Westmead Dermatology There are lots of discussions of how we should name this group of skin conditions, with different countries and clinicians supporting one name or another. Naming things is very important. It help us to frame the problem, to recognise what is in it and what is not, and to perform better research. But the tools we have used up to know may not be the best.
- Clinical diagnosis in dermatology is very difficult. Visual literacy is no common. Many clinicians call everything on the skin a rash, or a dermatitis (from “dermat-” meaning skin and “-itis” meaning inflammation). Unfortunately, all inflamed skin would be a dermatitis, but not all dermatitis is what we are talking here. Only very well trained physicians (dermatologists) can recognise visually different skin diseases and “this” dermatitis from “other” dermatitis.
- If we look at the skin under a microscope (histology), it is easy to find a common pattern in this group of diseases: “spongiosis”, but not all lesions with spongiosis are what we talk here and some forms of eczema (or dermatitis) do not show spongiosis… and we need biopsies, technicians to process the samples, and pathologists to read the slides.
In our group, we are working on eczema (or dermatitis) at a few levels.
- We manage patients: we have a clinic for severe eczema at Westmead Hospital: doctors and nurses specialised in diagnosing and managing eczema, using the latest tools for the treatment of the disease. We could do more in patch testing and photopatch testing, but due to lack of funding these techniques are not available.
- We do research in diagnosis: we are using scarless biopsies and photography to define better the disease. We have been successful in small grants that will kick up our research, but we need more resources.
- We do research in treatment: we are participating in clinical trials for patients with different forms of eczema (or dermatitis) and recruitment will be open soon for new trials in our Unit. If you are interested, you can reach us by phone +61 2 8890 5686, fax +61 2 8890 9673 or email WSLHD-Dermatology-ClinicalTrials@health.nsw.gov.au
- We educate: we teach about eczema to medical students, junior medical officers, clinicians and the general public.
