2156 Eye & Skin Flashcards
Lantanoprost ADRs (4)
- Conjunctival hyperaemia (redness of eyes)
- brown discoloration of iris
- lower eyelid pigmentation
- lengthening of eyelashes
Timolol eyedrop CI (1)
asthma
Red flag to refer for eye conditions (6)
- Pain or intense inflammation
- reduced visual acuity / blurred
- Photophobia
- N/V or halo around light (acute angle glaucoma)
- Unilateral (infection)
- contact lens use
DED differential question (1)
Dry mouth or enlarged glands? (Sjogren syndrome)
Infectious conjunctivitis differential question (4)
- Red eye with pus and sticky discharge? (bacterial)
- Swollen lymph node? (chlamydial)
- Unilateral?
- Contact lens?
AMD differential question (1)
Sudden dark spot in your central vision? (wet AMD –> refer)
TOP corticosteroids use ADR (3)
- Withdrawal Sx (erythema, burning, pruritus, stinging)
- telangiectasias (“spider veins”)
- Skin thinning, red stretch marks
TOP corticosteroids use to avoid (2)
- Avoid using long term < 2–4 weeks
- Avoid applying high intensity TCS on the face
Steroid strength order
hydrocortisone < Desonide < betamethasone Valerate / Mometasone Furoate
TOP Tacrolimus CI (2)
Long term use a/w (black box)
1. Lymphoma
2. Skin cancer
PO Steroids use ADR (6)
- osteoperosis
- Glaucoma
- Hyperglycemia
- Tachyphylaxis
- adrenal suppression
- eczema flares on discontinuation
TOP Benzoyl Peroxide ADR (2) + administration (1)
- dryness & peeling
- Erythema & burning
Admin: put with sunsreen
TOP Adapalene ADR (3)
- Dryness, erythema, irritation
- Photosensitivity –> use sunscreen
- worsen initially –> 6-8 weeks for improvement
TOP Tretinoin DDI (1) & CI (1)
DDI: benzoyl peroxide use OM, tretinoin use ON
CI: pregnancy
TOP Clindamycin use (2)
- Best in combi with benzoyl peroxide
- Only use in pregnancy when necessary
PO Abx choice for acne (2) + duration
- Doxycycline 50mg BD / 100 mg OD
- Macrolides
Shortest duration (< 12 months)
PO Isotretinoin CI (4)
- Hepatic / renal insufficiency
- Lipid level very high
- Pregnancy / breastfeeding (negative pregnancy test mandated)
- Tetracycline
TOP Imidazoles for fungal infection use (2)
- continue 1-2 weeks after symptoms resolution
- takes 4-6 weeks to heal
TOP Amorolfine (nail lacquer) administration (2)
- apply 1-2x a week
- takes 6 months for fingernail, 9-12 months for toenails
TOP Acyclovir administration (3)
- Apply thin later 5x/day for 5-10d
- do not cover cold sore with bandage / dressing
- dab instead of rub to minimise blister spreading
TOP Vitamin D analogs (calcipotriol / calcitriol) use (2)
- Combine with TCS as maintenance
- avoid use with salicylic acid
SC IL-23 Inhibitors (Guselkumab) ADR (2)
- increased risk of infection (URTI)
- Hypersensitivity (injection site)
SC IL-17 inhibitors (Ixekizumab) ADR (2)
- Increased risk of infection (candidal infection)
- Increased risk of IBD exacerbation
Systemic therapies for psoriasis (6)
- IL-23 inhibitors (Guselkumab)
- IL-17 inhibitors (Ixekizumab)
- IL-12/23 inhibitors (Ustekinumab)
- TNF-a inhibitors (infliximab)
- PDE4 inhibitor (Apremilast)
- TKI2 inhibitors (Deucravacitinib)
Skin red flags questions (6)
- involvement of unusual areas (face, genitalia, scalp, eyebrows, eyelashes)
- Extensive area, seriously inflamed, excess exudate
- DM / immunocompromised
- Recurrent / no improvement / worsening condition
- young children < 2 yo
- secondary infection (bacterial / viral)
