🌿Eczema / Dermatitis⌄

Recognise

• Dry, itchy, recurrent; flexural distribution is common in atopic eczema
• Look for trigger/contact pattern, secondary infection and eczema herpeticum features

Clinic direction

• Emollient + appropriate topical anti-inflammatory
• Use FTU and site/potency helper
• Review diagnosis/adherence if poor response

Escalate / review: Same-day specialist advice if eczema herpeticum is suspected; urgent escalation for eye involvement, systemic illness or rapidly worsening infection.

⭕Tinea Corporis / Cruris / Pedis⌄

Recognise

• Annular plaque, active scaly edge, possible central clearing
• Check feet/nails/groin as reservoir and prior steroid use

Clinic direction

• Avoid steroid monotherapy when dermatophyte infection is likely
• Keep area dry; review adherence and extent
• Consider systemic pathway/review if extensive, recurrent, scalp or nail disease

Escalate / review: Review or refer if diagnosis uncertain, immunocompromised, treatment failure, scalp disease or extensive recurrence.

🌙Scabies⌄

Recognise

• Intense itch, often worse at night
• Household/close-contact itch; webs, wrists, waistline and genital area are typical sites

Clinic direction

• Treat household members and close contacts at the same time when scabies is diagnosed/strongly suspected
• Wash/dry recently used bedding, clothing and towels on hot cycles when possible; seal non-washable items for several days
• Explain itch can persist for several weeks after successful treatment

Escalate / review: Escalate crusted scabies, severe secondary infection, institutional outbreak or immunocompromised patient.

🌊Urticaria⌄

Recognise

• Transient wheals, intensely itchy, lesions typically migrate
• Check medication/NSAID, infection and allergy context

Clinic direction

• First exclude anaphylaxis/angioedema
• Non-sedating antihistamine pathway if uncomplicated
• If recurrent >6 weeks, assess as chronic urticaria

Escalate / review: Emergency if airway symptoms, hypotension, wheeze, syncope or systemic anaphylaxis features.

🍯Impetigo / Infected Eczema⌄

Recognise

• Honey-coloured crusts, pustules or wet erosions
• Assess localised vs widespread and surrounding cellulitis

Clinic direction

• Use NAG/local guidance when antimicrobial treatment is indicated
• Hygiene and transmission counselling
• Review if spreading or not improving

Escalate / review: Escalate fever, extensive disease, infant/high-risk host, spreading cellulitis, ecthyma or poor response.

🔥Cellulitis / Abscess⌄

Recognise

• Red, hot, swollen, tender skin; abscess may be fluctuant or draining
• Check fever/systemic features, rapid spread, severe pain, entry point and comorbidity

Clinic direction

• Consider marking the erythema margin for outpatient follow-up
• A true abscess may require drainage rather than antibiotics alone
• Use NAG/local protocol for antimicrobial decisions

Escalate / review: Refer/escalate if severely unwell, infection is near the eye/nose, spreading despite treatment, or there is concern for sepsis, orbital cellulitis, necrotising infection, septic arthritis or osteomyelitis.

⚡Herpes Zoster / HSV⌄

Recognise

• Grouped vesicles; dermatomal unilateral pattern suggests zoster
• Check onset, pain, immunocompromise and dissemination

Clinic direction

• Eye/forehead/nose involvement needs urgent assessment
• Consider antiviral pathway according to timing/risk
• Give transmission advice while vesicles active

Escalate / review: Escalate ophthalmic involvement, dissemination, severe neurological features, pregnancy concern or immunocompromised patient.

⚪Hypopigmented / Numb Patch⌄

Recognise

• Differentiate depigmentation from hypopigmentation and look for fine scale
• Check for definite sensory loss and peripheral nerve symptoms/signs

Clinic direction

• Definite sensory loss in a pale/reddish patch or nerve enlargement with sensory loss/weakness raises concern for leprosy
• Fine superficial scale may support pityriasis versicolor
• Document sensory and peripheral nerve findings clearly

Escalate / review: Use the local leprosy referral pathway when cardinal signs are present or diagnosis is uncertain.

🔴Acneiform Eruption⌄

Recognise

• Comedones support acne vulgaris
• Look for inflammatory papules/pustules, nodules, cysts and scarring

Clinic direction

• Assess severity, pregnancy possibility and prior treatments
• Use stepwise acne therapy/local CPG
• Consider folliculitis if monomorphic itchy pustules

Escalate / review: Refer severe nodulocystic acne, scarring, major psychosocial impact or treatment failure.

🧩Psoriasis Pattern⌄

Recognise

• Well-demarcated plaques with scale; extensor surfaces and scalp are common
• Check nails, high-impact sites and symptoms suggesting psoriatic arthritis

Clinic direction

• Assess body surface area, severity and impact
• Use KKM psoriasis CPG for treatment pathway
• Arrange specialist review when topical management is inadequate or disease is severe/extensive

Escalate / review: Generalised pustular psoriasis or erythroderma requires immediate same-day specialist assessment; refer significant joint symptoms or diagnostic uncertainty.