Australian Family Physician July - Weird Skin Stuff
Vol 38, (7) 465 - 560
The theme for the July issue of AFP is Weird Skin Stuff. This
month's articles include Presentations of rash, Cutaneous melanoma -
atypical variants and presentations, Blistering skin conditions,
Difficult to diagnose skin cancer - the 'aggresive' BCC and Skin
manifestations of systemic disease.
The complexities of our outer layer
Jenni Parsons
Abnormalities of the skin should be easy to manage... it is
all laid out in front of us to observe, measure, touch, diagnose
and treat.
The doctor of the future
Des Gorman
An invitation to discuss the role of the doctor begs the
question, ‘What is wrong with the status quo?’ Given the
guild nature of the medical profession, any reform will need
to be well substantiated.
Letters to the editor
The opinions expressed by correspondents in this column are in no way endorsed by either the Editors or The Royal Australian College of General Practitioners.
Presentations of rash
Salma Fahridin, Graeme Miller
The gender distribution of patients presenting with rash
were similar to all BEACH encounters. However, younger
patients were more likely to present with rash, with one-quarter
(24.5%) of patients being under the age of 15 years compared
with 11.8% of all encounters.
Cutaneous melanoma - Atypical variants and presentations
Alex Chamberlain, Jonathan Ng
The incidence of melanoma continues to rise in Australia.
General practitioners treat the majority of skin cancers affecting
Australians. In the past decade, there has been improved uptake
of dermoscopy by GPs who realise its value in the assessment of
pigmented and nonpigmented lesions.
Blistering skin conditions
Belinda Welsh
Blistering of the skin can be due to a number of diverse aetiologies. Pattern and distribution of blisters can be helpful in diagnosis but usually biopsy is required for histopathology and immunofluoresence to make an accurate diagnosis.
Difficult to diagnose skin cancer - The ‘aggressive’ BCC
Steven Tomas
Basal cell carcinomas (BCCs) are common, and are regularly
diagnosed and managed by Australian general practitioners.
Skin manifestations of systemic disease
Adriene Lee
Dermatologic complaints are a common reason for presentation
to a general practitioner. In some cases, one needs to determine
if the complaint may be a manifestation of a more serious
underlying systemic disease.
Weight loss and malnutrition in the elderly - The shared role of GPs and APDs
Gemma Sampson
This article forms part of a series looking at the relationship
between diet and good health, and the role of the dietician in
the primary health care team.
The role of breast MRI in clinical practice
Meagan Brennan, Andrew Spillane, Nehmat Houssami
The use of magnetic resonance imaging (MRI) for breast screening
is increasing. Women may approach their general practitioner for
advice on its role in breast screening and diagnosis.
Osteomyelitis - A case report
Sudheer Ahamed Puthiyaveetil
Methicillin resistant Staphylococcus aureus (MRSA) infection has
classically been associated with institutional health care settings
such as hospitals and nursing homes.
AFP in Practice
AFP in Practice questions are designed to get you started in a small group learning (SGL) activity in your practice or with colleagues. Requirements to earn 40 Category 1 CPD points for a SGL activity are: minimum of four and a maximum of 10 people, minimum of 8 hours of discussion in a year, and at least two GPs.
Clinical Challenge
Questions for this month's clinical challenge are based on articles in this issue. The style and scope of questions is in keeping with the MCQ of the College Fellowship exam. The quiz is endorsed by the RACGP Quality Assurance and Continuing Professional Development Program and has been allocated 4 CPD points per issue.
Harassment of GPs
Sara Bird
Case histories are based on actual medical negligence claims or
medicolegal referrals; however certain facts have been omitted or
changed by the author to ensure the anonymity of the parties involved.
Electronic medical records – where to from here?
Christopher Pearce
Ninety percent of general practitioners use computers. Computers
are being used by GPs for an increasingly broad range of functions.
Effectively, Australia now has a national electronic medical record
(EMR) based in general practice.
Book reviews
Books reviewed this month are Fast Facts: Psoriasis 3rd edition by Alan Menter, Catherine Smith, Jonathan Barker, Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology 6th edition by Klaus Wolff, Richard Allen Johnson, A Parent’s Guide to Learning Difficulties – how to help your child by Peter Westwood and The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science by Norman Doidge.
Bacterial skin infections - An observational study
Geoffrey Spurling, Deborah Askew, David King, Geoffrey K Mitchell
We aimed to determine the feasibility of measuring resolution rates of
bacterial skin infections in general practice.
Anxiety and depression in Chinese patients attending an Australian GP clinic
George Wen-Gin Tang, Sarah Dennis, Elizabeth Comino, Nicholas Zwar
Incidence of depression among Chinese people living in traditional
Asian regions is low. Recent Chinese immigrants to Australia may be
at greater risk of depression and anxiety because of issues related to
integration into Australian society.
Education in skin cancer management - Assessing knowledge and safety
Anthony Dixon, Helena Rosengren, Thomas Connelly, John Dixon
General practitioners manage the majority of skin cancers in
Australia. There are a range of training opportunities for, and
certifications in, skin cancer management.