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ITCH WITH LOCALISED RASHSlow growing ring-like patch/patchesScaling moist lesions between toesand on soles of feetItchy rash on back of neckWell demarcated pink raised plaquescovered with a silvery scale.Ringworm likelyA clearly-demarcated active, scaly or blisteringedge is characteristic. If multiple or large lesions,test for HIV 60.• Give clotrimazole cream twice a day for 2weeks after lesion has cleared.• Advise patient to avoid sharing towels/clothes.• Give routine HIV care to the HIV patient 61.• Refer if rash is extensive, recurrent or respondspoorly to clotrimazole cream.Athlete’s foot likely• Give clotrimazole cream twice a dayfor 2 weeks after lesion has cleared.• Advise patient to wash and dry feetwell.• Encourage open shoes/sandals.Lice likelyLook for nits/eggs on hair.• Dip comb in vinegar and fine combthe hair.• Give permethrin 1% cream rinse:apply after washing and rinse after10 minutes or benzyl benzoate: applyto scalp overnight and wash off inmorning.• Repeat after 1 week if necessary.Psoriasis likelyConfirm diagnosis with doctor• Apply emulsifying ointment.• Expose skin to sunlight.• Apply LPC cream daily.• Refer if extensive or not respondingor LPC cream unavailable.ITCH WITH NO RASH• Confirm there is no rash, especially scabies or insect bites.• Is the skin very dry?NoReview patient’s medication.YesDry skin/ichthyosis likelyAll TB drugs can cause itch with no rash.• Continue TB treatment.• Chlorpheniramine 4mg at night, or upto 8 hourly, for up to 5 days (may causesedation).• Advise patient to return if rash developsor if no better after 5 days.• If not on any medication, refer forassessment of underlying cause.• Use emulsifying ointment, petroleum jelly or aqueous cream as moisturiser.• Use aqueous cream instead of soap to wash.42TB HIV CHRONIC RESPIRATORYDISEASECHRONIC DISEASESOF LIFESTYLEMENTAL HEALTH EPILEPSY MUSCULOSKELETALDISORDERSWOMEN'S HEALTH