InnovAiT: Education and inspiration for general practice

Pruritus, or itch, is a common sensation that causes a person to want to scratch. It is a complex process that commonly occurs with skin disorders such as xerotic eczema, atopic dermatitis and urticaria. It may also be related to an underlying disease process such as cholestasis or hyperthyroidism or simply be caused by dry skin, especially in the cold. Effective treatment of pruritus can prevent scratch-induced complications such as lichen simplex chronicus and impetigo. Therapy is often aimed at eliminating the underlying cause first, followed by the management of the itchy sensation.

In the UK, 15% of consultations in primary care relate to problems with the skin. Bacterial skin infections are common and range widely in their size, severity and variety of skin changes produced. This article aims to provide information on the clinical presentation and management of bacterial skin infections including folliculitis, furunculosis, impetigo, ecythma, staphylococcal scalded skin syndrome, cellulitis, erysipelas and necrotizing fasciitis.

Blisters are fluid-filled eruptions on the skin or mucous membranes. They are commonly seen in general practice in patients with herpes infection, insect bites, burns and friction trauma. Primary blistering disorders, for example bullous pemphigoid (BP) and pemphigus vulgaris (PV) are rare in comparison. These are immune or inherited disorders of proteins that bind the skin together. Blistering conditions may present alone or in association with other diseases, for example dermatitis herpetiformis and gluten-sensitive enteropathy. Blistering may be trivial or life threatening and therefore requires a logical approach to assessment, management and referral in the primary care setting.

The population in the UK is ageing, with increasing proportions living beyond 65 years of age. The epidemiology of diseases is shifting to more people dying of chronic as opposed to acute illnesses. It has been predicted that the number of people dying each year in the UK will rise by 17% in the next 20 years. Thus, there will be a rapidly increasing demand for provision of palliative care in the future. Much of this care will continue to be provided by the GP. This article specifically discusses the management of gastrointestinal symptoms in palliative care.

Respiratory symptoms are extremely common in palliative care patients. They can have significant and profound effects on the quality of life of the patient and those around them so their control is essential. Assessment and management of respiratory symptoms in palliative care patients broadly follow that of the general population and are within the abilities of all clinicians. However, this patient group does pose particular management problems that the GP should be familiar with. The aim of this review is to familiarize the GP with the main respiratory symptoms encountered in palliative care along with the main causes, their assessment and management.

Laryngeal cancer is a disease that usually presents with hoarseness. It is most common in older people and those of lower socio-economic classes. Understanding the warning signs and symptoms can help in making an early referral to the ear, nose and throat (ENT) specialist. This article aims to provide an overview of the ways in which laryngeal cancer can present, its treatment and problems that are sometimes encountered.

All the world's a stage,

And all the men and women merely players:

They have their exits and their entrances;

And one man in his time plays many parts.

Shakespeare, (1600) As You Like It, Act 2, scene 7.

Oral presentations may be thought of as performances. At the heart of all performances should lie the question: Am I serving my audience well and what can I do to raise my standard? To gauge if your audience enjoyed and valued your presentation, you can listen to their applause and remarks made in the discussion section in addition to reading your peers' review. For your oral presentations most of this feedback may be captured through a well designed evaluation form.