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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.

Please note:

  1. 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.
  2. 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.

For the latest BAD advice on Covid-19 for patients, please check the News and Media section of the website. Find this here. Our information for healthcare professionals is here.

Urticaria and angioedema

  • Urticaria, also known as hives, is common, and affects about 20% of people (one in 5 people) at some point in their lives. Urticaria consists of pink or white raised areas of skin resembling nettle rash, known as wheals (also spelled weals), which are usually itchy.  The wheals are often round or ring-shaped. Wheals can also appear as lines when the skin is firmly stroked. They can appear anywhere on the skin. Individual wheals typically disappear of their own accord within 24 hours without a trace, although the course of the condition is longer.  
  • Angioedema is characterised by deeper swelling in the skin, which may take over 24 hours to clear. It is not usually itchy and can affect the lips and tongue. Some patients have one or the other condition, others have both.

Urticaria pigmentosa

Urticaria pigmentosa is the commonest type of a group of diseases called cutaneous mastocytosis, which has 3 other different types (see ‘What are the symptoms of urticaria pigmentosa?’ section).

Mastocytosis means increased number of mast cells. Mast cells are a type of blood cell belonging to our immune system, which secrete histamine if triggered. They can exist in the blood vessels or in any body tissue or organ.  Urticaria pigmentosa is composed of pigmented brown patches, made of collections of mast cells that swell when rubbed similar to urticaria. In the majority of cases, urticaria pigmentosa is a harmless condition with excellent outcome.

More than 75% of cases of urticaria pigmentosa happen to infants and children less than 10 years old, but it can also affect older children and adults. It affects both sexes equally and occurs in all races equally. 


Ustekinumab is a drug that has been specially designed to mimic normal human molecules, and for this reason it is classed as a ‘biological’ drug. It reduces skin inflammation by blocking the activity of chemical molecules called cytokines (interleukin 12 and 23) in the body that trigger inflammation in psoriasis.

Vascular birthmarks

They are marks made up of excess or abnormal blood vessels in the skin. There are many different types, and only three are described in this leaflet: salmon patches (naevus simplex); port wine stains (naevus flammeus); and strawberry naevi (infantile haemangiomas).

Venous eczema

Venous eczema is also known as varicose or stasis eczema and is the name given to a type of eczema on the lower leg. The word eczema (or dermatitis) refers to a common inflammatory skin condition. Venous eczema is more common as people get older and occurs more often in women than in men.

Venous lake

A venous lake is a small blood vessel (vein) in the skin, which over time has become enlarged and wider (or dilated).

Venous leg ulcers

A venous leg ulcer is an open wound in the skin of the lower leg due to high pressure of the blood in the leg veins.


Vitiligo is a persistent or chronic condition in which areas of skin lose their normal pigment and become very pale or pink. It is common, affecting about 1% of the world's population. It can start at any age after birth, but in more than half of people affected it does so before 20 years of age. The extent of the condition is unpredictable, varying from single small patches to total loss of skin colour. In most people, it tends to change slowly, with periods of stability often lasting several years. The pigment may return in some patients, but is not guaranteed, and seldom returns completely.


Vulvodynia means ongoing pain in the vulva (the female genital area) when there is nothing abnormal to see and no known cause for the pain.

Vestibulodynia is a term used for pain arising at the entrance of the vagina, in the area known as the vestibule (the area of the openings to the vagina and the urethra), when any pressure, be it touch or friction, is applied. It is also called localised vulvodynia.

Vulvodynia, whether it is generalised or localised, may be described as provoked (caused by touch) or spontaneous (occurring without touch as a trigger).

Many conditions affecting the vulva can be painful (e.g. infections such as thrush or herpes, as well as skin diseases such as eczema). In vulvodynia, pain is felt in the vulva when there is no obvious visible cause for it and other diagnoses have been ruled out by examination and investigation.

Xeroderma pigmentosum

XP is a very rare condition with about 100 patients living with it in the UK. XP can affect both sexes and all racial groups.

With XP the genetic material in the skin is unable to repair itself correctly after exposure to ultraviolet radiation (UVR), which is present in all forms of daylight and some artificial light. Without this repair mechanism working correctly a person is much more likely to develop skin cancers. XP can be divided into different types known as complementation groups A to G and Variant. There are slight clinical differences between the groups; with around 30% developing neurological problems such as hearing loss, balance problems or learning difficulties.

Zoon's balanitis

Zoon’s balanitis describes inflammation of the head of the penis (glans penis) and foreskin.  It usually affects middle-aged to elderly men who have not been circumcised.

The word balanitis is derived from the Greek word balanos, which means ‘acorn’. The ending ‘-itis’ stands for inflammation. Balanitis means inflammation of the glans penis. Zoon’s balanitis is named after Professor Zoon, a Dutch dermatologist, who described the condition in 1952.In addition to the glans penis, the foreskin is often involved.

It has also been called ‘balanitis circumscripta plasmacellularis’ because the patches are well defined, and ‘plasma cell balanitis’ because many plasma cells (a type of white blood cell) may be seen when the affected skin is examined under the microscope.

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