The Pharmaceutical Journal
Vol 276 No 7387 p166
11 February 2006

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· Skin conditions (2)
· Statins
· Independent prescribing
· Compliance aids (2)
· Universal health care
· Assisted dying
· CPD
· The Society

Letters to the Editor

Skin conditions

Fungal nail infections are not trivial

From Mr P. Lapsley

Run by patients for patients, the Skin Care Campaign represents the interests of all people with skin diseases in the UK. We, at the campaign, have become concerned recently to learn that several primary care trusts have removed treatments for fungal nail infections from their formularies, preventing GPs from prescribing them.

Skin diseases and, with them, dermatology are not always taken seriously enough, either by those members of the public who are not affected by them or by health professionals and managers. Potentially fatal conditions like skin cancer and epidermolysis bullosa aside, the quality of life issues associated with many skin diseases can be serious.

Fungal nail infections are not trivial. Left untreated or treated inappropriately, they can cause severe complications and be damaging to patients’ quality of life.

Treatments for fungal nail infections are widely used throughout the UK and we find it difficult to understand why some PCTs are apparently determined to deny such treatment to their patients. Such cases seem to us to be clear examples of so-called “postcode prescribing” — one of the least attractive, residual characteristics of the old NHS.

We would ask pharmacist advisers to bear this in mind when reviewing formularies.

Peter Lapsley
Chief Executive
The Skin Care Campaign

Dangers of the sun outweigh a lack of vitamin D

From Mrs N. R. Soulsby, MRPharmS

I am a British pharmacist who has been living in Australia for the last five years. I read Oliver Gillies’s Broad spectrum article (PJ, 7 January, p10) and was astounded by his recommendations. I was diagnosed with melanoma in November last year and had to have extensive surgery. Fortunately it had not spread and I am just left with physical and psychological scarring. My melanoma was picked up during a routine mole check carried out by my GP. Thankfully, I live in a country where the dangers of sun bathing are well known and we are on our guard. My mole was not typical since it had been there for years and had not changed in any way. If I had still been living in the UK I would never have thought to have had my moles checked. Melanoma is associated with being burnt in your formative years but the risk continues, especially if you expose yourself to the sun in the middle of the day. I was put at risk (unknowingly) when I lived in the UK and had holidays in Europe.

If I were worried about a lack of vitamin D in my or my family’s diet, I would rather ensure that we took vitamin D supplementation than run the risk of getting skin cancer. It can happen to anyone — I do not have fair skin. In fact, I tan and have dark features.

Skin cancer is preventable but only if we are sun safe. That includes avoiding sun beds, too.

Natalie Soulsby
Clinical Pharmacist
Royal Adelaide Hospital and University of South Australia

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