Clare P Tait

Pilot study of store and forward teledermatology services in Perth, Western Australia.

In remote areas, telemedicine services can improve the quality of access to specialist medical care and dermatology is well suited to the use of this technology. There is no published work on teledermatology services in Australia. Our purpose was to investigate the reliability of dermatological diagnoses obtained using a store and forward telemedicine system, which is being developed to offer specialist consultative services to patients in remote areas of Western Australia. We report on a small prospective non‐randomized pilot study conducted at Royal Perth Hospital, Western Australia which compared diagnoses reached following telemedicine consultations with diagnoses reached following traditional face‐to‐face consultations. In 25 out of 30 consultations, identical diagnoses were reached. In the remaining five cases, the preferred diagnosis and first differential diagnosis were reversed in order of preference. We feel this system is sufficiently promising to trial more extensively in the field.

Brachioradial pruritus and cervical spine manipulation

Brachioradial pruritus (BRP) causes significant morbidity in the majority of patients for whom no effective treatment is found. Chronic ultraviolet radiation exposure has usually been cited as the cause, but nerve damage from cervical spine disease has also been implicated. We report on a small retrospective exploratory study, conducted by questionnaire, of a group of patients who were treated with a specific cervical spine manipulation. Ten of 14 patients reported resolution of symptoms following manipulative treatment. All six patients who had had previous cervical spine disease responded to manipulation, as did half the remaining eight patients who had no previous history of neck symptoms. Although patients with BRP, by definition, share similar symptoms, the aetiology is almost certainly multifactorial. Prospective studies looking for cervical spine disease, as well as assessment of this particular method of cervical spine manipulation as a treatment modality for BRP, should be considered.

Impact on the dermatology educational experience of medical students with the introduction of online teaching support modules to help address the reduction in clinical teaching

Background/Objectives:  With increasing medical student numbers and decreasing clinical teaching opportunities, there has been a need to develop alternative learning resources. The aim of this study was to examine the effectiveness of a new dermatology online teaching resource, from a student perspective.

Use of infliximab in pyoderma gangrenosum

A 57‐year‐old man, with a 2‐year history of Crohns disease, presented with a rapidly progressive abdominal ulcer. It was clinically and histologically consistent with pyoderma gangrenosum but it did not respond to either high‐dose oral prednisolone or intravenous hydrocortisone. Infliximab resulted in an early, dramatic and sustained improvement. His bowel symptoms, which flared a few weeks prior to the onset of pyoderma gangrenosum, only partially improved. Despite six infliximab infusions, the inflammatory bowel disease is poorly controlled, whereas the pyoderma gangrenosum remains healed.

Impact on dermatological educational experience of medical students with the introduction of online teaching support modules to help address the reduction in clinical teaching

Background/Objectives:  With increasing medical student numbers and decreasing clinical teaching opportunities, there has been a need to develop alternative learning resources. The aim of this study was to examine the effectiveness of a new dermatology online teaching resource, from a student perspective.

Non-antibiotic properties of tetracyclines and their clinical application in dermatology

Dermatologists have used tetracyclines since the 1950s to treat disorders that do not necessarily have an infectious aetiology. Their anti‐inflammatory and anti‐collagenase properties contribute significantly to their success in treating diseases such as rosacea and acne. This article reviews the non‐antibiotic properties of tetracyclines and their clinical application in dermatology.

Sclerosing lipogranuloma of the penis.

We present a case of sclerosing lipogranuloma of the penis in a 25‐year‐old man of Burmese origin complicating injection of an unknown non‐biodegradable oily foreign material into his external genitalia. Despite frequent complications, penile augmentation with exogenous paraffin material is still practised in some parts of the world. Sclerosing lipogranuloma is a rare condition in Australia that dermatologists need to consider in the differential of a genital ulcer or indurated penile mass, particularly in young men from South‐East Asia. A causal relationship between the procedure and adverse events may not be made because complications are frequently delayed for many years. A high degree of clinical suspicion and a skin biopsy is essential, as a history of injection may not be disclosed.

Tanning bed and nail lamp use and the risk of cutaneous malignancy: A review of the literature

Malignant melanoma (MM) and non‐melanoma skin cancer (NMSC) are increasingly common and both can be fatal. In 2009 the World Health Organization (WHO) classified the whole ultraviolet spectrum and tanning beds as carcinogenic to humans, placing them in the same category as asbestos and tobacco. Despite this, the trend for indoor tanning continues. A growing body of evidence has now associated indoor tanning with an increased risk of MM and NMSC. As a result, there has been an upsurge in regulations in the tanning industry ranging from age restrictions to complete bans on commercial tanning. This article examines the evidence and strengthens the case for a complete ban of a recognised modifiable risk factor for cutaneous malignancy.

Sjögren's syndrome and granulomatous panniculitis.

An 83‐year‐old Cambodian woman presented with multiple painful erythematous nodules on the lower legs, forearms and wrists. Subsequent history and investigations revealed a granulomatous lobular panniculitis associated with Sjögren’s syndrome. This is a rare cutaneous association of Sjögrens syndrome with only three similar case reports in the literature.

Mycophenolic acid in dermatology a century after its discovery.

Mycophenolic acid was first discovered in 1913 and first used clinically in the 1970s as an immunosuppressant to prevent organ transplantation rejection. It was later used in the treatment of psoriasis. However due to its side‐effect profile and fears over its carcinogenic potential it was abandoned. From the late 1990s a prodrug, mycophenolate mofetil (MMF), was developed and more recently, enteric‐coated mycophenolate sodium (EC‐MPS), both of which have gained increasing use in the field of dermatology for a variety of skin conditions. This review discusses the pharmacology, mechanisms of action, side‐effects and current clinical applications in dermatology of MMF and EC‐MPS.