Dermatology Flashcards
Acne Red flags
Require urgent referral
Severe psychological distress
Uncontrolled acne leading to scarring
Nodulo-cystic acne
Uncertain diagnosis
Acne Mx
Top Retinoid for all - Adapalene, Isoretinoin
Epiduo - retinoid/ BPO
Duac - Abx/ BPO
Treclin - retinoid/ Abx
COCP - eg Dianette - stop after 3 months if acne controlled
PO Abx - eg Lymecycline, Doxycycline (not to be used as monotherapy eg add to Epiduo)
Avoid tetracycline Abx and retinoids in PREGNANCY
Melasma Mx
Lifestyle - SPF 50, sun protection, avoid perfume/ deodarant, discuss hormone contraceptives can contribute risk/ benefit
Medication - Pigmanorm (hydorquinone, tretinoin, steroid)
Eczema Mx
ABC
Avoid triggers - soap, detergent, smoke
Bland moisturiser - QDS, fragrances free, emollient soap subs
Control inflammation
Top Steroids - once daily, increase in flares, decrease twice weekly in maintenance
2nd line Calcineurin inhib (tacrolimus) - eg eyelid, face
Eczema when to refer
Diagnostic uncertainty
Failure to respond to treatment
Cutaneous atrophy - from chronic topical steroid use
Suspicion for contact dermatitis
Refer urgent - severe infected eczema eg bacterial or HSV
Psoriasis Limb/ trunk Mx
1st - 4 weeks AM steroid/ PM vit d
2nd - Steroid only 8 weeks
3rd - Vit D analogue BD 8 weeks only
4th - combined steroid/ vit d eg Enstilar foam, Dovobet
Psoriasis scalp Mx
1st - potent steroid 4 weeks
2nd - alternative steroid and add ointments/ shampoos
3rd - combined steroid/ vit d (entilar, dovobet) OR vit d analogue only (calcipotriol)
4th - very potent steroid/ coal tar/ derm
