Dermatology Flashcards
What class is hydrocortisone in and what is it used to treat?
steroid; dermatitis and psoriasis
What are the side effects of hydrocortisone applied locally?
Atrophy/thinning of skin (collagen), stretch marks, talangiectasias, acne, cataract or glaucoma if applied near eye
May be permanent
What are the systemic side effects of hydrocortisone?
effects hypothalamic-pituitary-adrenal axis causing growth retardation
How many classes of hydrocortisone are there and which are the strongest and weakest?
7 classes; 1 strongest, 7 weakest
What class is cyclosporine and what is it used to treat?
immunosuppresant; inflammatory conditions like psoriasis
What are the side effects of cyclosporine?
Raise blood pressure, damage kidneys if used long-term
What class is methotrexate and what is its mechanism of action?
folate analog; inhibits DHFR
What is methotrexate used to treat?
Inflammatory conditions like psoriasis, and conditions needing immunosuppression
What are the side effects of Methotrexate?
Hepatotoxicity (develops slowly, can give up to 4.5 g over life), pulmonary toxicity, leukopenia, rarely, renal toxicity, nausea and vomitting
What types of drugs can cause methotrexate toxicity and by what mechanism?
any drug increasing unbound protein (sulfa, salicylates, TCN, phenytoin)
What is the mechanism of the biologics?
Blocks TNF-a
What are the biologics used to treat?
Inflammatory conditions, arthritis
What are some side effects of the biologics?
may unmask neurologic disease, latent infections (must do PPDs), and malignancies
What is the mechanism of action of UV light therapy (UVA, UVB, UVC)?
Immunosuppression of T-cells via type I or type II reactions leading to mono- or bifunctional adducts in DNA
What is UV light used to treat?
ONLY Inflammatory conditions: atopic dermatitis, CTCL, lichen planus, psoriasis
What are some side effects of UV light therapy?
skin cancer, thinning/leathering of skin
What other drug is UV light therapy usually used with?
Usually used with psoralens (photosensitizing agents that increase efficacy); phenothiazines, thiazides, sulfonamides, NSAIDs, tetracycline, benzodiazapenes also sensitize skin to light therapy
What is the mechanism of action of isoretinoin and acitretin?
Stimulate epithelial cell turnove and anti-inflammatory
What is Isoretinoin used to treat?
Acne (this is accutane)
What are some side effects of isoretinoin?
teratogenic effects (wash out in 3 weeks)
Name to retinoid drugs.
Isoretinoin (accutane) and Acitretin (soriatane)
What is Acitretin used to treat?
Psoriasis
What are some side effects of Acitretin and how is it different from Isoretinoin?
teratogenic effects (stays in fat stores for up to 3 years, isoretinoin washes out in 3 weeks)
Are the retinoids commonly used as primary treatment or as adjunctive therapy?
adjunctive therapy
Passage through what layer of the skin is the rate limiting step?
stratum corneum
By what mechanism are topicals absorbed?
passive diffusion
Rank the following from strongest hydrating to strongest drying: gel, cream, ointments and lotions
ointments, creams, lotions, gels
