Curriculum Treatment Flashcards
Mild cellulitis
first-line treatment
Amoxicillin
Flucloxacillin
Severe cellulitis
first-line treatment
Stronger gram +ve antibiotic
Benzylpenicillin
Flucloxacillin
in patients allergic to penicillin first-line treatment for severe cellulitis
Clindamycin
Mild atopic eczema
Moderate atopic eczema
Severe atopic eczema
First line topical treatments?
Emollients
Topical corticosteroids
Infantile haemangioma
(benign vascular tumour)
first-line treatment
Propranolol
Congenital Melanocytic Naevi (CMN)
First line recommended imaging
MRI
Any child born with two or more congenital melanocytic nevus in any location should have a routine MRI scan of the brain and spine, preferably by the age of six months,
Mongolian blue spots
first-line treatment
No treatment necessary
Sebaceous Naevus
first-line treatment
No treatment necessary
Tuberous Sclerosis
hint: think scans
first-line treatment
4 Options • MDT • MRI • Renal Imaging • Genetic counselling
Impetigo
(golden crusted lesions)
first-line treatment
Antibiotic for infection
• Flucloxacillin
Scarlet Fever
(group A streptococcus)
First line treatment for the infection + backup?
Antibiotic for infection
• Penicillin
• Erythromycin
Urticaria
Recommended patient lifestyle management advice and a recommended medication (hint: think hayfever)
Avoid trigger
Antihistamines
Psoriasis
First line topical treatments
Topical Treatments • Emollients • Topical steroids • Vitamin D analogues - calciprotriol • Vit D and steroid combinations
Psoriasis
Systemic therapy treatment examples
Biologics example
- Methotrexate Tablets (immunosuppressant)
- Acitretin (Retinoid)
- Ciclosporin Tablets (immunosuppressant)
4 Biologics: • Infliximab • Etanercept • Adalibumab • Ustekinumab
Scalp Psoriasis
first-line treatment according to NICE
back up for first line according to NICE
Potent topical corticosteroid OD + review after 4 weeks
Vitamin D preparation
Diphtheria first-line treatment
(Corynebacterium)
Name one Topical treatment
Name one Systemic treatment
Topical Treatment
Clindamycin
Systemic Treatment
Oral Erythromycin
Necrotising Fasciitis
(Group A Strep)
Name the four medications used to treat Necrotising Fasciitis
- Metronidazole
- Clindamycin
- Tazocin
- Gentamicin
Common Warts
(HPV epidermal infection)
Name three treatment options if warts do not self-resolve after 6-12 months
- Salicylic acid
- Lactic acid
- Cryotherapy – repeat every 3-4 weeks
- Curettage Scraping
- Excision
Genital Warts
(HPV 6/11 infection)
Name two creams
Name a treatment option if the cream does not work
First Line Treatment
Creams
• Podophyllotoxin 0.15%
• Imiquimod 5%
Second Line Treatment
• Cryotherapy
Scabies
(Infestation by Sarcoptes scabiei mite)
Name a topical treatment and give instructions on how to use
Topical treatment
Permethrin 5% (insecticide)
- left on for 24 hours
- applied to neck down
- reapplied to hands after washing
- repeated after 1 week
Seborrhoeic dermatitis
(Eyebrow Dandruff)
(Nose dandruff)
Name 2 creams that can be used to relieve symptoms
- Moderately potent topical steroids
* Topical tacrolimus ointment (Protopic)
Flexural Psoriasis first-line treatment
Underboob
Topical Agents
• Mild or moderate potency
topical steroids
• Combination therapies with
anti fungals
• Silkis ointment Vitamin D
analogue
Herpes Simplex first-line treatment
Herpes Zoster first-line treatment
antiviral cream
Tinea corporis first-line treatment
thrush first-line treatment
candida oesophagitis first-line treatment
topical antifungal (fluconazole)
thrush nystatin
oral antifungal
ACNE first-line treatment
Acne vulgaris first-line treatment
Acne rosacea first-line treatment mild
topical retinoids
topical metronidazole or azelaic acid
Bullous pemphigoid first-line treatment
Pemphigus vulgaris first-line treatment
Pemphigus foliaceus first-line treatment
Corticosteroids (oral or cream)
dapsone high doses of steroid medication
Topical treatment with corticosteroids and antibiotics
Erythrodermic psoriasis
You are the GP
Patient presents with this condition
What do you need to tell them at the end of the consultation when discussing management?
(hint: dont forget to referr or admit to hospital if necessary)
That you will arrange for an immediate same-day specialist dermatology assessment
rapidly developing angiodema first-line treatment
Give slow intravenous (IV) or intramuscular (IM) chlorphenamine and hydrocortisone
anaphylaxis first-line treatment
IM adrenaline
BASAL CELL CARCINOMA first-line treatment
Stage 0
Stage 1
Stage 2
Consider topical imiquimod1 to treat stage 0 melanoma in adult
Offer excision with a clinical margin of at least 1 cm to people with stage I melanoma
Offer excision with a clinical margin of at least 2 cm to people with stage II melanoma
BENIGN NAEVI first-line treatment
watch and wait
Bowen’s Disease (in situ squamous cell carcinoma) first-line treatment
non melanoma skin cancer
Freezing with liquid nitrogen
Curettage
Excision
5-fluorouracil cream
Malignant melanoma first-line treatment
Chemotoxic chemotherapy
Immunotherapy
BRAF V600 targeted therapy
SEBORRHOEIC KERATOSIS first-line
treatment
also known as seborrhoeic warts
Benign
if patient wants removed cryotherapy or curettage
SOLAR (ACTINIC) KERATOSIS first-line treatment
Rough areas of sun damaged skin can be brown in appearance
destructive therapies
- cryotherapy,
- dermabrasion,
- photodynamic therapy [PDT]),
topical medications
- topical fluorouracil
- imiquimod,
- mebutate,
- diclofenac
chemical peels
SQUAMOUS CELL CARCINOMA first-line treatment
non melanoma skin cancer
SCC Mgx 1st Line = Surgical excision
4mm margins if lesion <20mm in diameter.
6mm margins if lesion >20mm in diameter.
Mohs micrographic surgery high-risk patients and in cosmetically important sites.
Melasma (chloasma) first-line treatment
For symptoms of abnormally
tan or dark skin discoloration
Benign
Avoiding triggers, such as the oral contraceptive pill
sun avoidance + sun-blocking
Skin-lightening agents
Chemical peels, dermabrasion and laser treatment.
Skin camouflage.
Vitiligo first-line treatment
Image
Topical corticosteroids — Mid- to super-high-potency topical corticosteroids are commonly used as a first-line therapy for the treatment of limited vitiligo
However no treatment is an option
Alopecia areata first-line treatment
If there is evidence of hair regrowth
If there is no hair regrowth and the person has less than 50% hair loss
If there is no hair regrowth and the person has more than 50% hair loss, or treatment is preferred
no treatment
watch and wait
Consider a trial of a potent topical corticosteroid
Erythema multiforme first-line treatment
Mild rashes
Severe rashes
will clear up in a few weeks spontaneously
In the absence of infection, oral
corticosteroids are sometimes given in the early stages of the eruption.
Stevens Johnson syndrome first-line treatment
What causes Stevens Johnson syndrome normally? Is a big hint to treatment
medication induced
remove offending medication
IVIG
corticosteroids
Toxic epidermal necrolysis first-line treatment
The usual cause is the same as for Stevens Johnson syndrome which is a hint to treatment
medication induced
remove offending medication
Eczema herpeticum
(widespread herpes simplex virus infection)
You are the A and E doctor
Patient presents with areas of rapidly worsening, painful eczema
clustered blisters consistent with early-stage cold sores
punched-out erosions 1–3 mm
fever
lethargy
You suspect Eczema herpeticum what do you need to give them as first line treatment?
IV Aciclovir
Venous Leg Ulcer
You are the GP
Patient presents with this condition
What do you need to tell them when discussing the management of a venous leg ulcer?
keep the ulcer clean and in a dressing
use compression bandages if there is no problem with arterial supply to leg
Guttate psoriasis
You are the GP
Patient presents with this condition
What do you need to tell them at the end of the consultation when discussing the prognosis of guttate psoriasis?
usually a self-limiting condition that typically resolves within 3–4 months of onset, and reassure that it is not infectious
Erythema Nodosum
No active treatment
