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The article presents the summaries of papers on dermatology presented at the main plenary sessions. The National Health Service (NHS) Plan 2000 proposed the development of specialist general practitioners (GPs) to take referrals from other GPs in specialties including dermatology. The NHS Modernization Agency Action on Dermatology program funded pilot site studies of dermatology GPwSI, services and preliminary results were encouraging. By the end of 2005, all referrals from primary care will be performed electronically using a referral template. Currently only a proportion of referrals are electronic, allowing comparison with established paper referrals.

The article presents the summaries of papers related to dermatological surgery. The reported frequencies of dermatological malignancies in Great Britain population suggests an incidence of 125 basal cell carcinomas, 27 squamous cell carcinomas and 7 malignant melanomas per 100 000. Another study reports that the number of patients attending the researchers' melanoma screening clinic since its inception in 1997 has increased fourfold. This is in contrast to the number of melanomas diagnosed, which has remained constant. During that time, 15000 patients have attended and 500 melanomas have been diagnosed; 18 melanomas have been missed.

The article presents the summaries of papers related to paediatric dermatology. Atopic dermatitis (AD) accounts for at least 15% of referrals to secondary care dermatology, often requiring multiple visits and occupying much valuable time and resources. The researchers audited the usefulness of two quality-of-life measures, the Infants Dermatitis Quality of Life index (IDQOL) and Dermatitis Family Impact (DFI), which are easy to use in a routine clinical setting. A retrospective study on allergic contact dermatitis in children was conducted in Great Britain. 503 children were identified who had undergone patch testing consecutively in the reserchers' department between the years 1995 and 2004. This represents the largest study of children who have undergone patch testing in Great Britain.

The article presents summaries related to studies in dermatology in Great Britain. Medical students from the country conducted a survey to evaluate final year medical students' experience of dermatology. Another study conducted a retrospective review on the use of azathioprine in a childhood population over an 8-year period. Furthermore, a retrospective study on all skin surgical specimens processed by the teaching hospital hispathology department for 3-month period is conducted.

The article presents research summaries related to clinicopathological cases in Great Britain. In one of the studies, it presented a patient having deeply pigmented Eccrine porocarcinoma (EP) which occurs at a site of previous radiotherapy. Another study presents the case of patient whose diagnosis is mycosis fungoides several years after a successful treatment of chronic myeloid leukaemia. Moreover, the case of cholesterol embolization syndrome presented as lobular panniculitis is cited.

The article presents summaries regarding the symposium of registrars. One of the symposiums aimed in identifying the departments concerned in the management of skin lesions, the accurateness of the clinical diagnosis, and the appropriateness of the treatment. Another is an audit which aims to look at the number of sentinel lymph node biopsy (SLNB) in the management of melanoma in Great Britain. Moreover, a retrospective analysis on toxic epidermal necrolysis is presented.

The article presents research summaries related to dermatological surgery in Great Britain. It includes an evaluation among doctors if they informed their patients on their level of training in skin surgery before performing a practical procedure. In another study, pulsed dye laser treatment has been depicted to have a low incidence of adverse events. Moreover, a case series on the results of treatment for hidradenitis suppurativa having carbon dioxide laser is presented.

The article presents research summaries related to dermatitis in Great Britain. According to a study, it has found out that the new fungicide could be the allergen responsible for sofa dermatitis. Another study examines the use of hair dye and the frequency and nature of reported adverse reactions and the risk factors. Furthermore, a study stresses the need for education of all users of epoxy resins in regard to the skin hazard in the workplace and using proper protective equipment.

The article presents research summaries related to dermatopathology in Great Britain. In one of the studies, it aims to increase the awareness of prototheca wickerhamii which causes neutropenic sepsis after a chemotherapy. Another study reports a case of histiocyctic sarcoma having secondary skin involvement and a presumed primary in the lung. Furthermore, a case report on symplastic haemangioma which is developing on a background of chronic leg ulcer is given.

The article presents several summaries related to health studies in the Great Britain. It has been proven that there is growing risk of skin cancer with the use of artificial tanning devices. On the hand, the prevalence of and characteristic of polymorphic light eruption (PLE) in a larger cohort of the healthy British population has been assessed. Moreover, a case report concerning solar urticaria with a carrier state for erythropoietic protoporphyria is presented.

Presents the subject index for the December 1, 1995 issue of "British Journal of Dermatology."

Presents an abstract of the research paper 'Pruritus Vulvae–Allergic Contact Dermatitis to Textile Dyes and Toilet Roll Paper,' by I.C. Hay, A.D. Ormerod and M.I. White presented at the annual meeting of the British Contact Dermatitis Group in Great Britain.

The article discusses the summaries of topic headings discusses in July 1985 issue of the "British Journal of Dermatology." In the article "The U.K. erythropoietic protoporphyria register: a progress report," a national register was set up in 1979 to establish the prevalence and natural history of erythropoietic protoporphyria (EPP). Detailed information on EPP patients has been received from dermatologists throughout the U.K. Three hundred and eighty-two patients with confirmed EPP have been identified including two patients in clinical remission and in latent cases. A further 83 biochemically unconfirmed cases have been found from family studies.

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'Facial Dermatitis: An Evaluation of the Final Diagnoses and Role of Prick Testing in 209 Patch Test Patients,' by N.M. Stone and S.M. Powell; 'Dermatitis Affecting Abdominal Stomas: How Much is Allergic?,' by C.C. Lyon, M. Bruze and M.H. Beck.

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'A Systematic Review of Antistreptococcal Interventions for Guttate and Chronic Plaque Psoriais,' by C.M. Owen, R.J.G. Chalmers, T. O'Sullivan and C.E.M. Griffiths; 'Fixed Drug Eruptions in the U.K.—An Ever-Changing Scene,' by J.A. Savin.

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'What is the Incidence of Lichen Sclerosus?,' by J. Powell, F. Wojnarowska, K. Hollowood and M. Vessey; 'Genital Carriage of Human Papiloma Virus (HPV) in Prepubertal Girls With and Without Vulval Disease,' by J. Powell, J. Gray and E. Ewojnarowska.

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'Pulsed Tunable Dye Laser Treatment of Generalized Essential Telangiectasia,' by Y.A.I. Beshir and S.W. Lanigan; 'Efficacy of Pulsed Dye Laser (PDL) Treatment of Port Wine Stain (PWS) Malformations on the Upper Limb,' by J.C. Avenscroft, R. Mahendran and R. Sheehan-Dare.

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'A Survey of Childhood Malignant Melanoma in the East of Scotland,' by B.D. De Silva and V.R. Doherty; 'Earliest Clinical Features of Childhood Haemangiomas,' by K. Batta, H. Goodyear, R. Waters and C. Moss.

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'Pyoderma Gangrenosum, Bronchial Carcinoma and Tacrolimus,' by C.C. Lyon, C.E.M. Griffiths and M.M. Beck; 'Birt Hogg Dubé Syndrome and Multiple Pilar Cysts,' by S. Laube and M. Ali.

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'Occupational Contact Dermatitis Has an Appreciable Impact on Quality of Life,' by C.V. Hutchings, K.W. Shum and D.J. Gawkrodger; 'Photopatch Test Methodology— A Reassessment,' by B. Pollock and M. Wilkinson.

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'A New Formulation TiO[sub 2] and ZnO[sub 2] Cream: Visible Wavelength Photoprotection,' by H. Cameron, C. Clark, T. McLeod, H. Moseley and J. Ferguson; 'The Treatment of Vitiligo With Topical Khellin and Solar Radiation,' by J.T. Milne, G. Todd and L. Godggryp.

Eczema is a common skin condition that affects around one in five children and one in ten adults. Qualitative research uses methods such as interviews to find out people's views and experiences. Pulling together the findings of qualitative research studies can make it easier to understand what lots of people commonly think about conditions like eczema and what they find easy or difficult about using treatments. This can help researchers find effective ways to support people managing conditions like eczema. This study, from the UK, aimed to pull together all available qualitative studies on the views and experiences of eczema and eczema treatments from people with eczema and parents or carers of children with eczema. We searched four online databases containing lists of research papers from academic journals covering medicine, nursing, healthcare and psychology. We found 39 research papers from 13 different countries. We used an analytical technique called thematic synthesis to pull together the findings of these studies. Our paper highlights four themes. (1) Eczema is not always viewed as a long‐term condition. People may unrealistically seek a 'cure' or not appreciate the need for long‐term treatment. (2) People with eczema and their carers find it frustrating that eczema is often seen by others as mundane, even though it can have a huge impact on daily life. (3) Hesitancy or concerns about eczema treatments made the condition more difficult to manage. (4) People often felt they received conflicting or insufficient information and advice about eczema treatments. Doctors could help people with eczema and their carers by addressing their concerns and understandings about treatment, acknowledging the impacts of eczema, and providing clear and consistent advice and information. Linked Article: Teasdale et al. Br J Dermatol 2021; 184:627–637. Linked Article: Teasdale et al. Br J Dermatol 2021; 184:627–637. [ABSTRACT FROM AUTHOR]

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'Preliminary Report on the Skin of Ancient European Mummies From the Silk Road in China,' by K. Liddell and L.J. Liddell; 'Hippocrates of Cos— The First Dermatologist 9460–370 BC),' by L. Liddell.

Presents several abstracts related to dermatology presented during the annual meeting of British Association of Dermatologists in Great Britain. 'Early Diagnosis of Netherton's Syndrome: A Clinical and Molecular Genetic Study,' by A.D. Irvine, S. Chavanas, M. Malone, A. Hovnanian and J.I. Harper; 'The Melanocortin 1 Receptor Gene Determines Cutaneous Prototype in Individuals Without Red Hair,' by N. Flanagan, E. Healy, A.J. Ray, C. Todd, J.N.S. Matthews, M.A. Birch-Machin and J.L. Rees.

The article presents abstracts of medical research. They include ""Dyeing" to be beautiful: a historical review of artificial hair colouring and its consequences," by A. M. Skellett, N.K. Webber and N. J. Levell and "Why did Britain's early skin hospital develop? The example of the Blackfriars Skin Hospital," by H. J. M. Malhomme de la Roche and A. S. J. Barkley.

Presents an index of authors for the December 1, 1995 issue of "British Journal of Dermatology."

Linked Article: Sarkany et al. Br J Dermatol 2022; 186:713–720. Xeroderma pigmentosum (XP) is a genetic disease in which the system that repairs damage caused by ultraviolet (UV) radiation (which mainly comes from the sun) is faulty. Patients with XP develop eye and skin cancers from childhood and usually die in early adulthood. The main means of preventing the cancers and increasing lifespan is extreme protection against the UV found in daylight, particularly for the face, which is where the cancers mostly occur. Not enough is known about how well patients with XP protect against UV radiation. In this paper, with authors from the UK, the Netherlands and Denmark, a new method was used to estimate face exposure in 36 patients with XP over 3 weeks in the summer. The method combines measurements from a wrist‐worn UV detector with an 'activity diary' of what patients did to protect their face when outside. Some patients with XP protected themselves well whereas others did not. The difference between the face UV dose in the best and worst protecting patients was over 100‐fold. Those patients protecting themselves the least from UV exposure had exposure levels similar to healthy adults. Adults and children with XP had similar exposure to UV but achieved it differently. Adults protected less well when outside but went outside less whereas children went outside more but protected better. This variation in UV exposure is important. Poor protection in patients with XP is likely to cause cancers and premature death. As well as being useful in XP, this new method to estimate facial UV exposure may also be useful in other more common diseases, particularly patients at high risk of basal and squamous cell carcinomas, which are mostly caused by UV and mainly affect the face. Linked Article: Sarkany et al. Br J Dermatol 2022; 186:713–720. [ABSTRACT FROM AUTHOR]

The human body is built up of millions of cells that together function as tissues and organs. Desmosomes are tiny structures on cell surfaces that enable cells not only to stick to their neighbours but also to communicate with them. Desmosomes in skin cells have been studied in detail partly because this organ is the most easily accessible to researchers. Also, mutations (mistakes) in the genes that code for the various protein components of desmosomes can cause serious life‐long skin problems such as blistering, fragility or excessive skin thickness. Some mutations affect desmosomes in the heart, causing life‐threatening problems such as sudden disturbance in heart rhythm. In this paper, researchers at a major UK dermatology centre review current knowledge of the desmosomal genes, proteins and diseases. Using clear diagrams, they summarize the roles of the three protein superfamilies involved: the cadherins (desmogleins and desmocollins); the armadillo proteins (plakoglobin plakophilin); and the plakin family (desmoplakin). Genetic disorders affecting the skin or mucous membranes (which line and protect, for example, the mouth, stomach and lungs) can be caused by mutations in any one of nine genes (DSG1, DSG3, DSC2, DSC3, JUP, PKP1, DSP, CDSN, PERP); hair disorders can result from mutations in eight genes (DSG4, DSC2, DSC3, JUP, PKP1, DSP, CDSN, PERP); mutations in three genes can cause syndromes affecting skin, hair and heart (DSC2, JUP, DSP) and mutations in five genes can cause heart problems without any abnormality in the skin or hair (DSG2, DSC2, JUP, PKP2, DSP). This knowledge will help dermatologists to advise patients with desmosomal skin and hair disorders. Linked Article: Lee and McGrath. Br J Dermatol 2021; 184:596–605. Linked Article: Lee and McGrath. Br J Dermatol 2021; 184:596–605. [ABSTRACT FROM AUTHOR]

Erosive pustular dermatosis of the scalp (EPDS) is a skin disease that causes non‐healing wounds on the scalp. It may be more common than previously thought, as it can be misdiagnosed. EPDS usually affects older patients with lots of sun damage, and it may also be caused by injury, surgery, or certain treatments used by dermatologists, such as 5‐fluorouracil cream, which is used to treat pre‐cancerous lesions. As there are no guidelines for treating EPDS yet, we are a group of researchers in the U.K. who wanted to find out which treatments work best, by looking at all previously published research. We found that many different treatments have been used for EPDS, with the most common being steroid creams: 91.3% of patients improved completely or partially by using these creams, but they may also develop side effects such as skin thinning if used for too long. Other treatments that have been used include tablet steroids, antibiotics, tacrolimus cream, nonsteroidal drugs, zinc, calcipotriol cream, antifungals, retinoids, photodynamic therapy, dressings, grafts, methotrexate and tofacitinib. Some of these treatments worked better than others, and sometimes they were used in combination. Although the papers we looked at did not give enough information to give definite answers, we think that using a strong steroid cream, followed by tacrolimus cream (and possibly adding a zinc tablet), is the best way to treat EPDS. Photodynamic therapy (a type of treatment where a chemical is put on the skin and then a light is shone on it) also seems to work well. Linked Article: Junejo et al. Br J Dermatol 2021; 184:25–33. Linked Article: Junejo et al. Br J Dermatol 2021; 184:25–33. [ABSTRACT FROM AUTHOR]

This study, by a group based in Nottingham in the UK, is a critical assessment of a systematic review of treatments used for the skin cancer, basal cell carcinoma. The review that triggered this assessment was published in another journal and focused on the use of the immune stimulating cream, imiquimod, compared with other treatments. In the analysis there were 13 studies of more than 4200 patients. The authors of the systematic review concluded that imiquimod cream was better in clearing the tumour (skin cancer), as assessed by histopathology (using a skin biopsy which is examined under the microscope) or a combination of histopathology and visual inspection by an expert doctor. They compared this treatment with other therapies such as surgical excision (removing the cancer by surgery), photodynamic therapy, fluorouracil, and a placebo. The conclusion of the subsequent assessment, now published in the British Journal of Dermatology, was that there were a number of deficiencies in the methods used by the reviewers, which cast doubt on their conclusions. For instance, the review analysed all varieties of basal cell carcinoma together as a single disease, although these behave differently and have different relapse rates after treatment. The reviewers also used information from papers, some of which analysed the same study more than once. There were also concerns that the reviewers had analysed the results of placebo cream even though this is known to have a very low success rate in the treatment of cancers. Finally, the authors of the critical assessment also discovered that the same review had been published twice in different journals and by different authors using the same data and reaching the same conclusions. The original study appears to have sufficient flaws to cast doubt on the results. Linked Article:Olabi et al. Br J Dermatol 2020; 183:650–654. Linked Article:Olabi et al. Br J Dermatol 2020; 183:650–654. [ABSTRACT FROM AUTHOR]

Summary: Primary biliary cholangitis (PBC) is a long‐term disease affecting 35 in every 100,000 people in the United Kingdom (UK) and United States. It is driven by the immune system and causes inflammation of bile ducts (tubes carrying bile from the liver to the gut), leading to bile duct destruction and eventual scarring of the liver. For unclear reasons, PBC causes persistent itch (cholestatic itch) that is difficult to suppress with conventional treatments. Several case studies have shown that phototherapy (treatment of the skin with UV light) can be used to reduce cholestatic itch, although the processes behind this treatment remain poorly understood. This review article, written by researchers in the UK, summarises the evidence behind the use of phototherapy to treat cholestatic itch and explores potential reasons (mechanisms) for how it works. Fifty articles were included in this review, alongside the authors' own expertise. Key theories about potential mechanisms include the effect of phototherapy on bile salt components, enzyme activity and the expression of receptors involved in cholestatic itch pathways. This paper has developed several testable hypotheses (theories) that can be trialled to increase knowledge on this important subject and to aid the development of effective treatments. Linked Article: Hussain et al. Br J Dermatol 2019; 181:1138–1145 [ABSTRACT FROM AUTHOR]

Summary: Skin cancer is increasing in many countries, including in the UK. For example, in the USA in 2017, over 87,000 people had been diagnosed with a dangerous type of skin cancer (melanoma); of these it was expected that nearly 10,000 would die from the condition. We are a U.K based research team that conducted a review of scientific papers from across the world. Our aim was to examine and pool the existing research on whether the different approaches to helping people to examine their own skin, to detect skin cancer early, are effective or not. This review identified all the relevant published articles for available research studies up to April 2018. The identified relevant studies totalled 18 in number, which we then summarised. These approaches included education, such as teaching and reminding people (sometimes using technology, for example, using computers and mobile phones) to examine their skin and quickly report any suspicious changes to their doctor. We found that the various approaches used had a positive effect on peoples' likelihood and ability to examine their skin, especially in the short‐term. More studies targeted people at higher risk of skin cancer, such as those with a previous diagnosis of skin cancer, compared to people at no greater risk. Of the research we looked at, two thirds of the studies were poorly designed. Skin specialists should raise awareness and support people to routinely examine their skin for skin cancer, especially those at high risk. Linked Article: Ersser et al. Br J Dermatol 2019; 180:1339–1347 [ABSTRACT FROM AUTHOR]

The article reports on an informal survey of the state of clinical academic dermatology within Great Britain conducted by manually searching the top four dermatology journals, namely, the "British Journal of Dermatology," the "Journal of Investigative Dermatology," the "Archives of Dermatology," and the "Journal of the American Academy of Dermatology." Number of research papers by country and region of origin for the years 1995 and 2004 were recorded.

Background In 2006 a U.K. government White Paper recommended making NHS care in England more accessible by shifting services from secondary care into community settings. There is a shortage of contemporary activity data for U.K. dermatology units to allow benchmarking for service development. This study will not only provide useful comparative data for the future in Wales, but will also serve to highlight the impact of changes made in England. Objective To provide an overview of 1 week’s dermatology outpatient activity for the whole of Wales. Methods All dermatology units in Wales collected data for 1 week in early 2007. The case mix, appropriateness of referral, requirement for surgery or second-line therapies and follow-up requirements were all determined. Results A total of 2142 patients were seen. Of new patients, 21% had skin cancer. Seventeen per cent of skin cancers had no diagnosis suggested by the general practitioner (GP) and 10% of basal cell carcinomas, 33% of squamous cell carcinomas and 17% of malignant melanomas were inappropriately diagnosed. In all, 26% of new patients had benign lesions, and this group caused the greatest diagnostic difficulty for GPs. Seventy-one per cent of these patients were diagnosed, reassured and discharged at their first visit without the need for biopsy or surgery. Thirty-seven per cent of new patients required surgery, of which 21% required complex intervention. Twenty-six per cent of follow-up patients were receiving second-line therapies. The new to follow-up ratio varied considerably according to diagnosis, the mean ratio being 1 : 0·21 for benign lesions through to 1 : 5·53 for psoriasis. This highlights the inappropriate nature of a ‘one fits all’ ratio. The majority of follow-up patients in secondary care required this level of input for monitoring of cancer, complex second-line therapies or surgery. Conclusions This study provides evidence to support logical planning of dermatological services and to assess the impact of proposed changes on different healthcare systems in the U.K. [ABSTRACT FROM AUTHOR]

Psoralen photochemotherapy [psoralen ultraviolet A (PUVA)] plays an important part in dermatological therapeutics, being an effective and generally safe treatment for psoriasis and other dermatoses. In order to maintain optimal efficacy and safety, guidelines concerning best practice should be available to operators and supervisors. The British Photodermatology Group (BPG) have previously published recommendations on PUVA, including UVA dosimetry and calibration, patient pretreatment assessment, indications and contraindications, and the management of adverse reactions.1 While most current knowledge relates to oral PUVA, the use of topical PUVA regimens is also popular and presents a number of questions peculiar to this modality, including the choice of psoralen, formulation, method of application, optimal timing of treatment, UVA regimens and relative benefits or risks as compared with oral PUVA. Bath PUVA, i.e. generalized immersion, is the most frequently used modality of topical treatment, practised by about 100 centres in the U.K., while other topical preparations tend to be used for localized diseases such as those affecting the hands and feet. This paper is the product of a recent workshop of the BPG and includes guidelines for bath, local immersion and other topical PUVA. These recommendations are based, where possible, on the results of controlled studies, or otherwise on the consensus view on current practice. [ABSTRACT FROM AUTHOR]

This first comprehensive study of atopic eczema management describes an audit of service structure (phase 1), process (phase 2) and outcome (phase 3) in the U.K. This paper describes the phase 1 results. Service structure was audited by a single-page questionnaire containing 10 questions on outpatient facilities. This was sent to the lead dermatologist at 187 dermatology centres throughout the U.K., and a final response rate of 98% was achieved. Although the percentage of centres reporting the presence of recommended facilities did not reach the 100% working standard for any one specific criterion, about half of the recommended items, such as provision of height and weight measuring facilities, access to a dietician, patch testing and photochemotherapy, was reported in over 90% of centres. Areas of service structure which were infrequently reported to be in place were issuing of new appointment letters asking patients to bring their treatment details to clinic (52% of centres) and access to nurses with dermatology experience on paediatric wards (57% of centres). Some audit measures, e.g. access to counselling services, showed wide regional variation (range 33–94% of centres), and these variations could not be explained simply in terms of provision of specialists. Some of the elements of service structure, such as access to nurses with dermatology experience on paediatric wards, may be difficult to change in the short term because of funding and staffing constraints, but others, such as provision of growth charts, are easy to change at little cost. This preliminary audit serves as a framework for future audits of atopic eczema management. [ABSTRACT FROM AUTHOR]

Focuses on papers related dermatology presented in the British Society for Investigative Dermatology Annual Meeting on September 1986 in Great Britain. "Leu 8-positive Cells in Skin and Blood in Patients With Cutaneous Lymphoma," by Marlyn Turbitt, Rosemary Lever, S. Jones, A. Sanderson and Rona MacKie; "T Cell Receptor Gene Analysis in Lymphomatoid Papulosis," by S. J. Whittaker, L. Foroni, R. Russel Jones, N. P. Smith, L. Luzzatto, and A. C. Chu; Dysplastic Epidermal Change in Immunosuppressed Patients With Renal Transplants," by D. Shuttleworth and R. Marks.

Skin cancers are the most common cancers in the UK. Malignant Melanoma (MM) is the most dangerous type of skin cancer. Primary Care Physicians (GPs) often have difficulty in distinguishing harmless skin blemishes from MM, leading to many patients being referred to dermatology departments. There have been enormous advances recently in the application of computer‐based Artificial Intelligence (AI) to the field of image analysis. This paper from four authors in London (UK) explores the current position of AI systems in analysing skin lesions (affected patches of skin). Important AI concepts such as convolutional neural networks (CNN) and "deep learning" are explained. By exposing AI systems to hundreds of thousands of pictures of skin lesions, it is possible to "train" them to recognise lesions with a high degree of accuracy. Skin cancer detection, particularly melanoma detection, has now been tested by numerous different groups with multiple AI systems; the most successful ones are generally "convolutional neural networks". When comparing their performance to dermatologists who are presented with photographs of skin lesions, these AI systems perform similarly, if not better, at identifying whether something is a melanoma or a benign (non‐cancerous) mole. However, these programmes are limited by the data sets on which they have been "trained"; for example, a lot of the datasets are trained on Caucasian skin, and will perform less well when detecting melanoma in skin of colour, as they may not have been exposed to enough of this type of image to perform well. They have also not been shown to be particularly useful for diagnosing other types of skin conditions yet and they are not able to provide any kind of explanation for their classification. Because of these limitations, it is unlikely that they will replace dermatologists. The legal framework for AI systems also doesn't allow them to take responsibility for decisions, so responsibility for diagnosis still falls to a responsible clinician. However, in the near future they may well prove to be extremely useful in aiding GPs in making clinical decisions about skin lesions, particularly with regards to urgent referrals to dermatology. Linked Article: Du-Harpur et al. Br J Dermatol 2020; 183:423–430. Linked Article: Du-Harpur et al. Br J Dermatol 2020; 183:423–430. [ABSTRACT FROM AUTHOR]

The article presents abstracts of various research papers to be presented at annual meeting of Great Britain Psychodermatology Society which includes Patient perceptions of specialist services, importance of taking a multidisciplinary approach to provide combined psychological and pharmacological therapies, and Body dysmorphic disorder experiences from a psychodermatology service.

Background: Vulval lichen sclerosus (VLS) is a chronic inflammatory condition predominantly affecting the anogenital skin. Symptoms can be distressing and affect quality of life and everyday activities. Very little research has been undertaken to explore the experience of living with VLS from the perspective of people with the condition. Objectives: To understand individuals' experiences of VLS and its impact on their lives. Participants and methods: Semi‐structured remote (telephone or video) interviews were conducted with a purposive sample of 20 women living in the UK with VLS recruited via online support groups and social media. Data collection and analysis was informed by social constructionist grounded theory, using a constant comparison method. Results: We developed three themes to interpret the experience of living with VLS: missed opportunities (participants experienced delayed diagnosis, lack of information and disempowering encounters with healthcare professionals); learning to live with a long‐term condition (the amount of work involved in learning how to self‐manage the disease and the impact on everyday life); a secret life (experiences of the condition were often shrouded in secrecy, and there was stigma associated with a vulval skin condition resulting in them feeling isolated and lonely). Conclusions: Patients attending healthcare appointments with vulval complaints should be examined and LS should be considered as a diagnosis. Healthcare professionals' awareness and knowledge of VLS needs to be improved and they should avoid language which is blaming or minimizing of patients' experiences. VLS is a chronic condition and patients need to be supported in self‐management. Support groups may be a source of support and information but can also be challenging when hearing others' difficult experiences. Wider public health educational activities are needed to change societal attitudes towards female genitals and tackle the stigma around vulval conditions. What is already known about this topic?Vulval lichen sclerosus (VLS) can have a profound impact on quality of life and self‐identity but is relatively underexplored from the perspective of those living with the condition. What does this study add?In‐depth findings about the experiences of living with VLS including ongoing issues with timely diagnosis, learning to live with a long‐term condition and the secrecy and stigma about the condition.The needs of women with symptoms of and diagnoses of VLS are not being met sufficiently by the healthcare system. What are the clinical implications of this work?Healthcare professionals should consider addressing knowledge gaps in vulval conditions including VLS to prevent delayed diagnosis and avoid the use of certain terminology which can minimize patients' experiences.Patients with vulval complaints should be examined and LS should be considered as a diagnosis.Regular follow‐up would reflect its chronic nature and could provide patients with reassurance and confidence in self‐management.Wider public health activities are needed to change societal attitudes and tackle stigma around vulval conditions. [ABSTRACT FROM AUTHOR]

The article discusses the meetings of Dermatology related associations in Great Britain. One of them includes the third meeting of Great Britain Psychodermatology Special Interest Group which took place at the Medical Society of London on January 27, 2005. Many dermatologists, psychiatrists and psychologists attended it. Professor Christopher Griffiths from The Hope Hospital, Manchester, England, opened with a talk on 'The Brain-Skin Axis in Psoriasis'. Richard Staughton, a Dermatologist introduced the topic, 'The Psychodermatology of Hair.' Other meeting focuses on the 1st Congress of the International Dermoscopy Society Naples, Italy, which organizes a meeting on April 6, 2006 designed for all colleagues interested in the diagnosis and management of pigmented skin lesions.

Reports on activities in the field of dermatology in Great Britain, as of December 2002. Information on the 12th Meeting of the British Epidemdermo-Epidemiology Society on March 6, 2003 in Nottingham, England; Information on the 2003 Niels Hjorth Prize which will be given to experimentally or clinically orientated research papers on dermatology.

Offers dermatology-related news briefs as of March 2004. Teaching Dermatology course relevant to dermatologists involved with undergraduate teaching or post-graduate training in Great Britain; Second annual meeting of the Facial and Aesthetic Conference and Exhibition in London, England; Opening of the competition for the Maison G. de Navarre Young Scientist Prize, a prize granted to cosmetic scientist to attend the International Federation of the Society of Cosmetic Chemists Congress in Orlando, Florida.

Summary: Psoriasis is a skin condition that causes a scaly, red rash which can vary from affecting only small areas of the body, such as the elbows and knees, to affecting a larger area of the body. It affects approximately 2% of people in the U.K. There are many treatments for psoriasis, including creams, tablets and injections. The injections are known as biologics and these target specific parts of the immune system that can be very active in psoriasis. The authors of this paper, based in the U.K., aimed to assess the quality of two trials (called UltIMMa‐1 and UltIMMa‐2) that compared two of these biologics, risankizumab and ustekinumab. These trials included patients from 14 countries, and showed that risankzizumab is more effective than ustekinumab for treating patients with moderate or severe psoriasis. The authors found that these trials were well‐conducted because they recruited a large number of patients and the methods used were sound and clearly reported. They analysed the data in a way which is conservative and doesn't over‐estimate the effect of the new treatment, risankizumab. One criticism of the trials is that it could be difficult to apply the results to some groups of patients in the clinical setting (i.e. in real life treatment rather than in a trial). For example, it's not clear whether patients who have failed tablet or some other injection treatments would respond differently from those who have never had such treatments. Additionally, some patients with other illnesses were excluded from the study, though it was not specified which illnesses lead to exclusion. The authors conclude that this study does clearly demonstrate that risankizumab is more effective than ustekinumab, though more work needs to be done to identify why this is the case. Linked Article: Al‐Janabi et al. Br J Dermatol 2019; 180:1348–1351 [ABSTRACT FROM AUTHOR]

Presents an abstract of the research paper 'Clinical Features of Subungual Myxoid Cysts,' by D.A.R. de Berker and R. Baran presented at the annual meeting of the British Society for Dermatological Surgery in Great Britain.

Presents an abstract of the research paper 'Is the Pulsed Dye Laser and Effective for Treatment of Port-Wine Stains in Pigmented Skin?,' by S. Sommer and R. Sheehan-Dare presented at the annual meeting of the British Society for Dermatological Surgery in Great Britain.

Presents an abstract of the research paper 'Severe Contact Allergy to Footwear Responding to Hand-Made Shoes,' by A.M.R. Downs and J.E. Sansom presented at the annual meeting of the British Contact Dermatitis Group in Great Britain.

Summary: Background: There is a lack of population‐based information on the disease burden and management of alopecia areata (AA). Objectives: To describe the epidemiology of AA, focusing on incidence, demographics and patterns of healthcare utilization. Methods: Population‐based cohort study of 4·16 million adults and children, using UK electronic primary care records from the Oxford‐Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network database, 2009–2018. The incidence and point prevalence of AA were estimated. Variation in AA incidence by age, sex, deprivation, geographical distribution and ethnicity was examined. Patterns of healthcare utilization were evaluated in people with incident AA. Results: The AA incidence rate was 0·26 per 1000 person‐years. AA point prevalence in 2018 was 0·58% in adults. AA onset peaked at age 25–29 years for both sexes, although the peak was broader in females. People of nonwhite ethnicity were more likely to present with AA, especially those of Asian ethnicity [incidence rate ratio (IRR) 3·32 (95% confidence interval 3·11–3·55)]. Higher AA incidence was associated with social deprivation [IRR most vs. least deprived quintile 1·47 (1·37–1·59)] and urban living [IRR 1·23 (1·14–1·32)]. People of higher social deprivation were less likely to be referred for specialist dermatology review. Conclusions: By providing the first large‐scale estimates of the incidence and point prevalence of AA, our study helps to understand the burden of AA on the population. Understanding the variation in AA onset between different population groups may give insight into the pathogenesis of AA and its management. Whatis already known about this topic?Alopecia areata (AA) is a common cause of nonscarring hair loss associated with psychological morbidity.Large‐scale population‐based information on the disease burden and clinical management of AA is lacking. Whatdoes this study add?In the largest population‐based study of AA to date, comprising 4·16 million people, we estimate that new‐onset AA peaks at age 25–29 years.People of Asian ethnicity, and from socially deprived and urban areas, are more likely to present with AA.After diagnosis, one in four people with AA are referred for specialist dermatology review. Specialist referral rates are lower in people from more socially deprived areas. Linked Comment: R. Sinclair. Br J Dermatol 2022; 186:206–207. Plain language summary available online [ABSTRACT FROM AUTHOR]

In this article the author discusses the use of touch screen video technology for informed consent, particularly in diagnostic biopsies, procedures or complex treatment in Great Britain. He cites the paper of A. W. Armstrong and colleagues published within the journal, which show increased knowledge of shave or punch biopsies and postoperative care by use of portable video technology. He stress that video education preconsent may become the gold standard in the near future.

Background Nonmelanoma skin cancer (NMSC) is the most common cancer affecting white-skinned individuals and the incidence is increasing worldwide. Objectives This systematic review brings together 75 studies conducted over the past half century to look at geographical variations and trends worldwide in NMSC, and specifically incidence data are compared with recent U.K. cancer registry data. Methods Following the development of a comprehensive search strategy, an assessment tool was adapted to look at the methodological quality of the eligible studies. Results Most of the studies focused on white populations in Europe, the U.S.A. and Australia; however, limited data were available for other skin types in regions such as Africa. Worldwide the incidence for NMSC varies widely with the highest rates in Australia [> 1000/100 000 person-years for basal cell carcinoma (BCC)] and the lowest rates in parts of Africa (< 1/100 000 person-years for BCC). The average incidence rates in England were 76·21/100 000 person-years and 22·65/100 000 person-years for BCC and squamous cell carcinoma (SCC), respectively, with highest rates in the South-West of England (121·29/100 000 person-years for BCC and 33·02/100 000 person-years for SCC) and lowest rates by far in London (0·24/100 000 person-years for BCC and 14·98/100 000 person-years for SCC). The incidence rates in the U.K. appear to be increasing at a greater rate when compared with the rest of Europe. Conclusions NMSC is an increasing problem for health care services worldwide. This review highlights a requirement for prevention studies in this area and the issues surrounding incomplete NMSC registration. Registration standards of NMSC should be improved to the level of other invasive disease. [ABSTRACT FROM AUTHOR]