Department of Dermatology
ST VINCENTS HOSPITAL MELBOURNE FITZROY AUSTRALIA
B I E N N I A L R E P O RT 2 0 0 1 - 2 0 0 2
It is remarkable how time seems to go more rapidly the older we get. In the case of the academic
Department of Dermatology at St. Vincent’s Hospital Melbourne it is hard to believe that we are
now eight years old. But perhaps the feeling that time has passed quickly is a reflection of how
much has been achieved over that time.
In this fourth Biennial Report we give details of what we have achieved in the last two years, specifically
related to the Operational Plan 2000-2004. These are in the areas of Clinical Services, Teaching and
Research. As you will see, we have an extremely active and dedicated team working in different ways in
each of these areas.
Within the administrative structure, plus the service and research staff, we have a stable team who have all
been with us since the last Biennial Report, and a substantial proportion of whom have been with us for
many years. This continuity creates a very stable environment to support the productive endeavours of our
In the Service area we have now moved into the new outpatient facilities which have been designed to
facilitate the delivery of care in the ambulatory setting. This has worked out to be very satisfactory for not
only for the staff providing the care, but also for the patients receiving it. The presence of a computer
terminal on each of the desks has supported the upgraded Dermatology Database. The Photobiology
Services provided under the guidance of Chris Baker and Peter Foley have been substantially enhanced by
the addition of a new solar simulator, kindly provided with funds from the St. Vincent’s Hospital Foundation.
This group is now one of the large photobiology centres in the world. Other specialised services include the
vascular/lower leg ulcer services of Robert Kelly, the cutaneous lymphoma interest of Chris McCormack and
the immunobullous diseases interest of Belinda Welsh. They are providing a highly specialised component of
dermatological care which is appropriate for a tertiary teaching institution of the level of St. Vincent’s
Hospital Melbourne. Of course, we still provide a general dermatological service underpinning the highly
You will see in the Teaching section the wide range of education we provide from public education programs
through to medical student and postgraduate medical practitioner training. St. Vincent’s Hospital Melbourne
has a very special clinical school with the medical students frequently taking the large majority of prizes in the
final year medical exam. It is an indication of the calibre of students who want to come into this teach-ing
environment and certainly is revealed when we have them involved in dermatology as part of their training.
Like any academic department the research is an important driving force that determines directions both
now and in the future. The major arms, as you can see in the body of this Report, include the Health
Services Research group headed by Robin Marks and Jan Campbell, along with the Hair Research group
managed by Rod Sinclair and the Photobiology Research group managed by Peter Foley. Each of these
groups has research/project staff helping to expand their output.
The nature and extent of the work of the Department means that we are now not only well known in
Victoria, but are seen as a major national group in the areas of expertise of this Department. We also have
an international reputation with members of the Department being invited to present papers at many of the
major international dermatological meetings throughout the world. The recent appointment as President of
the International League of Dermatological Societies was a feather in the cap for Australian dermatology in
general and the Department in particular.
In summary, the enthusiastic and very positive approach of all members of the Department has resulted in an
outstanding record, once again, for the last two years. We have received support for our work from many
different groups and individuals. I am sure they will be proud of what has been done on their behalf in
improving the outlook for people suffering from skin conditions in our community.
I commend this Report to you.
Professor/Director of Dermatology
The clinical arm of the Department of Dermatology has continues to be an active area in the
delivery of clinical services, medical student teaching and registrar training. The medical, nursing
and office staff, continue to strive to deliver excellence in dermatological care. In the 2001 – 2002
biennium, in addition to inpatient admissions and consultations, 10,927 outpatient services were
provided by the Department.
The clinical service is an integral component of the Department complimenting and providing crucial support
for the research and teaching activities. Patients attending our clinics continue to come from metropolitan
Melbourne, rural Victoria and interstate, with referral source ranging from local general practitioners and the
emergency department to other dermatologists and specialists. The work of the Department continues to be
well supported by the Hospital administration and is therefore able to provide a range of consultative services
to other units and departments.
The Department offers a range of general Dermatological services and manages a all common skin problems
as well as providing opinion and treatment for more complex and challenging problems. Expertise in several
super-speciality areas is provided. These include cutaneous lymphoma (Dr Christopher McCormack with
valuable assistance from Professor Miles Prince and Dr Gail Ryan, Peter MacCallum Cancer Institute), vascular
and wound healing service (Dr Robert Kelly) and immunobullous disorders (Dr Belinda Welsh).
The photodermatology clinic, under the direction of Dr Peter Foley and myself, continues to provide a unique
service investigating sun sensitivity skin disorders. The photodermatology data base now encompasses 9
years of clinical experience and has undergone further development and refinement. In 2001 we
commissioned the Solar Simulator which was purchased through a generous donation from the St. Vincent’s
Foundation. The solar simulator is now an integral part of the phototesting regimen. Our clinical nurse,
Leonie Hill, continues to perform phototesting and phototherapy services. Her exper-ience and expertise in
this area is unique.
The Department maintains a close working relationship with the skin and Cancer foundation.
The Foundation registrar and St Vincent’s Registrar exchange positions mid year to provide a broader
experience in clinical Dermatology. The Hospital has two dedicated Dermatological Trainees. These are the St
Vincents Hospital Registrar and the Professorial Registrar. In addition, a number of registrars in the Victorian
training program rotate through clinics at St Vincent’s, providing addition clinical support and gaining
valuable training experience. Finally, the entire clinical team and in particular Professor Robin Marks and
Dr Andrew Michaelides play an important role in the undergraduate training program.
In July 2002, a new outpatient clinic area was opened. This is a state of the art facility on the ground floor
of the Daly wing, with a comfortable well designed clinic area including PC facilities and internet access in all
consulting rooms. In addition, the Department has a dedicated area for phototherapy and phototesting
The upgraded facilities will allow the clinical service arm of the Department continue the high standard of
services offered. To further develop patient services, the Department has recently received a grant from the
William Joseph Payne Trust to develop a system of digital imaging of skin conditions and integration of this
record with the patient’s file. This system combined with our new outpatient facilities should help in the
diagnosis and monitoring of a patient’s condition.
Once again, as Director of Clinical Services in Dermatology, I wish to thank all members of the Department
and associated staff for their commitment and effort.
Dr Chris Baker
Director of Clinical Dermatology
OUTPATIENT ATTENDANCES 1995-2000
1995/1996 1997/1998 1999/2000 2001/02
TYPE OF CLINIC n= n= n= n=
Dermatology 7876 7593 8638 6556
Dermatology Investigations 345 534 411 1044
PUVA & UVB 1784 2091 1949 2687
Photobiology 203 428 429 640
TOTAL 10,208 10,646 11,427 10,927
Rate of Disease Groups for 1999/2000 and 2000-2002
0 5 10 15 20 25 30
*Other conditions include: mycosis fungoides, pruritis, nodular prurigo, ulcers, keratosis pilaris, lichen planus,
bulous pemphigold, scars and patients with diagnoses pending.
Dermatology education is one of the core activities of the Department with our target audience
including medical students, general practitioners, dermatology registrars, paramedical staff and
the general community. The many facets are highlighted in the details of this Report.
The Department had substantial input into the development of the new University of Melbourne medical
curriculum. This not only involved redefining the core curriculum for medical students, but also inserting
a dermatology component into various semesters over the period of the course. Medical students from the old
curriculum, and also the new curriculum, are still receiving clinical teaching in the St. Vincent’s Hospital clinics
and at the Skin and Cancer Foundation of Victoria as they have identified this as an important contribution to
their development as a medical practitioner. With the involvement of Rosemary Nixon and the Occupational
Dermatology Research and Education Centre it is hoped to have involvement of Monash University medical
students before long.
General practitioner education was enhanced by the new booklet on diagnostic procedures developed by the
Department and mailed to every general practitioner in Australia. It was a sequel to the first book on treatment
of common skin conditions and will be completed by a third book on diagnosis, each produced within the
Department. Department members have participated in a wide range of teaching sessions for general
practitioners including those arranged by the Skin and Cancer Foundation, the Royal Australasian College of
General Practitioners, the Essex series and by the GP divisions throughout Victoria. General practitioner
teaching remains a very high priority of the Department.
Registrar teaching at St. Vincent’s Hospital continues to be strong with all Victorian candidates for fellowship of
the Australasian College of Dermatologists being successful in the last two years. The Department has
coordinated a program of tutorials on clinical dermatology and dermatopathology at the Skin and Cancer
Foundation of Victoria. The regular Thursday morning teaching sessions at St. Vincent’s Hospital, combined
with Royal Melbourne Hospital, have continued to create interest for registrars and dermatologists.
Members of the Department have published a large variety of educational articles in various medical textbooks
and journals directed at medical students, general practitioners and dermatology registrars. The public
educational resources of the Department developed for primary and secondary schools and Maternal and Child
Health centres have extended the reach of the Department widespread into the community, as have various
articles written by members of the Department in response to media approaches.
In summary, the Department covers a very wide range in its teaching activities all of which we hope in the long
term will contribute to improved practice by medical professionals and better access, understanding and care
for those in the community with disease affecting their skin.
Dr Rodney Sinclair
Senior Lecturer in Dermatology
> Staff of the Friday morning
Special Investigative and
GENERAL PRACTITIONER LECTURES/WORKSHOPS
Topic Date Meeting
Acne Therapies/Skin Biopsy April 2001 Yarra Valley Division of GPs
Advanced psoriasis (PF) June 2001 GP update series (Skin and Cancer
Foundation / Essex Pharma)
Novotel Glen Waverley
Non-melanoma skin cancer (RM) August 2001 Dermatology Update Conference for
General Practitioners, St. Vincent’s Hospital
An Approach to Dermatology (PF) June 2001 Essex Pharma Lecture Series for GPs
Hair and Nails (PF) August 2001 Cabrini Medical Centre GP lecture series
Pigmented Lesions (RM) November 2001 Goulburn Valley Division of General
Paediatric Dermatology (CB) May 2002 Whitehorse Division of GPs
Non-melanoma skin cancer (RM) May 2002 Dermatology Update Conference
for General Practitioners, SVHM
Acne, Warts and Hair Problems (PF) July 2002 GPEA Training Program Evening
Lecture Series, Melbourne
Practical Procedures in Dermatology (CB) August 2002 Yarra Valley division of GPs
MEDICAL STUDENTS LECTURES
The Art of Medicine (RM) February 2001 IV years
Sunscreens & skin cancer (RM) April 2001 Royal Victorian Eye & Ear Hospital lecture
Red Scaly Rashes (CB) May 2001 6th Year Medical Students - SVHM
Sunscreens & skin cancer (RM) March 2002 Royal Victorian Eye & Ear Hospital lecture
New curriculum PBL 2001/2002 4th Year Medical Students - SVHM
Hair diseases 2001/2002 Royal Victorian Eye & Ear Hospital lecture
Weekly /fortnightly clinic attendances 2001/2002 SVHM 6th Year students
JOINT RMH & SVHM TEACHING SESSIONS
- DERMATOLOGY REGISTRARS & DERMATOLOGISTS
March Photodynamic Therapy for Skin Malignancies Speaker: Dr Peter Foley
March Approach to Urticaria Speaker: Dr Richard O’Brien
April Flap Prefabrication and Tissue Engineering Speaker: Professor Wayne Morrison
May Research projects in the Department of Dermatology
- current update
June 1. Incomplete BCC excision. Speaker: Dr Tam Dieu
2. Melanoma research
July Warfarin Necrosis Speaker: Dr Cate Scarff
August Immunosuppressive and immunomodulatory drugs Speaker: Associate Professor Tom Kay
September Cutaneous lymphoma: Update on the Melbourne Speakers: Drs Lee Mei Yap & Cate Scarff
October 1. Cutaneous surgery of the lower leg. Speaker: Mr Tony Pennington
2. What ever happened to Eusol?
November Using cyclosporin and managing side effects Speaker: Dr Ian Fraser
February Cases, quizzes and discussions
March Retinoids, lipids and the skin
April Cardiology concerns in cutaneous surgery: Speaker: Dr Peter Kistler
Heart valves, anticoagulants, pacemakers and long CT
May Special presentation by Visiting Fellow, Dr Susan Burge,
Oxford University, UK
July Nail Surgery Speaker: Mr Bruce Johnstone
August Update on the Role of Sentinel Node Biopsy Speaker: Mr Michael Henderson
Adjuvant Radiotherapy in Melanoma Speaker: Dr Jill Ainsley
October Leprosy and Lupus Vulgaris Speakers: Drs Lee Mei Yap and
November Pruritis ani - a sore point for doctors Speaker: Mr. Joe Tjandra
TEACHING THROUGH GP JOURNALS AND LAY MAGAZINES
Australian Doctor ‘Concepts in Skin’ Series (RM) 2001
A measured response to tinea January
Perioral inflammatins March
Itch treatment up to scratch May
Helpful advice on scaly scalps July
Sensitive soles present problems August
Making the call on common conditions November
Australian Doctor ‘Concepts in Skin’ Series (RM) 2002
Combination of science and art helps diagnosis March
Best way to shine in melanoma diagnosis April
Which treatment? Follow this guide June
Critical to diagnose dermatitis at work (RM and Rosemary Nixon) August
Occupational Dermatology – RM and Rosemary Nixon) October
How to stop treatment in Dermatology
Everybody Magazine (RM)
Don’t touch! Common environmental factors can play Spring
havoc with our skin
Stress & the skin Summer
Sensitive skin - the cure may be as simple as switching products Autumn/Winter
The 10 biggest sunscreen mistakes Spring
Health Services &
The research activities supported by the Department of Dermatology are diverse and wide-ranging.
Projects conducted over the past two years reflect this diversity, with staff having qualifications and
experience in dermatology, epidemiology, health information management, social research, quality
performance measurement, health promotion and education, data management and project
management. Projects carried out during 2001 and 2002 are reported under the headings of
Epidemiology and Health Services, Health Promotion and Education, Hair, Photobiology and Clinical
A two-year study of a cohort of psoriasis patients completed in 2000 was supported by an additional qualitative
component involving face-to-face interviews with a small group of participants which was conducted during
20001. A study involving a cohort of patients with atopic dermatitis collected information on the impact that
inflammatory skin conditions can have on the individual and community.
The field of health promotion and community education has increased with the development of statewide
education programs on common skin diseases for all secondary and primary schools in Victoria. A program for
Maternal and Child Health nurses and their clients was also developed and distributed to all Maternal and Child
Health centres throughout Victoria during 2002. Each of these programs has been developed in conjunction
with the appropriate professional organisation and the high rate of use within each group reflects the
consultative component and the research base underpinning these programs.
The development of the Standardised Dermatology Database, which has been trialled successfully at St
Vincent’s Hospital over the past year, has the potential to collect data from all dermatology clinics and thus
contribute to epidemiology, research and quality improvement projects while also facilitating the teaching of
Undergraduate Health Information Management students from La Trobe University have completed their
practical placements within the department. They have been involved in a variety of projects including auditing
clinical databases and quality management activities.
Rod Sinclair, who specialises in hair and nail conditions, heads a team of Clinical and Genetic researchers
comprising Masters of Medicine students Jack Green, Keng-Ee Thai, and Shannon Harrison, and also Bachelor
of Medical Science student Desmond Gan. They have worked on a number of projects related to a variety of
forms of alopecia as part of their degrees. This vibrant team has contributed much that is new and exciting to
the world research into hair disorders.
Peter Foley’s team who conduct research into the uses of Photobiology in Dermatology includes Chris Baker, Lee
Mei Yap and Bachelor of Medical Science student, Jonathan Ng. Peter is also responsible for an increasing
number of clinical trials involving new treatments for dermatological conditions which are conducted at SVHM
and the Skin & Cancer Foundation.
Over the past two years a number overseas visitors, in particular Andrew Messenger (UK), Veerle Verlinden
(Belgium) and Mirjam Werwenike (Netherlands) have swelled the ranks of the research team and added an
international flavour to the diverse range of talents within the Department.
The group of people who comprised the research team during 2001 and 2002 have built on the work of all
those who contributed to the first eight years of this unique Department and accomplished much that is new
to facilitate the future development of the Department and Dermatology.
EPIDEMIOLOGY AND HEALTH
A one year study of the morbidity, severity A Pilot Study To Investigate The Association
and cost of having atopic eczema in Australia Between Fungiform Papillary Glossitis And Atopy
Nicole Harman, Jan Campbell, Maria Moore, Anne Cate Scarff, Jan Campbell, Robin Marks
Plunkett, Robin Marks
Patients often report symptoms related to the
A one year study aimed to determine the tongue. Unfortunately, our understanding of these
morbidity, severity and cost of having atopic is often limited. While some conditions such as
eczema in Australia. A total of 85 participants geographic tongue are well described, they do not
were recruited. Each participant attended a explain the symptoms reported by patients in all
baseline interview where an introductory cases. The survey, which recruited 84 subjects,
questionnaire, Dermatology Life Quality Index investigated whether atopic subjects reported more
(DLQI) and Modified Rajka and Langeland Severity symptoms and had a different appearance of the
Assessment (MRLSA) were completed. Participants tongue compared with non-atopic subjects. This
then had a skin examination performed by a involved a questionnaire about medical history and
dermatologist to determine the severity of their symptoms in the mouth, an examination of the
condition. Following this there were six follow ups, tongue and skin prick testing to four common
one every two months where participants were aeroallergens. A classification system was
sent and asked to complete the DLQI and MRLSA developed to record the spectrum on features seen
questionnaires on the morbidity and severity of on the tongue. Results showed atopic subjects
their atopic eczema and a diary of their atopic tended to have an appearance of the tongue that
eczema costs and health care consultations. was clustered to one end of the spectrum. The
number of non-atopic subjects who volunteered
Of the 53 (64%) participants who returned all
was small, but their examination findings were
follow up questionnaires, 45% felt that their skin
more evenly distributed. Greater numbers of non-
had been itchy, sore, painful or stinging, 36%
atopic subjects need to be recruited to see if this
spent over 10 minutes applying daily treatments,
trend is confirmed.
28% were influenced by the clothes worn, 21%
felt embarrassed or self conscious because of their Date commenced: January 2001
skin and 15% had problems with the treatments
Progress of project: Pilot completed December
for their skin i.e. making their home messy.
2001; Report written.
Date Commenced: December 1998
Funding source: Core budget, St. Vincent’s
Date Completed: March 2001 Hospital Melbourne
Progress of Project: Report written,
publication in progress
Funding Source: Core budget; Scientific
Fund Australasian College
A continuation of a study investigating the HEALTH PROMOTION
association between fungiform papillary AND EDUCATION
glossitis and atopy
Lee Mei Yap, Veerle Verlinden, Jan Campbell,
Peter Foley, Robin Marks
Skin - an education program for Maternal and
200 subjects were recruited from St. Vincent’s
Hospital Melbourne and the Skin and Cancer
Foundation. Data regarding personal and family Kate Merlin, Jan Campbell, Maria Moore,
history of atopy, mouth discomfort, burn response Robin Marks
and inflammatory changes of the fungiform
papillae were collected to determine if there is an This program targeted Maternal and Child Health
association between fungiform papillary glossitis (MCH) nurses and the parents/guardians of babies
and atopy. and children who attend MCH centres in Victoria.
Date commenced: August 2002 The program aimed to improve the awareness and
knowledge of those who advise parents/guardians
Date completed: November 2002
about children with common skin conditions. The
Progress of project: Data being analysed. information concentrates on the prevention of
Funding source: Core budget many of these conditions, as well as treatment
where appropriate, to improve the management
and outcome of these children.
A Qualitative Study Of Having Psoriasis In The program was developed in consultation with
Australia: The Patient’s Viewpoint
MCH nurses. Nurses completed surveys which
Jan Campbell determined the most suitable resources and
This study aimed to gain further information on the program strategies. The resources were trialled in a
morbidity that affects psoriasis sufferers, through selection of MCH centres and feedback was
individual face-to-face interviews with a sample of provided through surveys and telephone interviews.
6 participants who had completed the Psoriasis and The resources, comprising a folder with
Health Survey. The interviews provided them with
information and photographs for nurses and
the opportunity to expand on their own responses
information sheets which could be photocopied for
and further discuss the quality of life issues they
each experience in relation to having psoriasis. parents/guardians, were then modified, printed and
Qualitative research, such as this, complements and distributed to all Victorian MCH nurses.
contributes to the interpretation of the quantitative
Date commenced: September 2000
data that have been collected during the survey.
Date completed: May 2002
Date commenced: September 2001
Progress of Project: Report in progress Progress of Project: Completed
Funding sources: Core Budget Funding sources: Ian Potter Foundation,
Foundation, RE Ross Trust,
Gwendolyn Holly Bequest
Skin - an education program for Primary
Kate Merlin, Jan Campbell, Maria Moore,
This program targets children in the upper level,
grades 5 and 6, of primary schools in Victoria, their
teachers and their parents. The program aims to
improve their knowledge of the nature and
management of particular skin conditions, shown
in previous Department research to be common in
Development, Implementation and Evaluation
this age group. A primary school teacher was
of Internet Web site
employed to assist in the development of the
education resources and a selection of teachers Nicole Harman, Jan Campbell, Kate Merlin,
completed surveys to determine the most suitable Robin Marks
resources and program strategies. The resources
Feedback received following evaluation of the Skin
were trialled in a group of primary schools and
Education Programs highlighted the need to set up
teachers and students provided feedback through
a web site that could provide information and
surveys and telephone interviews. All Victorian
activities related to the programs. The aim of this
primary schools were offered a free resource kit in
project is to develop an Internet site for the
December 2002 and these will be delivered to
Department that will be used to provide details of
schools in early 2003. The kit comprises three
our activities; information about diagnoses,
components: a resource book containing
management and treatment of common skin
information about the skin and common skin
diseases; and linkage to related sites. The Skin
conditions plus lesson plans and activities; 11
Education Programs will be a major component of
information cards about common skin conditions
this Internet site. The first phase of the project
for use by students; and four posters highlighting
involved researching other web sites, including
important information about the Skin,
dermatology web sites to view different contents,
Inflammatory Conditions, Infections and
styles and visual effects. Our target audience,
consisting of teachers and Maternal and Child
Date commenced: September 2000 Health nurses were surveyed to find out what they
required from the web site. Consultation took
Date completed: December 2002
place with an education / IT expert and the web
Progress of Project: Resource developed; site prototype was developed. The web site is due
Distribution underway to ‘go live’ at the beginning of 2003.
Funding sources: Jack Brockhoff Foundation, Date Commenced: June 2002
Progress of Project: To ‘Go Live’ early 2003
Funding Source: Skin and Cancer
Foundation of Victoria
The SDD Quality Assurance Auditing
Nicole Harman, Maria Moore, Jan Campbell,
Katie O’Farrell, Jessica Chudwok (Health Information
Management students), Robin Marks
In 2001 it was found that the database contained
a large number of ‘Diagnosis pending’ codes that
DATA COLLECTION SYSTEMS had not been updated. An audit was conducted in
April 2002 to update ‘Diagnosis pending’ codes in
the database and investigate reasons why the
diagnoses had not been updated.
The Standardised Dermatology Database In 2002, the SDD was implemented into SVHM.
Project To evaluate the training sessions and identify how
Nicole Harman, Kate Merlin, Maria Moore, accurately data was being entered into the SDD, a
Robin Marks series of 3 sequential audits of the database were
performed. This involved reviewing all the essential
In 1995, a computerised Dermatology Data information from the outpatient data entered into
Collection System was established in Victorian the SDD from February to August 2002. It was
public hospitals to collect demographic and found that 26% of patients were not being
diagnostic data on patients attending dermatology entered into the SDD. However, the data being
outpatient clinics. As the hospitals were using entered into the SDD, showed that the amount of
different databases and data collection systems, a information being entered for each patient
new project was established to standardise data increased over the audits, e.g. the percentage of
collection system and develop a database that can diagnostic details entered in audit 1 was 80.4%
be implemented across the hospitals commenced. and in audit 3 this had increased to 88.4%.
Dermatologists and registrars at the hospitals Ongoing education and training to the clinicians
completed a survey of their requirements for a each year is vital for the data collection system to
standardised system, department heads were be accurate, reliable and valid.
interviewed to discuss positive and negative aspects
to their databases, and quality assurance audits Date Commenced: February 1995
were conducted on the existing systems. Using the Date Completed: Ongoing
information obtained from the interviews, surveys
Funding Source: Core budget
and audits, a new standardised system was
developed and has been implemented at the
hospitals. The database is currently being
Date Commenced: May 2000
Progress of Project: Database being evaluated
Funding Source: Australian Dermatology
Research & Education
Database and Research Program – CLINICAL AND GENETIC RESEARCH
Skin and Cancer Foundation
Nicole Harman, Jan Campbell, Rod Sinclair,
Familial alopecia areata
This program aims to facilitate the collection and
Jack Green, Rodney Sinclair
analysis of data from the clinics at the Skin and
Cancer Foundation (Vic). To achieve this the Skin Alopecia areata is an autoimmune disorder of the
and Cancer Foundation has subcontracted the hair follicle that displays complex genetic
services of two staff members from the inheritance. On average, 20% of individuals with
Department of Dermatology for 3 days a week. As alopecia areata have at least one other affected
from November 2002, Jan Campbell is working as relative. The purpose of this study was to survey
a Research Fellow and Nicole Jenner as the Clinical familial alopecia areata on the Australian continent.
Data Manager. The data collected has a number of Methods used to ascertain families included a mail
potential uses including epidemiology studies; out to members of the alopecia areata support
research projects; constructing continuing association, the internet and from our hair clinics.
education programs; teaching trainees; auditing Probands were interviewed by phone or in person
and quality assurance projects; and linking with and questionnaires were completed for each
other clinical databases such as pathology. pedigree. Subjects with an unclear diagnosis were
Date Commenced: November 2002
In 64 pedigrees, there were 169 affected family
Date Completed: ongoing
members, equally divided between females (53%)
Progress of Project: SCF SDD data being and males (47%). Other conditions frequently seen
analysed; Questionnaires in these pedigrees included thyroid disease (46%),
are being developed. eczema (53%), asthma (46%), NIDDM (34%) and
Funding Source: Skin and Cancer psoriasis (27%). The results are consistent with
Foundation of Victoria other reports of a majority of pedigrees having a
small number of affected members, of equal sex
distribution of alopecia areata and of association
with other immune disorders.
Date commenced: 1999
Date completed: 2001
Progress of Project: Presented at World
Congress of Dermatology,
Funding source/s: Core budget
Genetics of Alopecia areata are sub-clinical and that grade variability exists
between individuals and the number of hairs
Shannon Harrison, Jack Green, Justine Ellis,
affected and within the same individual in the
Steven Harrap, Rod Sinclair
degree to which different hairs are affected. We
Alopecia areata is a complex genetic disease which also found that the clinical banding pattern can be
most likely has several genes interacting with lost after other insults to the hair cycle such as
environmental co-factors to cause disease. In the alopecia areata of telogen gravidarn.
initial part of the study an analysis was undertaken
Date commenced: 2001
in a single family with significant members over 3
generations. Linkage was assessed to candidate Date completed: 2001
gene areas on chromosome 21 and no significant
Progress of Project: Published, Clinical and
linkage was identified. Subsequently, an association
study in alopecia areata was undertaken in 15
individuals with alopecia areata to determine if
there was a genetic association between the Funding source/s: University of Melbourne
androgen receptor gene on the X chromosome. Collaborative Research
A negative association was identified. This study is Fund
ongoing and we are currently in the process of
collecting sib pairs as part of an international
collaborative effort with the aim being to
undertake a genome wide scan. Genetics of pili annulati
Date commenced: February, 1999 Jack Green, Elizabeth Fitzpatrick, Sue Forrest, Justine
Progress of Project: Ongoing Ellis, Steven Harrap, Rod Sinclair
Funding source/s: Scientific Research Fund of Pili annulati is thought to be a single gene disorder,
the Australasian College of however, the pathogenesis of this condition is
Dermatologists: National unknown. We identified 3 large families with Pili
Alopecia Areata Foundation Annulati and undertook an investigation of the
of America genetics. After extracting DNA and excluding a
number of candidate gene loci, we undertook a
genome wide scan in a single family. Linkage has
been identified and we have excluded one
candidate gene in that area by mutation analysis.
Clinical diagnostic criteria for Pili annulati
We are currently in the process of undertaking
Jack Green, David de Berker, Rodney Sinclair mutational analysis of all the candidate genes
within the target region.
Pili annulati is rare hair shaft disorder that causes
banding of hairs. The alternating dark and light Date commenced: 2000
bands which are more obvious in those with fair
Progress of Project: Ongoing
hair are caused by cavities located in the cortex of
the hair shaft. Most reported cases have been Funding source/s: Scientific Research Fund of
inherited in an autosomal dominant fashion where the Australasian College of
there have been some sporadic examples. In three Dermatologists, Skin and
families with this condition, we formally Cancer Foundation.
investigated their clinical and transmitted light
microscopic findings. We found that most cases
Genetics of Marie Unna Hypotrichosis Date commenced: 2001
Jack Green, Elizabeth Fitzpatrick, Sue Forrest, Date completed: 2002
Justine Ellis, Steven Harrap, Rod Sinclair
Progress of Project: Paper in the Journal of
Marie Unna Hypotrichosis is a rare, inherited hair Investigative Dermatology,
disease that causes patterned hair loss and is also 2002
associated with irregularities of the hair shaft. We
Funding source/s: Scientific Research Fund of
identified a large family who clinically appeared to
the Australasian College of
have Marie Unna Hypotrichosis. Marie Unna
Hypotrichosis has been linked to an area on
chromosome 8. Our investigation of the genetics in
this family failed to identify linkage to that area on
chromosome 8 and, in fact, any association was
excluded. We then proceeded to do a genome De Novo Mutations in Monilethrix.
wide scan and were able to identify linkage to an Horev L, Djabali K, Green J, Sinclair R, Martinez-Mir R,
area on another chromosome. We are planning to Ingber A, Christiano AM, Zlotogorski A.
perform mutational analysis of that region to try
Mutations in the hair keratins hHb1 and hHb6 have
and identify the causative mutation for this variant
been recently reported to cause monilethrix, an
of Marie Unna Hypotrichosis.
autosomal dominant hair shaft disorder
Date commenced: 2000 characterized by variable degrees of hair fragility
Progress of Project: Ongoing and follicular hyperkeratosis. We found 10 families
with monilethrix in which parents were not
Funding source/s: Scientific Research Fund of clinically affected, and sequenced the hair keratin
the Australasian College of hHb1, hHb3 and hHb6 genes in seven patients.
Dermatologists, Skin and In five patients no mutations were found, while in
Cancer Foundation. two patients we identified de novo mutations, at
the helix termination motif. We were unable to
identify any correlations between the phenotype
and the genotype in affected individuals.
Genetics of Papular Atrichia
Date commenced: 2001
Jack Green, Rod Sinclair, Abraham Zlotogorski,
Date completed: 2002
Progress of Project: Accepted for publication in
Papular atrichia is a rare, inherited cause of
complete hair loss. A causative mutation was
identified in a Pakistani family in 1998. We had Funding source/s: Department o Dermatology,
previously seen an individual with this condition in Haddad Hospital, Jerusalem
1991. Our patient had an apparent autosomal
dominant inheritance of this normally autosomal
recessive disorder. Genetic analysis was undertaken
of both the patient and his mother and it was
determined that his late father was a heterozygous
carrier of this condition. This is the first pseudo-
dominant case of papular atrichia.
Loose anagen syndrome Androgenetic alopecia, prevalence and risk
factors: findings from an Australian study
Alvin Chong, Elizabeth Fitzpatrick, Sue Forrest,
Rodney Sinclair Sinclair R, Severi G, Giles GG, English DR,
McCredie MRE, Hopper JL.
Loose anagen syndrome is a rarely reported
disorder, mainly of childhood, where anagen hairs 1,390 men were recruited at random from
a poorly anchored to the follicle and hence, easily electoral rolls to serve as controls in a case
and painlessly extracted. The condition was first controlled study of prostate cancer. All subjects
described in 1984 and since then approximately 65 were interviewed in person and direct observations
cases have been reported in the worldwide of baldness were made. Men were grouped into
literature. We identified 16 families with loose the falling baldness categories; no baldness, frontal
anagen syndrome involving over 120 people and baldness, vertex baldness and full baldness. The
undertook a study of the clinical aspects and epidemiological data collected on these men was
molecular genetics of the syndrome. We were able used for analysis of risk factors for baldness using
to identify that there is variation in the phenotype unconditional logistic regression with androgenetic
over time with marked fluctuations occurring in the alopecia as the response variable adjusted for age.
ease with which hair can be plucked. We also Further research is required to confirm the negative
determined that it is an autosomal dominant association between lean body mass and the
disease with incomplete penetrance after having completion of growth risk of androgenetic alopecia
clearly defined the clinical diagnostic criteria for later in life.
Date commenced: 2001
Date commenced: 1997
Date completed: 2002
Date completed: 2001
Progress of Project: Submitted for publication
Progress of Project: Thesis accepted for Master
Funding source/s: NH&MRC, Tattersall’s and
of Medicine, University of
Anti Cancer Council of
Funding source/s: University of Melbourne
A new clinical grading scale for female were compared with 305 women who underwent
androgenetic alopecia 2 biopsies, with one being sectioned horizontally
and the other vertically. To correlate the histological
Andrew Messenger, Rodney Sinclair
diagnosis with the clinical severity mid scalp, a
The pattern of hair loss seen with androgenetic clinical grading scale was developed. We found
alopecia differs between men and women. In that application of the current diagnostic criteria
women the frontal hairline seems to be preserved achieved accurate diagnostic definition in 98% of
and women may notice just a diffuse thinning over women with triple horizontal biopsies versus 79%
the crown generally. The currently used grading with a single horizontal biopsy. 97% with a mid
scale to assess female androgenetic alopecia is that scalp clinical grade of 3, 4 or 5 were diagnosed on
designed by Ludwig in the 1970’s. We developed triple biopsy with female pattern hair loss. Scalp
and validated a new clinical grading scale. Women biopsy for diagnosis should therefore be reserved
who presented with grades 1 or 2 hair loss were for women with a mid scalp clinical grade of 1 or 2.
found on histology to have androgenetic alopecia
Date commenced: 1999
in 60% of cases and chronic telogen effluvium in
40%. In contrast, women who presented with Date completed: 2002
stage 3, 4 and 5 hair loss had a 97% chance of
Progress of Project: Accepted for publication
having androgenetic alopecia histologically. In the
Journal of the American
final evaluation the terminal to vellus hair ratios
Academy of Dermatology.
were correlated with clinical grade and a good and
linear correlation was recorded between the grade Funding source/s: Core budget
of hair loss and the terminal to vellus hair ratio
Date commenced: 2000
Women Who Present With Female Pattern Hair
Date completed: 2002 Loss Tend To Underestimate The Severity Of Their
Progress of Project: Being prepared for Hair Loss
publication Seba Biondo Rodney Sinclair
Funding source/s: Core budget, Monash Female pattern hair loss can be a source of
University Alfred Hospital considerable distress for affected women. Our
hypothesis was that women with female pattern
hair loss who seek treatment would rate their
condition as more severe than the treating doctor.
Histological Diagnosis of female androgenetic We undertook this project to identify discrepancies
alopecia between the severity ratings of the women and the
clinicians. 30 women receiving treatment for biopsy
Rica Mallari, Damian Jolley, Jill Magee, David Whiting,
proven androgenetic alopecia and 44 women on
Stephen Kossard, Rodney Sinclair,
the waiting list to receive treatment for
We undertook an investigation to evaluate the androgenetic alopecia were recruited. Each
reliability of a single horizontally sectioned scalp women completed a self report photographic
biopsy in the diagnosis of female pattern hair loss. measure on the severity of their hair loss,
207 women presenting with chronic diffuse hair specifically developed for the study. No difference
loss had three 4mm punch biopsies taken from was found between the severity ratings of the
immediately adjacent skin on their mid scalp and all women receiving treatment and their clinicians,
3 biopsies were sectioned horizontally. The findings it was found that women in the waiting list group
Quality of Life in Women with Female Pattern
Hair Loss and the Impact of Medical
underestimated the severity of their hair loss as
Seba Biondo Rodney Sinclair
compared to their clinicians ratings. The results
indicate that women affected with androgenetic Female pattern hair loss has recently become the
alopecia who seek treatment for their hair loss do preferred term for female androgenetic alopecia, a
not overestimate the severity of their hair loss, in conditionproducing chronic progressive hair loss in
fact, they tend to underestimate it. women. The morbidity related to the hair loss is
predominantly psychological. The purpose of this
Date commenced: 2001
study was to examine the impact of female pattern
Date completed: 2002 hair loss on quality of life and the effect of
Funding source/s: Department of Psychiatry, comprehensive medical assessment, explanation of
Monash University disease process and initiation of treatment by an
experienced dermatologis. 77 women with biopsy
proven female pattern hair loss receiving treatment
with oral anti-androgens, 53 women on a waiting
list to receive treatment for female pattern hair loss
Community Prevalence of female androgenetic
and 82 women not affected by hair loss were
studied. Participants completed the women’s
Desmond Gan, Rodney Sinclair female pattern hair loss quality of life
questionnaire. Findings confirmed the detrimental
In this study questionnaires have been developed to
impact of hair loss on the quality of life of affected
be sent out to a random sample of 6,000 people
women and the lack of impact of medical
aged above 18 sampled from the Australian
intervention on quality of life at 2 months. This
electoral roll in the city of Maryborough in central
has significant implications for the treatment of
Victoria. The questionnaire will be used to obtain
psychological difficulties associated with female
information about whether they or family members
pattern hair loss and suggests a possible role for
have experienced baldness, dandruff, greying of
adjunctive psychological intervention in the
the hair or complications pertaining to baldness
management of this chronic dermatological
(solar keratosis or skin cancer of the scalp). They
will be asked to self assess their hair thickness
using the scale provided. 500 respondents will be Date commenced: 2001
invited for face to face hair and scalp examination
Date completed: 2002, Report completed
by a dermatologist and registrars recording the
degree of hair loss, greying of hair, and the Funding source: Department of Psychiatry,
presence of dandruff. Monash University
Date commenced: Ongoing
Funding source/s: Core budget, Pharmacia
Genetics of Androgenetic Alopecia
Shannon Harrison, Justine Ellis, Steven Harrap,
Common Baldness, Dandruff and Greying of
In recent years researchers at the Department of Hair in Twins
Physiology at the University of Melbourne have
Desmond Gan, Rodney Sinclair
identified the genetic association between men
with androgenetic alopecia and polymorphisms on Common baldness, seborrheoic dermatitis and hair
the androgen receptor. There has been much greying are thought to be under genetic control. In
recent controversy about whether female pattern order to investigate the nature of this genetic
hair loss is indeed the female corollary of male association, we are developing a survey for
androgenetic alopecia. There has been a revision of monozygotic and dyzogotic twins from the
terminology with female patterned hair loss Australian Twin Registry.
becoming the preferred term because of the Date commenced: 2001
uncertainty about the nature of this association.
In order to determine whether female pattern hair Progress of Project: Ongoing
loss is genetically association with the same Funding source/s: Core budget
polymorphisms on the androgen receptor seen in
male androgenetic alopecia, we undertook a study
of 150 women with clinical and histological
evidence of female pattern hair loss. Because
Treatment of female androgenetic alopecia
women have two X chromosomes of which by
with oral antiandrogens
lyonisation only one is active, the power required to
demonstrate an association is greater than that Miriam Wewerinke, Rodney Sinclair
required for the men. To date, DNA from over 100
The prevalence of clinical hair loss in women
women have been analysed and whilst a suggestive
increases with age. Most data on the use of
association exists, further analysis is required to
androgen receptor antagonists pertain to their use
achieve statistical significance.
in women with hirsutes or acne. The role of
Date commenced: 2001 androgens in the management of women with
biopsy proven androgenetic alopecia, we studied in
Progress of Project: Ongoing
100 women who received anti andorgenetic
Funding source/s: Skin and Cancer treatment for more than 12 months. Pre- and
Foundation, Department of post-treatment photographs were assessed side by
Physiology, University of side by three independent clinicians experienced in
Melbourne the treatment of patients with hair loss and scored
using a visual analogue scale. The concordance
between examiners was assessed. Photographs
were rated as either improved, no change or worse.
Fewer than 10% of women were identified as
worse while on treatment and over 90% showed
either no change or improved. 30% had clearly
improved using the photographic documentation.
Date commenced: 1999
Date completed: 2001
Funding source/s: Core budget
Prevention of Hospital Acquired Pressure CLINICAL TRIALS
Ulcers: a randomised controlled trial in the use
of a sheepskin underlay
Ken Montgomery, Damian Jolley, Rodney Sinclair
A Phase III Multicentre, Double-Blind, Active-
Controlled, Parallel Study Comparing the
Pressure ulcers are a costly, burdensome and Efficacy and Safety of ZOVIRAX™ Cold Sore
prevalent complication to hospital stay. The Cream (Aciclovir 5% Cream) and Lidocaine 2%
majority (up to 80%) have reported pressure ulcers to ZOVIRAX™ Cold Sore Cream Alone
as stage 1 or stage 2, indicating damage to the Administered for 5 Days in Subjects with
superficial layers of the skin. This type of injury is Herpes Labialis Infection
often associated with combined forces of pressure, Funding source: Glaxo- Wellcome
moisture and friction and is potentially preventable (Zovirax study ZOV30009/Parexel
with the appropriate pressure reducing/relieving No.22209)
support surface. Although many pressure relieving
Date Completed: March 5th, 2001
support surfaces are available, there is little reliable
evidence to distinguish between them, on the basis
of either efficacy or cost effectiveness. This study
A double-blind, single-centre, placebo-
was a randomized trial that compared the
controlled clinical trial to examine the efficacy
Australian Medical Sheepskin (AMS) to standard
and safety of DA-5018 cream as a treatment
hospital care in a large metropolitan teaching
for pruritus associated with mild/moderate
hospital. The results suggest that the AMS can
provide effective reduction in the incidence of
pressure ulcers in low to moderate risk hospital Funding source: Stiefel (study CP S217-AUS-02)
patients. Widespread use of the AMS has the
Date Completed: April 29th, 2001
potential to substantially reduce patient discomfort,
hospital costs and possible litigation.
Date commenced: 1998 A multicenter, phase III, double blind study of
photodynamic therapy (PDT) with Metvix 160
Date completed: 2002
mg/g cream in comparison to PDT with
Funding source/s: NH&MRC placebo cream in patients with primary
nodular basal cell carcinoma
Funding source: Photocure (study PC T308/00)
Multicenter, multinational, double-blind,
parallel, randomized, placebo controlled study
of leflunomide in the treatment of psoriatic
Funding source: Aventis (study HWA486/3L01)
Date Completed: July 15th 2002
A Multi-Centre, Double-Blind, Placebo- REFERENCE LIBRARY
Controlled Parallel Group Clinical Evaluation of
the Efficacy and Safety of 1.5% Ciclopirox
Olamine Body and Hair Shampoo in the Topical
Treatment of Tinea Versicolor (Pityriasis A reference library is maintained on a bibliography
Versicolor) database using the computer software Endnote, in
order to catalogue all papers held within the
Funding source: (Stiefel study S227-AUS-03)
department. This database, which is continuing to
Status: Ongoing grow, now contains over 3,000 publications.
Double Blinded Placebo controlled cross-over
study to investigate hydroxychloroquine and
acitretin in the treatment of cicatricial alopecia
Martin Wade, Keng Ee Thai, Shannon Harrison,
Edward Upjohn, Rod Sinclair
Date commenced: 1999
Funding source/s: ADREF; Skin and Cancer
ARTICLES Thai KE, Young R, Sinclair R. Nail Apparatus
Melanoma. Aus J Dermatol. 2001; 42: 71-83.
Green J, Sinclair R. Perceptions of acne vulgaris in
final year medical student written examination
Marks R. Dermatoepidemiology, Wherefore art thou answers. Aus J Dermatol. 2001; 42:98-101.
in this perilous time of need? Int J Dermatol.
De Berker D, Sinclair R. The Hair Shaft, normality,
2001; 40: 167- 168.
abnormality and genetics. Clinics in Dermatol.
Marks R, Gebauer K, Shumack S, Amies M, Bryden 2001; 19:129-34.
J, Fox TL, Owens ML. Imiquimod 5% cream in the
Sinclair R, Dawber R. Androgenetic alopecia in
treatment of superficial basal cell carcinoma,
men and women. Clinics in Dermatol. 2001;
Results of a multi-centre 6 week dose-response
trial. J Am Acad Dermatol. 2001; 44:807-813.
Dawber R, Sinclair R. Hirsutes. Clinics in Dermatol.
Marks R. (Guest Editor). Beyond the year 2000.
Clinics in Dermatol. 2001; 19, 1.
Sinclair R. Commentary. Clinics in Dermatol. 2001;
Lau PM, Marks R, Stewart K. The outcome of an
education program to assist pharmacists in
prescribing over-the-counter (OTC) products for Sinclair RD. Management of male pattern hair loss.
common skin diseases. Pharmacy Education. 2001; Cutis 2001; 68(1):35-40.
1: 83-90. Curnow P, Sinclair R, Marks R. A public health
Marks R, Foley PA, Sinclair RD. Dermatology. model for the prevention of cancer, the Australian
Med J Aust. 2001; 176: 10. experience with melanoma and non melanoma skin
cancer’. Austral-Asian Journal of Cancer. 2001.
Green A, Marks R. Invasive squamous cell
carcinoma of the skin, non-metastatic. Thai KE, Sinclair R. Cutaneous Pili Migrans.
Clinical Evidence. 2001; 5: 1190-1195. Br J Dermatol. 2001; 144:219.
Plunkett A, Lau P, Stewart K, Marks R. Thai KE, Sinclair R. Spironolactone induced
Skin conditions in the pharmacy, consumer Hepatitis. Aus J Dermatol. 2001; 42: 180-182.
satisfaction and economic considerations. Thai KE, Sinclair RD. Keratosis Pilaris and hereditary
Int J Pharm Practice. 2001; 9: 9-14. koilonychia without monilethrix.
Marks R. The public health approach to the burden J Am Acad Dermatol. 2001; 45: 627-629.
of common skin conditions in the community. Green J, Sinclair RD. Oral cyclosporin does not
J Dermatol. 2001; 28: 602-5. arrest progression of androgenetic alopecia.
Marks R. Diagnosis in Dermatology - Tricks of the Br J Derm. 2001; 145:842-44.
trade. Aust Fam Phys. 2001; 30: 1028-32.
Foley P, Zuo Y, Plunkett A, Marks R. The frequency 2002
of common skin conditions in preschool-age
children in Australia, 1. Atopic dermatitis. Arch. Marks R. The changing incidence and mortality of
Dermatol. 137; 293-300, 2001 melanoma in Australia. Recent Results in Cancer
Research. 2002; 160: 113-21.
Ng J, Foley, PA, Crouch RB, Baker CS. A case of
actinic prurigo successfully treated with Marks R, Foley P, Sinclair R. Updates in medicine,
thalidomide. Australas. J. Dermatol. 42; Dermatology. Med. J. Australas. 176, 10, 2002
Crouch R, Foley, P, Baker C. Actinic prurigo, Jenner N, Campbell J, Plunkett A, Marks R.
A retrospective analysis of 21 cases referred to an Cost of psoriasis: A study on the morbidity and
Australian photobiology clinic. Australas. J. financial effects of having psoriasis in Australia.
Dermatol. 43: 128-32, 2002 Aust J Dermatol. 2002; 43: 255-61
Wade MS, Sinclair RD. Disorders of hair in infants Ciconte A, Mills A, Shipley A, Marks R. Subacute
and children other than alopecia. cutaneous lupus erythematosus in six year old a
Clinics in Dermatology. 2002; 20:16-28. child, A report of a case and a review of the
literature. Austral J Dermatol. 2002, 43,62-4.
Dolianitis C, Sinclair R. Optimal Treatment of Head
Lice, Is a No-Nit Policy Justified? Clinics in Marks R. The changing incidence and mortality of
Dermatology. 2002; 20: 94-95. melanoma in Australia. Recent Results in Cancer
Research. 2002; 160: 113-21.
Sinclair R. Cryosurgery in dermatology, treatment
of malignant and premalignant skin disease. Crouch RB, Foley, PA, Baker CS. The results of
Medical Cryology 2002; 2:149-170. photopatch testing 172 patients to sunscreening
agents at the photobiology clinic, St. Vincent’s
Zlotogorski A, Martinez-Mir A, Green J, Lamdagger
Hospital Melbourne. Australas. J. Dermatol.
H, Panteleyevdagger AA, Sinclair R, Christiano AM.
43; 74: 2002
Evidence for Pseudodominant Inheritance of
Atrichia with Papular Lesions. J Invest Dermatol. Crouch R, Foley, P, Baker C. Actinic prurigo,
2002;118:881-886. A retrospective analysis of 21 cases referred to an
Australian photobiology clinic.
Chong A, Sinclair R. Loose anagen syndrome,
Australas. J. Dermatol. 43, 128-32, 2002
A prospective study of three families.
Australas J Dermatol. 2002; 43:120-4.
Giles GG, Severi G, Sinclair R, English DR, McCredie
MRE, Johnson W, Hopper JL, Boyle P. Androgenetic Thai KE, Sinclair R. Cutaneous Pili Migrans.
alopecia, acne and prostate cancer, findings from Br J Dermatol. 2001; 144:219.
an Australian case-control study. Cancer Epidemiol
Thai KE, Sinclair R. Spironolactone induced
Biomarkers Prev 2002; 11:549-53.
Hepatitis. Aus J Dermatol. 2001;42:180-182.
White PJ, Gray AC, Fogarty RD, Sinclair RD,
Thai KE, Sinclair RD. Keratosis Pilaris and hereditary
Werther GA, Wraight CJ. C-5 propyne-modified
koilonychia without monilethrix.
antisence oligonucleotides penetrate the epidermis
J Am Acad Dermatol. 2001;45:627-629.
in psoriatic and not normal human skin after topical
application. JID 2002;118:1003-1007. Green J, Sinclair RD. Oral cyclosporin does not
arrest progression of androgenetic alopecia.
Harrison S, Sinclair RD. Telogen Effluvium.
Br J Derm. 2001;145:842-44.
Clin Exp Dermatol. 2002;27:389-95
Thai KE, Sinclair RD. Treatment of Bowen’s disease
Harrison S, Sinclair RD. Telogen Effluvium. (German
of the penis with imiquoimod.
Translation) Zeitscrift fur Hautkrankenheiten.
J Am Acad Dermatol 2002;46:470-1
Wade MS, Sinclair RD. Persistent depigmentated
Wade MS, Sinclair RD. Persistent depigmentated
regrowth following alopecia areata. J Am Acad
regrowth following alopecia areata. J Am Acad
Dermatol 2002; 46: 619-20
Thai KE, Sinclair RD. Chronic telogen effluvium in a
man. J Am Acad Dermatol. 2002;47:605-7.
Thai KE, Sheffield L, Forshaw K, Sinclair R, Herman Green J, Zlotogorski A, Martinez-Mir A, Lam HM,
G, Pitt J, du Sart D. Somatic Mosaicism explains Panteleyev A, Christiano A, Sinclair R Evidence of
the occurrence of X-linked dominant Conradi pseudodominant inheritance of atrichia with
Hunnerman Syndrome in an affected male. papular lesions. Aus J Dermatol 2002; 43:A31
Aus J Dermatol 2001, 42, A13.
Tosti A, Piraccini BM, Bergfeld WF, Camacho F,
Green J, de Berker D, Sinclair R. Marie Unna Dawber RP, Happle R, Olsen EA, Price VH, Rebora
Hereditary Hypotrichosis, First Australian Family. A, Shapiro J, Sinclair R, Vanneste D, Whiting
Aus J Dermatol 2001, 42, A126 DA.Occupational alopecia or alopecia areata?
J Am Acad Dermatol. 2002 Oct;47(4):636-7.
Green J, de Berker D, Sinclair R. Pili Annulati,
Characterization of the Phenotype. Aus J Dermatol
2001, 42, A126
NON-PEER REVIEW PUBLICATIONS
Sinclair R, Howard A. Epidermoid carcinoma of the
nail apparatus treated with imiquomod 5% cream. Thai KE, Sinclair R. Androgenetic Alopecia.
Aus J Dermatol 2002, 43, A6 Medical Observer. 19 January 2001.
Thai KE, Sinclair R. Differential Diagnosis: alopecia
areata vs trichotillomania. Medical Observer.
ABSTRACTS AND LETTERS 2 February 2001.
Thai KE, Sheffield L, Forshaw K, Sinclair R, Herman Dolianitis C, Sinclair R. Management of Psoriasis.
G, Pitt J, du Sart D. Somatic Mosaicism explains Medical Observer. 25 May 2001.
the occurrence of X-linked dominant Conradi
Hunnerman Syndrome in an affected male.
Aus J Dermatol 2001;42:A13. BOOKS
Green J, de Berker D, Sinclair R. Marie Unna Price C, Sinclair R. Fast Facts-Minor Surgery. Health
Hereditary Hypotrichosis: First Australian Family. Press Limited. Oxford 2001.
Aus J Dermatol 2001;42:A126
Sinclair R, Marks R. A guide to the performance of
Green J, de Berker D, Sinclair R. Pili Annulati: diagnostic procedures used in the management of
Characterization of the Phenotype. Aus J Dermatol common skin diseases. St. Vincent’s Hospital
2001;42:A126 Department of Dermatology, Melbourne, 2002.
Sinclair R, Howard A. Epidermoid carcinoma of the Sinclair R, Banfield C, Dawber R. Handbook of
nail apparatus treated with imiquomod 5% cream. diseases of the hair and scalp. (Italian Translation)
Aus J Dermatol 2002;43:A6 Blackwell Science, Oxford 2002
Green J, Forrest S, Sinclair R. Familial alopecia Campbell J, Foley P, Jenner N, Marks R, Merlin K,
areata in Australia. Ann Dermatol Venereol. 2002; Sinclair R, Welsh B. Skin - an education program for
129: 1S516. Maternal & Child Health. Melbourne: Department
Green J, Fitzpatrick E, Forrest S, Sincalir R. of Dermatology, St. Vincent’s Hospital Melbourne.
A possible second locus for Programd patterned 2002.
alopecia. Aus J Dermatol 2002; 43:A25 Merlin K, Campbell J, Witherow E, Jenner N, Foley
Chong A, Fitzpatrick E, Forrest S, Sincalir R. P, Marks R. Skin - an education program for Primary
Clinical and Molecular genetics of loose anagen Schools. Melbourne: Department of Dermatology,
syndrome: Results form a study of 16 families. St. Vincent’s Hospital Melbourne. 2002.
Aus J Dermatol 2002; 43:A17
BOOK CHAPTERS OTHER ACTIVITIES
Wade M, Sinclair R. Hair abnormalities in women The Department has been responsible for
and girls. In Parish LC, Brenner S, Ramos-e-Silva M. innumerable public relations/ education activities
Eds. Women’s Dermatology. From infancy to and resources such as comments in lay magazines,
maturity. Parthenon Publishing Group. New York radio and television interviews and patient
2001. information leaflets and advice. These activities are
too numerous to specify.
Korpan NN, Amaro JA, Gonsalves JCA, Monfrecola
G, Nordin P, Le Pivert PJM, Scalvenzi M, Sinclair R.
Cryosurgical dermatology. In Korpan NN. Ed. Atlas
of cryosurgery. Springer. Vienna. 2001.
Thai KE, Sinclair R. Androgenetic Alopecia.
In Lebwohl, Heymann, Berth-Jones Coulson. Ed.
Treatment of Dermatological Disease.Harcourt
Health Sciences. London. 2002.
Scarfe C, Sinclair R. Actinic Keratosis.
In Lebwohl, Heymann, Berth-Jones Coulson.
Ed.Treatment of Dermatological Disease. Harcourt
Health Sciences. London. 2002.
Marks R, Hill D. Prevention of Skin Cancer.
In, Sober AJ, Haluska FG, Eds. Skin Cancer.
The American Cancer Society Atlas Series.
Ontario,BC Decker Inc. 2001;325-339.
Hill D, White V, Marks R, Borland R. Changes in
sun-related attitudes and behaviours, and reduced
sunburn prevalence in a population at high risk of
melanoma. In, Public Health Communication,
Evidence for behavior change. Hornik RC Ed.
New Jersey,Lawrence Erlbaum Associates.
CONFERENCE PRESENTER CONFERENCE PRESENTER
International Meetings - 2001 International Meetings 2002 cont...
5th World Conference on Melanoma, Venice, Italy RM Annual Scientific Meeting, Wellington PF
American Academy of Dermatology Annual Meeting, RS 11th Congress European Academy of Dermatology & RM
Washington DC Venereology, Prague, Czech Republic
100th Meeting Japanese Dermatological Association, RM Koelmeyer Clinical Group, WHERE???? CB
Hair Forum 2002. Malayasian Society for Hair Science, RS
Sixth Asia-Pacific Environmental and Occupational PF Kuala Lumpar
The Philippine League of Dermatologists 15th Regional RS
The Eden IDEA Congress, Noordwijkerhout, Netherlands RM Conference of Dermatology, Manilla
8th World Congress on Cancer of the Skin Zurich, RM Josef Plenck Lecture, Austrian Society for Dermatology RM
Switzerland and Venereology, Vienna, Austria
International Society of Dermatology, Regional Meeting RM
Australian Meetings 2002
Medical Education in Dermatology, Rhodes, Greece
Maternal and Child Health Nurse Seminar, Melbourne PF
New Zealand Dermatological Society and the PF, RS, CB, LMY
Australasian College of Dermatologists Cutaneous Biology and Endocrinology Workshop, Melbourne RS
Combined Meeting, Queenstown The Australasian College of Dermatologists RM, NJ, PF,
European Academy of Dermatology and Venereology, Munich PF Annual Scientific Meeting,Melbourne LMY,RS, JG
6th Asian Dermatology Congress, Thailand RS Maternal and Child Health Saturday RM, JC, KM, NJ
Conference, RMIT, Melbourne
Australian Meetings 2001
12th Annual Scientific Meeting Australasian Health NJ, KM and
The Australasian College of Dermatologists PF, RS, RM, JG Research – Data Managers Association
Annual Scientific Meeting, Adelaide (AHR-DMA), Brisbane.
Australian Health Promotion Association Conference, KM The General Practitioner Conference and Exhibition, PF
Gold Coast Melbourne
Alopecia, Hair Today, Gone Tomorrow Cutaneous Biology RS
International Meetings 2002 and Endocrinology Workshop, Melbourne
Global Transplant/Skin Cancer Collaborative Group Berlin, RM
Croatian Dermatovenerological Society of the Croatian RM
Medical Association, Optija, Croatia
Hellenic Dermatological Society, Scientific Meeting, RM
European Hair Research Society, Brussels RS, JG
World Congress of Dermatology, Paris RM, RS, CB, JG,PF
British Association of Dermatology, Edinburgh RS
International – Elective Students
Helen Bryden University of Glasgow
Sabine Seidl University of Munich
Carola Schmidt Ruprecht-Karls-Universitaet, Heidelberg, Germany
Jessica Nehrling University of Maryland, Baltimore, USA
International and Local Visitors to the Department
Dr Julie Cronk Dermatology resident, University of Minnesota, USA
Dr Mirjam Wewerinke Visiting doctor, University of Gronigen, Netherlands
Dr Roger Timms GP, James Paget Hospital, Great Yamouth, UK
Dr Behnaz Fazeli Visiting doctor, Elisabethinen Hospital, Linz, Austria
Dr Kirstin Charlesworth GP, Daylesford
International – Elective Students
Elke Marksteiner University of Michigan, USA
Paul Foggit St. Bartholomew’s & The Royal London Hospital, UK
Katrina Barnett University of Maryland, USA
Lucy Schomberg St George’s Hospital, London, UK
Chantal Tomkins University of Nottingham, England
Eitan Amir University of Nottingham, Manchester, UK
International and Local - Visitors to the Department
Dr Sue Burge Clinical Dean,Oxford University School of Medicine, and Senior
Lecturer in Dermatology, The John Radcliffe, Oxford, England
Dr Veerle Verlinden Dermatology Registrar, University of Leuven, Belgium
Dr Andrew Messenger Senior Lecturer in Dermatology, Royal Hallamshire Hospital
Prof Richard Scher Professor of Dermatology, University of Columbia New York, USA
Dr Kevin White Dermatology Resident, University of Pennsylvania, USA
Dr Stephen Richardson Lahey Clinic Dept, Internal Medicine, Burlington, MA, USA
Dr Jane Tam GP
Dr Zina Akhounova GP
Dr Jim McDonald GP
The Skin & Cancer
Foundation of Victoria
The Skin and Cancer Foundation of Victoria maintains its close relationship with St. Vincent’s Hospital,
the University of Melbourne and Australasian College of Dermatologists in supporting the academic
Department at St. Vincent’s Hospital. This cooperative venture has been the envy of other medical
disciplines who are looking at ways of maintaining their service, teaching and research bases in a time
of economic rationalism when many of these components previously provided through the public
hospital system are being so constrained.
In service, the Department at St. Vincent’s Hospital has close links with the Skin and Cancer Foundation in many
aspects. This includes the dermatology registrar at St. Vincent’s undertaking biopsies and other minor
procedures on St. Vincent’s patients using the facilities at the Foundation. The St. Vincent’s registrar is able to
benefit from the supervision by plastic surgeons who attend the Foundation at the time of the procedure clinic.
Patients from St. Vincent’s are also referred across to the Foundation for phototherapy, for diagnostic purposes
in the contact dermatitis clinic, for hair and nail advice and management and to obtain the phototherapy
facilities which form such a large component of the clinical load at the Foundation these days.
The skin cancer assessment clinic has acted as a teaching and training resource for medical students as well as
the registrars from St. Vincent’s Hospital. Patients from this clinic have also been used in the teaching seminars
for 6th year medical students provided by the Foundation throughout the year.
The St. Vincent’s Department is frequently acting as an adviser to pharmaceutical companies on clinical trials of
new products. To undertake the clinical trials, the Department links with the Foundation as a central trials base.
This benefits both the Foundation and St. Vincent’s. Other research projects which have been shared between
St. Vincent’s and Skin and Cancer Foundation include the hair and nail research activities of Dr Rodney Sinclair.
The photography services of the Foundation have been a major contributor to the hair research. They have also
contributed in both the research and service in supporting the Department at St. Vincent’s Hospital. Other
technical resources at the Department have been supported by the Foundation such as the new internet site to
back up our public and professional education programs. The Foundation has provided a grant for this project
developed in the Department by Nicole Jenner.
As the Department has database expertise, a contractual arrangement has been commenced in which the
Department provides their expertise in developing and managing the Skin and Cancer Foundation patient
database. These databases, while strictly complying with the new privacy legislation, provide extremely
important research data which can be extracted and reported to enhance the clinical services provided by the
Foundation. The new occupational dermatology developments of Dr Rosemary Nixon have gone from strength
to strength since their establishment. Dr Nixon is an Honorary Senior Lecturer in Dermatology at the St.
Vincent’s Hospital Department, and the Department also assists with advice and guidance on directions and
research being undertaken by the new Centre. Dr Nixon has also been active in expanding the activities of the
Foundation to Monash University as well as the initial links with the University of Melbourne. In time, no
doubt, there will be sharing between University of Melbourne and Monash University medical students of the
teaching that is occurring at the Foundation.
The Foundation now has a very stable financial base, particularly with the development of the new Skin and
Cancer Foundation Pathology. This has allowed it to take both a short and long term view in its forward
planning and much of that has involved its relationship with the Department at St. Vincent’s Hospital. The
relationship is a strong one. It will continue to grow and we look forward to our future activities together.
Skin & Cancer Foundation of Victoria
International League of
The 20th World Congress of Dermatology in Paris, in June 2002, was
attended by 1,200 dermatologists. It was the largest gathering of
dermatologists ever seen in the world.
During the Congress, the Assembly of Delegates representing the member
societies of the International League of Dermatological Societies (ILDS) met to
discuss and decide future directions of the League. They elected a new board
for the ILDS (the International Committee of Dermatology) who then went on
to elect the President and Office bearers for the next five years. Professor
Robin Marks was elected the new President. Professor Georg Stingl from
Vienna was elected Secretary-General and Professor Ana Kaminsky from
Buenos Aires was elected the Treasurer. This is the first time an Australian has
ever held a position of this nature in international dermatology.
The ILDS has a number of other strategic directions, apart from running the
World Congress of Dermatology. These include the International Foundation
for Dermatology, the arm of the League dedicated to improving the outlook
for people affected by skin diseases in developing countries. The Foundation
runs a Regional Dermatology Training Centre in Moshi, Tanzania. Over 100
paramedical trainees have graduated after a two year course at the Centre.
They then return to organise dermatology practice or administration in their individual African states trying to
provide some level of dermatological service for those in need. A community-based project was undertaken in
Mali, West Africa, last year looking at four of the major common infestations/infections in Africa. Models of
care tested in this project may be applicable to other developing countries throughout the world.
The ILDS also acts as a global political body for dermatology, being the only non-government organisation in
dermatology in official relations with the World Health Organisation. It has contributed to the development of
the latest International Classification of Diseases list (ICD-10), as well as providing the section on dermatology in
the "Essential Drugs Handbook" of the WHO. Under the Derm-Link program, the League provides small grants
to dermatologists within the member societies in developing countries. These grants can provide items of
equipment for a dermatology department or support travel for training purposes.
One of the major new tasks, recommended by the Assembly of Delegates, is to look at and define the
boundaries of dermatology. We plan to develop and publish a document showing clearly what dermatology is
and what services dermatologists can provide. Individual member societies could use such a document within
their own country, with the imprimatur of the ILDS the global body for dermatology, to negotiate with
government and other organisations in these difficult times when dermatology seems to be being encroached
upon by so many people around us.
We have a marvellous International Committee of people who are widely experienced and very committed to
the League. There is no doubt that there is a lot to achieve. Keep your eye on this spot - over the next five
years there will be increased awareness of the activities of the League associated with steps forward in our aim
of improving access and care for people with diseases affecting their skin throughout the world.
International League of Dermatological Societies
Cutaneous Biology and
November 8-10, 2002
The Department of Dermatology at St. Vincent’s Hospital Melbourne, together with the Australasian
Hair and Wool Research Society, hosted the first Cutaneous Biology and Endocrinology Workshop at
the Mary Aikenhead Conference Centre, St. Vincent’s Hospital Melbourne in November 2002.
There were over 60 delegates, including dermatologists and basic scientists. Professor Chen Ming Chuong, a
developmental biologist from San Francisco and Dr Dennis Roop from the University of Baylor in Dallas, Texas
were the two international guest speakers. A variety of excellent scientific and clinical papers were delivered at
the meeting much of which, although arising within the context of hair research, had applications right
through cutaneous biology, particularly in the area of genetics research and gene therapy. A special part of the
meeting was a registrar training forum and clinical day held at the Skin and Cancer Foundation.
The meeting was an enormous success and no one who attended could fail to have been impressed by the
quality of scientific cutaneous research being conducted in Australia and New Zealand. The abstracts will be
published in full in Experimental Dermatology, the official journal of the Australasian Hair and Wool Research
Organisational Charts 2001-2002
DEPARTMENT OF DERMATOLOGY 2001
Robin Marks Dr Abe Dorevitch
Professor of Dermatology A/Prof Damien Jolley
Dr Harvey Rotstein
Dr Andrew Michaelides
Dr Rosemary Nixon
Dr Chris Baker Dr Peter Foley Ms Jan Campbell Dr Rod Sinclair
Director of Clinical Services Senior Lecturer in Dermatology Department Manager Senior Lecturer in Dermatology
Consultant Ms Marlene Rennie
Dermatologists Dr Lee Mei Yap
Dr Peter Foley Mrs Helen Gibson
Dr Robert Kelly Administrative Officer
Registrars Research Staff Research Fellows
Dr Chris Mc Cormack
Dr Mei Tam Dr Cate Scarff Ms Kate Merlin Ms Jack Green
Dr Belinda Walsh Research Registrar Programs Officer Doctorate Student
Dr Suresh Chandra Ms Nicole Harman Dr Martin Wade
Dermatology Nurse Programs Officer Doctorate Student
Dr Laura Scardamaglia
Ms Leoni Hill Hospital Registrars Ms Maria Moore Dr Keng-Ee Thai
(shared 6 monthly) Programs Assistant P/T Masters Student
DEPARTMENT OF DERMATOLOGY 2002
Honorary Senior Associates
Dr Abe Dorevitch
A/Prof Damien Jolley
Robin Marks Dr Harvey Rotstein
Professor of Dermatology Dr Andrew Michaelides
Dr David Harman
Honorary Senior Lecturer
Dr Rosemary Nixon
Dr Chris Baker Dr Peter Foley Ms Jan Campbell Dr Rod Sinclair
Director of Clinical Services Senior Lecturer in Dermatology Department Manager Senior Lecturer in Dermatology
Research Fellow Administrative Staff Visiting Fellows
Consultant Dr Stephen Gilmore Ms Marlene Rennie Dr Susan Burge
Dermatologists MD student Administrative Officer Dr Andrew Messenger
Dr Peter Foley Mrs Helen Gibson
Administrative Officer Research Staff
Dr Robert Kelly
Dr Chris Mc Cormack Ms Kate Merlin Research Fellow
Registrars Programs Manager
Dr Mei Tam Dr Shannon Harrison
Dr Belinda Walsh Dr Lee Mei Yap Ms Nicole Harman
Research Registrar Programs Manager
Dermatology Nurse Dr Paul Curnow Ms Maria Moore
Ms Leoni Hill Dr Adriene Lee Programs Assistant P/T
(shared 6 monthly) Ms Liz Whitherow
Programs Assistant P/T
HEAD OF DEPARTMENT Robin Marks, AM, MBBS, MPH, FRACP, FACD
DEPARTMENT MANAGER Jan Campbell, BA (Hons), MA
ADMINISTRATIVE STAFF Marlene Rennie, Administrative Officer
Helen Gibson, Secretary/Administrative Assistant – Part Time
Director of Clinical Dermatology Christopher Baker, MBBS, FACD
Visiting Consultant Dermatologists Peter Foley, MB, BS, B Med Sc, MD, FACD
Robert Kelly, MBBS, FACD
Christopher McCormack, MBBS FACD
Mei Tam, MBBS, FACD
Belinda Welsh, MBBS, MM, FACD
Andrew Michaelides, MBBS, MRCP, FACD
2001 Suresh Chandra, MBBS
Laura Scardiamaglia, MBBS
2002 Adriene Lee, MBBS
Paul Curnow, MBBS
Dermatology Outpatient Department Leonie Hill, RN
Senior Lecturers in Dermatology Rodney Sinclair, MBBS, FACD
Peter Foley, MBBS, B Med Sc, MD, FACD
Project Managers Kate Merlin, BMRA, GDipHSc (Hlth Prom & Hlth Ed), GCert IT
Nicole Harman, BMRA, Grad.Cert.HS (CDM)
Research Assistant Maria Moore, RN, BH
2001 Cate Scarff, MBBS
2002 Lee Mei Yap, MBBS (Hons)
Bachelor of Medical Science Student
2002 Desmond Gan
Honorary Research Fellows
2001 Jack Green, MBBS RACGP
Keng-Ee Thai, MBBS BMed Sci
2002 Shannon Harrison, MBBS BMed Sci
List of Supporters
The Department was established in 1995 with corporate sponsorship from:
with support from:
Commonwealth Serum Laboratories
Victorian Faculty of the Australasian Janssen-Cilag
College of Dermatologists
Skin & Cancer Foundation (Victoria)
St. Vincent’s Hospital (Melbourne) Ltd
Lederle Laboratories (Wyeth)
The University of Melbourne
F & E Bauer Foundation
The following external funding sources were used to assist research projects for 2001/2002
The Jack Brokhoff Foundation Skin Education Project for Primary Schools
ANZ - Felton Bequest
The Ian Potter Foundation Skin Education Project for Maternal and
RE Ross Trust Child Health Centres
Gwendolyn Holly Bequest
The University of Melbourne for Loose Anagen Syndrome.
Postgraduate Research Scholarship.
Australasian College of Dermatologists Eczema Morbidity Study
Scientific Research Fund
F & E Bauer Foundation Psoriasis Qualitative Studies
Skin & Cancer Foundation of Victoria Development of the Website
William Joseph Payne Trust Digital camera for digital imaging of skin conditions
Without this support, the Department would not have been possible and we express our sincere
appreciation of these efforts and contributions from all those people and organisations