Resources

Acroangiodermatitis (AAD), or Pseudo-Kaposi sarcoma (PKS), is a rare, benign skin condition, which can be seen by community nurses or in lymphoedema clinics, as it occurs in patients with lower limb oedema, chronic venous insufficiency (CVI), varicose vein removal, paralysis, congenital arteriovenous malformations (such as Klippel-Trenaunay and Parkes-Weber syndromes), or iatrogenic malformations caused by renal dialysis shunts or prosthetic suction limbs. AAD should be diagnosed by biopsy and differentiated from Kaposi sarcoma (KS), a rare malignancy with a similar presentation,
which is possible through histological differences. However, as said, the two conditions do present similarly, especially in the case of homosexual/bisexual men or human immunodeficiency virus (HIV) positive patients, as even with restored immune systems and an undetectable viral load, they are 30 times more likely to contract KS, which is malignant, than the general population. This article presents a clinical case, which is contrasted with past international case studies to portray a collective overview of AAD/PKS, and how to manage it effectively from the sparse literature available.

Cavity wounds present unique challenges in both assessment and management due to their complex anatomy and potential for complications such as tunnelling, undermining, and infection. Accurate documentation and thorough evaluation are critical for monitoring wound progression and guiding appropriate interventions. This article explores best practices for assessing and managing cavity wounds. Strategies for managing these wounds are discussed, emphasising the importance of maintaining a moist wound environment, preventing infection, and promoting granulation tissue formation. Multidisciplinary approaches, evidence-based techniques, and patient-centred care are highlighted as essential components in achieving optimal outcomes for patients with cavity wounds.

This article, the first in a two-part series, introduces and discusses the importance of movement and gait on the lower extremity in relation to chronic venous insufficiency (CVI) and chronic oedema (CO). It outlines and highlights the importance of the venous and lymphatic systems and their influence on how fluid is moved from the periphery into the trunk. The article introduces and explores the role of important anatomical systems like the veno-muscular pumps within the lower extremity, and how underlying  musculoskeletal (MSK) issues that affect movement and walking can influence
the onset, chronicity, and severity of CVI and CO. It also touches on how fluid is moved from the lower extremity into the trunk. Finally, the importance of compression and its benefits are explained through key scientific principles and the vital role that it plays in
fluid movement from the periphery into the trunk. The second part of the series will focus on how movement, orthotics and footwear can complement compression and their role in reducing peripheral oedema, improving gait and managing pain in the foot and ankle.

an abnormal build-up of fat and connective tissue in the legs, thighs, buttocks, and sometimes the arms (Wounds UK, 2017). Due to lack of understanding and no definitive diagnostic test, the condition is often confused with conditions such as lymphoedema or obesity (Child et al, 2010). This paper presents the findings of two surveys — a patient and healthcare professional one — undertaken by Daylong Direct in association with Lipoedema UK and this journal. The former explored the multifaceted challenges faced by individuals
living with lipoedema, including diagnostic delays, treatment gaps, emotional impact, and unmet healthcare needs, while the latter captured data on healthcare professionals’ awareness and knowledge of lipoedema and treatments available, highlighting the need for more education to improve patient care. The survey results provide valuable insights for improving clinical practice and patient support.

Here, Dr Anne Holdoway, malnutrition pathway clinical director and consultant dietitian, looks at a recently launched online resource, ‘A Guide to Managing Frailty, Sarcopenia and Malnutrition’, to help healthcare professionals in managing the overlapping syndromes of frailty, sarcopenia and malnutrition, which are often wrongly considered to be an inevitable part of ageing. This new resource outlines considerations for protein consumption while also highlighting the importance of exercise to enhance muscle synthesis and strength. In addition, other areas of consideration include vitamin D supplementation, hydration, medicines management, social support, cognitive function, comorbidity optimisation, and falls and fragility fracture prevention.

Welcome to the final issue of the Journal of Community Nursing for 2024. How quickly has this year gone? As always, please take some time to reflect on all your achievements this year, as well as anything that hasn’t gone too well. Reflection is an excellent tool for learning and is something that many of us do constantly as it really does support our ongoing development. Take some time to make plans for 2025 and aim to achieve those goals.

One of the cornerstones of nursing practice is teamwork. Academics and practice guidelines never tire of reminding nurses of the importance of effective communication skills, multidisciplinary working and group reflection. And that’s without the regular social activities that go handin-hand with working in a busy healthcare team — birthday drinks,
leaving dos and retirement parties.

Most nurses working in primary care settings will assess, treat and manage patients with a wide range of chronic wounds and skin conditions (Armstrong, 2017). Venous leg ulceration is extremely common; however, it is thought that around only 53% of patients heal fully within one year (Guest et al, 2018). This represents a significant number of patients and a large proportion of nursing time. Patients often experience skin disorders because of chronic venous insufficiency (CVI), and to improve outcomes there is a need not only to heal the ulceration, but also to manage the whole limb in respect of dermatological issues, such as wet, itchy varicose eczema, hyperkeratosis, dermatitis and fungal infection, to name a few.

New guidance, produced as the result of a 15-month project funded by the Burdett Trust
for Nursing during 2023 and 2024, has been published by the Queen’s Nursing Institute (QNI) to improve the care of people experiencing homelessness with diabetes. 

People experiencing homelessness with diabetes face multiple challenges and are known to have poor health outcomes. They are at much higher risk of serious complications or death because of their condition, partly due to daily challenges of accessing healthy food and adequate care.

The British Dermatological Nursing Group (BDNG) recently hosted a successful in person event in central London focusing on four main hot topics, including: an update on  dermatology in primary care, menopause and the skin, research and patch testing.