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transitory exanthema Miscellaneous: Feeling of swelling of entire body B-12 Compliance Injection Dosage and Administration Avoid using the intravenous route

Prescription and administration: Once B12 deficiency is confirmed, GPs prescribe hydroxocobalamin injections according to standardised protocols: Standard loading regimen: 1mg intramuscularly three times weekly for two weeks Neurological involvement: 1mg intramuscularly on alternate days until no further improvement Maintenance therapy: 1mg every three months for life in pernicious anaemia or malabsorption conditions (or every two months if there was neurological involvement) Injections are typically administered by practice nurses at GP surgeries

Rapidly progressive symptoms accompanied by weight loss are concerning for esophageal cancer, although patients with secondary causes of achalasia (which may also include malignancy) can present similarly

Corticosteroids are associated with tendon weakening and rupture, transient hypoglycaemia, lipoatrophy and fat necrosis