1. It’s This Rash Doc…. Richard de Ferrars GP Programme Director

2. Name and one Test Xanthelasma – check lipids Learning Point You MUST understand primary & secondary prevention Primary prevention – use risk scoring But NOT if familial dyslipidaemia, diabetes

3. What’s the Diagnosis & Management? Trick question Mix of measles, Kawasaki & scarlet fever Learning Point Rash in child with fever: 1) Think why is this NOT meningitis 2) Sick/ toxic – think and admit 3) Eyes, mouth, lips funny - think

4. Name and One Test Butterfly rash (SLE) – anti-DNA antibodies Learning Point Immunology blood tests are complex and full of false positives Always do esr/ crp first and never request immunology if esr/ crp normal

5. Variations on a Theme These all come from the same “cell line” What is that cell line? What is each a picture of? All squamous cell – actinic (solar) keratosis, Bowen’s disease, keratoacanthoma, SCC Learning Point: Look at old people’s hands and faces and start to form an idea of this spectrum

6. Eczema Creams Arrange these creams used in eczema in ascending potency Which are available OTC? *Diprobase, *Hydrocortisone, *Eumovate, Betnovate, Dermovate Learning Point: Know what you are using. DO NOT prescribe Eumovate generically

7. Name and Treatment Erythema Marginatum (Lyme Disease) - Doxycycline Learning Point: Getting more common. Surrey is a hot-spot If suspected – do paired serology as well as treating

8. Moles – The Alphabet Four are melanomas One is a benign mole What does ABCD stand for? Asymmetry, border, colour, diameter Learning point: Look at lots, ask lots BEWARE “let me look again in 6-8 weeks”

9. Name and Treatment Pityriasis Rosea – Presumed viral, lasts 6-8w, no treatment Learning point: Must remember as commonly brought to the GP

10. Name and Treatment Pityriasis Versicolor – Fungal (malasessia furfur). Anti-fungal (orally) Learning Point: People who chose the names (diagnosis and cause) are having a laugh….

11. It’s All Swollen Up… Name the 3 conditions and your first treatment for each Urticaria Angio-oedema Anaphylaxis Anti-histamine Stop the ACE/ AT2 Panic?? Adrenaline? Learning Points: AKT loves emergency drugs.Funny reaction – think drugs

12. Name and Treament Molluscum contangiosum – viral & no treatment – Wart virus infection 2 different conditions Learning Point: If you start a treatment with low success-rate for a self-limiting & harmless condition you will only be making life difficult for yourself (or other GPs)….

13. Four Types of Psoriasis Name the four types shown and good first treatment option Erythrodermic Admit Plaque Vit D analogue Flexural Topical steroids Guttate PUVA Learning Point: Psoriasis is tricky to get right Definitely worth doing learning modules

14. Four Blisters To Finish… Pemphigoid Shingles Pomphlyx HFM Learning Point: Pemphigoid is the rarest cause of blistering rash!

15. Learning Points Rash in child with fever –Think meningitis, think harder if eyes & mouth Look at lots of age changes AND ASK Look at lots of moles AND ASK If in doubt – ask!

16. The End