Patient Information Leaflets (PILs)
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.
There are thousands of different skin complaints, therefore, the focus of the British Association of Dermatologists' PILs production is on the most common, rarest or debilitating skin conditions.
The offer to provide details of source materials used to inform the British Association of Dermatologists' PILs is for instances where the advice provided in the PILs does not reflect local practice and therefore evidence supporting said advice needs to be produced. It is not an offer to conduct literature searches or supply bibilographic materials for your own research.
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Acitretin is a type of drug called a retinoid. Retinoids are closely related to Vitamin A and work by slowing down cell growth 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 forearms, backs of the hands, face, ears, bald scalp and the lower legs. 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. Actinic keratoses may be unsightly, sometimes they can itch, but generally are harmless. There is a very small risk that the patches could progress into a form of skin cancer called squamous cell carcinoma. Nonetheless, patients who have actinic keratoses are more at risk of all types of skin cancer compared to someone of the same age without actinic keratoses. Patients most at risk are those who have numerous actinic keratosis patches and those on immunosuppressive drugs for accompanying conditions. 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).
Alitretinoin (brand name Toctino) belongs to a group of drugs called retinoids, which are closely related to vitamin A. It works by reducing skin cell turnover and also helps to reduce skin inflammation.
Alopecia is a general term for hair loss. Alopecia areata is a common cause of non-scarring (does not cause scarring to the scalp) 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.
Apremilast is an oral medication which works by inhibiting (stops it from working as it usually does) an enzyme known as phosphodiesterase inhibitor (PDE4). PDE4 controls the inflammation process in the skin. Reducing or controlling the inflammation in the skin can lead to improvement of symptoms in people with psoriasis.
Atopic eczema is a very common skin condition due to skin inflammation. It may start at any age but the onset is often in childhood. 1 in every 5 children in the UK is affected by eczema at some stage. It may also start later in life in people who did not have AE as a child.
The term ‘atopic’ is used to describe a group of conditions, which include asthma, eczema and hay-fever and food allergy. These conditions are all linked by an increased activity of the allergy side of the body’s immune system. ‘Eczema’ is a term which comes from the Greek word ‘to boil’ and is used to describe red, dry, itchy skin which can sometimes become weeping, blistered, crusted, scaling and thickened.
An Atypical Fibroxanthoma (AFX) is an uncommon type of skin cancer, accounting for less than 0.2 % of all skin cancers. It occurs mainly on the head or neck of older people, usually after the skin has been damaged by prolonged exposure to sunlight.