C7 SKIN DISORDERS Flashcards
what is eczema?
inflammatory aka dermatitis
symptoms of inflammation
redness, swelling, itch, pain, heat
what is atopic eczema?
chronic, pruritic (itchy) inflammatory skin disease
high to low potency
clobetasol
betamethasone
mometasone
desonide
hydrocortisone
what is the max supply for betamethasone & mometasone?
15g for cream/ointment/gel
or
30ml for topical solution
what is contact dermatitis?
itchy rash caused by direct contact with allergen or irritant
what is seborrheic dermatitis?
skin condition that mainly affects your scalp
SS: yellow, greasy scales over eczematous-like lesion
should we apply topical corticosteroids or emollients first?
preference: emollients before TC -> space 10 to 15 mins apart -> or can be the other way
indication of emollients
dry and scaling SD
-> more oily preparations retain moisture better in the skin
less to more oily
aqueous cream/aqurea cream - soften keratin layer & hydrates skin, helps in steroid penetration
white soft paraffin (oily) - moisturizer
emulsifying ointment (wax like texture) - moisturizer, soap substitute
emollient CP
- applied immediately after washing/bathing to maximize effect of skin hydration
- removed with clean spoon/spatula to reduce contamination
- keep away from flames
applied liberally to affected area. aqurea cream -> apply 2-3 times daily
indication: coal tar
relieve itching & inflammation in psoriasis & eczema
CP of coal tar
- sometimes cause skin irritation, photosensitivity, acne breakouts
- may stain skin, hair, clothes or bedding & has a strong smell
oral medications
oral histamines - hydroxyzine (for severe itch), chlorpheniramine, cetirizine given for short period of time
oral steroids may be used short term to control severe flare
oral immunosuppressant
hydroxyzine info
indi: pruritus
dose: 10-25mg TDS-QDS (usually prescribed for bedtime)
SE: dw
eczema: non-pharm advice
moisturizer/emollient is essential for tx & helps to prevent symptoms
what is tinea?
caused by fungi aka ringworm infection
types of tinea
tinea corporis = circular shape, redness
tinea versicolor (white spot) = scaly rash that appears white, pink or brown patches
what are the imidazole antifungals?
ketoconazole
miconazole
clotrimazole
fluconazole (oral only)
how to prevent relapse of tinea?
topical antifungal tx should be continued for 1-2 weeks after disappearance of all signs of infection
indi of ketoconazole?
seborrheic dermatitis, dandruff & vinea versicolor
tx & prevention of ketoconazole?
for tinea versicolor: OD 5/7, OD for 3 days before sun exposure
dosing for clotrimazole?
1% cream/lotion/powder: BD (maybe used up to TDS)
CP: topical antifungals
- may cause local irritation, dermatitis or a burning sensation -> tx should be discontinued if SE are severe
- compliance is important -> continue applying for 1-2 weeks after disappearance of all signs of infection
fluconazole: indi, dose, SE
- tinea corporis & versicolor
- max 6 weeks orally 50mg OD
- abdominal discomfort, d, flatulence, hd, n, rash (discontinue if occurs)
tinea: non-pharm advice
- do not share towels etc
- while infected, use separate fresh towel to dry infected area
- wash socks etc in hot water to prevent re-infection
- check fam animals
- wear sandals around showers & pools
- allow sweaty shoes to dry out b4 wearing again
- wash & dry skin after physical activity or if sweaty
what is acne?
chronic or recurrent development of papules… aka acne vulgaris
acne: summary
topical keratolytic agent: benzoyl peroxide
topical antibiotics: clindamycin
topical retinoid: adapalene
oral antibiotics: doxycycline, minocycline & erythromycin
oral retinoid: isotretinoin
example of contra in acne?
oral antibiotic + oral retinoid (isotretinoin)
acne: mild
topical benzoyl peroxide / topical retinoid (adapalene) / topical combi therapy
topical combi therapy
- BP + antibio
- BP + retinoid
- all 3
acne: moderate
topical combi
or
oral antibio + topical (BP + R OR + ANTI)
acne: severe
oral anti + topical combi
or
oral retinoid -> isotretinoin
benzoyl peroxide: indi, dose, SE
mild acne vulgaris
OD-BD
skin irritation
CP: BP / clindamycin
common SE at start of tx -> consult Dr immediately if do not go away or severe
- mild stinging or burning sensation
- dryness & peeling of skin -> apply moisturizers after applying med
what does adapalene do?
reduce inflammation & unclog blocked pores -> applied to whole face
adapalene: indi, dose,
mild to moderate acne vulgaris, OD -> thinly in evening
adapalene: CP
- apply thinly to affected area OD, preferably at night
- CSE: dryness & skin irritation
- avoid exposure to UV light
- may worsen acne initially & takes 6-8 weeks
- avoid accumulation in angles of nose
macrolides: CP
- GI upset
- complete course
tetracyclines: CP
- avoid lying down for at least 30mins after ingestion -> drink water to avoid irritation
- avoid exposure to sunlight
- space apart from antacid
- complete course
isotretinoin: indi, dose, SE
severe acne
max 150mg/kg per course daily
anaemia, dry eyes…
isotretinoin: CP
- do not take vitamin A supplements
- teratogenic = women of child-bearing age should avoid unless use 2 contraceptive methods
- dry eyes / lips / nasal mucosa / skin -> apply moisturising cream etc to relieve or discontinue if skin peeling is severe or d develops
- avoid blood donation (can for at least 1 month after)
- avoid skin resurfacing producers (laser etc)
acne: non-pharm advice
keep face clean, moisturize, use makeup sparingly, keep hands off face stay out of sun, relax
