Management of Skin Conditions in Primary Care Flashcards
What common or important skin lesions may be seen in primary care?
Melanoma Squamous cell carcinoma Basal cell carcrinoma Actinic keratosis Pyogenic graunloma Dermatofibroma Benign pigmented lesions Solar Lentigo Sebaceous hyeprplasia Warts Skin tags Comedones Haemangiomas
Which skin lesions should be referred to dermatology urgently?
Lesions suspicious of melanoma or squamous cell carcinoma
Changing lesions
How urgently do basal cell carcinomas need to be referred to dermatology?
Routine referral as they are very slow growing
How can warts be treated in primary care?
Salicylic acid
Cryotherapy
How can seborrheic warts be treated in primary care?
Cryotherapy
No treatment
How can skin tags be treated in primary care?
Patient advised to do nothing or seek help from private sector
Why is it important, when treating skin lesions, that no active management is a viable treatment option?
Overmedicalising and overrating can cause morbidity
What general dermatology conditions are seen in general practice?
Acne
Psoriasis
Eczema
How can psoriasis be managed in primary care?
Lifestyle advice on smoking, weight and alcohol
Medical management with emollients, coal tar and vitamin D analogues
When should psoriasis be referred to dermatology?
If it is widespread or not responding to treatment
If there is a guttate pattern
If the patient requires UVB or systemic treatment
How can acne be managed in primary care?
Topical treatments - benzoyl peroxide, topical retinoid, topical antibiotics
Oral treatments - long term antibiotics. (doxycycline, arthromycin) and oral contraceptive pill
When should acne be referred to dermatology?
If not responding to oral and topical treatments for consideration of treatment with isotretinoin
Urgent referral if there is scarring or nodulocystic acne
How can eczema be managed in primary care?
Emollients Topical steroids Antihistmaines Tacrolimus Antibiotics (if secondary infection)
What type of eczema should be referred to dermatology as an emergency?
Erythrodermis eczema
When should eczema be referred urgently to dermatology?
If it is not responding to treatment
