Dear All

Thank you for attending the session today and making it so interesting.

In RRR we discussed:

• Preventing UTIs in children
• Chronic Fatigue Syndrome
• Asthma – diagnosis

The Video was on a young boy looking unwell. Inflamed lips, rash with flaccid blisters. Dr J took the hotseat and identified all the clinical signs. History had appropriate questions but Drugs were missed due to stress of the hotseat. Differential diagnosis also good.

Remember PAIN is one thing we can alleviate and is the kindest action.

The Learning points are:

• Toxic Epidermal Necrolysis is an EMERGENCY.
• Deterioration is very rapid and can be fatal.
• Nikolski sign – can ask directly.
• Acknowledge it – escalate to Consultant, Dermatologist.
• Plan for transfer to a burns unit as urgency.
• PAIN relief is urgent – before other treatment modalities: fluids, antibiotics etc
• Differential diagnosis is Steven Johnson Syn – milder spectrum of same disease process / Scalded Skin Syndrome are the top three – Mycoplasma to keep in mind
• Look up details, complications of this rare but common exam condition
• “What will you tell parents?” is a common management question in many conditions.

Visit www.mrcpchonline.org to add your comments or anything I may have missed.

Anil Garg