Chapter 39: Common Skin Conditions Flashcards
Drugs That Can Discolor Skin and Secretions: Brown
Entacapone
Levodopa
Methyldopa
Drugs That Can Discolor Skin and Secretions: Brown/Yellow
Nitrofurantoin
Drugs That Can Discolor Skin and Secretions: Orange/Yellow
Sulfasalazine
Drugs That Can Discolor Skin and Secretions: Red-Orange
Phenazopyridine
Drugs That Can Discolor Skin and Secretions: Red
Anthracyclines
Drugs That Can Discolor Skin and Secretions: Blue
Methylene Blue
Mitoxantrone
Drugs That Can Discolor Skin and Secretions: Blue-Gray
Amiodarone
Determinants of Ance
Androgens
Cutibacterium acnes
Fatty acids (sebum) present in oil (sebaceous) glands
OTC Acne Tx
Benzoyl Peroxide
Salacylic Acid
Rx Drug of Choice
Retinoids
must be avoided in pregnancy and breastfeeding
Oral Retinoid
Isotretinoin approved for severe recalcitrant nodular acne only
Cholesterol and pregnancy tests required
Azelaic Acid
Azelex, finacea
OTC and RX for acne and rosacea
Clascoterone
Winlevi
Mild acne in patient >=12 years
topical androgen receptor inhibitor
First Line for Mild Acne
Topical BPO and/or retinoid
First Line for Moderate Acne
Topical combo
or
PO abx + BPO + topical retinoid +/-topical abx
First Line for Severe Acne
Topical combo + po abx
or
PO isotretinoin
PO Isotretinoin Requirements
Female pts must sign informed consent about birth defects
Must have 2 negative pregnancy test before starting
Cannot get pregnant for 1 month before, while taking, or 1 month after stopped
Females must use 2 forms for BC (cannot use progestin only)
Minocycline info
Minocin, Solodyn
Can cause photosensitivity
Fetal harm if administered during pregnancy
Discoloration of teeth if used when teeth are forming
Cold Sores OTC
Abreva (docosanol)
Apply 5x daily at first sign of outbreak until healed
Cold Sore Rx
Acyclovir topical cream or oint
Apply 5x qd for 4 days
Dandruff Tx OTC
Ketoconazole 1% (nizoral ad) Selenium sulfide (selsun) Pyrithione zinc (head and shoulders) Coal tar (t-gel)
Dandruff Rx
Ketoconazole 2% shampoo (nizoral)
Alopecia Rx
Finasteride (propecia)
1mg qd
can take >3 months to see effects
Alopecia Topical
Minoxidil
5% foam, 2% and 5% solution
Hypotrichosis Tx
Thinning eyelashes
Bimatoprost (Latisse)
Do not use with PG analogs for glaucoma (IOP may increase)
Eczema OTC
Aquaphor
Eucerin
Eczema Rx 1st Line
Topical Steroids
Eczema Rx of Steroids Fail
- Topical CNI: tacrolimus (protopic), pimecrolimus (elidel)
- Topical PDE-4 inhibitors: crisaborole (eucrisa)
- MAB IL-4 antagonist: Dupilumab
Tinea Pedis
Athlete’s foot
Tinea Cruris
Jock itch
Tinea Corporis
Ringworm
OTC Antifungals: Terbinafine
Lamisil AT
OTC Antifungals: Butenafine
Lotrimin Ultra
OTC Antifungals: Clotrimazole
Lotrimin AF
OTC Antifungals: Miconazole
Lotrimin AF
OTC Antifungals: Tolnaftate
Tinactin
OTC Antifungals: Undecylenic acid
Toelieva
Rx Antifungals: Betamethasone/Clotrimazole
Lotrisone
Rx Antifungals: Ketoconazole
Extina
Onychomycosis Systemic Tx
Itraconazole and terbinafine
(pulse therapy sometimes used to reduce cost and toxicity)
(20% KOH smear is essential for diagnosis
OTC Topicals for Vaginal Fungal Infections
Clotrimazole
Miconazole (monistat 3)
Rx Topicals for Vaginal Fungal Infections
Butoconazole (gynazole-1)
Terconazole
Rx Oral for Vaginal Fungal Infections
Fluconazole 150mg po once
Hemorrhoids Non-Pharm
Fiber
Witch Hazel
Hemorrhoids OTC and Rx
Phenylephrine (preparation h)
Hydrocortisone (anusol hc)
Pinworm OTC
Pyrantel pamoate
Pinworm Rx
Albendazole (take with a high fat meal to increase absorption)
Mebendazole
Lice OTC Preferred Drugs
Topical pyrethrins (Rid) and permethrin (Nix)
Lice Tx: Ovide
Malathion lotions 0.5%
Can irritate skin and is flammable
Lice Tx: Lindane
No longer recommended due to neurotoxicity and is reserved for refractory cases. Never used in pregnancy
Neosporin
polymixin/bacitracin, neomycin
Bactroban
Mupirocin
Very good staph and strep coverage (including MRSA)
Cortisporin
Bacitracin/neomycin/polymixin b/ hydrocortisone (RX)
Poison Ivy, Oak, and Sumac Tx
Aluminum acetate astringent (drying agent)
Wash off with soap and water
Topical or oral steroids will help (PO needed in severe rash)
Cold compress can help
Very High Potency Steroids
Clobetasol 0.05%
Fluocinonide 1% cream
High Potency Steroids
Betamethasone Dip 0.05% crm
Fluocinonide 0.05% oint
Mometasone furoate 0.1% oint
High-Medium Potency Steroids
Fluocinonide 0.05% crm
Medium Potency Steroids
Mometasone furoate 0.1% crm
Triamcinolone acetonide 0.1% crm
Lowest Potency Steroids
Hydrocortisone 0.5, 1%
Time To Burn Formula
TTB (with sunscreen) = SPF x TTB (without sunscreen)
Sunscreen Labeling
No longer allowed to say “waterproof” or “sweatproof” since they all wash off at least partially in the water
“water-resistant” but only for 40-80 minutes