Derm E1 Flashcards
Environmental factors that can impact Acne
Emotional Stress
Repetitive Stress (such as using harsh soaps)
Occlusion and Pressure (via mechanical obstruction or makeup)
Heat and Humidity
Occupational acne (the chemicals you’re exposed to through your career path)
Relationship between foods and acne
very individuallized triggers
home care for acne
gentle cleansers twice a day
wash with fingers
Do NOT use scrubs
use mild pH products
Use water-based lotions, cosmetics, and hair products
What vehicles should be used with its corresponding type of skin texture?
Dry skin: lotions or creams
oily skin: gels or foams
hairy areas: foams
solutions are drying but can cover larger areas
Pledgets can cover larger areas as well
What are the factors acne treatment targets?
Follicular hyperproliferation
increased sebum production
c. acnes profilteraction (bacteria)
Inflammation
Androgen receptor inhibitor (the patho of acne is androgen can increase acne)
Isotrentinoin targeted treatment factors
Folicular hyperproliferation (oral and topical)
Increased sebum production (oral)
Inflammation (oral and topical)
Topical Retinoids NOT CI in prego
Topical trentinoin
Topical adapalene
Topical tazarotene
Benzoyl Peroxide ADE
Erythema
Scaling
Xerosus
Stinging/buring
Bleaching of hair/clothing
Reare reports of life threatening hypersensitivity
OTC agents for Acne
Differin Gel, Adapalene
Tea Tree Oil
What acne treatments can not be used in prego
Hormonal agents
Topical retinoids
Oral antibiotics
Isotretinoin
Oral isotretinoin ddi
Tetracyclines
Doxycycline
Minocycline
Above can cause pseudotumor cerebri (increased cranial HTN)
Vitamin A supplements, can OD on vitamin A toxicity
Acne Targeted Treatment Factors which Rx target - Follicular Hyperproliferation
Oral/Topical Retinoids
Azelaic acid
Salicylic Acid
Hormonal therapies
Acne Targeted Treatment Factors which Rx target - Increased Sebum Production
Oral Retinoids
Hormonal Therapies
Clascoterone cream
Acne Targeted Treatment Factors (5)
Follicular Hyperproliferation
Increased Sebum Production
C. Acne’s Proliferation
Inflammation
Androgen Receptor Inhibitor
Acne Targeted Treatment Factors Rx that target - C, Acnes proliferation
Benzoyl Peroxide
Antibiotics
Azelaic acid
Dapsone topical
Acne Targeted Treatment Factors Rx that target - Inflammation
Oral/Topical Retinoids
Oral tetracyclines
Azelaic acid
Clascoterone cream
Dapsone topical
Acne Targeted Treatment Factors Rx that target - Androgen Receptor Inhibitor
Clascoterone cream
Pharmacist’s Role in Drug-Induced Dermatologic Disorders
Identify culprit drug
Identify cross-reacting drugs to also avoid
Select alternative treatments for the patients underlying disorder
Educate patients and care givers about drug avoidance in the future
Differentiate and triage mild and serious drug eruptions
Provide pharmacotherapy recommendations for treating DIDD including supportive care measures
Develop monitoring plans for patients with DIDD
maculopapular rash offending agents
penicillins/cephalosporins
Sulfonamides
Anticonvulsants (barbiturates such as phenobarbital, phenytoin, carbamazepine, lamotrigine)
DRESS offending agents
ALLOPURINOL
Sulfonamides
Anticonvulsants - barbiturates (phenobarbital), phenytoin, carbamazepine, lamotrigine
Dapsone
DRESS risk factors
Excessive allopurinol dose (>1.5 * eGFR as the mg/day max)
renal dysfunction
Concomitant thiazide diuretic
HTN
Asian ethnicity
HLA-B * 58:01
Urticaria offending agents
Penicillins and related antibiotics
Sulfonamides
Aspirin
Opiates
Latex
Serum sickness-like reactions offending agents
Penicillins/cephalosporins
Sulfonamides
Fixed drug eruptions offending agents
Tetracyclines
Barbiturates
Sulfonamides
Codeine
Phenolphthalein
Acetaminophen
NSAIDs
SJS/TEN risk factors
HIV infection
Lupus (SLE)
Malignancy
UV light or radiation therapy
HLA-B*15:02
SJS/TEN offending agents
Sulfonamides
Penicillins
Anticonvulsants: phenytoin, carbamazepine, barbiturates, lamotrigine
NSAIDs (particularly the “-oxicams”)
Allopurinol
Drugs causing hyperpigmentation
Phenytoin
Tetracyclines, silver, mercury, anti malarial
Amiodarone
Drugs causing photosensitivity offending agents
Sulfonamides
Tetracyclines
Amiodarone
Coal tar
