Table of Contents
Skin & Wounds
Generalised itchy skin with rash
- Chronic renal insufficiency
- Cholestasis
- Iron deficiency
- Polycythaemia vera
- Hyperthyroidism
- Lymphoma
- Diabetic neuropathy
- Drug-induced (eg, opioid, chloroquine, vancomycin flushing)
- Chronic pruritus of unknown origin
Kawasaki disease
most prominent cause of acquired coronary artery disease in childhood.
- also known as mucocutaneous lymph node syndrome, is an acute, systemic vasculitis of small- and medium-sized arteries that predominantly affects patients younger than five years.
- Transthoracic echocardiography is the diagnostic imaging modality of choice to screen for coronary aneurysms,
- Treatment for acute disease is intravenous immunoglobulin and aspirin.
Classic (typical) Kawasaki disease is a clinical diagnosis. Based on the presence of a fever lasting 5/7 or more plus four out of five:
- bilateral conjunctival injection
- oral changes such as cracked and erythematous lips and strawberry tongue
- cervical lymphadenopathy
- extremity changes such as erythema or palm and sole desquamation (usually weeks 2, 3)
- polymorphous rash.
incomplete (atypical) - 2 or 3 findings
Pruritis in pregnancy
Prurigo
- intensely itchy spots - c/w pruritis in which there are no primary skin lesions
- Primary prurigo lesions are dome-shaped or warty looking papules.
- Secondary prurigo lesions are scratched papules which may become scaly, thick, darkened and scarring
- nodular prurigo - very itchy firm lumps
- strong FHx of atopic dermatitis
- cause unknown
- very difficult to treat
Dog and cat bites
- general cleaning and debridement where appropriate
- generally should be left to heal by primary intention
- puncture wounds should be cleaned after removal of any FB (eg teeth) where relevant and left open
- tetanus IgG, booster and antibiotics should be considered
- antibiotics especially if deep puncture or potential breach of tendon sheath or joint