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PAINFUL SKINFirm, red lump which softens in the centre todischarge pus.Sudden onset sharply demarcatedredness of skin.Blisters with crusting in a band along one side of the bodyor face for 3 days or less.Boil/abscess likelySkin is swollen, red, hot and tender to the touch.Cellulitis likelyThere may be blistering.Shingles likelyIf status is unknown test for HIV 60• Advise patient to wash with soap and water, keepnails short, and avoid sharing clothing or towels.• Give paracetamol 1g 6 hourly for pain relief asneeded.• Incise and drain if larger or fluctuant. Refer if on faceor perianal region.• If enlarged lymph nodes or temperature ≥ 38ºC, giveflucloxacillin 500mg 6 hourly for 5 days. If penicillinallergic, give erythromycin 500mg 6 hourly for 5 days.• If recurrent boils: test for HIV 60 and diabetes 70.Wash body daily for 1 week with antiseptic wash.• Give paracetamol 1g 6 hourly for pain relief.• Give flucloxacillin 500mg 6 hourly for 5 days. Ifpenicillin allergic, give erythromycin 500mg 6 hourlyfor 5 days.• Refer if symptoms worsen or no better after 4 days.• Treat rash topically with povidone iodine cream.• If blisters are fresh, give aciclovir 800mg 4 hourly(miss the middle of the night dose) for 7 days.• Shingles is very painful. Give regular analgesia:--Paracetamol 1g 6 hourly.--If no response, add tramadol 50mg 4 times a day.--If poor response or pain persists after rash hashealed, give amitriptyline 25mg at night, increaseby 25mg every 2 weeks if needed to 75mg.• If infected, add flucloxacillin 500mg 6 hourly for 5days. If penicillin allergic, give erythromycin 500mg 6hourly for 5 days.• A stage 2 HIV diagnosis. HIV patient needsroutine HIV care 61.• Refer same day if:--Eye involvement--Features of meningitis--Blisters elsewhere on the body41