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New link between smoking and acne, 17.09.07 Dermatologists discover skin disorder caused by socks, 17.09.07 Karl Marx suffered from a chronic skin disease that has profound psychological effects, study reveals For immediate release, Tuesday October 30th 2007 Karl Marx, the influential nineteenth century philosopher and revolutionary, suffered from a chronic and debilitating skin disease known to have profound psychological effects, a study in the British Journal of Dermatology will reveal. Historical accounts have always defined this disorder merely as ‘boils’, as Marx himself described his symptoms. But further investigation of the revolutionary-left thinker’s correspondence has led eminent dermatologist and clinical scientist Professor Sam Shuster to conclude that Marx in fact suffered from ‘hidradenitis suppurativa’ (HS). HS is a chronic and stubborn disease of the apocrine glands, the large, specialised sweat glands found mainly in the armpits and groins, which become blocked and inflamed. The hair follicles, from which apocrine sweat usually escapes, burst and their infected fluid is released into and under the skin and onto the skin surface. The abscesses tunnel into the skin which becomes painful and swollen, and constantly releases pus. While boil-like lumps do feature as part of this painful disease, a more widespread infection, with swelling and discharge eventually leads to more and more skin thickening and scarring. The study reveals that a number of Marx’s health complaints, not previously linked, could all be directly attributed to HS, including joint pain, lesions on the body, scalp and face, and a painful eye condition which often stopped him working. Furthermore, the study suggests that the severity of Marx’s symptoms could have had a major effect on his psychological wellbeing as well as his work. Professor Shuster, Honorary Consultant at the Norfolk and Norwich University Hospital dermatology department, explained: “This new diagnosis is not just important in terms of historical accuracy. The skin is an organ of communication which is why its disorders produce so much psychological distress, with depression of self image, mood and well being, and with self-loathing and disgust. “These adverse effects are particularly severe in patients with hidradenitis suppurativa, and there is much evidence of this in Marx’s letters, where he often complains that his skin affects his work output and also its quality. “In addition to reducing his ability to work, which contributed to his depressing poverty, hidradenitis greatly reduced his self-esteem. This explains his self-loathing and alienation, a response reflected by the alienation Marx developed in his writing.” Nina Goad of the British Association of Dermatologists said: “Hidradenitis is one of the many devastating diseases that dermatologists treat, and the psychological impact on the patient can be overwhelming. It is therefore fascinating to discover that such an influential figure suffered from it, especially considering how it might have affected his work. “It takes a real expert to use nineteenth century correspondence to form a diagnosis of a skin disease, as this dermatologist has achieved.” Eminent historian Francis Wheen, whose biography inspired the study, said: "Not being a dermatologist, I hadn't actually heard of hidradenitis suppurativa, but having read Professor Shuster's analysis of the correspondence I think he may well be on to something. His article offers a wholly original and remarkably persuasive diagnosis which no future biographer of Marx will be able to ignore.” -Ends- 1. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists. 3. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD 4. Study details: “The nature and consequence of Karl Marx’s skin disease”, Professor Sam Shuster, Department of Dermatology, Norfolk and Norwich University Hospital, to be published in British Journal of Dermatology, January 2008. 5. The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. 6. Blackwell Publishing is a leading society publisher, partnering with 665 medical, academic and professional societies. Blackwell publishes over 800 journals and has over 6,000 books in print. For more information please contact: Nina Goad, British Association of Dermatologists Communications Manager, Phone: 0207 391 6355, Email: nina@bad.org.uk, Website: www.bad.org.uk Response to Care Closer to Home report: Shifting Care Closer to Home Demonstration Sites - report of the speciality subgroups For immediate release 23.10.07 This week, the Department of Health released a report outlining the experiences of six speciality sub-groups, including dermatology, of shifting care into the community. See the report here on the Department of Health website. Dr Colin Holden, President of the British Association of Dermatologists: The British Association of Dermatologists supports the conclusions related to dermatology in this report, which recognizes that the specialty has been at the forefront of developing Care Closer to Home recommendations. The British Association of Dermatologists believes that people with skin diseases should receive the right care, in the right place, the first time, and that the provision of dermatology services should be based on the needs of patients. Accredited Dermatologists are the most expert practitioners of dermatological diagnosis and management and the local consultant should work with commissioners to develop and then co-ordinate and integrate pathways of care, working in partnership with GPs and nurses. Patients with severe or complex illnesses (for example skin failure) will require inpatient hospital-based services; many will require specialist care for complex treatments or skin cancer surgery. Some people with less severe skin disease can be managed successfully by attending a local hospital-based dermatology day unit; others may be managed in the community. Care, wherever it is delivered, should be of high quality and should not compromise patient outcome and safety. New services should be clinically and financially sustainable. Provision for training future clinicians should be an integral part of any service caring for NHS patients. Community services must meet the standards set out in ‘Implementing care closer to home; convenient quality care for patients’* and ‘National Guidelines for the accreditation of GPwSIs: Dermatology and skin surgery’.² * http://www.pcc.nhs.uk/173.php Dermatologists discover link between smoking and new form of acne For immediate release, 17.09.07 Shocking statistics have led scientists to identify a new skin disorder called ‘smoker’s acne’, the British Journal of Dermatologywill reveal. Researchers at the San Gallicano Dermatological Institute in Rome, Italy, observed that a specific form of acne, characterised by blocked pores and large blackheads but less inflamed spots than normal acne, seemed to particularly affect adult female smokers. They therefore conducted a study of 1000 women aged 25 to 50 to further explore this link. The team found that 42 percent of smokers had acne compared to only one in ten non-smokers. Furthermore, smokers who had suffered acne in their teens were found to be four times more likely to suffer acne as an adult than non-smokers who also had experienced teenage acne. In particular, a type of acne called NIA (noninflammatory acne) was prominent, especially in smokers. ‘Adult acne’ is commonly described as featuring inflammatory (red and swollen) spots, usually along the lower jaw line and chin, and is generally mild or moderate. This is known as inflammatory acne or ‘IA’. However, the team found that of women who had acne, NIA was present in three-quarters of cases. NIA differs from IA and is recognised by prominent white heads, blackheads and very small cysts, particularly on the cheeks and forehead, but rarely with inflammation. As well as finding that NIA is common in acne sufferers generally, the study showed a strong link between smoking and NIA. Over three-quarters of those with NIA were smokers, and 81 percent of those with severe NIA were smokers. Furthermore, of the non-smokers who suffered NIA, predisposing environmental factors not linked to smoking were identified in almost half of subjects. (Such factors involve the skin being chronically exposed to particular environmental conditions, like smoke or steam, usually in a place of work such as a kitchen.) 91 percent of smokers who had acne had the NIA form, whereas of the non-smokers who had acne, IA was the more common type (52.8 percent), and was always mild-to-moderate as opposed to severe. The individuality of symptoms and the strong link with smoking has led researchers to suggest that NIA could be considered a new entity among smoking-related skin diseases, called ‘smoker’s acne’. Dr Bruno Capitanio, one of the study’s authors, said: “Our study demonstrates that NIA affects a high percentage of women, and is especially high among smokers. “Recognizing this form of acne is fundamental to providing correct information about the effects of tobacco on the skin, which could contribute to anti-smoking information programmes. “In some subjects the severity of acne, the clinical peculiarities, the strong correlation with smoking, and the biochemical data could lead to NIA being considered as a new entity among smoking-related cutaneous diseases, called ‘smoker’s acne face’.” Dr Colin Holden, President of the British Association of Dermatologists, said: “Dermatologists have long associated smoking with premature ageing of the skin, wrinkles and a leathery complexion. “However, scientists are now increasingly linking the habit with acne. For people who suffered acne as teenagers, the probability of also suffering acne in adulthood is four times higher in smokers than non-smokers. This suggests that smoking could be a major contributing factor for adult acne if you are already predisposed to the disorder. “This study also shows an interesting link between a specific type of acne and smoking. All of these findings will hopefully provide people with an extra incentive to quit.” Summary of findings: • 18.5% of women had acne • Of the non-smokers who suffered NIA, predisposing environmental factors not linked to smoking were identified almost half (48.9%). -Ends- Notes to editors: 1. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists. 2. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD 3. Study details: ‘Smoker’s acne’: a new clinical entity? Published in British Journal of Dermatology, B. Capitanio, J.L. Sinagra, M. Ottaviani*, V. Bordignon†, A. Amantea‡, M. Picardo* - Pediatric Dermatology Department, *Laboratory of Skin Physiopathology, †Laboratory of Clinical Pathology and Immunology and ‡Laboratory of Histopathology, San Gallicano IRCCS, Via Elio Chianesi 53, 00144 Rome, Italy The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. Blackwell Publishing is a leading society publisher, partnering with 665 medical, academic and professional societies. Blackwell publishes over 800 journals and has over 6,000 books in print. In February 2007, Blackwell Publishing officially merged with John Wiley & Sons, Inc's Scientific, Technical and Medical business. For more information on Blackwell Publishing, please visit www.blackwellpublishing.com or www.blackwell-synergy.com. For more information please contact: Nina Goad, British Association of Dermatologists Communications Manager, Phone: 0207 391 6355, Email: nina@bad.org.uk, Website: www.bad.org.uk Dermatologists discover skin disorder caused by socks For immediate release, 17.09.07 Parents might be causing their children scarring simply by choosing the wrong socks, new research in the British Journal of Dermatology will suggest. Researchers believe that the tight elastic causes inflammation in the dermis (the lower layer of skin) or in the subcutaneous fat, which once healed can leave visible marks along the sock line. Dermatologists from across France, the USA and the UK have so far reported at least ten cases with these symptoms, although the exact causes have remained under dispute. In March, dermatologists at the University Hospital of Montpellier, France, described two children with similar symptoms and speculated that sock elastic may play a part.¹ Now, dermatologists at Washington University School of Medicine and St Louis Children’s Hospital, USA, have identified five more cases, which they believe confirm that sock elastic is the primary cause of such lesions. According to the Washington University team, several cases featured raised skin along the sock-line, and most showed ‘hyperpigmentation’ – where the skin becomes darker than the surrounding skin. The hyperpigmentation may fade but leave raised lines of skin coloured lesions. One of the study’s authors, Dr David Berk, explains: “The disorder ‘acquired raised bands of infancy’ is characterized by skin-coloured, often diagonal plaques on the arms, trunk or legs, including the thighs as well as the calves. “Furthermore, in contrast to sock-line hyperpigmentation, ‘acquired raised bands of infancy’ has been associated with amniotic bands in the womb, limb constrictions and limb defects including foreshortened toes and clubfoot, and pregnancy complications such as pre-eclampsia, prematurity and placental abruption. “Sock line bands appear to have a benign course, however it is important that we recognise the disorder to allow us to collect data and cases, to better characterise how the lesions develop.” Dr Colin Holden, President of the British Association of Dermatologists, said: “There are already thousands of skin disorders treated by dermatology, and this is a prime example of how research is discovering new patterns of symptoms all the time. “Dermatologists from around the world will look at case studies and new theories in the British Journal of Dermatology, and this allows shared knowledge to develop and researchers to learn from each other’s work. “That is what has led to the development of this new hypothesis – researchers from across Europe and the US have discussed different cases of children with bands on their limbs, and different theories have been developed by comparing similarities in symptoms. “While these bands are generally harmless, it is valuable for researchers to be able to discuss this possible new phenomenon in relation to already established skin disorders.” ¹ M.M. Marque, B. Guillot, G. Le Gallic, D. Bessis (2007), Raised limb bands in infancy: a post-traumatic aetiology? British Journal of Dermatology 156 (3), 578–579. Notes to editors: 2. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. Blackwell Publishing is a leading society publisher, partnering with 665 medical, academic and professional societies. Blackwell publishes over 800 journals and has over 6,000 books in print. In February 2007, Blackwell Publishing officially merged with John Wiley & Sons, Inc's Scientific, Technical and Medical business. For more information on Blackwell Publishing, please visit www.blackwellpublishing.com or www.blackwell-synergy.com. For more information please contact: Nina Goad, British Association of Dermatologists Communications Manager, Phone: 0207 391 6355, Email: nina@bad.org.uk, Website: www.bad.org.uk |
