By Michèle Leibowitch, Richard Staughton, Sallie Neill, Simon Barton, Roger Marwood
This very hot atlas has been revised and up to date, with 60 new color illustrations highlighting key medical issues
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Additional info for An Atlas of Vulval Diseases: A Combined Dermatological, Gynaecological and Venereological Approach
Precipitating factors include recent streptococcal infection (usually guttate psoriasis), and lesions may appear at sites of trauma (the Koebner phenomenon). A characteristic psoriasis-like eruption is seen in Reiter's syndrome (see page 118). Psoriasis is notoriously chronic, and patients understandably fear this diagnosis. Lesions in the perineum are common and may cause difficulty in diagnosis, because in this occluded flexural site the familiar silver-scaled plaque appears as an inflamed 'beefy-red' area.
All of the patient's topical preparations, as well as the Standard European Battery of Allergens, should be tested. The culprit allergen is removed and avoided. Grade II or, in severe cases, Grade I topical corticosteroids (see Appendix III) are prescribed. g. prednisolone 30 mg/day and gradually reducing. In acute weeping eczema, potassium permanganate soaks are useful (see Appendix II). 36 Acute contact allergic eczema. This case was due to allergy to a local anaesthetic (benzocaine). 37 Patch tests are applied to a patient's back and removed to be read 48 hours later.
27 Histology of lichen sclerosus. This is an example of lichen sclerosus with an overlying hyperplastic epithelium and gross hyperkeratosis. Note the underlying diagnostic superficial dermal hyalinization. 28 Lichen sclerosus complicated by squamous cell carcinoma. INFLAMMATORY DISEASES Seborrhoeic eczema Management Seborrhoeic eczema is a common itchy, red, scaly eruption with a predilection for the face and scalp skin. A long history of intermittent scalp dandruff is usually obtained. Patients show poorly demarcated red patches in the seborrhoeic areas - the scalp, behind the ears, the sideboards and nasolabial folds.
An Atlas of Vulval Diseases: A Combined Dermatological, Gynaecological and Venereological Approach by Michèle Leibowitch, Richard Staughton, Sallie Neill, Simon Barton, Roger Marwood