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Do not prescribe topical or systemic anti-fungal medication for patients with thickened, distorted toenails unless microbiological confirmation of a dermatophyte infection has been obtained
Choosing Wisely Australia
The Australasian College of Dermatologists
50% thickened distorted toenails are caused by pressure from footwear (onychogryphosis) or other trauma, disorders such as psoriasis, lichen planus, or congenital pachyonychia, and are not due to fungal nail infection.
ver más ... 2016Do not investigate episodes of acute urticaria of less than 6 weeks duration unless the clinical history or examination reveals a likely infective, inflammatory or neoplastic trigger or swelling and ...
Choosing Wisely Australia
The Australasian College of Dermatologists
The causes of acute urticaria are many and are rarely identified by blood investigations. The individual weals of acute urticaria and angioedema can be widespread and variable in appearance, resolving in 24 hours leaving normal skin.
ver más ... 2016Do not routinely prescribe antibiotics for inflamed epidermal cysts of the skin evaluated in the first 3-4 days of appearance unless infection is confirmed microbiologically
Choosing Wisely Australia
The Australasian College of Dermatologists
The initial inflammation with epidermal cysts is secondary to an intense foreign body reaction to the cyst contents leaking into dermis and subcutaneous tissues and will respond to incision and drainage plus/minus intralesional corticosteroids that will reduce the inflammatory response. Bacterial infection is a secondary complication.
ver más ... 2016Do not assume that bilateral redness and swelling of both lower legs is due to infection. Do not prescribe antibiotics unless there is clinical evidence of sepsis or microbiological confirmation of ...
Choosing Wisely Australia
The Australasian College of Dermatologists
Bilateral lower leg cellulitis is very rare. Most commonly the bilateral inflammation is due to underlying skin disease such as venous eczema, dry skin, irritant or allergic contact dermatitis, or lymphoedema. A careful history and physical examination should be undertaken and swabs taken from both legs for microbiology to confirm whether infection is present.
ver más ... 2016Don’t provide ongoing manual therapy for patients with adhesive capsulitis of the shoulder
Choosing Wisely Australia
The Australian Physiotherapy Association
Adhesive capsulitis (also termed frozen shoulder) is a condition characterised by spontaneous onset of pain, progressive restriction of movement of the shoulder and disability that restricts activities of daily living, work and leisure. Most studies indicate that it is a self-limiting condition lasting up to two to three years, although 40% people may experience clinically detectable restriction of movement and disability beyond this time point without significant pain. Well-designed randomised ...
ver más ... 2016