Dermatology

Question 1

What is the management plan for Cellulitis and Erysipelas?

Answer 1

• Upper and Lower limbs
  
  • ​1st line = oral flucloxacillin/cefalexin
    
    • If MRSA suspected = + Vancomycin
    • If severely ill - use parenteral ABx + MRSA cover
• ​​Orbital - cephalosporin e.g. cefuroxime + metronidazole
  
  • If abscess - inscision, drainage and culture
  • 2nd Line = orbitotomy + drainage of abscess ​

Note - management can be more specific if organism identified

Question 2

What is the management plan for Varicella Zoster?

Answer 2

• Chicken pox
  
  • ​1st Line = supportive care e.g. paracetomol + emolliant + diphenhydramine
    
    • ​If severe, consider oral aciclovir
    • If chicken pox in adults - oral aciclovir
• Shingles - same initial management as chicken pox
  
  • ​If unresponsive to oral aciclovir consider IV
  • Post-herpetic neuralgia - amitryptilline or gabapentin
    
    • ​last resort = ganglion ablation