Skin Conditions

Question 1

Eczema

Answer 1

Treatment:
- Emollients (i.e. creams, ointments)
- Hydrocortisone 1% (child >10)
- Eumovate (child >12)
(NO steroid pregnancy or use on face / genitals)

Red Flags:
- Broken skin (signs of infection)
- Facial involvement
- Widespread area

General Advice:
- Avoid irritants + extreme temp.
- Use corticosteroids sparingly
- Reapply emollients frequently
- Wait 30 min. after using steroid before applying other creams

Question 2

Contact Dermatitis

Answer 2

Treatment:
- Emollients
- Hydrocortisone 1% (child >10)
- Eumovate (child >12)

Red Flags:
- Broken skin
- Weeping, oozing, inflamed area (infection)
- Widespread area

General Advice:
- Avoid contact with allergen / irritant
- Using gloves + other protective clothing
- Rinse area straight after contact

Question 3

Acne Vulgaris

Answer 3

Treatment:
- Acnecide (benzoyl peroxide ~ 6 to 8 weeks)
- Freederm (nicotinamide 4% ~ inflammatory acne)

Red Flags:
- Moderate to severe acne
- i.e. skin scarring, inflamed lesions, long lasting (>6 months)

General Advice:
- Medication can bleach clothes so be aware
- Avoid vigorously scrubbing skin
- Don’t squeeze / pop pimples
- Have healthy, balanced diet
- Use mild soaps + water based profits (prevent blocking pores)

Question 4

Burns and Scalds

Answer 4

Treatment:
- Paracetamol, ibuprofen
- Wound dressings (i.e. paraffin gauze)

Red Flags:
- Burn is larger than size of patients hand
- Pale / charred skin
- Extensive blistering
- Burn on face / genitilia
- Shortness of breath / breathing problems (chemical burn)

General Advice:
- Run under cold water (20-30 minutes) ~ reduces pain + inflammation
- Don’t apply creams to burn
- Have preventative measures in place

Question 5

Bites and Stings

Answer 5

Treatment:
- Piriton (antihistamine)
- Antihisan (antihistamine cream ~ child >2 and NO use on broken skin / large area of skin)
- Topical antiseptics
- Topical corticosteroids
- Topical anaesthetics

Red Flags:
- Signs of infection (e.g. weeping, oozing, broken skin)

General Advice:
- Keep area clean
- Refrain from itching

Question 6

Warts and Verrucas

Answer 6

Treatment:
- Bazuka (up to 3 moths)
- Salactol (use in people >2)
- Wartner cryotherapy (use in >4, NOT 1st choice)

Red Flags:
- Itchy or bleeding
- Changes in size or colour
- Multiple / widespread
- If diabetic (can’t use salactol / salicylic acid)
- If on face / genital area

General Advice:
- Wear socks / cover with plaster to prevent spread
- File wart weekly to remove dead, hardened skin

Question 7

Fungal Nail Infection

Answer 7

Treatment:
- Canestan 1% (use: athletes foot, ringworm, sweat rash)
- Lamisil AT cream (athletes foot)
- Mycota powder (athletes foot)

Red Flags:
- Signs of infection
- immunosuppressed + diabetic patients
Fungal Nail:
- Multiple nails affected
- Nail trauma (e.g. nail is hanging off)
Athletes Foot:
- Nail involvement

General Advice:
- Ensure good hygiene
- Wash + dry feet everyday
- Avoid tight fitting shoes
- Switch shoes often to limit exposure to fungi

Question 8

Scabies

Answer 8

Treatment:
- Lyclear dermal cream (1st line - apply on whole body, wash after 12 hours)
- Derbac-M (used in pregnant / breastfeeding women)
- Antihistamine (to relieve itching)

Red Flags:
- Signs of infection
- Immunocompromised patient

General Advice:
- Treat whole family + those in close contact
- Wash clothes, towel, bedding at high temp. (= kill mites + prevent re-infestation)

Question 9

Impetigo

Answer 9

Treatment:
- REFER (need antibiotics)

Red Flags:
- Signs of infection (e.g. weeping, oozing, crusting on skin)
- Scalded skin syndrome (raw, peeling skin)
- If patient has eczema / other medical conditions

General Advice:
- Wash hands after contact with lesions
- Keep nail short + don’t scratch skin
- Whilst being treated don’t attend school / work

Question 10

Cold Sores (HSV)

Answer 10

Treatment:
- Zovirax (acyclovir) - 5x a day for 4 to 10 days
- Fenistil (penciclovir) - 8x a day of up to 4 days
- Paracetamol (relieve painful lesions)

Red Flags:
- Signs of infection (weeping, oozing etc)
- Lesions on or body / other parts of face (exc. mouth/lips)
- Painless sores
- If eyes are affected

General Advice:
- Care should be taken to prevent spreading
- Don’t share face cloths / towels
- Use protective agents e.g. lip balm to prevent lips from drying

Question 11

Shingles

Answer 11

Treatment:
- REFER
- Paracetamol (pain relief)

Red Flags:
- Eyes affects
- Pregnant
- Immunocompromised

General Advice:
- Avoid contact with others especially those who have not had chickenpox
- Don’t go to work / school
- Keep affected area clean + dry
- Cover rash to minimise risk spreading
- Use calamine to soothe itchy, unbroken skin