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This girl from Guatemala has #dystrophic-epidermolysis-bullosa and cleanliness is crucial as there is a high risk of infection. The water available to her is untreated and usually contaminated. Her family has no bathroom so she is washed by her mother using a washcloth and pail while sitting on a stool. Her skin is dressed using the dressings donated by AmeriCares. Vaseline or hydrocerin is used to keep the dressings from sticking and pulling off more skin. When the dressing supplies run out, her family use strips of newspaper.

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female late 70's a couple of ulcers on her right lower leg. Has been seeing her practice nurse for regular dressings came to me for weekend dressings to be shown this. Clear breakdown of tissue due to oedema of the legs more so where the dressing was stuck to the skin, on water tablets patient is compliant with advice , in a lot of pain and fed up. Been seeing her practice nurse for a few months trying to clear this up. What would you use? Do? Mepilex dressing has been used and mepitel. No infection present also. Poor lady struggling with this.

14 year boy with no known disease apart from (sever allergy from mosquitoe bites) Has some venous malformation on his right upper and forearm with frequent attacks of thrombophlebitis on it. Excision of this vascular lesion done two weeks ago (biopsy was cavernous hemangioma), in the fourth postoperative day developed a superficial skin lesion on forearm away from site of surgery but on the same line of incision started as ulceration then sloughing of skin, no venous or arterial compromisation no contact allergy to dressing plaster or antiseptic or any medications used. No obvious explanation was found it appeared just like second degree burns and treated as that, respond well to topical but last for ten days. Recently a new similar skin lesion appears same appearance same direction and same story (obvious on dorsum of wrist). Any explanation for that? Any idea how to manage? Thanks in advance

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pulp skin loss caused by tin can, covered with antiseptic dressing and review organized in 48 hours. What are the options?

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