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Friday, 23 August 2019

Rashes in Children

Eczema and Seborrhoeic Dermatitis
Are essentially the same thing, and I think don't forgetthebubbles have it covered!

Bites and Infestations 
Lyme disease causes erythema migrans (pathognomic). If rash present treat - otherwise test. You can get a Jarisch-Herxheimer reaction  - normally self limiting. Don't give routine prophylactic antibiotics. Remove a tip with direct forceful pressure. 

 Dog Bites
Probably OK for primary closure, and no routine prophylactic antibiotics. 
Human Bites
Prophylactic antibiotics - always. Don't close if over 24hours old. Remember tetanus and BBV prophylaxis.

Scabies
The classic burrows may be difficult to see in children. May look a bit pustular - but always VERY itchy! Treat with permethrin.

Head Lice or Nits
Can you read this without itching?

References
https://www.youtube.com/watch?v=QcpjbKCmqAw&feature=youtu.be
https://www.rcemlearning.co.uk/reference/trek-tragedy-review-on-lyme-disease/
https://www.rcemlearning.co.uk/modules/trek-tragedy-review-on-lyme-disease/exams/lyme-disease-post-test/
https://www.rcemlearning.co.uk/modules/lemons-and-lymes/
https://www.rcemlearning.co.uk/modules/the-forest/
https://first10em.com/dog-bite/
https://rebelem.com/myths-management-dog-bites/
https://www.cochrane.org/CD001738/WOUNDS_antibiotics-for-reducing-the-rate-of-infection-after-bites-by-mammals-such-as-humans
https://cks.nice.org.uk/bites-human-and-animal
https://dontforgetthebubbles.com/mel-thompson-eradicating-scabies-at-dftb17/

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