Chapter 13- Skin

Question 1

Why is urea used with other topical ingredients

Answer 1

To enhance penetration of the skin

Question 2

Caution with paraffin based products - why?

Answer 2

Flammable!

Question 3

A mild corticosteroid (0.5-1%) can be used in nappy rash for how long

Answer 3

No more than a week

Question 4

Topical skin products should be applied in the direction of hair growth - why?

Answer 4

To reduce risk of folliculitis

Question 5

What topical product is used for MRSA

Answer 5

Chlorhexidine scrub and mupirocin

Question 6

What can be used for acute impetigo

Answer 6

Short term application of fusidic acid

Question 7

Oral antibiotic good for skin infections and why?

Answer 7

Flucloxacillin Good penetration into skin

Question 8

Mupiricin and fusidic acid should not be used for longer than what and why

Answer 8

10 days risk of if resistance

Question 9

What’s used in the treatment of infected burns

Answer 9

Silver sulfadiazine

Question 10

To prevent relapse - local antifungal treatment is continued for how long after the disappearance of infection

Answer 10

1-2 weeks

Question 11

Name three treatment options for scabies

Answer 11

Permethrin Malathion Benzyl benzoate (less effective)

Question 12

How do you use dimeticone for headlice

Answer 12

8-12 hrs repeat after 7 days

Question 13

Malathion used for headlice has problems with what?

Answer 13

Resistance

Question 14

What’s the wet combing method of headlice removal

Answer 14

Plastic detection comb Over 30 mins 4 days intervals For minimum of 2 weeks Continue until no lice found on 3 consecutive occasions

Question 15

What’s used to treat crab lice

Answer 15

Permethrin Malathion

Question 16

Psoriasis can be provoked or exacerbated by what drugs

Answer 16

Lithium Chloroquine Hydroxychloroquine Beta blockers NSAIDs ACEI

Question 17

Emollients in addition to their effects on dryness, scaling and crackling have what additional effect in psoriasis

Answer 17

Anti-proliferative

Question 18

More specific topical treatment for chronic stable plaque psoriasis on extensor surfaces of trunk and limbs involved the use of vitamin D analogues - name three

Answer 18

Coal tar Dithranol Retinoid tazarotene

Question 19

First line treatment for scalp psoriasis

Answer 19

Tar based shampoo

Question 20

Second line treatment for scalp psoriasis

Answer 20

Keratolytic such as salicylic acid

Question 21

The keratolytic effect of salicylic acid does what to the absorption of topical corticosteroids

Answer 21

Facilitates it

Question 22

OTC advice with hydrocortisone cream

Answer 22

Can be sold for allergic contact dermatitis, irritant dermatitis, insect bite, mild to moderate eczema in patients over 10 to be applied sparingly for OD/BD for max 1 week (should not be sold to children under 10, pregnancy, or for application to:face, anogenital region, broken/infected skin)

Question 23

Canestan HC (clotrimazole + hydrocortisone) can be sold OTC when?

Answer 23

15g tube for athletes foot and fungal infection of skin folds with associated inflammation in patients 10years and over

Question 24

A 15g tube of hydrocortisone with miconazole is on sale OTC for what

Answer 24

Treatment of athletes foot and candida intertrigo

Question 25

What can be used for hyperhidrosis (perspiration)

Answer 25

Aluminium chloride hexahydrate Oxybutinin Botox

Question 26

List systemic diseases that can cause pruritus

Answer 26

Obstructive jaundice

Endocrine disease

Chronic renal disease

Iron deficiency

Malignant diseases

Question 27

What can be used to relieve pruritus

Answer 27

Levomenthol cream Crotamiton preps Calamine (ineffective) Doxepine 5% (used in eczema but drowsiness and sensitisation risk)

Question 28

Pruritus is common is biliary obstruction especially in primary biliary cirrhosis and drug induced cholestasis - what’s the drug of choice in this case?

Answer 28

Oral administration of colestyramine

Question 29

Treatment of choice in insect bites or stings

Answer 29

Short course topical corticosteroids +- sedating antihistamine

Question 30

Topical antihistamines should be avoided in eczema and are not recommended for longer than what

Answer 30

3days

Question 31

Name a hormone oral preparation used for acne that’s used in women only

Answer 31

Co-cyprindiol (cyproterone acetate with ethinylestradiol)

Question 32

Treatment for mild to moderate acne

Answer 32

Benzoyl peroxide or topical retinoid

Question 33

Oral antibacterial for acne

Answer 33

Oxytetracyclin Tetracycline Doxycycline Lymecycline

Question 34

Minocycline is as effective as other tetracyclines for use in acne but is associated with what

Answer 34

Greater risk of lupus erythematosus like syndrome and can cause irriversible pigmentation

Question 35

Side effects of isotretinoin

Answer 35

Dryness of skin Dryness of mucous membranes Nose bleeds Joint pain Teratogenic

Question 36

Side effects/ further information with isotretinoin

Answer 36

Risk of pancreatitis if triglycerides >9mmol/litre Psychiatric side effects Visual disturbances Skin peeling

Question 37

Treatment options for mild seborrhoeic dermatitis

Answer 37

Shampoos containing antimicrobials agents such as pyrithione zinc and selenium Ketoconazole Corticosteroid gels

Question 38

Cradle cap can be treated with what

Answer 38

Coconut oil Olive oil

Question 39

Hirsutism may result from hormonal disorders or as side effects of drugs such as..

Answer 39

Minoxidil Corticosteroids Anabolic steroid Androgens Danazol progestogens

Question 40

Treatment of androgenetic alopecia

Answer 40

Finasteride Topical minoxidil

Question 42

What skin condition is this and how to treat it?

Answer 42

ACNE:

The sebaceous (oil-producing) glands of people who get acne are particularly sensitive to normal blood levels of certain hormones, which are present in both men and women. These cause the glands to produce an excess of oil (bacteria multiply here). At the same time, the dead skin cells lining the pores are not shed properly and clog up the follicles.

Question 44

what is folliculitis?

Answer 44

when hair follicules are damaged and invaded by pathogens and bacteria

Question 45

what is this? and treatment

Answer 45

Hives. Rasied, itchy and red rash caused by contact with an allergen. antibiotics can cause it, and allergic reaction to drugs.

Treatment might be an epipen depending on severity. Alternatively, treatment might also be Antihistamines.

Question 46

dose of epipen to give in anaphylaxis?

Answer 46

under 6 years: 150 mcg

6-12 years: 300 mcg (and pre-pubescent kids)

pubescent 12 - 18 and adults 500 mcg.

Every 5 minutes