Category Archives: Dermatology

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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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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Permethrin 5% cream is first-line treatment; aqueous malathion is 2nd-line. If the first course doesn’t work, try the other one. Everyone in the family needs to be treated simultaneously, and all clothing (including clothes which have been worn but are … Continue reading

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Common rashes in newborns

Harmless rashes in newborns: Erythema toxicum Cutis marmorata Cradle cap Erythema toxicum Pinpoint papules on an erythematous base, moving every few hours. It spares the palms and soles. Beware of: cellulitis. Look at the skin between the lesions. If it’s … Continue reading

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Don’t use bath additives for children’s eczema

A simple and extremely useful study result; in children with eczema, don’t bother prescribing those additives that you put in the bath water. The BATHE study studied children from 1 to 11 with eczema (‘very mild’ eczema was excluded) who … Continue reading

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