Lecture Notes On Dermatology

ROBIN GRAHAM-BROWN BSc, MB BS (Lond), FRCP Consultant Dermatologist The Leicester Royal Infirmary, Leicestev, and Honorary Senior Lecturer in Dermatology, University of Leicester School oJMedicine TONY BURNS MB BS (Lond), FRCP Emeritus Consultant Dermatologist The Leicester Royal Infirmary, Leicester Eighth Edition Blackwell Publishing To all medical students, and t o our children: James, Matthew, John Joseph and David. C3 1965, 1969, 1973, 1977, 1983, 1990, 1996, 2002 by Blackwell Science Ltd a Blackwell Publishing Company Editorial Offices: Blackwell Publishing Ltd, 9600 Garsington Road, Oxford O X 4 2DQ, U K Tel: +44 (0) 1865 776868 Blackwell Science Inc., 350 Main Street, Malden, MA 02148-5020, USA Tel: + 1 781 388 8250 Blackwell Science Asia Pty Ltd, 54 University Street, Carlton, Victoria 3053, Australia Tel: +6 1 (0) 3 9347 0300 Blackwell Wissenschafts Verlag, Kurfurstendamm 57, 10707 Berlin, Germany Tel: +49 (0)30 32 79 060 The right of the Authors t o be identified as the Authors of this Work has been asserted in accordance with the Copyright, Designs and Patents A c t 1988. All rights reserved. N o part of this publication may be reproduced, stored in a retrieval system, o r transmitted, in any form o r by any means, electronic, mechanical, photocopying, recording o r otherwise, except as permitted by the U K Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. First published 1965 Second edition 1969 Third edition 1973 Fourth edition 1977 Fifth edition 1983 Sixth edition 1990 Seventh edition 1996 Reprinted 2001 Eighth edition 2002 Reprinted 2003, 2004, 2005 Library o f Congress Cataloging-in-Publication Data Graham-Brown, R. A. C. (Robin A. C.) Lecture notes on dermatology.+th ed./Robin Graham-Brown. Tony Burns. p. cm. Includes index. ISBN 0-632-06494-3 (pbk.) I. Dermatology-Outlines, syllabi, etc. 2. Skin-Diseases-Outlines, syllabi, etc. [DNLM: l. Skin Diseases. W R 140 G742L 20021 1. Title: Dermatology. II. Burns, Tony, FRCP. Ill. Title. RL74.3.G73 2002 6 1 6.5--dc2 I 2001008761 lSBN 0-632-06494-3 A catalogue record for this title is available from the British Library. Set in 911 1 % Gill Sans by SNP Best-set Typesetter Ltd, Hong Kong Printed and bound by Replika Press Pvt. Ltd, India For further information on Blackwell Publishing, visit our website: www.blackwellpublishing.com Contents Preface, iv Acknowledgements, v Structure and Function o f the Skin, Hair and Nails, I Approach t o the Diagnosis of Dermatological Disease, 9 Bacterial and Viral Infections, 17 Fungal Infections, 28 Ectoparasite Infections, 37 Acne, Acneiform Eruptions and Rosacea, 48 Eczema, 58 Psoriasis, 67 Benign and Malignant SkinTumours, 77 Naevi, 94 Inherited Disorders, 102 Pigmentary Disorders, 1 09 Disorders o f the Hair and Nails, I 14 Bullous Disorders, 122 Miscellaneous Erythematous and Papulosquamous Disorders and Light-induced Skin Diseases, 130 Vascular Disorders, 14 1 Connective Tissue Disorders, 148 Pruritus, 156 Systemic Disease and the Skin, 16 1 Skin and the Psyche, 169 Cutaneous Drug Reactions, 174 Treatment o f Skin Disease, 180 Index, 185 iii In this, the eighth edition of Lecture Notes on Dermatology, we have updated the text with particular regard t o advances in treatment. Numerous tables of salient points provide ready reference but, as in previous editions, we have attempted t o create a 'user-friendly' readability. W e hope that the book will be of value not only t o medica