Volume 6, Number 2

Rona MacKie MD FRCP Professor of Dermatology, Department of Dermatology, University of Glasgow

Actinic or solar keratoses are extremely common on the skin of older, white-skinned individuals and will frequently be seen incidentally in a primary care setting. A patient with actinic keratosis (AK) may be attending the surgery or receiving home visits from the practice nurse for quite a different problem – such as blood pressure measurement or leg-ulcer dressings – and the lesions will therefore be noticed by chance at a time when the patient may not even be aware of them.

Neil H Cox BSc (Hons) FRCP(Lond) FRCP(Edin) Consultant Dermatologist, Cumberland Infirmary, Carlisle; Julie Bowman MBE RGN FETC Health Ed Cert ENB 237 Editor and Nurse Manager, Cumberland Infirmary, Carlisle

Actinic keratoses (AKs) are the subject of two articles that will feature in the British Journal of Dermatology Nursing over the next few months. In this issue, Professor MacKie looks at diagnosis and treatment within the primary care setting, while in the autumn issue, we will examine the role of the nurse in the management of this condition. So why the interest, and why the title of this commentary?

Sandy Brown MA BSc(hons) Dip ENB 249 998 870 Nurse Consultant Critical Care; Richard Heaton, DipHE ENB 100 998 Advanced Clinical Care Charge, Nurse Intensive Care Unit, Cumberland Infirmary, Carlisle

The skin is the largest organ in the body and it is important for nurses to be aware of the consequences that occur when this organ fails. The nurse is pivotal in the management of the acutely ill dermatology patient, and we should never forget that dermatological conditions can cause a patient to be acutely ill or that skin conditions have significant mortality.1

Michael J Cork BSc PhD FRCP Head of Academic Dermatology*; Ruth Murphy BSc MB MRCP Consultant Dermatologist, Chesterfield and North Derbyshire Royal Hospital Derbyshire; Julie Carr RGN RN Child Diploma Specialist Nurse, Paediatric Dermatology, Sheffield Children’s Hospital, Sheffield; David Buttle BSc PhD Reader in Genomic Medicine*; Simon Ward BSc DPhil MA Reader in Biomedical Sciences*, Claes Båvik BSc Dr Med Sci (PhD) Senior Research Fellow*, Rachid Tazi-Ahnini DEUG B Licence Maîtrise DEA PhD Lecturer in Dermatology, Division of Genomic Medicine, University of Sheffield Medical School, The Royal Hallamshire Hospital, Sheffield

The prevalence of atopic eczema has increased dramatically over the last five decades, suggesting that genetic factors cannot be the only component in the development of the disease. The observation that the rise in the number of cases of atopic eczema coincides with a growing rate of exposure to environmental agents which break down the skin barrier, such as soaps, detergents and house-dust mites, has led to the hypothesis that these agents are another key factor in the expression of the disease.

Julie Bowman, Editor

Summer’s here and what an exciting time it is. The Queen’s Golden Jubilee, the World Cup – both events totally eclipsed by the annual conference of the British Association of Dermatologists (BAD) in Edinburgh.

Julie Van Onselen RGN RSCN DipN BA(Hons) Clinical Nurse Adviser, Medical Department, Leo Pharmaceuticals

Pregnancy causes a variety of skin changes which, in the majority of cases, are a normal physiological response. Certain skin conditions are specific to pregnancy, and these require treatment and specialist care. Existing skin conditions can also change in nature and appearance, either deteriorating or improving in the ante- and postnatal periods.

Deborah Hofman BA Hons RN Dip Nurs Clinical Nurse Specialist, Wound Healing Institute, Dept Dermatology, Churchill Hospital, Oxford

Over the last ten to 15 years, wound care has increasingly become the domain of nursing staff – to the extent that many GPs profess ignorance of wound management and leave decision-making entirely to nursing colleagues. In practice, the problem wounds are chronic wounds, with healing delayed for six weeks or longer. Included in this category are leg and pressure ulcers, and non-healing surgical or traumatic wounds.