Category Archives: Dermatology

Random assorted skin problems

As stated before; I’m currently working my way through a stack of very old articles prior to throwing them out. Many of them are about dermatological topics, so here are the collected points gleaned from those. Pityriasis versicolor Caused by … Continue reading

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Assessment of purpuric/petechial rashes

This was a BMJ module, based on this article. Steps in assessing purpuric/petechial rashes: Assess for acute illness and consider the possibility of meningococcal sepsis. If suspected, administer parenteral antibiotics and admit urgently. If meningococcus is not the suspected diagnosis, … Continue reading

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Indications for urgent referral of childhood eczema

Same day: Eczema herpeticum (widespread HHV infection of eczema). Will need same-day dermatology opinion and, if it affects periorbital skin, same-day ophthalmology opinion as well. Give systemic aciclovir in the meantime (not sure of practicalities of this). Within two weeks: … Continue reading

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Nail disorders

Acute paronychia: antibiotics usually enough (occasionally needs drainage). Most often due to S. aureus. Chronic paronychia: most important thing is to stop doing whatever’s exacerbating it, such as frequent washing up. Can also be treated with antifungals (either topical or … Continue reading

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Melanoma

7-point weighted checklist (7PCL) Major features: Change in size Irregular shape Irregular colour Minor features: >7mm Oozing Inflammation Change in sensation 2 points for a major feature, 1 for a minor feature; 3 or more -> 2ww referral (unless obviously … Continue reading

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Signs of Kawasaki’s disease

Kawasaki’s disease is an arteritis (primarily affecting the coronary arteries). Signs: high fever for 5 or more days and: Polymorphous erythematous rash (can be urticarial, scarlatiniform or morbilliform and can contain small aseptic pustules) Cervical lymphadenopathy Bilateral conjunctival injection Changes … Continue reading

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Indications for referring children with eczema

Immediately Eczema herpeticum where child is systemically unwell   Within two weeks Severe eczema not responding to optimal therapy within a week Bacterially infected eczema not responding to treatment   (Quick Quiz BMJ module)

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