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101. 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

102. 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

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

105. 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

106. 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

107. 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

109. 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

110. 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

111. 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

112. 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

113. 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.

2017 BMJ Best Practice

114. 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

115. 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

119. Conjunctivitis: Bacterial, Viral and Allergic

, thyroid disorder Drug-induced: anticholinergics, beta-blockers, oral contraceptives, ophthalmic products Adverse effect of an ophthalmic product Blepharitis – red eye associated with inflammation of eyelids, crusted eyelashes, scant watery discharge; slow onset, chronic condition, may be associated with rosacea Infectious keratitis – inflammation of the cornea caused by bacteria, viruses or fungi, can progress to corneal ulcers; may be rapid onset, loss of visual acuity, photophobia, severe foreign (...) – glaucoma Hyper-purulent discharge (copious amounts of thick yellow-green pus) with very rapid onset – gonococcal conjunctivitis Visible corneal haze or opacities – keratitis, iritis, glaucoma Focal rather than diffuse redness Contact lens wearer – higher risk of infection, corneal ulceration 1) Non-pharmacologic Avoid contact lens use until symptoms have resolved Discard any eye drop bottles used during infection No-tears baby shampoo (weak solution with warm water) can be used to cleanse crusts from

2018 medSask

120. Acne - Guidelines for Prescribing Topical Treatment

Occurs near hair-line cosmetic X XX XX X Occurs where cosmetics used occupational XX X X Excoriated X X Crusts, scar, erosions, hyperpigmentation Mechanical XX XX X occurs when sinus tracts (channels) form between acne lesions resulting in the formation of cysts and abscesses. This type of acne is considered severe and often requires systemic treatment. Suspected cases should be referred to their physician. is an acute eruption of large inflammatory nodules, occurring most frequent in males. It also (...) frequently caused by topical steroid use. Skin infections such as (small fragile pustules; honey-coloured crusted erosions) o (red, often itchy, papules and/or pustules, occur at base of a hair shaft). Diagnosis of acne is based on the presence of comedones and / or inflammatory lesions. Patients with mild acne signs / symptoms generally do not require further investigation, however assessment by the patient's primary care provider is recommended in the following situations: Pregnancy Age < 12 years

2018 medSask

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