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OTC > Dermatitis > Flashcards

Dermatitis Flashcards

1
Q

Two types of contact dermatitis:

A
  • irritant

- allergic

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2
Q

Irritant contact dermatitis (ICD) is the…

A

inflammatory reaction of the skin caused by exposure

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3
Q

Allergic contact dermatitis is the…

A

immunologic reaction of skin caused by exposure

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4
Q

Majority of cases of irritant contact dermatitis are related to…

A

occupation

  • water exposure
  • chemical exposure
  • cleaning substances
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5
Q

Clinical presentation of ICD:

A
  • inflammation
  • swelling
  • redness
  • itching
  • stinging
  • rash
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6
Q

Severity of ICD is determined by…

A
  • quantity

- concentration

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7
Q

ICD treatment:

A
  • avoid irritants
  • immediately wash exposed areas w/ warm water and mild soap
  • use emollients, moisturizers, and barrier creams for prevention
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8
Q

Which OTC treatments should be avoided for ICD?

A
  • topical caine-type anesthetics

- topical corticosteroids

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9
Q

T/F: allergic contact dermatitis (ACD) appears on first contact

A

F, initial exposure sensitizes immune system and the second contact induces immune response

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10
Q

Examples of ACD antigens:

A
  • toxicodendron genus (poison ivy, urushiol)
  • metal allergy
  • latex
  • neomycin
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11
Q

Clinical presentation of ACD:

A
  • rash anywhere on body that contacts the antigen
  • can be transferred
  • papules
  • small vesicles
  • larger bullae
  • inflamed and swollen skin
  • prominent itching
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12
Q

Exclusions of self-treatment of ACD:

A
  • < 2 YO
  • dermatitis present > 2 weeks
  • failure of self-management after 7 days
  • involves > 20% of body surface area
  • signs of infection
  • swelling of body
  • discomfort in genitalia
  • involves mucous membranes
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13
Q

Non-pharmacologic treatment of ACD:

A
  • wear long pants and sleeves
  • use barrier products
  • immediately wash exposed area
  • trim fingernails to help reduce scratch injuries
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14
Q

Bentoquatam (Ivy block) lotion is the only…

A

FDA approved product to provide protection against exposure to poison ivy/oak/sumac
- non-pharmacologic

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15
Q

Counseling points for bentoquatam (Ivy block) lotion:

A
  • apply at least 15 minutes before exposure
  • apply generously to clean, dry skin
  • reapply every 4 hours
  • remove with soap and water
  • do not use < 6 YO
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16
Q

Pharmacologic treatments of ACD:

A
  • oral antihistamines
  • topical hydrocortisone creams
  • calamine lotion
  • colloidal oatmeal baths
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17
Q

Examples of oral antihistamines:

A
  • for itching
  • cetirizine (Zyrtec)
  • diphenhydramine (benadryl)
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18
Q

What types of topical ointments and creams should not be used for ACD?

A
  • anesthetics
  • antihistamines
  • antibiotics
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19
Q

Calamine lotion should only be used on ____ for ACD

A

non-weeping lesions

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20
Q

Topical hydrocortisone counseling points:

A
  • for inflammation
  • apply QD or BID
  • don’t use dressings or bandages
  • don’t use < 2 YO
  • max of 7 days
  • if affected area is larger than 20%, topicals would not be recommended
21
Q

Astringents should be used for ACDs with…

A

weeping wounds

22
Q

Astringents:

A
  • slow oozing, discharge, or bleeding
  • cools and dries skin through evaporation
  • causes vasoconstriction, which reduces blood flow in inflamed tissue
  • can cleanse skin of crust and debris
23
Q

Activity of astringents are limited to…

A

cell surface

24
Q

Examples of FDA category 1 astringents:

A
  • aluminum acetate (burrow’s solution)

- witch hazel (hamamelis water)

25
Q

Alternatives to astringents:

A
  • isotonic saline solutions (1 tsp salt and 2 cups of water)

- white vinegar with tap water (1/4 cup to 1 pint of water)

26
Q

When should you follow up with ACD treatment?

A

w/in 5-7 days of treatment

27
Q

When should you refer to MD after ACD treatment?

A

if rash increased significantly in size, affects eyes, genitals, or even covers extensive areas of face

28
Q

When would complete remission of ACD occur?

A

up to 3 weeks

- should see reduction in itching, weeping, inflammation after 5-7 days of therapy

29
Q

Majority of diaper rash cases appear in…

A

infants < 2 YO

30
Q

Causes of diaper rashes:

A
  • occlusion: tight fitting diapers
  • moisture: held in diapers
  • microbes
  • mechanical chafing and friction
  • high sugar foods and dairy -> diarrhea
  • breast-fed have less incidents
31
Q

Presentation of diaper rashes:

A
  • red to bright red rash
  • can be shiny or wet looking
  • severe: papule formation with oozing
  • occurs in area covered by diaper
32
Q

Exclusions for self-treatment of diaper rashes:

A
  • lesions present > 7 days
  • fever, diarrhea, nausea, vomiting
  • secondary infections
  • rash outside diaper region
  • comorbid conditions
  • broken skin
  • behavioral changes
33
Q

Examples of non-pharmacologic treatment for diaper rashes:

A
  • increase frequency of diaper changes
  • try to change immediately after infant urinates
  • use plain water or sensitive baby wipes
  • allow for drying before re-diapering
34
Q

Pharmacologic treatment of diaper rashes:

A

skin protectants, which serve as a physical barrier between skin and irritants

35
Q

Skin protectants for diaper rashes:

A
  • absorbs or prevent moisture
  • used in treatment and prevention
  • should monitor because some have non-FDA approved ingredients
36
Q

Examples of skin protectants:

A
  • zinc oxide: most commonly used
  • calamine: mix of zinc and ferrous oxides
  • mineral oil
  • petrolatum
  • lanolin-bacterostatic product
  • dimethicone: repels water and soothes inflammation
  • topical cornstarch and talc: not on broken skin
37
Q

What agents are excluded from self-care use for diaper rashes?

A
  • topical nonrx antibiotics or antifungal
  • topical analgesics
  • hydrocortisone cream
38
Q

Why are topical analgesics not recommended for diaper rashes?

A

it can alter sensory perception in infants who can’t communicate the changes

39
Q

Why are hydrocortisone creams excluded from self-care use for diaper rashes?

A
  • not for < 2 YO
  • should be used under medical supervision
  • can increase risk of infections
40
Q

How long should treatment of diaper rashes be?

A

7 days

41
Q

What should one do if diaper rash has improved but not healed by 7 days?

A

continue therapy for 3 more days or until resolution

42
Q

What should one do if diaper rash isn’t improved or worsened after 7 days of treatment?

A

see MD

43
Q

What could you use for a diaper rash that recurs often?

A

prophylactic use of skin protectants

44
Q

What causes heat rashes?

A
  • blocked or clogged sweat glands

- inability to sweat causes dilation and rupture of epidermal sweat pores

45
Q

Heat rash causes…

A

acute inflammation, which results in stinging, burning, or itching

46
Q

Presentation of heat rash:

A

pinpoint lesions that are raised or red

- self limiting

47
Q

Common sites of heat rash:

A
  • axillae
  • chest
  • upper back
  • back of neck
  • abdomen
48
Q

Non-pharmacologic therapy for heat rash:

A
  • decrease sweating

- increase air flow to area

49
Q

Pharmacologic therapy for heat rash:

A
  • want to use water-washable, cream based products
  • self-limiting so don’t need to use anything
  • hydrocortisone cream
  • moisturizing lotions
  • colloidal oatmeal baths
  • above three alleviate symptoms of itching

OTC (23 decks)

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