Cutaneous adverse drug reactions comprise a significant proportion of all adverse drug reactions. They may mimic other dermatologic or systemic illnesses and may cause significant morbidity or mortality. Seven morphologic groups encompass the most commonly encountered cutaneous drug reaction syndromes: exanthematous (maculopapular), dermatitic/eczematous, urticarial, pustular, blistering, purpuric, and erythrodermic. Drug reactions may have significant downstream consequences for the older individual.

Cutaneous Drug Reactions in the Elderly.

The COVID-19 pandemic, caused by the SARS-CoV-2 coronavirus, has taken a catastrophic toll on society, health-care systems and the economy. Notably, COVID-19 has been shown to be associated with a higher mortality rate in men than in women. This disparity is likely to be a consequence of a failure to invest in men's health, as it has also been established that men have a lower life expectancy and poorer outcomes from non-communicable diseases than women. A variety of biological, social and economic factors have contributed to the sex disparities in mortality from COVID-19. A streamlined men's health programme - with the urologist as the gatekeeper of men's health - is needed to help prevent future tragedies of this nature.

Are sex disparities in COVID-19 a predictable outcome of failing men's health provision?

BACKGROUND Many plastic surgery departments in Australasia have experienced increasing referrals for management of skin lesions. This has driven a demand for new strategies to decrease patient waiting time and administrative costs. The aim of this study was to determine if a purpose-built See and Treat skin cancer clinic could provide a faster skin cancer treatment pathway with comparable clinical outcomes and acceptability to patients. METHODS This was a prospective observational study of patients treated through the See and Treat clinic with a retrospective control cohort. The prospective 'See and Treat' cohort included a consecutive series of 106 patients, while the retrospective cohort included a consecutive series of 200 patients. Patient demographics, time from referral to surgery and operative measures were analysed. One hundred patients in the prospective cohort completed an anonymous satisfaction survey regarding their treatment. RESULTS The average time from referral to surgery was reduced from 121 days in the retrospective cohort to 60 days in the See and Treat cohort (P < 0.001). Rates of complete excision of malignant and premalignant lesions were not different between the two groups, being 93% (178/191) and 91% (76/84), respectively (P = 0.609). Ninety-five percent (95/100) of patients were satisfied with their See and Treat experience overall. CONCLUSION We show that a considerable reduction in the time between referral and surgery can be achieved through a See and Treat clinic without compromise of the success of surgical treatment. Moreover, such a treatment pathway has been shown to be acceptable, and largely preferable, to patients.

Effect of a See and Treat clinic on skin cancer treatment time.

Background Reducing waiting times for patients is a worthy goal for all healthcare professionals. The means and ability to carry out nerve conduction studies in the hand outpatient clinic has the potential to reduce waiting times between appointments for patients with upper limb neural compression. Methods We assessed the pathway of patients presenting with upper limb neural compression in the Aneurin Bevan Trust. Overall, 115 patients were included, being assessed in four different patient pathway groups. Results We found that by implementing a nerve conduction clinic, and then that of a one stop clinic, we were able to reduce the median waiting times from referral to surgical intervention, to 133 days. Conclusion The introduction of nerve conduction clinics allowed the one stop clinic to be established, achieving the goal of reducing patient waiting times.

https://bmjopenquality.bmj.com/content/bmjqir/6/2/e000067.full.pdf

Improving waiting times in the orthopaedic outpatient clinic.

Volar Plate Injuries of the Proximal Interphalangeal Joint

DESCRIPTION A previously well 96-year-old woman underwent a hemiarthroplasty of her right hip. She was treated postoperatively with subcutaneous injections of enoxaparin for venous thromboembolic (VTE) prophylaxis, as per hospital protocol. She developed 2 areas of skin necrosis at the location of the injection sites 4 days postoperatively.

Enoxaparin-Induced Skin Necrosis

Ring Avulsion Injuries.

Management of Vulval Lichen Sclerosus-The Role of the Plastic Surgeon

Introduction “See and treat” one-stop clinics (OSCs) are an advocated NHS initiative to modernise care, reducing cancer treatment waiting times Little studied in plastic surgery, the existing evidence suggests that though they improve care, they are rarely implemented We present our experience setting up a plastic surgery OSC for minor skin surgery and survey their use across the UK Methods The OSC was evaluated by 18-week wait target compliance, measures of departmental capacity, and patient satisfaction Data was obtained from 32 of the 47 UK plastic surgery departments to investigate the prevalence of OSCs for minor skin cancer surgery Results The OSC improved 18-week waiting times, from a noncompliant mean of 80% to a compliant 95% average Department capacity increased 15% 95% of patients were highly satisfied with and preferred the OSC to a conventional service Only 25% of UK plastic surgery units run OSCs, offering varying reasons for not doing so, 42% having not considered their use Conclusions OSCs are underutilised within UK plastic surgery, where a significant proportion of units have not even considered their benefit This is despite associated improvements in waiting times, department capacity, and levels of high patient satisfaction We offer our considerations and local experience instituting an OSC service

/pdf/one-stop-clinic-utilization-in-plastic-surgery-our-local-nnlqasy957.pdf

One-Stop Clinic Utilization in Plastic Surgery: Our Local Experience and the Results of a UK-Wide National Survey.

Volar Plate Avulsion Injury.

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