Extensive Epidermal Skin Loss Secondary to HSV Type One: Neonatal Management Challenges.

We describe a rare case of a preterm neonate presenting at birth with extensive epidermal skin loss of over 90% due to disseminated herpes simplex virus type one infection. Differential diagnosis included aplasia cutis and epidermolysis bullosa. Serum PCR and mouth swabs confirmed HSV type one, and the patient required three weeks of treatment with intravenous aciclovir, followed by oral aciclovir. We describe the management challenges and give practical solutions applicable to the care of a neonate presenting with widespread skin loss due to any aetiology.

Are blood pressure levels taken during a secondary care diabetic clinic likely to be higher than when measured in primary care?

Blood pressure management guidelines are widely available. Our aim was to examine differences in blood pressure on the same subjects in primary and secondary care. We identified 661 diabetic subjects with measurements with the aid of the SAIL databank. Blood pressure in primary care was significantly lower than secondary care.