Dermatology: An Illustrated Colour Text

274 Pages·2017·79.74 MB·english

by  David Gawkrodger

Any screen.
Any time.
Anywhere.
Activate the eBook version
of this title at no additional charge.
Student Consult eBooks give you the power to browse and find content,
view enhanced images, share notes and highlights—both online and offline.
Unlock your eBook today.
1 Visit studentconsult.inkling.com/redeem Scan this QR code to redeem your
eBook through your mobile device:
2 S cratch off your code
3 Type code into “Enter Code” box
4 C lick “Redeem”
5 L og in or Sign up
6 G o to “My Library”
It’s that easy!
Place Peel Off
Sticker Here
For technical assistance:
email [email protected]
call 1-800-401-9962 (inside the US)
call [phone] (outside the US)
Use of the current edition of the electronic version of this book (eBook) is subject to the terms of the nontransferable, limited license granted on
studentconsult.inkling.com. Access to the eBook is limited to the first individual who redeems the PIN, located on the inside cover of this book, at studentconsult.inkling.com
and may not be transferred to another party by resale, lending, or other means.
2015v1.0
Dermatology
AN ILLUSTRATED COLOUR TEXT
Sixth Edition
This page intentionally left blank
Dermatology
AN ILLUSTRATED COLOUR TEXT
Sixth Edition
David J. Gawkrodger
DSc MD FRCP FRCPE
Professor Emeritus in Dermatology,
University of Sheffield,
Royal Hallamshire Hospital,
Sheffield, U.K.
and
Michael R. Ardern-Jones
BSc MB BS DPhil FRCP
Associate Professor and Consultant Dermatologist,
University of Southampton,
Southampton General Hospital,
Southampton, U.K.
Edinburgh  London  New York  Oxford  Philadelphia  St Louis  Sydney  Toronto  2017
© 2017 Elsevier Ltd. All rights reserved.
Previous editions copyrighted: 2002, 2008, 2012
Elsevier Ltd. All rights reserved.
First edition 1991 © Longman Group UK.
Second edition 1997 © Pearson Professional.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical,
including photocopying, recording, or any information storage and retrieval system, without permission in writing from the
publisher. Details on how to seek permission, further information about the Publisher’s permissions policies, and our
arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency can be found
at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as
may be noted herein).
ISBN 978-0-7020-6849-2
[eBook 978-0-7020-6854-6]
[Inkling 978-0-7020-6848-5]
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our
understanding, changes in research methods, professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any
information, methods, compounds, or experiments described herein. In using such information or methods they should
be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information
provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the
recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of
practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and
the best treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any
injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or
operation of any methods, products, instructions, or ideas contained in the material herein.
Senior Commissioning Editor: Jeremy Bowes
Senior Content Development Specialist: Ailsa Laing
Project Manager: Joanna Souch
Designer/Design Direction: Miles Hitchen
Illustration Manager: Amy Faith Heyden
The
publisher’s
policy is to use
paper manufactured
from sustainable forests
Printed in China
Preface to the sixth edition
There has been a near revolution in how trainee in dermatology. This is still the There is presently a greater emphasis than
a published medical text is handled by its case, and the printed version has been ever before on skin cancer, its recognition
users since we wrote the fifth edition of fully updated, but online publication has and management, and we have reflected
this work in 2011. For this type of book, given us the chance to broaden the scope this in our content. Other areas that have
there will be considerable usage online. of the book. We have added some developed into subspecialisms, which
The content and presentation of the sixth material at a higher level that can be have required additional text, include
edition of this book has been developed accessed by those that opt to use it, whilst genital dermatoses, psychodermatology,
to accommodate readers’ likely use in the bolstering the basic strengths of the text cosmetic procedures, and advances in
smartphone age. Our publishers, Elsevier, through the use of additional illustrations. dermatologic surgery.
have been of considerable assistance in Online publishing has allowed us, We trust that our target audience of
this task, providing the platform for the for each topic covered, to introduce medical students, family doctors, hospital
delivery of an interactive, searchable and innovations. These include self- residents, specialty registrars in
well illustrated text. assessment questions, flashcards, a dermatology or internal medicine, and
In order to make use of the picture gallery of dermatological diseases specialist nurses will continue to find our
opportunities offered by online and direct Internet links to other sources book helpful in the diagnosis and
publication, we have increased the of information and reference. It has also management of patients with skin
flexibility of the educational level of the been possible to highlight throughout the diseases.
text. Previously we aimed to write and text, new treatments and dermatological
illustrate a book that was suitable for emergencies. David J. Gawkrodger and
medical students and general practitioners We are aware that the specialty of Michael R. Ardern-Jones
but which would also appeal to the early dermatology is constantly changing. Sheffield and Southampton, 2015
Preface to the first edition
Recent advances in publishing technology point’ summaries. This unique approach, three sections. The first presents a
and book presentation demand that a which deals with each topic as an scientific basis for the understanding of
modern text be attractively and concisely educational unit, allows the reader better and clinical approach to skin disease. The
presented, in colour and at an affordable accessibility to the facts and greater ease second details the major dermatological
price. This is essential for success in a in revision than is possible with a conditions, and the third outlines special
very competitive market. In writing this conventional textbook. topics, such as photoageing and
book, I have attempted to present an The book is aimed at medical students dermatological surgery, that are of current
introductory dermatology text for the but contains sufficient detail to be of use importance or that are poorly dealt with
1990s, using a format of individually to family practitioners, physicians in in other textbooks.
designed double-page spreads, generously internal medicine, registrars or residents
illustrated with colour photographs, line in dermatology and dermatological David J. Gawkrodger
drawings, tables, bulleted items and ‘key nurses. The contents are divided into Sheffield 1992
Acknowledgements
In the production of the sixth edition of Nottingham, Dr J. Bowling of Oxford Bunker (University College Hospital,
this book it is a pleasure to acknowledge (dermoscopy images), the late Dr S.M. London), Dr P.K. Buxton, Dr G.B. Colver,
the contribution of the publishing staff at Morley of Dundee, Dr M. Shah of the late Professor F.J.G. Ebling, Dr M.E.
Elsevier, notably Jeremy Bowes, Alisa Burnley, Dr H.S. Ghura of Salford, and Kesseler, Dr Fiona Lewis (St Thomas
Laing and Kim Benson. We are grateful to Dr A.J.G. McDonagh, Dr A.G. Messenger, Hospital, London), Dr C. McGibbon,
colleagues who have advised on various Dr C. Yeoman, Mr D. Dobbs, Professor Dr A. McMillan, Mrs E. McVittie, Dr C.StJ.
aspects of the book, especially to Dr S.S. Bleehen and Dr C.I. Harrington of O’Doherty, Dr Glenda Sobey (Sheffield
Louise Ardern-Jones for her detailed Sheffield, and also Dr Efrem Eren, for Children’s Hospital), Miss M.J. Spencer,
review. provision of autoantibody fluorescence Dr M.D. Talbot and the late Dr A.E.
We thank colleagues who have images. Walker.
generously provided figures for this and We are grateful to the following We also thank those patients who gave
previous editions, including Dr E.C. for advice or for the provision of permission for their faces to be shown
Benton of Edinburgh, Dr J.E. Bothwell illustrations: Professor R.StC. Barnetson, without eyebars.
of Doncaster, Dr J.S.C. English of Dr G.W. Beveridge, Professor Chris
Contents
1 Basic Principles 1
1 Microanatomy of the skin 2 6  Molecular genetics and the skin 12 11 Basics of medical therapy 22
2 Derivatives of the skin 4 7 Terminology of skin lesions 14 12 Epidemiology of skin disease 24
3 Physiology of the skin 6 8 Taking a history 16 13  Body image, the psyche and the skin 26
4 Biochemistry of the skin 8 9 Examining the skin 18
5  Inflammation, immunity and the skin 10 10 Practical clinic procedures 20
2 Diseases 27
Eruptions 28
14  Psoriasis – Epidemiology,  17  Eczema – Basic principles and irritant  21  Lichenoid eruptions 42
pathophysiology and   contact dermatitis 34 22  Papulosquamous eruptions 44
presentation 28 18  Eczema – Allergic contact dermatitis  23  Erythroderma 46
15  Psoriasis – Management and  and patch testing 36
24  Photodermatology 48
complications 30 19 Eczema – Atopic eczema 38
16 Psoriasis – Biologics 32 20  Eczema – Other forms 40
Infections 50
25  Bacterial infection – Staphylococcal and  28  Viral infections – Herpes simplex and  31  Yeast infections and related disorders 62
streptococcal 50 herpes zoster 56 32  Tropical infections and infestations 64
26  Other bacterial infections 52 29  Human immunodeficiency virus disease  33  Infestations 66
27  Viral infections – Warts and other viral  and immunodeficiency syndromes 58
infections 54 30  Fungal infections 60
Disorders of specific skin structures 68
34  Sebaceous and sweat glands – Acne,  36  Disorders of nails 72 38  Leg ulcers 76
rosacea and other disorders 68 37  Vascular and lymphatic diseases 74 39  Pigmentation 78
35  Disorders of hair 70
Allergy and autoimmunity 80
40  Urticaria and angioedema 80 42  Connective tissue diseases 84 43  Vasculitis and the reactive erythemas 86
41  Blistering disorders 82
Internal medicine 88
44  Skin changes in internal conditions 88 45  Drug eruptions 90 46  Associations with malignancy 92
Inherited disorders 94
47  Keratinization and blistering  48  Neurocutaneous disorders and other 
syndromes 94 syndromes 96
Skin tumours 98
49  Benign tumours 98 53  Skin cancer – Squamous cell  55  Cutaneous T cell lymphomas and 
50  Naevi 100 carcinoma 106 malignant dermal tumours 110
51  Skin cancer – Premalignant  54  Skin cancer – Malignant melanoma 108
disorders 102
52  Skin cancer – Basal cell carcinoma 104
3 Special Topics in Dermatology 111
56  Phototherapy 112 60  Paediatric dermatology 120 64  Genital dermatoses 128
57  Basic dermatological surgery 114 61  The skin in old age 122 65  Racially pigmented skin 130
58  Advanced dermatological surgery 116 62  The skin in pregnancy 124 66  Occupation and the skin 132
59  Cosmetics and cosmetic procedures 118 63  Genitourinary infections 126 67  Immunological tests 134
Index 136
This page intentionally left blank