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Dermatology at the Conference

Dermatology at the Conference

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Ivan Bristow

The dermatology sessions are always well attended and every year it is an enjoyable challenge to find new speakers from within this vast field. This year, it was a pleasure to hear from Graham Ogg, a dermatologist and Professor from the University of Oxford, speaking at Thursday’s plenary session with an update on one of the commonest skin conditions in the young - atopic dermatitis. In the afternoon, Dr Bryan Markinson took to the stage. Bryan is a podiatrist working in the United States at Mount Sinai Hospital in New York, one of the country’s most prestigious hospitals, where he specialises in dermatology. He highlighted the vast array of skin conditions he had seen, with case studies of the weird and wonderful. Malignant skin conditions featured a lot – a key message being to request biopsies when the clinical picture is not clear.

On Saturday, Dr George Moncrieff was welcomed back for a second visit. George, a GP from Oxfordshire and chair of the English Dermatology Council, has a passion for all things skin related. He opened the session by recounting how an off-the-cuff remark about not using soap in 20 years ended up in the tabloids and an interview live on ‘This Morning’ with Holly and Phil as the great unwashed doc. George was quick to point out he did wash every day – but avoided all soaps, detergents and shampoos that can degrade epidermal lipids, leading to skin dryness. When he started in general practice, atopic dermatitis was uncommon but now it is reaching epidemic proportions. In part, he suggested that changes in our bathing habits (too frequently) and using harsh chemicals was leading to depletion of lipids from the skin. This degrades the skin barrier, leaving the skin prone to assault by allergens, which consequently leads to allergies and asthma.

He then discussed the role of UVA in daylight in skin ageing. At wavelengths of 320-400nm, UVA can travel through glass and much deeper into the skin than UVB. The effects of this wavelength of light can cause damage to fibroblasts deep in the dermis, which can lead to premature wrinkling and ageing of the skin. The key message from this was to consider using a sunscreen that provided a high level of UVA cover.

The final dermatology session on Saturday afternoon was by Catriona Henderson, a consultant dermatologist from Southampton. Following last year’s keynote where dermoscopy was introduced, it was suggested this was a skill podiatrists could use in the clinic. Catriona spent an hour discussing melanoma and other skin malignancies such as squamous cell carcinoma and how they may present. The use of dermoscopy, as she emphasised, can really enhance a practitioner’s ability to decide when an urgent referral is necessary.