A Manual of Dermatology Shernaz Walton, Zohra Zaidi, Ijaz Hussain, Zarnaz Wahid
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1Manual of DERMATOLOGY
2Manual of DERMATOLOGY3
Second Edition
Zohra Zaidi MCPS Former (Hon) Consultant Jinnah Postgraduate Medical Centre and Dow Medical College and Civil Hospital Karachi, Pakistan Shernaz Walton MD FRCP (London) Consultant Dermatologist Hull and East Yorkshire, UK and Honorary Clinical Reader Hull York Medical School, UK Co-authors Ijaz Hussain FCPS Professor Postgraduate Medical Institute Lahore General Hospital Lahore, Pakistan Zarnaz Wahid FCPS Professor and Head Department of Dermatology Dow University of Health Sciences and Civil Hospital Karachi, Pakistan Foreword Hywel Williams
4
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A Manual of Dermatology
First Edition: 2013
Second Edition: 2015
9789351527923
Printed at:
5Dedicated to
The memory of my parents: my father, Syed Qadeer Hasan (Ex-Surveyor General of Pakistan) and my mother, Mrs Marzia Qadeer Hasan. Both my parents realized the importance of education and practically helped to promote it in many ways. This book is a small tribute to my loving and affectionate parents.
— Zohra Zaidi
My parents: my father, Dr Pesi Framroze Bilimoria (GP and Anesthetist) and my mother, Mrs Dinoo Pesi Bilimoria (English Scholar). They have always supported me in my quest for knowledge. Knowledge is a lifelong learning experience, and the book is a tribute to my dear parents.
— Shernaz Walton6
7Contributors 9Foreword
No longer can a dermatology trainee working in Europe or the US say that he/she knows nothing about primary tuberculosis of the skin or leishmaniasis, as both conditions now crop up in skin clinics across the world—thanks to increased travel and the cosmopolitan nature of our societies. This book bridges the gap between the East and the West and is written by two busy clinical dermatologists having a vast experience of both the cultures. The book also bridges the gap between the introductory texts and the much larger definitive textbooks in dermatology. The book starts with a perfectly sized resume of the history of dermatology and then covers all of the main skin diseases and groups of diseases. Some of the chapters are arranged around common causes, such as ultraviolet light and the cold, which is helpful as patients rarely come into the clinic with their diagnosis. The chapters are supplemented with helpful summary tables and superb clinical photographs, as well as up-to-date treatment suggestions. The fact that two clinicians have written the entire book has helped its readability in terms of consistency and style. This book will be especially useful to trainee dermatologists, or any healthcare professional wishing to delve deeper into clinical dermatology than the introductory texts.
Hywel Williams
Director Centre of Evidence-based Dermatology
University of Nottingham
Nottingham, UK10
11Preface to the Second Edition
It is humbling indeed to write the preface for the second edition of our book A Manual of Dermatology within a short span of time. It gives us a sense of achievement and accomplishment. The former on account of its popularity with the trainee dermatologists, and the later due to a cause well served, as our younger colleagues found it useful in their clinical practice. It was unfortunate that due to some unavoidable circumstances the manual had some errors. This has been rectified; the manual has been extensively reviewed and updated. This edition is an easy to read, concise and up-to-date account of clinical dermatology to meet the needs of trainee dermatologists and general practitioners.
Finally, we owe our sincere thanks to our family members for their extended support and help.
We would like to thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), and Mr Tarun Duneja (Director-Publishing) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for publishing the book.
Zohra Zaidi
Shernaz Walton12
13Preface to the First Edition
The book A Manual of Dermatology is written for residents and registrars of dermatology, physicians in internal medicine, general practitioners interested in dermatology, and for all doctors on rotation in dermatology. The book is simple-to-read, easy-to-understand and remember. The book should complement the textbooks of dermatology, and should serve as an introduction to the difficult and complex topics of dermatology.
Infectious and parasitic disorders that are prevalent in tropical countries are discussed in equal depth with the inflammatory and cutaneous malignancy due to ultraviolet radiation relatively common in the West. Today, in an outpatient clinic, patients from all over the globe are present in any metropolis city. It is, therefore, incumbent to know the diseases of the East and the West.
Poor economic conditions in developing countries preclude the use of expensive medicines and sophisticated diagnostic procedures. Therefore, time-tested inexpensive medications and simple laboratory techniques are mentioned. Majority of skin diseases are diagnosed on clinical examination, sometimes skin rashes become a conundrum. An appendix of differential diagnosis is included which should help the physicians in the diagnosis of cutaneous disorders.
A chapter on the history of dermatology is included. Our special thanks go to Professor LC Parish and Dr Nick Levell for their valuable suggestions on the subject. History of dermatology is a subject by itself; this chapter only gives a brief outline.
The book is an edited compilation of the lectures that we gave to the medical and postgraduate students of dermatology. The book could not be written without the support and help of innumerable friends and colleagues. We thank all our colleagues who allowed us to use their clinical photographs. Dr Rehan Alvi, Dr Naseema Kapadia, Dr Daulat Pinjani, Dr Badr Dhanani and Dr Aziz Khan are some of the consultants who have shared their photographs. We also thank Dr Shahbaz Janjua and Dr Ian McColl from the “Global Skin Atlas” for sharing their photographs. We are extremely grateful to our seniors and professors who taught us: Professor TS Haroon, Madam Naseem Zehra Jafri, Major General Ashfaque Ahmed Khan, Dr VR Metha, Dr Eustace J Desouza, Dr RJ Fernandez, Dr RG Valia from Mumbai, India, Late Dr K Keczkes, Dr EH Wyatt and Professor WJ Cunliffe from the UK. Whatever little we know is due to the hard work put by them. We also owe our thanks to Esen Rizvi for making all the illustrations for the book. Finally, we owe our sincere thanks to our family members for their extended support and help.
We would like to thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), and Mr Tarun Duneja (Director-Publishing) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for publishing the book.
Zohra Zaidi
Shernaz Walton14
27Hippocrates (460–370 BC)
Excerpt
from the
HIPPOCRATIC OATH
I swear to fulfil, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply for the benefit of the sick, all measures that are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will not be ashamed to say “I know not”, nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. In purity and holiness I will guard my life and my art.
I will benefit the sick according to my ability and judgement; I will keep them from harm and injustice.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know.
In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, to those sound of mind and body, as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection after death.