Contact Dermatitis/ Diaper Dermatitis

Question 1

Irritant contact dermatitis (ICD):

Answer 1

individuals who frequently wash their hands, handle food, and or have repeated contact with irritants: (usually limited to the hands and the forearms

Question 2

Irritant contact dermatitis non-pharm

Answer 2

Patient should wash the exposed area with copious amount of tepid water and cleanse with a mild or hypoallergic, soap, such as Cetaphil of Dove, to reduce contact time with the irritant and minimize local symptoms.

Question 3

Irritant contact dermatitis exclusions

Answer 3

• <2 years
• dermatitis presents >2 weeks
• involvement of >20% of body surface area
• presence of numerous bullae
• extreme itching, irritation, or severe vesicle and bulla formation
• swelling of the body or extremities
• swollen eyes or eyelids swollen shut
• discomfort in genitalita
• infection
• involves mouth, eyes, nose, or anus
• longer then 7 days
• low tolerance for pain
• impairment of daily activities

Question 4

Irritant contact dermatitis pharm

Answer 4

1. Liberal application of emollients to the
   affected area can restore moisture to
   the stratum corneum and protect the area from further exposure.
2. Colloidal oatmeal baths may help relieve itching.
3. Corticosteroids: have questionable efficacy as they do not address the process
   directly; however, they may reduce inflammation and relieve itching.
4. Topical caine-type anesthetics and agents commonly found in therapy products, including propylene glycol- lactic acid, urea, and salicylic acid, should be avoided because of their ability to cause further skin irritation and potential ACD.

Question 5

Allergic contact dermatitis (ACD):

Answer 5

It Usually represent with distribution with rash in the area of exposure that is who we can differentiate. Chronic forms represent with lichenification

Question 6

Allergic contact dermatitis

non-pharm

Answer 6

For relieving of the itching:

1. Zanfel
2. Tecnu Original Outdoor Skin Cleanser.
3. Tecnu Extreme Medication Poison Ivy Scrub.

Question 7

Allergic contact dermatitis
pharm
for itching

Answer 7

SHOULD NOT BE USED FOR ACD; Topical ointment and cream containing anesthetic (benzocaine) antihistamine (diphenhydramine), or antibiotics (neomycin).

*Frist line antihistamine generation should be used for nighttime sedation if the
itching at night.
*If itching is alleviated, the patient should be referred to a primary doctor.

Question 8

Allergic contact dermatitis
pharm
For Weeping

Answer 8

• astringents applied to unhealthy skin or mucus membrane decrease weeping.
• Wet dressing or compress allow vasoconstriction and reduce blood flow and in inflamed tissue. *Burow’s solution 5% aluminum acetate solution its drying ability likely involves complexing of the astringent agent with protein therapy.

Question 9

Allergic contact dermatitis
pharm
For inflammation

Answer 9

*Hydrocortisone (0.5% and 1%) most effective to treat mild to moderate ACD. For 3-4 times a day.
Minimal adverse effects burning and itching. “pharmacist should know that topical hydrocortisone rarely causes contact dermatitis.
SHOULD NOT be used in children younger than 2 years, for more than 7 days, if the body is affected by 20%, around the eyes, and the pregnant women should not use it for too ling period of time.

Question 10

diaper dermatitis exclusion

Answer 10

• > 7 days
• secondary infection
• another disease cause
• out side of diaper region
• broke skin
• behavior changes
• other conditions
• onion-skin, bulla formation in affected area

Question 11

diaper dermatitis non pharm

Answer 11

using ABCDE; air, barrier, cleaning diaper, and education. *increase frequency of diaper change to a minimum 6 times per day. * Diaper holidays which allowing the baby to set w/o diaper to expose to air. Educate about the appropriate technique for diaper cleaning if the baby skin is sensitive chose the correct wipes.

Question 12

diaper dermatitis PHARM THERAPY

Answer 12

skin-protectants

petrolatum

Question 13

diaper dermatitis PHARM THERAPY

skin protectants

Answer 13

serve as physical barrier and lubricants in skin to skin or to diaper friction. Allows the body to heal normally. Use in each diaper change to prevent the skin from contacting with the diaper. (table 36-1) The most common one is Zinc Oxide (semisolid) needs soap to be washed from the skin. Zinc Oxide (creamlike) washable.

Question 14

diaper dermatitis PHARM THERAPY

petrolatum

Answer 14

Petrolatum is usually listed as active ingredients b/c it provides a good skin protectant. If the diaper dermatitis present after 7 days of treatment refer.

Question 15

Prickly Heat

Answer 15

partially clogged sweat gland and the trapped sweat cause dilation and rupture of epidermal sweat pores. Associate with hot and humid weather

Question 16

Prickly Heat non pharm

Answer 16

Aveeno Daily Moisturizing Lotion, Extra Strength Benadryl
Itch Stopping Cream, Cortizone 10 Maximum Strength Anti- Itching Cream, Eucerin Calming Itch Relief Treatment, and Lubriderm Daily Moisture Lotion. Also, taking cool bath after excessive sweating.

Question 17

Prickly Heat

PHARM THERAPY: (Only water washed should be used)

Answer 17

• Emollients, Skin Protectants, And Antipruritic: Colloidal oatmeal bath products and lotions are useful. Powders should be used only prophylactically to absorb moisture and keep skin dry.
• The hydrocortisone: is counterindication in infants, but it can be used in adult if the body area surface involves 10% or less (for the relief of itching only).
• Topical antihistamines and local anesthetic: Carry the risk of sensitizer.