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181. CRACKCast E119 – Allergy, Hypersensitivity, Angioedema, and Anaphylaxis

, used for BB overdoses) [10] Compare and contrast the management of angioedema with urticaria and without urticaria Urticaria appears as papules or wheals that consist of central swelling with surrounding reflex erythema, and it is associated with itching or a burning-type sensation. These lesions are a result of mediators (predominantly histamine) released from mast cells. They tend to occur on the extremities and trunk and are usually transient, with skin often returning toits normal appearance

2017 CandiEM

182. CRACKCast E120 – Dermatologic presentations

circumscribed pigmentation area >0.5cm in diameter Papule Elevated, solid, palpable lesion, variable colour <0.5cm in diameter Plaque Elevated, solid, palpable lesion, variable colour >0.5cm in diameter Nodule Solid, palpable, subcutaneous lesion >0.5cm in diameter Abscess Erythematous, fluctulant, tender, fluid-filled nodule Any Tumour Solid, palpable, subcutaneous lesion >0.5cm in diameter Vesicle Elevated, thin walled, circumscribed, clear fluid-filled lesion >0.5cm in diameter Pustule Elevated (...) , malignancy, or treatment with corticosteroids, antibiotics, or immunosuppressive agents. [6] Describe the stepwise management of diaper dermatitis (list 4) “Contact dermatitis is an inflammatory reaction of the skin to a chemical, physical, or biologic agent, which acts as an irritant or allergic sensitizer. The primary lesions of contact dermatitis are papules, vesicles, and bullae on an erythematous base. Streaky, linear, intensely pruritic lesions are characteristic. A pattern in the region in contact

2017 CandiEM

183. CRACKCast E087 – Peripheral Arteriovascular Disease

that lodge in distal small arteries. (Ischemic strokes, cool painful cyanotic toes). Thrombosis (arterial thrombosis) ●In-stitu formation of blood clots in the arteriovascular system. ●Usually due to atherosclerosis ●Often caused by atherosclerotic plaque rupture or endothelial injury due to trauma or vasculitis Inflammation ●Can be due to drugs, irradiation, mechanical trauma, bacterial invasion, IVDU, etc. ●Noninfectious systemic: necrotizing vasculitis ( look for macules, papules, vesicles, bullae

2017 CandiEM

184. CRACKCast E098 – Sexually Transmitted Infections

or Pneumonitis Disseminated infection Question 6) What are the clinical stages/phases of syphilis? How do you diagnose syphilis? How are the phases managed? Syphilis Manifestation Primary Painless papule at the site of inoculation → ulceration forming chancre (relatively painless, clean based ulcer with well demarcated, indurated edges 1-2 cm in size). Non-tender regional lymphadenopathy may be seen. Often in genital or perianal region but may be present in oropharynx, breast, or hands etc. Secondary (...) . Penicillin remains drug of choice in pregnancy, neurosyphilis, and congenital syphilis, even in the presence of penicillin allergy. Admission for desensitization and treatment. Question 7) What is the causes of chancroid? How is it managed? Chancroid – Ulcerating infection caused by gram-negative organism Haemophilus ducreyi . Common in developing world but extremely uncommon in Western world. Incubation of less than a week preceded by tender erythematous papule that rapidly ulcerates to form multiple

2017 CandiEM

185. Dupilumab and Crisaborole for Atopic Dermatitis: Effectiveness and Value

) 50, 75, and 90 and Investigator’s Global Assessment (IGA) outcomes through meta-analyses (see Appendix D): • EASI assesses severity and body surface area affected by erythema, induration/papulation/edema, excoriations, and lichenification, which are graded systematically for each anatomical region and assembled in a composite score and reported as a percentage improvement from baseline (e.g., EASI 75 is a percentage improvement of EASI score from baseline that is = 75%) • IGA is a clinician

2017 California Technology Assessment Forum

186. British Association of Dermatologists? guidelines for the management of contact dermatitis

Scoring of patch test reactions according to International Contact Dermatitis Research Group recommendations 60 Symbol Morphology Interpretation – No reaction Negative ? Erythema only, no in?ltration Doubtful reaction + Erythema, in?ltration, possibly discrete papules Weak positive reaction ++ Erythema, in?ltration, papules, vesicles Strong positive reaction +++ Erythema, in?ltration, con?uent vesicles Extreme positive reaction ir Different types of reactions (soap effect, vesicles, blister, necrosis

2017 British Association of Dermatologists

191. Diaper Dermatitis, Irritant and Candidal - Guidelines for Prescribing Topical Antifungals and Hydrocortisone

with candida). Satellite papules, and superficial pustules at the margins of the inflammatory plaques. Unlike irritant diaper dermatitis, candida often begins in the creases/skin folds and then extends out to the buttocks and pubic skin. Excoriations are prominent. Often painful - severe crying during diaper changes or when urinating or defecating. Questioning may reveal a history of recent antibiotic use, or a bout of diarrhea, or a case of oral thrush. Diaper dermatitis is diagnosed based on the presence (...) . - 1 to 2 mm fragile pustules and honey-colored, crusted erosions. (Refer to guideline for Bacterial Infections.) - acute, widespread, pruritic dermatitis. Lesions typically occur on the palm, soles or between the fingers. Not a solid rash. - severe rash. Red/orange or yellow/brown scaly papules, erosions, or petchiae. - sharply demarcated erythematous scaly papules and plaques. There may be a family history of psoriasis. Lesions will typically be elsewhere on the body as well. Lack of response

2017 medSask

192. Atopic Dermatitis - Guidelines for Prescribing Topical Corticosteroids

swelling Vesicles form and rupture releasing serous fluid (IE. weeping) Crusts form as serous fluid dries Excoriations caused by scratching Chronic Thickening of skin with accentuated skin marks (lichenification) Hypo- or hyperpigmentation of the skin Scaling, fissures Fibrotic papules Dermal lesions Distribution Infants: trunk, face, and extensor surfaces. (Extensor surface is an anatomy term used to describe certain areas of the body. A body part flexes when it bends and extends when it straightens (...) . The parts of the skin that touch when a joint bends are called the flexor surfaces. The parts of the skin on the opposite side of the joint are called the extensor surfaces.) Children: the flexor surface of the elbow and of the knee. Adults: scalp, face, neck, hands, upper chest, and genital areas. Morphology of lesions: Infants: erythema (redness) and papules (solid skin elevation not containing pus); may develop oozing, crusting vesicles. Children and adults: chronic eczema may lead to skin

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2017 medSask

193. Tinea Corporis Infection - Guidelines for Prescribing Topical Antifungals

in the form of circular scaly pink patches. Can have diffuse inflammation and ill-defined borders - appears as small round plaques of small papules and blisters, usually on arms, neck and legs. Very itchy, can may persist for months - presents as red spots covered with thick silver scales, with no central clearing. Refer to patient's primary care provider - is a viral rash that lasts 6 to 12 weeks, beginning with a "herald" patch: a small, scaly, pink-coloured lesion on the trunk. It starts as a single

2017 medSask

194. Superficial Bacterial Skin Infections - Guidelines for Prescribing Topical Antibiotics for impetigo and folliculitis

itchy, papules and/or pustules at the base of the hair shaft. The causative agent is usually aureus . Furuncles or boils usually begin as folliculitis which spreads and forms a tender, red swelling with a central pustule. This may progress to carbuncles, an aggregate of furuncles which penetrates to deeper layers of skin and can lead to cellulitis, a diffuse inflammation of the skin. Furuncles may require systemic antibiotic treatment. For more information and photos, go to: Less severe form (...) When blister breaks, in 3-5 days, it forms an oozing, yellow crust Areas affected are usually moist diaper areas, armpits and legs Systemic symptoms more likely, such as fever and diarrhea Small red, often itchy, papules and/or pustules at the base of hair shafts especially on neck, groin or armpits Secondary lesions which may follow folliculitis Start as a tender, reddened area or a folliculitis Progress to a hard, tender area with a white pustule at the center The pustule may break open and drain

2017 medSask

196. Intrapartum care for healthy women and babies

of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 28 of 89pyrexial. The temperature of the water should not be above 37.5°C. [2007] [2007] 1.8.6 Keep baths and birthing pools clean using a protocol agreed with the microbiology department and, in the case of birthing pools, in accordance with the manufacturer's guidelines. [2007] [2007] 1.8.7 Do not use injected water papules. [2007] [2007] 1.8.8 Do not offer acupuncture, acupressure or hypnosis, but do not prevent women

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

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

. The classical clinical presentation of the first episode of symptoms of primary genital HSV infection is characterized by bilateral clusters of erythematous papules, vesicles or ulcerations on the external genitalia, in the perianal region or on the buttocks, occurring 4–7 days after sexual exposure. This classical syndrome occurs only in 10–25% of primary infections. Although HSV-1 and HSV-2 are usually transmitted by different routes and affect different areas of the body, the signs and symptoms overlap (...) clusters of erythematous papules, vesicles or ulcerations on the external genitalia, in the perianal region or on the buttocks, occurring 4–7 days after sexual exposure. This classical syndrome occurs only in 10–25% of primary infections. Patients present with genital pain and itching and 80% of women also report dysuria. Constitutional symptoms, such as fever, headache, myalgias and malaise are common. Cervicitis and tender inguinal and femoral lymphadenopathy frequently accompany initial infections

2016 World Health Organisation Guidelines

198. WHO guidelines for the treatment of Treponema pallidum (syphilis)

and is divided into stages. Early syphilis consists of primary syphilis, secondary syphilis and early latent syphilis, while late syphilis consists of late latent syphilis and tertiary syphilis. Primary syphilis classically presents as a solitary, painless chancre at the site of inoculation, usually in the vagina, penis or anus (but it may be extra-genital), after a mean incubation period of 21 days (range: 9–90 days). The primary lesion begins as a raised papule and ulcerates before healing within 3 to 10

2016 World Health Organisation Guidelines

199. Position on reproductive donors and smallpox vaccine: a committee opinion

naturally occur- ring disease. Routine vaccination against smallpox has since been dis- continued worldwide. However, the US government recently has become concerned that smallpox virus might be used as a bioterrorism weapon (1, 2). As a result, new smallpox vaccination strategies have been reinitiated in the United States for both military personnel and civilians. Vaccinia vaccine is administered percutaneously. After a primary (?rst) vaccination, a papule forms in 3 to 5 days. The formation (...) of a papule is consideredevidenceofa ‘‘take’’orsuc- cessful immunization. The papule sub- sequently becomes a vesicle that becomes pustular and reaches its maximumsize8to10daysaftervacci- nation, surrounded by erythema and induration, which gradually subside. A scab forms and usually separates from the skin 14 to 21 days after the vaccination, but can persist for up to 6 weeks in some cases (3). Vaccinia virus may be spread from thevaccinationsitetootherpartsofthe bodyand tootherpeople untilthe scab falls

2016 Society for Assisted Reproductive Technology

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