Category Archives: Dermatology

Localised hypopigmentation

Posted on March 29, 2020 by Dr Sarah

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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Vulval itch

Posted on March 17, 2020 by Dr Sarah

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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Diagnosing lower limb cellulitis

Posted on March 10, 2020 by Dr Sarah

I’m clearly not alone in having difficulty with this; not only is there limited evidence on how to differentiate causes of red legs, but there isn’t actually a gold-standard way of diagnosing cellulitis accurately, so even the evidence we have … Continue reading →

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Random assorted skin problems

Posted on February 15, 2020 by Dr Sarah

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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Dermatology snippets

Posted on January 14, 2020 by Dr Sarah

A few bits and pieces from MIMS Learning, dermatology, 2019; 15(2): Hidradenitis suppurativa This is a disease of follicular occlusion with chronic inflammatory response (both cutaneous and systemic). It’s strongly associated with smoking and obesity, but not exclusively so. It’s … Continue reading →

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Assessment of purpuric/petechial rashes

Posted on September 12, 2019 by Dr Sarah

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

Posted on September 8, 2019 by Dr Sarah

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

Posted on April 20, 2019 by Dr Sarah

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

Posted on April 19, 2019 by Dr Sarah

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

Posted on September 22, 2018 by Dr Sarah

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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