Patient Information Leaflets (PILs)

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These Patient Information Leaflets (PILs) are specially written by the British Association of Dermatologists (BAD).

The BAD has been awarded The Information Standard certification for the process it employs to develop information products aimed at the general public, which include PILs, Sun Awareness Campaign materials, and other information products.

The BAD shall hold responsibility for the accuracy of the information published, and neither the scheme operator nor the scheme owner shall have any responsibility for costs, losses, or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of the BAD.

The BAD has also prepared a limited number of PILs translations.

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5-FU cream is a treatment which destroys sun-damaged cells in the skin by blocking an enzyme called thymidylate synthetase that is highly active in these cells, thus causing their death and sparing the normal cells. It has been in use for about 50 years. In the UK, a 5% 5-FU cream is available (trade name Efudix®), but other formulations are on the market in other countries.

Acitretin (trade name Neotigason) is a member of a group of drugs called retinoids, closely related to Vitamin A. It works by slowing down cell reproduction in the skin.

Acne is a very common skin condition characterised by comedones (blackheads and whiteheads) and pus-filled spots (pustules). It usually starts at puberty and varies in severity from a few spots on the face, neck, back and chest, which most adolescents will have at some time, to a more significant problem that may cause scarring and impact on self-confidence. For the majority it tends to resolve by the late teens or early twenties, but it can persist for longer in some people.

Acne can develop for the first time in people in their late twenties or even the thirties. It occasionally occurs in young children as blackheads and/or pustules on the cheeks or nose.

Actinic keratoses are areas of sun-damaged skin found predominantly on sun-exposed parts of the body, particularly the backs of the hands and forearms, the face and ears, the scalp in balding men and the lower legs in women. They may also occur on the lips. The terms actinic and solar are from Greek and Latin, respectively, for ‘sunlight-induced’, and the term keratosis refers to thickened skin. They are usually harmless but there is a very small risk of some actinic keratoses progressing to a form of skin cancer called squamous cell carcinoma (see Patient Information Leaflet on Squamous Cell Carcinoma). Actinic keratoses are not contagious.

The term 'actinic prurigo’ is the term used for a rare (less than 1:1,000) type of skin sensitivity induced by sunlight (photosensitivity); 'actinic' is Greek for 'sunlight', ‘pruritus’ is the medical term for itching, and ‘prurigo’ is a related word which describes the changes that appear in the skin after it has itched and been scratched for a long time. In actinic prurigo the skin becomes firm, raised and itchy on the areas of the skin surface which are exposed to the sun.

Adalimumab is a powerful drug that has been specially designed to mimic normal human molecules, and for this reason it is classed as a ‘biological’ drug. It reduces inflammation by inhibiting the activity of a chemical ‘cytokine’ in the body called ‘tumour necrosis factor alpha’ (TNF-alpha).

Alopecia is a general term for hair loss. Alopecia areata is a specific, common cause of hair loss that can occur at any age. It usually causes small, coin-sized, round patches of baldness on the scalp, although hair elsewhere such as the beard, eyebrows, eyelashes, body and limbs can be affected. In some people larger areas are affected and occasionally it can involve the whole scalp (alopecia totalis) or even the entire body and scalp (alopecia universalis).

It is not possible to predict how much hair will be lost. Regrowth of hair in typical alopecia areata is usual over a period of months or sometimes years, but cannot be guaranteed. The chances of the hair regrowing are better if less hair is lost at the beginning. Most people, with only a few small patches get full regrowth within a year. If more than half the hair is lost then the chances of a full recovery are not good. The hair sometimes regrows white, at least in the first instance. Most people get further attacks of alopecia areata. In alopecia totalis and alopecia universalis, the likelihood of total regrowth is less.

Androgenetic alopecia is the most common type of progressive hair loss. It is also known as male-pattern baldness, female-pattern baldness, or just common baldness. It affects about 50% of men over the age of 50, and about 50% of women over the age of 65. In women the severity varies, it may present as widespread hair thinning but in some cases it can lead to complete baldness.

Atopic eczema is an extremely common inflammatory condition of the skin. It may start any age but is most common in children, affecting 1 in every 5 children in the UK at some stage. The term ‘atopic’ is used to describe a group of conditions which include asthma, eczema and hay-fever. These conditions are linked by an increased activity of the allergy component of the immune system.

An atypical fibroxanthoma (AFX) is an uncommon (< 0.2 % of all skin cancers) type of skin cancer that occurs mainly in older people after the skin of the head and neck has been damaged by sunlight and/or by radiotherapy used to treat a previous cancer.

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