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pharmacotherapy 3271 > dermatology > Flashcards

dermatology Flashcards

1
Q

this is a vital organ; one of the largest in our human body with a surface area of about 1.8m^2. consists of the outer epidermis and the inner dermis

A

skin

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2
Q

this layer of skin primarily provides protection from the environment and performs a critical barrier function - keeping water and other vital substances in and foreign substances out

A

epidermis

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3
Q

this layer of skin is a connective tissue layer with primarily provides resiliency and support for various skin structures or appendages as well as sweat glands, sebaceous glands, hair and nails; contains collagen and elastin

A

dermis

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4
Q

subcutaneous tissue lies beneath the epidermis or the dermis?

A

dermis

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5
Q

what are the five stratum layers that make up the epidermis?

A

stratum corneum (horny layer)
stratum lucidity
straum granulosum (granular layer)
stratum spinosum (prickle cell layer)
stratum basale (where keratinocytes (skin cells) are made)

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6
Q

these are also known as skin cells; they produce keratin and forms the physical protective barrier

A

keratinocytes

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7
Q

these cells produce melanin and provides UV protection

A

melanocytes

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8
Q

this type of sweat gland flows out of the hair shaft

A

apocrine sweat gland

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9
Q

this type of sweat gland flows out through its own sweat pore

A

eccrine sweat gland

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10
Q

what are the functions of the skin?

A
  • protects the body against injury, physical agents, and UV radiation
  • regulates body temperature
  • prevents dehydration thus helping to maintain fluid balance
  • acts as a sense organ (e.g. touch, pain, heat and cold)
  • acts as an outpost for immune surveillance
  • has a role in vitamin D production and absorption
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11
Q

skin hydration is usually 10-20% water by weight. What may happen if the skins hydration drops below 10%?

A
  • stratum corneous becomes brittle and may crack easily
  • allows irritants to penetrate skin which may lead to mild inflammation and impaired cell maturation which may result in chapping
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12
Q

barrier efficiency generally begins to regenerate within __ hours of skin damage.

A

24

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13
Q

true/false: when skin is damaged, the skin forms a temporary barrier of parakeratotic cells and dried exudate

A

true

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14
Q

what factors can decrease skin hydration/contribute to dry skin?

A
  • extremes of temp
  • aging
  • physical trauma
  • chemical irrigation/trauma
  • medications
  • other medical conditions
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15
Q

what are some physiological changes in aging skin?

A
  • thinning epidermis (fewer active basal cells in epidermis)
  • slower healing (slower cell turnover)
  • delayed inflammatory response (fewer langerhan cells)
  • reduced tactile sensitivity (reduced acuity of pain perception)
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16
Q

this is known as inflammation of the skin; an acute or chronic skin reaction with corresponding clinical patterns and history

A

dermatitis

17
Q

this is a common condition in infants an diaper wearing incontinent elderly nursing home residents

A

diaper dermatitis

18
Q

what are some risk factors for diaper rash?

A
  • moisture retention
  • friction and contact irritation
  • urine and ammonia (ammonia does not cause diaper rash but aggravates it, especially if the skin is broken)
  • feces and alkaline ph (may cause skin to lose barrier function)
  • some foods may increase urine ph (high protein diets0
  • vigorous cleansing
  • psoriasis
  • immobility
19
Q

what are some drugs that may contribute to drug-induced diaper dermatitis?

A
  • penicillins
  • sulfonamides
  • topical antihistamines
  • lanolin
20
Q

this fungal microorganism is the most frequent cause of diaper rash. Requires drug tx

A

candida albicans

21
Q

this bacterial microorganism is a frequent colonizer of dermatitic skin. occasionally causes severely inflamed dermatitis with follicular pustules. requires drug tx

A

staph aureus

22
Q

what are the goals of therapy of diaper dermatitis?

A
  • relief of symptoms
  • resolution of diaper dermatitis
  • prevent reoccurrence
  • provide cost-effective therapy
  • minimize adverse reactions from therapy
  • prevent complications (untreated/infected dermatitis, which can lead to ulcerations, UTIs, infection of penis/vulva, etc)
23
Q

explain the clinical presentation of diaper dermatitis.

A
  • found in the diaper area (rash generally spares inguinal skin folds, except for candida diaper rashes)
  • erythemateous rash, often with shiny patches over convex surfaces of diaper rash (may appear dusky purple on darker skin)
  • severe rashes: may have vesicles, may have oozing and widespread erosions
24
Q

explain the clinical presentation of candida diaper rash.

A
  • early maceration of anal mucosa and perianal skin
  • confluent tomato red plaques, papules, pustules
  • culture will be positive for candida
  • almost always involves the inguinal folds
25
Q

know when to refer for diaper dermatitis

A
  • if rash does not respond after a week of recommended therapies
  • if rash does not heal in 7-10 days
  • increase in pain, inflammation, itching
  • oozing blisters or pus seen
  • deep ulceration present
  • frequent recurrences; chronic cases
  • complicated by secondary infection
  • systemic signs or symptoms present (fever, N/V, diarrhea, rash or skin lesions elsewhere on body)
    -immunodeficiency present
  • dermatitis is related to another disease state (underlying cause needs to be treated)
  • behavioural changes present in the patient
26
Q

know the ABCDE for the management of diaper rash

A

A - air, absorptives, antifungals, anti-inflammatories
B - barriers
C - cleansing
D - diaper
E - education

27
Q

what are some non-pharmacological strategies to tell the patient in terms of air drying for the management of diaper rash?

A
  • remove diaper for as long as practical after diaper changes or cleansing
  • do not dry buttocks using hair dryer or heat lamps
28
Q

what is the treatment choice for yeast diaper rash?

A

Topical Imidazole (miconazole 1% [Monistat] or clotrimazole 2% [Canesten]); use bid x 7/7

29
Q

nystatin may be used for yeast diaper rash. what is the dosing and a counsleing point patients should be aware of?

A

use bid-tid for 14 days. may cause staining

30
Q

can butenafine be used to treat yeast diaper rash?

A

Butenafine [Lotramin] is an OTC butyl-amine that is used for athletes foot. It has been shown to also have efficacy vs Candida (80%)

31
Q

if using both an anti fungal and a barrier cream, which should be applied first?

A

apply anti fungal first, followed by the barrier cream - when inflammation subsides, may stop anti fungal and continue with barrier creams.

pharmacotherapy 3271 (1 decks)

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