Dermatology Flashcards
What is the first line treatment of psoriasis?
Emollient (reduce scale and itch)
Potent topical corticosteroid + topical vitamin D applied at different times
What is the second line treatment of psoriasis?
Emollient (reduce scale and itch)
Stop topical corticosteroid and just apply topical vitamin D twice daily
What is the third line treatment of psoriasis?
Emollient (reduce scale and itch)
Stop topical vitamin D and apply a potent topical corticosteroid twice a day
When would coal tar preparations typically be used for psoriasis?
In patients with scalp psoriasis
What are the two secondary care management options for psoriasis?
Phototherapy
Systemic therapy
(methotrexate or ciclosporin)
When would UVB phototherapy be used in psoriasis patients?
Mainly guttate psoriasis
Also used for classic and plaque psoriasis
What are the treatment options for seborrhoeic keratosis?
Cryotherapy
Curettage
Give advantages of topical emollients?
Direct application
Reduced systemic effects
Give disadvantages of topical emollients?
Time consuming
Messy to use, inconvenient
Correct dosing is difficult
What are the types of topical emollients in dermatology?
Gels
Creams
Ointments
Pastes
Lotions
Foam
What type of emollients have a fire risk associated with them?
Paraffin-based emollients
Give some emollient application tips?
Apply after bathing
Apply in direction of hair growth
Be aware of slippery surfaces
Use a spatula to remove from tubs
What are the three key actions of topical corticosteroids?
Vasoconstrictive
Anti-inflammatory
Antiproliferative properties
What are topical corticosteroids used for in dermatology?
Eczema and psoriasis
Keloid scars
Non-infective inflammatory dermatoses (lichen planus etc)
What can occur as a result of strong steroids / sudden steroid halting?
Rebound flare of disease
Note* mostly seen in psoriasis
What is the fingertip rule?
One fingertip unit of topical steroid should cover the front and back of the hand
Usually 1-2g
List some side effects of topical steroids?
Rebound flare of disease
Thinning of the skin
Purpura
Stretch marks
Steroid rosacea
Perioral dermatitis
Fixed telangiectasia
Tachyphylaxis
Systemic absorption
When are antiseptics used in dermatology?
Recurrent infection
Skin cleansing
Wound irrigation
What are antibiotics used to treat in dermatology?
Acne and rosacea
Skin infection
Infected eczematous process
What are antivirals used to treat in dermatology?
Herpes simplex
Eczema herpeticum
Herpes Zoster
What are topical antifungals used to treat in dermatology?
Candida
Dermatophytes
Pityriasis versicolor
Name some antipruritics?
Menthol
Capsaicin
Crotamiton
Camphor / phenol
What are keratolytics and what are they used to treat?
Drugs used to soften keratin
Viral warts, hyperkeratotic eczema & psoriasis, corns, calluses etc.
When area cytotoxic & antineoplastic therapies used in dermatology?
Solar damage
Bowen’s disease
Superficial basal call carcinoma
Give examples of cytotoxic & antineoplastic therapies?
Fluorouracil
Imiquimod
Give some side effects of topical therapies?
Burning and irritation
Contact allergic dermatitis
Local toxicity
Systemic toxicity
What are some systemic effects of topical therapies?
Salicylism
Hypercalcaemia / hypercalciuria
Suppression of pituitary - Cushingoid features
What is used to treat actinic keratosis?
5-flurouracil cream
What is used to treat bullous pemphigoid?
Highly potent topical steroids
How is pemphigus vulgaris managed?
Local - topical steroids + topical anaesthetics
Systemic - high dose oral steroids + immunosuppression +/- rituximab
How is dermatitis herpetiformis managed?
Gluten free diet
Dapsone
What is used first line in the treatment of acne?
Benzoyl peroxide +/- topical antibiotic
What is given by a dermatologist for severe acne?
Systemic antibiotic therapy
Oral isotretinoin
What systemic treatment is given to children under 12 with acne?
Erythromycin or clarithromycin twice daily
What systemic treatment is given to patients over 12 with acne?
Lymecycline or doxycycline once a day
OR
Erythromycin / clarithromycin twice a day
How is rosacea managed?
Avoiding triggers
Topical metronidazole
Topical therapies + antibiotics
Isotretinoin
Laser therapy
How is mild eczema managed?
Avoiding irritants
Emollients
1% hydrocortisone cream - mild topical steroid
How is moderate eczema managed?
Avoiding triggers
Emollients
Betamethasone valerate
Clobetasone butyrate
How is severe eczema managed?
Avoid triggers
Emollients
Betamethasone valerate 0.1%
Clobetasone butyrate
How is impetigo managed?
Topical fusidic acid
Oral flucloxacillin / clarithromycin
How is lichen planus managed?
Topical steroids
Antihistamines
