This use of teledermoscopy as a triage tool offers the potential to shorten waiting lists and thus improve healthcare access and delivery.

Classical acupuncture focuses primarily on treating the person, and secondarily treating the illness. The "symptoms" are regarded as "branch" expressions of a "root" (constitutional) imbalance. Different root imbalances can produce the same symptoms. Five patients with eczema, for example, may reveal five distinct root imbalances and would all be treated very differently. Because acupuncture treats the whole person, it has something to offer almost every condition. In many cases, acupuncture aims to bring about a complete cure; in others, it aims to manage the problem. Acupuncture remains a substantial part of the traditional Chinese medicine, which is used to treat many conditions including acne, alopecia, dermatitis, pruritus, psoriasis, rosacea, systemic lupus erythematosus, urticaria, herpes zoster, chicken pox, impetigo, leprosy, vitiligo, and tinea. This review introduces the historical context of acupuncture within Chinese medicine and how it relates to skin disease. Specifically, a key question is, what can we learn from the ancients with regard to their use of acupuncture as part of a holistic system of medicine, and how does this relate to the practice of modern dermatology?

There was good agreement among dermatologists A-D but dermatologist E varied from the group with more frequent diagnosis of melanoma and atypical naevus. This difference could be due to different definition of terms with lack of consensus guidelines in definition of atypical naevus, lack of familiarity with the specific patient population and/or diagnostic drift.

Eccrine porocarcinoma (EPC) was first described by Pinkus & Mehregan in 1963 (1) as "epidermotropic eccrine carcinoma" and is the malignant counterpart of eccrine poroma. It is a rare tumour (0.005-0.01% (2, 3) of cutaneous tumours), thought to arise from the acrosyringium of the sweat gland of the skin. The term "porocarcinoma" was first used by Mishima & Morioka in 1969 (4). Although initial case series suggested that this was a highly aggressive tumour, with approximately 60% of cases reported to have local recurrence, metastases or death, later larger case series of 18, 24 and 27 patients, respectively, did not support such an aggressive natural history (3, 5, 6) The largest case series to date (69 cases) in 2001 (7), reported EPC as a less aggressive tumour, with 17% local recurrence, 19% lymph node metastasis and 11% distant metastases or death. This study analysed the age-standardised incidence rates for the population of the East of England (East Norfolk and Waveney), and estimated the numbers of cases likely to be found here and in the UK for 2020, 2025 and 2030. This cohort (n = 152) is the largest reported so far and there are long-term follow-up data for recurrences, metastases and survival/death, thus helping to clarify the natural history of this tumour.

Urticaria is characterised by transient swellings of the skin, which fluctuate over hours. Deeper swellings of the subcutaneous and submucosal tissue are known as angio-oedema. Drug-induced urticaria has been reported with a wide range of drugs and vaccines. NSAIDs and antibiotics are the drugs most commonly associated with urticaria, although reliable data from prospectively controlled studies is scarce. Spontaneous reports of drug-induced urticaria to the Committee on Safety of Medicines, UK, over a 40-year period also implicate bupropion, selective serotonin re-uptake inhibitor antidepressants, angiotensin-converting enzyme inhibitors (ACEI), H2 and H1 antihistamines, and systemic antifungals. New evidence suggests that selective COX-2 inhibitors may be tolerated in patients with aspirin-sensitive urticaria. The safety of angiotensin II receptor antagonists in patients with angio-oedema induced by ACEI has not yet been established.