Derm Flashcards
Treatment of psoriasis to trunk and limbs
- coal tar 1% emulsion or gel topically, nocte, 1 month
OR - LCP6% + salicylic acid 3% cream or ointment BD 1month
–> if tar alone not enough add topical steriod - methylprednisolone aceponate 0.1% cream/oint/fatty OD until clear (2-6 wks) OR
- mometasone furoate 0.1% cream/hydrogel/oint OD until clear (2-6 wks)
if inadequate respose after 3 weeks, change steriod to betamethasone dipropinonate 0.05% cream or ointment topically OD
once controlled, reduce potency of steroid gradually and withdraw if posit. continue tar as maintenance.
if only few scattered plaques do not respond to tar or need longer term steroid use calcipotriol + betamethasone 50+500microg/g pint OD
Mx impetigo
- Flucloxacillin 500mg QID for 7 days
(Trimethoprim + Sulfamethoxazole 160/800mg BD for 3 days - penicillin allergy)
- Topical Mupirocin 2% TDS for 5 days
Seborrheic dermatitis (facial, flexure) - mx
Hydrocortisone 1% + clotrimazole 1% cream
Phytophotodermatitis
- phototoxic reaction to contact with certain plants
Pompholyx
- itchy vesicles, usually on fingers
- lasts weeks, tends to recur
- may be larger vesicles on palms / soles
- can be precipitated by tinea of the feet
Adverse effects of roacutane
- dry lips, eyes, mucosal lining of nose
- early flare of acne
- chelitis
- sun sensitivity
- impaired night vision
- headache
- lethargy
Mx guttate psoriasis
- coal tar topical 1% emulsion BD for 1/12 OR LPC 6% +Salycilic acid 3% 1/12
- potent topical corticosteroids - mometasone 0.1% daily for 2/52
- calcipotriol topical daily
- antihistamine for pruritis
Erythromelalgia tx (red hot painful extremities)
Aspirin 300mg daily
Peri-oral dermatitis mx
- Seborrhoeic dermatitis
- Peri-oral dermatitis
- Acne vulgaris
- Keratosis pilaris
- SLE
Triggers associated with worsening rosacea
- hot or cold
- wind
- spicy food
- alcohol
- sun exposure
- exercise
- dairy
- certain skin products, makeup, cosmetics
Non-pharmacological mx rosacea
- inform patient of chronic, intermittent, inflammatory condition
- identify and avoid triggers
- broad spectrum sunscreen
- moisturiser if skin is dry
- avoid abrasive products
- cosmetics with green tint can camouflage erythema
DDx atopic dermatitis (eczema)
- allergic / irritant dermatitis
- seborrhoeic dermatitis
- psoriasis
- scabies
ddx inflam rash to hands
- contact dermatitis
- atopic dermatitis/eczema
- tinea magnum
- photophytodermatitis
- palmoplantar psoriasis
- palmoplantar pustulosis
Vitiligo mx options
- cosmetic camouflage
- potent topical steroid Diprosone 0.5% cream BD 3/12
- topical pimecrolimus 1% cream BD 3/12
- phototherapy
- do nothing if pt happy to leave alone
Erythema multiforme (target lesions) - 3 possible causes
- idiopathic
- HSV
- medications
Self limiting, can tx with potent topical steroid
