Pub Date : 2025-07-08DOI: 10.1016/j.mpmed.2025.05.007
Sarah H Wakelin
Benign skin lesions are one of the most common reasons for a dermatology consultation. They can be congenital or acquired at any age from infancy to late in life, and can be classified according to the cell of origin. Numerous histopathological entities exist, the most common including benign melanocytic naevi (moles), lentigines, seborrhoeic keratoses, epidermoid cysts, skin tags, dermatofibromas and haemangiomas. Careful examination and dermoscopy allow a confident diagnosis in most cases. Rarely, benign lesions are associated with genetic syndromes that predispose to internal malignancy, so-called hereditary cancer predisposition syndromes.
{"title":"Benign skin lesions","authors":"Sarah H Wakelin","doi":"10.1016/j.mpmed.2025.05.007","DOIUrl":"10.1016/j.mpmed.2025.05.007","url":null,"abstract":"<div><div>Benign skin lesions are one of the most common reasons for a dermatology consultation. They can be congenital or acquired at any age from infancy to late in life, and can be classified according to the cell of origin. Numerous histopathological entities exist, the most common including benign melanocytic naevi (moles), lentigines, seborrhoeic keratoses, epidermoid cysts, skin tags, dermatofibromas and haemangiomas. Careful examination and dermoscopy allow a confident diagnosis in most cases. Rarely, benign lesions are associated with genetic syndromes that predispose to internal malignancy, so-called hereditary cancer predisposition syndromes.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 8","pages":"Pages 533-537"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-30DOI: 10.1016/j.mpmed.2025.05.011
Mishal Iqbal, Cher-Han Tan
Erythroderma is a condition characterized by widespread erythema involving >90% of the body surface area. It is usually acute, but may be chronic. It a potentially life-threatening condition and can lead to complications. Damaged skin barrier function, immune dysregulation and genetic and environmental factors play a key role in the development of this condition. Skin conditions including eczema and psoriasis, drug eruptions and haematological malignancies are the main causes of erythroderma, with genetic conditions contributing to rarer causes. Early recognition with systematic history taking and examination is key, and prompt initiation of treatment is vital to prevent systemic complications such as organ failure. Management is largely targeted at the underlying cause. By understanding and recognizing the causes, course and implications of erythroderma, healthcare professionals can better support affected individuals and improve patient outcomes via a multidisciplinary team approach.
{"title":"Erythroderma and acute skin failure","authors":"Mishal Iqbal, Cher-Han Tan","doi":"10.1016/j.mpmed.2025.05.011","DOIUrl":"10.1016/j.mpmed.2025.05.011","url":null,"abstract":"<div><div>Erythroderma is a condition characterized by widespread erythema involving >90% of the body surface area. It is usually acute, but may be chronic. It a potentially life-threatening condition and can lead to complications. Damaged skin barrier function, immune dysregulation and genetic and environmental factors play a key role in the development of this condition. Skin conditions including eczema and psoriasis, drug eruptions and haematological malignancies are the main causes of erythroderma, with genetic conditions contributing to rarer causes. Early recognition with systematic history taking and examination is key, and prompt initiation of treatment is vital to prevent systemic complications such as organ failure. Management is largely targeted at the underlying cause. By understanding and recognizing the causes, course and implications of erythroderma, healthcare professionals can better support affected individuals and improve patient outcomes via a multidisciplinary team approach.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 8","pages":"Pages 512-516"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-30DOI: 10.1016/j.mpmed.2025.05.004
Ruth C Lamb, Sorcha L O'Sullivan
Skin changes can be the first sign of an underlying medical condition. The skin can therefore act as a window to a patient's general health and guide practitioners to making a diagnosis. Other patients have a pre-existing diagnosis and subsequently develop skin changes as part of multisystem disease.
{"title":"Skin manifestations of systemic disease","authors":"Ruth C Lamb, Sorcha L O'Sullivan","doi":"10.1016/j.mpmed.2025.05.004","DOIUrl":"10.1016/j.mpmed.2025.05.004","url":null,"abstract":"<div><div>Skin changes can be the first sign of an underlying medical condition. The skin can therefore act as a window to a patient's general health and guide practitioners to making a diagnosis. Other patients have a pre-existing diagnosis and subsequently develop skin changes as part of multisystem disease.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 8","pages":"Pages 487-493"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-30DOI: 10.1016/j.mpmed.2025.05.010
Cedric PSP Ho Tiu, Michelle L McNeil
Cutaneous adverse drug reactions are common and occur with around 2% of new prescriptions. They can vary significantly in their presentation and often mimic other skin pathologies. Most are mild drug eruptions, and management is largely supportive until resolution upon withdrawal of the causative drug. In rarer cases, they present as severe cutaneous adverse reactions (SCARs) with systemic involvement, which carry potential significant morbidity and mortality. Prompt recognition of SCARs results in better patient outcomes. Correct and timely diagnosis is often challenging because of clinical presentations that evolve over time and difficulty in identifying the culprit drug in multi-medicated patients.
{"title":"Cutaneous adverse drug reactions","authors":"Cedric PSP Ho Tiu, Michelle L McNeil","doi":"10.1016/j.mpmed.2025.05.010","DOIUrl":"10.1016/j.mpmed.2025.05.010","url":null,"abstract":"<div><div>Cutaneous adverse drug reactions are common and occur with around 2% of new prescriptions. They can vary significantly in their presentation and often mimic other skin pathologies. Most are mild drug eruptions, and management is largely supportive until resolution upon withdrawal of the causative drug. In rarer cases, they present as severe cutaneous adverse reactions (SCARs) with systemic involvement, which carry potential significant morbidity and mortality. Prompt recognition of SCARs results in better patient outcomes. Correct and timely diagnosis is often challenging because of clinical presentations that evolve over time and difficulty in identifying the culprit drug in multi-medicated patients.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 8","pages":"Pages 517-523"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-21DOI: 10.1016/j.mpmed.2025.05.005
Robert Sarkany
About 5% of sunlight is ultraviolet (UV) radiation. UV causes gene mutations in skin cells, and is the main cause of all forms of skin cancer. Sun protection is crucial for people at high risk of malignant melanoma: those with fair skin, who are moley or have a family history of melanoma. It is required in patients at risk of squamous and basal cell skin cancers, and is vital in patients with photosensitivity. There is no agreement about how much sun protection is advisable for healthy adults at low risk of skin cancer. Protecting against UV in sunlight involves a set of behaviours: avoiding the hottest part of the day, wearing a hat and long sleeves, and wearing sunscreen. Sunscreens contain chemicals that absorb UV. The ‘sun protection factor’ (SPF) measures a sunscreen's effectiveness at protecting against sunburn. Protection in real life is less than the SPF predicts because people apply sunscreens thinly. Individuals are resistant to changing their behaviour for better photoprotection, even when advised to after having had a malignant melanoma. This is an example of the ‘non-adherence’ to medical advice that is a major barrier to good health outcomes in all branches of medicine.
{"title":"Sun protection","authors":"Robert Sarkany","doi":"10.1016/j.mpmed.2025.05.005","DOIUrl":"10.1016/j.mpmed.2025.05.005","url":null,"abstract":"<div><div>About 5% of sunlight is ultraviolet (UV) radiation. UV causes gene mutations in skin cells, and is the main cause of all forms of skin cancer. Sun protection is crucial for people at high risk of malignant melanoma: those with fair skin, who are moley or have a family history of melanoma. It is required in patients at risk of squamous and basal cell skin cancers, and is vital in patients with photosensitivity. There is no agreement about how much sun protection is advisable for healthy adults at low risk of skin cancer. Protecting against UV in sunlight involves a set of behaviours: avoiding the hottest part of the day, wearing a hat and long sleeves, and wearing sunscreen. Sunscreens contain chemicals that absorb UV. The ‘sun protection factor’ (SPF) measures a sunscreen's effectiveness at protecting against sunburn. Protection in real life is less than the SPF predicts because people apply sunscreens thinly. Individuals are resistant to changing their behaviour for better photoprotection, even when advised to after having had a malignant melanoma. This is an example of the ‘non-adherence’ to medical advice that is a major barrier to good health outcomes in all branches of medicine.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 8","pages":"Pages 544-547"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-21DOI: 10.1016/j.mpmed.2025.05.009
Ioannis Theocharopoulos, Catherine Drislane, Katie Lacy
The incidence of pre-malignant skin disease has been rising in recent decades, with varying rates of progression to invasive disease. This article describes the most common forms of pre-malignant lesions: actinic keratoses, Bowen's disease, dysplastic naevi and melanoma-in-situ. We discuss their clinical significance and management. We also discuss the importance of early detection of malignant melanoma by long-term follow-up in high-risk patients.
{"title":"Pre-malignant skin lesions","authors":"Ioannis Theocharopoulos, Catherine Drislane, Katie Lacy","doi":"10.1016/j.mpmed.2025.05.009","DOIUrl":"10.1016/j.mpmed.2025.05.009","url":null,"abstract":"<div><div>The incidence of pre-malignant skin disease has been rising in recent decades, with varying rates of progression to invasive disease. This article describes the most common forms of pre-malignant lesions: actinic keratoses, Bowen's disease, dysplastic naevi and melanoma-<em>in</em>-<em>situ</em>. We discuss their clinical significance and management. We also discuss the importance of early detection of malignant melanoma by long-term follow-up in high-risk patients.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 8","pages":"Pages 530-532"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-21DOI: 10.1016/j.mpmed.2025.05.012
{"title":"Self-assessment/CPD answers","authors":"","doi":"10.1016/j.mpmed.2025.05.012","DOIUrl":"10.1016/j.mpmed.2025.05.012","url":null,"abstract":"","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 8","pages":"Pages 548-550"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-21DOI: 10.1016/j.mpmed.2025.05.003
Sangeetha Yogarajah, Jane Setterfield
Ulceration represents a full-thickness breach in the oral epithelium. This can result in pain and difficulty with eating, drinking, speech and maintaining oral hygiene. Ulcers are common and can solely involve the oral cavity or can represent localized changes associated with an underlying medical condition. Oral ulceration has a wide range of causes, including trauma, recurrent aphthous stomatitis, immunobullous disease, manifestations of systemic disease, infection and malignancy. Diagnosis can be challenging because of similarities in clinical presentation between the different conditions. The priority with localized persistent oral ulceration is to exclude carcinoma, as early detection and treatment significantly decreases morbidity and mortality. This article reviews the most important types of oral ulceration and their distinguishing features, with a focus on the importance of history taking, clinical examination and further investigation in making a definitive diagnosis.
{"title":"Ulceration of the oral cavity","authors":"Sangeetha Yogarajah, Jane Setterfield","doi":"10.1016/j.mpmed.2025.05.003","DOIUrl":"10.1016/j.mpmed.2025.05.003","url":null,"abstract":"<div><div>Ulceration represents a full-thickness breach in the oral epithelium. This can result in pain and difficulty with eating, drinking, speech and maintaining oral hygiene. Ulcers are common and can solely involve the oral cavity or can represent localized changes associated with an underlying medical condition. Oral ulceration has a wide range of causes, including trauma, recurrent aphthous stomatitis, immunobullous disease, manifestations of systemic disease, infection and malignancy. Diagnosis can be challenging because of similarities in clinical presentation between the different conditions. The priority with localized persistent oral ulceration is to exclude carcinoma, as early detection and treatment significantly decreases morbidity and mortality. This article reviews the most important types of oral ulceration and their distinguishing features, with a focus on the importance of history taking, clinical examination and further investigation in making a definitive diagnosis.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 8","pages":"Pages 497-503"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-21DOI: 10.1016/j.mpmed.2025.05.008
Guy Fletcher, Kathy Taghipour
Autoimmune blistering diseases are a rare group of disorders characterized by blistering and/or erosions of the skin and/or mucous membranes. There may be associated skin fragility and scarring. An accurate and timely diagnosis affects the management and prognosis. This is usually achieved through a careful history, thorough mucocutaneous examination and histology and immunofluorescence tests of skin and serum. It is important to determine the level of blister formation as this distinguishes subepidermal from intraepidermal diseases.
{"title":"Autoimmune blistering skin diseases","authors":"Guy Fletcher, Kathy Taghipour","doi":"10.1016/j.mpmed.2025.05.008","DOIUrl":"10.1016/j.mpmed.2025.05.008","url":null,"abstract":"<div><div>Autoimmune blistering diseases are a rare group of disorders characterized by blistering and/or erosions of the skin and/or mucous membranes. There may be associated skin fragility and scarring. An accurate and timely diagnosis affects the management and prognosis. This is usually achieved through a careful history, thorough mucocutaneous examination and histology and immunofluorescence tests of skin and serum. It is important to determine the level of blister formation as this distinguishes subepidermal from intraepidermal diseases.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 8","pages":"Pages 504-511"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-21DOI: 10.1016/j.mpmed.2025.05.006
Emma Craythorne, Prini Nicholson
Skin cancer is the most common cancer in the UK, and incidence rates continue to increase. We discuss the common presentations, clinical features, examination techniques, referral guidelines, management and prognosis of both non-melanoma skin cancer (basal cell carcinoma, squamous cell carcinoma) and melanoma.
{"title":"Diagnosis and management of skin cancer","authors":"Emma Craythorne, Prini Nicholson","doi":"10.1016/j.mpmed.2025.05.006","DOIUrl":"10.1016/j.mpmed.2025.05.006","url":null,"abstract":"<div><div>Skin cancer is the most common cancer in the UK, and incidence rates continue to increase. We discuss the common presentations, clinical features, examination techniques, referral guidelines, management and prognosis of both non-melanoma skin cancer (basal cell carcinoma, squamous cell carcinoma) and melanoma.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"53 8","pages":"Pages 524-529"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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