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121. CRACKCast E137 – Skin Infections

that extends through the epidermis into the dermis. It is manifested as ulcers with a punched-out appearance, with raised reddened margins covered with thick crust. It has a predilection for the lower extremities. Unlike impetigo, ecthyma can result in cutaneous scarring. Treatment: Mild-moderate non-bullous impetigo = topical mupirocin TID for 5 days Severe impetigo, bullous impetigo, ulcerative impetigo = Staph and MRSA coverage: Clindamycin AND Septra Cephalexin AND Septra [2] What is the eagle effect

2017 CandiEM

122. CRACKCast E130 – Viruses

, FACE, and FEET Primary varicella: Chickenpox is a febrile illness characterized by malaise and rash. The rash begins first on the scalp and face and then spreads to the trunk and extremities. (rarely involves the hands and feet) The lesions start as maculopapular, and progress to fluid filled vesicles that eventually crust over and form scabs. The lesions occur as crops at various stages of development. Patients are contagious until all lesions are scabbed over, which can typically take 1 to 2

2017 CandiEM

123. CRACKCast E071 – Ophthalmology Part A

SYSTEMIC extension of the infections require IV abx 4) Describe typical features of conjunctivitis and management options Conjunctivitis #1 cause of a red eye Symptoms: Redness, FB sensation, lid swelling, eye crusting, drainage NO photophobia, NO visual loss Caseus: Viral, bacterial, mechanical, allergic, toxic Called KERATOconjunctivitis when the cornea is involved as well Most commonly viral Bacterial causes: Pneumoniae, H. influenzae, Staph, Moraxella, Neisseria gonorrhoeae, Klebsiella, Pseudomonas (...) eyelid margins with pronounced blood vessels NOT an infection., just an inflammation VERY common! Symptoms: Eye burning, itching, tearing, FB sensation, morning crusting Treatment: Rubbing eyelid margins with mild shampoo + cloth Warm compresses QID Severe: topical abx 9) Compare periorbital and orbital cellulitis PEX and treatment — See — Orbital Cellulitis Etiology Symptoms Important differences to periorbital cellulitis Maxillary/ethmoid sinusitis Orbital trauma Dental Infection Need CT to rule

2017 CandiEM

124. Guidelines for care of patients with actinic keratosis

/amenability; ??? very ?exible/amenable. First hospital clinic attendance NHS tariff 2014–15: £104. 178 Hospital follow-up attendance: £68. GP visit: £44. 179 © 2017 British Association of Dermatologists British Journal of Dermatology (2017) 176, pp20–43 28 Guidelines for actinic keratosis 2017, D. de Berker et al.8.2 Active treatments All topical therapies for AK may result in side-effects of irrita- tion. Some AKs proceed to ooze, crusting and soreness with local swelling. Details are cited (...) and low-cost treatment. 63 It can be used either as lesional treatment or as part of ?eld treat- ment. The side-effects with the latter can be substantial, and it is important that the patient is counselled about them, includ- ing soreness, redness and possible crusting. All of these can be minimized through reduction in the frequency of application or short breaks in a course of therapy. It is permitted to wash the area and apply thin emollient. If the reaction is excessive, weak steroid can

2017 British Association of Dermatologists

125. Diagnosis and treatment of respiratory illness in children and adults.

and rhinorrhea. Harms : The most common side effects of intranasal corticosteroids are nasal irritation (dryness, burning and crusting) and epistaxis. Nasal septal perforation has been reported. Benefit-Harms Assessment : Given the efficacy and relative safety of intranasal corticosteroids in controlling the spectrum of allergic rhinitis symptoms and relative to harms, which can be decreased by use of the proper technique for administration, the ICSI work group recommends intranasal corticosteroids

2017 National Guideline Clearinghouse (partial archive)

128. Persistent Pain with Breastfeeding

be responsible for nipple and/or breast pain in lac- tatingwomen.Anyoftheseconditionsmaybesecondarily infected with Staphylococcus aureus, causing impetigi- nous changes such as weeping, yellow crusting, and blis- ters. 18 (III) 1. Eczematous conditions These conditions can affect any skin, but are com- monly seen on and around the areola in breastfeeding women. Attention to the distribution of skin irritation and lesions may help identify the underlying cause/ trigger. Eczematous rashes vary considerably. B (...) . Adjust level of suction or ?t of ?ange. Eczematous conditions Erythematous skin Acute episodes: blisters, erosions, weeping/oozing, and crust formation Chronic eruptions: dry, scaling, and licheni?ed (thickened) areas. Lesions can be pruritic, painful, or even burning. 18,20 Reduce identi?able triggers. Apply an emollient. Apply low/medium-strength steroid ointment twice daily for 2 weeks (immediately after a breastfeed to maximize contact time before the next breastfeed). 20 Usesecond

2016 Academy of Breastfeeding Medicine

129. WHO guidelines for the treatment of Genital Herpes Simplex Virus

. Over a period of 2–3 weeks, new lesions appear and existing lesions progress to vesicles and pustules and then coalesce into ulcers before crusting over and healing. Lesions on mucosal surfaces may be ulcerative without initially presenting as vesicles (5). Atypical presentations of infections due to HSV-2 may include small erosions and fissures, as well as dysuria or urethritis without lesions. Although HSV-1 and HSV-2 are usually transmitted by different routes and affect different areas

2016 World Health Organisation Guidelines

130. Radiofrequency Ablation for Hypertrophy of the Inferior Nasal Turbinates

conventional surgery include performance of the procedure on an outpatient basis; preservation of the surface mucosa; and fewer adverse events, such as pain, bleeding, crusting and loss of smell. 1 However, it should be noted that squamous metaplasia (benign cancer) has been observed within the scar tissue 7 to 60 days post-intervention. 3 Company or developer Several companies develop and market radiofrequency generators and probes for treating nasal obstruction. For example, the Olympus AFU-100 (...) required by either group following the interventions and no ulceration, crust formation or mucosal erosion was observed. The most common complaints were minor nasal discharge and post-procedural obstructions up to five days following treatment. No further information regarding the frequency of these events was reported. Prokopakis et al 2014 12 The aim of the non-randomised controlled trial was to compare the efficacy of RFA, CO 2 laser ablation and electrocautery for the treatment of rhinitis. Between

2016 COAG Health Council - Horizon Scanning Technology Briefs

131. Blepharitis (Lid Margin Disease)

of dry eye including blurred vision and contact lens intolerance Signs Anterior blepharitis (staphylococcal) lid margin hyperaemia lid margin swelling crusting of anterior lid margin (scales at bases of lashes) misdirection of lashes loss of lashes (madarosis) recurrent styes and (rarely) chalazia conjunctival hyperaemia secondary signs include: punctate epithelial erosion over lower third of cornea; marginal keratitis; phlyctenulosis; neovascularisation and pannus; mild papillary conjunctivitis (...) on the comparative efficacy of the various lid hygiene regimes. There is evidence that long-term compliance with lid hygiene measures may be poor (GRADE*: Level of evidence = moderate, Strength of recommendation = strong) Wet warm compresses loosen collarettes and crusts in anterior blepharitis. Dry warm compresses melt meibum in posterior blepharitis (compress applied to lid skin twice daily for not less than 5 minutes at 40°C. Commercial products are available that are able to maintain temperatures

2016 College of Optometrists

132. Moisturisers improve eczema symptoms and lessen the need for corticosteroids

the opportunity to choose between different moisturisers and use the ones that suit them best. Some may prefer using less oily creams during the day and thicker ointments at night. Share your views on the research. Why was this study needed? Eczema is a chronic skin disorder characterised by itchy dry skin. Scratching and cracking lead to further damage with redness, crusts, and oozing, and the itching can result in sleep deprivation and have a considerable impact on quality of life. Eczema often develops (...) Task Force on Atopic Dermatitis. . Dermatology. 1993;186:23-31. NICE. . London: National Institute for Health and Clinical Excellence; 2007. SIGN. . Edinburgh: Scottish intercollegiate guidelines network; 2011. Why was this study needed? Eczema is a chronic skin disorder characterised by itchy dry skin. Scratching and cracking lead to further damage with redness, crusts, and oozing, and the itching can result in sleep deprivation and have a considerable impact on quality of life. Eczema often

2018 NIHR Dissemination Centre

133. Gynecologic Care for Women and Adolescents With Human Immunodeficiency Virus

as noninfected women. Women infected with HIV are at increased risk of crusted scabies, which should be managed in consultation with a specialist (24). How does treatment of menstrual disorders differ between HIV-infected and non-HIV-infected women? Women with HIV should receive the same evaluation and treatment for menstrual disorders as uninfected women. Menstrual disorders are frequently reported by HIV-infected women, but the role of HIV and HIV-related immunosuppression in menstrual abnormalities

2016 American College of Obstetricians and Gynecologists

134. Management of scabies

is uncommon but can occur in those wearing heavily contaminated clothing or using a bed recently occupied by an infested person. 2 It is more likely to occur with crusted scabies due to the greater number of mites present 4,6,7 and because mites can survive longer for up to 7 days. 8 Clinical Manifestations Classical scabies The main clinical feature of scabies is intense generalised pruritus that is usually worse at night. The pruritus is due to a delayed type-IV hypersensitivity reaction to the mite (...) regions and these are intensely pruritic. They tend to persist after treatment and are thought to result from a hypersensitivity reaction to the mite. Urticarial lesions may rarely occur. 13,14 Presence of itchy papules and nodules on the penis and scrotum are indicative of sexually acquired scabies. Crusted scabies Crusted scabies (Scabies crustosa, Norwegian scabies) occur in immunocompromised states: e.g. in AIDS, leprosy, lymphoma, those receiving systemic or potent topical steroids, organ

2016 British Association for Sexual Health and HIV

135. Kawasaki Disease Patients With Redness or Crust Formation at the Bacille Calmette-Guérin Inoculation Site. (PubMed)

Kawasaki Disease Patients With Redness or Crust Formation at the Bacille Calmette-Guérin Inoculation Site. A specific diagnostic test for Kawasaki disease (KD) is currently unavailable. Redness or crust formation at the Bacille Calmette-Guérin (BCG) inoculation site is listed as a positive sign in the diagnostic guidelines of KD. The purpose of this study was to investigate the epidemiologic features of KD patients with such changes at the BCG inoculation site and to evaluate the specificity (...) of this sign in KD diagnosis.Data on KD patients who received BCG vaccination were analyzed from a Japanese nationwide epidemiologic survey on KD conducted in 2007. Patients who had 5 or 6 principal signs (complete cases) with redness or crust formation at the BCG inoculation site were compared by sex, year of hospital visit, day of first hospital visit, recurrent status, and presence of KD in siblings. To evaluate the specificity of the sign for KD diagnosis, patients aged 2 years or younger who were

2009 Pediatric Infectious Dsease Journal

136. Geological significance of new zircon U-Pb geochronology and geochemistry: Niuxinshan intrusive complex, northern North China Craton. (PubMed)

into two groups. One group's geochemical signature exhibits steep rare earth element (REE) patterns with negligible Eu anomalies, lower Yb, higher Sr, and negative Nb-Ta-Ti (NTT) anomalies, which indicate a volcanic-arc environment with a thickened crust in a convergent setting. The other group exhibits flat REE patterns with obvious negative Eu anomalies, higher Yb, lower Sr, and weak NTT anomalies, which indicate an intra-plate extensional environment with a thinning crust. Combining geochronologic

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2019 PLoS ONE

137. Is There an Association Between Hyperbaric Oxygen Therapy and Improved Outcome of Deep Chemical Peeling? A Randomized Pilot Clinical Study. (PubMed)

PCP underwent 5 consecutive daily HBOT sessions, compared with PCP alone. Pain, pruritus, erythema, crusting, scaling, and edema were daily evaluated up to 28 days following PCP. Photographs taken on days 14 and 35 following PCP were assessed. Confidence to appear in public was assessed 14 days following PCP.Eight participants equally assigned to HBOT and control groups. Lower severity scores for erythema, scaling, and pruritus were documented in the HBOT group (mean difference 1.19, P = .006; .84 (...) , P = .04; and 2.19, P = .001, respectively). Photographic assessment severity score was higher for skin tightness, edema, erythema, crusting, and scaling in the control group on day 14 post PCP (P < .05) and for erythema on day 35 post PCP (P < .05). Epithelialization percentage was higher in the HBOT group on day 14 post PCP compared with controls (98.5% ± 1% vs 94.2% ± 1%; P = .021). The HBOT group scored higher in confidence to appear in public (20.8 ± 1.7 vs 14.5 ± 1.3; P = .029).Hyperbaric

2018 Plastic surgery (Oakville, Ont.)

138. Interventions for prevention of herpes simplex labialis (cold sores on the lips). (PubMed)

Interventions for prevention of herpes simplex labialis (cold sores on the lips). Herpes simplex labialis (HSL), also known as cold sores, is a common disease of the lips caused by the herpes simplex virus, which is found throughout the world. It presents as a painful vesicular eruption, forming unsightly crusts, which cause cosmetic disfigurement and psychosocial distress. There is no cure available, and it recurs periodically.To assess the effects of interventions for the prevention of HSL

2015 Cochrane

139. Mycosis Fungoides (Including Sézary Syndrome) Treatment (PDQ®): Health Professional Version

for Cutaneous Lymphomas; LN = lymph nodes; NCI = National Cancer Institute. a Reprinted with permission from AJCC: Primary cutaneous lymphomas. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, p 613-5. b For skin, patch indicates any size skin lesion without significant elevation or induration. Presence/absence of hypo- or hyperpigmentation, scale, crusting, and/or poikiloderma should be noted. c For skin, plaque indicates any size skin lesion (...) that is elevated or indurated. Presence or absence of scale, crusting, and/or poikiloderma should be noted. Histologic features such as folliculotropism or large-cell transformation (>25% large cells), CD30+ or CD30-, and clinical features, such as ulceration, are important to document. d For skin, tumor indicates at least 1 cm diameter solid or nodular lesion with evidence of depth and/or vertical growth. Note total number of lesions, total volume of lesions, largest size lesion, and region of body involved

2018 PDQ - NCI's Comprehensive Cancer Database

140. International Consolidated Venous Ulcer Guideline

. >1.985 mm as measured using high frequency ultrasound or other clinically documented technique. A (Choh et al., 2010; Vesic et al., 2008; Volikova et al., 2009; Xia et al., 2004), CVI= 0.667, Moderate SOR A.2.b.iii. Stasis dermatitis including tan or red-brown skin color (hemosiderin deposits) usually at medial ankle, or small erosions that may be open or crusted. A (Alguire et al., 1997; Burton, 1993; Pappas et al., 1997) CVI= 0.952, High SOR A.2.b.iv. Lipodermatosclerosis, (fibrosis of dermis

2015 Association for the Advancement of Wound Care

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