Dermatology

Question 1

Treatment for dermatitis

Answer 1

• Emollients: water or liquid paraffin based (highly flammable)
• Corticosteroids: Hydrocortisone cream (mild), Clobetasone (moderate) to help reduce redness + itchiness
• Apply sparingly using 1 finger tip unit (cover tip of finger)

Question 2

Advice for dermatitis

Answer 2

• Do not share towels
• Avoid the aggressor
• Use emollient as soap substitute if really struggling with dryness (massage onto to wet skin and pat dry to avoid irritation)

Question 3

Treatment for ringworm

Answer 3

• Imidazole (all ages): Clotrimazole 1% w/v, Miconazole
• Fungicide: Terbinafine-Lamsil AT 1% gel: preferable because it clears symptoms quicker but more £££ (cannot be used on children
• Hydrocortisone- only if there is an inflammation associated with fungal infections (redness, itching, swelling)

Question 4

Treatment for athletes foot/tinea pedis

Answer 4

• Clotrimazole 1% cream (mild)
• Miconazole 2% cream
• Fungicidal: Terbinafine 1% cream (mild non extensive disease)
• Hydrocortisone- if associated with inflammation

Question 5

Treatment advice for athletes foot/tinea pedis

Answer 5

• Wash + dry affected skin before treatment, wash hands, do not scratch affected skin
• Prevent recurrence: footwear that keeps foot cool, dry + fresh, new pair of cotton socks everyday, wash feet daily, change shoe pair every 2-3 days
• Avoid moisturising between toes (helps fungi to multiply)
• Reduce transmission: Do not share towels, wash them frequently, avoid barefoot in public

Question 6

Treatment/Management for Impetigo

Answer 6

• Mostly treated by antibiotics but is also self limiting
• Simple analgesics to help with pain
• Topical antiseptics for 5-7 days: Hydrogen peroxide 1%, fusidic acid. Crust on lesions should be removed with warm water before topical treatment (this is prescription only tho)
• Bandages/ dressings to stop the spread

Question 7

Advice for those with Impetigo

Answer 7

• Practice good hygeine, avoid sharing towels
• Stay away from school + work
• Warm water to remove crusts

Question 8

Treatment for Scabies

Answer 8

• Scabiecide: First line–Permethrin 5% w/v
• 2nd line– Malathion 0.5% liquid
• Chlorphenamine piriton if significant night itch
• Crotamiton 10% cream– if post-scabietic itch is present less than 4 weeks after treatment course completion

Question 9

Treatment application advice for Scabies

Answer 9

• Creams should be applied to cool dry skin
• Cream is flammable (stay away from fire)
• Corticosteroids for eczematous reaction should be witheld until treatment completion
• Apply before bed

Question 10

Patient advice for scabies

this is for the long ass one

Answer 10

• Potential contaminated objects should be decontaminated by washing at a high temp + drying in hot air dryer
• Keep contaminated objects that can’t be washed in a black bin bag
• All members of household should be treated simultaneously
• Can go back to work 24 hours after 1st treatment
• Sexual partners within past month should be contacted + seek treatment

Question 11

Treatment for warts/verrucae

Answer 11

Salicylic acid (first line of treatment)- Affected area soaked in warm water + towelled dry, surface of wart/verrucae should be rubbed with a emery board to remove hard skin, few drops applied to lesion. Repeat daily, keep away from unaffected skin

Question 12

Patient advice for warts/verucae

Answer 12

• Do not pick at the warts (allows viral particle shedding to skin breaks and transfer to other body parts)
• Cover with waterproof plaster when swimming
• Avoid sharing shoes, socks and towels
• Keep feet dry and change socks daily
• Wear flip-flops in communal showers