatology multidisciplinary team

Table 15.3 Organisations that lead clinical–academic excellence in psychode...

Table 15.4 Models of provision of psychodermatology services

Table 15.5 Well‐validated questionnaires and tools to assess psychosocial c...

Table 15.6 Coping strategies and simple signposting for patient support

Table 15.7 Coping strategies suggested by Changing Faces

Table 15.8 The Changing Faces REACHOUT mnemonic to assist coping with livin...

Table 15.9 Antidepressants used in psychodermatology

Table 15.10 Risk factors for suicide

Table 15.11 Causes of delusional infestation (DI)

Table 15.12 Treatment of dermatological obsessive–compulsive disorders (OCD...

Table 15.13 Factitious skin disease criteria

Chapter 16

Table 16.1 Management of potential complications due to loss of skin functio...

Table 16.2 Likely causes of erythroderma based on the age of the patient

Table 16.3 Causes of Stevens–Johnson syndrome and toxic epidermal necrolysis

Table 16.4 Factors used to calculate the severity of illness score in toxic ...

Table 16.5 Extracutaneous manifestations of Stevens–Johnson syndrome and tox...

Table 16.6 Causes of angio‐oedema

Table 16.7 Differential diagnosis of blistering rashes based on the age of t...

Table 16.8 Medications associated with bullous pemphigoid

Table 16.9 Features of three main types of pemphigus

Table 16.10 Causative medications of acute generalised exanthematous pustulo...

Table 16.11 Classification of vasculitis based on the size of the affected v...

Table 16.12 The causes of vasculitis

Chapter 17

Table 17.1 Some examples of emollients

Table 17.2 Soap substitutes

Table 17.3 How much emollient cream to prescribe: minimum requirement if app...

Table 17.4 Corticosteroid ladder in eczema (PASS: Potency, Age, Site, Severi...

Table 17.5 Topical corticosteroid combinations

Table 17.6 Selected topical formulary (up‐to‐date information can be found a...

Table 17.7 Topical preparations for psoriasis

Chapter 18

Table 18.1 Examples of factors to consider when prescribing systemic therapy

Table 18.2 Comparative efficacy of glucocorticosteroids

Table 18.3 Biologic therapies: indications and uses

Table 18.4 Biologic therapies: mechanisms of action and indications

Chapter 19

Table 19.1 Patient preparation

Table 19.2 General Medical Council guidance on consent: the key principles

Table 19.3 Surgical checklist

Table 19.4 Punch biopsy

Table 19.6 Incisional biopsy

Table 19.7 Suture removal

Table 19.8 Avoiding wrong‐site surgery

Table 19.9 Indications for Mohs micrographic surgery

Table 19.10 Options for wound repair

Table 19.11 Potential side‐effects and pitfalls of cryotherapy

Table 19.12 Staying out of trouble

Chapter 20

Table 20.1 Aetiological factors and cofactors in leg ulceration

Table 20.2 History taking in leg ulceration

Table 20.3 Procedure for recording Doppler ankle brachial pressure index (AB...

Table 20.4 Advantages and disadvantages of handheld Doppler

Table 20.5 Assessment of leg ulceration

Table 20.6 SSKIN is a five‐step approach to preventing and treating pressure...

Table 20.7 Prevention of diabetic foot ulceration in patients with diabetes ...

Table 20.8 Methods of debridement

Chapter 21

Table 21.1 Four types of botulinum toxins available in the UK, with unit con...

Chapter 22

Table 22.1 Abbreviations used concerning lasers

Table 22.2 Definition of key terms

Table 22.3 Laser classification

Table 22.4 Therapeutic applications of lasers

Table 22.5 The Kirby–Desai scale to estimate the number of laser treatments ...

Chapter 23

Table 23.1 Examples of allergens encountered in various occupations

Table 23.2 Causes of occupational contact urticaria

Table 23.3 Latex allergy

Table 23.4 Causes of non‐immunological and immunological contact urticaria

Table 23.5 Contact urticaria syndrome

Table 23.6 Indications for patch testing

Table 23.7 Important history points in patch testing clinic

Table 23.8 Scheme for interpretation of patch testing results

Table 23.9 2020 British Society for Cutaneous Allergy Baseline (Standard) Se...

Table 23.10 2019 British Society for Cutaneous Allergy Facial (Cosmetic) Ser...

Table 23.11 Allergen series available

Table 23.12 Allergens that commonly cause irritant patch test reactions

Table 23.13 Late‐reacting allergens (a delayed reading may be useful, e.g. d...

Table 23.14 Unexplained positive patch tests

Table 23.15 Adverse effects of patch testing

Table 23.16 Common skin irritants

Chapter 24

Table 24.1 Fitzpatrick skin phototype

Table 24.2 Suggested skin assessment questionnaire (Manchester). This is mor...

Table 24.3 History taking: photosensitivity

Table 24.4 A classification of photosensitivity disorders

Chapter 25

Table 25.1 Advantages and disadvantages of UVB therapy compared with PUVA

Table 25.2 Contraindications to UVB therapy and PUVA

Table 25.3 Main indications for photodynamic therapy

Table 25.4 Relative contraindications to photodynamic therapy

Table 25.5 Adverse effects of photodynamic therapy (PDT)

Table 25.6 Advantages of photodynamic therapy

Table 25.7 Factors influencing risk of photodynamic therapy‐induced pain

Table 25.8 Management of photodynamic therapy‐induced pain

Chapter 26

Table 26.1 Causes of lymphoedema and chronic oedema

Table 26.2 Lymphoedema consultation guide

Chapter 27

Table 27.1 The North American Hair Research Society (NAHRS) classification o...

Table 27.2 Causes of telogen effluvium

Table 27.3 Investigations for hair fall

Table 27.4 Common nail signs

Table 27.5 Benign tumours of the nail unit

Chapter 28

Table 28.1 Development of male and female genitals

Table 28.2 Histological features of three types of skin and mucosa found at ...

Table 28.3 History taking: key facts

Table 28.4 Management of vulval dermatoses

Table 28.5 Questions when taking a dermatological history

Table 28.6 Questions to ask when taking a sexual history

Table 28.7 Examples of pre‐malignant and malignant lesions, and rashes that ...

Table 28.8 When to refer for circumcision: medical reasons

Table 28.9 Treatment failure and solutions

Chapter 29

Table 29.1 Differential diagnoses for key signs and symptoms

Table 29.2 Oral Disease Severity Score (ODSS)

Table 29.3 Main indications for referral to oral medicine or oral surgery fo...

Table 29.4 Presentations of oral ulceration

Table 29.5 Presentation and treatment of recurrent oral aphthae

Table 29.6 Distinguishing features for autoimmune bullous disease

Table 29.7 Diagnosis and management of autoimmune bullous disease

Table 29.8 Cheilitis: clinical features and investigation

Table 29.9 Other oral problems

Dermatology training and Capabilities in Practice

Table 1 Capabilities in Practice (CiPs) for dermatology: generic and special...

Table 2 Capabilities in Practice (CiPs) for dermatology mapped to the textb...

List of Illustrations

Chapter 1

Figure 1.1 The key components of the audit process.

Figure 1.2 Pyramid of evidence.

Figure 1.3 Forest plot for improvement in Dermatology Life Quality Index (DL...

Figure 1.4 CONSORT diagram describing flow of patients through a parallel gr...

Chapter 2

Figure 2.1 Remote virtual consultations can complement face‐to‐face meetings...

Chapter 3

Figure 3.1 Your mother should know.

Figure 3.2 A picture’s worth a thousand words.

Figure 3.3 Spotted in the lift.

Chapter 4

Figure 4.1 An overview of the skin structure demonstrating the epidermis, de...

Figure 4.2 Layers of the epidermis. Basal cells express keratin 5 (K5) and/o...

Figure 4.3 Tight junctions (TJs) between cells in the second layer of the st...

Figure 4.4 (a) Desmoglein is a key component of desmosomes, and the expressi...

Figure 4.5 As profilaggrin accumulates in keratinocytes in the stratum granu...

Figure 4.6 In formalin‐fixed and paraffin‐embedded normal skin, the stratum ...

Figure 4.7 Basement membrane zone, where keratinocytes of the stratum basale...

Figure 4.8 Hair follicle anatomy. FancyTapis/iStock/Getty Images.

Figure 4.9 Anatomy of the nail plate. (a) Axial view and (b) sagittal view....

Figure 4.10 Asteatotic eczema (eczema craquelé), induced by erlotinib. This ...

Figure 4.11 This is human skin – complete with hair follicles – that has bee...

Chapter 5

Figure 5.1 Fragmented curettings from a suspected keratoacanthoma (magnifica...

Figure 5.2 Architecture of keratoacanthoma. The lesion shows symmetry, which...

Figure 5.3 The correct way to biopsy a blister or an ulcer.

Figure 5.4 Crush artefact. The arrow indicates an area where lymphocytes hav...

Figure 5.5 Scalp biopsies (×4). (a) Vertical section (alopecia areata); (b) ...

Figure 5.6 Method of taking step sections (levels) through a biopsy of a sus...

Figure 5.7 Periodic acid–Schiff stain highlighting fungal hyphae (black arro...

Figure 5.8 Anatomical comparison. (a) Acral skin showing thick stratum corne...

Figure 5.9 Normal skin showing some anatomical features (×4).

Figure 5.10 Psoriasis, low‐power view showing regular acanthosis and paraker...

Figure 5.11 Bandlike (lichenoid) infiltrates (×4): (a) lichen planus; (b) cu...

Figure 5.12 Panniculitis. Septal pattern in erythema nodosum (×10).

Figure 5.13 Pleomorphism. Variable cell size and shape seen in a high‐power ...

Figure 5.14 Biopsy of an epithelioid blue naevus stained for S100 (immunoper...

Figure 5.15 Skin pathology algorithm.

Figure 5.16 Superficial basal cell carcinoma (×4).

Figure 5.17 Psoriasiform (psoriasis‐like) epidermal hyperplasia in a case of...

Figure 5.18 Lupus erythematosus (low power, ×4).

Figure 5.19 Insect bite reaction (low power, ×2).

Figure 5.20 Macular amyloidosis (low power, ×2).

Chapter 6

Figure 6.1 Skin cancer teledermatology patient pathway.

Chapter 7

Figure 7.1 How dermoscopy works. (a) Normally, most light rays falling on th...

Figure 7.2 A benign junctional naevus on the leg of a 32‐year‐old man. The n...

Figure 7.3 A dark naevus on the back of a 46‐year‐old woman. Dermoscopy show...

Figure 7.4 The globules in this naevus are similar in size and symmetrically...

Figure 7.5 A melanoma on the lower back. On dermoscopy, irregularly distribu...

Figure 7.6 Radial lines emerging from a central structureless black blotch a...

Figure 7.7 The whole lesion is a structureless uniform blue blotch of ‘homog...

Figure 7.8 This melanoma with a Breslow thickness of 0.7 mm shows a blue‐whi...

Figure 7.9 A hypomelanotic melanoma with Breslow thickness of 2.5 mm lacks c...

Figure 7.10 A lentigo maligna on the nasal ala. Dermoscopically the adnexal ...

Figure 7.11 A lentigo maligna on the upper forehead shows adnexal openings o...

Figure 7.12 A benign acral naevus on the great toe shows pigment predominant...

Figure 7.13 An acral melanoma on the heel of a 52‐year‐old woman. Pigmentati...

Figure 7.14 A papillomatous naevus on the upper chest shows short curved (co...

Figure 7.15 A dark red lesion on the posterior thigh of a young female patie...

Figure 7.16 A flat red scaly patch on the nose. Dermoscopy shows a red backg...

Figure 7.17 A flat scaly pink patch on the shoulder of an elderly patient sh...

Figure 7.18 A smooth plaque on the glabella shows branching (arborising) ves...

Figure 7.19 A scaly red plaque on the shoulder of an elderly woman with sign...

Figure 7.20 A tender crusted nodule on the ear helix suggests squamous cell ...

Figure 7.21 A pigmented patch on the nasal wall shows a moth‐eaten border on...

Figure 7.22 A dark seborrhoeic keratosis on the lower abdomen. Dermoscopy sh...

Figure 7.23 A keratotic plaque of seborrhoeic keratosis on the back. On derm...

Figure 7.24 Another seborrhoeic keratosis, on the flank, where the ridges an...

Figure 7.25 A uniform plaque of seborrhoeic keratosis on the shoulder shows ...

Figure 7.26 A warty non‐pigmented plaque of seborrhoeic keratosis on the low...

Figure 7.27 A non‐specific dusky red plaque on the calf of an elderly patien...

Figure 7.28 A shiny papule on the temple of a middle‐aged man shows white/ye...

Figure 7.29 A dusky red lesion on the arm. Dermoscopy shows the lacunae in m...

Figure 7.30 A firm lesion on the arm of a young adult. Under the dermatoscop...

Figure 7.31 A pink dermatofibroma on the thigh of a young adult. Dermoscopic...

Figure 7.32 Dermoscopic approach in skin lesion examination. BCC, basal cell...

Figure 7.33 Wickham’s striae can be easily observed under the dermatoscope a...

Figure 7.34 The pathognomonic ‘jet with contrail’ of scabies.

Chapter 8

Figure 8.1 The handprint.

Figure 8.2 The Patient‐Oriented Eczema Measure (POEM) tool to measure atopic...

Figure 8.3 A visual analogue scale (VAS).

Figure 8.4 The Dermatology Life Quality Index (DLQI).

Figure 8.5 The cartoon version of the Children’s Dermatology Life Quality In...

Chapter 9

Figure 9.1 Crusted scabies.

Figure 9.2 The Regional Dermatology Training Centre in Tanzania.

Chapter 10

Figure 10.1 Guttate psoriasis. Note the small, widespread scaly plaques on a...

Figure 10.2 Palmoplantar pustulosis. Note the different colours of the pustu...

Figure 10.3 Typical plaques of psoriasis on the lower legs, with redness, sc...

Figure 10.4 Chronic plaque psoriasis. Note the thick scaly plaque on the kne...

Figure 10.5 Psoriasis of the nails. Note the onycholysis and nail pitting....

Figure 10.6 Atopic eczema. Note the flexural redness, lichenification and se...

Figure 10.7 Eczema of the arm, showing hyperpigmentation and papular thicken...

Figure 10.8 Eczema of the lower legs, showing hyperpigmentation and papular ...

Figure 10.9 Linear hyperpigmentation of the neck in atopic dermatitis.

Figure 10.10 Eczema herpeticum (early). Note the numerous tiny fluid‐filled ...

Figure 10.11 Eczema herpeticum (late). No blisters remain, but there are tin...

Figure 10.12 Moderate‐to‐severe acne. Note the papules, pustules, comedones ...

Figure 10.13 Acne on the right side of the face and neck, showing papules, p...

Figure 10.14 Severe nodulocystic acne. Note the open and closed comedones, c...

Figure 10.15 Hidradenitis suppurativa affecting the axilla.

Figure 10.16 Rosacea on the left cheek, typically showing papules but no com...

Figure 10.17 Rosacea on the right cheek.

Figure 10.18 Rhinophyma with distortion of the shape of the nose.

Figure 10.19 Lichen planus. A close‐up view showing a violaceous plaque topp...

Figure 10.20 Typical lichen planus: shiny papules on the wrist.

Figure 10.21 Hypertrophic lichen planus on the shin.

Figure 10.22 Widespread urticaria, showing a clear edge with faded areas cen...

Figure 10.23 Dermographism in urticaria. Note the raised weals, a response t...

Figure 10.24 Treatment of chronic spontaneous urticaria.

Figure 10.25 Subacute cutaneous lupus erythematosus. Marano AL

et al.

Subacu...

Figure 10.26 Thick plaque of discoid lupus erythematosus. This lady two year...

Chapter 11

Figure 11.1 Examining a child.

Figure 11.2 Standard height and weight growth chart. The 2‐year‐old had been...

Figure 11.3 Naevoid basal cell carcinoma syndrome: family tree.

Figure 11.4 Xeroderma pigmentosum: family tree.

Figure 11.5 X‐linked ichthyosis: family tree.

Figure 11.6 Typical brown scales in flexures in X‐linked ichthyosis.

Figure 11.7 Child with extensive atopic eczema, with mother and nurse specia...

Figure 11.8 Haemangioma on the lower back.

Chapter 12

Figure 12.1 Mechanisms of mucocutaneous lesions. Invasion can occur directly...

Figure 12.2 Common viral warts on a child’s nose.

Figure 12.3 Molluscum contagiosum on a child’s trunk.

Figure 12.4 Staphylococcal impetigo affecting the face of a young child.

Figure 12.5 Herpes simplex affecting the periocular region.

Figure 12.6 Tinea capitis on a child’s scalp.

Figure 12.7 Kerion on a child’s scalp.

Figure 12.8 Head‐louse eggs on hair shafts.

Figure 12.9 Erysipelas affecting a woman’s cheek.

Figure 12.10 Orf on a finger.

Figure 12.11 Purple‐red nodules of

Mycobacterium marinum

infection.

Figure 12.12 Mycobacterium chelonae infection within a tattoo.

Figure 12.13 Onychomycosis.

Figure 12.14 Cutaneous larva migrans affecting a patient’s toe.

Figure 12.15 (a) Urticarial rash with COVID‐19. (b) Pseudo‐chilblain‐like ch...

Chapter 13

Figure 13.1 Superficial malignant melanoma.

Figure 13.2 Acral malignant melanoma in skin of colour.

Figure 13.3 Asymmetry in colour, shape and edge of a malignant melanoma.

Figure 13.4 The ugly duckling sign.

Figure 13.5 Rodent ulcer.

Figure 13.6 Nodular basal cell carcinoma.

Figure 13.7 Superficial basal cell carcinoma.

Figure 13.8 Morphoeic basal cell carcinoma.

Figure 13.9 Squamous cell carcinoma.

Figure 13.10 Keratoacanthoma.

Figure 13.11 Moon‐crater scar seen in a healed keratoacanthoma.

Figure 13.12 Actinic keratosis.

Figure 13.13 Bowen’s disease.

Figure 13.14 Merkel cell carcinoma.

Figure 13.15 Mycosis fungoides.

Figure 13.16 Sézary syndrome.

Figure 13.17 Diffuse large B‐cell lymphoma.

Chapter 14

Figure 14.1 Futcher’s line on the arm.

Figure 14.2 Hairline in an infant.

Figure 14.3 Hyperpigmentation of the sole.

Figure 14.4 Longitudinal melanonychia.

Figure 14.5 Idiopathic guttate hypomelanosis.

Figure 14.6 (a) Acute severe eczema on the legs. (b) Papular eczema on the s...

Figure 14.7 Psoriasis on the lower legs. (a)

Figure 14.8 Seborrhoeic dermatitis on the scalp.

Figure 14.9 Vitiligo on (a) the face and (b) the neck.

Figure 14.10 (a) Hypertrophic lichen planus on the leg. © Medical Illustrati...

Figure 14.11 Acne with peri‐ and post‐inflammatory hyperpigmentation.

Figure 14.12 Rosacea on (a) the cheek and (b) the forehead.

Figure 14.13 (a) Pigmented basal cell carcinoma.(b) Acral melanoma.

Figure 14.14 Traction alopecia.

Figure 14.15 Central cicatricial centrifugal alopecia.

Figure 14.16 Pseudofolliculitis barbae.

Figure 14.17 (a) Folliculitis keloidalis on the neck; (b) in close‐up. (c) F...

Figure 14.18 (a, b) Keloid on the ear. (c) Keloids on the chest.

Figure 14.19 Melasma on (a) the cheek, (b) the nose and (c) the forehead....

Figure 14.20 Exogenous ochronosis. (a) © Waikato District Health Board. (b)...

Chapter 15

Figure 15.1 The specimen sign: material submitted from a patient with delusi...

Figure 15.2 Nodular prurigo. Note nodules with overlying excoriation and oth...

Figure 15.3 Skin picking syndrome. Note erosions and ulcers with serosanguin...

Figure 15.4 Dermatitis artefacta. Odd‐shaped erosion over the dorsum of the ...

Figure 15.5 Dermatitis artefacta. Oval‐shaped ulcer with surrounding bruisin...

Chapter 16

Figure 16.1 Erythroderma.

Figure 16.2 Erythema multiforme. Note the target‐like skin lesions.

Figure 16.3 Stevens–Johnson syndrome. Note the stomatitis and conjunctival r...

Figure 16.4 Toxic epidermal necrolysis. (a) Note the dusky maculopapular ras...

Figure 16.5 Angio‐oedema. Note the swelling of the lips in individuals with ...

Figure 16.6 Bullous pemphigoid. (a) Note the tense blisters, some of which h...

Figure 16.7 Pemphigus vulgaris. Note the superficial erosions and crusting, ...

Figure 16.8 (a) Cutaneous small vessel vasculitis. (b) Note the purpura, whi...

Chapter 17

Figure 17.1 Approximate number of fingertip units (FTUs) required to treat v...

Chapter 18

Figure 18.1 Corticosteroid side‐effects extend to every body system.

Chapter 19

Figure 19.1 Types of skin biopsy. Finlay AY, Chowdhury MMU.

Specialist Train

...

Figure 19.2 Diagram of the face to show the location of the branches of the ...

Figure 19.3 (a) The surface markings demonstrating the region within which t...

Figure 19.4 Diagram showing Erb’s point and the danger zone for nerve damage...

Figure 19.5 Punch biopsy – stretch the skin (a) at right angles to the inten...

Figure 19.6 Shave biopsy. Inject (a) the local anaesthetic deeply so as not ...

Figure 19.7 Ensuring the skin is stretched firmly facilitates a superficial ...

Figure 19.8 Full‐thickness biopsy through the edge of the tumour. This allow...

Figure 19.9 Note how the excision is designed pre‐operatively to place the s...

Figure 19.10 Ellipse of skin containing a tumour examined using ‘bread‐loaf’...

Figure 19.11 The tumour is debulked by curettage. A thin plate encompassing ...

Figure 19.12 Advancement flap examples (Burow’s and island pedicle flap). (a...

Figure 19.15 Interpolated flap. (a) Significant loss of distal nose after Mo...

Figure 19.16 Full‐thickness skin graft. (a) Large defect of the left frontal...

Figure 19.17 Split‐thickness skin graft. (a) Large occipitoparietal split‐th...

Figure 19.18 Wounds in concave areas may heal very well via granulation. Thi...

Figure 19.19 Cryotherapy. Hold the spray tip (a) 5–10 mm from the skin surfa...

Chapter 20

Figure 20.1 Ulcer healing can be monitored by measuring length and width as ...

Figure 20.2 Handheld Doppler ultrasound examination.

Figure 20.3 Doppler waveforms. (a) Triphasic waveforms. (b) Biphasic wavefor...

Figure 20.4 Varicosities and hyperpigmentation in a patient with venous hype...

Figure 20.5 A selection of currently available compression bandages.

Figure 20.6 Diabetic foot ulceration.

Figure 20.7 Debridement is an essential step in wound management.

Figure 20.8 A selection of currently available topical antibacterial agents....

Figure 20.9 A selection of currently available dressings.

Figure 20.10 Wound dressings used for fragile skin.

Chapter 21

Figure 21.1 A 69‐year‐old US truck driver with extensive asymmetrical wrinkl...

Figure 21.2 Bateman’s purpura on the forearm. Chronic sun damage results in ...

Figure 21.3 Photodamage on the neck. (a) Cutis rhomboidalis nuchae: note yel...

Figure 21.4 Solar lentigines in a Chinese man: pigmentation is more prominen...

Figure 21.5 Chemical peel depths.

Figure 21.6 (a) Clinical appearance of volume deflation with age, and change...

Figure 21.7 (a) Before and (b) after hyaluronic dermal filler injections to ...

Figure 21.8 Before and after botulinum toxin injections to the glabellar reg...

Figure 21.9 Complication of dermal filler injection for augmentation rhinopl...

Chapter 22

Figure 22.1 The components of a laser system. Adapted from Finlay AY, Chowdh...

Figure 22.2 Diagrammatic representation of the absorption spectra of princip...

Figure 22.3 Laser–tissue interactions. Adapted from Finlay AY, Chowdhury MMU...

Chapter 23

Figure 23.1 (a) Positive prick test to latex. (b) Close‐up view of a positiv...

Figure 23.2 Finn Chamber allergens ready to be applied to the back.

Figure 23.3 (a) Patches applied to the patient’s back. (b) One set of 10 all...

Figure 23.4 (a) Positive patch test reactions shown on the back. (b) Positiv...

Figure 23.5 Management of hand dermatitis.

Chapter 24

Figure 24.1 The electromagnetic spectrum, highlighting ultraviolet (UV) radi...

Figure 24.2 Monochromator light testing system.

Figure 24.3 Ultraviolet A provocation.

Figure 24.4 Solar simulator.

Figure 24.5 Photopatch test results with a range of responses.

Figure 24.6 Polymorphic light eruption: (a) papules on the chest, (b) papule...

Figure 24.7 Chronic actinic dermatitis.

Figure 24.8 Solar urticaria photoprovocation: (a) with monochromator light t...

Figure 24.9 Actinic prurigo to (a) the face and (b) the dorsal hands.

Figure 24.10 Xeroderma pigmentosum.

Chapter 25

Figure 25.1 The essentials of photodynamic therapy. 1O2, singlet oxygen; ROS...

Figure 25.2 ‘Porphyrin’ photodynamic therapy – harnessing the haem cycle. AL...

Figure 25.3 Wood’s light examination showing lesion‐specific crimson red flu...

Figure 25.4 Conventional photodynamic therapy with red light‐emitting diode ...

Figure 25.5 Conventional photodynamic therapy (PDT) for superficial basal ce...

Chapter 26

Figure 26.1 Blood vessels (red/blue) filter fluid from plasma into the tissu...

Figure 26.2 A positive Stemmer sign (otherwise known as Kaposi–Stemmer sign)...

Figure 26.3 Milroy disease due to a mutation in the vascular endothelial gro...

Figure 26.4 An extensive lymphatic malformation interrupting the main lymph ...

Figure 26.5 Phlebolymphoedema represents lymphoedema that has developed as a...

Figure 26.6 An abnormal lymphoscintigram characteristic of changes seen with...

Figure 26.7 Papillomatosis and hyperkeratosis of a lymphoedematous lower lim...

Figure 26.8 Lymphangiectasia of the labia on a background of genital lymphoe...

Figure 26.9 Elephantiasis skin changes in a patient with chronic lymphoedema...

Figure 26.10 Lipodermatosclerosis represents an inflammatory change (without...

Chapter 27

Figure 27.1 (a) Anagen hairs have pigmented, distorted bulbs and an attached...

Figure 27.2 Frontal fibrosing alopecia.

Figure 27.3 Dermoscopy of central centrifugal cicatricial alopecia. Arrows p...

Figure 27.4 Female pattern hair loss. The Sinclair photographic classificati...

Figure 27.5 Schematic of the fingernail.

Figure 27.6 Nail psoriasis.

Figure 27.7 Nail dystrophy secondary to lichen planus with evidence of nail ...

Figure 27.8 Benign melanonychia.

Figure 27.9 Nail melanoma.

Chapter 28

Figure 28.1 Development of the male external genitalia.

Figure 28.2 Schematic representation of the normal adult vulva.

Figure 28.3 Diagnostic algorithm for vulval symptoms. VIN, vulval intraepith...

Figure 28.4 Normal surface anatomy of the male genitalia.

Figure 28.5 Cross‐section of the penis.

Figure 28.6 A systematic approach to male genital examination.

Figure 28.7 When to refer and to whom.

Chapter 29

Figure 29.1 A schematic diagram to demonstrate the sites to inspect and anno...

Figure 29.2 Optimal site to biopsy (green circle) in a patient with a suspec...

Figure 29.3 Examples of a single episode of oral ulceration. (a) Secondary s...

Figure 29.4 A minor aphthous ulcer demonstrating a white grey base and periu...

Figure 29.5 Recurrent erythema multiforme affecting the lips with sparing of...

Figure 29.6 Pemphigus vulgaris. (a) Painful irregular erosion on the junctio...

Figure 29.7 Paraneoplastic pemphigus demonstrating panstomatitis with charac...

Figure 29.8 Mucous membrane pemphigoid demonstrating (a) mild gingival redne...

Figure 29.9 Clinical subtypes of oral lichen planus (LP). (a) Combined retic...

Figure 29.10 The management of oral lichen planus. GDP, general dental pract...

Figure 29.11 (a) Generalised desquamative gingivitis in a patient with vulvo...

Figure 29.12 Exfoliative cheilitis showing characteristic peeling, fissuring...

Figure 29.13 Actinic cheilitis. (a) Before treatment: a violaceous hue. Pre...

Figure 29.14 Orofacial granulomatosis. (a) Bilateral soft fluctuating swelli...

Guide

Cover Page

Title Page

Copyright Page

Preface

About the Editors

Foreword

Authors

Acknowledgements

Abbreviations

About the Companion Website

Table of Contents

Begin Reading

Key resources and websites

Specialty Certificate Exam (SCE): questions

Specialty Certificate Exam (SCE): answers

Dermatology training and Capabilities in Practice

Index

Wiley End User License Agreement

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Dermatology Training

The Essentials

Edited by

Mahbub M.U. Chowdhury FRCP

Consultant Dermatologist and Honorary Senior LecturerWelsh Institute of DermatologyUniversity Hospital of WalesCardiff, UK

Tamara W. Griffiths FRCP

Consultant Dermatologist and Honorary Senior LecturerDermatology CentreSalford Royal Hospital NHS TrustManchester, UK

Andrew Y. Finlay CBE, FRCP

Professor of DermatologyDivision of Infection and ImmunitySchool of MedicineCardiff UniversityCardiff, UK

This edition first published 2022© 2022 The British Association of Dermatologists.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.

The right of Mahbub M.U. Chowdhury, Tamara W. Griffiths and Andrew Y. Finlay to be identified as the authors of the editorial material in this work has been asserted in accordance with law.

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Library of Congress Cataloging‐in‐Publication Data

Names: Chowdhury, Mahbub M. U., editor. | Griffiths, Tamara W., editor. | Finlay, Andrew Y., editor.Title: Dermatology training : the essentials / edited by Mahbub M.U. Chowdhury, Tamara W. Griffiths, Andrew Y. Finlay.Description: Hoboken, NJ : Wiley‐Blackwell, [2022] | Includes bibliographical references and index.Identifiers: LCCN 2021023722 (print) | LCCN 2021023723 (ebook) | ISBN 9781119715702 (paperback) | ISBN 9781119715719 (adobe pdf) | ISBN 9781119715733 (epub)Subjects: MESH: Skin DiseasesClassification: LCC RL74.2 (print) | LCC RL74.2 (ebook) | NLM WR 140 | DDC 616.50076–dc23LC record available at https://lccn.loc.gov/2021023722LC ebook record available at https://lccn.loc.gov/2021023723

Cover Design: WileyCover Images: Courtesy of Medical Illustration Cardiff and Vale UHB, Aneurin Bevan University Health Board, Dr Saleem Taibjee, and Andrey_Popov/Shutterstock

Preface

There are plenty of excellent reference books to turn to when wanting more facts about a skin disease. This book seeks to meet a different need. At the start of training in dermatology, how does one go about making sense of such a completely new discipline? All those years of training in the broader aspects of internal medicine are essential to build upon, but this book provides an effective framework that lays down the fundamentals required to rapidly upskill and work effectively in a demanding dermatology training post.

As an introductory training textbook, it is key reading for the novice in dermatology. The contributors are actively engaged in dermatology education as trainers or trainees. This combination of experience and current insight into what a new trainee really needs to know gives the pages direct relevance to many aspects of a trainee’s day. The book is packed with practical tips including, for example, how to handle common clinical situations, how to develop leadership skills, how to begin to get into research and how to gain surgical experience. It also provides insights into future directions for many aspects of our specialty, which aim to stimulate and inspire.

Key topics from the 2021 UK dermatology training curriculum are introduced in the 29 chapters. There is particular reference to the new assessment tool, Capabilities in Practice (CiPs), which evaluates the trainee’s ability to deliver and perform in the workplace. Read early in training, the chapters will provide a sound foundation on which to build further knowledge and map training progression. Specialty Certificate Exam (SCE) questions aligned to each chapter are included as a separate section to be used as a learning tool and to assist exam preparation.

The sequence of chapters within the specific book sections attempts to mirror how a trainee would ideally wish to progress their own development. They will need to gain professional skills, learn the essentials for effective clinical practice, and expand general and emergency dermatology knowledge. Introduction to subspecialty elements may spark interest for consideration of further training in a post‐CCT fellowship approved by the British Association of Dermatologists (BAD).

It is vital that we all acknowledge the importance of diversity and increase our understanding of issues relevant to skin of colour, in order to optimise the care of all patients without bias, whatever background and culture. In addition to a chapter dedicated to skin of colour, we have throughout the book integrated images of disease presentations in various skin types, and incorporated relevant issues relating to skin diversity within the text.

As well as being of interest to trainee dermatologists, we hope that this book will be of help to specialist dermatology nurses, to general practitioners wanting to develop their practical understanding of the subject, and to medical students or junior doctors considering the possibility of dermatology as a career. It also aims to become the ‘go‐to’ quick reference for educational supervisors to ensure that dermatology trainees experience and complete the entire curriculum. The book may help to identify training gaps when planning future rotations, study leave or assessments.

This essential introductory training textbook, commissioned and developed by the BAD, showcases the high standard of UK postgraduate dermatology education. The 2021 training curriculum, coupled with the BAD syllabus guidance, implements pioneering educational tools to deliver the entire breadth and depth of our expanding specialty utilising evidence‐based methodology.

Finally, we hope this book will contribute significantly to enhancing knowledge and skills underpinned by professional values and behaviours to ensure a well‐rounded, balanced clinician with expertise in skin health and disease.

We would welcome any constructive feedback and corrections for future editions.

Mahbub M.U. Chowdhury

Tamara W. Griffiths

Andrew Y. Finlay

August 2021

About the Editors

Dr Mahbub M.U. Chowdhury, MBChB, FRCP, FAcadMEd

Dr Chowdhury is Consultant Dermatologist at the Welsh Institute of Dermatology, University Hospital of Wales, Cardiff, and Honorary Senior Lecturer at Cardiff University.

He became President‐elect of the British Association of Dermatologists (BAD) in July 2021, which will lead to the role of President in July 2022. As previous Academic Vice‐President, he chaired the Education Subcommittee to update the new pre‐CCT trainee syllabus implemented in August 2021.

He is Clinical Lead for Dermatology e‐learning for Health and oversees 160 e‐modules, which map to the new curriculum. He was Chair of the SCE Exam Board and Welsh Training Programme Director for 10 years. He has published over 110 papers and is co‐author of the undergraduate textbook Dermatology at a Glance and Associate Editor for the 10th edition of Rook’s Textbook of Dermatology.

His current interests include cutaneous allergy, and medical management and leadership. He has trained over 20 specialty registrars and supervised the first completed post‐CCT cutaneous allergy fellow in the UK.

Dr Tamara W. Griffiths, BA, MD, FRCP, FAAD

Dr Tamara Griffiths is Consultant Dermatologist at the Dermatology Centre, Salford Royal Hospital NHS Trust, and Honorary Senior Lecturer at the University of Manchester.

In 2015, she was appointed Chair of the Royal College of Physicians’ Dermatology Specialist Advisory Committee, responsible for all aspects of postgraduate dermatology training in the UK, including development and implementation of the 2021 curriculum. She was simultaneously elected as inaugural Director of the BAD Education Board, now recognised as the British College of Dermatology.

In addition to education, Dr Griffiths has a specialist interest in cosmetic dermatology. She was advisor to the Department of Health’s Review of the Regulation of Cosmetic Interventions (2013) and Health Education England’s curricula for non‐surgical cosmetic interventions (2015). She is Medical Programme Director of the MSc in Skin Ageing at the University of Manchester, and Associate Editor for the 10th Edition of Rook’s Textbook of Dermatology. Due to her commitment to education, training and standards, in 2021 she was named BAD Clinician of the Year.

Professor Andrew Y. Finlay, CBE, MBBS, FRCP

As Professor of Dermatology at Cardiff University, Andrew Finlay created the successful international distance learning Diploma in Practical Dermatology. He co‐authored the undergraduate textbook Dermatology at a Glance and has led dermatology training and education in Wales.

Andrew Finlay has held the positions of Director of Postgraduate Courses in the School of Medicine, Cardiff University and Chair of the RCP Specialist Advisory Committee for UK dermatology training, and was the UK representative on the European Union of Medical Specialists, with responsibility for dermatology training in Europe.

He has pioneered the use of quality‐of‐life measures in dermatology across the world, including creating the Dermatology Life Quality Index and other patient and family instruments. He has over 400 publications, and many of these have contributed to dermatologists and researchers being more focused on what really matters to patients.

Previously, he served as President of the BAD, and was awarded the prestigious Sir Archibald Gray Medal in 2020.

Foreword

The British Association of Dermatologists (BAD) is a charity whose vision is ‘Healthy Skin for All’. To enable this, we strive to support and strengthen the education and training of all those involved in skin healthcare provision. For those starting a dermatology journey, Dermatology Training: The Essentials is the perfect first step.

Dermatology is very different from other medical specialties, as it not only covers adult medicine but also includes paediatrics, dermatopathology and skin surgery. There is a whole raft of new disciplines, treatments and terminologies that you may never have come across before. This book will support you in that initial steep learning curve and hopefully give you confidence and make you feel less overwhelmed!

Although it is relevant to all healthcare practitioners interested in dermatology, the book has been written to support the 2021 UK Dermatology Curriculum for specialist registrars. There are no other dermatology texts that achieve this, and the Editors, with their wealth of experience in education and training in dermatology, have more than met the brief. The 29 chapters, authored by renowned experts, cover the essential topics to support the first two years of training, with a ‘how to’ approach that is mapped to the new curriculum. There are also new Specialty Certificate Exam (SCE) style questions accompanying each topic.

The range of topics cover the essential building blocks and this will help produce a rounded, holistic training experience in dermatology. There are more than 4000 diagnoses in dermatology that affect the skin, hair, nails and mucosal surfaces, and all the common conditions are covered. Skin of colour has been embedded within the text, as well as in a standalone chapter, to ensure that all people with skin disease are represented equally. Practical information is covered, including advice on how to run a clinic, take a history, write a prescription, measure disease outcomes and take consent. The chapter on skin surgery is written for the novice, with advice on basic techniques, local anaesthesia, suturing and much more. Research is central to our specialty and the authors emphasise this with practical information on how to get involved and how to overcome the hurdles. At the end of each chapter there are ‘pearls and pitfalls’ offering excellent, practical top tips from experts. Throughout the book there are useful resource links for deeper learning.

Dermatology Training: The Essentials