The British Association of Dermatologists' Undergraduate Curriculum Update 2021.

The General Medical Council (GMC) plans to introduce a national Medical Licensing Assessment (MLA) in 2024 for all UK medical students as part of their primary medical qualification, with dermatology specified in its assessment blueprint. We present an Update to the British Association of Dermatologists' Undergraduate Curriculum, aligned both to the MLA Content Map and the GMC Outcomes for Graduates 2018.

An overview of burning mouth syndrome for the dermatologist.

Burning mouth syndrome is characterized by an idiopathic burning pain affecting the oral mucosa, with no clinically apparent changes. It can present to a variety of health professionals including dermatologists. This article summarizes the important aspects of the condition, including theories of pathogenesis, diagnosis and management.

Comparative life histories of fishes in the subgenus Limia (Pisces: Poeciliidae).

This study presents life-history descriptions for 12 species in the subgenus Limia, which are endemic to the Greater Antilles. All species in this study lack evidence of superfoetation, producing a single brood of offspring before developing subsequent broods. Interbrood intervals (number of days between parturition events) are also consistent with intervals of species that lack superfoetation. Maternal provisioning, characterized by matrotrophy index, is <1.0 for all species of Limia. This is consistent with species that provide little or no maternal provisioning to developing embryos after ovum fertilization (lecithotrophic). Four species exhibit potentially bi-modal size distributions of mature males. Work on other poeciliids suggests that such bimodal distributions can be caused by genetic polymorphisms in some species. Principle component analyses revealed an axis of interspecific variation in life histories that separated species with small size at maturity and the production of many, small offspring from those with large size at maturity and that produce few, large offspring. This pattern of life-history diversity occurs in many other groups of organisms.

Guidance on the diagnosis and clinical management of acne.

This article discusses the effects of acne (sometimes referred to as acne vulgaris), how to diagnose it confidently and how to distinguish it from rosacea, and the options available for treatment, especially in primary care. We also suggest when referral to dermatology should be considered, and try to anticipate some frequently asked questions.

Guidance on the diagnosis and clinical management of atopic eczema.

This article discusses the effects of atopic eczema, how to diagnose it confidently, and the options available for treatment, especially in primary care. We also suggest when referral to dermatology departments in secondary care should be considered, and try to anticipate some frequently asked questions.

Guidance on the diagnosis and clinical management of psoriasis.

This article discusses the effects of psoriasis, how to diagnose it confidently, and the options available for treatment, especially in primary care. We also suggest when referral to dermatology should be considered, and try to anticipate some frequently asked questions.

Acral histiocytic nodules: a possible new variant of non-X histiocytosis.

Many types of histiocytoses have been described. We present a case of a 56-year-old woman who presented with multiple nodules on the hands. On histological examination of an excision biopsy, a mainly dermal lesion was seen, with scattered mononuclear inflammatory cells and occasional multinucleated cells in the background. The tumour was composed of short spindle-shaped histiocyte-like cells with vesicular nuclei and small nucleoli. These cells were positive for CD68 and focally positive for smooth-muscle actin. There was no lipid or haemosiderin pigment, and no cholesterol clefts. Further investigations did not find evidence of bony or systemic involvement. The non-Langerhans cell histiocytoses, also known as non-X histiocytoses, are rare and of unknown aetiology. Clinicopathologically, this case does not seem to fit with any of the recognized subtypes, and we propose that it may represent a previously undescribed variant of the disease.

Assessing the assessments: U.K. dermatology trainees' views of the workplace assessment tools.

BACKGROUND: The workplace assessments, direct observation of procedural skills (DOPS), mini-clinical evaluation exercise (mini-CEX) and multisource feedback (MSF, formerly known as 360 degrees appraisal), are now mandatory during dermatology specialist training in the U.K. The opinions of those undergoing such assessments in any medical specialty have rarely been sought. OBJECTIVES: To collate the experience and views of U.K. dermatology trainees on the three workplace assessments. METHOD: A questionnaire was circulated in autumn 2006 to all U.K. dermatology specialist registrars (SpRs) registered as members of the British Association of Dermatologists (n = 269). RESULTS: A total of 138 responses were received (51%). Seventeen SpRs had not experienced any of the assessments; 92 had undergone MSF, 95 DOPS and 54 mini-CEX. The total experience of the respondents amounted to a minimum of 251 DOPS, 122 MSF and 142 mini-CEX. Trainees appreciated the formative aspects of the assessments, especially feedback and training opportunities, although not all trainees reported receiving useful feedback. MSF was praised for the insights that it provides. All of the assessments were found to be time-consuming and difficult to organize. DOPS and mini-CEX carried a degree of stress and artificiality. Concerns were raised over the possibility of victimization by MSF raters. Discussion of performance in the assessments was rarely prominent in trainees' annual summative reviews. CONCLUSIONS: Trainees appreciate the formative benefits which derive from the assessments, namely feedback, reassurance of satisfactory performance and, in the case of DOPS and mini-CEX, additional one-to-one training from consultants. Some problems came to light. The issues raised will not be unique to dermatology and other specialties should take note.

Bidirectional replication from an internal origin in a linear streptomyces plasmid.

Commonly, linear replicons that have protein covalently attached to 5' DNA termini replicate by protein-primed, strand-displacing, continuous synthesis of full-length strands. The synthesis of DNA in pSLA2, a 17-kilobase linear plasmid of Streptomyces rochei containing 5' terminal protein, occurs bidirectionally from an internally located replication origin. The replication intermediates are linear duplex molecules that have recessed (approximately 280 nucleotides) 5' ends rather than full-length single strands. The 3' over-hangs may serve as templates for the non-displacing synthesis of the lagging strand terminus primed by the covalently attached 5' DNA binding protein.

Position effects on the timing of replication of chromosomally integrated simian virus 40 molecules in Chinese hamster cells.

Simian virus 40 (SV40) DNA molecules chromosomally integrated at different sites in three Chinese hamster lung fibroblast lines replicated during the middle portion of S phase but not precisely at the same time in all three cell lines. The time of replication was unrelated to the presence of T antigen or to its relative activity in promoting SV40 replication. SV40 sequences and chromosomal DNA sequences adjacent to the SV40 insert in one cell line expressing a temperature-sensitive T antigen showed a T-antigen-independent difference in replication timing from the homologous, allelic locus not linked to SV40. Our results indicate that the timing of replication of these integrated SV40 molecules is dependent upon the site of integration and is not determined by the level of T antigen replication-promoting activity.

Hormonally mediated negative regulation of human pro-opiomelanocortin gene expression after transfection into mouse L cells.

We report results indicating that expression and hormonally controlled negative regulation of the human pro-opiomelanocortin (POMC) gene in mouse fibroblasts can be accomplished by the placement nearby of a simian virus 40 enhancer sequence. Expression resulting from correctly initiated transcription required the enhancer in cis both in cells stably transfected with the POMC gene and in a transient expression assay with constructs that fused that POMC promoter region to the protein-coding region of the herpes simplex virus thymidine kinase (TK) gene. Negative regulation of POMC transcription by glucocorticoids was demonstrated in transiently infected cells by assaying for TK activity encoded by the POMC-TK fusion constructs and by quantitative S1 nuclease mapping. The sequences responsible for such regulation were shown to be contained within a DNA segment that extends 670 base pairs upstream from the cap site for POMC mRNA.