Skin Care Resources

Erosive pustular dermatosis (EPD) of the leg is a rare condition that is challenging and complex to diagnose and treat. This cutaneous inflammatory disease is associated with trophic changes of the lower limb, and while its incidence is unknown, it is believed to be more common than previously thought. Care of leg ulcers poses a considerable burden to the health service, although it is estimated that only half of patients receive the appropriate treatment. This article reflects on the case of a patient with chronic ulcerated and swollen legs who was referred to a wound advisory clinic by his GP. It critically assesses the data from the patient history, physical examination and treatment decisions. It is hoped that describing this case — patient history, findings from physical examination and treatment plan — will help further community nurses’ understanding of the condition.

The 2014 National Institute for Health and Care Excellence (NICE) guidelines for the assessment and management of psoriasis were updated in 2017. There is little of note in relation to the previous articles in this series, however since the development of more biologics and cheaper forms of biosimilars, the guidelines were amended to reflect these readily available treatments (NICE, 2017a). The seventh and final article in this series provides an overview of systemic non-biological and biologic therapies. It looks at how these treatments target and treat psoriasis, as well as side-effects, contraindications and monitoring recommendations of certain drugs.

Skin tears are a common type of tissue injury, which often go unrecognised and misdiagnosed. Furthermore, classification and documentation of skin is often poor, resulting in chronic wounds with associated adverse patient outcomes. The International Skin Tear Advisory Panel (ISTAP) recently updated the International Best Practice Guidelines and definition of a skin tear based on emerging evidence and expert discussion and consensus. This article presents a discussion of the epidemiology, risk factors and causes of skin tears. In addition, the most recent best practice recommendations for the prevention, assessment, and management of skin tears is summarised.

Skin tears are a largely preventable common injury, particularly in the elderly. However, if not managed appropriately, they have the potential to develop into problematic wounds. This article discusses their classification, why they are common in ageing skin, gives advice on correct wound management strategies and how assessing the patient and their environment and simple strategies can be employed to prevent their reoccurrence.

This series has addressed the treatments for psoriasis as advised by
the National Institute for Health and Care Excellence (NICE, 2017). This condition affects between 1.3-2.2% of the population (Parisi et al, 2011). It is recognised that psoriasis can have a significant impact on mood, mental health, poor lifestyle choices (Cohen et al, 2016; Landriscina et al, 2016), reduced activities of daily living, and is linked with other comorbidities, such as diabetes (Armstrong, 2013) and cardiovascular disease (Rutter et al, 2016). NICE developed a treatment pathway, advising bland emollients, topical treatments, phototherapy, systemic medications and systemic non-biological and biologic therapy. In recent years, the latter options have increased dramatically. This article focuses on the more traditional systemic
treatments, as advised by NICE.