derm treatments Flashcards
rosacea: moderate to severe papules and/or pustles
topical ivermectin + oral doxy
rosacea: mild to moderate pustules and/or papules
1st line: ivermectin
alternative: topical metronidazole or azaelic acid
rosacea: predominant erythema/flushing but limited telangiectasia management
topical brimonidine gel, used on an “as required” basis
(its an alpha adrenergic agonist)
rosacea
simple measures management
-recommended daily application of a high factor sunscreen
- camouflage creams to conceal redness
psoriasis primary care management
(1st-3rd line and 5 points overall)
GIVE DRUG NAMES
all patients use emollient to reduce scale & itch
-1st line: potent topical corticosteroid OD (eg betnovate) + topical vitamin D OD (eg. dovonex) applied at diff times
allow 4 weeks b4 starting seond line treatment
- 2nd: stop the topical corticosteroid, apply topical vitamin D twice daily
- 3rd: stop the topical vitamin D, apply potent topical corticosteroid twice daily
psoriasis secondary care management
Phototherapy
- UVB- classic/plaque and especially for guttate psoriasis
- PUVA - used in cases not responsive to UVA
Systemic therapy - immunosuppressive (e.g. methotrexate), immune modulation e.g. biologics
- Usually reserved for severe or non-responsive disease
Gas gangrene antibiotic treatment
and the common causitive organism for it
IV penicillin and clindamycin
clostridum perfinges which is g+ anaerobe
Treatment for raynauds
name of drug
Calcium channel blocker
eg. nifedipine
bullous pemphigoid treatment
Oral costicosteroid mainstay of treatment
topical costicosteroids, immunosuppressants and antibiotics are also used
venous ulceration treatment
include the drug name
(3 points)
1) compression bandaging!
- oral pentoxifylinne, a peripheral vasodilator, improves healing rate
Compression stockings to be offered once ulcer has healed
seborrheaoic dermatitis: scalp treatment
1st line- zinc pyrithione (head & shoulders) and tar (neutrogena t/gel)
2nd- ketoconazole
seborrheaoic dermatitis: face and body management
1st) ketoconazole
2) topical steroids- short periods
1st line acute uticaria management
(2 lines of management)
1st: non sedating anti histamine, (cetrilizine, lotradine)
2nd: oral prednisolone (short course and minimal dose)
keloids treatment
1st: intra lesional steroids
2nd: occasionally exscision (may lead to further scarring)
pityriasis versicolor treatment
(hypopigmented lesions on trunk)
(2 points)
1st: ketaconzole shampoo (anti fungal topical treatment)
2nd: if not working take scrapings to find other diagnosis + oral itraconazole
pyoderma gangrenosum managment
(2 points)
1st line: oral steroids
2nd: ciclosporin and infliximab
(avoid sugrery till disease is under control)
lichen planus treatment
treatemtn for oral lichen planus too
give drug name
(3 points)
1st line: potent topical steroids (eg. clobetasone butyrate)
2nd: oral steroids/immunosupression
oral lichen planus: benzydamine mouthwash/spray
shingles treatment
(3 points)
1st line: oral aniviral within 72 hrs of onset (famciclovir etc)
(contraindicted in <50y w/ mild truncal rash)
& analgesiacs anf NSAIDs
2nd: amitrypitline (neuroblocker for pain if analegsiacs not working)
Oral costicosteroids within 2 weeks, if patient is severely affected and not immunocomprimised
eczema herpitcum what is it?
treatment
child, hsv infection w/ eczema, punched out lesions w/ heamorraghic crusts
admit to hospital and give IV acriclovir
acitinic keratosis treatment
diclofenac,
5 flourauracil…
head lice treatment
malathion
nail infection caused by trichophyton rubrum (dermatophyte) treatment
1st line: amorolfine nail laquer for 3-6 months (<50% of nail affected, </=2 nails aff.)
2nd line (for more extensive disease): oral terbifine
extensive nail infection (due to candida) treatment
oral itraconazole
scabies treatment
1st line: permetherim
2nd line: malathion
lichen sclerosus treatment
topical steroids and emollients
tinia corpis treatment (ringworm)
give example of drug
topical antifungal - eg terbinafine. if it doesnt go away aftre 2 weeks then take scrapings
cellulitis tx.
include if pregnant
1st line: oral flucloxacillin
oral clarithromycin, erythromycin (in pregnancy)
or doxycycline those tht r penicillin allergic
Amit and give IV antibiotics if severe/systemically unwell
impetigo tx
1st line: hydrogen peroxide 1%
2nd line: topical fusidic acid
extensive disease: oral flucox
tinea pedis tx (aka athetes foot)
topical miconcazole, undecenoate or terbinafine first line
mild to moderate acne treatment
fixed combination of topical benzoyl peroxide with topical clindamycin
applied once daily in the evening
moderate to severe acne treatment
fixed combo of topical adalpene w/ topical benzoyl peroxide (ODE) + lymecycline/doxcy
not for pregnant women
when is metronidazole used for rosacea?
If women is pregnant or breastfeeding as ivormectin is contraindicted then
tx for pityriasis rosea
self limiting, conservative management
psoriasis flexural surfaces tx
mild topical corticosteroid
CHILD scalp seborrhoeic dermatitis (cradle cap) tx
1st line: emollient
2nd: if persistes topical antifungal cream
dermatitis herpetiformes tx
1st: gluten free diet
2nd: dapsone
3rd: topical/oral steroids
definitive mam
