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Empowering advanced clinical practitioners in managing acute dermatological emergencies

23 May 2024
Volume 33 · Issue 10


Advanced clinical practitioners (ACPs) encounter patients with acute dermatological presentations ranging from minor to life-threatening conditions in both primary and secondary care settings. However, ACPs often feel unprepared to assess and treat patients with dermatological emergencies. This article aims to provide guidance to trainee and qualified ACPs, whether in acute hospital settings or primary care, in understanding the essential aspects to consider when consulting with patients presenting with acute dermatological emergencies. It also emphasises appropriate referrals to relevant specialties for necessary inpatient or outpatient investigations and ensure prompt treatment.

In recent decades, the role of advanced clinical practitioners (ACPs) has emerged as a crucial component in alleviating the pressure on healthcare systems (Kuczawski et al, 2024). ACPs, unless specialised, should have a broad understanding of diverse medical and surgical domains, enabling them to work autonomously and effectively across primary and secondary care settings (Reynolds and Mortimore, 2021). This article aims to equip ACPs working in acute hospital and primary care settings with the knowledge and skills necessary to identify, manage and appropriately refer patients presenting with acute dermatological emergencies. Despite the complexity of this specialty, ACPs who may lack familiarity with acute dermatological conditions can enhance their expertise and contribute to optimal patient care.

Dermatological emergencies may arise due to exacerbation of primary dermatological conditions, systemic diseases, or reactions to external factors, such as medications or infections (Meltan et al, 2024). Severe rashes can compromise skin function and serve as indicators of critical underlying systemic conditions, necessitating prompt intervention and management (Primary Care Dermatology Society, 2024). In clinical practice, acute skin failure represents a critical condition marked by disruptions in thermoregulation, electrolyte homeostasis and protein equilibrium. This results in malnutrition and compromises dermal barrier function, which enables infiltration by infectious pathogens and foreign substances (Levine et al, 2022).

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