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1. 4th year > Derm treatments > Flashcards

Derm treatments Flashcards

1
Q

Bullous pemphigoid

A

oral corticosteroids

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2
Q

pemphigus vulgaris

  • localised
  • systemic
A

localised/1st line - topical steroids

systemic - high dose steroids + immunosuppression +/- rituximab

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3
Q

Dermatitis herpetiformis

A

gluten free diet +/- Dapsone

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4
Q

Guttate psoriasis

A

self-limiting, resolves in 6 weeks

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5
Q

Psoriasis 1st line

A

potent corticosteroid alongside vitamin D analogue

e.g. betamethasone + calciprotriol

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6
Q

psoriasis 2nd line

A

if no improvement after 8 weeks offer increase dose of vitamin D analogue to twice daily

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7
Q

psoriasis 3rd line

A

if no improvement after 8-12 weeks then either increase corticosteroid dose or coal tar preparation

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8
Q

psoriasis severe/non-responsive

A

oral methotrexate

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9
Q

when is methotrexate particularly useful in psoriasis

A

psoriatic arthritis

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10
Q

Scalp psoriasis

A

potent topical corticosteroid once daily 4 weeks - if no improvement use a different formulation e.g. shampoo to remove scale before application of the steroid

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11
Q

face/flexural/genital psoriasis

A

mild or moderate potency corticosteroid once or twice daily for max of 2 weeks

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12
Q

how much of a gap should be left between courses of corticosteroids

A

4 weeks

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13
Q

eczema herpeticum

A

admission for IV aciclovir

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14
Q

atopic eczema standard for everyone even when asymptomatic

A

avoid irritants

emollients

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15
Q

how should one be advised to use a steroid and emollient together

A

emollient first wait 30 mins then topical steroid

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16
Q

itch in atopic eczema

A

anti-histamine

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17
Q

flare in atopic eczema

A

topical steroids

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18
Q

mild eczema

A

emollient + mild topical steroid

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19
Q

example of mild topical steroid

A

hydrocortisone

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20
Q

moderate atopic eczema

A

emollient + moderate topical steroid +/- tacrolimus

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21
Q

example of a moderate topical steroid

A

eumovate

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22
Q

severe atopic eczema

A

potent topical steroid +/- UV light therapy +/- immunosuppresion e.g. ciclosporin - specialist advice

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23
Q

example of a potent topical steroid

A

betnovate

fluticasone

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24
Q

what kind of drug is tacrolimus

A

topical calcinurin inhibitor

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25
Q

example of a very potent topical corticosteroid

A

dermovate

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26
Q

seborrhoeic dermatitis - infantile

A

baby shampoo and baby oil

emollients +/- topical steroids

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27
Q

seborrhoeic dermatitis - adult scalp disease

A

neutrogena and head+shoulders

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28
Q

seborrhoeic dermatitis - adult 1st line, non-scalp

A

topical ketoconazole

+ emollients +topical steroids

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29
Q

pompholyx

A

cool compresses, emollients, topical steroids

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30
Q

azteototic eczema

A

emollients

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31
Q

venous eczema

A

compression bandage

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32
Q

contact dermatitis - allergic and irritant

A

antigen avoidance
regular emollients
potent topical steroids during flares

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33
Q

mild acne

A

topical therapy only - benzoyl peroxide
salicylic acid
topical retinoid

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34
Q

moderate acne

A

topical retinoid + topical benzoyl peroxide + topical antibiotic

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35
Q

what antibiotics are used in acne

A

tetracyclines

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36
Q

moderate/severe acne

A

oral antibiotic instead of topical

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37
Q

should oral antibiotic be given as a monotherapy in acne

A

no always co-prescribe with topical therapy

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38
Q

severe acne

A

topical therapies + oral isotretinoin

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39
Q

can GP prescribe isotretinoin

A

no - specialist advice needed so refer to dermatology

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40
Q

what is needed in women of CBA on isotretanoin

A

double contraception and pregnancy test before each monthly prescription

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41
Q

acne fulminans

A

hospital admission + oral steroids

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42
Q

Rosacea 1st line

A

topical metronidazole

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43
Q

what is good in rosacea with flushing and limited telangiectasia

A

topical brimonidine gel

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44
Q

severe rosacea

A

systemic antibiotics - tetracyclines

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45
Q

what tetracyclines are ok for use in pregnancy and breastfeeding

A

erythromycin

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46
Q

telangiectasia is rosacea

A

laser

47
Q

last line in rosacea

A

isotretinoin

48
Q

pityriasis rosea

A

self limiting over 6-12 weeks, emollients and anti-histamines if needed

49
Q

lichen planus

A

potent topical steroid

50
Q

oral lichen planus

A

benzydamine mouth wash

51
Q

port wine stain

A

cosmetic camouflage or laser therapy

52
Q

infantile haemangioma

A

leave alone

53
Q

erythema multiforme

A

supportive care and treat underlying cause

54
Q

investigation to do with erythema nodosum of unknown cause

A

xray to exclude sarcoidosis and TB

55
Q

necrobiosis lipoidica

A

improve glycaemic control

topical or intralesional steroid

56
Q

pyoderma gangrenosum

A

very potent topical steroid

immunosuppressant e.g. infliximab if resistant and treat underlying cause

57
Q

seborrhoeic keratoses

A

leave alone, cryotherapy, curettage

58
Q

BCC

A

leave alone and monitor
or
surgical (MOHS for awkward site)
topical imiquimod or 5-FU

59
Q

bowens/actinic keratoses

A

5-FU twice daily for 4 weeks

cryotherapy, curettage, excision

60
Q

SCC

A

biopsy then surgical excision with 4mm margins if < 20mm or 6mm margins if > 20mm
topical 5-FU

61
Q

melanoma

A

surgical excision with 2mm margins, check breslow thickness then wide local excision

62
Q

acute intermittent porphyria

A

avoid triggers

acute attack - IV haematin/haem arginate or IV glucose if former not available

63
Q

prophyria cutanea tarda

A

venesection or chloroquine

64
Q

herpes zoster opthalmicus

A

oral antiviral for 7-10 days

65
Q

Ramsay hunt

A

oral aciclovir and corticosteroids

66
Q

shingles

A

paracetamol and NSAIDs

67
Q

when can oral antivirals be used in shingles

A

within 72 hours of ash unless under 50

68
Q

antivirals aim to do what in the treatment of shingles

A

reduce post herpetic neuralgia

69
Q

urticaria

A

antihistamines - more effective if taken regularly

UVB phototherapy

70
Q

herpes simplex: gingivostomatitis

A

oral aciclovir

chlorhexidine mouthwash

71
Q

herpes simplex cold sore

A

topical aciclovir

72
Q

herpes simplex genital herpes

A

oral aciclovir

73
Q

herpes simplex in pregnancy if primary attack occurs after 28 weeks

A

elective c section at term

74
Q

herpes simplex in pregnancy recurrent (not first episode)

A

suppressive therapy and advise that transmission to baby is low

75
Q

solitary keratinised genital wart

A

cryotherapy

76
Q

multiple non keratinised genital warts

A

topical podophyllum

77
Q

2nd line genital wards

A

imiquimod

78
Q

common warts

A

salicyclic acid
cryotherapy
imiquimod

79
Q

molloscum in kids

A

resolve in 18 months encourage not to itch can prescribe emollient if that is an issue

80
Q

orf

A

resolve after 4-6 weeks

81
Q

hand foot and mouth

A

self limiting

82
Q

tinea capitis

A

topical ketoconazole shampoo

83
Q

localised tinea

A

topical antifungals - clotrimazole, miconazole continuing for 10 days post lesion healing

84
Q

widespread tinea or nails

A

oral antifungals

85
Q

finger nail tinea

A

terbinafine 250mg 6-12 weeks

86
Q

toe nail tinea

A

terbinafine 250mg 3-6 months

87
Q

alternative to oral terbinafine

A

oral itraconazole

88
Q

what monitoring does terbinafine need

A

LFTs

89
Q

tx genital candida 1st line

A

oral fluconazole 150mg single dose

90
Q

2nd line tx genital candida if oral contraindicated e.g. pregnant

A

topical clotrimazole - cream or pessary

91
Q

oral candida

A

nystatin

92
Q

skin candida

A

topical clotrimazole or oral fluconazole

93
Q

pityriasis versicolor

A

topical antifungal

94
Q

2nd line pityriasis versicolor

A

oral itraconazole

95
Q

impetigo

A

1st - hydrogen peroxide 1% cream

2nd line - topical fusidic acid 7 days

96
Q

extensive or severe impetigo

A

oral flucloxacillin
erythromycin if pen al

(if group A strep phenoxymethylpenicillin)

97
Q

folliculitis

A

topical benzylperoxide and loose clothes

98
Q

boil / furuncle

A

10 days oral flucloxicillin

99
Q

cellulitis

A

flucloxicillin

if PA - clarithromycin, erythromyin or doxycycline

100
Q

cellulitis in pregnancy

A

erythromycin

101
Q

severe cellulitis

A

co-amoxiclav, cefuroxime, clindamycin or ceftriaxone

102
Q

erysipelas

A

IV flucloxicillin

103
Q

necrotising fasciitis

A

urgent surgical debridement and IV antibiotics

104
Q

scabes 1st line

A

permethrin 5%

105
Q

scabies 2nd line

A

malathion 0.5%

106
Q

how many cycles of treatment does scabies require

A

2, 7 days apart

107
Q

do house hold contacts need to be treated in scabies?

A

yes, all household and close physical contacts treated as if they have it - 2 cycles 7 days apart

108
Q

lice - head/body/pubic

A

malathion

if resistant - dimeticone

109
Q

lyme disease

A

doxycycline

disseminated disease - ceftriaxone

110
Q

lyme disease in pregnancy

A

amoxicillin

111
Q

venous ulcer

A

compression banding

pentoxifylline - improves healing

112
Q

vitiligo

A

sun cream

topical steroids

113
Q

kawasaki

A

high dose aspirin and IV immunoglobulin

1. 4th year (23 decks)

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