dermatology Flashcards
topical therapy
drug directly contacts target tissue creating less systemic effects
effectiveness of topical drug penetration depends on
- nature of the skin
- nature of topical drug preparation
nature of the skin is determined by
stratum corner permeability
anatomic site (permeability varies between different parts of the skin)
skin metabolism - inflammation
types of topical preparation
monophonic
biphasic
triphasic
monophasic
powder, liquid, greasy base
contains active ingredient
liquid monophonic
wet dressings, baths, tinctures, lotions, gels
tinctures
evaporate quickly leaving behind a film of the active ingredient
biphasic vehicles
shake lotions, creams, ointments, pastes
something in a monophonic base
triphasic vehicles
cooling pastes (oil, water, powder) cream pastes
emollients
petrolatum, acetyl alcohol, etc
FTU
fingertip unit
eczema
inflammatory response of the skin
dermatitis
atopic eczema
chronic, relapsing condition characterised by
- intense pruritus, dry skin, inflammation
most common chronic skin condition affecting young children
atopic eczema
standard care of AD
moisturiser
topical corticosteroids
very effective
adverse effects
corticosteroids classified as
mild, moderate, potent and very potent
acute weeping skin shouldd use
cream base
dry or lichenified skin use
ointment
hairy areas should use
lotion
adverse effects of corticosteroids
skin atrophy, perioral dermatitis
glaucoma or cataracts when used near eyes
why people don’t like tars
smelly
stains clothes
immunomodulators
topical immunosuppressors
use where topical steroids fail or are contraindicated
psoriasis
inflammatory proliferative disease
T cell mediated inflammatory disease
genetic
associated systemic problems with psoriasis
psoriatic arthritis, diabetes, hypertension, cardiovascular disease
majority of psoriasis cases are
chronic plaque psoriasis
phototherapy
UV radiation to suppress T cells in the skin
reasons to use systemic therapies
psoriatic arthritis, impacting quality of life, poor response to topical therapy, inflammatory forms of psoriases, severe widespread disease
systemic therapy for psoriases
- retinoids - acitretin methotrexate cyclosporin biologicals apremalist
acitretin
retinoid
do not use in women child bearing age
side effects
affects mechanisms of proliferation
methotrexate
slows epidermal cell proliferation
do not use if pregnant or breastfeeding, alcoholic, underlying infection or malignancy
adverse effects - GI, bone and hepatic toxicity
cyclosporin
inhibits production and liberation of cytokines
causes hypertension, GI problems and
nephotoxocity with prolonged use
biologics
humanised monoclonal antibodies
can exacerbate latent infections eg. TB, HIV, Hep B or C etc.
patient must not be on any other systemic treatment and have no liver or demyalinating disease
patient must not be pregnant and breastfeeding not recommended
must not have live vaccine while on biologic
cause of acne
androgen production
roaccutrne
vit A derivative
teratogen
inhibits sebaceous gland activity
