Rash Decisions

Actinic Keratosis (Part 1) - The risk of malignancy

In this episode of Rash Decisions, hosts Dr George Moncrieff and Dr Roger Henderson delve into actinic keratoses (AKs), also known as solar keratoses. With expert insights, they discuss the nature of these common sun-induced lesions, their role as markers of both UV exposure and damage, along with practical approaches to diagnosis. 
Key Takeaways: 
How to differentiate AKs from other keratotic lesions, including Bowen’s disease, keratoacanthoma and squamous cell carcinoma (SCC)
The significance of clinical grading and the concept of "field cancerization"
Practical tips for dermatoscopic evaluation and deciding when to refer patients. 
Tune in to enhance your understanding of AKs and how the majority can be managed within primary care settings. 
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.  
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.  
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/   
LI: https://www.linkedin.com/company/fontus-health-ltd/  
IG: https://www.instagram.com/aproderm/ 
Got some feedback for us? Please rate and review Rash Decisions to help us keep creating educational podcasts for you.  
Is there a dermatology topic you’d like us to explore? Email us at info@aproderm.com, and we’ll do our best to cover it. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 

Viral Infections (Part 4) - From local to global

Your hosts Dr George Moncrieff and Dr Roger Henderson are joined once again by special guest Dr Marina Morgan, Consultant Clinical Microbiologist at the Royal Devon and Exeter Hospital. Together, they explore the fascinating and sometimes alarming world of viral skin infections, covering conditions from glandular fever to tropical viral infections like dengue, chikungunya and Zika, along with the global spread of mpox. 
Key takeaways: 
Recognising glandular fever and its differential diagnoses, including CMV and acute HIV seroconversion. 
How global travel and climate change are impacting the spread of tropical viral infections. 
The new dengue and mpox vaccines. 
Practical advice for identifying and managing mpox and its implications for patients and public health. 
Tune in to gain valuable insights into the complexities of diagnosing and managing viral skin infections. 
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.  
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.  
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/   
LI: https://www.linkedin.com/company/fontus-health-ltd/  
IG: https://www.instagram.com/aproderm/ 
Got some feedback for us? Please rate and review Rash Decisions to help us keep creating educational podcasts for you.  
Is there a dermatology topic you’d like us to explore? Email us at info@aproderm.com, and we’ll do our best to cover it. 
The views expressed in this podcast are those of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated in or been involved in the programme, materials or delivery of this educational content. 

Viral Infections (Part 3) - Viral or non-viral?

Dr Marina Morgan, Consultant Clinical Microbiologist at Royal Devon and Exeter Hospital, is back once again, joining Dr George Moncrieff and Dr Roger Henderson in their deep dive into the world of viral rashes. 
From Kawasaki disease to Covid-19-related skin issues, the trio explores the complexities of diagnosing and managing these, often misunderstood, conditions. 
Key Takeaways: 
Recognising the unique characteristics of Kawasaki disease, MIS-C, and toxic shock syndrome.
Understanding how Covid-19 can present a wide spectrum of skin manifestations.
Practical tips for primary care professionals to help identify urgent cases that require hospital referral. 
Tune in for expert insights and practical advice to enhance your dermatological knowledge. 
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.  
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.  
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/   
LI: https://www.linkedin.com/company/fontus-health-ltd/  
Got some feedback for us? Please rate and review Rash Decisions to help us keep creating educational podcasts for you.  
Is there a dermatology topic you’d like us to explore? Email us at info@aproderm.com, and we’ll do our best to cover it. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 

Viral Infections (Part 2) - More than just measles

We’ve gone viral!
Join Dr George Moncrieff and Dr Roger Henderson as they discuss paraviral rashes, where the rash is an immune response to the virus.  
They’ll be covering: 
Measles
Rubella
Fifth disease
Pityriasis rosea
Hand, foot and mouth disease
Herpangina 
Tune in to hear tips for diagnosis, the available treatment options and some potentially serious complications. 
Plus, the two hosts will be discussing why they think the MMR vaccine uptake is falling, resulting in rising cases of measles.  
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.  
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.  
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/   
LI: https://www.linkedin.com/company/fontus-health-ltd/  
Got some feedback for us? Please rate and review Rash Decisions to help us keep creating educational podcasts for you.  
Is there a dermatology topic you’d like us to explore? Email us at info@aproderm.com, and we’ll do our best to cover it. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 

Viral Infections (Part 1) - Viral wisdom

Dr George Moncrieff and Dr Roger Henderson share their wisdom on viral infections. In the first of three episodes on this topic, they’ll cover cytopathogenic rashes, where the virus is present in the skin lesion.  
Along with sharing their top six viral facts, they’ll talk you through: 
Viral warts 
Herpes simplex infections 
Chickenpox 
Shingles 
Orf 
Molluscum contagiosum 
For each of these conditions, they’ll discuss what the virus is up to, share their experiences on the available treatments and complications that you should be aware of in primary care. 
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.  
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.  
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/   
LI: https://www.linkedin.com/company/fontus-health-ltd/
Got some feedback for us? Please rate and review Rash Decisions to help us keep creating educational podcasts for you.  
Is there a dermatology topic you’d like us to explore? Email us at info@aproderm.com, and we’ll do our best to cover it. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 

Bacterial Infections (Part 3) - Flesh-eating bugs, Lyme disease and more!

In this episode, your hosts Dr George Moncrieff and Dr Roger Henderson are joined by Consultant Clinical Microbiologist Dr Marina Morgan to discuss some of the potentially very serious bacterial skin infections... 
Delving straight in with necrotising fasciitis, the trio cover how patients come to get this bacterial infection and, as it's so easy to miss this diagnosis, the signs and symptoms you should be looking out for in primary care. 
They then move onto discussing the secrets to diagnosing Panton-Valentine Leukocidin (PVL). Spread by close skin contact, they will be imparting key tips that you can share with your patients to reduce the risk of them passing on this devastating staphylococcus aureus infection. 
Ending with Lyme disease, which is now endemic in many parts of the UK, they discuss the likelihood of catching this tick-bourne infection, along with how you should treat someone who presents to you with the associated erythema migrans rash. 
But, if that isn’t enough, this episode also explores antibiotic resistance, and why primary care physicians should be reserving antibiotics for the more serious infections. 
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.  
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.  
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/   
LI: https://www.linkedin.com/company/fontus-health-ltd/  
Got some feedback for us? Please rate and review Rash Decisions to help us keep creating educational podcasts for you.  
Is there a dermatology topic you’d like us to explore? Email us at info@aproderm.com, and we’ll do our best to cover it. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 
Episode Resources:  
The Lee Spark NF Foundation Education Video: https://nfsuk.org.uk/education/severe-group-a-streptococcal-infections-leading-to-necrotising-fasciitis/ 
The Lee Spark NF Foundation: https://nfsuk.org.uk/ 
Morgan, M. (2005) 'Hospital management of animal and human bites', The Journal of Hospital Infection, 61(1), pp. 1-10.  
Morgan, M. et al. (2024) 'Group A beta-haemolytic streptococcal infection in children', BMJ, 385 (8426), doi:  https://doi.org/10.1136/bmj-2023-077561

Bacterial Infections (Part 2) - A deep dive into skin infections

Can you tell the difference between erysipelas and cellulitis? Or wondered whether you’re looking at venous eczema or bilateral cellulitis? Deep bacterial skin infections can be elusive but worry not... 
In this jam-packed episode, Dr George Moncrieff and Dr Roger Henderson share their top tips for spotting some common and not so common deep bacterial skin infections along with their differential diagnosis. In just 20 short minutes they will be covering a staggering 17 bacterial infections, including:  
Erysipelas 
Cellulitis 
Venous Eczema 
Lymphangitis 
Erythrasma 
Henoch-Schönlein Purpura 
Scarlet Fever 
Syphilis 
Not only will this episode help you to identify these conditions, but it will also leave you with Dr George Moncrieff and Dr Roger Henderson's tried and tested treatment options.  
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.  
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.  
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/   
LI: https://www.linkedin.com/company/fontus-health-ltd/  
Got some feedback for us? Please rate and review Rash Decisions to help us keep creating educational podcasts for you.  
Is there a dermatology topic you’d like us to explore? Email us at info@aproderm.com, and we’ll do our best to cover it. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 

Bacterial Infections (Part 1) Top facts about bacterial skin infections

The human body is outnumbered by bacteria almost 10 to 1, and in general, we live in harmony with them. It’s a truly symbiotic relationship, however, what happens when we get an imbalanced microbiome? 
In this episode, your hosts Dr George Moncrieff and Dr Roger Henderson will answer just that, as they cover some of the common and rarer bacterial infections seen in primary care. Listen along to hear:  
Their top six facts about bacteria
How to spot common bacterial infections including, impetigo, folliculitis and furuncles along with the not so common ones like carbuncles, Staphylococcal Scalded Skin Syndrome and ecthyma 
Their management and treatment strategies, along with their prescribing choices 
General tips and advice for patients 
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.  
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.  
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/   
LI: https://www.linkedin.com/company/fontus-health-ltd/  
Got some feedback for us? Please rate and review Rash Decisions to help us keep creating educational podcasts for you.  
Is there a dermatology topic you’d like us to explore? Email us at info@aproderm.com, and we’ll do our best to cover it. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 

Topical Steroid Concerns (Part 2) - When topical steroids bite back

In this episode on Topical Steroid Concerns, Dr George Moncrieff and Dr Roger Henderson will educate and upskill you on Topical Steroid Withdrawal, also known as Red Skin Syndrome. They will be sharing their experiences and covering:  
What Topical Steroid Withdrawal is?
Who it affects
Symptoms of Topical Steroid Withdrawal
The impact that the healthcare profession has had and is continuing to have by not being alert to this condition
What needs to be done urgently to help individuals who are experiencing this devastating condition
MHRA updates following the reports to the Yellow Card Scheme 
They are also fortunate enough to be joined by Briana Banos, to get a patient-perspective on Topical Steroid Withdrawal. This raw and emotional episode is not to be missed. 
Useful resources and links: 
MHRA: Topical corticosteroid and withdrawal reactions: https://www.gov.uk/guidance/topical-corticosteroids-and-withdrawal-reactions 
MHRA: Topical steroids: introduction of new labelling and a reminder of the possibility of severe side effects, including Topical Steroid Withdrawal Reactions, available at:  https://www.gov.uk/drug-safety-update/topical-steroids-introduction-of-new-labelling-and-a-reminder-of-the-possibility-of-severe-side-effects-including-topical-steroid-withdrawal-reactions# 
ITSAN – www.itsan.org 
Scratch That – https://scratchthat.org.uk 
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis. 
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence. 
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/ 
LI: https://www.linkedin.com/company/fontus-health-ltd/ 
Thank you for listening. We hope you find this podcast interesting and helpful, please leave us a review or email info@aproderm.com with any feedback on this episode or suggestions for what you would like to hear about in future podcasts. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 

Topical Steroid Concerns (Part 1) - The power and pitfalls

While topical steroids are indispensable in dermatology, understanding their powers and pitfalls is essential for healthcare professionals. Listen along to hear: 
The impact of topical steroids on the skin barrier, from the thinning of the stratum corneum to the disruption of the all-important “acid mantle”. 
Insights into the accelerated absorption from long-term use and its consequences in the deeper layers of the dermis. 
Considerations for children, exploring absorption rates in relation to their body surface area to weight ratio. 
How the language we use can increase the risk of poor clinical response and treatment failure. 
The statistics around steroid allergies, and how this is often underrecognised. 
How the immune suppressing effect of topical steroids can be a real problem in the presence of skin infections.
Tune in for valuable insights that balance the power and pitfalls of topical steroids, the dermatological cornerstone for managing so many skin conditions. 
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis. 
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence. 
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/ 
LI: https://www.linkedin.com/company/fontus-health-ltd/ 
Thank you for listening. We hope you find this podcast interesting and helpful, please leave us a review or email info@aproderm.com with any feedback on this episode or suggestions for what you would like to hear about in future podcasts. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content.