Two hundred years of dermatology.

Two hundred years ago the English physician Robert Willan published the first section of his masterwork, On cutaneous diseases. In it he described and demonstrated a new way of examining cutaneous eruptions that enabled physicians dealing with skin diseases to impose, for the first time, a significant degree of order on a field in which disorder had been the rule. The utility and successful application of the new approach soon attracted the attention of a talented cadre of physicians who embraced the study of the skin and its problems with enthusiasm, and dermatology as a specialty came into its own. The details of the Willan approach and the overwhelming influence it exerted on the future of the specialty are described in this article. 1798, the year the section was published, was an annus mirabilis for dermatology, and 1998 can be considered the bicentennial of the birth of the specialty.

Common dermatophyte infections. A simple diagnostic test and current management.

Tinea pedis, onychomycosis, tinea cruris, and tinea capitis are among the most common dermatophyte infections and are seen in all socioeconomic groups. Successful treatment of these conditions depends first on accurate diagnosis, which is often quickly accomplished with a KOH examination. Culture may be needed in some cases, but results may not be available for 2 weeks or more. Immunocompromised patients are particularly susceptible to dermatophyte infection, and any deviations in presentation or failure to respond to treatment should prompt investigation for an underlying problem.

Puncta pruritica.

Puncta pruritica is a chronic condition of unknown cause that is characterized by the occurrence of one or more intensely itchy pinpoint spots in clinically normal skin. Four cases are reported here.