Store and forward Teledermatology - the Newport way.

Teledermatology plays a vital role within Aneurin Bevan University Health Board. Alongside Consultant Dermatologists we developed Teledermatology to meet clinical needs. This article illustrates the implementation process of the service, highlighting legal and ethical issues that were considered along with the success and scope of the service. The Teledermatology service rapidly reduced waiting times for patients and increased access to specialist care which is cost effective for the Health Board. Following successful implementation and increased demand, there is the scope for expansion. The service is developing additional Teledermatology clinics within the Health Board, evolving telemedicine.

When fever is more than infection: two cases of vancomycin-induced drug reaction with eosinophilia and systemic symptoms (DRESS).

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, but serious systemic hypersensitivity reaction associated with a range of medications. We present two cases of vancomycin-induced DRESS, which occurred simultaneously in the orthopaedic ward in an outer metropolitan hospital. These cases demonstrate the complexity in the diagnosis and management of this inflammatory syndrome on the background of known infection as well as evidence for linezolid as an alternative to vancomycin. The first case was managed conservatively, but developed progressive renal and liver injury along with demonstrated cytomegalovirus reactivation and recurrent colitis, and was eventually palliated. The second was commenced on intravenous glucocorticoids and achieved remission, although had ongoing renal dysfunction at the time of discharge from outpatient follow-up.