We report nine travellers with confirmed chikungunya virus infection, returning from tourist areas of Thailand to Sweden, Switzerland, the United Kingdom, Romania, Israel and France, diagnosed in January and February 2019. These sentinel tourists support the intensification of chikungunya virus circulation in Thailand and highlight the potential for importation to areas at risk of local transmission.

Cutaneous toxicities associated with BRAF inhibitor treatment in patients with metastatic melanoma have been well described. We present a rare association of granulomatous dermatitis in association with the BRAF inhibitor vemurafenib. Three patients with metastatic melanoma all presented with asymptomatic papular eruptions 8–21 months into vemurafenib therapy. Skin biopsies confirmed the diagnosis of granulomatous dermatitis. Other causes of granulomatous dermatitis including infectious agents and sarcoid were excluded. Treatment with potent topical and oral steroids improved the eruptions, but only after the cessation of vemurafenib did all 3 cases of granulomatous dermatitis completely resolve within 2 weeks. It is important to recognize that this association, unlike most other BRAF inhibitor–related skin toxicities, can occur many months after commencement of therapy and that vemurafenib treatment can be continued without clinically significant adverse effects.

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GPs conduct approximately 13 000 000 consultations relating to skin conditions on an annual basis. The majority of chronic skin disease can be supervised in the primary care setting, however, high rates of morbidity and mortality are associated with a proportion of presentations, for which early diagnosis and prompt referral to a specialist dermatology service is required. Despite this, dermatology remains a relatively low priority in undergraduate and postgraduate medical training, leaving many GP trainees with limited exposure. We will highlight key clinical signs and construct a basic algorithm to help trainees structure their approach when managing these patients.