Weird Skin Stuff

July 2009

AFP Cover 2009 July

Weird Skin Stuff

July 2009 Vol 38 (7) 465-560

The theme for the July issue of AFP is Weird Skin Stuff. This month's articles include Presentations of rash, Cutaneous melanoma - atypical variants and presentations, Blistering skin conditions, Difficult to diagnose skin cancer - the 'aggresive' BCC and Skin manifestations of systemic disease.


Blistering skin conditions

Belinda Welsh

Cutaneous melanoma

Atypical variants and presentations

Alex Chamberlain, Jonathan Ng

Presentations of rash

Salma Fahridin, Graeme C Miller

Skin manifestations of systemic disease

Adriene Lee

Difficult to diagnose skin cancer

The ‘aggressive’ BCC

Steven Tomas

Up front

Letters to the editor

The complexities of our outer layer

Jenni Parsons


The role of breast MRI in clinical practice

Meagan Brennan, Andrew J Spillane, Nehmat Houssami


A case report

Sudheer Ahamed Puthiyaveetil

Weight loss and malnutrition in the elderly

The shared role of GPs and APDs

Gemma Sampson


Anxiety and depression in Chinese patients attending an Australian GP clinic

George Wen-Gin Tang, Sarah M Dennis, Elizabeth Comino, Nicholas A Zwar

Bacterial skin infections

An observational study

Geoffrey Spurling, Deborah A Askew, David King, Geoffrey K Mitchell

Education in skin cancer management - Assessing knowledge and safety

Anthony Dixon, Helena Rosengren, Thomas Connelly, John B Dixon


Electronic medical records – where to from here?

Christopher Pearce

Harassment of GPs

Sara Bird


The doctor of the future

Des Gorman

Back pages

Book reviews

Clinical challenge

Rachel Lee


AFP Podcasts

Interviews July 2009

Blistering skin

Dr Belinda Welsh discusses the causes and clinical features of a variety of bullous skin rashes. Belinda discusses distinguishing features such as blister location, presence of mucosal involvement or whether the blisters are tense and intact (indicating dermal blistering) or fragile (indicating superficial blistering). Most presentations to GPs will be the result of infection, topical contact reaction, insect bites or drug reactions. However, if common conditions such as these are excluded, then often histology and immunofluoresence is required for diagnosis. (Belinda discussed the techniques for biopsy for both histology and immunofluorescence). Early referral to a dermatologist is recommended for Immunobullous disorders and serious non immunobullous diosorders such as porphyria cutanea tarda.

Duration: 20 minutes 15 seconds
File size: 5MB

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Skin and systemic disease

Dr Adriene Lee discusses the association between skin problems and systemic disease. Adrienne discusses skin conditions such as generalised pruritis, cutaneous vasculitis and erythema that may be an indicator of an underlying systemic condition; skin conditions that are much more rare but have an association with occult malignancy; and typical skin manifestations of connective tissue disorders.

Duration: 14 minutes 50 seconds
File size: 3MB

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Difficult to diagnose and aggressive BCCs

Dr Steven Tomas discusses the features and management of subtypes of BCCs that have a more aggressive course.‘Infiltrative’ , ‘micronodular’ and ‘morphoeic’ BCCs can infiltrate widely and deeply with relatively little change in the overlying skin surface. Assessing the margins of the lesion histologically can bedifficult increases the chance of incomplete resection and recurrence. Recurrent or residual disease is more difficult to treat, and itself has higher recurrence and incomplete removal rates. These tumours require carefully planned, aggressive treatment to cure.

Duration: 17 minutes 42 seconds
File size: 4MB

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