Rash Decisions

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 les...

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...

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 th...

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...

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 cond...

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...

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...

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 he...

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 hav...

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 d...

In this third episode of the Rash Decisions melanoma series, Dr George Moncrieff and Dr Roger Henderson guide you through "The Art of Melanoma Spotting" in primary care. They’ll upskill you on the essential techniques for early melanoma detection, emphasising the key role of dermatoscopy and mole mapping. Our experts also share their thoughts on UVA and UVB exposure whilst exploring the complexiti...

Do you use ABCD to diagnose malignant melanomas? You may be contributing to the 84% of obviously benign melanomas that are referred to secondary care. Or even worse, you could be missing over two thirds of melanoma.  Dr George Moncrieff and Dr Roger Henderson scrutinise ABCD in this podcast episode, working through each letter of the acronym to decipher the helpfulness of distinguishing malignant...

“Over half of all our referrals to dermatology are for suspected skin cancer.  But this is the alarming thing, only 6% of those referrals turn out to be either a melanoma or a squamous cell carcinoma...” Dr George Moncrieff.  So, as primary care physicians, how can we help to reduce the percentage of benign melanoma referrals?  You can start by listening to this podcast where your hosts Dr George...

In this third instalment of our series on mental health and the skin, we, Dr George Moncrieff and Dr Roger Henderson, are joined once again by special guest Professor Anthony Bewley, a distinguished authority in the field of psychodermatology.  In this episode, we delve into the fascinating world of mental health conditions that manifest through the skin. Drawing from Professor Bewley's wealth of...

This episode contains some eye-opening statistics revealing the staggering toll the likes of atopic dermatitis, rosacea, acne, psoriasis and alopecia areata take on an individual's mental wellbeing.  BUT, the episode doesn’t just shed light on the problem. Dr George Moncrieff and Dr Roger Henderson have enlisted the help of Professor Anthony Bewley, a world authority on psychodermatology, to help...

“…the skin is not just the skin. Underneath the skin, there is a person, who is really suffering.” Professor Anthony Bewley. In 2020, the 'Mental Health and Skin Disease' report produced by the All-Party Parliamentary Group on Skin highlighted that 98% of individuals with skin disease reported an impact on their wellbeing, despite this, only 18% received effective professional help.  The report st...

“...when you then see the patient who comes in [with] rosacea and they [have] then got the broken capillaries, the blood vessels starting to appear. It's not that my heart sinks when I see those, compared to a patient with simple background flushing, but I start thinking, we're in for a slightly trickier time here to start pulling them back.” Dr Roger Henderson.  In this episode, your hosts, Dr Ge...

"What do Rembrandt, the Hollywood actor W. C. Fields and the former president Bill Clinton all have in common?" The answer is rosacea, and in this first episode on this common skin condition, your hosts Dr George Moncrieff and Dr Roger Henderson explore how to identify rosacea in your patients, giving you clarity on the clinical presentations to avoid potential misdiagnosis. They will also cover:...

As Dr Roger Henderson aptly puts it, “...The one thing guaranteed to make my heart sink, if I'm walking down the high street, is to see someone with acne scarring... Because you know that, that was preventable.”   In this insightful episode, your hosts Dr George Moncrieff and Dr Roger Henderson discuss acne treatments, emphasising the crucial importance of preventing acne scarring.  From topical r...

“Now many patients of mine do believe that acne, is acne, is acne. But one of the things I have learnt, over too many years of treating them, is that there's a massive range of presentations, including the 'no need to treat, so mild', to the... specialist referral level with horrendous scarring, which I think we've failed, if we get to the scarring point...   So, there's this massive sort of A to...

“Somebody with moderate atopic eczema has nine flares a year, each of those flares, perhaps needing topical steroids for two to five weeks at least. So, they're barely stopping the topical steroids.” Dr George Moncrieff  Already you can see how patients can very easily, and unintentionally, be prescribed topical steroids long-term, which they are neither intended for, nor licensed for. The impact...

“…we’ve been using topical steroids now for over 70 years, which means they've been around longer than paracetamol.  So, we know how to get the best results from them, and we know what to expect from them.” Dr George Moncrieff  Or do we?  Join our hosts as they unravel the essentials of prescribing topical steroids. Dr George Moncrieff and Dr Roger Henderson explore key topics, including:  The ant...

“...Appropriate use of an emollient reduces overall health costs because the patient's eczema gets better, they have less appointments with doctors, they have less eczema, they're using less steroids, and in the paper that I showed not only were they using less topical steroids, they were using less antibiotics. So, it really is a win. You're using a very safe agent.” Dr George Moncrieff.  In this...

“Patients sometimes think that an emollient is an emollient. But when we're prescribing, we mustn't forget about splitting them into simple and sophisticated types and actually think about what we're putting on our patient's skin, which sounds an obvious thing to say, but it really is horses for courses” - Dr Roger Henderson.  Following on from the first episode in the “Emollients” topic, which co...

Before we attempt to understand the critical role that emollients play in the management of dry skin conditions, we first need to understand our largest organ, the skin. Dr Moncrieff and Dr Henderson delve deep into the remarkable structure that is our skin, looking at how this organ punches way beyond its weight simply because it’s the part of the body that everyone sees and notices. They explore...