Monthly Archives: March 2020

Sudden sensorineural deafness, and vibration without a tuning fork

From this month’s BJGP: Sudden sensorineural hearing loss (SSNHL) is an otological emergency. The guidance is that sudden hearing loss that developed within the past 30 days needs to be referred for assessment within 24 hrs. If over 30 days … Continue reading

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A couple of tips on skin cancers

From last week’s BMJ, this article on non-melanotic skin cancers. Again, mostly visual, but here are a couple of things I want to remember: Deciding whether a lesion is an AK or SCC? Look for: Induration Ulceration Tenderness Rapid enlargement … Continue reading

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This week’s BMJ has an article about Bowen’s disease and its differential diagnosis. As you might expect, revision from this one was mostly visual, reminding my occipital cortex of what the different images look like; it doesn’t translate well into … Continue reading

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Bell’s palsy

Management Eye care (lubricants + night-time taping) If seen in 1st 72 hrs, 50 mg Prednisolone daily for 10 days If Ramsay-Hunt syndrome (look for painful vesicles around ear, mouth, or scalp) also antivirals. Note that rates of complete resolution … Continue reading

Posted in Credits 2020, Neurology | Leave a comment

Localised hypopigmentation

Causes Vitiligo Pityriasis alba Pityriasis versicolor Depigmented seborrhoeic keratosis Idiopathic guttate hypomelanosis Sarcoidosis (rare but important) Mycosis fungoides (rare but important)   Vitiligo Most often, but not invariably, on peripheral sites Repigmentation occurs in a perifollicular pattern Local areas can … Continue reading

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Hypertension: updated NICE guidelines

BMJ article from November summarised the updates to the previous guidelines, which I wrote about here. The actual guidance is here. Points to be aware of: Measuring BP Initially, check both arms; if the difference between arms is ≥15 mmHg, … Continue reading

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Vulval itch

Another one from the same old BMJ. Questions to ask: The usual; duration, affect on life (ask about sex life), exacerbating/relieving factors Vaginal discharge (?thrush) Anything used in that area for toiletries, treatment, fragrances, also condoms/spermicides/lubricants STI risk Other skin … Continue reading

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