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101. British Association of Dermatologists guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in children and young people

and candidal culture from areas of lesional skin, particularly sloughy or crusted areas, throughout the acute phase. R47 (↑↑) Take* viral swabs from eroded areas if HSV infection is suspected at any point. R48 (↑↑) Administer* systemic antibiotics only if there are clinical signs of systemic infection. The choice of systemic antibiotic should be guided by local microbiological advice. R49 (↑↑) Encourage* mobilization. R50 (↑↑) Involve* physiotherapy for mobilization, those needing respiratory support

2019 British Association of Dermatologists

102. Guidelines for topical photodynamic therapy (PDT)

. If necessary, any loose scale or crusts are removed first. A dressing is then applied over the cream and you will be asked to return in about 3 hours. This wait is to allow the photosensitiser to be absorbed and to convert into the active chemical by the skin. The cream is then wiped off and the area cleaned. A bright coloured light is then shone onto the treatment area for approximately 10 to 45 minutes (the precise time will be determined by your doctor or nurse depending on the light source). After

2019 British Association of Dermatologists

103. Management of Rhinosinusitis in Adolescents and Adults

should ONLY be given in chronic rhinosinusitis at Otorhinolaryngology centre. Refer to Appendix 4 on Proper Use of Nasal Spray. 7.1.3 Nasal Saline Irrigation Buffered saline irrigation facilitates mechanical removal of mucus, infective agents and inflammatory mediators. It also decreases crusting in the nasal cavity and increases mucociliary clearance (MCC). Nasal saline irrigation is recommended to be used in ARS. 1, level III Refer to Figure 9 on its application. A recent Cochrane systematic review

2019 Ministry of Health, Malaysia

104. British Association of Dermatologists and British photodermatology Group guidelines for topical photodynamic therapy

to limitations in the ability to compare studies. Lesion preparation is a routinely performed aspect of deliv- ering topical PDT regardless of which product is being used. The gentle removal of crusts and scale with a scalpel or curette is commonly performed without causing pain and does not require local anaesthesia. The treatment area can be degreased with 70% isopropyl alcohol (especially for Ameluz). Other additional preparation techniques or combination treatment approaches reported include

2019 British Association of Dermatologists

106. Pruritus

, papulo-vesicles, blisters, pustules or wheals are observable and, according to the patient history, have been present since the onset of itch, pruritus on primarily diseased (inflamed) skin can be diagnosed. Further investigations can be performed to determine the underlying dermatosis, including skin biopsy, microbiological investigations and, in certain cases, laboratory testing (e.g. IgE, indirect immunofluorescence). 21 Secondary skin lesions encompass excoriations, ulcerations, necrosis, crusts

2019 European Dermatology Forum

107. Topical Photodynamic therapy

efficacy if lesions are not debrided prior to PDT 14,17 while others have not noted increased drug uptake following lesion preparation of SCC in-situ and BCC. 40 However, gentle removal of overlying crust and scale is commonly performed for moderate thickness/hyperkeratotic AK and for SCC in-situ and superficial BCC. Lesion preparation is probably more important when treating nodular BCC by PDT with recommended practice to gently remove overlying crust with a curette/scalpel in a manner insufficient

2019 European Dermatology Forum

108. Imiquimod (Zyclara) - actinic keratosis

by 34% of imiquimod 3.75% and 1.3% of vehicle-treated patients. The most common severe local skin reactions were erythema (25% and 0%) and scabbing/crusting (14% and 0%). In addition, flaking/scaling/dryness was reported by 8.2% and 1.3% of patients respectively, oedema by 5.7% and 0% respectively and weeping/exudate by 5.7% and 0% respectively. Application site reactions were the most frequently reported treatment-related adverse event by 11% and 1.3% of imiquimod 3.75% and vehicle-treated patients

2019 Scottish Medicines Consortium

110. Atopic keratoconjunctivitis

, usually bilateral Blurred vision, photophobia White stringy mucoid discharge Onset of ocular symptoms may occur several years after onset of atopy Symptoms usually year-round, with exacerbations Signs Eyelids may be thickened, crusted and fissured Associated chronic staphylococcal blepharitis Tarsal conjunctiva: giant papillary hypertrophy, subepithelial scarring and shrinkage Entire conjunctiva hyperaemic Limbal inflammation Corneal involvement is common and may be sight-threatening: beginning

2019 College of Optometrists

112. Cutaneous melanoma

into types on the basis of clinical features and pathology. 4.1.1 SUPERFICIAL SPREADING MALIGNANT MELANOMA Superficial spreading malignant melanoma (SSMM) is the most frequently encountered type of melanoma; characteristically an asymmetrical pigmented lesion with variable pigmentation and sometimes an irregular outline. Patients may have noted growth, a change in sensation and/or colour, crusting, bleeding or inflammation of the lesion. The duration of the symptoms varies from a few months to several (...) of the features in the ABCDE system, is an indication for referral. The presence of minor features should increase suspicion. It is accepted that some melanomas will have no major features. Table 3: The 7 -point checklist lesion system Major features Minor features • change in size of lesion • inflammation • irregular pigmentation • itch/altered sensation • irregular border • lesion larger than others • oozing/crusting of lesion Table 4: The ABCDE lesion system A Geometrical Asymmetry in two axes B Irregular

2017 SIGN

113. 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

2017 BMJ Best Practice

114. Granuloma annulare

-coloured, pink, or brown macules or small papules soft-tissue nodules perforating papules, crusting or ulcerated lesions erythematous patches diabetes mellitus haematological malignancy herpes zoster HIV hepatitis hyperlipidaemia thyroid disease medications Diagnostic investigations clinical diagnosis skin biopsy fasting blood sugar thyroid function tests lipid screening hepatitis screen HIV testing Treatment algorithm ACUTE Contributors Authors Assistant Professor Dermatology and Internal Medicine

2017 BMJ Best Practice

115. Angular cheilitis

Angular cheilitis Angular cheilitis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Angular cheilitis Last reviewed: February 2019 Last updated: December 2017 Summary Inflammation of the angles of the mouth, characterised by fissures, scaling, erythema, and crusting. Aetiology is multi-factorial and includes mechanical factors, infectious agents, nutritional deficiencies, or inflammatory dermatological conditions (...) . Diagnosis is made clinically; however, laboratory tests help to identify aetiology. Successful therapy is based on identifying and correcting each and all factors of this multi-factorial condition. Definition Angular cheilitis is inflammation of the angles of the mouth, characterised by fissures, scaling, erythema, and crusting. Skinner N, Junker JA, Flake D, et al. Clinical inquiries: what is angular cheilitis and how is it treated? J Fam Pract. 2005 May;54(5):470-1. http://www.ncbi.nlm.nih.gov/pubmed

2017 BMJ Best Practice

116. Guidelines for the Management of Genital Herpes in New Zealand

. The area may be oedematous and can be extremely tender. Pain on urination is typical, particularly in women and spontaneous urination may be impossible. The ulcers dry to form crusts and later heal, leaving a transient red macule with minimal scarring (if any). Less commonly, lesions can pass through the blister phase quickly and blisters may not be noticed. Involvement of the cervix occurs but speculum examination may not be possible. Lesions may also appear extra-genitally, commonly on thighs

2017 New Zealand Sexual Health Society

117. Atopic Eczema

. Barrier disruption leads to inflammation, and 12 protease-antiprotease imbalance is a crucial intermediate step (45). 13 14 Cleansing and bathing 15 The skin must be cleansed thoroughly, but gently and carefully to get rid of crusts and 16 mechanically eliminate bacterial contaminants in the case of bacterial super-infection. 17 Cleansers with or without antiseptics (the duration of action of antiseptics is very limited, 18 thus mechanical cleansing is probably more important) in non-irritant and low

2018 European Dermatology Forum

118. Guidelines of care for the management of cutaneous squamous cell carcinoma

measurement should exclude parakeratosis or scale/crust and should be made from base of the ulcer is present. If clinical evaluation of incisional biopsy suggests that microstaging is inadequate, consider narrow-margin excisional biopsy. Table IV Recommendations for grading and staging of cSCC Stratification of localized SCCs using the NCCN guideline framework is recommended for clinical practice. Clinicians should refer to the BWH tumor classification system to obtain the most accurate prognostication

2018 American Academy of Dermatology

119. Shingrix vaccine for herpes zoster

may be preceded by prodromal pain or itching, after which erythematous macules or papules appear. These progress into vesicular lesions, then into pustules. The pustules typically crust over within the course of about ten days. In many patients, the HZ rash heals and painful symptoms resolve entirely within about four weeks. 6 In up to about thirty percent of patients, however, the pain will persist for months beyond the initial rash, known as postherpetic neuralgia (PHN). 3 PHN is conventionally

2018 Therapeutics Letter

120. CRACKCast E191 – Weapons of Mass Destruction

and pharyngeal mucosa. A maculopapular rash soon appears, which becomes vesicular and finally pustular. In contrast to chickenpox, the rash first appears on the face and forearms, later spreading to the legs and trunk. All the lesions in any one area of the body are at the same stage. During the next 8 to 14 days, the pustules crust over and separate from the skin, leaving pitted scars. Highly recommend this resource from the CDC: [5] How are nerve agents treated (3 drugs)? Unlike biological WMD

2018 CandiEM

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