Letters What is the future of minor surgery in northern ireland editor, The NHS here faces challenging times with significant disinvestment over the next few years. The arrival of commissioning will provide an opportunity to continue to provide the best service we can within financial constraints. Now, more than ever, we need to be looking at who provides what service and where. Minor surgery h...

Insulin resistance is a metabolic disorder in which target cells fail to respond to normal levels of circulating insulin. Insulin resistance has been associated with presence of acanthosis nigricans and acrochordons. It is known that early diagnosis and early initial treatment are of paramount importance to prevent a series of future complications. These dermatoses may represent an easily ident...

Sir, Tacrolimus onitment for the treatment of atopic dermatitis has recently received marketing approval under the trade name Protopic. According to the approved summary of product characteristics the known local side effects include: burning sensation, itching and erythema, folliculitis, acneiform eruption and eczema herpeticum. In addition, flushing or skin irritation may occur after intake o...

CONTEXT Ureteral fibroepithelial polyps are rare benign nonepithelial tumors, and less than 200 cases have been reported in the literature. We report on a pregnant patient with ureteral fibroepithelial polyps that were successfully treated with laparotomy. CASE REPORT A 23-year-old pregnant woman presented with a three-month history of intermittent lumbar pain of low intensity. Abdominal ultr...

Medications, including topical 0.2% glyceryl trinitrate (GTN), can reduce anal spasm and pain after excisional hemorrhoidectomy. GTN after stapled hemorrhoidopexy was compared with routine postoperative management. Patients with symptomatic grade 3/4 hemorrhoids were recruited. After stapled hemorrhoidopexy, residual perianal skin tags were excised as appropriate. Those requiring double purse-s...

Two hundred four cases of fibrous lesions of the gingiva were studied histologically for the presence of calcified tissue, the nature of the connective tissue, the type of keratinization, and the degree of epithelial thickness. Initially these lesions were subcategorized into four specific entities, namely fibrous epulis, fibroepithelial polyp, calcifying fibroblastic granuloma, and ossifying f...

BACKGROUND Benign anorectal conditions are fairly common. Physicians of various specialties usually see patients with these conditions before being referred to colorectal specialists, frequently with an incorrect diagnosis.We sought to evaluate the effect of attending an outpatient colorectal clinic by medical students on the diagnostic accuracy of these conditions. METHODS Over a 1-year peri...

A rare case of a large fibroepithelial polyp (FEP) of the vulva is described. The polypoidal growth was 10 cm in its largest diameter, having a long pedicle with features of inflammation secondary to infection, and was found arising from the left labia majora. The patient did not manifest any signs of recurrence following excision. A large and infected FEP of the vulva is a rare occurrence and ...

An acute fissure when observed by everting the anus *shows longitudinal muscle fibres in the floor of the ulcer. These are fibres of the conjoint longitudinal muscle layer which have passed downwards through the internal anal sphincter to gain attachment to the anal canal and perianal skin. If the lesion persists, the longitudinal fibres ulcerate through to expose the underlying whitish circula...

Fibroepithelioma of Pinkus is considered to be a rare variant of basal cell carcinoma with well-defined histopathological features. Clinical diagnosis often requires differentiation from benign lesions such as acrochordon, intradermal melanocytic nevus, neurofibroma, seborrheic keratosis, and even malignant lesions such as amelanotic melanoma. Dermoscopy of this type of lesion is not extensivel...