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CONTINUING PROFESSIONAL DEVELOPMENT
1. A non-blanching maculopapular rash
is a characteristic feature of:
b) Meningococcal disease.
d) Erythrodermic psoriasis.
2. A child presents to the pharmacy
with a widespread rash which is not
causing itch. The lesions appear to be
small spots which are bluish-grey in
colour. This rash is MOST LIKELY to be
c) Atopic dermatitis.
3. Lichenification is characteristic of
which skin condition?
c) Atopic dermatitis.
4. Psoriasis is:
a) Caused by a histamine-mediated
b) A contagious condition.
c) Typically preceded by a viral infection.
d) Usually a genetically acquired condition.
5. Treatment of guttate psoriasis does
not involve the use of:
a) Tar-based products.
b) A routine course of penicillin.
You refer Josie to her family doctor
as you are aware of the multitude of
differential diagnoses for this unique
skin rash. Josie visits her doctor that
afternoon and returns to the pharmacy
confirming that William is suffering
from guttate psoriasis. Her doctor has
recommended some moisturisers to
keep the skin from drying – Josie would
like your advice. You explain that there
are a number of possible treatments
for this condition (some of which
require a prescription from the doctor)
(see Table 2). Guttate psoriasis is usually
self‐limiting, but you can recommend
some products that may relieve
You recommend the use of an emollient
for William, both whilst bathing, and as
a regular skin moisturiser throughout
the day (applied at least twice daily).
You indicate that you can offer a
stronger product to relieve the itch and
inflammation, and Josie is hesitant to
use anything ‘too strong’ on William’s
skin. In light of this, you provide her with
some tar‐based lotion for application as
required to relieve any itch. You advise
Josie to apply the tar‐based lotion to
the affected areas and rub in gently.
In cases of guttate psoriasis, it is
generally recommended that patients
take another course of antibiotics,
if required, to eliminate any remaining
streptococcal infection. Josie indicates
that the doctor mentioned this,
and after checking William, he is sure the
infection has cleared up.
William returns to the pharmacy with
his father, Richard, six weeks after his
initial visit. He is very proud to show you
that the rash on his torso has virtually
disappeared and he has not experienced
any further symptoms. Richard explains
that they have been using the products
you recommended and thanks you for
helping them solve this problem.
On a daily basis, pharmacists are
presented with a multitude of skin
conditions, for which there can be a
variety of causes. It is essential that
pharmacists are confident when
assessing skin conditions, to enable
them to make appropriate patient
recommendations. Of vital importance
is the need to gather a detailed patient
history to ensure a holistic approach
1. Riordan A, Thomson A. Recognition, treatment and
complications of meningococcal disease. Paediatr Drugs
2. Wells L, Smith J, Weston V, Collier J, Rutter N. The child
with a non-blanching rash: how likely is meningococcal
disease. Arch Dis Child 2001:85;218−22 .
3. Sabella C. Measles: not just a childhood rash. Cleve Clin J
4. DermNet NZ: measles[revised Jun 2013]. At: www.
5. DermNet NZ: chickenpox (varicella) [revised Jun 2013]. At:
6. Better health channel: chickenpox [revised Aug 2013].
7. Sohn A, Frankel A, Patel R, Goldenberg G. Eczema. Mt Sinai
J Med 2011:78;730−9 .
8. Peate I. Eczema: causes, symptoms and treatment in the
community. Br J Community Nurs 2011:16(7);324−31.
9. Grattan C. The urticarias: pathophysiology and
management. Clinical medicine 2012:12(2);164–7.
10. Schaefer P. Urticaria: evaluation and treatment. Am Fam
11. DermNet NZ: psoriasis [revised Oct 2013]. At: www.
12. Therapeutic guidelines. Dermatology. Version 3.
Melbourne: Therapeutic Guidelines Ltd; 2009.
13. DermNet NZ: psoriasis of the palms and soles [revised
Oct 2013]. At: www.dermnetnz.org/scaly/palmoplantar-
14. Hyun-Chang K, Seung-Wook J, Song M et al.Clinical course
of guttate psoriasis: long-term follow-up study. Jpn J
Dermatol B 2010:37;894–9 .
15. Potok O, Prajapati V, Barankin B. Dermacase – can you
identify this condition? Can Fam Physician 2011:57;55–8 .
16. Rossi S, ed. Australian medicines handbook. Adelaide:
Australian Medicines Handbook; 2013. At: www.amh.net.
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