2007 press releases

The botanical ingredient aloe vera is a valuable treatment for a common skin disorder and could be used to treat mouth ulcers, new research in the British Journal of Dermatology will suggest.
Oral lichen planus is a fairly common, chronic inflammatory disorder within the mouth, causing symptoms similar to a mouth ulcer, namely burning, stinging and pain. Persistent mouth ulcers due to lichen planus can, very rarely, give rise to cancerous changes within the ulcer, and so need to be monitored by a doctor.
Unlike lichen planus of the skin, the oral version does not always respond well to treatment when symptoms are present. However, there had previously been one reported case of successful treatment using aloe vera.

A team of dermatologists therefore conducted a study of 54 patients, half of whom were treated with a topically applied aloe vera gel while the other half received a placebo.

81 percent of patients treated with aloe vera had a good response after eight weeks of treatment, while only four percent of placebo patients had a similar response.

Where improvement did occur, it was on a significantly greater scale in those treated with aloe vera – symptoms improved by more than 50 percent in 63 percent of aloe vera patients, whereas only seven percent of the placebo patients had this level of improvement. Furthermore, seven percent of the aloe vera group had a complete clinical remission.

Burning pain completely disappeared in a third of the aloe vera patients, compared to only four percent of the placebo group. No serious side effects were found in either group, and the researchers believe that aloe vera could not only be used to treat oral lichen planus, but common mouth ulcers also.

Aloe vera is a cactus-like plant. Some cosmetic and medicinal products are made from the tissue in the centre of the leaf, which is called aloe vera gel. The plant is known to have anti-inflammatory, antibacterial, antiviral and antifungal properties.

According to Dr Charoen Choonhakarn, Dermatologist at Srinagarind Hospital Medical School, Khon Kaen University, Thailand, and one of the study’s authors: “Current treatments for oral lichen planus are aimed at alleviating pain and eliminating the lesions.

“Existing evidence demonstrates that aloe vera used in a variety of concentrations might be effective in shortening the duration of wound healing.

“We found that the effect of 70 percent aloe vera gel on the disorder was significantly better than a placebo. The results showed decreases both in clinical signs and in pain scores. Mild, adverse effects were reversible and aloe vera was generally well tolerated.
“Thus, aloe vera gel is a safe and effective treatment for oral lichen planus, and most likely mouth ulcers too.”

Nina Goad of the British Association of Dermatologists said: “Many cosmetic products contain botanical ingredients, as people like using products that are labelled ‘natural’ or containing natural plant extracts. However, often the ingredient, while harmless, is unlikely to have any impact on the skin’s health or appearance.

“However, aloe vera is an ingredient that has proven anti-inflammatory and wound healing properties. This is an interesting development for the treatment of mouth ulcers.”
The cause of oral lichen planus is still not known, but is likely to be linked to the body’s immune system.

-Ends-
Notes to editors:
1. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.
2. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD
3. Study details: ‘The efficacy of aloe vera gel in the treatment of oral lichen planus: a randomised controlled trial’, Published in British Journal of Dermatology, C. Choonhakarn, P. Busaracome, B. Sripanidkulchai* and P. Sarakarn²; Division of Dermatology, Srinagarind Hospital Medical School, Faculty of Medicine, *Department of Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences and ²Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University, Thailand.

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.
Blackwell Publishing is a leading society publisher, partnering with 665 medical, academic and professional societies. Blackwell publishes over 800 journals and has over 6,000 books in print. In February 2007, Blackwell Publishing officially merged with John Wiley & Sons, Inc's Scientific, Technical and Medical business. For more information on Blackwell Publishing, please visit www.blackwellpublishing.com or www.blackwell-synergy.com.

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Dermatologists urge eczema patients to seek advice before diet changes
For immediate release, 12.12.07

Dermatologists are warning eczema patients not to make significant changes to their diet without consulting their doctor, following new research in the British Journal of Dermatology.

Dermatologists at Leicester Royal Infirmary conducted a survey of 100 patients with contact dermatitis, a common type of eczema caused by irritants or allergens, to ascertain how many had attempted to alleviate the condition by making changes to their diet.

Almost a third reported that they had tried dietary restriction, including cutting out dairy products, bread, wheat, alcohol, tomatoes and / or eggs. However, 80 percent found that such restrictions resulted in no improvement to their skin.

Furthermore, 13 percent had tried some form of dietary supplementation in an attempt to manage their symptoms, including evening primrose oil, multivitamins, cod liver oil, omega-3-oils and increased fruit consumption. Less than a quarter of those who had tried supplements felt that it made any difference to their skin.

More worryingly, a previous study by the department discovered that three-quarters of parents of children with atopic eczema – the most common type of eczema, affecting one in five children – had tried some form of dietary exclusion and 41 percent had used dietary supplements.

However, only half of parents had consulted a doctor or dietician before making changes to their child’s diet.

The results for this group were more positive, but still only 39 percent felt that dietary changes had improved their child’s eczema. Interestingly, a similar survey by the group in 1989 showed that although approximately the same number of parents (71 percent) had tried diet changes for their child’s eczema, only 10 percent deemed it beneficial. The reason for why more parents now report dietary changes as having any impact on the symptoms is unclear.

Dr Graham Johnston, Consultant Dermatologist at Leicester Royal Infirmary and one of the study’s authors said: “The majority of our patients reported that their skin failed to improve as a result of dietary manipulation. Of ongoing concern is the significant number of patients who attempt dietary manipulation without seeking appropriate expert advice.”

Nina Goad of the British Association of Dermatologists said: “Many people think that diet is an important factor in atopic eczema and in some cases this is true. However, it is also possible that some parents restrict their child's diet without any real benefit to their child's eczema and very restrictive diets could harm a child's growth.

“We don’t know how important food allergy is in atopic eczema with any certainty, because the effects of foods on the skin are complicated and difficult to assess.

“If you suspect food allergy in your child, you should really discuss this with your doctor or dermatologist before excluding any foods in your child's diet. Remember that milk in particular is an excellent source of calcium and protein for a growing child and it is therefore important to make sure that you child has enough of these nutrients from elsewhere if you give your child a milk free diet.

“You should also bear in mind that some children can also be allergic to soya milk, so it is important to discuss your child's diet with your doctor.”

About eczema:

Two main factors cause contact dermatitis: irritants and allergens. Irritants are substances like detergents and solvents that strip the skin of its natural oils, and cause eczema to develop if contacted frequently and without skin protection. Allergens are things to which your immune system can develop a specific reaction after you have come into contact with them. Examples include substances such as nickel, rubber, and perfumes or preservatives used in some creams and cosmetics.

Atopic eczema is a dry, itchy inflammation of the skin, often accompanied by asthma and/or hayfever. It is very common in children, affecting as many as one in five. It often clears up, but can carry on into adult life or come back in the teenage or early adult years. ‘Atopic’ people have an overactive immune system and their skin easily becomes inflamed (red and sore). Their skin ‘barrier’ does not work well, so that their skin may become dry and prone to infection.

-Ends-

Notes to editors:
1. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.
2. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD
Study details:
‘The use of dietary manipulation in patients referred to a contact dermatitis clinic’, Due to be published in British Journal of Dermatology, (provisional date January 2008 t.b.c). Correspondence (DOI 10.1111/j.1365-2133.2007.08380.x
R.F. Davis, N.J. Mortimer, M.J. Sladden, G.A. Johnston, Department of Dermatology, Leicester Royal Infirmary, Leicester, LE1 5WW, UK
N.B. Since completion of this study, Dr Sladden has moved to practise in Launceston, Tasmania and Dr Mortimer in Tauranga, New Zealand.
’The use of dietary manipulation by parents of children with atopic dermatitis’, British Journal of Dermatology 2004, DOI: 10:1111/j.1365-2133.2004.05888.x
G.A. Johnston, R.M. Bilbao, R.A.C. Graham-Brown, Department of Dermatology, Leicester Royal Infirmary, Leicester, LE1 5WW, UK

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

Blackwell Publishing is a leading society publisher, partnering with 665 medical, academic and professional societies. Blackwell publishes over 800 journals and has over 6,000 books in print. In February 2007, Blackwell Publishing officially merged with John Wiley & Sons, Inc's Scientific, Technical and Medical business. For more information on Blackwell Publishing, please visit www.blackwellpublishing.com or www.blackwell-synergy.com.

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Response to news story that using satin pillow cases will help fight wrinkles
For immediate release, Wednesday December 5th 2007

Nina Goad of the British Association of Dermatologists: "While this idea is interesting, unfortunately I don't think buying satin pillow cases is the answer to youthful skin. In terms of lifestyle changes that we can make to prevent premature skin ageing, preotecting the skin from the sun and not smoking are known to help keep wrinkles at bay.
Some wrinkling of the skin is unavoidable as the body ages, but external factors also play a major role – especially UV exposure and smoking, which lead to wrinkles and a sallow, leathery texture. Sun exposure is one of the main causes of premature skin ageing, as well as skin cancer. There are different types of UV light from the sun, and it is UVA that predominantly causes skin ageing. This is because it breaks down collagen and elastin, which give the skin its structure and firmness. As they break down, the skin sags and wrinkles. You don’t have to get sunburned for this type of damage to occur. Sunlight also causes pigmentation changes known as ‘age spots’ that give the skin an older appearance.

"The skin gets its elasticity to a large extent from collagen. Smoking enhances an enzyme in the skin (matrix metalloproteinase-1) which degrades collagen, so the skin loses its elasticity and develops lines. In addition, smoking causes blood vessels to constrict, which limits the amount of oxygen that can reach the skin. This lack of oxygen reduces production of collagen and elastin (which also gives the skin its structure) and negatively affects the skin’s health and appearance generally. Smoking can also cause an unattractive yellowing of fingernails which makes the hands look older.

Another main causes of wrinkles is the natural movement of the face – such as through smiling and frowning. Genetic factors also influence how our skin ages."

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Foot and mouth, blue tongue… now new disease plagues UK farmers
For immediate release, Tuesday November 1st 2007

A mysterious skin disorder affecting farmers at lambing time has been discovered by a Hampshire farmer and a team of doctors from Southampton, the British Journal of Dermatology will reveal.

Following several turbulent months for UK farmers, with outbreaks of foot and mouth and blue tongue, dermatologists have now discovered a disorder which affects the farmers themselves.

The strange disorder specifically targets the ears, which initially become hot, itchy and sore and soon suffer blistering and crusting which can be painful and unsightly. No other parts of the body are affected.

The symptoms are also confined to lambing season (which usually lasts from one to three months) and disappear promptly when lambing is over.

In some farmers, the blistering appears every year during lambing, in one case for the previous 30 years, and in all patients both ears are affected. It also occurs in farmers who are calving, but less frequently.

The condition was discovered by George Heathcote, a farmer from Hampshire and one of the study’s authors, who experienced blistering on his ears and consulted doctors in Southampton.

He said: “I was convinced that lambing was involved, so I decided to place a letter in Farmer’s Weekly magazine and equivalent overseas publications, asking other farmers with similar symptoms to contact me. I received responses from 69 affected UK farmers but, interestingly, none from abroad.”

The Southampton doctors reviewed his and four comparable cases seen over a four-year period, and discovered striking similarities that suggest a new skin disorder linked to the farming practice, which they named ‘lambing ears’.

The reasons for the phenomenon remain unclear, but the study’s authors suggest several possibilities.

Biopsies showed a similarity to ‘polymorphic light eruption’ (PLE), a rash that comes up after exposure to sunlight.

This led to the idea that sunlight or artificial light sources could be part of the problem. The absence of reported cases in Australia, a sunny climate where lambing tends to take place outdoors, suggests that indoor artificial lighting is a more likely culprit than sunlight. However, this could also be due to the minimal contact with the sheep involved in outdoors farming.

It is also thought that lighting alone is not responsible, as the disorder only occurs specifically during lambing, whereas lighting is used for other farming practices throughout the year.

Consultant Dermatologist at Southampton General Hospital and one of the study’s authors, Professor Peter Friedmann said: “During shearing, which takes place in May or June and may be indoors or outdoors, the same farmers who suffer lambing ears can shear the sheep with no symptoms at all.

“This suggests that bodily fluids from the sheep, such as amniotic fluid, sac and placenta, or chemicals used as part of the process, play a part, although intriguingly, the disorder does not affect the hands, which have maximum contact with fluids and products involved in lambing.

“The disorder is far more common in farmers who conduct lambing indoors. Bodily fluids are the only unique factor at lambing time, and give another reason aside from natural lighting why ‘lambing ears’ may not occur in farmers who conduct lambing outdoors, as these farmers have far less contact with the ewes during the birth.”

Nina Goad of the British Association of Dermatologists said: “This study is fascinating and illustrates how dermatologists are coming up against new diseases all the time.

“Following foot and mouth and blue tongue, the discovery of a disease affecting the farmers themselves may seem like an extra blow. However, it is actually positive that the disorder has been identified and can now be shared with dermatologists across the UK, as it will allow for more research and shared knowledge. The next step is to carry out an epidemiological study to clearly define the numbers of farmers affected.”

-Ends-

Notes to editors:

1. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.

2. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD

3. Study details: ‘Lambing ears’: a blistering disorder affecting farmers at lambing time; to be published in British Journal of Dermatology (planned date Jan 2008), K. Heathcote, J.M. Theaker*, N. Gibbins, E. Healy², G.B. Heathcote³, P.S. Friedmann²

Departments of ENT Surgery, *Cellular Pathology and ²Dermatology, Southampton University Hospitals NHS Trust, Southampton S016 6YD, UK
³Warborne Farm, Hampshire, UK

4. The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

5. Blackwell Publishing is a leading society publisher, partnering with 665 medical, academic and professional societies. Blackwell publishes over 800 journals and has over 6,000 books in print.

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Sensitive skin, is not limited to the face, study reveals
For immediate release, Thursday November 1st 2007

70 percent of women with sensitive skin, a disorder long associated only with the face, suffer symptoms on the body also, a study in the British Journal of Dermatology will reveal.

The surprising statistic was uncovered by dermatologists is France, who conducted a study of 400 women aged over 15.

Of the 70 percent of women who claimed to suffer sensitive skin on the body as well as the face, the most common sites were the hands (58 percent), scalp (36 percent), feet (34 percent), neck (27 percent), torso (23 percent) and back (21 percent).

The most common triggers included cold (66 percent), heat (28 percent), stress (61 percent), sun exposure (51 percent), wind (42 percent), water from a shower (29 percent) or swimming pool (40 percent), soaps (42 percent), cosmetics (28 percent) and pollution (18 percent).

In three quarters of cases, redness (erythema) was the main reported characteristic of sensitive skin. However, other symptoms included itch (61 percent), prickling (39 percent) and burning (31 percent). Dandruff was another common symptom associated with sensitivity.

Nina Goad of the British Association of Dermatologists said: “Sensitive skin can be hard to define as it means different things to different people, from mild redness to persistent stinging.

“However this study shows that many women are noticing symptoms that they associate with sensitivity on the body, which is interesting as the term ‘sensitive’ is generally only used for facial skin.

“Some of these symptoms might actually be disorders treatable by a dermatologist, such as eczema, rosacea or acne.
“The problem is that many people don’t know exactly what is wrong with their skin because it takes a diagnosis from an expert, such as a dermatologist, so they just assume their skin is ‘sensitive’. Sometimes it’s best to get it checked out, as it may be easy to remedy, given the correct treatment.”

Sensitive skin is generally defined as prickling, burning or stinging, usually due to environmental factors, such as temperature and UV, or chemicals including cosmetics and pollution, or occasionally stress or hormones.

The exact causes are not fully understood, but in most cases the skin’s barrier function is impaired, often making it dry and less tolerant of external irritants.

-Ends-

Notes to editors:

1. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.

2. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD

3. Study details: ‘Sensitive skin is not limited to the face’, British Journal of Dermatology (planned date Jan 2008), C. Saint-Martory, A.M. Roguedas-Contios*, V.Sibaud², A. Degouy, A.M. Schmitt, L. Misery*
CERPER, Pierre Fabre Research Institute, Toulouse, France. *Department of Dermatology, University Hospital, 29609 Brest cedex, France. ²Ducray Laboratories, Lavaur, France

4. The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

5. Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Together, these two companies publish more than 1,400 scholarly peer-reviewed journals and an extensive collection of books with global appeal. Blackwell's publishing programme is being merged with Wiley's global Scientific, Technical and Medical business to form Wiley-Blackwell.

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Karl Marx suffered from a chronic skin disease that has profound psychological effects, study reveals
For immediate release, Tuesday October 30th 2007

Karl Marx, the influential nineteenth century philosopher and revolutionary, suffered from a chronic and debilitating skin disease known to have profound psychological effects, a study in the British Journal of Dermatology will reveal.

Historical accounts have always defined this disorder merely as ‘boils’, as Marx himself described his symptoms. But further investigation of the revolutionary-left thinker’s correspondence has led eminent dermatologist and clinical scientist Professor Sam Shuster to conclude that Marx in fact suffered from ‘hidradenitis suppurativa’ (HS).

HS is a chronic and stubborn disease of the apocrine glands, the large, specialised sweat glands found mainly in the armpits and groins, which become blocked and inflamed. The hair follicles, from which apocrine sweat usually escapes, burst and their infected fluid is released into and under the skin and onto the skin surface. The abscesses tunnel into the skin which becomes painful and swollen, and constantly releases pus. While boil-like lumps do feature as part of this painful disease, a more widespread infection, with swelling and discharge eventually leads to more and more skin thickening and scarring.

The study reveals that a number of Marx’s health complaints, not previously linked, could all be directly attributed to HS, including joint pain, lesions on the body, scalp and face, and a painful eye condition which often stopped him working.

Furthermore, the study suggests that the severity of Marx’s symptoms could have had a major effect on his psychological wellbeing as well as his work.

Professor Shuster, Honorary Consultant at the Norfolk and Norwich University Hospital dermatology department, explained: “This new diagnosis is not just important in terms of historical accuracy. The skin is an organ of communication which is why its disorders produce so much psychological distress, with depression of self image, mood and well being, and with self-loathing and disgust.

“These adverse effects are particularly severe in patients with hidradenitis suppurativa, and there is much evidence of this in Marx’s letters, where he often complains that his skin affects his work output and also its quality.

“In addition to reducing his ability to work, which contributed to his depressing poverty, hidradenitis greatly reduced his self-esteem. This explains his self-loathing and alienation, a response reflected by the alienation Marx developed in his writing.”

Nina Goad of the British Association of Dermatologists said: “Hidradenitis is one of the many devastating diseases that dermatologists treat, and the psychological impact on the patient can be overwhelming. It is therefore fascinating to discover that such an influential figure suffered from it, especially considering how it might have affected his work.

“It takes a real expert to use nineteenth century correspondence to form a diagnosis of a skin disease, as this dermatologist has achieved.”

Eminent historian Francis Wheen, whose biography inspired the study, said: "Not being a dermatologist, I hadn't actually heard of hidradenitis suppurativa, but having read Professor Shuster's analysis of the correspondence I think he may well be on to something. His article offers a wholly original and remarkably persuasive diagnosis which no future biographer of Marx will be able to ignore.”

-Ends-
Notes to editors:

1. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.

2. More information on hidradenitis can be found on the British Association of Dermatologists’ online patient information pages: http://www.bad.org.uk/public/leaflets/bad_patient_information_gateway_leaflets
/hidradenitis/causes.asp
http://www.bad.org.uk/public/leaflets/hidradenitis.asp

3. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD

4. Study details: “The nature and consequence of Karl Marx’s skin disease”, Professor Sam Shuster, Department of Dermatology, Norfolk and Norwich University Hospital, to be published in British Journal of Dermatology, January 2008.

5. The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

6. Blackwell Publishing is a leading society publisher, partnering with 665 medical, academic and professional societies. Blackwell publishes over 800 journals and has over 6,000 books in print.

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Response to Care Closer to Home report: Shifting Care Closer to Home Demonstration Sites - report of the speciality subgroups
For immediate release 23.10.07

This week, the Department of Health released a report outlining the experiences of six speciality sub-groups, including dermatology, of shifting care into the community. See the report here on the Department of Health website.

Dr Colin Holden, President of the British Association of Dermatologists:

The British Association of Dermatologists supports the conclusions related to dermatology in this report, which recognizes that the specialty has been at the forefront of developing Care Closer to Home recommendations.

The British Association of Dermatologists believes that people with skin diseases should receive the right care, in the right place, the first time, and that the provision of dermatology services should be based on the needs of patients.

Accredited Dermatologists are the most expert practitioners of dermatological diagnosis and management and the local consultant should work with commissioners to develop and then co-ordinate and integrate pathways of care, working in partnership with GPs and nurses.

Patients with severe or complex illnesses (for example skin failure) will require inpatient hospital-based services; many will require specialist care for complex treatments or skin cancer surgery.

Some people with less severe skin disease can be managed successfully by attending a local hospital-based dermatology day unit; others may be managed in the community.

Care, wherever it is delivered, should be of high quality and should not compromise patient outcome and safety. New services should be clinically and financially sustainable. Provision for training future clinicians should be an integral part of any service caring for NHS patients.

Community services must meet the standards set out in ‘Implementing care closer to home; convenient quality care for patients’* and ‘National Guidelines for the accreditation of GPwSIs: Dermatology and skin surgery’.²

* http://www.pcc.nhs.uk/173.php
² http://www.pcc.nhs.uk/uploads/pwsis/gpwsis_dermatology.pdf

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Dermatologists discover link between smoking and new form of acne
For immediate release, 17.09.07

Shocking statistics have led scientists to identify a new skin disorder called ‘smoker’s acne’, the British Journal of Dermatologywill reveal.

Researchers at the San Gallicano Dermatological Institute in Rome, Italy, observed that a specific form of acne, characterised by blocked pores and large blackheads but less inflamed spots than normal acne, seemed to particularly affect adult female smokers.

They therefore conducted a study of 1000 women aged 25 to 50 to further explore this link.

The team found that 42 percent of smokers had acne compared to only one in ten non-smokers.

Furthermore, smokers who had suffered acne in their teens were found to be four times more likely to suffer acne as an adult than non-smokers who also had experienced teenage acne.

In particular, a type of acne called NIA (noninflammatory acne) was prominent, especially in smokers.

‘Adult acne’ is commonly described as featuring inflammatory (red and swollen) spots, usually along the lower jaw line and chin, and is generally mild or moderate. This is known as inflammatory acne or ‘IA’.

However, the team found that of women who had acne, NIA was present in three-quarters of cases. NIA differs from IA and is recognised by prominent white heads, blackheads and very small cysts, particularly on the cheeks and forehead, but rarely with inflammation.

As well as finding that NIA is common in acne sufferers generally, the study showed a strong link between smoking and NIA. Over three-quarters of those with NIA were smokers, and 81 percent of those with severe NIA were smokers.

Furthermore, of the non-smokers who suffered NIA, predisposing environmental factors not linked to smoking were identified in almost half of subjects. (Such factors involve the skin being chronically exposed to particular environmental conditions, like smoke or steam, usually in a place of work such as a kitchen.)

91 percent of smokers who had acne had the NIA form, whereas of the non-smokers who had acne, IA was the more common type (52.8 percent), and was always mild-to-moderate as opposed to severe.

The individuality of symptoms and the strong link with smoking has led researchers to suggest that NIA could be considered a new entity among smoking-related skin diseases, called ‘smoker’s acne’.

Dr Bruno Capitanio, one of the study’s authors, said: “Our study demonstrates that NIA affects a high percentage of women, and is especially high among smokers.

“Recognizing this form of acne is fundamental to providing correct information about the effects of tobacco on the skin, which could contribute to anti-smoking information programmes.

“In some subjects the severity of acne, the clinical peculiarities, the strong correlation with smoking, and the biochemical data could lead to NIA being considered as a new entity among smoking-related cutaneous diseases, called ‘smoker’s acne face’.”

Dr Colin Holden, President of the British Association of Dermatologists, said: “Dermatologists have long associated smoking with premature ageing of the skin, wrinkles and a leathery complexion.

“However, scientists are now increasingly linking the habit with acne. For people who suffered acne as teenagers, the probability of also suffering acne in adulthood is four times higher in smokers than non-smokers. This suggests that smoking could be a major contributing factor for adult acne if you are already predisposed to the disorder.

“This study also shows an interesting link between a specific type of acne and smoking. All of these findings will hopefully provide people with an extra incentive to quit.”

Summary of findings:

18.5% of women had acne NIA affected 74.6 (three quarters) of those with acne
76% of those with NIA were smokers
81% of those with severe NIA were smokers
91.3% of smokers who had acne had the NIA form, whereas of the non smokers who had acne, IA was the more common type (52.8%), and was always mild-to-moderate as opposed to severe.
Of the non-smokers who suffered NIA, predisposing environmental factors not linked to smoking were identified almost half (48.9%).
While acne is more common in smokers, the number of cigarettes smoked did not seem to make a difference.

-Ends-

Notes to editors:

1. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.

2. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD

3. Study details: ‘Smoker’s acne’: a new clinical entity? Published in British Journal of Dermatology, B. Capitanio, J.L. Sinagra, M. Ottaviani*, V. Bordignon†, A. Amantea‡, M. Picardo* - Pediatric Dermatology Department, *Laboratory of Skin Physiopathology, †Laboratory of Clinical Pathology and Immunology and ‡Laboratory of Histopathology, San Gallicano IRCCS, Via Elio Chianesi 53, 00144 Rome, Italy

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

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Dermatologists discover skin disorder caused by socks
For immediate release, 17.09.07

Parents might be causing their children scarring simply by choosing the wrong socks, new research in the British Journal of Dermatology will suggest.

According to the study, ‘sock-line bands’ is a newly discovered condition in babies, caused by tight bands of elastic around the top of socks or the bottom of trousers.

Researchers believe that the tight elastic causes inflammation in the dermis (the lower layer of skin) or in the subcutaneous fat, which once healed can leave visible marks along the sock line.

Dermatologists from across France, the USA and the UK have so far reported at least ten cases with these symptoms, although the exact causes have remained under dispute.

In March, dermatologists at the University Hospital of Montpellier, France, described two children with similar symptoms and speculated that sock elastic may play a part.¹

Now, dermatologists at Washington University School of Medicine and St Louis Children’s Hospital, USA, have identified five more cases, which they believe confirm that sock elastic is the primary cause of such lesions.

According to the Washington University team, several cases featured raised skin along the sock-line, and most showed ‘hyperpigmentation’ – where the skin becomes darker than the surrounding skin. The hyperpigmentation may fade but leave raised lines of skin coloured lesions.

In their report, the researchers distinguish sock-line bands from other raised limb bands developing in infancy and not linked to clothing (‘acquired raised bands of infancy’), and ‘amniotic band syndrome’ which develops in the womb.

One of the study’s authors, Dr David Berk, explains: “The disorder ‘acquired raised bands of infancy’ is characterized by skin-coloured, often diagonal plaques on the arms, trunk or legs, including the thighs as well as the calves.

“Sock-line bands, however, are darker, horizontal lines that only appear on the ankle or calf.

“Furthermore, in contrast to sock-line hyperpigmentation, ‘acquired raised bands of infancy’ has been associated with amniotic bands in the womb, limb constrictions and limb defects including foreshortened toes and clubfoot, and pregnancy complications such as pre-eclampsia, prematurity and placental abruption.

“Sock line bands appear to have a benign course, however it is important that we recognise the disorder to allow us to collect data and cases, to better characterise how the lesions develop.”

Dr Colin Holden, President of the British Association of Dermatologists, said: “There are already thousands of skin disorders treated by dermatology, and this is a prime example of how research is discovering new patterns of symptoms all the time.

“Dermatologists from around the world will look at case studies and new theories in the British Journal of Dermatology, and this allows shared knowledge to develop and researchers to learn from each other’s work.

“That is what has led to the development of this new hypothesis – researchers from across Europe and the US have discussed different cases of children with bands on their limbs, and different theories have been developed by comparing similarities in symptoms.

“While these bands are generally harmless, it is valuable for researchers to be able to discuss this possible new phenomenon in relation to already established skin disorders.”

-Ends-

¹ M.M. Marque, B. Guillot, G. Le Gallic, D. Bessis (2007), Raised limb bands in infancy: a post-traumatic aetiology? British Journal of Dermatology 156 (3), 578–579.
doi:10.1111/j.1365-2133.2006.07673.x

2. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD

3. Study details: ‘Sock-line bands in infancy’, Published in British Journal of Dermatology , D.R. Berk, S.J. Bayliss, Departments of Internal Medicine and Pediatrics, Division of Dermatology, Washington University School of Medicine and St Louis Children’s Hospital, 660 S. Euclid – Campus Box 8123, St. Louis, MO 63110, U.S.A.

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

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BJD study reveals link between scalp disease and hairstyles
Embargo: 00.01am, Friday August 24th 2007

Hairstyling practises may be triggering certain scalp diseases in African children and adults, two new studies in the British Journal of Dermatology will reveal.

Anecdotal reports suggest that certain scalp and hair diseases are more common in people of African descent. To further understand the reasons for this, researchers based in Cape Town conducted two separate studies, one of 1042 school children and the other of 874 adults, with the results focusing on specific skin conditions.

Of almost 2,000 adults and children examined as part of the studies, nearly one in seven school girls and a third of women suffered from ‘traction alopecia’ (TA) - hair loss thought to be caused by hairstyles that induce excessive and prolonged pulling of the hair.

One in ten men had ‘acne keloidalis nuchae’ (AKN), a skin disorder causing pimples, scarring and hair loss, usually at the back of the head.

TA
In children, TA was significantly more prevalent with chemically relaxed (straightened) hair. One in five children with relaxed hair had TA compared to just five percent of those with natural hair. School uniform restricted the variety of hairstyles in children, so it was not possible to monitor the effects of braiding and extensions which are not permitted.

In adults, TA prevalence was higher in both relaxed hair and braided natural hair compared to natural hair without braids; and was highest when the hair was relaxed and also had extensions (such as braids or weaves) attached. This suggests that relaxed hair may be weakened and less resistant to traction, such as is caused by attaching extensions to the hair.

AKN
Frequent close shave haircuts are currently popular in African men. One in ten men suffered from AKN, compared to just 0.3 percent of women.

Although the length of haircut did not make a significant difference, AKN was higher is men who suffered adverse reactions to head shaving, such as small cuts or bleeding. While the irregular scalp surface of men with AKN could make them more likely to suffer accidental cuts, bleeding was also reported in participants without AKN, which could mean that such symptoms may contribute to disease development. More worrying is the potential for infections carried in the blood to be transmitted by hairdressing implements.

On of the authors Dermatologist Dr Nonhlanhla Khumalo said: “TA is common in women and girls and is significantly linked to hairstyles, particularly when relaxed hair has braids, extensions or weaves attached. This can cause unsightly hair loss which is distressing.

“AKN appears to be more common in men who frequently cut their hair, and we have found that it is linked to haircut-associated symptoms, such as pimples, crusts and bleeding. To achieve the shortest possible hair cut metal electric shavers are often dug into the scalp.

“The possible risk for blood borne diseases transmission, such as viral hepatitis and HIV, associated with such haircuts needs to be quantified and non mechanical methods of cutting hair may be safer.”

Additionally, seven in a hundred women aged over 50 years had central centrifugal cicatricial alopecia (CCCA) – permanent hair loss that spreads from the centre from the scalp. While hair relaxers are thought to play a part, the exact causes remain unknown.

Key statistics:

Relaxed hair is far more common in females (78 percent of girls, 59 percent of women) than males (9 percent of boys, 2 percent of men). 20 percent of children with relaxed hair had TA compared to just 5 percent of those with natural hair. In addition women are more likely to have had many hairstyles. Subsequently, TA affects more females than males (one in three women and 2 percent of men; 17 percent of girls and was not diagnosed in boys).

The overall prevalence of AKN was 3.5 percent – significantly higher in men (10.5 percent) than women (0.3 percent). Three-quarters of men had had a haircut within the past month, compared to just 10 percent of women. Men’s haircuts are shorter, more frequent and more likely to cause ‘haircut symptoms’. It is thought that the latter is a factor in the development in AKN, which may explains why it is more common in men.

Notes to editors:

1. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.

2. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD

3. Study details: “Hairdressing and scalp disease in African adults”, and “Hairdressing is associated with scalp disease in African schoolchildren”, both authored by N.P. Khumalo, S. Jessop, F. Gumedze* and R. Ehrlich†; Division of Dermatology, *Department of Statistical Sciences and †School of Public Health and Family Medicine, Groote Schuur Hospital and the University of Cape Town, Observatory 7925, South Africa

4. Embargo: 00.01 Friday August 24th 2007

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

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Wrist monitor reveals blood chemicals linked to itching in eczema
Embargo: 00.01am, Friday August 24th 2007

Scientists have used a novel wrist monitor to discover a link between chemicals in the blood and the itching caused by atopic eczema, a study in the British Journal of Dermatology will reveal.

Researchers at the Chinese University of Hong Kong used the DigiTrac wrist monitor on a group of children suffering from atopic eczema - a dry, itchy inflammation of the skin which is most common in children, affecting at least one in ten babies.

The monitor was programmed to record wrist movement, monitoring how often children scratched their eczema during the night while sleeping.

The researchers then cross referenced these results with blood samples from each child, looking specifically at certain elements thought to play a role in the itching and scratching response associated with the disorder.

They found that high blood serum levels of ‘BDNF’ (brain-derived neurotrophic factor) and ‘substance P’ correlate with high levels of itching, suggesting that these are important mediators that create the annoying itching sensation.

BDNF is a growth factor initially found in the nervous system. Substance P is another neuropeptide that seems to correlate with the severity of the disease.

Recently, scientists at Washington University identified the GRPR (gastrin-releasing peptide receptor) gene which they believe carries the itch signals from the skin to the brain.¹

This latest research in British Journal of Dermatology further explains the possible causes of itching, as it is known that the process behind the mechanism is complex and various neuropeptides and other molecules may be involved.

Kam-lun Ellis Hon, one of the study’s authors, said: “Itching and scratching are important clinical parameters for assessing to what extent eczema impacts on the patient’s everyday life, and to gauge the efficacy of its treatment.

“As far as we are aware, this is the first report to demonstrate that BDNF and substance P are neuropeptides that are significantly linked to disease activity, quality of life, as well as the levels of scratching as recorded by the wrist monitor.”

President of the British Association of Dermatologists, for which British Journal of Dermatology is the official publication, Dr Colin Holden said: “For most eczema sufferers, itching is the worst symptom of the disease. It is more than a slight annoyance - itching is known to keep children awake at night, which in turn affects the parents and can put pressure on the whole family, and sleep deprivation can even affect children’s performance at school. Subsequent scratching of the skin can lead to bleeding, tearing of the skin and infection, exacerbating the disorder.

“This study provides information about the role of two neuropeptides in nocturnal scratching of eczema. It is by discovering the mechanisms behind the disease and its symptoms that we can develop new therapies that specifically target the root cause of the problem.”

¹ A gastrin-releasing peptide receptor mediates the itch sensation in the spinal cord , Yan-Gang Sun, Zhou-Feng Chen, Nature, 25 Jul 2007.

Notes to editors:

1. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.

2. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD

3. Study details: ‘Pathophysiology of nocturnal scratching in childhood atopic dermatitis: the role of brain-derived neurotrophic factor and substance P’ (Short title: BDNF and substance P in nocturnal scratching of AD); K-L.E. Hon, M-C.A. Lam, K-Y. Wong, T-F. Leung and P-C. Ng; Department of Paediatrics, The Chinese University of Hong Kong, 6/F, Clinical Science Building, Prince of Wales Hospital, Shatin, Hong Kong

4. Embargo: 00.01 Friday August 24th 2007

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

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Shocking sunbed study shows increased cancer risk
For immediate release, Friday July 20th 2007

A study due to be published in the August 2007 British Journal of Dermatology has uncovered worrying new findings about sunbeds, including a rise in ‘high power’ sunbeds and a lack of knowledge by users of the cancer risks involved.

Scientists at the Ninewells Hospital & Medical School in Dundee compared current sunbed usage to a 1998 survey of sunbeds in the Dundee , Perth and Kinross areas, and also surveyed the habits and opinions of sunbed users.

Their study revealed a 30 percent increase in the number of privately operated sunbeds since 1998, despite increased warnings over the cancer dangers involved in sunbed use.

The team also measured the levels of cancer-causing UV radiation created by each sunbed, and found that a shocking 83 percent produced UVB radiation levels that exceed the European standard. UVB is generally considered to be the particularly dangerous and is closely linked to induction of skin cancer.

Equally worrying is the emergence of stronger, high power sunbeds. Dr Harry Moseley , Consultant Clinical Scientist and one of the study’s authors, said: “In an earlier study we found that sunbeds carried a cancer risk similar to that of summer sun. However, since our initial study, there have been technological developments leading to new, high power ‘fast tan’ units. These have become increasingly popular, along with the emergence of unmanned sun parlours.

“People sometimes use sunbeds in the mistaken belief that they are a safe alternative to conventional tanning, but this is simply not the case – the average sunbed is now carries the same cancer risk as the midday southern European sun.”

The researchers then conducted a survey of sunbed users, discovering that a staggering 15 percent do not believe that sunbeds carry a health risk. Of those who did feel sunbeds carry risks, only 56 percent mentioned cancer.
Other findings of concern are as follows:

Half of respondents started using sunbeds early in life, between the ages of 16 and 24
Almost a quarter have been using sunbeds for more than 10 years
Over a third have had between 29 and 40 sunbed sessions in the past year, and over a quarter more than 50 sessions
A quarter never use goggles to protect their eyes
Only seven percent had actually been advised to wear goggles

Dr Moseley said: “In comparing these results with those obtained in the 1997 study, a number of key differences should be highlighted. We have found a 30 percent increase in the number of privately operated sunbeds. This is particularly disturbing because in the earlier study, in which we looked at environmental health factors, we found that many privately operated sunbeds had major faults; for example, 89 percent did not attempt to impose a limit on the number of sessions, 81 percent provided inadequate information, 59 percent maintained no customer records and 33 percent failed to display guidance. Therefore, it is a cause for concern that the number of sunbeds provided by the private sector is increasing.

“Another factor that has emerged is that the mean cancer risk for all machines is now comparable to that from Mediterranean sun, whereas in the previous study this only applied to stand-up booths. This increase in carcinogenic potential is directly related to the widespread use of high power sunlamps, both in stand-up booths and lie-down sunbeds.

“Also, for the first time, we identified premises with unmanned sunbeds. These have no supervision and anyone, including children, may use the facilities. There is no limit imposed on the dose per session nor the number of sessions.

“The majority of sunbeds do not comply with the British and European standard for cosmetic tanning units. 83 per cent of sunbeds produced UVB irradiances that exceeded the limit specified in the standard. Product standards are intended to protect the public but, clearly, sunbed manufacturers are ignoring the standard and there is no effective control on the suppliers or operators.

Notes to editors:

If using this study, please ensure you mention that the study is being released in the British Journal of Dermatology, the publication of the British Association of Dermatologists (August 2007 edition)
The study is titled ‘Qualitative risk assessment of sunbeds: impact of new high power lamps’. Authors: Harry Moseley , James Ferguson , Hannah Oliver – The Photobiology Unit, University of Dundee , Ninewells Hospital & Medical School, Dundee DD1 9SY ,
BJD is published by Blackwells. The full article can be viewed online here (click on 'latest issue')
For more information please contact:

Shona Singers, Head of Corporate Communications, NHS Tayside, Phone: 01382 424138
Dr Harry Moseley , Phone: 01382 633894 / 0796 1824631, email h.moseley@dundee.ac.uk

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Study shows school children are not protected from skin cancer
EMBARGOED TO 00.01, TUESDAY JULY 10 TH 2007

A study due to be released at the British Association of Dermatologists’ Annual Conference this week will reveal that school children are shockingly unprotected from cancer-causing sun damage.

To better understand sun safety measures in schools in the South East of Ireland, researchers at Waterford Regional Hospital in Waterford, Irealnd, surveyed 345 primary schools. The aim of the survey was to determine whether a sun protection policy existed in these schools, to find out about current school practices in sun protection and teachers’ opinions about the importance of sun protection for children.

Although every school surveyed had outdoor activities scheduled between 10am and 2 pm , when the sun is at its strongest, almost half had had no shaded areas in the playground. Additionally, 95 percent had no documented sun protection policy, although eight out of ten of principals and teachers feel this was a necessary measure.

Dermatologist Mary Laing, one of the scientists who conducted the study, said: “Skin cancer is the most common type of cancer worldwide. All types of skin cancer are largely preventable through limiting exposure to UV radiation in sunlight.

“Childhood exposure to UV radiation from the sun and a history of sunburns are risk factors for melanoma and basal cell car carcinoma. School policies addressing sun protection are therefore an important issue. Schools are an appropriate venue for sun protection programmes as learning sun protective behaviour at school may lead to protective behaviour outside school also. The majority of teachers feel that sun exposure in childhood is an important health concern, however there is no sun protection policy in place for schools in Ireland .”

Nina Goad of the British Association of Dermatologists said: “It is thought that just a couple of cases of sunburn as a child could as much as double your chance of getting skin cancer later in life. That’s why we are working hard to promote sun safety information to schools with leaflets and posters, and we hope this study will encourage schools to be more sun savvy and take steps to protect their students.”

Summary of results:

95 percent of schools had no written policy to limit student’s sun exposure.
100 percent of schools had outdoor activities scheduled between 10am and 2pm.
44 percent of schools had no shade-producing structures.
The school uniform included hats in 24 percent, shorts in 38 percent and short sleeves in 66 percent of schools. Only 55 percent of schools allow students to wear sunglasses during outdoor activities.
22 percent of school personnel (including teachers, PE teachers, school nurses) never wear hats, long sleeves, parasols / umbrellas or sunglasses.
Sunscreen was encouraged in only 55 percent of schools, mainly on school excursions.
Although no sun protection policy exists in schools, 80 percent of principals and teachers feel this is required.
79 percent of teachers felt that excessive sun exposure in childhood was an important health concern, however one percent of teachers felt it was not at all important.
Notes to editors:

EMBARGOED TO 00.01, TUESDAY JULY 10 TH 2007
The study is being released at the British Association of Dermatologists’ Annual Conference. The conference is being held at Birmingham ICC from 10 th to 13 th July 2007 and is attended by UK and worldwide dermatologists and dermatology nurses.
The study is titled ‘A study of sun avoidance and protection measures in primary schools in the south east of Ireland ’. Authors: Mary Laing, Jessica Sui, Colin Buckley - Waterford Regional Hospital , Waterford , Ireland. A list of schools was obtained from the Department of Education website. School sizes varied from 9 - 425 pupils. Of 345 distributed questionnaires, 274 were returned. This represented 29,369 students (6.4% of the total primary level education population in Ireland for 2005/2006).

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Deadly skin cancer cases continue to rise in the south-west
EMBARGOED TO 00.01, SUNDAY JULY 8TH 2007

A study due to be released at the British Association of Dermatologists’ Annual Conference this week will reveal worrying skin cancer rates in Cornwall.

The South West region has among the highest levels of ‘malignant melanoma’, the deadliest form of skin cancer, in the UK .

In 2002, the Chief Medical Officer announced that diagnosed cases of malignant melanoma in the South West region were over a third higher than the national average. Of even more concern, he also stated that the South West has 26 percent more deaths from the disease than the national average. This meant that the South West had the highest numbers of both cases and deaths from the disease, compared to eight other English regions.¹

A team of scientists from Royal Cornwall Hospital in Truro and Derriford Hospital in Plymouth conducted the new study to see whether melanoma cases are continuing to rise in the region, comparing data from 2003, to the most recently available data (2005).

Due to be presented on Tuesday July 10 th at the conference, the study reveals a rise in melanoma cases of 18 percent in just two years.

Consultant Oncologist (cancer specialist) at the Royal Cornwall Hospital in Truro and one of the team who carried out the study , Dr Alastair Thomson said: “The south-west has a particularly high number of melanoma cases. Our study was to see if this high number is increasing further. By reviewing the Royal Cornwall Hospital records for 2005, we found that there was an increase in patients with melanoma of 18 percent comparing 2005 with 2003, with 134 new diagnoses in 2005 in Cornwall.

“As well as an actual rise in cases of melanoma, there are several other possible reasons for this increase, including better detection, treatment and recording of cases, or if people with a high risk of melanoma moved to the area. However, it is also worth noting that the actual figures could be higher still, as some people do not seek treatment or are treated elsewhere.

“It is not clear why the south-west has such high numbers, but possible reasons are too much exposure to the sun, outdoor lifestyles and having a fairer skinned population. Overall, we can conclude that the number of melanoma cases does still remain high in this region, and appears to be increasing. We are therefore hoping this study will encourage people to take care protecting their skin from the sun, and to seek advice from a health professional at an early stage if they notice any changes to their skin.”

Nina Goad of the British Association of Dermatologists said: “This study shows a worrying trend that is present across the UK but particularly in Cornwall and surrounding areas. Melanoma kills 2,000 people in the UK every year – that’s equivalent to a bus load of people dying every week.

“In the vast majority of cases, it is a preventable disease, with excess sun exposure as the main cause.

“We have sent leaflets and posters to various hospital departments, schools, pharmacies and businesses across the south-west, as part of a campaign to educate people on staying safe in the sun and to show what changes to look out for that may indicate a skin cancer, so people can seek treatment early.

“ Australia is often thought of as the skin cancer capital of the world, however the UK death rate from the disease is now one and a half times higher than theirs. Following a publicity campaign, skin cancer figure in Australia have finally started to plateau, while ours continue to rise. Our aim is to mimic their success in teaching people about staying safe in the sun.”

¹Sir Liam Donaldson, Chief Medical Officer, ‘Health Check - Annual Report of the Chief Medical Officer 2002’

- ends-

Notes to editors:

EMBARGOED TO 00.01, SUNDAY JULY 8 TH 2007
The study is due to be released at the British Association of Dermatologists’ Annual Conference. The conference is being held at Birmingham ICC from 10 th to 13 th July 2007 and is attended by UK and worldwide dermatologists and dermatology nurses.
Study details: Is the incidence of malignant melanoma continuing to increase in the South West of the United Kingdom? Alastair Thomson, Richard Corkill, Faheem Bishr, Royal Cornwall Hospital, Truro, Cornwall, United Kingdom.

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BAD launches new sun safety information
For immediate release, 28.06.07

THE British Association of Dermatologists (BAD) has teamed up with the British Skin Foundation charity (BSF) for a new Sun Awareness Campaign.

Launched during the BAD’s Sun Awareness Week in May, the campaign aims to educate people about the dangers of too much sun exposure. In particular, the association is looking to provide information in areas that have been confusing up until now, including sun advice for dark skin types, how to use the UV index, how to check your moles and new sunscreen labelling.

A new range of easy to understand, colourful leaflets and posters have been made available free of charge, and include:

SOS – sun safety tips to Save Our Skin
Know your Skin Type – with sun safety information for darker skin types
UV index
ABCD E-asy way to check you moles

These are complemented by a ‘fact sheet’ and web page with frequently asked questions about sunscreen, sun safety, skin colours, and advice about new labelling on sunscreens to come into affect next year.

Topics include:

What are UVA and UVB?
How do sunscreens work?
What is SPF?
The UVA star system
The future of sunscreen labelling (due to change next year following EU recommendation)
What is photostability?
Does an SPF in a moisturiser work?
How should I apply sunscreen, and how much should I use?
Vitamin D
I'm dark skinned - can I get skin cancer?
Will I tan through sunscreen?
What is a tan?
Why should we be careful?

The fact sheet can be viewed online at: www.bad.org.uk/sunawareness

Nina Goad of the British Association of Dermatologists, directing the Sun Awareness Campaign said: “More than 70,000 new cases of skin cancer are diagnosed every year, with malignant melanoma causing 2,000 deaths per year. That’s equivalent to a bus load of people being killed every week. We recently carried out a survey which showed that three-quarters of people don’t understand about UVA and UVB protection, while alarmingly, one in ten men don’t believe skin cancer is linked to sun exposure. Clearly, we have a lot of work to do, and we hope this campaign will make a good start.”

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Note to editors:

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BAD welcomes new guidelines to protect skin disease patients
For immediate release, 21.06.07

NEW guidance has been published by the Department of Health to ensure that all GPwSIs (GPs with Special Interests) treating skin disease patients are suitably qualified and have the necessary clinical skills to do so.

Previously, GPwSIs did not have a formal accreditation system, unlike all other health professionals. GPs could become GPwSIs with highly variable and sometimes very little training and experience of dermatology.

“National Guidance and competencies for the provision of services using GPs with special interests ( GPwSI) in community settings: Dermatology and skin surgery” was developed by the British Association of Dermatologists (BAD), Primary Care Dermatological Society, Skin Care Campaign and the Royal College of General Practitioners.

The document provides information about a dermatology curriculum, core competencies, teaching methods and assessment.

This supports the new commissioning guidance in “Care Closer to Home – Convenient Quality Care for Patients” , also recently launched, and together these new documents should ensure that all dermatology GPwSIs are properly trained to provide the service they have been commissioned to deliver.

The need for improved, mandatory guidance was highlighted by a 2004 survey of GPwSIs in dermatology, in which only a third of respondents indicated that they were working within the existing DH framework; half had not completed an accreditation process in the first place, and almost half admitted to not attending the required minimum of a monthly session in the local secondary care dermatology department. *

Dermatologists raised concerns that skin disease patients referred to new ‘community’ clinics, for example Clinical Assessment, Treatment and Support Services (CATS) and Independent Sector Treatment Centres (ISTC), instead of dermatology departments might not see the most appropriately trained person, and that ‘patient choice’ was removed if patients were not given the option to see a dermatologist ². Since 15% of a GP’s consultation time relates to skin disorders³, rectifying this situation was a priority for the BAD.

Dr Julia Schofield, Consultant Dermatologist and co-author of the new guidance, said: “Without mandatory accreditation, there is a danger that GPwSI dermatology services will be brought into disrepute. It is vitally important for the maintenance of a high standard of care and the credibility of dermatology services that all existing and new GPwSIs are accredited in accordance with the GPwSI in dermatology accreditation framework.”

Dr Susan Burge, Consultant Dermatologist and President of the BAD said: “The British Association of Dermatologists believes that people with skin diseases should receive the right care, in the right place, the first time. The provision of dermatology services should be based on the needs of patients: those with severe or complex illnesses will require hospital-based services; others may be managed in the community.

“The documents should ensure that care, wherever it is delivered, is of high quality and does not compromise patient safety. It is reassuring that Primary Care Trusts in England are expected to pay due regard to the provisions in these documents when commissioning dermatology services”,

Dermatologist and President -elect of the BAD Dr Colin Holden said: “The BAD is proud to be involved with the development of the Guidance for GPwSI in dermatology. The guidance emphasises the training requirements, service standards and continuing development of skills that patients should expect to receive from GPs who take a special interest in skin.

“It is essential that purchasers of health care apply these standards to services they commission and also understand the need specifically stated in the guidance that such services should be integrated with local Dermatology Consultant services.”

-Ends-

Notes to editors:

*The NHS Modernisation Agency, Action on Dermatology programme survey of GPwSIs in dermatology – results from 80 returns were analysed and audited against the DoH document “Guidelines for the Appointment of General Practitioners with Special Interest in the Delivery of Clinical Services Dermatology (April 2003)”

² Many PCTs are setting up ‘intermediate services’ that are not covered by the Choose & Book system (if you require a hospital appointment, you are able to choose which hospital you would prefer to attend) and which they perceive to be cheaper. Patients referred to these services will not be offered ‘choice’, nor are they likely to be seen by a fully trained and accredited dermatologist on the GMC (General Medical Council) specialist register. Patients may be seen by a GP with a special interest in dermatology and perhaps a dermatology diploma, a doctor trained elsewhere in Europe or perhaps a specialist nurse. Some, but not all, of the individuals working in intermediate services may also work closely with a consultant dermatologist in the local hospital department.

If your GP suggests that you are referred for a dermatology opinion, you should be offered a choice of hospital under the Choose & Book scheme. If you are not offered any choice, then it is likely that you are being referred to an intermediate clinic.

³Royal College of General Practitioners, "Morbidity Statistics from General Practice: Fourth National Study 1991-92", published in 1995 by HMSO.

The British Association of Dermatologists is the central and long-established association of practising UK dermatologists, and our aim is to continually improve the treatment and understanding of skin disease.

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Dermatologists claim smoking ban will not only save lives but will make people look younger
For immediate release, 14.06.07

DERMATOLOGISTS, the experts on skin disease, envisage a little-known extra benefit to July 1st’s smoking ban in England – younger looking skin.

If, as supporters of the ban predict, more smokers are inspired to quit, fewer people will experience the premature ageing caused by cigarette smoke. Recent studies even suggest that passive smoking leads to wrinkles, so it is not just smokers themselves who could benefit from a more youthful complexion.

Dermatologist and President of the British Association of Dermatologists, Dr Colin Holden said: “When we think of the impact of smoking on the body, we obviously concentrate on the risks of lung cancer and heart disease.

“However, strong evidence now links the habit to premature ageing of the skin, including wrinkles. These findings may provide an extra incentive for people to quit.”

Some wrinkling of the skin is unavoidable as the body ages, but external factors also play a major role – especially UV exposure and smoking, which lead to wrinkles and a sallow, leathery texture.

Dr Holden explained: “The skin gets its elasticity to a large extent from collagen. Smoking enhances an enzyme in the skin (matrix metalloproteinase-1) which degrades collagen, so the skin loses its elasticity and develops lines.

“In addition, smoking causes blood vessels to constrict, which limits the amount of oxygen that can reach the skin. This lack of oxygen reduces production of collagen and elastin (which also gives the skin its structure) and negatively affects the skin’s health and appearance generally. Smoking can also cause an unattractive yellowing of fingernails which makes the hands look older.

“If everyone in the UK was to quit smoking, and also take a bit more care in the sun, in decades to come the population would keep its youthful appearance for a lot longer than at present.”

Anti smoking groups and cancer charities have strongly encouraged the ban, citing cancer causing chemicals in second-hand smoke as the key motivation for the move. But those who are not convinced by these arguments may be swayed by the fact that smoking is a major factor in premature ageing of the skin.

Nina Goad of the British Association of Dermatologists said: “Many people spend a lot of money on anti ageing products but also sunbathe and smoke – rendering all the time and money they have spent on their anti-wrinkle skincare regime a bit pointless.

“In the same way that some women wear sunscreen to protect against wrinkles more than through concerns about skin cancer, we may find that publicising how smoking ages your skin provides another good reason to ditch the habit.”

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Notes to editors:

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Dermatologists offer best advice on skin problems, survey reveals
For immediate release, 15.02.07

THREE-quarters of adults in Great Britain would consult a dermatologist for the best advice on skin problems, according to new research for the British Association of Dermatologists.

However, one in five adults incorrectly believe that dermatologists conduct treatments like facials, tanning, waxing or facelifts.

The Ipsos MORI survey – to understand the public’s perception of dermatologists – is thought to be the first of its kind and was undertaken in light of current threats to dermatology care from the Government’s NHS reforms.

When asked who, from a list of people including healthcare professionals, would give the best advice on skin problems, the majority of adults (73%) choose a dermatologist. This comes some way ahead of GPs mentioned by 58% of adults.

In spite of this, the government’s health reforms are rationing patients’ access to expert advice, as GPs are forced to treat patients with skin problems themselves or to refer them to “community clinics”, most of which are not staffed by consultant dermatologists.

The survey clearly shows that people associate the profession with the treatment of some of the most common skin disorders.

When asked what springs to mind on hearing the word “dermatologist”, nearly three-quarters (72%), mention skin, skin disease, or skin cancer without prompting.

Three-quarters (76%) of GB adults associate dermatologists with the treatment of eczema, a condition which affects one in five children and one in twelve adults. Likewise, over two-thirds (68%) link the treatment of acne – which affects over 80 per cent of adolescents – with dermatologists.

Several other roles were linked with dermatologists by half or more of those interviewed, including treating/diagnosing rashes (66%), checking moles (50%) and treating skin cancer (49%).

“Nine out of ten adults were able to correctly identify at least one of the treatment areas provided by a dermatologist, which is really positive,” said Nina Goad of the British Association of Dermatologists.

“However, a significant minority (one in five adults) incorrectly believe that dermatologists conduct treatments like facials, tanning, waxing or facelifts – a misconception which the British Association of Dermatologists will be seeking to correct.”

President of the British Association of Dermatologists Dr Susan Burge said:

“Dermatologists are the experts in skin disease, and this survey shows that people know this. Each year around two million people are cared for by teams of dermatologists and nurses in hospitals.

“There are many different skin disorders and they can be difficult to diagnose. Skin cancers can kill. Infants with eczema may lie awake crying and scratching until the skin is torn and bleeding. Acne devastates the lives of many teenagers and the scars are a permanent reminder. Severe psoriasis may reduce quality of life as much as diabetes or asthma.

“Patients are being denied choice of access to expert advice, as GPs are forced to treat patients with skin problems themselves or divert referrals to services which are not run by consultant dermatologists. As a result, life-threatening skin cancers may be missed; people may suffer because the diagnosis was wrong or the treatment second-best.

“What choice do you have if your GP is unable to refer you to a dermatologist? If you are referred to such a service, will you see a registered specialist?

“This survey proves that adults are well aware that dermatologists are skin specialists, and it follows that access to experts should be provided on the basis of need, not restricted on the basis of cost.”

Survey summary:

Ipsos MORI poll of over 2000 GB adults.

When asked who would give the best advice on skin problems, 73% chose a dermatologist.

When asked what springs to mind on hearing the word “dermatologist”, 72%, mentioned skin, skin disease, or skin cancer.

76% associated dermatologists with the treatment of eczema,

68% linked the treatment of acne with dermatologists

88% identified at least one correct activity from a list of options given, relating to services provided by dermatologists (e.g. acne treatment, skin cancer treatment)

17% selected one or more incorrect treatments, (e.g. facials, tanning, waxing, cosmetic surgery or facelifts).

ENDS
NOTE FOR EDITORS

The Ipsos MORI Social Research Institute interviewed a representative sample of 2,013 adults aged 15+ across Great Britain . Interviews were carried out face-to-face, in home, using CAPI, as part of the Ipsos MORI Omnibus. Fieldwork was conducted between 7 and 12 December 2006 . Results are weighted to the known population profile of GB.
Research was carried out by Ipsos MORI on behalf of the British Association of Dermatologists.
The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

For more information please contact Communications Manager, Nina Goad, 0207 391 6355 ; comms@bad.org.uk

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