Wounds
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Wounds
Burns
It is customary for all major burns to be managed by general or plastic surgeons in regional burn units with access to intensive care facilities. A scald is a burn caused by moist heat. First-degree burns involve only the epidermis and papillary dermal blood vessels and produce pain, redness and swelling. In second-degree or partial skin thickness burns, the epidermis blisters and becomes necrotic. In third-degree or full thickness burns, the necrosis is deeper and pain may be absent if nerve endings are destroyed. If the wound is anaesthetic, it is likely that the skin appendages will also have been destroyed and this has important implications for healing.
Varicella Zoster Virus Infections
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Varicella Zoster Virus Infections
Richard J. Whitley
DEFINITION
Varicella-zoster virus (VZV) causes two distinct clinical entities: varicella (chickenpox) and herpes zoster (shingles). Chickenpox, a ubiquitous and extremely contagious infection, is usually a benign illness of childhood characterized by an exanthematous vesicular rash. With reactivation of latent VZV (which is most common after the sixth decade of life), herpes zoster presents as a dermatomal vesicular rash, usually associated with severe pain.
Urinary tract infections
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Urinary tract infections
A high fluid intake and complete bladder emptying assist antimicrobial therapy of urinary tract infections (UTI).
Acute cystitis
A high fluid intake and complete bladder emptying assist antimicrobial therapy of urinary tract infections (UTI).
Escherichia coli and Staphylococcus saprophyticus are the commonest causative organisms, although other members of the Enterobacteriaceae may be responsible. Some patients require investigation to exclude an underlying abnormality when cystitis is confirmed by a positive urine culture. These patients are males of any age, females under 5 years and premenarcheal females with recurrent UTI.
Urticaria and angioedema
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Urticaria and angioedema
Urticaria
Urticaria: introduction and pathogenesis
Urticaria is a term describing erythematous or oedematous swellings of the dermis or subcutaneous tissues. The defining characteristic of urticaria is the transient nature of the lesions, which persist only for minutes up to 24 hours.
Superficial swellings tend to be itchy, whereas deeper swellings are painful and are often described as angioedema.
Lesions are frequently more irregular or bizarre in outline in children than in adults, but diagnosis is rarely possible based on the appearance of the lesion alone.
In a minority of instances, the clinical phenomenon of urticaria is associated with identifiable physical causes, and these are often termed physical urticarias
Ulcers
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Ulcers
Leg ulcers
Leg ulcers: background
Skin heals more slowly below the knee. If the arterial circulation, the venous circulation or the natural aversion to trauma that is associated with normal sensation is impaired, then the skin may not heal at all. This results in the development of a chronic ulcer at sites of trauma.