Most chronic skin conditions are managed in primary care, with input from secondary care when necessary. However, certain cases necessitate urgent referral to dermatology secondary care, for prompt management. These include life-threatening conditions, but also common conditions when normal function and quality of life are affected. This article gives an overview of same-day dermatology in Marietta, GA, and what conditions warrant urgent skin care treatment.
Skin Cancer
Patients with suspected skin cancer usually have two-week wait referrals. Individuals who are most at risk of developing melanoma include those with skin that burns easily and have a family history of melanoma and atypical mole syndrome.
A lesion that changes is asymmetrical and irregularly pigmented could be a sign of developing melanoma. Other features that cause concern are having different colors within the lesion if it extends beyond the border and is abnormally large.
Early treatment and management are important for both melanoma and non-melanoma skin cell cancers. All skin cancers should be examined as soon as possible
Erythroderma
Erythroderma is used to describe widespread and generalized redness/irritation of the skin. Patients have intensely red, hot skin, which may be itchy. They may be systemically unwell, with symptoms of fever, shivering, fast heartbeat, hypotension, or shock.
These patients are usually managed in hospitals because they can rapidly become very unwell – they are unable to maintain homeostasis in temperature and are at risk of fluid and protein loss, clotting abnormalities, potential infection, and multi-organ failure.
Infected Eczema
Patients with eczema have sensitive skin, which renders them susceptible to bacterial and viral skin infections.
The typical lesions are red/irritated, weeping, itching, and painful. There may be a history of cold sores. In children especially, symptoms may include not eating, drinking, or sleeping well.
These patients need to be referred urgently.
Generalized Pustular Psoriasis
Generalized pustular psoriasis is usually considered a different condition from psoriasis which is unstable and requires early admission.
It can be life-threatening and compromises normal function, so it is a dermatology emergency and requires hospitalization. It presents numerous white pustules on red, inflamed skin.
Stevens-Johnson Syndrome
Patients present with similar symptoms as the flu, with fever, sore throat, cough, sore red eyes, and malaise. Soon after, target-like, red macules can develop on the body. These are painful and might blister, spreading rapidly to the face and the rest of the body.
The mouth and lips exhibit extensive painful ulcers. There is significant conjunctival injection and risk of corneal damage. SJS affects all ages. In children, however, there is an increased association with infections.
Management includes immediately stopping all medications that might have been the cause. Supportive care and treatment of any underlying cause are also initiated.
DRESS Syndrome
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is another serious skin disorder, caused by adverse reactions to a drug which also affects multiple systems.
Patients usually present with a high fever and extensive rash. The rash can look like measles or be target-like in shape. Also, it is associated with facial edema, including ear swelling. There is also mucosal involvement. Patients are often very unwell and need urgent referral to the hospital.
Blood tests may reveal eosinophilia, deranged LFTs, hematological abnormalities, and other organ involvement.
Pemphigus Vulgaris
Pemphigus vulgaris usually occurs in older individuals and can be more challenging to manage since it can take years of treatment.
It is difficult to see intact blisters since they are flaccid. Patients are more likely to have additional involvement of the mucosal surfaces, requiring a more in-depth and involved approach.
If you think that you might need same-day dermatology in Marietta, GA then call Acworth Dermatology and Skin Cancer Center at (678) 505-8030 to schedule an appointment as soon as possible.
