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OTC > atopic dermatitis, dry skin, contact dermatitis > Flashcards

atopic dermatitis, dry skin, contact dermatitis Flashcards

1
Q

atopic dermatitis definition

A

chronic, relapsing, skin disorder characterized by redness and inflammation caused by an exaggerated reactivity from environmental stimuli +/- genetic component

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2
Q

atopic triad

A

atopic dermatitis, asthma, allergic rhinitis

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3
Q

epidemiology of AD

A
  • most common dermatologic condition in children

- more common in males, Caucasians, in urban areas, and occurs in higher socioeconomic classes

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4
Q

signs and symptoms of AD

A

intense itching, vesicles and papules, chapping, redness, crusting and dry skin

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5
Q

2 months

location and signs of AD

A

location: chest and face
signs: red, raised vesicles, dry skin, oozing

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6
Q

2 years

location and signs of AD

A

location: scalp, neck, and extensor surface of extremities
signs: less acute lesions, edema, erythema

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7
Q

2-4 years

location and signs of AD

A

location: neck, wrist, elbow, knee
signs: dry and thickened plaques, hyperpigmentation

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8
Q

12-20 years

location and signs of AD

A

location: flexors, hands
signs: dry and thickened plaques, hyperpigmentation

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9
Q

xerosis common in

A

elderly population

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10
Q

xerosis is result

A

of decreased water content of the skin

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11
Q

exclusions for self treatment of atopic dermatitis and xerosis

A
  1. moderate - severe conditions with intense pruritus
  2. involvement of large area of body
  3. <1 year of age
  4. possible skin infection
  5. involvement of face or intertriginous areas
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12
Q

goals of therapy for atopic dermatitis and xerosis

A
  1. stop the itch/scratch cycle
  2. maintain skin hydration
  3. avoid or minimize aggravating factors
  4. prevent secondary infections
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13
Q

how to maintain skin hydration

A

drink plenty of water, avoid dehydration with improper bathing

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14
Q

soaps for AD and xerosis

A
  • use glycerin bars, non soap cleansers, bath oils

- bath oil in bathwater is very good for xerosis

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15
Q

use of emollients in AD and xerosis

A

applied within three minutes of bathing and reapplied 3-4x daily prn

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16
Q

emollient examples

A
  • petroleum emollients

- lubricating ointments

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17
Q

non pharm treatment for AD and xerosis

A
  • drink plenty of water
  • use humidifiers to maintain room hydration
  • use cold compresses for wet oozing or crusty vehicles
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18
Q

cold compress examples

A

isotonic saline solution or wet cold compresses using tap water for 15-20 minutes at a time 4-6 times daily

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19
Q

avoid or minimize aggravating factors of AD or xerosis

A
  1. avoid irritating or tight clothing; cotton is recommended
  2. follow proper bathing techniques
  3. use of hypoallergenic cleansers
  4. use detergents and cosmetics without perfumes or fragrances
  5. avoid fabric softeners
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20
Q

AD pharm treatment

A

no cure, controlling symptoms

  • hydrocortisone cream or ointment
  • topical anesthetics
  • antihistamines
  • astringent compresses
  • topical antibiotics
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21
Q

hydrocortisone application

A

apply sparingly 1-2 times daily with intermittent courses of therapy

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22
Q

do not use hydrocortisone longer than

A

7 days

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23
Q

hydrocortisone can be used on

A

neck, face, axillae, and groin (do not apply to > 20% BSA)

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24
Q

avoid hydrocortisone if

A
  • oozing / weeping lesion or open / cracked skin

- not for children < 2 y/o

25
Q

topical anesthetics moa

A

block conduction along the axonal membranes that carry sensation of itching and pain to the CNS

26
Q

applying topical anesthetics

A

apply sparingly, 3-4x a day for up to 7 days

27
Q

avoid topical anesthetics if

A

skin is raw, blistered, or on large surface areas

28
Q

do not take topical antihistamines longer than

A

7 days, they are sensitizers and can make AD worse

29
Q

astringent compress examples

A
  • aluminum acetate (burrow’s solution) diluted 1:40 with water
  • witch hazel
30
Q

topical antibiotic examples

A

polysporin or Neosporin

31
Q

xerosis pharm treatment

A
  • moisturizers w urea or lactic acid
  • aluminum lactate 12% lotion
  • hydrocortisone
32
Q

irritant contact dermatitis

A

direct tissue damage by irritant; usually results from occupational exposure to chemicals or solvents

33
Q

first and second likely cause of ICD

A
  1. occupation exposure

2. diaper rash

34
Q

ICD generally appears

A

after single exposure

35
Q

ICD usually seen on

A

hands, face, forearms

36
Q

signs/symptoms of ICD

A

red, inflamed, swollen skin; dry, macerated, or cracked skin; +/- vesicles or papule formation and/or peeling or sloughing of skin; painful, burning or stinging

37
Q

goals of treatment for ICD

A

remove offending agent, prevent future exposure, relieve inflammation/irritation, and patient education

38
Q

non pharm treatment of ICD

A
  • avoid irritant and use protective clothing (if irritant cant be avoided use barrier creams)
  • immediately wash exposed area
  • apply emollients liberally or cold compresses
39
Q

pharm treatment of ICD

A
  • liberal application of emollients

- colloidal oatmeal baths

40
Q

avoid use of ____ in ICD

A

topical -caine anesthetics

41
Q

allergic contact dermatitis (ACD)

A

immunologic reaction of the skin caused by exposure to an antigen

42
Q

ACD is a _____ reaction

A

delayed; typically does not appear on first contact

43
Q

induction phase of ACD

A

usually no rash forms after initial exposure; immune system is sensitized to the antigen

44
Q

second exposure in ACD

A

patient has type IV hypersensitivity reaction and release t-cells to fight antigen –> rash

45
Q

ACD most commonly caused by

A

urushiol (poison ivy/oak), nickel, and latex

46
Q

signs and symptoms of ACD

A

rash develops only in area where skin was exposed; intense pruritus, erythema, vesical formation; rash typically clears in 10-21 days

47
Q

only FDA approved barrier product for prevention of ACD

A

ivyblock lotion

  • needs to be applied 15 minutes prior to exposure and every 4 hours
  • avoid in children < 6 years
48
Q

prevention of ACD

A
  • wear protective clothing

- wash all previously exposed clothing with detergent and hot water

49
Q

goals of treatment in ACD

A

remove offending agent, treat inflammation / irritation, relieve itching/scratching

50
Q

non pharm treatment of ACD

A
  • wash exposed area (within 10 min of exposure)

- use approved soap/wash

51
Q

approved washes for non pharm treatment of ACD

A

tecnu and zanfel

52
Q

tecnu

A
  • contains mineral spirits, water, soap, surface active ingredient
  • no more effective than soap
  • rub into affected area ASAP for at least two minutes
53
Q

zanfel

A
  • polyethylene granules, surfactant, etc.
  • marked to bind and remove urushiol from new or old rashes
  • expensive
54
Q

pharm treatment of ACD

A
  • hydrocortisone cream (2-4 times daily for up to 7 days)

- oral antihistamines

55
Q

avoid ____ use in ACD

A

topical products containing anesthetics, antihistamines, and antibiotics (can cause drug induced ACD)

56
Q

if ACD has nonweeping/oozing lesions

A

calamine lotions

57
Q

if ACD has weeping/oozing lesions

A

consider astringent solutions to dry, soothe pruritus, or loosen exudate

58
Q

exclusions for self treatment of ICD and ACD

A
  1. patients < 2y/o
  2. dermatitis present > 2 weeks
  3. involvement of > 20% BSA
  4. presence of numerous large blisters
  5. extreme itching, irritation, or severe vesicle and blister formation
  6. swelling of the body or extremities
  7. swollen eyes or eyelids swollen shut
  8. discomfort in genitalia from itching, redness, swelling, or irritation
  9. involvement and/or itching of mucous membranes of the mouth, eyes, nose, or anus
  10. signs of infection
  11. symptoms worsen
  12. low tolerance for pain, itching, or symptom discomfort
  13. impairment of daily activities

OTC (22 decks)

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