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81. Balloon dilation for chronic eustachian tube dysfunction

several months, and repeated tube insertions may be needed. Some tubes are designed to stay in place for longer, but these can become crusted, infected or obstructed. Tympanostomy tubes may result in a small permanent hole in the tympanic membrane; this is more common with long-lasting tubes. Balloon dilation for chronic eustachian tube dysfunction (IPG665) © NICE 2019. All rights reserved. Subject to Notice of rights ( conditions#notice-of-rights). Page 2 of 4The

2020 National Institute for Health and Clinical Excellence - Interventional Procedures

84. Ivermectin for Parasitic Skin Infections of Scabies: A Review of Comparative Clinical Effectiveness, Cost-Effectiveness, and Guidelines

for the treatment of crusted scabies alone in one guideline and in combination with permethrin cream in another guideline, though these recommendations do not appear to be based on clinical evidence. The applicability of the guideline recommendations to the Canadian setting is unclear as the guidelines were developed for the European and Japanese settings. Files Rapid Response Summary with Critical Appraisal Published : May 16, 2019 Follow us: © 2019 Canadian Agency for Drugs and Technologies in Health Get our

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

85. Assessment of rash in children

by dermal oedema (e.g., urticaria). Scale: flakes of stratum corneum (e.g., eczema, psoriasis). Crust: dried serum, blood, or purulent exudate on the skin surface (e.g., impetigo). Erosion: loss of epidermis, heals without scarring (e.g., Stevens-Johnson syndrome, toxic epidermal necrolysis). Ulcer: loss of epidermis and dermis, heals with scarring (e.g., venous ulcer, pyoderma gangrenosum). Excoriation: loss of epidermis following trauma such as scratching (e.g., pruritus). Fissure: a split in the skin

2018 BMJ Best Practice

86. Blepharitis

Blepharitis Blepharitis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Blepharitis Last reviewed: February 2019 Last updated: October 2018 Summary Significant cause of discomfort, causing foreign body sensation, burning, itching, and crusting around eyelashes. Typical findings include lid erythema, collarettes around eyelashes, and capped meibomian glands. In severe cases, corneal changes, including (...) . It typically occurs bilaterally. Disease is usually chronic with intermittent exacerbations. History and exam burning sensation itching sensation foreign body sensation crusting of eyelids dry eye lid erythema, telangiectasias collarettes around lashes capped meibomian glands conjunctival hyperaemia unstable tear film with rapid tear break-up time chalazion scalp changes photophobia facial telangiectasias, erythema, pustules, papules depigmentation of lashes trichiasis madarosis lid margin thickening

2018 BMJ Best Practice

87. Pediculosis capitis

who are socially active, particularly young children. History and exam presence of risk factors scalp pruritus live nymphal or adult louse eggs visible on hair shaft within 1 cm of scalp small red papules under hairline at nape of neck lymphadenopathy erythema with honey-coloured crust on scalp aged 3-12 years female sex ethnicity other than black close contact with infested individual overcrowding or close living conditions low socioeconomic status poor hygiene contact with contaminated clothes

2018 BMJ Best Practice

88. Erythema multiforme

. These are in direct contrast to targetoid lesions, which can also be present but are less common, in which the centre is not blistered. In general, the lesions cover <10% of the total body surface area. Mild symptoms of an upper respiratory infection, including low-grade fever, can sometimes be noted prior to and at the start of an episode. Orolabial lesions are noted in two-thirds of patients; 40.9% of cases have oral lesions alone. Erosions, blisters, and crusts can be noted in any of the mucous membranes

2018 BMJ Best Practice

89. Porphyria cutanea tarda

Porphyria cutanea tarda Porphyria cutanea tarda - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Porphyria cutanea tarda Last reviewed: February 2019 Last updated: March 2018 Summary Presents with blistering and crusted skin lesions on the back of hands and other sun-exposed areas of the body. Other common features include skin fragility, with minor trauma causing blister formation, hypertrichosis, skin

2018 BMJ Best Practice

90. Cholesteatoma

cholesteatoma. Heilbrun ME, Salzman KL, Glastonbury CM, et al. External auditory canal cholesteatoma: clinical and imaging spectrum. AJNR Am J Neuroradiol. 2003 Apr;24(4):751-6. History and exam presence of risk factors hearing loss ear discharge resistant to antibiotic therapy attic crust in retraction pocket white mass behind intact tympanic membrane tinnitus otalgia altered taste dizziness

2018 BMJ Best Practice

91. Herpes simplex infection

can occur and typically recurrences are in the same site. Recurrences last from 6 to 48 hours; pain, burning, or tingling starts, and then vesicles form. Systemic manifestations do not typically occur and the lesions will crust and heal in about 10 days. Genital herpes is caused by infection with either HSV-1 or HSV-2. The first clinical episode of genital ulceration may represent either new acquisition of the virus or newly recognised disease with remote acquisition of the virus. Sexual contact

2018 BMJ Best Practice

92. Contact dermatitis

lichenoid lesions corrosion or ulceration pustules and acneiform lesions social hx of exposure persistence of symptoms scaling lichenification crusting erythema multiforme cellulitic lesions leukoderma hypopigmentation hyperpigmentation purpura miliaria alopecia granulomatous lesions occupation with frequent exposure to water or caustic material atopic dermatitis Diagnostic investigations patch testing repeated open application test (ROAT) or provocative use test (PUT) skin biopsy reflectance confocal

2018 BMJ Best Practice

93. Scabies

:1718-1727. History and exam infants, children, and the elderly hx of overcrowding hx of itching in family members or close contacts over the same period generalised and intense pruritus, typically worse at night burrows papules, vesicles, excoriations positive ink burrow test papules on face, neck, palms, and soles in children immunosuppression bullae thick, crusted lesions occurring on elbows, knees, hands, and feet with dystrophic

2018 BMJ Best Practice

94. Oral candidiasis

, oesophagitis, vulvovaginitis), focal invasion (endophthalmitis, meningitis, endocarditis), and dissemination (candidaemia). History and exam presence of risk factors creamy white or yellowish plaques, fairly adherent to oral mucosa cracks, ulcers, or crusted fissures radiating from angles of the mouth lesions on any part of the oral mucosa atrophic, fiery red, flat lesions on the palate patchy areas of loss of filiform papillae on the dorsum of the tongue spotty red areas on the buccal mucosa lesions

2018 BMJ Best Practice

95. Assessment of vesicular-bullous rash

Assessment of vesicular-bullous rash Assessment of vesicular-bullous rash - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of vesicular-bullous rash Last reviewed: February 2019 Last updated: June 2018 Summary Primary vesicular-bullous skin lesions include vesicles, bullae, or pustules. Other distinguishing features include scales, crusts, milia, and scarring. These conditions are classified by depth (...) spontaneously or evolving into bullae through enlargement or coalescence. Bullae Bullae are blisters >1 cm in diameter containing serous or seropurulent fluid. When bullae are located within the epidermis, they present with thin and flaccid walls, which rupture resulting in erosions, scale, and crusts. Erosions are the result of loss of the superficial layers of the epidermis and (in the absence of secondary infection) typically heal without scarring. The fragility of a blister is related to body location

2018 BMJ Best Practice

96. Folliculitis

in the submaxillary area small, uniform papules and pustules background erythema alopecia/scalp scaling erythematous plaques with haemorrhagic crusts in a dermatomal distribution trauma, including shaving and extraction occlusion perspiration topical corticosteroid preparations systemic antibiotics diabetes mellitus immunosuppression immersion in underchlorinated water drugs Diagnostic investigations Gram stain potassium hydroxide (KOH) preparation Tzanck smear direct fluorescent antibody (DFA) assay tissue

2018 BMJ Best Practice

97. Squamous cell carcinoma of the skin

and citation for the preceding image starts]: Squamous cell carcinoma on the dorsal hand with evidence of extensive sun damage From the private collection of Dr Nwaneshiudu and Dr Soltani [Citation ends]. Precursor lesions for SCCs are called actinic (or sun-damage) keratosis. History and exam presence of risk factors growing tumours previous skin cancer bleeding crusting evidence of sun damage to skin tender or itchy non-healing wound originally caused by trauma erythematous papules or plaques thin, flesh

2018 BMJ Best Practice

98. Basal cell carcinoma

telangiectasias plaques, nodules, and tumours with rolled borders small crusts and non-healing wounds non-healing scabs pearly papules and/or plaques metastases associated with large or neglected BCC local destruction with advanced lesion Ultraviolet (UV) radiation sun exposure x-ray exposure arsenic exposure xeroderma pigmentosum basal cell naevus syndrome (Gorlin-Goltz syndrome) transplant patients Diagnostic investigations biopsy for dermatohistopathology in vivo multiphoton microscopy Treatment algorithm

2018 BMJ Best Practice

99. Overview of skin cancer

papules and/or plaques; non-healing scabs; small crusts and non-healing wounds; plaques, nodules, and tumours with rolled borders; or papules with associated telangiectasias. Lear W, Dahlke E, Murray CA. Basal cell carcinoma: review of epidemiology, pathogenesis, and associated risk factors. J Cutan Med Surg. 2007 Jan-Feb;11(1):19-30. Raasch BA, Buettner PG, Garbe C. Basal cell carcinoma: histological classification and body-site

2018 BMJ Best Practice

100. Impetigo

/bullae crusting erythema pruritus pain mucopurulent exudate lymphadenopathy fever increased humidity poor hygiene, malnutrition, and overcrowding chronic colonisation with Staphylococcus aureus - nasal, axillary, pharyngeal, perineal concomitant skin disease Diagnostic investigations clinical diagnosis bacterial skin culture Treatment algorithm ACUTE Contributors Authors Dermatologist Associate Professor Bond University Queensland Australia Disclosures MF declares that he has no competing interests

2018 BMJ Best Practice

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