A few tips for my colleagues when it comes to the skin
1) If the skin lesions come up rapidly with constitutional symptoms like catarrh and fever especially in children, it's most likely a viral exanthem. Treat symptomatically. Don't be too quick to prescribe antibiotics.
1) If the skin lesions come up rapidly with constitutional symptoms like catarrh and fever especially in children, it's most likely a viral exanthem. Treat symptomatically. Don't be too quick to prescribe antibiotics.
2. If you find lesions on the skin in the neonatal period, and the child is not irritable, no fever or other constitutional symptoms and the child is feeding well...most likely one of those transient neonatal lesions due to maternal hormones. Reassure the parents alone.
3. Read up Pityriasis rosea. There would come a time during the year where there'll be clusters of it. Don't be in a hurry to prescribe antibiotics; might make it worsr. It is usually self limiting. I have done a thread about it before. Use the #dermatologyteaching to look for it
4. It is important to counsel your patients when managing skin conditions as most may be chronic else they may think you're inept. Acne for example is a chronic inflammatory condition of the pilosebaceous unit. The fact that the face is clear today does not mean it can't recur.
5. Itching is acommon complaint. You need to determine whether there's a rash associated with it. If there's none, rule out any systemic disease. If there's none..reinforce good skincare practice together with symptomatic relief of the itching. No medicated soaps and moisturize
6. In this environment, the most common skin conditions are infections and inflammatory diseases. It is impt to be able to diagnose superficial fungal infections like Tinea corporis and bacterial infections like impetigo. I've done threads on each one before.
7. Of all the superficial fungal infections, tinea capitis (scalp) and unguim (nails) must be treated with oral drugs together with topical else cure will not be achieved. And note that not ALL nail conditions are fungal. Once you have it affecting all the nails..its unlikely
8. In all...know when you refer. And know how to treat the simple things. Added knowledge of dermatology makes you even more valuable to your hospital where most people have no idea at all.
I have had former interns call me to thank me profusely for all the dermatology learnt
I have had former interns call me to thank me profusely for all the dermatology learnt
9. I end with this aphorism from the Fitzpatrick's dermatology textbook.
"To cure sometimes, to relieve often, to comfort always".
In all...you must always aim to improve the QoL of the patient even if a complete cure cannot be achieved.
"To cure sometimes, to relieve often, to comfort always".
In all...you must always aim to improve the QoL of the patient even if a complete cure cannot be achieved.
