Second Edition
Sanjay Ghosh MD
Professor Department of Dermatology and Venereology MGM Medical College and LSK Hospital
Kishanganj, Bihar, India
Medical Director (Honorary) Institute of Allergic and Immunologic Skin Diseases (IAISD)
Kolkata, West Bengal, India
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151 Skin Cases: Diagnosis and Treatment
First Edition: 2005
Second Edition: 2014
9789351521167
Printed at
5Dedicated to
My wife Shrabani
- Primary aim of this book is to judge the clinical acumen. The book, however, does not ignore the importance of investigations by laboratory and other methods, which may be necessary in many clinical situation to confirm diagnosis, assess degree of severity and find associated features.
- The target readers of this book are MBBS undergraduate students or practicing physicians who have not done any specialization in dermatology. Hence, common skin diseases have mostly been described but some uncommon and major dermatological cases signifying serious prognosis or systemic involvement demanding immediate referral have been included as well.
- Treatment guidelines represent only sketchy plan to treat the individual case described which may require elaboration in certain cases and may not be applicable to all similar cases.
- Only standard conventional treatment mentioned in the authentic textbooks or journals have been mentioned omitting therapies which are not much evidence-based.
- Standard dose of the drugs have been mentioned which will, of course, depend on body weight, other concurrent medication, liver and renal status, known drug allergy, etc.
- Pre-therapy and post-therapy monitoring of drugs by laboratory tests should be done whenever required.
- This book does not insist that all the cases should be managed by nondermatologists. The book has attempted to provide a basic visual knowledge for diagnosis of certain skin disorders along with basic management strategy for the primary-care physicians. Referral to dermatologist seems to be desirable whenever situation arises.
When the first edition of this book came in 2005, we could not predict such huge popularity of the book among medical students and practitioners. Since last few years, my publisher has been after me to bring a new edition of the book which I was not able due to my hectic schedule and too many commitments. I feel extremely sorry for this unintentional delay and must seek apology from my dear readers who have been waiting eagerly for the new version. In this edition, the book has been enriched with all new cases and addition of another 50 cases and updated management as well.
Dermatological training is often inadequately executed in MBBS undergraduate and post-MBBS internship days, which leads the qualifying remarks either ‘too difficult’ or ‘very simple’ regarding the subject ‘Dermatology’ by some qualified doctors in their practice. Some feel interest but are very much apprehensive about diagnosing and managing even an easy case. Some consider the subject by oversimplification and diagnose each ring-shaped case as a ring worm or tinea. They never find any depth in dermatology! Many others are totally indifferent about the subject. Of course, there are large numbers of physicians who, even without any specialization in the subject, have acquired the unique skill to deal skin cases adequately and confidently.
Whatever may be the attitude of the physicians towards the subject, each and every doctor whether practising or non-practicing has to face and even treat dermatological cases in certain situation. Hence, doctors should have some basic concept about the subject of dermatology, so that they may not take the cases casually. They may not manage all the cases, but they should know when to refer the patient to prevent fatal consequences.
Another myth regarding the skin cases is that skin cases neither kill nor are cured. Yes, skin cases can cause life-threatening situations such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), erythroderma, drug hypersensitivity syndrome, pemphigus vulgaris, bullous pemphigoid, and malignant melanoma. Scabies, by secondary infection, may lead to acute glomerulonephritis, a fatal condition if not treated promptly. Manifestations of some of the serious systemic ailments may be first detected on skin, e.g. purpura from leukemias, nodules from internal malignancy, hyperpigmentation from Addison's diseases, etc.8
This book represents a small attempt to bridge the gap or a humble dialogue to communicate. This endeavor, however, has been based totally on visual language, which remains the basic conversation in clinical dermatology. However, this small book would never be able to substitute larger textbooks or atlas published earlier with the same mission and above all practical clinical training and day-to-day practice.
The new edition of the book would not see daylight unless the continuous urge, encouragement and request of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, the eminent medical publisher of Asia, who had a long experience and association with our medical fraternity. I must give deep regards to them and their entire publishing team, both in New Delhi and Kolkata, who have supported whole-heartedly this project.
I feel all my efforts would go in vain unless the readers find the book suitable for their need. Any clarification or queries may be made to me directly by e-mail (drsanjayghosh1@gmail.com).
Sanjay Ghosh
9Preface to the First Edition
Dermatological training is often inadequately executed in MBBS undergraduate and post-MBBS internship days which leads to the qualifying remarks either ‘too difficult’ or ‘very simple’ regarding the subject ‘Dermatology’ by some qualified doctors in their practice. Some feel interest but are very much apprehensive about diagnosing and managing even an easy case confidently. Some consider the subject by oversimplification and diagnose each ring shaped case as a ring worm or tinea. They never find any depth in dermatology! Many others are totally indifferent about the subject. Of course, there are large numbers of physicians who, even without any specialization in the subject, have acquired the unique skill to deal skin cases adequately and confidently.
Whatever may be the attitude of the physician towards the subject, each and every doctor whether practicing or non-practicing has to face and even treat dermatological cases in certain situation. Hence, doctors should have some basic concept about the subject of dermatology so that they do not take the cases casually. They may not manage the case but they should know when to refer the patient to prevent fatality.
Another myth regarding the skin cases is that skin cases neither kill nor are cured. Yes, skin cases can cause life-threatening situations such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), erythroderma, drug hypersensitivity syndrome, pemphigus vulgaris, bullous pemphigoid, and malignant melanoma. Scabies, by secondary infection, may lead to acute glomerulonephritis, a fatal condition if not treated promptly. Manifestations of some of the serious systemic ailments may be first detected on skin, e.g. purpura from leukemias, nodules from metastases of internal malignancy, hyperpigmentation from Addison's disease, etc.
This book represents a small attempt to bridge the gap or a humble dialogue to communicate. This endeavor, however, has been based totally on visual language, which remains the basic conversation in clinical dermatology. However, this small book would never be able to substitute larger textbooks or atlas published earlier with the same mission and above all practical clinical training and day-to-day practice.
The book would never be written unless the continuous urge, encouragement and request of Mr Tarun Duneja, the General Manager (Publishing) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, the eminent medical publisher of the country, who had a 10long experience and association with our medical fraternity. I must give deep regards to him and his entire publishing team, both in New Delhi and Kolkata, who have supported whole-heartedly this project.
I must also give sincere thanks to Mr Tapas Kr Kayal, for doing the DTP and all laborious computer jobs for me in spite of his period of personal grief and turmoil.
I feel all my efforts would go in vain unless the readers find the book suitable for their need. Any clarification or queries may be made to me directly by e-mail (drsanjayghosh1@gmail.com).
Sanjay Ghosh